Tuesday, April 28, 2009

Feline Stomatitis, Stomatitis in Cats

Dear Dr Gordon: I have a 3 year old Maine Coon cat that has a constant odor coming from the mouth. When I took him to the vet, she was able to look into the back of the mouth and show me my cat’s throat. I couldn’t believe what I was seeing. The back of my cat’s throat was raw and the gum tissue around the teeth was very red. The doctor convinced me to put my cat under anesthesia and biopsy the back part of the throat. All the teeth were cleaned and the biopsy revealed a disease (which I can’t remember) that the doctor says has no cure. I am worried that my cat will suffer his entire life with this sore mouth. Is there anything else that I can do? PB

Dear P.B.

Although it is possible that your cat may have some type of cancer in the back of the mouth (a disease that has no cure), I am hoping it is something else. You probably would have remembered if the doctor had said that your cat has a form of throat cancer. I suspect that the biopsy may have revealed a syndrome we see in a certain percentage of pure breed and mixed breed cats, called lymphocytic and/or plasmacytic stomatitis. Please call the doctor to get the name of the disease, for that can affect treatment and outcome.

It is essential to use immune support such as  Power Probiotic for your kitty to feel better. Probiotics can help restore the natural flora in the mouth and throughout the digestive tract.

Let’s dissect the words describing this syndrome. Stomatitis is an inflammation or infection in the mouth. Ok, so far so good. Lymphocytic and/or plasmacytic is a descriptive term illustrating the type of inflammatory cells that are migrating to this inflamed area.

What causes this infection/inflammation to occur in certain cats and not others? We are not sure.
Some viral infections are suspected of increasing the cat’s susceptibility to this disease. Your cat should be checked for the Feline Immunodeficiency Virus (FIV or Feline Aids virus) and the Feline Leukemia Virus. I suspect your doctor has already done this. If not, get it done. The virus does not cause the disease but makes cats more vulnerable to the disease. Others speculate that certain cats (ones that are genetically predisposed), are having an exuberant response to antigens or foreign invaders in the mouth. The suspected culprits are the bacteria inhabiting the tooth roots of some of these cats.

The syndrome is first recognized in fairly young cats that have halitosis (very bad breath, trouble swallowing, lack of appetite, and sometimes gagging). Examination of the teeth and back part of the throat reveals areas of extreme inflammation. It looks (and I am sure feels) like the worst sore throat you have ever had your entire life.

How is this dealt with? If the cat is FIV or FeLV positive, steps should be taken to insure your cat stays indoors and does not expose other cats to the disease. Oral antibiotics and frequent dental cleanings will help keep the mouth in good shape. Although controversial, acupuncture, interferon and lactoferrin can be used to improve the condition of the cat’s lesions. Supplements that we have seen help include Not Drops and Power Probiotic  If the cat is negative for these viruses, most veterinarians will use some type of strong immunosuppressive drug (like corticosteroids or others) to calm down the inflammation and analgesics to relieve the pain.

Although it may sound very extreme, sometimes full mouth extraction of the teeth is the only thing that will bring about relief and return the cat to a decent quality of life. I have seen several cases over the years that have completely resolve only by removing all of the teeth. Most veterinarians will only do this as a last resort, when all other therapies have failed after repeated attempts. I personally have been reluctant to recommend this procedure because it is difficult for the pet in the short term, expensive for the owner, and time consuming for the doctor. The long term success rate, however, leads me to believe that this may be the only thing that will save the cat from life-long pain and suffering.
Thursday, April 16, 2009

Hepatic Lipidosis "fatty liver" in cats


Dr. Dr Gordon: My cat is very sick. I took him to the vet because he had become very lethargic. After the vet ran some tests, he determined that my cat has “fatty liver” disease. My cat is very overweight to begin with, but I did not know that he could get this disease just by being “fat”. The vet said that treatment can be very difficult. Can you help me understand this disease? RK


Lypozyme is recommended by veterinarians to help cats with hepatic lipidosis. Lypozyme optimizes fat digestion and metabolism. 

Dear RK: I am very sorry to hear that your cat is not feeling well. From time to time, veterinarians encounter cats that develop fatty liver disease or hepatic lipidosis. This is a disease that is specific to the cat, since its’ dietary requirements and metabolism are much different than the dog’s metabolism. Let me explain.

If a cat, especially an overweight cat, stops eating, it can suffer serious liver problems. Cats are extremely dependent upon having protein in their diets. Unlike many species, cats cannot adequately synthesize their own protein from other building blocks. If a cat is not taking in enough protein, it will start breaking down proteins from its body, including important muscle and liver proteins. At the same time, the body is starving for energy, so it mobilizes fat stores for calories, and carries this fat to the liver for processing. Normally, the liver would metabolize these fats to use them for energy, store them, or secrete them through bile. If the liver is missing some of the proteins needed for fat metabolism, all a liver cell can do is store the fat. The fat builds up inside the cells, a condition called hepatic lipidosis, or "fatty liver,"and the cells swell, pinching off bile ducts. Bile, with all its waste products, cannot empty from the liver into the intestine as it normally does, and the cat becomes jaundiced.These changes in the liver occur within 36 hours of not eating. Since the liver cannot metabolize the fat for energy, the cat suffers further starvation, setting up a vicious cycle of fat mobilization and liver damage. Although this buildup of fat inside liver cells is often associated with diseases that cause decreased appetite, or metabolic disorders such as diabetes, we also see cases that are idiopathic, or have no identifiable underlying cause.

The diagnosis is made by doing blood tests that may first indicate an increase in the liver enzyme values. Usually an ultrasound exam of the abdomen should be the next step, which usually shows the liver that is extremely “shiny” on the ultrasound image. A fine needle aspirate can then be sent to the lab so that the pathologist can definitively diagnose the problem.

Treatment of the condition can be difficult. If there are any underlying diseases that are causing the cat to have stopped eating (infection, inflammation, etc.), these must be addressed to allow the cat to feel better. But the cornerstone of therapy is to get the cat to eat once again. Many times, this is more difficult than it sounds, for the cats in this situation usually do not feel well enough to have any appetite  and they need a lot of calories to offset the metabolic effects of the disease. To counteract this, the veterinarian will usually suggest syringe feeding a very high protein and high carbohydrate diet up to 4 times a day. Sometimes appetite stimulants are used to encourage eating. If the patient is resistant to syringe feedings, a special feeding tube may need to be surgically placed in order to provide the cat with adequate nutrients to reverse the process. Once the cat starts eating on its own, the feeding tube can be removed.

Fortunately, most cases of fatty liver are reversible with intense veterinary care. Although most cats present being very ill and lethargic, the majority are able to recover as long as they begin eating on their own. This may take several days of hospitalization at the veterinary clinic however. This underlies the importance of keeping cats at a healthy weight and realizing that any change in the cat’s normal routine or food, can cause the cat to stop eating, possibly resulting in “fatty liver”.
In addition to getting the cat on a healthy diet, supportive care using liver supplements can help. Products such as Pet Liver Rescue, Special SAMe and digestive enzymes containing lipase such as Lypozyme may be helpful in addition to the care provided by your veterinarian.
Wednesday, April 8, 2009

Dodger--An Adorable Cute Cairn Terrier Mix Needs a Home


Adorable, sweet Dodger needs your help. Dodger is a 1 year old Schipperke/Cairn Terrier mix. He is a very loving, sweet happy dog who only weighs 12 pounds. His fur is short, chocolate brown and easy to groom. He loves to ride in the car, as shown above and is good with other dogs. Please call Ariel Rescue at 949-499-9380 if you live in Southern California and would like to adopt him. More information can be found on www.petfinder.com under Ariel Rescue.
Adoptions have been slow due to the economy so please spread the word!
Friday, April 3, 2009

Arthritis in Dogs--NSAIDS and Joint Support Supplements


If your dog has been diagnosed with arthritis, is slowing down with age, limping or showing signs of difficulty getting up and down, it is important that you take your pet to the veterinarian for an examination. Quite commonly, your dog may be diagnosed with arthritis. In an effort to promote quality of life and keep the dog comfortable, non-steroidal anti-inflammatories (NSAIDs) will often be prescribed. Examples are Rimadyl, Metacam and Deramaxx to name a few. While these medications are helpful for chronic pain management, they do have side effects especially affecting the liver. This is why your veterinarian will often recommend that if your pet is using NSAIDs that your dog get a blood test every so often to check your dog's liver values. While NSAIDs can be very helpful and even critical for some pets that are in chronic pain, for most pets, there are holistic alternatives that should be tried first and/or in conjunction with their use. Many of our clients are confused about these medications and somehow think that because their dog is no longer limping or in pain, that the joint or limb problem has been cured. This is not at all the case--in fact, it is quite the contrary. The medication is actually reducing inflammation which is giving temporary pain relief.

To really help support your dog's long-term pain, mobility and joints, you need to use vitamins and nutritional supplements that are proven to help. Many minerals such as calcium, nutraceuticals such as glucosamine and herbs such as turmeric and boswelia have been shown to help. It is important to find combination formulas that contain a comprehensive mixture of vitamins, herbs and nutraceuticals.  We have had excellent success using Special SAMe along with the ArthroStride.   It is absolutely essential to use the Special SAMe if your dog has been using NSAIDs as long term use can compromise liver health.  Special SAMe is scientifically proven to help with arthritis and is a vital antioxidant to support the liver.  The ArthroStride includes key nutrients such as Curcumin and Omega 3s along with herbs such as bowelia and glucosamine to improve mobility and joint health. The Omega 3 fish oils found in Amazing Omegas help reduce inflammation and are derived from sardines and anchovies and are at a much more therapeutic level than salmon or other fish oils for pets. Many times using these nutritional formulas can be enough that the dog may only require NSAIDs after heavy exercise.

It is important that you use these formulas, if possible, as your dog starts to age, rather than waiting until the arthritis has set in. But, it is never too late to start with them and they can certainly be beneficial to use in addition to using NSAIDs. Many clients report that they were able to greatly reduce the frequency of using NSAIDs on their dog because of the benefits achieved from using these nutritional supplements.

Finally, acupuncture and chiropractic for dogs are also very important considerations. Ariel was able to run and jump at 14 years of age because of her weekly chiropractic and acupuncture treatments. To find a veterinarian who performs acupuncture in your area, go to www.ahvma.org