Tuesday, September 2, 2014

The Double Whammy: When Chronic Kidney Disease (CKD) and Hyperthyroidism Occur Together

Chronic kidney disease (CKD) is a common cause of illness in cats, especially in older cats, and the incidence is increasing.  In 1990, for every 1000 cats admitted to veterinary teaching hospitals, there were 45 cases of CKD.  In 2000, the number increased to 96 cases per 1000 admissions.  In my feline specialty practice, CKD remains the most common illness we encounter, and the most common reason for euthanasia.  

Hyperthyroidism is the most common glandular disorder in cats.  It is mainly a disease of elderly cats, with cats typically being around 13 or 14  years of age at the time of diagnosis.  Hyperthyroidism occurs when the thyroid gland, located in the neck, secretes an excessive amount of thyroxine, the main thyroid hormone in cats.  (Thyroxine is commonly abbreviated as T4.)  Untreated, hyperthyroidism can lead to heart failure and dangerous high blood pressure.

CKD is incurable.  With the exception of a kidney transplant, it is difficult or impossible to improve kidney function in cats with CKD.  The focus of treatment is to delay the progression of the disease, improve the cat's quality of life, and extend a cat's survival time.  This is usually achieved through a variety of dietary and drug interventions.    There are many treatment options for hyperthyroidism. In fact, depending on the treatment option, hyperthyroidism may be curable.  

Because both diseases are primarily found in older cats, it is not uncommon for both disorders to be present in a cat simultaneously.  In fact, most published reports indicate that about 10% of hyperthyroid cats have concurrent CKD at the time of diagnosis.  While the treatment of hyperthyroidism is fairly straightforward, and the methods for controlling CKD are well-established, treatment of thyroid disease in cats with concurrent CKD must be undertaken with caution.

Friday, August 29, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 10 – Our Last Day in Morocco

Day 10 –  Our Last Day in Morocco (Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8-1 Day 8-2 Day 9)

Hard to believe, but our last day in Morocco is upon us.  Today’s agenda is to explore as much of Tangier in one day as we can, and then head back home to our own cats, who we miss a lot. 

We started the day at the Gran Café de Paris.  With its tufted brown leather seats impeccable service, and walls covered with fading photos, you feel like you’re back in the ‘50s here.

This is a famous café.  Burroughs wrote here, and parts of The Bourne Ultimatum were filmed here.  The outdoor seats are a popular gathering spot to watch the paseo (the evening stroll that everyone takes) on the boulevard.  We sat outside and had a nice breakfast.

Across the street, just outside the French embassy, two kittens were playing non-stop, and they provided a good half hour of breakfast entertainment.

Monday, August 25, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 9 – Train Trip to Tangier

Day 9 – Train Trip to Tangier  (Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8-1 Day 8-2)

I’ve always wanted to visit Tangier.  The city is at the meeting point of two continents and two seas, and it defies comparison with any other city in Morocco.  For the first half of the 20th century, Tangier was an international city, with its own laws and its own administration.  It attracted a lot of writers, including Paul Bowles, the American novelist whose “The Sheltering Sky” is arguably considered the best travel novel ever written.  (After visiting the city, I read another book of his, “Let it Come Down”, which is set in Tangier, and which I really loved.)  William S. Burroughs spent much of the 1950s in Tangier, which he referred to as “Interzone” in his books.  He wrote Naked Lunch while living in Tangier.  Tangier was also the world’s first and most famous gay resort, favored by people like Joe Orton and Tennessee Williams. 

The city’s tourism future wasn’t looking too rosy for a while, though. Over the years, the city gained a reputation as a place to avoid, due to lots of sleazy characters who liked to prey on tourists.  The new king, King Mohammed VI, however, is a cool guy, and he promoted a bunch of renovation and building projects, including a new marina and remodeled port that aims to complete with some of the better known holiday ports along the Mediterranean. 

Day tripping Spaniards are a big part of the tourist market, as Tangier is just across the Strait of Gibraltar.  Other first time visitors, however, might be in for a rude awakening, as mobs of faux guides and bona fide hustlers greet the arriving ferries and immediately start figuring out how to separate these tourists from their money.  I had done my reading, though, and I was prepared.

We left Fez early in the morning and caught the 10:30 train to Tangier.  Again, we had a first class ticket, and we had the travel compartment almost entirely to ourselves.  Before we knew it, it was 2:55 p.m. and we had arrived in Tangier.  The train station is located two miles west of town.  We grabbed a cab and were soon at the famous El Minzah Hotel.

Thursday, August 21, 2014

It's Take Your Cat To The Veterinarian Day - August 22nd, 2014!

Friday August 22nd, 2014 is Take Your Cat To The Veterinarian Day!

Might I suggest Manhattan Cat Specialists if you are in New York City.  212-721-2287 for an appointment.

Did you know that approximately 10% of pets presented to veterinary clinics for annual check-ups have some underlying disease or abnormality? Most of these pets appear normal on their physical examination, and therefore any abnormalities go undetected without a wellness health screen. That's why I recommend a physical examination for your feline twice a year for life.

Friday, August 8, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 8, Part 2 - The Donkeys of Fes Need You!

Dr. Plotnick's Moroccan Cat Adventure - Day 8, Part 2 - The Donkeys of Fes Need You! (Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8-1)

After visiting the Royal Granaries in Meknes, we decided to skip the medina in Meknes.  It was a tough decision, but we had hired our driver, Naji, just for the day, and we had to decide what to do:  explore the souks and food stalls in the Meknes medina, or visit the American Fondouk, a veterinary hospital just outside the Fes medina.  For me, this was an easy decision.  I’m a veterinarian, and I was struck by the number of stray cats in the cities we visited, and how so many of them are in ill health.  I was also very aware of the number of mules and donkeys in the Marrakech and Fes, and was anxious to learn about their veterinary care as well.   Naji wasn’t sure of their operating hours, but we were willing to risk it.

The drive back to Fes was about 90 minutes.  As we got close, Naji pointed out a white compound with tall green hedges all around it.  “There it is”, he said.  I spotted the American flag alongside the Moroccan flag.

Obscured by the hedges was the sign identifying the building.

As we approached the imposing door, we saw the posted hours.  Open from 8:00 a.m. to 12:00 noon.  I looked at my watch.  4:30.  Sigh.  Naji could see the disappointment in my face.  So he tried something radical.  He knocked on the door.

Thursday, August 7, 2014

Signed Copies of The Original Cat Fancy Cat Bible Available at Manhattan Cat Specialists

The Original CatFancy Cat Bible

The Definitive Source for All Things Cat

by Sandy Robins with Arnold Plotnick, MS, DVM, ACVIM, Lorraine Shelton, and Sarah Hartwell 

Pick up a signed copy of The Original Cat Fancy Cat Bible at Manhattan Cat Specialists.

Or you can purchase an unsigned copy on Amazon:

Tuesday, August 5, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 8, Part 1 - Meknes and the Roman ruins of Volubilis

Day 8, Part 1 - Meknes and the Roman ruins of Volubilis (Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7)

Fes’s location allows for some neat day trips.  A popular destination from Fes is the city of Meknes and the Roman ruins of Volubilis.  Mark and I have always enjoyed Greek and Roman ruins, and the ruins and Volubilis were said to be impressive.  So much so that the site was a key location for Martin Scorsese’s film The Last Temptation of Christ. 

I made reservations in advance with a tour company, and on the morning of our third day in Fes, we were met at our riad by Naji Redouane, our driver. The van he was driving was equipped to hold six passengers, and I knew that there was a possibility that we’d be touring with a small group, but as luck would have it, Mark and I were his only passengers and we had the van to ourselves. 

The drive to Volubilis was about 90 minutes. Most of the drive was like the drive from Marrakech to Essaouira: brown, dry, and boring, however, as we got closer, a spectacular vista appeared on our right.

Naji, having made the drive countless times, knew it was coming up, and stopped for us to stretch our legs and take in the view.

Thursday, July 24, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 7 - Last Day in Fes

Dr. Plotnick's Moroccan Cat Adventure - Day 7 - Last Day in Fes (Day 1 Day 2 Day 3 Day 4 Day 5 Day 6)

Today our itinerary was simple.  Just stroll through Fes with no sites in mind and no agenda to speak of.  There’s 9600 streets and alleys.  Plenty to explore.

We made our way to Bab Boujeloud, but this time we veered right, onto the other main artery, Tala’a Sghira, to see what we’d find.  The first stretch consists of another market.  I saw one of my favorite sites again, a butcher stall with cats politely, if impatiently, waiting below.

We arrived at the Attarine medersa.  Attarine medersa translates to “Koranic school of the Spice Sellers”. This medersa is not as awesome as the Bou Inania medersa, but its graceful proportions, elegant geometric carved-cedar ornamentation and excellent state of preservation (it’s from the 14th century) makes it a really great example of Moorish architecture.

Monday, July 21, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 6 - Full Day in Fes

Morocco Day 6 - Full Day in Fes (Day 1 Day 2 Day 3 Day 4 Day 5)

After last night’s foray into the hectic maze that is Fes, I was ready to tackle it head on.  Take a look at this map

Your best bet is to make your way to the main entry gate to the medina, Bab Boujeloud, which is depicted as an arch in the lower left corner.

Lots of signs pointing to it, so finding it wasn’t too tough.  From there, the road splits into the two main road in the medina, Tala’a Kebira, which meanders north, and Tala’a Sghira, which runs sorta parallel to the south of Tala’a Kebira, before eventually heading north and intersecting with it.  Tala’a Kebira is the road with most of the good stuff. 

We headed to just outside the medina, and started our first full day in Fes. 

Tuesday, July 15, 2014

Dr. Plotnick's Moroccan Cat Adventure - Day 5 - Fes

Day 5 – Goodbye Marrakech, Hello Fes.   (Day 1 Day 2 Day 3 Day 4)

Today is a bittersweet day.  We were sorry to say goodbye to fascinating Marrakech, but excited to check out Fes.  We woke up early, took one last look at our beautiful riad from our balcony, and one last look at the lovely balcony outside our door.

We bid Sara and her brother adieu.  Anyone traveling to Marrakech would be guaranteed an excellent time if they stayed at Riad Tamarrakecht.  Sara and her brother really made the trip a pleasure.

Now we’re off to the train station.  Track 3.  Destination: Fes.

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