Wednesday, June 30, 2010

Cognitive Dysfunction in Cats: When Kitties go Senile

Cognitive Dysfunction Syndrome in Cats
by Arnold Plotnick MS, DVM, ACVIM, ABVP

Orlando Adan was used to his cat meowing a lot. From the day he adopted her, Roxy was a talker. The meowing continued as the years went by. In fact, she became even more vocal as she aged. It was part of her charm, and Orlando never failed to be amused by the little “conversations” that he and Roxy had experienced over the years. A week after her 18th birthday, however, Roxy’s initiated a conversation that was a bit different than most.

“I was upstairs reading, and Roxy was downstairs, in the kitchen. She started meowing for food, as usual. But this time, there were subtle differences. Her crying was a bit more urgent, a bit more strained. It wasn’t her ‘feed me” meow. Call me crazy, but after 18 years, I know my cat pretty well.”

Orlando went downstairs to find Roxy sitting in the narrow space between the refrigerator and the dishwasher, staring off into space with an odd expression. “Roxy used to get between the fridge and the dishwasher and hide, and when I passed by, she’d leap out and surprise me. It’s a game we’ve played for years”, he explained. “This time, though, she was staring ahead with a vacant, almost blank look in her eyes, meowing as if she had no idea where she was. And what was even more upsetting,” he laments, “was that she seemed confused as to who I was, too”.

As pets get older, they will sometimes experience a decline in cognitive function. Changes in memory, learning, perception, and awareness are well documented in aging people, and similar changes have been described in aging companion animals. In dogs and cats, this decline may manifest itself in several ways. Forgetting previously learned behaviors such as housetraining, acquiring new fears and anxieties, failure to recognize people, places, and other pets, altered sleep-wake cycles, and acting generally “disoriented” are the most common behavior changes described by owners of aging pets. Not all of these behavior changes are due solely to cognitive dysfunction, however. While primary behavior problems may develop in aging cats and dogs, the possibility of an underlying medical condition should first be considered. “I took my cat to my veterinarian as soon as Roxy started acting weird”, notes Orlando. “Aside from the expected physical problems – dirty teeth, mild kidney failure – she was in pretty good health. My vet said that this one incident of bizarre behavior wasn’t enough to make a certain diagnosis, but he felt that Roxy probably had Cognitive Dysfunction Syndrome, a condition that dogs and cats sometimes develop as they age”.

Cognitive Dysfunction Syndrome (CDS) is a clinical syndrome defined as the development of one or more geriatric-onset behavior problems that cannot be attributed to an unrelated medical condition such as cancer, infection, or organ failure.

Although most studies of CDS have focused on the condition in dogs, the occurrence of the syndrome in cats has become a hot topic of study in recent years. Amy D. Shojai is the author of more than a dozen pet books, including “Pet Care in the New Century: Cutting –Edge Medicine for Dogs and Cats”. She is currently researching CDS in cats and dogs. “I hear owner concerns all the time about older cats (greater than 9 years old) having lapses in litter box allegiance, crying or howling especially at night, staring into space, not seeming to recognize people, places, or animals, pacing aimlessly, getting lost in corners of rooms, and ‘forgetting’ how to do normal behaviors”, says Shojai. “One woman described how her cat seemingly forgot how to eat! Smokey, a 17 year old cat, stood over the food bowl and simply looked confused until he was prompted with a finger-tap against the bowl to take a taste. Another owner with a 15 year old Manx described looking into her cat’s eyes and there being ‘nobody home’”.

There haven’t been very many studies of behavior problems in aging pets, especially cats. One unpublished study in 1998 showed that 55% of cats aged 11 – 15 years develop at least one geriatric-onset behavior problem, and that the percentage increases to 80% for cats aged 16 – 20. Disorientation in particular is seen in 2.5% of cats aged 11 – 15, and dramatically increases to 40% of cats aged 16 – 20! Shojai’s review of the handful of published cat studies shows a similar trend, namely, that the incidence of behavior problems in cats increases greatly with age. Dr. Debra Horwitz is a board certified veterinary behaviorist. She tells of a study presented at the American Veterinary Society of Animal Behavior last July in which 45 of 152 cats aged 11 years and older demonstrated signs consistent with cognitive dysfunction. “When the cats were further divided into those aged 11 – 15, and those age 15 and older”, she reports, “the cats in the older group showed even more signs of cognitive dysfunction per cat than the younger group”. While cats show similar types of geriatric-onset behavior problems as dogs, the percentage of cats that are affected with CDS is much lower. “Bottom line”, says Amy Shojai, “is that cats age very gracefully!”

Exactly why pets develop behavior problems when they age is not fully understood. Several theories have been put forth. The threshold theory basically asserts that an individual animal will tolerate a certain number of stimuli without actually exhibiting a behavior problem. When a stimulus exceeds the threshold, or if multiple stimuli combine to exceed the threshold, behavior problems may be seen. For example, a cat that is fearful may not exhibit undesirable behavior such as aggression until another stimulus (for example, pain from dental disease) “pushes” the cat beyond the threshold to a point where behavior problems are manifested. Alternatively, some medical conditions might “lower” the threshold. This lower level of tolerance is especially significant in aging pets, as organ function begins to weaken, sensory awareness begins to decline, and age-related central nervous system pathology begins to develop. True brain pathology, including accumulation of a substance called amyloid within the brain and associated blood vessels, has been seen in humans with Alzheimer’s disease, and similar findings have been described in dogs and cats. The brain of a cat may become chronically deprived of oxygen due to slowly declining heart function and/or high blood pressure (common in older cats with renal failure and/or hyperthyroidism). Examined microscopically, the brains of these cats show cerebral atrophy and a decrease in the number of neurons. It can be difficult to differentiate which changes are normal, expected changes and which ones are pathological and may be contributing to the clinical signs of CDS. There are also a number of neurochemical changes that occur in the brains of aging cats and dogs, such as alterations in the levels of dopamine and serotonin, two chemicals that affect mood and behavior. There are no simple explanations when assigning a cause for the development of geriatric-onset behavior problems.

Treatment options for cats with Cognitive Dysfunction Syndrome are limited. In early 1997, Canada gave approval for the use L-deprenyl, a drug used in humans with Parkinson’s disease, for the treatment of canine CDS. The drug had already been approved for use in the United States (and Canada) for treatment of canine Cushing’s disease, a disorder of the adrenal glands. The drug is now approved for use in CDS in the United States, but only for dogs. There are currently no drugs specifically licensed in North America for the treatment of cognitive dysfunction in cats, however, drugs that help normalize the levels of neurotransmitters that become depleted as cats age, such as dopamine and serotonin, as well as drugs that increase blood flow to the brain, hold promise for cats. Although there are no published studies on the use of L-deprenyl in cats, anecdotal reports of cats being given the drug off-label suggest that some cats might benefit from this drug. Cat owners should be aware that administration of medication that is not approved for use in that particular species is considered to be “extralabel” usage, and cat owners are asked to sign a form stating that they understand this and are willing to assume the risks involved.

Orlando decided not to take risks with Roxy. “I spoke to my veterinarian at length about this, and we decided to not prescribe any medication, since these episodes don’t occur very often, and she’s fine in every other way”, he says. “I’ve had her for 18 years, and I can deal with her being a space-cadet every now and then.”


Signs of CDS Description

Disorientation Appears lost or confused, doesn’t recognize familiar people, places, or other pets in the house
Altered interaction with family Solicits attention less, has less tolerance for petting

Decreased greeting behavior No longer greets owners, or shows a less enthusiastic greeting

Change in sleep-wake cycles Sleeps more overall, but sleeps less at night

Change in activity Demonstrates more aimless activity, such as wandering or pacing

Loss of housetraining Urinates or defecates inappropriately; signals less to go outside (dogs), fails to use the litter box consistently (cats)

Tuesday, June 29, 2010

Sticky urine and foamy vomit. Welcome to my world.

A Japanese client brought in her cat today because she thought that he was walking funny and that his rear end was painful. The client was sitting in the waiting room with the cat, a big fuzzy black Persian, on her lap. We called her into the exam room, and as she was carrying him to the room, unbeknownst to her (and us), he had started to urinate. By the time we all noticed, he had left a nice little stream on the floor. We quickly placed him on the exam table, where he deposited a bit more. Before we wiped it up, I sucked up some of it into a syringe, just in case we needed a sample later on.

I began to examine the cat when my assistant, Kamilla, who was cleaning up the urine stream in the hallway, informed me that the urine was sticky. I grabbed the syringe with the urine, and put a drop on a urine dipstick. In ten seconds, the pad turned from green to brown. Brown means sugar. Diagnosis: diabetes. Another good example of how you don’t always need fancy equipment or tests to make a diagnosis. Interestingly, the cat did not have any of the classic signs of diabetes. He wasn’t drinking a lot, urinating a lot (not counting the river he created on our floor), ravenously hungry, or losing weight. I would have performed bloodwork on him regardless, since he was 13 years old and we hadn’t seen him in two years, and I would have detected that he was diabetic when the results became available tomorrow, but the sticky urine led me to the diagnosis today. Kamilla gets credit for that diagnosis. Thankfully, I had my Japanese technician Hiromi with me to help explain the home care of diabetic cats.

[In case you were wondering, the painful rear end turned out to be an anal gland abscess that was about to rupture. The cat had a sizzling hot fever (104.4 F), and he cried when you touched his rear end on the left side. We sedated him, pierced the area with a scalpel blade, and boy oh boy, you should have seen the pus flow! Be grateful that I didn’t videotape it.]

A second interesting case had to do with Billy, a cat that we diagnosed with lymphoma a few weeks ago. I believe I mentioned him in a previous blog post. His case of lymphoma was odd. It was in a single lymph node. This is an unusual presentation. I consulted with an oncologist colleague of mine, and she said that lymphoma in a single lymph node is often seen in cats with FIV. This cat’s history fit the bill – he used to go outdoors all the time and get into fights with other cats. I asked the client if I could run the test, and she said okay. Sure enough, he tested positive. In fact, the FIV spot on the in-house test turned positive even quicker than the positive control. The client is now trying to decide whether to continue with the chemotherapy or not. Cats who have lymphoma and are FIV positive will go into remission, just like cats who are negative for FIV, however, their remission doesn’t last as long. She’s not sure whether it is worth putting her cat through chemotherapy if his remission is likely to last only a few months. Tough decision.

This morning I checked my e-mail, and was delighted to receive three photos of cat vomit. One of my clients’ cat had vomited three times last night, and my client was compelled to photograph the vomit spots and pass them on to me. I don’t imagine there are too many jobs that involve receiving cat vomit pictures. All in a day’s work, I guess.

Monday, June 28, 2010

Nobody Nose the Trouble I've Seen

A sad day. Another euthanasia. A cat named Lilly. A very interesting case. Lilly was a Maine Coon. Eighteen months ago, Lilly developed signs of an upper respiratory infection. Her breathing became very noisy. She sounded like a bulldog, in fact. Whenever cats have breathing this noisy, it often means that something is present in the nasal cavity. Treatment with antibiotics had minimal effect. In order to figure out what was really going on, we needed to do rhinoscopy. This is a procedure requiring anesthesia. Lilly’s owner agreed to this, so we called Dr. Hopper, the traveling ultrasonographer/endoscopist, and scheduled the appointment.

On rhinoscopy, things looked abnormal. The right nasal passage was swollen, reducing the flow of air through the nose. No masses were seen, though. Biopsy specimens were obtained. Dr. Hopper felt pretty certain that this was a case of lymphosarcoma, a type of cancer. I prepared the owner.
Surprisingly, the biopsy came back as chronic rhinitis – inflammation of the nasal cavity. No cause was determined. This was very frustrating, because “chronic rhinitis” is a pretty vague diagnosis. I mean, duh, it’s pretty obvious that there is rhinitis going on. We needed to know why.

About a week later, we re-examined Lilly, and upon looking in her mouth, I noticed a small growth on the roof of her mouth. This was definitely not there before. We had gotten a pretty good look at the roof of her mouth during her rhinoscopy, when we had to intubate her. Whatever was in her nasal cavity that was not detected during the rhinoscopy was starting to break though the roof of Lilly’s mouth.

I recommended that we snag a biopsy of the mass that was starting to protrude into Lilly’s mouth, but understandably, cost was becoming a concern. These diagnostic procedures are not cheap. With all that money spent on anesthesia and rhinoscopy, was there some other option?

I felt very certain that this mass was lymphosarcoma. Nasal lymphosarcoma is a very common cancer in cats. I suggested that we go with our best guess: the mass is lymphosarcoma, and that we begin the chemotherapy treatment. Nasal lymphosarcoma is very chemotherapy-responsive, and if we’re right, we should see a response fairly quickly. Lilly’s owner agreed.

We began Lilly’s chemotherapy. The chemo protocol we decided to use was a standard protocol that involved weekly intravenous injections for the first four weeks, and various oral medications. The intravenous injections had to be administered very precisely. The drug we were using, vincristine, is a fairly mild, but very effective drug. Cats tolerate it very well, but if you don’t place the intravenous catheter perfectly and some of the drug leaks out into the surrounding tissue, cats will develop a horrible, terrible, disastrous skin reaction. Thankfully, we didn’t have to worry about this with Lilly, because she was the absolute best cat ever, when it came to her chemotherapy. She sat there quietly on the table, giving us her front leg almost willingly, and never flinching or protesting as my technician placed the catheter. We never had to poke Lilly a second time; she was so well-behaved that her cathethers went in smoothly and easily every time. Lilly’s owner leans toward the spiritual/organic/zen side, so she was pleased to hear that vincristine comes from the periwinkle plant. “Tincture of periwinkle” was what we cheekily called it from that point on.

One week later, Lilly was back for her second treatment. Lilly’s owner reported a dramatic improvement in clinical signs. No more bulldog-breathing. I opened Lilly’s mouth. The mass was gone! After just one treatment! I do not like to use a response to therapy as a way to make or confirm a diagnosis, but that was the path we had chosen, and we were right. Lilly’s response was dramatic.
And so it went. After four weeks, Lilly was in complete remission. She was to come back every three weeks for maintenance chemotherapy. The chemotherapy made her lose a lot of her hair (not something that happens often), but other than that, she did great. Her weight fluctuated a bit, and her appetite waxed and waned, but every time I looked at the roof of her mouth, it was normal. Lilly motored along on her chemo. Month after month after month.

One month ago, Lilly came in for another round of maintenance chemotherapy. This time, however, her physical exam was not normal. A lump was evident on the right side of her neck. A nearby lymph node was also enlarged. The cancer was back. A biopsy of the lump confirmed our suspicions: high grade lymphosarcoma.

Although Lilly was out of remission, she was doing pretty well. The mass on the roof of her mouth had not returned, and her breathing was normal. Her appetite was okay, and he weight was fairly stable. After some discussion, it was decided to try to induce another remission using a different chemotherapy protocol. The protocol I chose included the drug doxorubicin, a very effective (but pretty nasty) chemo drug.

Once again, Lilly took her chemo like a champ, never complaining, never resisting. The following week, the node in her neck was unchanged. The week after that, the node was larger. The week after that: still larger. These cancer cells were not like the first population of cancer cells. These ones were resistant. Lilly was losing weight, and her appetite had dropped.

I consulted with an oncologist colleague of mine. Radiation therapy was one option, he said. Lymphosarcoma is a very radiation-sensitive cancer, and this might shrink that lymph node. This, though, was cost-prohibitive. Another chemo protocol was suggested, but the drugs in this protocol were super-expensive. A third chemo protocol, using a drug called CCNU was discussed, and this seemed the best. The drug is a capsule, given orally every few weeks, and the oncologist had reasonable success with it. I was ready to give it a try, especially for a sweetheart like Lilly. We were set to start her new chemotherapy protocol in a week.

Lilly, however, was doing poorly at home. The cancer was taking its toll. She was losing muscle mass. Her appetite was gone. All of the spirit and joy that had possessed Lilly for years was gone. After battling cancer for 18 months, it was time to stop.

And so, this afternoon, I saw Lilly for the last time. We took her out of her carrier. In just a few days, she had lost even more weight, and was weak and scrawny. I’m used to seeing Maine Coons as giant, fluffy teddy bears. Lilly was just a shell of her former self now. She looked defeated. She was ready. Once again, she took her injection, her final one, with no complaints, no resistance, no struggle. Both of her owners were right there with her, and she passed away peacefully and quietly. You get pretty attached to a cat that you see at least once-a-month, and my staff and I became very fond of Lilly, admiring her low-key strength and bravery.

Cat Man Do

Friday, June 25, 2010

Cats vs. Horses (and Palpation)

I examined a cat belonging to a veterinary school classmate of mine, Mike Galvin. The cat was brought in by Mike's very nice girlfriend. I was bummed that Mike wasn't with her. I hadn't seen Mike in about 20 years. Mike couldn't make it to the appointment because he had to be at the racetrack. You see, Mike is an equine veterinarian. Of my 81 classmates, he was probably the most equine-oriented of the bunch. He knew exactly what he wanted to do after he graduated. I, on the otherhand, was what the large-animal oriented classmates referred to as a "P's and K's" - puppies and kitties veterinarian. Horses, cows, sheep, goats, pigs... I like 'em, but it was pretty clear that I was not cut out to work on them.

Thinking about Mike and the horses reminded me of something funny that happened when I was in veterinary school. We had just finished a class in equine reproduction. In the class, we were being taught how to palpate the horses. Allow me to explain what this involves. You put a thin plastic glove with a sleeve that goes all the way up your arm to your shoulder, generously apply lube, and then insert your lubricated hand and arm into the horses rectum, all the way to your shoulder, and feel for the ovaries and uterus through the rectal wall. With this method, it is possible to feel for follicles on the ovaries, feel a fetus in the uterus, etc.

 Not my cup of tea, I can tell ya.

After the class, there was a quiz for us: three horses, side by side in their narrow chutes, with a quiz question written above each horse. Above the third horse was the question, "Which ovary is bigger - left or right?" A few of my tobacco-dippin', large-animal oriented, skeet-shooting classmates palpated the horse, and then started chatting amongst themselves. "The left one, definitely". "No way, the right one is obviously bigger". Meanwhile, I'm feeling and feeling, and I just can't find 'em. Dr. Asbury, our professor, was standing nearby. "Dr. Asbury, I know we've been practicing this all day, but I have to tell you", I said, sheepishly, "I can't find 'em. I'm sorry!" "Ah, don't worry about it today. Just practice a bit more when you can." After a bunch of us finished this informal quiz, Dr. Asbury asked for the verdict. "The left one", said one of the tobacco chewers. "No, no, the right one, you idiot", countered another. After a few more minutes of bickering, Dr. Asbury yells out to them, "You blowhards are so full of crap! Look closely at this horse". Dr. Asbury opened the door of the chute, so you could now see the underside of the horse. "It's a male", said an exasperated Dr. Asbury. Then he points to me. "At least Plotnick was honest when he said he couldn't find the ovaries. I don't know what you other guys were feeling in there, but Plotnick is the only one of ya who got it right!"

Score one for the P's and K's.

Cats Rule!

Thursday, June 24, 2010

Careful with that Insulin

Recently, I saw a case as an emergency. A diabetic cat was coming in, very lethargic, barely moving, not eating. The cat, Phil, was a 14 year old domestic shorthair, receiving 5 units of PZI insulin twice daily. I had examined the cat just one week before, and performed full bloodwork. The cat was in great shape, and the diabetes was very well regulated.

The cat arrives, and indeed, he's not right. He's too weak to stand, and is mentally stuporous, staring off into space, not reacting to his environment. Immediately, I reach for the glucometer and measure his blood sugar. In ten seconds we have our answer. His blood sugar is a frighteningly low 30 mg/dl. Diagnosis: insulin shock.

This is strange. Phil was perfectly regulated a week ago. What the heck is going on?

Apparently, Phil didn't eat this morning, but he was given his insulin injection anyway. There's the problem. You shouldn't give insulin if you're not eating. The insulin will lower the blood sugar, and without any food to counteract it, the blood glucose will plunge, causing the cat to become weak, uncoordinated, and spacey.

I asked the owner how the cat was behaving the day before. He was fine, I was told. He ate the previous morning like a normal cat. How about that evening? Not sure, he said.

I admitted the cat to our hospital, and put in an intravenous catheter. I grabbed the bottle of 50% dextrose (basically, just some sugar-water), and gave 4 cc intravenously. About two minutes later, the blood glucose was 137. Normal. We offered the cat some food, and he scarfed it down as if he was a stray cat. The plan now was to monitor Phil's blood sugar throughout the day. The 5 units that he was given that morning would be out of his system soon enough, and he should return to his old self. I was still puzzled as to why this happened. Why would a cat who was so nicely regulated just a week before suddenly crash like this.

Upon further questioning, I found out from the owner that they had recently taken the cat to their summer home, and had brought the cat to the local veterinarian for an exam and vaccines. The owners were running out of insulin and decided to pick up another bottle at the local vet. The owner showed me the bottle, and my technician Hiromi immediately spotted the problem.

The insulin we use is called U-40 insulin. This means that every cc contains 40 units of insulin. The insulin that Phil's owner had obtained was made by a compounding pharmacy. Right on the label, plain as day, was our answer. "PZI insulin, U-100". This insulin is 2.5 times stronger than our standard insulin! Phil didn't receive 5 Units that morning. He received 12.5 units! Lemme tell ya, that'll bring your blood sugar down pretty effectively.

Phil was on a bit of a rollercoaster throughout the day. After his blood sugar injections, he became a new cat. Bright, alert, aware. He also ate ravenously. But as the injections wore off, he sunk back into a stuporous state, and blood sugar measurements revealed a relapse back into hypoglycemia. As closing time neared, it was clear that the insulin that he was given was still very active, and that Phil needed overnight monitoring. I sent him to our favorite emergency facility for this. He'll return to our hospital in the morning for continued monitoring. Phil is going to do fine once the insulin wears off, and re-regulating him should be no problem. My recommendation to the owner: throw that other bottle of insulin in the trash!
(P.S. He did).
Cats rule!

For my published article on diabetes, click here

Thursday, June 17, 2010

‘Catios’ Bring Cats Outdoors - Dr. Plotnick gets a mention in the New York Times!

Tony Cenicola/The New York Times

‘Catios’ Bring Cats Outdoors

WHEN it comes to their homes, there are few things New Yorkers prize as much as a little outdoor space — a terrace, perhaps, or a small deck in the backyard.

Their cats feel the same way.

So some cat owners who would never dream of letting their pets roam free outside have come up with a creative compromise: an enclosed space — usually in the form of a screened-in porch or deck — that allows them to share the great outdoors.

Please don’t call it a cage. They prefer the term “catio.”

[Read the Full Story HERE]

Top 5 Summer Cat Health Concerns

Top 5 Summer Cat Health Concerns

By Karen Asp

Summer may be your favorite time of year, but for your cat, this season can mean a host of health troubles. Fleas top the concerns, along with others that can make these months miserable for your feline. Here's what you need to know to tackle cat health threats:

No. 1: Fleas
Fleas thrive in summer heat and humidity. Although over-the-counter products and flea collars may help, topical prescription medications offer the best protection, says Susan Nelson, DVM, clinical assistant professor at Kansas State University College of Veterinary Medicine. The medication is applied directly to your cat's skin to kill existing fleas and prevent future infestations. The length of time to apply this medicine depends on where you live, so be sure to consult with your veterinarian. Flea medicine isn't just for outdoor cats, either. "Indoor-only cats should also be on flea prevention medication, as fleas could enter your home on your shoes, clothes or via an outdoor pet's fur," says Dr. Nelson.

No. 2: Allergies
Excessive scratching, biting at the base of the tail and red, inflamed skin are allergy symptoms. The most likely triggers? Fleas and pollen. For allergies related to the latter, cut your cat's exposure to pollen by regularly changing air conditioning filters and washing your cat's bedding, dusting, vacuuming and keeping your cat inside at all times, says Diane Delmain, DVM, medical director of Bay Hill Cat Hospital in Orlando, Fla. Your veterinarian may also prescribe medication or give allergy shots to treat pollen-related health problems in your cat.

No. 3: Hairballs
Although spring is the main shedding season for cats, indoor cats also shed when it's hot, ingesting more hair and spitting up hairballs. Frequently brushing your cat helps. You can also investigate some of the hairball prevention products on the market, including flavored lubricants, treats and fiber tablets. "It's a matter of finding one that both the cat and the owner agree upon," Dr. Delmain says. 

No. 4: Heat-related Illnesses
Dehydration and heat stroke can plague pets. Although they are less likely than dogs to be in situations where heat is an issue, cats can still get sick from heat. Traveling or having to leave your cat outside for extended periods -- such as while you're having your house worked on -- could put your pet at risk. Always make sure your cat has water and a cool place to rest. If you have air-conditioning, keep it running during heat waves. If you don't have air-conditioning, turn on an indoor fan. And if you're traveling by air with your cat, check the airline's policies about warm-weather travel. (Some airlines won't let pets fly if the temperature is too high, simply because the heat may cause illness or even death.)

No. 5: Fireworks
Although we tend to associate fireworks with Fourth of July, these colorful yet noisy displays are often featured at baseball games, outdoor concerts and other events too throughout the summer. The din of these celebrations can make cats anxious and skittish, forcing them into hiding. Close your doors, windows and curtains during firework displays. Also turn on soothing music or the TV to help drown out the noise, especially if you're going to be gone when the fireworks are scheduled to go off.
Overall, keeping your cat indoors is the best prevention for any health concern. If you want to still provide your cat with the fresh air and sunshine of summer, consider installing a screened-in enclosure. As Dr. Nelson explains, "You can then give your cat a taste of the outdoors and still offer protection."

Friday, June 11, 2010

De Poezenboot, Amsterdam (part 2)

I've been extremely busy since I got back from my trip to Amsterdam and Brussels, plus I have over 2000 photos to sort through, but I want to make sure I share some more pictures.  Here are some more from Poezenboot, and I'll post more from my Europe excursion soon.

Tuesday, June 8, 2010

Meeting Kittens in Amsterdam and Brussels

As some of you know, I was recently in Europe for a mini-vacation; three days in Amsterdam, two days in Brussels. It was my third time in Amsterdam, although the last time was 11 years ago.

The main objective of my trip was just to get some rest and relaxation. For me, however, relaxation means hanging around with cats. Usually when I’m in a new international city, I manage to make friends with a few street cats here and there (I found a few in Amsterdam, but only one in Brussels), but this trip was different. I met a boatload of cats, in the literal sense. I visited Amsterdam’s famous Poezenboot, the houseboat that serves as a floating cat sanctuary.

In Dutch, poezenboot is pronounced “poozin-boat”. Although this rhymes with cruisin’ boat, this boat doesn’t cruise anywhere; it is permanently docked on the Singel canal.

I introduced myself to the staff as a feline-only veterinarian from the United States, and asked if I could interview them and take photos for my blog, and for an article I wanted to write for an upcoming issue of Catnip, the newsletter from the Cummings School of Veterinary Medicine at Tufts University. They were happy to oblige.

Over the next few days, I will post many photos of the wonderful staff and the exceptional, sweet cats on the Poezenboot. Meanwhile, here are a few pictures of the cats I ran into on the streets of Amsterdam and Brussels.

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