Tuesday, November 30, 2010

Why You Should NOT Toilet Train Your Cat

Teaching your cat to use a toilet rather than the litterbox is a relatively new phenomenon that became somewhat vogue after the movie “Meet the Parents” with Ben Stiller and Robert DeNiro. The film featured a cat that was very adept at using the toilet. Pet stores sell kits that are designed to toilet train your cat, and there are countless websites and several books devoted to the topic. At Manhattan Cat Specialists, we take a different view when it comes to toilet training your cat. We’re completely against it.

Cats should not be made or expected to use a toilet designed for people. It is completely unnatural for them. Cats instinctively dig and bury their urine and feces. Toilet training robs them of this instinct.

Toilet seats are slippery. There is always a chance of the cat losing its grip and falling into the bowl, possibly injuring itself in the process. The incident may be frightening enough to prevent the cat from using the toilet ever again. For a kitten or a small cat, it can actually be life threatening.

Cats that use the toilet are required to jump up. For younger cats, this is usually not a problem. Elderly, sick, injured or arthritic cats may find it difficult or painful to do this. Public restrooms provide handgrips, and hospitals and nursing homes provide bedpans for elderly and infirm humans. Why should we expect our elderly and infirm cats to tolerate pain and difficulty when eliminating?

Some medical conditions require monitoring the urine for the presence of blood, or the feces to see if there is blood or diarrhea. Toilet training makes it impossible to see the urine output, and the water in the toilet may change the consistency of the feces, making it difficult to assess diarrhea. Some cats develop medical conditions that result in increased urination. Owners often notice this by noticing more urine in the litterbox. For cats that use the toilet, it is impossible to get an idea as to whether the cat is producing an excessive volume of urine.

If you ever have to board your cat or if he needs to be hospitalized, it can be very confusing for him to be in a cage with a litterbox instead of a toilet. Stress weakens a cat’s immune system, and this kind of stress can only serve to delay recovery in an already sick cat.

Toilet training means that the toilet lid has to always remain up. This seems like a small detail, but if you have guests over, they might not remember to do this, potentially leading to inappropriate elimination and behavior problems.

It’s no wonder that so many cats that have been subjected to toilet training develop behavioral problems. At Manhattan Cat Specialists, we feel that people should just let cats be cats. Tending to a litterbox is part of the bargain we make when we get a cat, and it’s the least we can do for such wonderful companions.

Thursday, November 18, 2010

Reader Question: My Senior Cat Meows Loudly

My Senior Cat Meows Loudly

Dr. Arnold Plotnick is one of CatChannel's feline health experts. Check out more of his CatChannel answers.

Q: My cat, Bailey, just turned 22 this past Easter! She is a seal point Siamese mix. Bailey still gets around fairly well, and even jumps onto our kitchen counter to get to her food. Aside from some occasional random places we have caught her urinating, she seems to be aging well. For the past several years, however, Bailey has made some incredibly loud meows, mostly at night. She actually wakes me up at night. They sound similar to a cat in heat and seem to becoming more frequent. Do have any idea what the cries are?

Friday, November 5, 2010

Feline Gum Disease

Feline Gum Disease

Dental disease is the most common disease in cats, affecting nearly every cat 5 years and older, according to Dr. Arnold Plotnick of Manhattan Cat Specialists. Gum disease is one of the leading diseases of the mouth in felines, often leading to other medical problems such as tooth loss, sinus infections and even heart failure. With awareness of the problem and some precautions, you can help your cats avoid this very preventable ailment.


Feline periodontal disease, also known as feline gum disease, is inflammation of the tissues surrounding and supporting the teeth. Feline periodontal disease weakens cats' teeth and gums, often leading to other more serious medical conditions.


Look for the following signs and symptoms if feline periodontal disease is suspected. Look at the appearance of the teeth and gums. Yellow or brown spots on the teeth, receding gum lines, or reddened edges of gum lines are all symptoms of periodontal disease. Bad breath is another telling sign. Other symptoms include blood-tinged drool, mouth pain, and difficulty chewing food.


Over-crowded teeth and genetics are two contributors to feline periodontal disease, but there are many others. The older a cat grows, the more likely it is to suffer from gum disease. Certain breeds such as Persians, Himalayans and Siamese suffer from periodontal disease more often than other breeds. If the cat's diet consists of mainly soft food, it will be more at risk for periodontal disease than a cat that eats hard food. Also, cats that do not receive regular home or veterinary dental care will be more at risk of developing periodontal disease.


A veterinarian will examine a cat's mouth to diagnose feline periodontal disease, looking for irritated gums or decayed teeth. The veterinarian may recommend oral radiographies (X-rays) to determine the severity of the disease. Most often, the cat will be anesthetized and the tooth debris, along with any infection, will be physically removed. In severe cases, badly decayed teeth will often be removed. Antibiotics may be required to help treat infection, and pain medication may be required to help treat pain from any dental procedures.


Regular dental care and maintenance are the only ways to prevent feline periodontal disease. Ask your veterinarian to recommend a specially formulated toothpaste to use with a feline toothbrush , and brush your cat's teeth at home several times per week. Use brushing your cat's teeth as an opportunity to get a good look at his mouth, checking for any signs of problems. Also, take your cat to the veterinarian for a yearly dental exam to look for and prevent any upcoming dental problems.

Articles by Dr. Plotnick - Dentistry and Oral Disorders

Thursday, November 4, 2010

Strangest Things Ever Found Inside of a Patient Contest

Yay! Dr. Plotnick received honorable mention for the 'Strangest Things Ever Found Inside of a Patient' contest brought to us by Clinician's Brief.

Subject: Clinician's Brief Strangest Thing Contest

Hello Dr. Plotnick,

Congratulations! You won honorable mention for our “Strangest Thing Ever Found Inside a Patient” contest! Attached is the layout featuring your photos and as your prize, we’re going to send you a free algorithm binder. Please reply with your mailing address so that we can send your prize. Thank you so much for your participation in our contest; we sincerely hope that you participate in future photo contests.

Best regards


Check out the full article with the winners as well as Dr. Plotnick's entry here (PDF).

Tuesday, November 2, 2010

Reader Question: How Can I Help My Cat With Chronic Renal Failure Feel Better?

How Can I Help My Cat With Chronic Renal Failure Feel Better? 

CatChannel veterinary expert Arnold Plotnick, DVM, examines ways that a cat with CRF can be comforted and treated.

Dr. Arnold Plotnick is one of CatChannel's feline health experts. Check out more of his CatChannel answers.

Q: Can my 17-year-old cat with probable kidney failure really be treated? My vet said to bring her in, but I have been down this road with my other geriatric cat. Can’t I do something besides bring her in, most likely, to die in his office? Can the traditional practice of veterinary medicine provide palliative care in for this kind of situation to make it easier for my cat and me?

Monday, November 1, 2010

Diabetes Emergency Preparedness as Important as Insulin

Diabetes Emergency Preparedness as Important as Insulin
via Veterinary Practice News

Owners often are shell-shocked when they hear their pet has diabetes. But a veterinarian’s optimistic attitude can help a client successfully manage the disease.

“It’s usually a traumatic piece of information for an owner when a veterinarian tells them their pet has diabetes,” says Randy Lynn, DVM, a technical service veterinarian with Intervet Schering-Plough Animal Health of Summit, N.J.

“If the owner is handling the news well, you can discuss the emergency situations that may occur in a diabetic animal. If you’re speaking to them and their eyes gloss over, you might want to send them home with written information, and then have the owner return in a day or two once they’ve processed everything.

“It’s a delicate balance that the veterinarian has to weigh. If you tell them too much on day one, you could tip them over the edge.”

Dr. Lynn says a diabetes diagnosis gives veterinarians a “chance to shine,” noting that owners will rely heavily on them for information on choosing insulin, injecting insulin and monitoring the animal.

Besides hearing the diabetes news, distressed clients also have to be warned about hypoglycemia, the No. 1 emergency concern of veterinarians who deal with diabetic patients. The likelihood of hypoglycemia occurring in an animal is greater in the early weeks after diagnosis.

“When veterinarians have the emergency talk with owners, they must tell them specific signs of hypoglycemia and not speak in generalities such as ‘If the animal is acting strange, do this.’ Give examples,” says Audrey K. Cook, BVMS, MRCVS, Dipl. ACVIM, Dipl. ECVIM (companion animals). “Tell them an animal may stare into space, have tremors, walk like it’s drunk, run into walls or lean into furniture or even become unconscious.”

What to Do

Though all the contents may never be utilized, Ruth MacPete, DVM, of Del Mar Heights Veterinary Hospital in Del Mar Heights, Calif., says owners should have a diabetes kit. The kit should contain glucose testing supplies, syringes, ketone test strips, Karo syrup and what Dr. Cook calls “a junky kind of food.”

“Tell owners to keep a junky, fun-to-eat food on the shelf just in case,” says Cook, a clinical associate professor at Texas A&M University. “Some corn syrups are better than others for this, so tell owners a specific type and brand. If the animal is able to eat, giving food would be the first step, but if not, reach for the Karo and get the animal to the veterinary office.”

Another option for initial hypoglycemia treatment and an item for the emergency kit is Glucose RapidSpray.

“Glucose RapidSpray is basically sugar water,” says Arnold Plotnick, DVM, Dipl. ACVIM, Dipl. ABVP (feline), the owner of Manhattan Cat Specialists in New York City. “Four or five pumps of the spray on the gums should do the trick, and then the owner needs to get the animal to the veterinarian.”

Clients should monitor a diabetic pet’s appetite, water intake and urine output, Dr. MacPete says.
“Owners should record this information in a log and bring it with them to veterinary visits. They should alert their veterinarian immediately if they notice any changes,” MacPete says.

Why Hypoglycemia Occurs

Hypoglycemia has several causes, but one of the most avoidable is giving the wrong insulin dose.

“Insulin comes in different strengths,” Dr. Plotnick says. “U40 and U100 must be used with their corresponding syringes. When a client runs out of syringes, they might go to a local pharmacy or get leftover syringes from a friend whose pet had diabetes. Make sure clients are aware that syringe substitutes will not work and they should always buy their diabetes supplies through the prescribing veterinarian.”

During the hypoglycemia discussion, veterinarians should tell clients that only one person in the household should give insulin injections, authorities agree. This avoids potentially deadly confusion over missed or additional injections.

“Give insulin at the same time every day,” Plotnick says. “Since insulin is usually given every 12 hours, tell the owner to choose two 12-hour time frames in which they know they’ll be home. One of my clients gives his cat an injection at 3 a.m. and one at 3 p.m.”

Veterinarians might be tempted to start a cat on two units twice a day, according to Plotnick. This can lead to hypoglycemia.

“We gradually make our way to finding a patient’s correct insulin level,” Plotnick says. “Start with one unit twice a day, increasing it by an additional unit twice a day, if needed, after two to three weeks at the initial rate.”

Watch the Food

Diet is an important component in regulating an animal’s diabetes and preventing hypoglycemia, experts say.

“Although veterinarians are aware of the importance of diet, they have to convey that to the client,” Cook says. “I think about it in my mind like a teeter-totter—balance food and exercise with insulin.”

Maintaining proper weight plays a large role in diabetes regulation, Intervet’s Lynn says. This means the obligate carnivore cat needs a high-protein, low-carbohydrate food. Dogs also can benefit from a special diet.

“Altering a cat’s diet can have a huge impact on its diabetes status,” Lynn says. “Thirty to 80 percent of diabetic cats can become non-diabetic through diet and insulin therapy. Dogs are more omnivores, and we attribute their diabetes status more to bad genetics rather than obesity level, which is often the case with cats.” And watch the treats.

“With diabetic dogs, the big diet upset is giving snacks,” Cook says. “Changing the habit of giving diabetic dogs extra treats is an immediate need.”

Diabetic Ketoacidosis

Another emergency situation for diabetic cats is diabetic ketoacidosis (DKA). Experts say this occurs less frequently in diabetic animals than hypoglycemia but needs to be part of the early discussion with owners.

“An animal being treated for diabetes will suffer from DKA most frequently because there is a concurrent disease that counteracts the insulin being given,” Plotnick says. “The animal will vomit, stop eating and show distinct signs of not feeling well. Increased thirst, increased urination, weight loss despite a good appetite and sudden blindness can also occur.

“In this scenario, owners need to know they should immediately take the animal to their veterinarian.”

Two factors cause DKA. If an animal is given the required amount of insulin, the inability of the B-cells to secrete sufficient insulin gives rise to an absolute deficiency. An increased insulin requirement may lead to an inability to produce sufficient extra insulin, which is called a relative deficiency. This is an important distinction.

“If an animal appears particularly difficult to regulate despite being on an appropriate treatment regimen and the client is being compliant, the veterinarian should evaluate for the presence of medical conditions that may be making the regulation of diabetes more challenging, like an occult infection or other medical conditions,” MacPete says.

Cook says concurrent Cushing’s disease or immune mediated anemia can make regulating insulin very complicated.

Non-Stop Monitoring

Cook says diabetic emergencies can be avoided when owners are educated, motivated to monitor their pet at home and know when to take action.

“There are devices to help with this process,” she says.

Charles Wiedmeyer, DVM, Ph.D., Dipl. ACVP, adapted the human MiniMed continuous glucose monitoring device to minimize the stress of drawing blood and avoid emergencies. Dr. Wiedmeyer, an assistant professor of clinical pathology at the University of Missouri, says the device can be used with dogs, cats, horses and cows.

“Cats especially can get stressed during blood draws,” Wiedmeyer says. “This monitoring device is only a couple of centimeters in diameter and is inserted under the skin with a 22-gauge needle. The probe stays in the animal for three days, sending real-time data to a laptop that will graph the animal’s glucose rate.

“This would be used most in newly diagnosed diabetic patients.”
Wiedmeyer says the reusable monitoring device, from Medtronic Inc., costs about $1,200. One-time-use probes cost $35.

The company is considering directly marketing to the veterinary industry.

“An important part of educating pet owners about diabetes is preparing them for possible diabetic emergencies,” MacPete says. “Complications can occur and they need to know how to recognize the signs and symptoms and how to treat them.

“The more educated a client is about potential diabetic emergencies, the better.”
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