Browsing tag: cat

Ask A Vet Online – My cat is itchy with watering eyes…

Ellie Masters asked:

My cat is scratching above his eyes and losing fur, sometimes his eyes water too. this happened earlier in the summer he went through testing nothing found, he’s treated with stronghold so no fleas etc. All help appreciated as at wits end now


Hi again Ellie, thanks for your question!

To answer it, I’m going to discuss the possible causes, then the investigations available to demonstrate them, and then finally possible treatment options.

What possible causes are there?

Given that he’s scratching the area around his eyes, losing fur and has watery eyes, there are three immediate possibilities that spring to mind.

The first is a primary eye disease – conjunctivitis, a corneal ulcer, chlamydia or calicivirus infection are probably the four conditions I’d be wanting to rule out. In this situation, the hair loss is because of his constant rubbing at his sore eyes.

The second possibility is that it is a skin disease, manifesting most dramatically on his head above his eyes. This may sound unlikely, but many cats suffer from a condition called miliary dermatitis, where the skin becomes very itchy and forms tiny red scabs or bumps – often it is focussed above the eyes and in front of the ears, although along the back is also a possibility. This is not a diagnosis, but a symptom – and is most commonly associated with parasites, allergies, or skin infections.

The third option is a condition that affects both the skin and the eyes – classically, this would be a more general allergy of some sort. Allergies in cats are less well understood than in dogs, however, food allergies are thought to be the second most common cause of itching in cats (after fleas and other parasites). Other possibilities would include auto-immune disease, where the immune system starts attacking healthy tissues.

So, how do you tell which it is?

If the condition is a primary eye disease, the skin will appear basically normal (although it may be a little reddened or bald due to rubbing, it will not be itchy itself, and the affected areas will ONLY be around the eyes, there won’t be any symptoms anywhere else).

In miliary dermatitis, the tiny (1-3mm across) scabs or bumps will be obvious in the skin – typically above the eyes, in front of the ears, sometimes on the sides or bottom of the neck, and often along the back as well. In fact, it has been called “lumpy cat disease”!

Of course, if both systems are affected, then both sets of symptoms will be apparent.

What could have caused it?

Primary eye diseases are commonly associated with trauma (typically, fighting with other cats, but running through vegetation is also a possibility) or cat-flu infections. Other options include uveitis (inflammation inside the eye) or a displaced lens. I’m not going to talk in much detail about these, because from what you’ve said, it doesn’t sound like this is a specifically eye-related problem.

Itchy skin diseases, however, are fairly common in cats. By far the most common is parasitic dermatitis, caused by ectoparasites (those that live on the surface of the animal) such as fleas, mites (e.g. Notoedres cati, the Cat Scabies Mite) and lice. This is relatively unlikely in your case, because it appears that you use a very effective anti-parasitic, selamectin (Stronghold); if used monthly, in most cats this is very effective at killing fleas and mites, although less good for lice.

I say usually effective, because sometimes, for some reason, we do find that cats get flea problems despite appropriate treatment; this may be because there is a massive environmental reservoir of pupae and larvae (or even adults on other cats or animals) so killing the adults doesn’t resolve the problem; or it may be because the cat is so severely allergic to them that a single bite causes generalised skin disease – even though the biting flea dies within hours, the symptoms may persist for days afterwards.

You can, however, check for fleas and lice easily at home. Fleas are rarely seen live unless in very severe infestations, but their droppings appear as black sand in the coat and when wetted turn bright red (because they are digested blood – this is called the Wet Paper Test). Lice are small insects that are visible with the naked eye, and often you can see the eggs or “nits” adhering to the hair. Mites, on the other hand, can only be ruled out by your vet, by doing skin scrapes and examining them under the microscope. At the same time, they will check for skin infections – bacteria, yeasts, and even ringworm (another fungus) may all cause skin symptoms.

Assuming that you have ruled out these parasites and infections, the next most likely problem is an allergy – reportedly, food allergies are the most common in cats after flea allergies. In cats (and indeed dogs), food allergies do not usually have intestinal symptoms, but instead cause itchy skin disease – and can be a response to any component of the diet (for example, an outdoor cat can become allergic to mice!). Unfortunately, they are very difficult to diagnose – the mechanisms are poorly understood and allergy blood tests are highly unreliable for food reactions. The only way to diagnose the condition in a cat is to perform a Dietary Exclusion and Challenge Trial. This involves:

  • Put the cat on a diet containing only protein and carbohydrate sources they have never eaten before – this is rarely possible in practice (!), so usually a commercial hydrolysed hypoallergenic diet is prescribed by the vet, which has been specially formulated and processed so that none of the potentially allergenic molecules is big enough to be recognised by the immune system.
  • They must stay on this diet, and this diet only (no treats, snacks or other foods) for 8-13 weeks. If the symptoms do not resolve, then the cat doesn’t have a food allergy. If they do resolve, then either they have a food allergy, or they have another disease which has spontaneously improved (which many allergic conditions do).
  • If the symptoms resolved, then you move to the Challenge part of the test, which is to return to the original diet. If there is no change, the cat probably doesn’t have a food allergy; but if the symptoms recur within 10 days, then the condition is a food allergy to one component in the original diet, so they should go back onto the hypoallergenic food.
  • You then have the choice of either reintroducing components of the original diet one at a time to try and find out exactly what they’re reacting to, or just stick with the diet that prevents the symptoms – the vast majority of owners (quite sensibly in my opinion) stick with what works!

If parasites, infections and food allergies have been ruled out, there are two possibilities remaining. The first is an environmental allergy – an allergic reaction to something around the cat, such as pollen, dust, dust mites etc etc. Fortunately, there are blood tests available that can help diagnose these conditions – you should discuss them with your vet. Unfortunately, many cats don’t respond very well to antihistamines so these drugs are often of limited use in managing allergies. Allergen avoidance (keeping the cat away from the substance, or vice versa) is therefore the mainstay of treatment, although sometimes medication (e.g. steroids) is used as well.

The final possibility is atopic dermatitis. This condition has been well recognised in dogs for many years, but we now know that cats can suffer from it as well (although it is probably rarer than in dogs). This is a genetic condition that makes the cat abnormally prone to developing allergies, often to a wide range of different harmless substances simultaneously. Although allergen-avoidance (keeping the cat away from the substances they are allergic to) is the ideal, it is often not possible, and in the vast majority of cases, medication to reduce the over-reaction of the immune system is needed (typically cyclosporine and/or steroids).

So where do I go from here?

The key to working out what’s causing any skin condition is to work with your vet and work it up logically:

  1. Rule out parasites – with wet paper tests, visual examination and skin scrapes. Sometimes, trying a different flea treatment makes a dramatic difference (although from what you’ve said I doubt this is your issue).
  2. Rule out skin infection – using tape strips, skin swabs and culture (bacterial and possibly fungal).
  3. Rule out a food allergy with an Exclusion and Challenge Trial
  4. Test for other allergies.
  5. If all the above are negative, further tests are needed for more exotic conditions such as feline leprosy or mast cell tumours – however, these are pretty rare!

All the best with him, and I hope you can get to the bottom of the problem!


David Harris BVSc MRCVS

Ask A Vet Online – Help! The fleas are revolting…


Anne Stafferton asked:

This one is a bit boring really I’ve spent hundreds of pounds on flea stuff only for it not to work I breed cats so it’s a nightmare I’m now combing them all every day to get fleas out any suggestions on what really really works


Hi Anne, thanks for your question about fleas in cats. I know exactly what you mean – they can be a real nightmare to get under control! I’m going to answer your question by (briefly!) discussing the flea life-cycle and how it can be broken, and then talking about the specific treatments that are available. As a warning, on a blog like this I am legally obliged to use the generic names for all the drugs and medicines (otherwise I would get nasty letters from the Veterinary Medicines Directorate, the government department who regulate advertising of veterinary medicines). You can, however, look up any of the generic names for the active substances and “translate” them into brand names on the VMD’s Product Information Database.

What are fleas?

Fleas are a group of obligate ectoparasites – this means that they live on the outside of other animals, and cannot survive in any other way but by sucking the blood of their hosts. Once an adult flea lays her eggs, they fall onto the floor, the carpet, and into the cat’s bedding. Here they hatch into larvae, which live, hidden deep in the fabric, in the dust, and in cracks in floorboards etc.

The larvae survive primarily by eating the faeces of adult fleas, which fall off the cat as the “black sand” we all know and hate! This material is semi-digested blood, and is very nutritious for the larvae. After their final moult, they turn into pupae (like the chrysalis of a butterfly but less pleasant) and there they stay, waiting for a chance to hatch.

Pupae can remain dormant for months or years, and in this state they are more or less impervious to virtually any treatment we can use against them (although apparently repeated steam cleaning can kill them). When they detect air movement, heat, or increased carbon dioxide levels (all indicators that a cat, dog or human is close), they hatch and leap on board, to feed, breed and repeat the cycle.

Traditionally, we think of fleas as being a spring and summer problem; however, with modern insulation and central heating, nowadays we see them all year round. The flea life cycle can only complete in a relatively warm environment, but we kindly provide them with a nice warm, comfy house to grow up in.

So how do you break the cycle?

There are a number of points at which the cycle is vulnerable – however, it’s important to remember that if the cats go outside (even briefly) they can pick up new fleas (deposited by other cats, dogs, foxes and even small mammals such as rodents). It only takes one amorous flea couple to reinfest a whole household…

The adult fleas are actually pretty easy to kill – even old-fashioned drugs like fipronil will kill most of the adults present, and many of the newer medications are much more potent.

The larvae need to cut their way out of their eggs (using a special “egg tooth” made of chitin); if their synthesis of chitin is impaired (e.g. by lufenuron) they cannot hatch.

The larvae cannot develop into adults in the presence of juvenile hormone – if this is chemically supplied (as an Insect Growth Regulator, e.g. S-Methoprene), they cannot make the change into adults.

The number of eggs, larvae and pupae in the house can also be reduced, by washing of fabrics (especially bedding) in hot (60C) soapy water. Although it won’t kill all of them, it will reduce the numbers and wash a lot away down the drain where they can’t hurt anyone!

The pupae themselves are pretty much impervious to any treatment, but they can be “tricked” into coming out as adults, which are then much easier to kill. The common method is regular vacuuming – the air movement and heat trick the pupae into hatching; you won’t catch many in the cleaner, but once out, they are vulnerable to environmental insecticides.

In fact, if you keep a “closed household”, with all the cats (and dogs if you have any) living indoors 24/7, it is theoretically possible to break the life cycle without treating the adults at all… but it will take a long time (the adults may live for 4-6 months) and you’re always at risk of a new introduction (in your clothes, for example).

So how do I kill them?

As you’ve found, there are a huge range of different flea control products on the market! Broadly speaking, these can be divided into 5 categories:

Environmental insecticides:

These are products used to spray the infested house, killing adults, sometimes eggs, and larvae. They will not kill pupae, but if applied rapidly after vacuuming, they can be very effective.

Most products contain permethrin, which is toxic to cats – this means that you have to be careful using them, by treating rooms one at a time and shutting the cats out until they have ventilated. The cans will explain how long to leave it for on the label, or talk to your vet, before reintroducing the cats.

On-cat environmental treatments:

These are applied to, or administered to, the cat, to treat the environment, and rely on the fact that the larvae are eating the flea’s droppings. There are 3 particularly important ones:

  • Lufenuron – a chitin inhibitor, available as an oral liquid, a tablet, or an injection. Does not kill adults, but prevents larvae and pupae from hatching properly.
  • Pyriproxifen – an Insect Growth Regulator, available in some prescription-only fipronil products.
  • S-methoprene – another IGR, available in some prescription-only fipronil products.
  • Imidacloprid – an insecticide available as a spot-on that kills adults and larvae in the vicinity of the treated cat.

Over-the-counter adulticides (products that kill adult fleas only):

These are of various effectiveness; most contain piperonyl butoxide or dimpylate (not very potent but pretty harmless) but there are still some on the market containing permethrin, which although effective is potentially lethal to cats. In general, if it is available over-the-counter without any regulation, it’s probably not that powerful.

The most popular products in this group are the spot-ons containing fipronil, which is an older drug but still fairly effective. Some of these products are over the counter, and others are classified “NFA-VPS” (which means there are certain restrictions on their supply, but they still do not require a prescription) Contrary to popular opinion, there is no conclusive evidence that resistance of fleas to fipronil is widespread – however, fipronil containing products are water soluble (so may wash off if the cat gets wet) and are much less effective than the modern prescription-only products.

The other commonly used active ingredient is imidacloprid, which is a different class of insecticide that is active against adult and against the larvae. Again, it doesn’t suit every cat but may be useful.

There is also an interesting product available as a tablet containing nitenpyam, which is very effective at killing adults – but only lasts 24 hours after being given. It is best used to kill off the bulk of the adults when starting a flea control program.

Prescription-only products:

Fipronil-combos – spot-on products containing fipronil plus an Insect Growth Regulator, to treat the adults and the environment simultaneously. Last between 4 and 8 weeks, but the adulticide (killing of adults) effect tends to wear off after about 4-5 weeks.

Flumethrin/Imidacloprid combo collar – this is a collar containing flumethrin (a form of permethrin that is safe for cats) and imidacloprid. It lasts about 6-8 months, and is very effective – if the cat will keep it on!

Imidacloprid/Moxidectin combo – another spot-on, that treats a wide range of different parasites. Lasts about 4 weeks.

Selamectin – a spot-on product, but one that is absorbed into the cats system so it cannot be washed off – very useful for outdoor cats! It also treats roundworms and both mange- and ear-mites, but does require the flea to bite before it works. Lasts about 4 weeks.

Indoxacarb – Another spot-on, but one that is utterly inactive in the cat’s body, until it is “turned on” by a unique metabolic action inside the flea, and the larvae if repeated every 4 weeks.

Spinosad – a tablet, given once a month, that is really effective against fleas, but does cause some cats to vomit; if given with food, however, it normally stays down – it does require the flea to bite, but kills very, very fast (in a few hours).

Herbal and homeopathic remedies:

Available, but no proven effectiveness. I have heard garlic recommended, but, sadly, in my experience it just doesn’t work and is potentially toxic to cats.

There’s so much choice! What do I do?

Bottom line – you’ll never control fleas if you only attack one stage of the life cycle. You need to kill the adults (and I’d recommend you talk to your vet about the more potent, modern, prescription products rather than rely on older and less powerful medications); however, you also need to decontaminate the environment, with regular vacuuming, insecticidal sprays, and good old fashioned washing and cleaning! If you’re still struggling to get on top of the situation, talk to your vet – not every product suits every cat, and it’s sometimes necessary to try several alternatives until you find the product, and the control methods, that suit your cats and their lifestyle.

All the best – I hope you can rid your cats of their unwelcome visitors!

David Harris BVSc MRCVS

Oscar, the grumpy cat who needed twice daily injections to treat his diabetes

Oscar does not tolerate humans who annoy him

Oscar does not tolerate humans who annoy him

Oscar, a ten year old cat, had started to lose weight, despite the fact that he was eating well. His coat had begun to look bedraggled, as if he was not grooming himself as much as usual. His owner had noticed him visiting his water bowl more frequently, and she had needed to fill up the bowl every day, rather than every three days.

When I examined him it was clear that Oscar had lost a significant amount of weight. His ribs were prominent, and I could feel the sharp tips of the bones of his back. When I weighed him, I discovered that he had lost a kilogram since his previous visit.

Physically, I could find no obvious cause of a problem, so I decided that a blood profile was needed. Fifteen minutes later, the printout from the biochemistry analyser gave me the clear-cut diagnosis of his illness.

Oscar’s blood glucose was around four times higher than normal. The only possible reason for this was the condition known as diabetes mellitus. Oscar’s pancreas had stopped producing the hormone called insulin, and as a result, his blood glucose was not being controlled. Weight loss, ravenous appetite and copious thirst are classical signs of diabetes, in cats just as in humans and dogs.

As I explained the diagnosis to his owner, I could see a worried furrow developing across her brow. I explained that Oscar’s condition was treatable, but that he would need to have a daily injection of insulin for the rest of his life. Her shoulders slumped, and she looked at me sadly. “Nobody would dare to give Oscar an injection”, she told me. “He’d just get so annoyed with us if we tried something like that!”

I reassured her that the injection was given with an ultra-fine needle, and that only a tiny amount of liquid would be needed. For a cat of Oscar’s size, the volume of insulin would probably be around one hundredth of a teaspoonful, which is literally a single drop. It was very likely that he would barely notice the injection.

I demonstrated the injection technique, using a piece of fruit – an orange – as a practice target. It took a few attempts until she had learned to hold the syringe correctly, but soon she was able to insert the needle steadily and firmly into the orange. She was still very anxious about injecting her cat, so we decided that it would be best for her to bring him in to see me for his injection every morning for the first week.

The technique was simple. I gave Oscar a bowl of his favourite food, and as he lowered his head to eat, I quickly slipped the injection into the scruff of his neck. He stopped eating for a moment, and looked suspiciously at me before recommencing his meal. On day three, his owner gave the injection herself, and by day five, she was able to do this quickly and confidently.

After several dose adjustments over a few weeks, Oscar’s blood glucose had returned to normal. At the same time, his owner reported that his excessive thirst had disappeared. It seemed that his diabetes had been controlled.

The success of his treatment was confirmed at his final visit six weeks later. As the cage door was opened, Oscar stepped out in a confident and dignified fashion, with his head held high. He had put on weight, he was grooming himself again, and even his whiskers looked alert and bristling. He was definitely a healthy cat again.

How to help stressed-out cats whose owners think they are “behaving badly”


One of the challenges for veterinary surgeons working in the media is that is that they are often asked about one specific patient, with a particular problem. While it’s helpful for the individual owner to discuss their own pet, it can be less enthralling for other readers.

Here are a couple of examples:

  • Ginger, a 5 year old neutered tom cat, had started urinating in his owner’s bathtub, and occasionally in the sink downstairs. He had always been a “good” cat, going out through the cat flap to do his business. Why would he change like this?
  • Harry, a two year old neutered male tabby cat, had recently started to suffer from injuries caused by cat fights. His owner had seen a big tom cat stalking him in the garden, and the cat had even come into the kitchen on one occasion, stealing Harry’s food. Why was this other cat doing this, and what could be done?

Ideally, both of these questions deserve to be analysed in their own right, and a full, detailed response given. Vets in the media often do this, publishing the dialogue and outcome. While this is useful, it isn’t always the best way to give a detailed explanation about cat behaviour that will be useful for all readers.

This is an area where Wikivet offers a different approach. There are two Wikivet sections that are particularly relevant to the cases under discussion.
First, there is an entire section on feline territorial behaviour. This is an up-to-date scientific review of our current understanding of cat social life, and it’s highly relevant to any incident involving cat-cat interactions. The Wikivet entry includes some useful facts:

  • In urban areas the density of cat populations may be high, exceeding 50 cats per square kilometre.
  • 81% of 734 UK cat owners whose cats were allowed outdoor access indicated that their neighbours also had at least one cat that was allowed outside
  • In houses with a standard cat flap, 24.8% reported that other cats came into their home to fight with their cats, and 39.4% reported that they came in to steal food.
  • Cats that had experienced injuries due to conflict with other cats showed 3.9 times the rate of indoor spray marking compared with cats that had not experienced injuries.

You can read the full Wikivet page for yourself to find out more helpful facts about cat social life.

Second, another Wikivet page  focuses specifically on the issue of indoor marking, highlighting the fact that the two main scenarios leading to indoor marking are conflict with non-resident cats, and conflict with resident cats. The page suggests some answers that may help specific cases, including mentions of treatment approaches ( from an electronic coded cat flap so that outside cats cannot gain access to the home to the use of Feliway diffusers and spray, to mentions of some of the psychoactive  medication that may be prescribed by vets for super-stressed moggies.

There are also links to detailed videos by behavioural specialists which go into more details on the subject.

So if you have a cat who seems to be agitated by local rivals, or who has taken to indoor urinating, read these Wikivet pages. They may help you solve the problem, and if they don’t, you’ll be far better informed when you do take your “badly behaving” cat to your vet for the next stage of help.

Old cat, young cat: a bittersweet episode in the life of a companion animal vet

Mrs Kennedy was an elderly widow, whose only companion was a small seventeen year old cat called Puss. Mrs Kennedy had phoned me because she thought that Puss had broken her leg after chasing another cat.

I wasn’t expecting anything too serious. Cats commonly hurt themselves while fighting with each other. An owner may think that the leg is broken, but in most cases the problem is a simple cat bite abscess, which can be easily treated. However, this time it was different. The owner was right.

Mrs Kennedy explained how a neighbouring cat had sneaked into the kitchen, and Puss had leapt up to chase it away. Immediately afterwards, she’d started limping, and since then she had barely moved from her bed.

When I touched Puss’s shoulder I could feel heat and swelling, and when I gently probed deeper, I could feel the rough ends of broken bone. I asked a few more questions, and it turned out that Puss had been drinking more than normal for a few months, and she had begun to be fussy about her food. She had also started to vomit occasionally. The pieces of the jigsaw began to fit together, and I explained it to Mrs Kennedy.

Puss is very elderly and at this stage in her life, her body is gradually failing her. Her main problem is that her kidneys have stopped working properly, which is why she has developed an increased thirst and a poor appetite. As a result of her kidney failure, her bones have become very fragile. Unfortunately, advanced kidney failure in a seventeen year old cat is not easily treated. And worse again, a broken bone in a cat like Puss cannot be fixed. At this stage, all of her bones will be as weak as egg shells. If she carried on, Puss would continue to suffer from further broken bones during normal activities.”

Mrs Kennedy sadly shook her head. “ So it’s time to say goodbye.” She knelt down beside her cat, and gave her a last, long hug. I gave the painless injection, and Puss quietly passed away, as her owner whispered into her ear.

Mrs Kennedy told me how Puss had originally been a wild stray cat. She had finally been tamed after months of coaxing her into the kitchen with food. She had been Mrs Kennedy’s closest friend, but she would never have another cat. She was elderly and she could not bear to think about what might happen if she died herself. I tried to tell her that somebody would look after her cat, and that this could be arranged in advance, but she just shook her head again. I felt very sad as I left her house.

Two weeks later, I received a call from someone who had a half-tame feral kitten in their garden. They were moving house, and they didn’t know what to do with it. An idea occurred to me. I collected the kitten, and drove on to Mrs Kennedy’s house. When she answered the door, I smiled and I said that I had something that might interest her.

Mrs Kennedy could not take her eyes off the kitten in the basket beside me. “He is just like Puss used to be –the poor frightened creature. Bring him inside”. She went to her kitchen cupboard and took out a tin of cat food. I stood back, as she spooned the food onto a plate, and opened the cat basket. The kitten licked the food hesitantly, and then began to eat heartily. As he ate, Mrs Kennedy chucked his cheek gently. He looked up at her, and to my surprise, he purred. A new friendship had begun.

Could your cat have high blood pressure?

High blood pressure is a common problem for humans but did you know that cats can get it too? High blood pressure, also known as hypertension, is actually quite common in older cats, especially those with other diseases such as kidney disease or hyperthyroidism. The symptoms can be quite subtle or mimic those of other diseases so many cases remain undetected for quite some time. If left untreated, however, hypertension can lead to significant secondary health problems, so it’s definitely worth testing for.

Bob having his blood pressure checked.

Bob having his blood pressure checked.

What exactly is high blood pressure?

High blood pressure occurs when the pressure within the blood vessels exceeds a certain threshold. Think of the hosepipe used to water your garden. If you turn the tap on too strongly, the water shoots out of the nozzle uncontrollably, damaging your flowers. The same is true for the body – organs like the brain and kidneys need blood to survive but if the blood pressure gets too high, it can start to damage the very organs it is trying to keep alive. To further complicate things, blood vessels have a tendency to leak under pressure and this extra fluid can cause further problems.

How do cats develop high blood pressure?

Many things can cause hypertension in cats from certain medications to neurological disease, but the two most common causes are kidney failure and hyperthyroidism. Both of these illnesses cause alterations in the very precise mechanisms that monitor and control blood pressure. It doesn’t always correlate with the severity of the disease (i.e., severe hypertension can be seen with only mild kidney disease) and in the case of hyperthyroidism, we sometimes see hypertension develop only after the thyroid problem has been treated.

What are the symptoms of hypertension?

The clinical signs associated with high blood pressure depend on which organs are most badly affected. One of the most common signs is acute blindness because the high pressure within the vessels of the eye causes the retina to detach from the nerves that tell the brain what the eye is seeing. So you may notice the cat bumping into things (although it’s amazing how many owners aren’t aware of their cat’s blindness because cats are so good at using their other senses to compensate), staying closer to home or having very dilated pupils or ‘wide eyes’. Another organ that is commonly affected is the brain so you might see serious signs such as circling and seizures or perhaps much more subtle behavioural changes such as crying out at night or being less sociable when people are around (how else would you tell if your cat had a headache?). You may see bleeding in unexpected places like nosebleeds or blood in the urine. It can also speed up the progression of kidney failure. The list goes on so any unexplained physical or behavioural change warrants a blood pressure check, especially in older cats.

How is high blood pressure diagnosed?

The only way to tell if a cat has high blood pressure is to measure it. The process is much the same as it is in humans – a cuff is inflated around the arm or leg (or possibly the tail) which controls blood flow to the limb. A special device (sometimes a handheld Doppler unit or sometimes an automatic sensor) then measures the blood pressure. It doesn’t hurt and isn’t usually a stressful process that is good because if the cat is stressed the reading can be artificially elevated. Sometimes the cat objects to the cuff being tightened so it can help to practice a few times before taking the reading. Some cats just plain hate going to the vet or any kind of restraint whatsoever so it isn’t always possible to get a reading, although many clinics have special protocols in place to help the cat stay as calm as possible before attempting to take a blood pressure. If all else fails in the clinic, a reading might be possible at home where they are more comfortable.

Is there any treatment?

Absolutely. There are several medications that can treat high blood pressure but the one that most vets use these days is called amlodipine. A very tiny dose goes a long way, and it’s important that once you start the medication, you give it regularly to avoid dangerous spikes in blood pressure. Once a cat starts the medication (usually a tiny tablet that most cats seem to tolerate relatively well) it’s important to follow up with regular blood pressure checks to ensure that they are on the correct dose.

I’ve seen many cats respond very well indeed to treatment and many owners report that their cat seems years younger once their blood pressure is under control, even if they hadn’t noticed any symptoms in the first place. It is yet another example of how well cats can hide their illnesses and how important it is for owners and vets to work together to detect health problems while there is still time to treat them effectively.

If you think your cat is showing signs of high blood pressure or if you have an older cat with unexplained physical or behavioural changes, please speak with your vet about having their blood pressure checked. You may never know unless you make an effort to look for it.


Communicating with pets: body language versus speaking English

One of the biggest challenges for vets is our lack of ability to have conversations with our patients. This isn’t always a huge problem: for example, if a dog has a broken leg, or a cat has an abscess, the problem is very easy to identify just by examining the patient. But we could still learn useful information from a verbal discussion. I would like to ask “How painful is it?”, or “Which cat attacked you?”. Treatment would also be easier to give if we could give our patients verbal instructions, such as “You must not chew this plaster cast off” or “You must let your owner bathe the sore area twice daily”.

Pain is a specific area where communication would be particularly useful. An animal in pain does not usually yelp or miaow. This only happens if the sore area is touched. More frequently, pain just causes an animal to become dull and quiet. If you could ask them, they would certainly tell you about the pain, but in the absence of language, you need to learn to interpret the more subtle signs of pain. Dilated pupils, an increased heart rate and rapid shallow breathing are all indications that an animal may be in pain. A better understanding of the non-vocal signs of pain in pets has led to much wider use of pain relief for animals, especially after surgery.

Over the years, vets have learned to understand the body language of their patients. If a dog holds his head to one side, he may have a sore ear. If a cat spends more time hovering near her water bowl, she is probably thirsty and may be suffering from kidney disease. A dog who stops wanting to go up steps will often be suffering from back pain. Close observation of animal body language can give plenty of information.

Owners also become very tuned in to their own pets’ attempts at communication. I have often been told that an animal ‘would almost talk to you’. Dogs in particular learn that if they behave in a certain way, they will get what they want, and they can be very persistent.

I know a Cavalier King Charles Spaniel called Chloe who always sleeps in the kitchen. Mrs O’Reilly, her owner, had recently started to put a big floor cushion on the tiled surface, to give Chloe a softer bed. After a few weeks, Chloe had learned the routine, and towards the end of the evening, Chloe recognised the signs that bedtime was approaching. The television was turned off, the doors were locked, keys were hung on the hook and finally Chloe’s cushion was put on the kitchen floor. Last week Mrs Reilly was away and her husband was doing the evening routine alone. He forgot about Chloe’s cushion! Chloe did her best to tell him that she wanted her cushion. Firstly, she followed him around, deliberately getting in his way so that he would surely know that she wanted something. When he did not understand, she went over to the cupboard where the cushion was kept, and she pawed at the door. He still did not get the message, and so finally she barked repeatedly at the cupboard door. Only then did the poor man understand what his dog wanted. As soon as he had placed her cushion in its usual place, Chloe contentedly lay down on it, and slept.

Pets cannot speak but they are much better than humans at using body language. If my dog could talk to me, the first thing he might say would be: “Why can’t you humans understand the most basic body language?”

Do vets charge too much for bitch spays?

As part of my work as a “media vet”, I’m a strong advocate for spaying and neutering pets as the best way to control the problem of pet overpopulation. Accidental pregnancies still account for a high number of unwanted puppies and kittens, and routine spaying/neutering of young adult pets is the best way to prevent these. This doesn’t meant that every pet needs to be spayed/neutered when young (there are some good reasons to delay or even not to do the operation for some individual animals), but it does mean that every pet owner should at least discuss the options with their vet around the time of puberty.

Why do people refuse to have their pets spayed?

People have a variety of reasons for not having the operations done on their pets, and the cost is a major factor. In a recent social media discussion, the following comment came in.

“Vets should reduce their fee to £120 for a female dog. A lot of people genuinely just can’t afford it.”

Why don’t vets reduce their fees?

This is a good point. Why don’t vets reduce the price of spaying? Let’s look at how this could be done: what makes up the cost of an operation, and how can those items be reduced?

To put this in perspective, what are the typical fees for spaying? The recent SPVS survey found that the median fee nationwide for an adult bitch spay was £204. There is significant regional variation on this, but the figure acts as a reasonable starting point for discussion. How could it be reduced to £120?

If you look at the pie chart at the foot of this page, you can see that over half of the costs of vets’ fees are made up of overheads that are difficult to reduce: rent, heat, light, phone, drugs, surgical supplies, cleaning, nurses’ wages and administration costs. Vets already do as much as they can to keep these costs down: it’s in their own interests to do so. So let’s leave these alone for the sake of this discussion.

So what about the obvious “top item” on the cost list for most people: the money that goes to the vet. Surely vets can manage with less? For every £10 you give the vet, typically only £2 to £2.50 goes to the vet. If a vet gives you a 20 to 25% discount, they are working for nothing. Vets are well enough paid, but their salaries are lower than most people expect. A typical new graduate vet earns around £30000, and a vet qualified for 20 years might earn £50000. Should vets work for less than that, with five years of tough training and high costs in getting through college?

For the sake of this discussion, let’s say yes, and agree that vets will operate for free on bitch spays: take 25% off £204, and you’re left with £153. What next?

What about VAT? The government charges 20% on all vet fees, making up £34 of the £204. If this was not charged, £153 minus £34 = £119. Bingo: it’s less than £120.

So if vets work for nothing, and the government agrees to stop charging VAT, the cost of a bitch spay would reach the desired target. Is this going to happen? Of course not.

In the real world, how can pet owners pay as little as possible for bitch spays?

So what can impoverished pet owners do? Here are three tips.

First, plan in advance. You should budget for the spay/neuter surgery when you get a pet, just as you should think about how much it will cost you to feed your new animal. If you genuinely can’t afford it, perhaps you should not get a pet. For the financially disadvantaged, there are some subsidised schemes to help, but charity resources are limited, and most of the working population will not qualify for these.

Second, shop around, but don’t do this on price alone. You should physically visit at least three vets, eyeballing the premises (are they clean?), talking to staff (do they seem to care?) and asking some specific questions:

• Do they have qualified veterinary nurses?

• Do they use up-to-date anaesthetic, pain relief and monitoring equipment?

• Does they monitor all pets after anaesthesia until they are awake?

You may not be fully aware of the “right answers” to these questions, but even just by asking the questions and judging the tone of the response, you will learn a lot about the practice.

Third, ask for a discount. Some vets may just say “no” ( this is understandable – it directly eats into the 20 – 25% that they are paid), but as in any other consumer transaction, there is no harm in asking the question.

If you think a bitch spay is expensive at £200, remember that it would cost around £5000 to have a similar operation carried out on a human. And if you want to help with the pet overpopulation problem, as well as benefitting your own pet’s health, it’s a price that’s well worth paying.

Elizabethan Collars – a necessary evil?


Elizabethan collars are named after clothing worn in the time of Queen Elizabeth I


One of my clients was talking about his recently neutered bitch today. “She needs one of those Victorian Buckets” he said. I knew what he was talking about, but his terminology was not quite correct. The problem was that his bitch had been licking her operation wound, and he wanted to stop her. The item he was describing is an important tool to assist the healing of animals’ wounds. It is more correctly called an ‘Elizabethan Collar’, because it resembles the white starched lace collars that Queen Elizabeth I and her subjects used to wear. Most people have seen animals wearing these large, lampshade-shaped cones, fastened around their necks and extending up around their heads.

Animals have a strong instinct to lick their wounds. In moderation, such licking can be cleansing and beneficial. The problem is that animals do not know when to stop. Excessive licking causes redness, soreness and itchiness, and this makes an animal want to lick a wound more and more. It is a vicious circle – the more licking , the more sore a wound becomes, and the more the animal wants to lick it. In the worst cases, a wound can be completely prevented from healing. Animals have even been known to cause themselves serious open wounds by biting and chewing itchy areas.

Drugs can be used to ease the itchiness, but they are seldom adequate alone. The only sure answer is the Elizabethan collar. These were originally home-made by vets, using pieces of cardboard, or by cutting the bottoms out of buckets. However, it was not always easy to create a finished product which was effective.

Modern pet Elizabethan collars are custom-made from shiny lightweight plastic. They are manufactured in different sizes, to suit anything from a kitten to a Great Dane. They have become more sophisticated as time has passed, and there is now a range of different products available. The traditional collars are made from white plastic, but these restrict an animal’s vision, causing animals to crash blindly around the house, bumping into people and furniture. Some modern collars are semi-transparent, to allow animals to see where they are going. We often advise people to line the outer edge of the collar with elastoplast, to blunten the sharp plastic edge which can otherwise cause painful scratches on an owner’s legs as an excited animal barges past.

Attaching the collar to the animal can be a fiddle – buckles and slots are fitted into place and the whole construction is strung onto the animals normal leather collar.

Owners sometimes feel that it is unfair to inflict these collars on their animals, but you only need to see one example of the serious damage which self mutilation can cause to realise how important it is to stop some animals from reaching their wounds.

Animals cope with the imposition of an Elizabethan collar in different ways. Most accept their fate sadly but in a quietly resigned fashion. Some Labrador-types seem to enjoy their new ‘hats’, and they dash around the room enthusiastically causing chaos as they bounce off walls, people and objects. Some cats do what I call an ‘Elizabethan Dance’, when they twist, leap and pirouette in an effort to escape the collar. After an initial uneasy settling in period, most pets do not mind this odd looking, but very effective structure.

There are, of course, a number of modern alternatives, from inflatable life-ring type products to neck braces to soft floppy collars. Some of them are definitely worth trying, but as is often the case in life, I suspect that the reason there are so many alternatives is that nobody has yet found the perfect way of preventing pets from interfering with their own wounds.

Antifreeze, the killer chemical of pets – don’t let yours be a victim.

Antifreeze, which often contains ethylene glycol, is very good at doing what it says on the bottle.  If you have ice on your windscreen or want to keep various pipes and water features from freezing up, then adding antifreeze will do the job.  What the bottle DOESN’T always say, however, is that antifreeze is so toxic to cats, dogs and other small mammals and that it takes only about a teaspoon in a cat or a tablespoon in a dog of the substance to bring about a rapid and unpleasant death.  In fact, a recent news article has highlighted the fact that around 50 cats a month in the UK are killed by antifreeze poisoning.

Why is it such a big problem?

Antifreeze is a commonly used chemical, especially in the winter months, but many people are unaware of the danger it poses to animals.  Even small children are at risk, because ethylene glycol has a sweet taste that most mammals wouldn’t think twice about consuming.  It can leak out of damaged car pipes and onto the drive where cats then lick it up, or perhaps a small amount of the substance was left in the bottle and left open after use.  Ethylene glycol can be found in radiator coolant, windscreen de-icing agents, motor oils, hydraulic brake fluid, paints, photographic chemicals and various solvents.  A worrying new trend is for people to use it in their garden water features to keep them from freezing – an extremely dangerous action as many cats and also wildlife use these features to drink from.  Unfortunately, some heartless people also use the substance to intentionally poison cats that get into their garden, and there are several cases of this under investigation at the moment.

How does it affect cats?

Initial signs include behavioural changes, such as looking groggy or ‘drunk’, which makes sense because the chemical binds to the same receptors as alcohol in the body.  These initial signs may only last for 1-6 hours, then they seem to recover but although they may appear to temporarily feel better, the real damage has already begun.  Ethylene glycol causes crystals of calcium oxalate to form within the kidneys and because these crystals cannot be dissolved once formed, the damage is irreversible and rapid kidney failure results.  Within hours to days the cat may start urinating more, then not at all as the kidneys shut down.  This results in a build-up of toxins within the blood causing severe lethargy and lack of appetite, panting, vomiting, oral or gastric ulceration and sometimes coma or seizures.  Death almost always occurs within a few days.

Is there any treatment?

If you are lucky enough to see your cat or dog ingest antifreeze and can get them to the vet within about 3 hours before the product has a chance to be metabolised, then treatment is possible though the recommended treatment is very expensive and most vets aren’t able to stock it.  Interestingly, one of the treatments for antifreeze toxicity is ethanol (aka the ‘vodka drip’ you may have heard about), as the alcohol prevents the ethylene glycol from binding to receptors in the body.  This treatment is dangerous in itself however, so the prognosis for recovery is still guarded.  If treatment is successful, affected animals will likely have to stay in hospital for several days on a drip to flush out any remaining toxins from the body and some degree of permanent kidney damage is likely.

What can we do to cut down on antifreeze poisonings?

The best thing you can do at home is to not use antifreeze that contains ethylene glycol.  Many newer products now contain propylene glycol, which isn’t nearly as toxic.  Have your car serviced regularly to ensure there are no leaks onto the drive, and if you do spot a leak, clean it up immediately and dispose of all waste or empty containers properly.  Many suppliers put bright fluorescent green dye into their products so it’s easy to spot in a puddle on the drive.  Most vets stock a UV or black light which makes this dye glow brightly and finding the dye on the cat’s paws or muzzle can be a good way to confirm exposure.  If your neighbour has a water feature in their garden, it might be wise to confirm that they are not using antifreeze and to inform them of the dangers if they are not already aware.  Another recommendation that has been suggested is to put a bitter-tasting substance (Bitrex) in the antifreeze so that any sensible animal or child would spit it out as soon as they tasted it, but not all companies regularly do this.  This would also cut down on intentional poisonings.  At the very least, all products containing ethylene glycol should be clearly labelled as being fatal to animals.

Spread the word – antifreeze kills!


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