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Lasers

Most of our surgeries are done with lasers. This can have many benefits for the patient. A laser cuts tissue with a very intense beam of invisible light. This instantly seals blood vessels and nerve endings as it cuts. This not only reduces blood loss but incisional pain.

Monitors

Every dental and surgical patient is continuously monitored during anesthesia for all of the following.

• Electrocardiogram
• Pulse oximetry
• Blood pressure
• Oxygen levels
• Carbon dioxide levels
• Temperature
• Heart rate
• Respiration rate

Anesthesia

Anesthetic protocols are individually tailored for every pet and every procedure. Isofluorane inhalant anesthesia greatly reduces risks compared to injectable anesthetics. All pets receive a pre-anesthetic physical exam . Blood screening tests are available in house for all pets and required for senior pets. The objective is to make the procedure as safe as possible.

Common Surgeries

Ovariohysterectomy (Spay) and Neuters

Spaying eliminates heat cycles, avoids accidental pregnancies and unwanted offspring. Spaying also significantly reduces the incidence of breast tumors and undesirable behavior as well as eliminates the chances of ovarian and uterine cancers, and uterine infections, which can be common in older animals.

Neutering reduces the incidence of prostate cancer and eliminates the incidence of testicular cancer. Undesirable behavior is significantly reduced and the objectional odor of male cat urine is eliminated.

Spaying and neutering should be normally done when your pet is 4-6 months of age. The first heat cycle can occur about six months of age. Females spayed BEFORE their first cycle have much lower incidence of breast cancer. Behavior patterns of non-spayed and neutered animals may include: roaming, aggression, urinating in inappropriate places and undesirable sexual behavior in males. These unacceptable behaviors are easier to prevent than to correct.

Contrary to public opinion a pet does not have to become “fat and lazy” after surgery. Diet, exercise and heredity have much more influence on the weight and attitude of your pet than does spaying/neutering.

As with any surgery, human or animal, there is some risk to the general anesthesia. Doing a pre-anesthetic blood screen will identify any underlying problems and minimize the risks. Veterinary procedures have become highly sophisticated and are very similar to human medical procedures. With proper precautions, the risk is minimal.

Onychectomy (Declaw)

The Guilt Free Laser Declaw!

Concerned about declawing? We know how you feel. While that furry little friend can cause great damage to your furniture, draperies, your clothes, and even your skin, you feel guilty about having him declawed. We know this because we consistently hear comments from pet owners just like you.

Did you know…that declawing can now be performed with a laser? Yes! That same tool that removes facial wrinkles can varicose veins from people can be used to declaw a cat. Laser surgery makes declawing a better, safer, less painful procedure. Read on to see why.

Seals nerve endings! Lasers cut tissue with a beam of light which seals the nerve endings so there is very little pain upon recovery. Seals blood vessels! Lasers also seal blood vessels as they cut so there is usually no need for bandaging after surgery.

On the prowl the very next day! Since there are no bandages, your furry friend can be up to normal speed the next day and…without leaving his usual trade “marks” on the furniture and skin!

All cats, young or old, big or small can have a laser declaw. We think it is, without a doubt, the best technique developed for declawing.

The cost for declawing? Yes, it costs a little more, but we think the benefit for your pet is worth it. Properly done, a declaw will provide the cat a lifetime of comfort and allow him to be an inside pet without causing all the damage. Consider having your pet declawed at the time of spaying or neutering. It is not only more cost effective for you, but it is less stressful for the pet.

Cruciate Ligament Repair

Cruciate Ligament Injury and Repair in Dogs

The knee (stifle) joint of the dog is one of the weakest in the body. Just as athletes (football players, in particular) frequently suffer knee injuries, the dog also has knee injuries. The knee joint is relatively unstable because there is no interlocking of bones in the joint. Instead, the two main bones, the femur and tibia, are joined with several ligaments. When severe twisting or excessive extension of the joint occurs, the most common injury is a rupture of the anterior cruciate ligament (ACL). When it is torn, instability occurs that allows the bones to move in an abnormal fashion in relation to one another. When this happens, it is not possible to bear weight on the leg without it collapsing.

Contributing Factors

A special note is appropriate concerning the dog’s weight. Obesity or excessive weight can be a strong contributing factor in cruciate rupture. The ligament may become weakened due to carrying too much weight; this causes it to tear easily. Obesity will make the recovery time much longer, and it will make the other knee very susceptible to cruciate rupture. If your dog has a weight problem, there are prescription diets that can be used to assist weight reduction.

Prevalence

Rupture of the ACL is most common in middle aged and older dogs, particularly those that are overweight house pets.

Causes

In younger dogs, rupture of the ACL is usually the result of trauma to the stifle joint. In some cases, the ligament may only partially tear; however, this will eventually lead to complete tearing of the ligament. When ACL rupture occurs in older dogs, it is most frequently initiated by a progressive degenerative change in the ligament with eventual total rupture.

Clinical Signs

Dogs with a ruptured ACL are usually lame and may refuse to bear weight on the affected leg. Eventually, most dogs become more willing to bear weight but some degree of lameness remains.

Diagnosis

The most reliable means of diagnosing this injury is to move the femur and tibia in a certain way to demonstrate the instability. This movement is called a “drawer sign.” It can usually be demonstrated with the dog awake. If the dog is very painful, has very strong leg muscles, or is uncooperative, it may be necessary to use sedation in order to examine the joint adequately.

Treatment

Correction of ACL rupture requires surgery. A skilled surgeon can fashion a replacement ligament and stabilize the joint so it functions normally or near normally. If surgery is not performed within a few days to a week, arthritic changes will begin that cannot be reversed, even with surgery.

Occasionally, the injury that causes a ruptured anterior cruciate ligament will also result in tearing of one or both of the menisci or “cartilages.” At the time of surgery, these are examined and removed if necessary.

Prognosis

Following proper and prompt surgical correction, the joint is sound again. Most dogs walk and run without any lameness; however, some have either a mild limp or lameness associated with cold and damp weather.

Occasionally, a dog that has a ruptured cruciate ligament will become sound (will no longer limp), even if surgery is not performed. However, progressive, degenerative arthritis will develop and result in lameness a few months later. Once these degenerative changes are established, the lameness cannot be corrected, even with surgery.

Pain Management

Myth: Animals tolerate pain better than people do.

Animals have reason to hide pain and may communicate pain in ways that people fail to recognize. Animals instinctively hide pain because in their evolution from wild animals, it could be a sign of vulnerability to predators. Also, pack animals will kick out members of the group who are wounded. Your pet does not want that to happen to them (and they consider you a part of their pack) and thus do not show pain as we do.

When pain becomes so intense that it cannot be hidden, animals may not show it in ways that we can easily recognize. Guarding or protecting an area of the body, unusual vocalizations, a change in posture, self-mutilation, a change in personality, restlessness, decreased activity, withdrawal from the group, or even loss of appetite can all be interpreted as signs of pain. An animal’s inability to verbally communicate pain does not negate its existence. Since companion animals’ nervous systems evolved very much as ours did, with pain as a mechanism to protect us from further injury, we should assume that animals not only feel pain, but what would be painful to us, would be painful to them. Thus pain should be managed accordingly: with diet, with exercise therapy, and with medication when necessary.

Tapeworm Infection in Cats

Tapeworms are intestinal parasites of the cat (and dog). Because they are classified as cestodes, they belong to a different family than the hookworms and roundworms (called nematodes). Several types of tapeworms are known to infect cats; Dipylidium caninum is by far the most common.

The tapeworm uses its hook-like mouthparts for anchoring to the wall of the small intestine. Eventually, adult tapeworms may reach several inches in length. As the adult matures, individual segments (proglottids) break off from the main body of the tapeworm and pass into the cat=s feces.

Contributing Factors

Fleas are the intermediate host for the tapeworm. In other words, the tapeworm is unable to complete it=s life cycle without the presence of fleas in the environment. Regardless of whether the owner may have seen fleas, the cat must have ingested a flea in order to have tapeworms. Consequently, tapeworms are more common in environments that are heavily infested with fleas. Lice are also reported as intermediate hosts for tapeworms, but they are relatively uncommon parasites of cats.

The Life Cycle Works Like This: Tapeworm eggs eaten by flea larvae Fleas mature to adult Adult flea swallowed by cat Tapeworm segment passes in stool tapeworm eggs eaten by flea larvae (cycle continues)

Causes

First, tapeworm eggs must be ingested by flea larvae (an immature stage of the flea). Contact between flea larvae and tapeworm eggs is facilitated by contaminated bedding or carpet. Adult fleas do not participate in this part of the tapeworm life cycle.

Next, the cat chews or licks its skin as a flea bites; the flea is then swallowed. As the flea is digested within the cat=s intestine, the tapeworm hatches and anchors itself to the intestinal lining.

Clinical Signs

Tapeworms are not particularly harmful to the cat and few clinical signs are attributed to their presence. Usually, the cat is presented because of the owner’s reaction to the presence of the crawling proglottids. Rarely, tapeworms may cause debilitation or weight loss if they are present in large numbers. Also, a cat will occasionally scoot or drag its anus across the ground or carpet due to the anal irritation caused by the proglottids. However, this behavior is much more common in dogs than cats.

Occasionally, a tapeworm will release its attachment in the intestines and migrate to the stomach. When this happens, the cat may vomit an adult tapeworm several inches in length.

Diagnosis

Most commonly, owners recognize that the cat has tapeworms and bring this to the attention of the veterinarian. When terminal segments of the tapeworm break off and pass into the cat=s stool, they can be seen crawling on the surface of the feces. These proglottid segments look like grains of cooked white rice. Less commonly, they are seen crawling around the cat=s anus. Each of these proglottid capsules contains up to 20 tapeworm eggs.

When these proglottids are released into the environment, they dehydrate and harden; they become quite small and take on a golden hue. Eventually, they break open and release their contents (eggs).

Be aware that tapeworms are not readily diagnosed with routine fecal examinations. Because of this, you should notify your veterinarian when tapeworm segments are found in your cat=s stool.

Treatment

Available treatments are safe and effective. The deworming medication (called an anthelmintic) may be given as a tablet or an injection. After treatment, the tapeworm dies and is usually digested within the intestine, so worm segments do not usually pass into the stool. Side-effects, such as vomiting and diarrhea, are rarely reported with the newer medications.

Control of fleas is the cornerstone of preventing tapeworm infection. With the new and exciting flea control products that have become available, this is now much easier than in years past. Depending on the type of product you use and the presence of other pets in your home, your veterinarian will help you decide whether you also need to treat your house and yard for fleas. With some of the newer products, environmental control of fleas may not be needed. Circumstances vary, however, so be sure to talk to your veterinarian.

If the cat lives in a flea-infested environment, tapeworm infection can become re-established within a few weeks. This is very rarely due to treatment failure; in most cases, reappearance of tapeworms represents reinfection of the cat. Additional recommendations include:

1. Prompt deworming when tapeworms are detected.
2. Appropriate disposal of all pet feces, especially in public parks, yard, or playgrounds.
3. Strict hygiene practices for children after playing outdoors.

Prognosis

New medications are safe and effective. The prognosis for successful treatment is good.

Transmission to Humans

Human can become infected with tapeworms, although infection is rare because it is established by ingestion of a flea. Most reported cases have involved children. The risk for human infection with Dipylidium caninum is quite small but does exist.

Another less common group of tapeworms, called Echinococcus, is of increasing concern as a threat to human health. These tapeworms cause serious, potentially fatal, disease when humans become infected. Infection with this parasite is harder to diagnose than Dipylidium because the segments are small and not readily seen. Trappers and hunters in the north central United States and south central Canada may be at increased risk for infection with this worm when strict hygiene is not practiced. Foxes and coyotes (and the wild rodents upon which they prey) are important in the life cycle of this parasite. Dogs and cats may also become infected if they eat rodents carrying the parasite. When eggs of Echinococcus are passed in the feces of the dog and cat, humans are at risk for infection. Free-roaming cats and dogs may need to be periodically treated with tapeworm medication. Rodent control and good hygiene are important in preventing the spread of this disease to humans. As with the more common tapeworm, infection with Echinococcus is infrequent yet possible.

Tapeworms and Pinworms

Tapeworms and pinworms look very similar. However, contrary to popular belief, pinworms do not infect cats or dogs. Any worm segments seen associated with cats are due to tapeworms. Children who get pinworms do not get them from cats or dogs.

Roundworm Infection in Cats (Ascariasis)

Roundworms are the most common intestinal parasite of the cat. Infection rates in kittens are thought to approach 100%. They can represent an important cause of illness, and even death, in kittens. As their name implies, these are large-bodied round worms, averaging about 3-6 inches (8-15 cm) in length. They do not attach to the wall of the intestine as do hookworms. Instead, they are literally swimming within the intestine.

The scientific name for the feline roundworm is Toxocara cati. Another less common roundworm, Toxascaris leonina, can infect both dogs and cats. Roundworms are sometimes called Aascarids.

Contributing Factors

Contributing factors for roundworm infection include queens with pre-existing infection, heavily contaminated environments, and the presence of intermediate hosts (roaches, earthworms, birds).

Clinical Signs

Roundworms are not particularly pathogenic (harmful) to mature cats, but large numbers may cause life-threatening problems in kittens and debilitated adult cats. In kittens, common signs include a pot-bellied appearance, abdominal discomfort, depressed appetite, vomiting and diarrhea, or poor growth.

In both kittens and adult cats with light infections (small numbers of worms), no signs may be apparent.

Causes

Transmammary, or milk-borne, infection is the major route of roundworm transmission to kittens. The immature roundworms (called larvae) are present in the mother=s mammary glands and pass through her milk to the kittens. Additionally, both kittens and adult cats may become infected by swallowing eggs that contain infective roundworm larvae. These eggs may come from the feces of infected cats or from the tissues of intermediate (called paratenic) hosts. Common intermediate hosts for roundworms include earthworms, cockroaches, rodents, and birds.

Once ingested, the larvae hatch out in the cat’s gastrointestinal tract and migrate through the muscle, liver, and lungs. After several weeks, the larvae return to the intestine to mature. When these worms begin to reproduce, eggs will pass into the cat’s stool, thus completing the life cycle of the parasite.

LIFE CYCLE OF TOXOCARA CATI

Larvae pass through mother’s milk to nursing kitten

Adult Eggs pass into feces > Cat ingests infected eggs > Worms mature in intestine > Eggs pass in feces
roundworms in small intestine > Paratenic host infected > Cat eats paratenic host

Diagnosis

To diagnose roundworm infection, a small amount of the cat=s stool is mixed into a special solution that causes the eggs to float to the top. The distinctive eggs are easily recognized under the microscope. Roundworm eggs are usually plentiful but, in some cases, it may take more than one fecal examination to find them. Occasionally, intact adult roundworms can be found in the cat’s stool or vomit.

Treatment

Fortunately, treatment is safe, simple, and relatively inexpensive. After administration of the deworming medication (called an anthelmintic), the worms will pass into the stool. Because of their large size, they are easily identified. At least two or three treatments are needed; they are typically performed at 2-3 week intervals. Ideally, kittens are then dewormed again with each visit for kitten vaccinations. None of these treatments will kill the immature forms of the worm or the migrating larvae.

Prognosis

With diagnosis of roundworm infection and appropriate deworming, the prognosis is good. In some instances, extremely debilitated kittens may die.

Prevention

Prevention of roundworm infection should include the following measures:

1. Deworming of breeding queens prior to pregnancy and again in late pregnancy. This will reduce environmental contamination for new kittens.

2. New kittens should be appropriately dewormed as recommended by your veterinarian. The first deworming should be given at 2-3 weeks of age. Note that this is prior to the time most kittens are seen for first vaccines. It is entirely appropriate to present new kittens for deworming only.

3. Adults cats remain at risk for re-infection with roundworms throughout their lives. Whenever roundworms are seen, the cat should be promptly dewormed. It is appropriate to routinely deworm all cats who remain at high risk for reinfection. For example, it is advisable for cats with predatory habits to have a fecal examination several times a year.

4. Control of insects and rodents is important since they may serve as sources of roundworm infection for cats.

5. Stool should be removed from litterboxes daily, if possible. Litterboxes can be cleaned with a 1% bleach solution to facilitate removal of eggs. Rinse the litterbox thoroughly to remove all bleach since it is toxic to cats. Similarly, surfaces that may be contaminated with roundworm eggs can also be treated with this bleach solution. It makes the eggs easier to rinse away but does not kill the eggs. Always wash your hands after handling litterbox material.

6. Appropriate disposal of cat (and dog) feces, especially from yards and playgrounds, is important. Once an environment is contaminated with roundworm eggs, they may remain viable for long periods unless they are exposed to direct sunlight or very dry conditions.

7. Strict hygiene is especially important for children. Do not allow children to play in potentially contaminated environments. Be mindful of the risk that public parks and non-covered sandboxes pose. Even though stool may not be visible, roundworm eggs may be present. Sandboxes that have fitted covers are popular and are well-advised to prevent infection of children with roundworms.

8. Contact your animal control officials when ownerless animals are found.

Human Infections

Roundworms pose a very real health risk for humans. The most common source of human infection is by ingesting eggs that have come from soil contaminated with cat (or dog) feces.

As many as 10,000 cases of roundworm infection in humans have been reported in one year. Children, in particular, are at risk for health problems should they become infected. A variety of organs may be affected as the larvae migrate through the body. In suitable environments, the eggs may remain infective to humans (and to cats) for years.

Hookworm Infection in Cats

Hookworms are intestinal parasites of the cat (and dog). Their name is derived from the hook-like mouthparts they use to anchor to the lining of the intestinal wall. They are only about 1/8″ (1-2 mm) long and so small in diameter that they are barely visible to the naked eye.

The scientific names for the most common feline hookworms are Ancylostoma tubaeforme and Ancylostoma braziliense. Occasionally, cats will also become infected with the dog hookworm, Ancylostoma caninum.

In general, cats tend to harbor relatively few hookworms when compared to the large numbers found in dogs. Also, feline hookworms tend to be less aggressive bloodsuckers than the canine species.

Contributing Factors

Hookworms are more common in warm, moist environments. Conditions of overcrowding and poor sanitation contribute to re-infection.

Clinical Signs

Feline hookworms tend to Agraze along the lining of the small intestine and are considered Atissue feeders. When they do suck blood, an anti-coagulant substance is injected at the feeding site. Therefore, the cat can suffer blood loss from ingestion by the hookworm, as well as continued bleeding into the bowel. The blood-loss anemia attributed to hookworms is a more significant problem in kittens than adult cats.

Evidence of hookworm infection includes anemia, the presence of digested blood in the stool, a poor haircoat, and weight loss.

Causes

Adult hookworms pass hundreds of microscopic eggs in the cat’s stool that are invisible to the naked eye. Larvae (immature worms) will hatch from the eggs and persist in the soil for weeks or months. When larvae are swallowed by the cat, hookworm infection is established. The larvae may also burrow through the cat’s skin and migrate to the intestine, where they may mature and complete their life cycle.

In dogs, prenatal infection (infection prior to birth) may be a significant problem. Puppies may become infected by the placental blood flow and then later through the mother=s milk. Prenatal infection has not been demonstrated to occur in kittens.

DiagnosisTo diagnose hookworm infection, a small amount of the cat=s stool is mixed with a special solution, causing the eggs to float to the top. With a microscope, the eggs are easily identified because of their unique ppearance. Since the eggs are produced on a daily basis, hookworm infection is usually fairly easy to diagnose. The number of eggs does not necessarily correlate with the number of worms present. In fact, the number of eggs passed can be greater with light infections (smaller numbers of worms).

Treatment

Fortunately, treatment is safe, simple, and relatively inexpensive. After administration of the deworming medication (called an anthelmintic), the adult worms are killed. Two treatments are needed; they are typically performed at a 2-3 week interval. Ideally, kittens are dewormed during their vaccination series.

Since the cat’s environment can be laden with hookworm eggs and larvae, it may be necessary to treat it with a chemical to kill them. There are several available formulations that are safe to use on grass.

In rare cases, kittens or debilitated cats might require a blood transfusion because of severe anemia.

Prognosis

With early diagnosis and treatment, the prognosis is good for full recovery from hookworm infection. However, if severe anemia is present, some cats will not survive.

Prevention

Prevention of hookworm infection should include the following measures:

1. All new kittens should be treated by 2-3 weeks of age. To effectively break the life cycle of the most common intestinal parasites, kittens should be dewormed on the schedule recommended by the veterinarian
2. Prompt deworming should be given when any parasites are detected; periodic deworming may be appropriate for cats at high risk for reinfection.
3. Appropriate disposal of cat (and dog) feces, especially from yards and playgrounds, is important.
4. Strict hygiene is especially important for children. Do not allow children to play in potentially contaminated environments. Be mindful of the risk posed by public parks and non-covered sandboxes. Sandboxes that have fitted covers are popular and are recommended to prevent infection of children with intestinal parasites.
5. Control of rodents is important since they may play a role in transmission of hookworms to cat.
6. Stool should be removed from litterboxes daily, if possible. Always wash hands after handling litterbox material.
7. Contact your animal control officials when ownerless animals are found.

Transmission to Humans
Feline hookworms do not infect humans internally. However, the tiny larvae can burrow into human skin, causing a disease called cutaneous larval migrans. Also known as Aground itch, this skin infection does not lead to maturation of the larvae. Because contact of human skin with moist, larvae-infected soil is required, infection rarely occurs when good hygiene is practice.

Heartworm in Cats

Heartworms are 9-11” long worms that live in a cat’s heart or in the arteries going to the lungs (pulmonary arteries). Although they occur commonly in dogs, most people do not consider them a problem for the cat. However, recent studies of cats with heart and respiratory diseases have found an incidence of heartworms that is far greater than we previously thought.

Dogs vs. Cats

Dogs often have 30 or more worms present; however, many cats have only 2-4 adult worms in the heart. Adult heartworms live 3-4 years in the dog’s heart but only 1-2 years in circulation; cats usually do not produce any immature worms. Dogs have changes in the shape of the heart and pulmonary arteries as seen on radiographs (x-rays). Their pulmonary arteries become tortuous (curved) and enlarged. However, cats will usually have normal shaped hearts with pulmonary arteries that are blunted, presumably related to partial obstructions due to the presence of adult worms. Dogs usually have a persistent rise in eosinophils, a normal white blood cell that can be associated with parasitic infection. Cats have an eosinophil increase that occurs briefly within a few months of infection. By the time clinical signs are present, most cats have a normal eosinophil count.

Contributing Factors

Because heartworms are transmitted by mosquitoes, the disease is more common in areas of the country with large numbers of mosquitoes. Infection with feline leukemia virus or feline immunodeficiency virus does not seem to increase the risk that cats will get heartworms, even though they adversely affect the immune system.

Prevalence

The southeastern United States has a relatively high incidence of heartworm disease for both dogs and cats when compared to other parts of the country, although heartworm disease may occur anywhere that mosquitoes can survive. There is no apparent difference between infection rates between male and female cats, although male cats generally have greater numbers of worms than female cats. Although indoor cats might be at less risk for heartworm infection, more recent studies indicate that infection rates between indoor and outdoor cats are about the same. All ages are at risk for infection.

Transmission

Heartworms are transmitted through mosquitoes. When an infected mosquito bites a cat, it deposits baby heartworms (larvae). The larvae migrate and mature for several months, ending up in the right side of the heart and the pulmonary arteries. They mature into adult heartworms about 6 months from the time they enter the cat. Shortly thereafter, they begin to release immature heartworms, known as microfilaria. Microfilaria live in the cat’s blood for about one month. They are ingested by mosquitoes feeding on the cat. (However, most mosquitoes acquire microfilaria by feeding on heartworm-infected dogs.) Because of their life cycle, it is necessary for a cat to be bitten by a mosquito to be infected with heartworms. Heartworms are not transmitted directly from one cat to another nor from a dog directly to a cat.

Diagnosis

There are several methods used in diagnosing heartworms; unfortunately, none are 100% reliable so a combination of tests is often needed. The diagnostic sequence usually progresses as follows:

Clinical Signs

One of the difficult things about diagnosing heartworms is that there are no consistent clinical signs. The most common signs are coughing and rapid breathing. However, both can be caused by several other diseases. Other common clinical signs include weight loss and vomiting, also common in other diseases. Some cats seem to be normal, then die suddenly. This happens due to a reaction within the lungs to the young heartworms or when dead or live heartworms enter the pulmonary arteries and obstruct the flow of blood to the lungs.

Blood Tests

1. There are two relatively new tests that are proving to be very helpful in diagnosing heartworms. The heartworm antibody test determines that the cat’s immune system has been exposed to heartworms. A positive test may indicate that an active infection is present. However, cats who have had heartworms but whose heartworms have died will also have antibodies for an unknown period of time, suspected to be 2-4 months. This test is very sensitive, so it is used first. However, if it is positive the next test is performed.
2. The next test is the heartworm antigen test. This detects the presence of the adult female heartworms. It is very specific, but not as sensitive. This means that a positive test indicates that heartworms are present, but a negative test does not mean that they are absent. Because the cat must have at least 2 adult female worms present to make this test positive, a negative test may mean that the cat may only have a small number of worms or that all the worms present are male.

   In summary, a diagnosis of heartworms is confirmed if both the antibody and antigen tests are positive.

   It should be noted that most veterinarians are able to perform an in-hospital test to detect heartworm antigen in dogs. However, the canine test is not as sensitive as the test for cats so using it will result in more false negative results.

3. Blood can be tested for the presence of microfilaria. However, less than 10% of cats with heartworms have microfilaria in their blood, and the microfilaria are only present for 1-4 weeks. Therefore, a negative test means little.
4. Cats suspected of heartworms can be tested for their level of eosinophils. Eosinophils are normal white blood cells that occur in increased numbers when certain parasites are present. They are elevated in the presence of heartworms, but this elevation only occurs for a few months. In addition, cats with intestinal parasites (“worms”) and allergies also commonly have increased eosinophil counts.

Radiographs

Radiographs (x-rays) permit us to view the size and shape of the heart. They also allow us to measure the diameter of the pulmonary arteries. Many cats with heartworms have an increase in the size of the pulmonary arteries; they may suddenly come to an apparent stop (blunted) on their way to the lungs due to worms obstructing them. However, many cats with heartworms have no abnormal findings on their radiographs, especially early in the infection.

An angiogram is an x-ray study in which contrast material (dye) is injected into the heart or veins and seen as it goes through the pulmonary arteries. This illuminates the arteries so they can be seen better. There is some risk to this procedure so it is not used often.

Ultrasound

An ultrasound machine produces an image of internal organs and structures without the use of radiation. It is a testing procedure that is becoming more and more common in veterinary practices. With it, one is able to view the internal structures of the heart and the pulmonary arteries. In some cats, the actual heartworms can be seen; this finding confirms the presence of heartworms. However, in many cats the worms are not seen.

Treatment

Dogs that have heartworms are treated with a new drug this is safer than the previously used drug and is very effective. However, there is no such drug for cats. Another problem is that when the heartworms die they are pass through the pulmonary arteries to the lungs. This can result in sudden death. Thus, we have a dilemma when a cat is diagnosed with heartworms. One of two choices must be made:

1. Treat with the drug designed for dogs. However, this is a drug that is unproved for cats and is not recommended as the chance for complications and side effects is high.
2. Treat the symptoms of heartworm disease and hope the cat outlives the worms. Since heartworms live in a cat for about two years, several months of treatment is needed. When cats are in a crisis, they are treated with oxygen, corticosteroids (“cortisone”) to relieve the reaction occurring in the pulmonary arteries and lungs, and, if needed, drugs to remove fluid from the lungs (diuretics). When they are stable, they are treated continuously or periodically with corticosteroids. However, the threat of an acute crisis or sudden death always exists.

Indoor Cats
Logically, we would think that indoor-only cats would be very unlikely to get heartworms. However, studies of heartworm infected cats consistently show that about one-third of them live indoors all of the time. As strange as this seems, there is a good explanation. The cat is not the natural host for heartworms. Because of this, the cat’s immune system is able to kill the larval stages most of the time. Each time a cat is exposed and successfully kills heartworm larvae, some immunity is develops. This is a type of natural vaccination. However, indoor-only cats do not get this constant exposure so their natural immunity is not as good. When a mosquito gets into the house and bites the cat, this cat is actually more likely to develop heartworms than most outdoor cats.

Prevention

It is strongly recommended that dogs take drugs to prevent heartworms. It is well accepted that even dogs in cold climates should be on heartworm prevention at least part of the year. Now, some of the same drugs are formulated for cats. Therefore, prevention of heartworms is safe and easy. The reasons that heartworm prevention should be considered for your cat are:

1. Diagnosing heartworms is not as easy in cats as in dogs. A simple and reliable in-hospital blood test is not yet available, and the tests that are most reliable must be sent to an outside laboratory. Often, radiographs or ultrasound studies are needed to confirm the diagnosis. Many cats are diagnosed with an autopsy following sudden death.
2. Heartworms are not nearly as common in cats as they are in dogs. However, they are probably more common than we realize. As we look more aggressively for heartworms in cats with better and better tests, we expect to find that the incidence is greater than we thought in the past.
3. There is not a good treatment for heartworm-infected cats. Effective drugs are not available, and cats that seem to be doing well may die suddenly. Treating heartworm infections in cats is risky, and not treating these cats is just as risky. If they are cured of the disease, it takes about two years.
4. Cats given heartworm prevention drugs have not shown signs of toxicity. Since they only have to be given once each month and since they are formulated so that cats will eat them readily, administration is not a problem (in most cats). There is a wide margin of safety, even in kittens as young as 6 weeks of age.
5. Exposure to mosquitoes is all that is required for transmission. Cats do not have to be exposed to cats or dogs infected with heartworms.

Giardia Infection in Cats

Giardiasis is an intestinal infection of man and animals caused by a protozoal parasite called Giardia intestinalis. It is widely known as the source of traveler’s diarrhea. These single-celled parasites are not to be confused with the common intestinal parasites: roundworms, hookworms, and tapeworms.

Giardiasis is a important cause of illness in animals and man. Fortunately, even though the prevalence rate is high in cats and dogs, clinical disease is less common.

Predisposition

Infection is relatively rare in healthy cats. It is more common in densely-populated groups of animals, such as in a cattery, pet store, or animal shelter. Also, kittens have been shown to shed more Giardia cysts in their feces than older cats.

Similarly, human infection is more common in dense populations. Scientific studies have demonstrated greater prevalence in nursing homes and day-care centers when compared to the population at-large.

Clinical Signs

These microscopic parasites attach themselves to the intestinal wall and cause a sudden-onset (acute) foul-smelling diarrhea. The stool may range from soft to watery and occasionally contains blood. Infected cats tend to have excess mucus in the feces. Sometimes, vomiting can occur.

Causes

Ingestion (swallowing) of the cyst stage of the parasite leads to infection. Once inside the cat’s intestine, the cyst goes through several stages of maturation. Eventually, the cat is able to pass infective cysts in the stool, where they can contaminate the environment and infect other cats.

Infection can also occur from drinking water that has been contaminated with the cysts.

Diagnosis

Because of the prevalence of Giardia in the cat, presence of cysts in the stool does not necessarily indicate that a problem is present. However, when the cysts are present in a cat with diarrhea, it is important. In particular, kittens and debilitated adult cats are at risk for death from dehydration associated with the diarrhea.

Although a fecal examination is needed for diagnosis, the routine flotation test may fail to detect these small cysts. A special solution may be needed for accurate identification of the cysts in the stool. Occasionally, the parasites may be seen on a direct smear of the feces. A test is available for detection of antigens (cell proteins) of Giardia in the feces. A delay of several days may occur as the test is only performed in select laboratories. Also, the reliability of this test in the cat remains under investigation.

Treatment

Metronidazole and fenbendazole are the drugs most commonly used to treat Giardia. The former is a tablet, and the latter is a liquid. They are given orally for 5-7 days. Other drugs may be needed as supplemental therapy should diarrhea and dehydration occur.

Prognosis

The prognosis is good in most cases. Debilitated or geriatric animals and those with incompetent immune systems are at increased risk for death.

Transmission to Humans

Giardiasis is the most common intestinal parasitic infection of man. In the past, it has been assumed that cats and dogs served as the source of infection for humans. However, current research is beginning to indicate that perhaps cats and dogs do not serve as an important reservoir of the disease for man. Some scientists are suggesting that human-to-human transmission may be the more important factor. Also, in cities which do not have water treatment facilities with a sand filtration system, Giardia may not be removed from drinking water.

Nevertheless, until the issue of transmission is resolved, caution is advisable when a pet has been diagnosed with giardiasis. In particular, humans with immunodeficient states (AIDS, chemotherapy) should use extreme care.

For environmental disinfection, a cup of chlorine bleach in a gallon of water is effective. First be sure that the surfaces and premises can be safely treated with bleach.

Successful flea control has two aspects. Fleas must be controlled on your cat, and fleas must be controlled in your cat’s environment. Since cats and dogs share the same fleas, the presence of a dog in your cat’s environment makes flea control much more difficult.

Diagnosis of Flea Infestation

When a cat is heavily infested with fleas, it is easy to find them. If the numbers are small, it is best to quickly turn your cat over and look on its belly. If you do not find them there, look on the back just in front of the tail. Be sure to part the hair and look at the level of the skin. When the numbers are very small, look for “flea dirt.” Flea dirt is digested blood left behind by the fleas. Flea dirt is actually fecal matter from the flea. Finding flea dirt is a sure indication that fleas are present or have been present recently.

Flea dirt looks like pepper. It varies from tiny black dots to tubular structures about 1/32″ (1/2 mm) long. If you are in doubt of its identification, put the suspected material on a light colored table top or counter top. Add one or two drops of water, and wait about 30 seconds. If it is flea dirt, the water will turn reddish brown as the blood residue goes into solution. Another trick is to put some of the material on a white paper towel and then wet the paper towel with water. A red stain will become apparent if you gently wipe the material across the surface of the paper towel.

Many people find tiny drops of blood in a cat’s bedding or where the cat sleeps. This is usually flea dirt that was moistened, then dried. It leaves a reddish stain on the bedding material and is another sign that fleas are present.

The Flea’s Life Cycle

To appreciate the complex issue of flea control, you must understand something about the flea’s life cycle.

Although you are only able to see the adult flea, there are actually 4 stages of the life cycle. The adult flea constitutes only about 5% of the entire flea population if you take into account all four stages of the life cycle. Flea eggs are pearly white and about 1/32″ (1/2 mm) in length. They are too small to see without magnification. Fleas lay their eggs on the cat, but the eggs do not stick to the cat’s hair. Instead, they fall off into the cat’s environment. The eggs make up 50% of the flea population. They hatch into larvae in 1 to 10 days, depending on temperature and humidity. High humidity and temperature favor rapid hatching.

Flea larvae are slender and about 1/8 – 1/4″ (2 to 5 mm) in length. They feed on organic debris found in their environment and on adult flea feces, which is essential for successful development. They avoid direct sunlight and actively move deep into carpet fibers or under organic debris (grass, branches, leaves, or soil.) They live for 5 to 11 days before becoming a pupae.

Moisture is essential for their survival; flea larvae are killed by drying. Therefore, it is unlikely that they survive outdoors in shade-free areas. Outdoor larval development occurs only where the ground is shaded and moist and where flea-infested pets spend a significant amount of time. This allows flea feces to be deposited in the environment. In an indoor environment, larvae survive best in the protected environment of carpet or in cracks between hardwood floors. They also thrive in humid climates.

Following complete development, the mature larvae produce a silk-like cocoon in which the next step of development, the pupa, resides. The cocoon is sticky, so it quickly becomes coated with debris from the environment. This serves to camouflage it. In warm, humid conditions, pupae become adult fleas in 5-10 days. However, the adults do not emerge from the cocoon unless stimulated by physical pressure, carbon dioxide, or heat.

Pre-emerged adult fleas can survive up to 140 days within the cocoon. During this time, they are resistant to insecticides applied to their environment. Because of this, adult fleas may continue to emerge into the environment for up to 3 weeks following insecticide application.

When the adult flea emerges from its cocoon, it immediately seeks a host because it must have a blood meal within a few days to survive. It is attracted to people and pets by body heat, movement, and exhaled carbon dioxide. It seeks light, which means that it migrates to the surface of the carpet so that it can encounter a passing host. Following the first blood meal, female fleas begin egg production within 36 to 48 hours. Egg production can continue for as long as 100 days, which means that a single flea can produce thousands of eggs.

This entire life cycle (adult flea –> egg –> larvae –> pupa –> adult) can be completed in 14-21 days with the proper temperature and humidity conditions. This adds to the problem of flea control.

If untreated, the female flea will continue to take blood for several weeks. During that time, she will consume about 15 times her body weight in blood. Although the male fleas do not take as much blood, they, too, contribute to significant blood loss. This can lead to the cat having an insufficient number of red blood cells, which is known as anemia. In young or debilitated cats, the anemia may be severe enough to cause death.

Contrary to popular belief, most cats have rather limited itching due to fleabites. However, many cats become allergic to the saliva in the flea’s mouth. When these cats are bitten, intense itching occurs, causing the cat to scratch and chew on its skin.

Flea Control

Successful flea control must rid the cat of fleas and it must rid the cat’s environment of fleas. In fact, environmental control is as important as treatment of the cat. If your cat remains indoors and you do not have other pets that come in from the outside, environmental control is relatively easy, especially with the advent of the new topical products (see below). However, the cat that goes outdoors or stays outdoors presents a somewhat greater challenge and a few fleas may occasionally be seen indoors.

Many of the older insecticides (which have been the mainstay of flea control for years) have limited effectiveness against fleas because they are only effective for a few hours after application on the cat. Also, these are primarily geared to kill adult fleas. Flea powders, sprays, and shampoos will kill the fleas present on your cat at the time of application. However, most of these products have little or no residual effects, so the fleas that return to your cat from his environment are not affected. Thus, your cat may be covered with fleas within a day after having a flea bath or being sprayed or powdered.

However, there are some newer, more effective sprays that can be a valuable part of the overall treatment plan. They kill adult fleas rapidly and are safe enough to use daily, if necessary. Flea sprays containing insect growth regulators are helpful in managing the overall problem because they help to break the flea life cycle. Some of the newer sprays with growth regulators are not recommended for daily use; once weekly application is recommended. Always read the label when first using any new product on a cat. In general, flea sprays, collars, powders and dips have become less popular since the introduction of the newer products.

Newer Products

Two relatively new products have come onto the market in the last couple of years. The Aflea pill@ is an oral medication that is given to the cat once a month. This product does not kill adult fleas but is helpful in breaking the life cycle of the flea. When the female flea produces eggs, they are essentially Asterile@ eggs and do not hatch. In effect, this product acts like a birth control product for the flea. The new topical treatments that are applied to the cat include a spray with residual effects, as well as a liquid that is applied over the nape of the neck. These both have residual effects of up to three month and will kill the adult flea.

Environmental Control

The newer topical products do not require the aggressive environmental control that is necessary if only dips, sprays, or collars are used. This is one reason that they have become so popular with pet owners. Please consult with us about the requirements for your specific situation.

When environmental flea control is indicated, it must be directed at your house and your yard.

House. Even though fleas may be in your house, most people never see them. Fleas greatly prefer cats and dogs to people; they only infest humans when there has not been a cat or dog in the house for several days. (There are exceptions to this.) A professional exterminator may be called to treat your house or you may use a house fogger or a long-lasting spray. These foggers and sprays are very effective for adult fleas, but they will not kill adults that are still in their cocoon. You should purchase a fogger or a spray that kills the adult fleas and inhibits development of the eggs and larvae. In climates with extended warm temperatures and high humidity, it may be necessary to treat two or three times with a 30-day residual product before all stages of the fleas are removed from the house. The second treatment is most effective if it is done 2 weeks after the first.

There is at least one company that will treat your carpet with a flea-killing powder. The powder is non-toxic to people. It is worked deeply into the carpet to prevent it from being removed by vacuuming. This treatment has proven very successful, even in the face of heavy flea infestations. However, the treatment does not address fleas in your yard. The same chemical, a form of boric acid, is also available for application by the homeowner. However, the self application kits do not offer the year guarantee.

Yard. A professional exterminator may also do yard control with various insecticides or you may use some yourself. Be sure that any insecticide that you use has a 30-day residual. This keeps you from having to spray every week. In climates with extended warm temperatures and high humidity, it will often be necessary to treat monthly during the warm months of the year. You should use a 30-day residual product each time. Your veterinarian is able to help you choose the most effective product for your situation.

Re-emergence of Fleas

If you recall, pre-emerged adult fleas can survive up to 140 days within the cocoon. This is significant when your pets are gone from home for extended periods of time. During the time that the house is quiet and empty, pre-emerged adults remain in their cocoon. Even if the house was treated with an insecticide, their cocoon protects them. When people and pets return to the house, adults emerge from their cocoons and immediately begin to seek a blood meal. They jump on cats, dogs, and even people. Although it may appear that a cat just returned from boarding brought fleas to your home, it is also very possible that a sudden emergence of adult fleas may account for the fleas present. If large numbers of fleas are seen, they are almost certainly newly hatched fleas and have not been brought home with the pet.