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    Life Cycle Needs

    Life Cycle Needs

    By Arnold Plotnick, DVM

    Maintaining the health and well-being of a cat through all the stages of life is a great responsibility. To be able to accomplish this, owners must know and understand each stage of a cat's life, how needs change from one stage to another, and what kind of daily and veterinary care is required as a cat progresses from kitten to adult to senior. First, we look at reproduction. Even though the majority of cat owners today will adopt their cats from shelters, already spayed or neutered, it's important to understand the unique reproductive life of cats, how that affects their health, and how it has led to the urgent need for programs to spay and neuter. If, for some reason, you do end up with a pregnant cat under your care, this section also lays out basic health care needs of the mother and her newborn kittens. Knowing how to care for an orphaned kitten can also be important. Finally, cats are living longer than ever before. It is no longer a rarity to see cats reach the age of twenty. We conclude this chapter by addressing the special issues and needs of the elderly cat.

    Reproductive Care

    Reproductive Care

    Cats have long been recognized for their fertility. Bastet, the Egyptian goddess of fertility, is depicted as a cat in artwork, and the ancient Egyptians worshipped cats as a symbol of fertility. When it comes to making babies, cats are one of the most prolific of domestic pets. Like rabbits, they are capable of multiple pregnancies within a single reproductive season. BibleSome aspects of the cats' reproductive capabilities are truly remarkable. A female cat in estrus or "heat" may allow several males to mate with her, and it is possible for kittens in a litter to have different fathers. (The technical term for this is superfecundity.) Lactation (production of milk) does not suppress the heat cycle, and cats who are actively nursing kittens can come into heat as soon as two weeks after giving birth. Even being pregnant doesn't necessarily suppress the heat cycle. In fact, 10 percent of female cats come into heat between the third and sixth week of pregnancy. Although these cycles are rarely fertile, it is theoretically possible for a cat to be carrying fetuses of different ages, resulting from separate matings in different heat cycles! (The scientific term for this is superfetation.)The unique reproductive features of the cat-polyestrous (multiple heat cycles during the reproductive season), early onset of puberty, extreme fertility, heat cycles not suppressed by lactation, and short gestation period (sixty-five to sixty-seven days, on average)-all contribute to the sad fact that there are many more cats than there are homes for them. In the United States, an estimated 3 to 4 million cats are euthanized every year.

    It is your responsibility to care for your feline through all the stages of her life.

    Puberty

    Although the average age at which queens reach puberty and have their first heat cycle is between five and nine months, some cats experience puberty as early as three and a half months and at a body size as small as 4½ pounds (2 kg). Male cats become sexually mature approximately one to two months later than females do. There are many factors that affect the onset of puberty. General health, physical condition, nutritional status, social environment, time of year, and breed can all influence puberty. In general, domestic shorthaired cats come into heat at an earlier age than do domestic longhaired cats, and mixed breeds come into puberty earlier than do purebreds. Persian cats are especially late in reaching puberty, often not experiencing their first heat until twelve months of age. Females are at their most fertile between the ages of one and a half and eight, although they can reproduce up to about fourteen years of age. Males can reproduce several years longer.If allowed to mate naturally, a typical queen having two or three litters a year, with three or four kittens per litter, can have anywhere from 50 to 150 kittens in her lifetime.

    On average, female cats can first get pregnant at the age of five to nine months.

    Mating

    Estrus is the period in which the female will allow males to mate with her. This period varies in length between five days to three weeks. If the female does not mate with a male during the heat cycle, she will experience repeated cycles every twelve to twenty-two days. In the Northern Hemisphere, as the days get longer in late January and early February, queens begin to cycle, coming into heat approximately every two weeks. This usually continues until late September. In October, November, and December, cats tend to stop cycling until the new season resumes in late January. For housecats, the actual parameters of the reproductive season can vary due to the effects of artificial lighting on the reproductive cycle, although most housecats stop coming into heat during the winter months. Siamese cats are less affected by photoperiod than other breeds and often cycle year round.

    The signs that a cat is in heat include excessive vocalization, becoming very affectionate, rubbing her head and neck against people and objects (more than she usually does), rolling and squirming, assuming the mating posture (the rump in the air, tail deflected to the side, and back arched downward), and making "treading" movements with her back legs. When a female goes into heat, the smell she gives off and the vocalizations she produces alert the tomcats in the neighborhood. If several tomcats are nearby, they may gather around the female, engaging in fights with rivals. The victorious male will then pursue the female, who appears to play "hard to get." Premature attempts to mate by the male often elicit a very aggressive rebuff by the female. After a while, however, the female becomes ready to mate and will assume the mating posture described above. The male will grasp the female by the skin over the nape of her neck and begin copulation. When the male ejaculates, the female produces a loud shriek, hisses aggressively, and violently swats the male away. The female's reaction is believed to be due to pain upon withdrawal by the male, caused by the barbs on the penis. After mating, the female rolls around on the ground while the male retires a discrete distance away. This mating process is often repeated several times, and females may mate with more than one male during their heat cycle. The males depart after the heat cycle and do not participate in the care of their kittens.

    Spaying and Neutering

    Cat overpopulation is a very serious problem. A major part of the responsibility of cat ownership is guaranteeing that your cat doesn't reproduce. Neutering and spaying are two of the most commonly performed elective surgical procedures. Not only do they help curtail cat overpopulation, they also bring many health and behavior benefits to both you and your cat. Spaying is the surgical procedure performed on female cats. The medical term for this surgery is ovariohysterectomy-removal of the ovaries and uterus. The advantages of spaying are no more heat cycles; no more crying, yowling, or trying to escape outside; no more unwelcome visits by unneutered male cats in the neighborhood; no uterine infections; and a greatly reduced incidence of mammary tumors if the cat is spayed before experiencing her first heat.

    Neutering or castration is the procedure used for males; the actual medical term for the procedure is orchiectomy. In this procedure, the testicles are removed. The advantages of neutering are a reduced urge to roam, stopping the mating drive, stopping or preventing urine spraying, and less territorial aggression (which reduces the risk of cat-fight abscesses or acquiring FeLV or FIV from another cat through fighting). Many cat owners are concerned that spaying or neutering their cats will result in undesirable behavioral changes. One concern is that the cat will become fat and lazy. Although the metabolism does slow down a bit after spaying and neutering, most cats gain weight because they are fed too much and they don't get enough exercise-not because of the operation. After spaying or neutering, monitor your cat's appetite and activity patterns and adjust the diet accordingly. Some people feel that neutering a male cat will result in him feeling like less of a male. These concerns are unwarranted. Cats don't have any concept of sexual identity or ego and don't suffer any kind of emotional reaction or identity crisis when neutered. A popular misconception is that it is better for a female cat to have one litter before spaying. Medical evidence, however, shows the opposite to be true. Dogs who are spayed before their first heat rarely, if ever, develop mammary tumors. The same holds true for cats. This is important because feline mammary tumors are much more malignant than those seen in dogs and they carry a worse prognosis.

    Cats are not being deprived of parenthood by being spayed. Unlike people, cats do not experience a sense of emotional fulfillment by giving birth or by the mothering process. Some people want to breed their cat because they are hoping that the kittens will be exactly like the mother or father in appearance and/or temperament. This is a misconception. Breeding two purebred animals rarely results in offspring who are exactly like one of the parents, and with mixed breeds it is virtually impossible to have offspring who are exactly like one of the parents. The idea that a cat should have a litter so that children can witness the miracle of birth is disconcerting. There are countless books and videos available to teach children about birth in a responsible manner. Letting a cat produce offspring that the family has no intention of keeping is teaching children irresponsibility. Millions of dogs and cats are euthanized in shelters each year. Approximately 75 percent of all cats entering shelters are euthanized. While you may be able to find homes for all of the kittens in your cat's litter, each home you find means one less home available for cats at shelters and humane organizations who truly need them. Having your cat neutered or spayed is the ultimate sign of responsible pet ownership.

    Cat being shaved just prior to her spay surgery.

    Pregnancy

    As the winter turns to spring and the weather begins to get warm, the longer periods of daylight stimulate the reproductive hormones in the cat. The pituitary gland in the brain releases follicle stimulating hormone (FSH), which causes the ovaries to produce eggs. The act of mating causes the pituitary gland to release another hormone called luteinizing hormone (LH). This hormone stimulates the release of eggs (ovulation) from the ovary. Once released, the eggs travel down the fallopian tubes, where they encounter sperm from the male and become fertilized. The fertilized eggs implant themselves onto the wall of the uterus. The ovaries then secrete progesterone, the primary hormone responsible for maintaining pregnancy. About thirty days into the pregnancy, fetuses can be felt through the abdominal wall by a veterinarian. (Cat owners should not attempt this, to avoid potential damage to the fetuses.) Fetuses can be detected even earlier than this (about fifteen days in) by ultrasound.

    Pregnant cats should be kept indoors. The nutrition requirements of the pregnant cat will increase, and she may eat twice as much as before. A high-protein, high-energy diet should be fed during this time and during nursing. About ten days before the kittens are born, the progesterone levels begin to drop and the estrogen levels start to rise. These hormonal changes give rise to behaviors that indicate labor and delivery are approaching. Cats may seclude themselves and exhibit nesting behavior as they search for the most suitable place to give birth. Provide your cat with a nesting box-a comfortable box or bed for her to have her kittens. The box should contain towels or easily shredded material, such as paper.

    The birthing procedure is a natural process for cats and usually proceeds without any problems. If possible, the owner should stay by the cat's side to monitor delivery. The birth process proceeds in stages. Initially, the cervix relaxes and the uterus begins to contract. The contractions become stronger and more frequent, propelling the first fetus toward the pelvis. When the fetal head fully enters the pelvis, its pressure causes the cat to voluntarily contract her abdominal muscles. This deliberate push helps propel the fetus through the pelvis. Once the head emerges from the vulva, one or two more pushes from the female should result in delivery. Each kitten is covered with fetal membranes. As each kitten is born, the queen will tear open the membranes and clear the kitten's mouth and nose. She will also bite off the umbilical cord and eat the placenta that emerges after the kitten has been born. The interval between kittens is variable. On average, it takes approximately an hour between kittens; however, in some cases kittens can be born as quickly as ten minutes apart. Although the average litter size is four, it can range from one to twelve. Problems during the birthing process are rare. If problems do develop, however, veterinary attention should be sought immediately.

    An average cat pregnancy is sixty-five to sixty-seven days, but an individual cat may give birth a few days early or a few days late. Be prepared.

    Orphaned Kitten Care

    Most people will never have to take care of an orphaned kitten, but if circumstances bring a neonate into your life, it is critical that you understand the proper care. A kitten who does not have a mother to look after it during the first few weeks of life is said to be orphaned. If an orphaned kitten is to survive, it requires proper nutrition, hygiene, and medical and emotional support. Nutritional support is of utmost importance. Orphaned kittens should be fed kitten milk replacer. This can be purchased at pet stores and is composed of water, proteins, fats, carbohydrates, vitamins, and minerals in proportions similar to feline milk.Cow's milk it not an appropriate substitute and should not be used. Kitten milk replacer should be warmed to 100°F (38°C) before feeding. How much to feed will depend on the weight of the kitten and the schedule of the caretaker. The label on the kitten milk replacer will give detailed instructions.

    The best method of feeding orphaned kittens is by nursing bottle, provided that an appropriately sized bottle and nipple are used. A nipple that is too small can be swallowed. A nipple that is too big can prevent proper nursing. The opening in the nipple must also be appropriate size. A hole too small will restrict the flow of milk. A hole too large can lead to an excessive amount of milk exiting the nursing bottle, which may result in aspiration of the milk into the lungs. Kittens under ten days of age may need to be fed via feeding tube since kittens this young have an absent or poorly developed swallowing reflex. Your veterinarian can provide you with the proper sized tube (typically a 5 French tube for kittens weighing less than 300 grams and an 8 French tube for kittens weighing over 300 grams) and can demonstrate the proper procedure. After each feeding, kittens should be burped to remove any swallowed air from the stomach. For the first three weeks of life, kittens will need to be stimulated to urinate and defecate after every feeding. This is accomplished by wiping a warm moist cotton ball on the genital and anal area. Newborn orphan kittens should be fed 6 to 8 times a day. As the kitten approaches two to three weeks of age, the frequency of feedings can be reduced to three to four times per day. Newborn kittens typically weigh around 100 grams and are expected to gain about 10 grams per day. At 6 weeks of age, kittens should weigh around 500 grams. Caretakers of orphaned kittens should obtain a scale so they can monitor the kittens' weight gain. A log should be maintained for each kitten. The log should note the weight, amount that the kitten ate, urination and defecation, deworming history, and vaccination history.

    By three weeks of age, solid food can be offered to the kitten. Initially, a thin gruel of canned kitten food mixed with kitten milk replacer is fed. Bottle feedings should be continued during this time. Over a two-week period, the gruel should be gradually made thicker. By 6 to 8 weeks of age, the food should be nearly solid in consistency. Fresh water should always be available during this time. Orphaned kittens need a well-regulated environment. Kittens should be kept in a box or container that is warm and free of drafts. A heat lamp, light bulb, or heating pad covered with towels should be used to provide heat. The temperature in the box should be 85 to 90°F (29.5 to 32°C) during the kittens' first week of life, and then 80 degrees (26.5°C) for the next four weeks. A thermometer should be kept nearby to accurately measure the temperature. Once they reach 6 weeks of age, a room temperature of 70°F (21°C) is acceptable. To reduce the risk of infection, exposure to other animals or multiple people should be avoided. Wash your hands before and after each handling, and clean all equipment after use. The nesting box should be kept clean using towels or newspapers that can be easily changed when soiled. Kittens should be handled only when being fed to avoid interrupting their sleep pattern. At two weeks of age, kittens should be dewormed. This should be repeated two weeks later. Orphaned kittens should receive their initial vaccinations at approximately 4 to 6 weeks of age.

    A queen may have between one and twelve kittens in a litter, but the average litter size is four.

    Newborn orphaned kittens should be fed six to eight times a day.

    Geriatric Care

    Geriatric Care

    Pets today are living longer and better-quality lives than ever before, thanks to improved nutrition, better veterinary care, and educated owners. This increased longevity means that more cats are reaching an older age, and cat owners will be faced with the special demands and problems that become apparent with age. Understanding the aging process and the most common problems that face the elderly cat is the first step in providing the best possible care for your geriatric cat. It is important to realize that aging itself is not a disease; it is simply a stage of life. Increasing age causes a gradual decline in the body's ability to repair itself, maintain normal body functions, and adapt to the stresses and changes in the environment. Many changes occur in cats as they age. Metabolism changes, for example, so less food is required. Housecats in general have a more sedentary lifestyle, and older cats specifically are usually less active, so weight gain and obesity are common problems. The lack of exercise contributes to reduced muscle tone and strength, further adding to the potential for obesity.

    With time, cats begin to have a gradual decline in their sense of hearing, smell, vision, and taste. Decreased taste sensation can contribute to anorexia, especially if the cat becomes ill. It is not uncommon for older cats to spend more time sleeping and have more difficulty being roused. Metabolic and endocrine problems, organ dysfunction, and cancer are all seen with increased frequency in the geriatric feline population. Cancer is generally a disease of older animals, so it should come as no surprise that the prevalence of cancer in cats is increasing. This is the fateful price cats must pay for their increasing longevity. Exactly when a cat is considered to be senior or geriatric is not well defined. Most veterinarians would classify cats as being mature at ages seven to ten, senior at ages eleven to fourteen, and geriatric at ages fifteen and older. In the following sections, the terms senior, elderly, and geriatric are used synonymously.

    Wellness Program

    Most veterinary hospitals have designed a wellness program specific for geriatric cats. These programs consist of a thorough physical examination and a variety of diagnostic tests designed to ensure that the early stages of disease are identified and appropriate preventive measures and treatment plans are instituted. The most effective way of maintaining excellent health in a geriatric cat is to participate in your veterinarian's geriatric wellness program. Practicing prevention is always better than treating a disease already present. In the long run, preventive medicine improves quality of life and is more cost effective than waiting for problems to appear. The most common diagnostic tests performed as part of a complete geriatric work-up include the following.

    Complete medical history

    It is very important to obtain a thorough geriatric health history. Some veterinarians have specific geriatric health history questionnaires that can be filled out by the owner. In addition, any problems or concerns that owners have about their cat should be discussed; some problems that an owner may simply attribute to "old age" are very often signs of underlying diseases that may be treatable.

    A cat is considered a senior when she is eleven years old.

    Thorough physical examination

    This should be performed to attempt to uncover specific problems. The eyes are examined, and a retinal exam may be performed if there is some question as to whether your cat may be experiencing some loss of vision. The ears are examined for signs of infection, parasitism, or allergies. The mouth, gums, and teeth are evaluated, with dental disease and gingivitis being common findings. Lymph nodes and the thyroid gland are evaluated for enlargement. The skin and quality of the hair coat are observed. Skin tumors or swellings are noted. A poor hair coat or a lack of grooming may be signs of allergies, parasites, infections, or systemic illness. The heart and lungs are evaluated with the stethoscope, and any abnormalities or murmurs are noted. The abdomen is palpated for any masses or organ enlargements. Finally, the general body condition is scored, and the weight is recorded.

    Complete blood count

    This test evaluates the circulating blood cells-the red cells, white cells, and platelets. Abnormalities in the complete blood count are common in elderly cats. Anemia can be seen as a result of kidney failure or inflammatory or cancerous conditions. Changes in the white cell count may indicate inflammatory or infectious conditions

    Biochemical profile

    This profile is a very valuable test in the geriatric animal. Information about the liver, kidneys, blood sugar, and electrolytes is obtained through this important test.

    Thyroid testing

    Hyperthyroidism is the most common glandular disorder in elderly cats. Untreated, it can lead to serious health consequences. Thyroid testing enables veterinarians to diagnose this very treatable disorder.

    Urinalysis

    Analysis of the urine can help detect underlying urinary tract infection, kidney problems, and diabetes. If the urinalysis suggests the presence of an infection, a urine culture may be recommended.

    Fecal examination

    Since gastrointestinal parasites may be more debilitating in geriatric animals, a yearly fecal exam is recommended.

    Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) testing

    Both of these viral diseases may cause suppression of the immune system and can contribute to many other systemic illnesses. In cats who are at risk of exposure to these viral diseases (i.e., outdoor cats or cats who have contact with other cats), routine blood testing is recommended. If the viral status of a cat is unknown, testing is also advised. Cats who have previously tested negative and have had no possible exposure to other cats may not need this test.These tests represent the most routine diagnostic tests that are recommended for senior cats. Based on the history, physical examination findings, and initial test results, common additional testing might include:

    Blood pressure measurement

    Hypertension (high blood pressure) is often identified in the geriatric cat. Hypertension is usually associated with other disease conditions such as kidney disease and hyperthyroidism.

    The most effective way of maintaining excellent health in a senior or geriatric cat is to participate in your veterinarian's geriatric wellness program.

    Cats often become less active once they enter their senior years.

    Aspiration of skin masses

    A common finding on the physical examination of older cats is small masses on or in the skin. Many times, these are benign tumors or cysts that grow slowly and rarely cause problems. However, cats do have a higher incidence of malignant skin tumors than do dogs. Because of this, it is usually recommended that skin tumors on cats be aspirated (a needle is inserted into the mass) and the recovered cells evaluated microscopically for evidence of malignancy. The size and location of all masses should be recorded in the medical record so that changes in previous masses or the development new masses can be noted.

    Radiographs

    Radiographs (x-rays) may be advised based on the initial tests or physical exam findings. Chest radiographs are part of a cardiac investigation if a heart murmur is discovered, as well as a screening test for cancer. Abdominal radiographs might be needed if organ dysfunction is suspected or organ enlargement or masses are detected during the physical examination.

    Cardiac (heart) evaluation

    If there are signs of potential heart disease, such as a newly discovered heart murmur or labored breathing, a more complete cardiac evaluation is indicated. Chest radiographs, an electrocardiogram (EKG), and an echocardiogram will help better define the extent and cause of potential cardiac disease and whether treatment is necessary.

    Abdominal ultrasound

    Abdominal ultrasound offers a noninvasive method of visualizing masses and organs within the abdomen. Generally, more detail can be obtained with an ultrasound than with radiographs.

    Endoscopy

    Evaluating the stomach and intestines through the use of endoscopy is a valuable diagnostic tool. Inflammatory bowel disease (IBD) and gastrointestinal lymphoma are common gastrointestinal disorders seen in senior cats. Endoscopy offers a relatively noninvasive method of obtaining gastrointestinal biopsies for establishing a diagnosis. By participating in and following a geriatric health plan, disorders can be detected early enough so that prompt medical or surgical intervention can be provided, allowing for significant improvements in the quality of a cat's life.

    Conditions Associated with Aging

    Although most cats age very gracefully, many suffer from some of the same conditions and diseases that aging humans do, including arthritis, hearing and vision loss, and cognitive dysfunction. As with people, for instance, arthritis can be present in cats of all ages, but it is more common in older cats. A study of cats of all ages showed that 22–33 percent of cats have x-ray evidence of arthritis and that the incidence increases with age. Furthermore, 90 percent of cats over the age of twelve have radiographic signs of arthritis. The elbows and hips are the most commonly affected joints. Many cats have multiple affected joints.

    Arthritis

    Arthritis is a well-recognized problem in dogs but is often overlooked or unrecognized in cats. This lack of awareness is due to several factors. Cats with arthritis are less likely than dogs to show true lameness because cats are adept at redistributing weight bearing to unaffected limbs. The feline lifestyle is also a factor. When an arthritic dog can no longer jump into the back of the van or has to stop and rest during long walks, the owner immediately recognizes that there's a problem. When a cat can no longer jump onto the windowsill or bed, she merely chooses a new favorite place to sleep or meditate, and the owner simply thinks the cat has discovered a novel location for her lounging. Many cat owners don't consider that their cats might be suffering from arthritis. As we've noted before, cats are very good at hiding their signs of illness or pain.Arthritis can be categorized as either primary or secondary. In primary arthritis, there is no clear underlying cause of the arthritis. With secondary arthritis, an underlying cause is identified or suspected, such as hip dysplasia or previous joint trauma. Most cases of arthritis in cats are primary.

    Symptoms

    Unlike dogs, lameness is not a typical clinical sign in cats. Cats with arthritis will often show signs such as inappropriate elimination (urinating and/or defecating outside the litter box) because their normally very flexible spine become stiffer and less compliant as they develop spinal arthritis, making it difficult to squat in the litter box. Often, the cat will urinate or defecate immediately outside the box instead. Decreased grooming, matting of hair, or an unkempt coat may be seen because stiffness of the spine can make it difficult to twist the torso properly to groom the rear parts of the body. You may also see reluctance to jump up or down, inability to jump as high as before, sitting down and standing up more slowly than in the past, hiding, becoming annoyed about being combed or groomed, and sleeping more. These signs are often incorrectly attributed to simple aging, leading cat owners to delay or avoid seeking veterinary advice.

    Diagnosis and treatment

    The diagnosis of arthritis is usually based on a history of behavioral changes associated with arthritis and physical examination findings. Radiographs confirm the diagnosis, but the clinical signs of arthritis do not always correlate well with the radiographs. In other words, a cat with mild x-ray changes may experience significant discomfort, whereas a cat with severe radiographic changes may feel OK. Joint fluid analysis may help to support or confirm the diagnosis, but this is rarely necessary. Treatment may involve lifestyle changes as well as pharmacological and nonpharmacological therapies. Food bowls should be placed in areas that do not require jumping for access, and litter boxes with high sides may need to be replaced with a lowsided box for easier access. Steps or ramps can be constructed to allow cats to have continued access to their favorite spots. As in dogs, obesity is suspected to contribute to the development and clinical signs of arthritis. Overweight cats should be placed on a diet with close veterinary monitoring. Exercise using toys (a laser pointer and other interactive toys) can encourage weight loss and keep joints limber. The cornerstone of pharmacological management of arthritis is the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Cats, however, often have trouble metabolizing drugs of this type, and some of these drugs can be toxic if given to cats. Meloxicam, an NSAID, has been reported to be effective in treating or controlling arthritis pain, but its use in cats is controversial, and it should only be considered as a last resort, in cases of crippling arthritis.

    Nonpharmacological management may include administering nutraceuticals such as glucosamine and chondroitin sulfate. These compounds are believed to slow the progression of cartilage degradation and promote cartilage health by providing the necessary ingredients to repair and maintain cartilage. Several formulations for use in cats are available. Polysulfated glycosaminoglycans (under the brand name Adequan) have also been shown to be helpful in treating arthritis. This nutraceutical is approved for use in dogs and horses, but has been used in cats by many veterinarians (myself included), with dramatic results in some cases. Acupuncture has also been used to treat arthritis in cats with varying success. Arthritis is an irreversible, progressive disease that cannot be cured by medical treatment. Although arthritis may not be as well documented in cats as in other species, it is essential that cat owners recognize the clinical signs associated with arthritis, especially now that cats are enjoying longer lifespans.

    An arthritic cat may spend more time on the floor because it is too difficult for her to jump up to her favorite resting spots.

    Cognitive Dysfunction

    As cats get older, they sometimes experience a decline in mental ability or cognitive function. Changes in memory, learning, perception, and awareness are well documented in aging people, and similar changes have been described in aging pets.

    Symptoms

    In cats, this decline may reveal itself in several ways. Some cats may forget previously learned behaviors, such as housetraining. Sometimes a cat will acquire new fears and anxieties. Other signs may include failure to recognize people, places, and other pets; altered sleep–wake cycles (such as sleeping more overall, but less at night); aimless activity, such as wandering or pacing; and acting generally "disoriented." Sometimes, when cats become geriatric, they may begin vocalizing excessively; cognitive dysfunction (CD) needs to be considered as the possible cause of this vocalization. BibleIn lay terms, CD would be equivalent to senility or senile dementia in humans. Some cats as they age become mentally feeble, and this may express itself as increased, seemingly pointless vocalization.

    Diagnosis and treatment

    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. Studies have shown that about 55 percent of cats aged eleven through fifteen years develop at least one geriatric-onset behavior problem and that the percentage increases to 80 percent for cats aged sixteen through twenty. Although cats show similar types of geriatric behavior problems as dogs, the percentage of cats who are affected with CDS is much lower. As we noted before, cats age very gracefully.Treatment options for cats with cognitive dysfunction syndrome are limited. The drug L-deprenyl (Anipril) is approved for use in CDS in the United States but only for dogs. 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 for CDS is not approved for cats. A nutritional supplement containing s-adenosyl-methionine (SAMe) has been marketed under the brand name Novifit and is designed to help support cognitive function in aging cats and dogs.

    Senior cats with cognitive dysfunction may cry excessively for no discernible reason.

    Hearing Loss

    Cats have an amazing sense of hearing, being able to hear high frequencies that humans cannot. They can locate the source of a sound with pinpoint accuracy and can hear sounds at much greater distances than can humans. Unfortunately, hearing is another of the senses that diminish as cats age. Deafness that occurs in one ear only usually goes unnoticed by most cat owners because cats compensate very well.

    Symptoms

    Cats who are deaf in both ears may show signs of hearing loss such as responding only when they can see you, sleeping more than normal, turning their heads in the wrong direction when called, not responding to noises that formerly elicited a response (such as the opening of a can of cat food or the shaking a packet of cat treats), and not waking up unless physically touched.

    Diagnosis and treatment

    Specialized tests are available at referral centers to definitively prove a cat's deafness, but these are expensive and are rarely necessary. A simple test is to make a loud noise while the cat is asleep and see if the cat awakens. The item that makes the noise should not cause vibrations (such as a door slamming) because as this can confuse the assessment. Cats suspected of being deaf should be evaluated by a veterinarian to be certain that the deafness isn't due to a treatable condition. Sensorineural deafness, the kind that occurs as a natural part of the aging process, cannot be treated. (The use of hearing aids has been attempted in dogs and cats, but the majority of animals do not tolerate the presence of the hearing aid in the ear canal.) A deaf cat may no longer come when you call her, so consider attaching a bell to your deaf cat's collar so that you can more easily locate her. Deaf cats should never be allowed outdoors because they cannot hear dangers, such as cars.

    Vision Loss

    Many cat owners notice that their elderly cat's eyes have a cloudy appearance. This is often mistaken for cataracts. In fact, this condition is called lenticular sclerosis and is a benign clouding of the lens that occurs naturally as cats age. It does not cause significant vision impairment. When elderly cats do go blind, it can occur gradually as the visual system gradually degenerates with age, or it can be sudden, as is seen in cases of acute retinal detachment. Retinal detachment can occur as a result of high blood pressure. The most common cause for high blood pressure is chronic kidney disease, a very common disease of geriatric cats. Many owners don't notice that their cat is blind right away because the senses of hearing and smell can often compensate for the loss of vision. When vision loss is gradual, cats memorize their surroundings and owners may notice that their cat is blind only when the cat's surroundings are altered.

    Symptoms

    Signs of blindness include bumping into objects, acting easily startled or fearful, an inability to locate their food and water dishes, excessive sleeping, and decreased interest in toys, especially those that incorporate motion, like a laser pointer.

    Diagnosis and treatment

    Acute vision loss should be evaluated by a veterinarian promptly so that a cause can be determined. Cats with vision loss that occurs secondary to retinal detachment from high blood pressure may have some of their vision restored if the blood pressure is quickly brought to normal. Vision loss that occurs due to age-related degeneration, however, cannot be restored. Cats adjust to their blindness just like humans do, relying on their other senses, especially smell and hearing, which are very well developed in the cat. It may take time, however, for a blind cat to adjust to her vision loss, especially if the blindness occurred acutely. The most important thing is to keep the environment as consistent as possible. Furniture should not be rearranged. Clothing, toys, or other items should not be discarded on the floor. A consistent area for eating, sleeping, and eliminating is essential. Do not move the cat bed, litter box, or food and water bowls. Try to feed your cat around the same time every day to establish a routine. Remove or cover any sharp objects or edges, especially those at the cat's eye level. Keep the toilet lid closed. Cats navigate their way using their other senses as well as their memory. Do not carry the cat from one area to the other because this can be confusing to her. Blind cats do better if they walk from area to area. A familiar voice encouraging your cat to come toward you can help a cat who seems lost or disoriented. Taking your cat to the same familiar spot, such as the feeding area, is a good way to reorient her. Block your cat's access to stairways, balconies, and terraces.

    When she is sleeping, use your voice or some other kind of noise, rather than touch, to wake her up. Some blind animals may become startled when touched and may scratch or bite. Once awakened by a noise or your voice, you can gently touch her. Blind cats still enjoy playing with toys, but they should be toys that stimulate the other senses. If your cat responds to catnip, a catnip-scented toy can be a treat. Toys that make sounds can provide stimulation. Obviously, blind cats should never be allowed to go outdoors unattended. In the unlikely event that your cat escapes or finds her way outdoors, she is unlikely to find her way back home. Make sure she always has some identification on her, either a collar (with a medical alert tag that says that she is blind), a microchip, or both. If you do let your cat outside, a harness or leash should be used. A screened porch is a safe way for your blind cat to enjoy the outdoors.

    If your cat has become blind, don't move the furniture, litter pan, or food and water bowls from their familiar places.

    Blind or deaf cats should not be let outside, but they can still enjoy a screened-in porch.

    Metabolic and Cancerous Conditions Seen in Aging Cats

    Geriatric cats also have problems with periodontal disease and kidney disease. They are also more likely than young cats to succumb to diseases such as diabetes, hyperthyroidism, and cancer. Diabetes occurs when the pancreas fails to produce adequate amounts of insulin, a hormone necessary for controlling blood glucose (sugar) levels. Most cats diagnosed with diabetes are over seven years of age. Males are almost twice as likely to become diabetic as females. Overweight cats are more likely to be afflicted with diabetes.Hyperthyroidism is a common cause of weight loss in senior cats. A variety of other clinical signs can accompany the weight loss, most notably a dramatic increase in appetite. It occurs when the thyroid gland produces excessive amounts of thyroxine, the major thyroid hormone. Hyperthyroidism is a disorder of elderly cats. The vast majority of hyperthyroid cats are over twelve years of age.

    Cancer is unrestrained cell growth and replication. Normally, cell replication is tightly regulated. Occasionally, a single cell may experience one or more genetic mutations and cancer may arise. Control of cellular replication becomes unregulated, resulting in a tumor. Exactly what causes a cell to mutate into a cancerous cell remains unknown, although some environmental agents have been shown to be able to induce cancerous changes in cells, such as viruses, chemicals, radiation, and some hormones. The effects of these agents can accumulate over time, explaining why, although it does occur in younger animals, cancer more commonly affects older ones. Another word for cancer is neoplasia (new growth), and tumors are sometimes referred to as neoplasms. Tumors are classified as benign or malignant. Benign tumors remain at their original site of occurrence. Malignant tumors can invade surrounding tissues and gain access to the bloodstream or lymphatic vessels and then be transported to nearby lymph nodes or other parts of the body. This process is called metastasis and is commonly how cancer spreads. Cats are susceptible to a variety of cancers. Among the most common are mammary (breast) cancer, lymphosarcoma, and squamous cell carcinoma.

    Diabetes Mellitus

    Diabetes is one of the most common endocrine (glandular) disorders in cats, affecting about 1 in 400 cats in the United States. Although the exact cause of diabetes in not known, obesity, genetic predisposition, pancreatic disease, hormonal imbalances, and certain medications have all been incriminated.

    Symptoms

    Most cats are presented to the veterinarian with the classic signs of diabetes: excessive urination, excessive thirst, very good appetite, and weight loss. In a small number of diabetic cats, the nerves supplying the hind legs may be affected, resulting in an abnormal gait.

    Diagnosis and treatment

    Diabetes is usually easy to diagnose. High levels of sugar in the blood and the presence of sugar in the urine allow for a straightforward diagnosis. Occasionally, the clinical signs can be misleading and the blood and urine tests can be equivocal, making the diagnosis somewhat tricky. In these instances, some additional tests may be necessary before a definitive diagnosis can be reached. Caring for a diabetic cat takes a strong commitment from both the cat owner and the veterinarian. You must be able and willing to provide a high level of care on a daily basis. Although a few cats will experience remission of their diabetes if their blood sugar is aggressively controlled with insulin and diet, most cats require lifelong insulin therapy. Every day, you will have to give your cat insulin injections, watch her diet, and monitor her behavior. The initial cost of treating a diabetic cat can be significant. In some cats, the diabetes can be brought under control fairly quickly, with only a few visits to the veterinarian and a minimal number of adjustments to get the insulin dosage right. Other cats require more frequent initial visits and more dosage adjustments. The initial attempts to regulate the diabetes involve simple blood or urine tests and outpatient visits. As you and your veterinarian get closer to discovering the exact amount of insulin required to control the disease, your cat may need to be hospitalized for ten to twelve hours so that a "glucose curve" can be performed. This involves taking a tiny sample of blood every one to two hours and determining the blood sugar level. The glucose curve allows the creation of a blood glucose profile in the form of a graph, giving information about your cat's unique pattern of response to its insulin. In most cases, a glucose curve is not necessary, and progress can be monitored by measuring a cat's fructosamine levels. The fructosamine level is a reflection of the cat's average blood sugar level over the previous two weeks.

    Advances in home monitoring systems are leading some veterinarians to recommend that blood glucose curves be obtained in the home setting. Blood glucose concentrations are measured at home by collecting blood from the ear of the cat using a lancing device. This can be demonstrated in the office for the client. Collection of blood from the ear does not appear to be painful to the cat, and the puncture sites are barely visible, even after multiple collections. Once the initial testing is accomplished and the insulin requirements are determined, subsequent costs (insulin, syringes, prescription diets, progress examinations) decrease dramatically and are quite manageable. Treatment of diabetes involves medication and special diets. Although some diabetic cats may respond to treatment using oral glucose-lowering drugs, these drugs work poorly and have fallen out of favor. The majority of cats will require twice-daily insulin injections.Many studies have also shown that a high-protein, low-carbohydrate food is the ideal diet for diabetic cats. These diets are available as prescription diets and can be purchased at nearly all veterinary offices. Many cat owners cringe at the idea of injecting their cats. However, owners soon learn that most cats find injections far less stressful than pilling and get the technique down fairly quickly. Your veterinarian and his or her technicians will teach you the technique.

    Insulin must be given at the same time(s) every day. The majority of cats receive insulin twice daily. Choose the time frame that works best for you. If you're most likely to be home at 6 a.m. and 6 p.m., give the injections at these times. If 9:00 a.m. and 9:00 p.m. works better for you, this is fine too. As long as you're consistent, there should be few problems.Reusing needles is not recommended. After one use, needles are no longer sterile and bacteria from the cat's skin can contaminate the entire bottle of insulin when a used needle is stuck back into the vial. Needles also become dull very quickly, and dull needles are more likely to sting a little when they're inserted into the skin. Although most diabetics remain reasonably healthy before they present to the veterinarian, some cats can develop a condition called ketoacidosis, in which the cat may become extremely lethargic with signs such as vomiting, diarrhea, loss of appetite, dehydration, and coma. Ketoacidosis is considered a potentially life-threatening emergency, and any diabetic cat with these clinical signs should be evaluated by a veterinarian immediately. Diabetics are also more prone to infections, with oral and urinary tract infections being most common.

    Without insulin, your cat cannot survive. Too much insulin, however, is just as bad as too little. A potentially dangerous condition called hypoglycemia (low blood sugar) can result from an overdose of insulin. This is sometimes referred to as "insulin shock." Any cat undergoing treatment for diabetes must be watched carefully for signs of hypoglycemia. (See Signs of Hypoglycemia on this page.) Although the concern that a cat owner feels when told that his or her cat has diabetes can be overwhelming, it should be kept in mind that the prognosis for diabetic cats is good; diabetic cats do not go blind from cataracts like diabetic dogs do, and they do not suffer circulatory problems or other problems that human diabetics experience. Diabetes is a treatable condition, and cats can live normal, happy, healthy lives for many years after the diagnosis.

    Diabetic cats require daily insulin injections and a special diet-and a loving and committed pet parent.

    Obesity may contribute to diabetes in cats, so do your best to keep your kitty at a healthy weight.

    Hyperthyroidism

    Hyperthyroidism is a glandular disorder of geriatric cats. It occurs as a result of the thyroid gland (located in the neck) producing excessive amounts of thyroid hormone.

    Symptoms

    Cats with hyperthyroidism can have any of a number of clinical signs, the most common being weight loss despite an excellent appetite. Other possible signs include excessive thirst and urination, vomiting, diarrhea, panting, restlessness, excessive shedding, and increased vocalization.

    Diagnosis and treatment

    Fortunately, hyperthyroidism is easily diagnosed by a simple blood test, and the disorder is very treatable. In fact, it is curable. The ideal treatment is the administration of radioactive iodine. A dose of radioactive iodine is given subcutaneously (under the skin). The iodine travels to the thyroid gland (because the thyroid is where all of the body's iodine is stored), allowing for the radiation to treat the condition. A single dose of radioactive iodine is effective in approximately 95 percent of cases. The main advantage of radioactive iodine therapy is that it is curative, safe, and noninvasive; anesthesia and surgery are not required. The main disadvantages are the cost (at the time of this writing, the typical cost for this procedure is $1,500 to $2,000) and the requirement that the cat stay at the treatment facility for seven to ten days. Treated cats cannot be released to their owners until the level of radioactivity in the urine and feces decreases to an acceptable amount. Because this treatment requires the use of radioactive materials, it must be performed at a referral center.

    Thyroidectomy (surgical removal of the thyroid) is another curative procedure. However, the risks of anesthesia, the invasiveness of the procedure, and the fact that the cost is the same (or more) than radioactive iodine therapy have made surgical treatment nearly obsolete. The most common treatment is administration of medication that suppresses the release of thyroid hormone from the thyroid gland. The drug, methimazole, must be administered twice daily, doses approximately twelve hours apart. Although the medication is usually in tablet form, it can be compounded into a liquid form for cats who resist being pilled. For cats who resist any form of oral medication, the methimazole can be prepared (by a compounding pharmacy) into a gel that is applied to the inside, hairless portion of the ear. The methimazole is absorbed through the skin into the bloodstream.

    Hyperthyroidism can cause cats to become thin and shed excessively.

    Signs of Hypoglycemia

    These signs include weakness, lack of coordination, acting spacey or confused, and occasionally coma. Dogs often experience seizures when they become hypoglycemic. Cats may have seizures, but this is less common. Instead, cats seem to act "drunk" and confused. If a diabetic cat experiences an episode of hypoglycemia, contact a veterinarian immediately. While waiting for veterinary assistance, give your cat corn syrup or honey slowly, using a syringe to squirt it into her mouth. If she is able to eat, offer her normal food. If your cat is having seizures or is semi-comatose, rub a tablespoon of corn syrup or honey onto her gums. A noticeable effect should be seen within five minutes of administering the syrup. Overdoses can happen if an incorrect insulin dose is being measured on the syringe. A more common scenario that leads to overdosing is that one family member has given insulin to the cat not realizing that another family member already gave it. If more than one person is handling the medication of a diabetic cat, good communication between family members is essential to avoid this situation.

    With proper treatment, cats with hyperthyroidism have an excellent prognosis.

    Lymphoma

    Lymphoma (also called lymphosarcoma; the terms are often used interchangeably) is a cancer arising from lymphoid tissues. It is the most common cancer in the cat, accounting for one-third of all feline cancers. Affected cats range in age, on average, from two to six years although any age cat is susceptible. Infection with FeLV increases the risk of developing lymphosarcoma. This is especially true of younger cats. Older cats who develop lymphoma are less likely to be concurrently infected with FeLV. Cats infected with FIV are also more likely to develop lymphoma later in life. Exposure to second-hand cigarette smoke has also been shown to increase the relative risk of developing lymphoma.Lymphoma is often categorized by anatomic location. The five common types are mediastinal (involving structures inside the chest), alimentary (digestive system), multicentric (the lymph nodes), leukemic (the bloodstream), and extranodal (other organs, such as the kidneys, eyes, nervous system, nasal cavity, and skin). In cats, the most common sites are the gastrointestinal tract, the mediastinum (structures in the chest such as the thymus and associated lymph nodes), the liver, spleen, and kidneys.

    Treatment

    Once a diagnosis of lymphoma is made, there are three options: no treatment, euthanasia, or treatment. Some cat owners choose not to treat because of the financial, emotional, and time commitment involved. Lymphoma is one of the most treatable cancers in the cat, however, and for those who choose to treat a variety of options exist. Lymphoma is fairly responsive to chemotherapy, and your veterinarian can devise a protocol suitable for your cat's particular type of lymphoma. If more advanced therapies are appropriate, such as radiation or the use of investigational drugs, referral to a veterinary oncologist may be warranted. Lymphoma is controllable, but it is not considered curable by any currently available treatment. (For more information about gastrointestinal lymphoma, see the section on Gastrointestinal Cancer, chapter 16,

    Mammary Cancer

    Studies estimate that 1 out of 4,000 cats develop breast cancer. Although this may seem like a small incidence, breast cancer is in fact the third most common tumor in cats, accounting for 10–12 percent of all diagnosed feline tumors. The average age at onset is ten to twelve years. Siamese females are at twice the risk of developing this type of cancer compared with other cat breeds. Siamese also tend to develop these tumors at a younger age. Males of any breed rarely develop breast cancer. Unspayed cats are at an increased risk of breast cancer. Spaying a cat, especially before her first heat, greatly reduces this risk. Spaying a cat prior to six months of age leads to a 91 percent reduction in the risk of mammary cancer development. In other words, a cat spayed prior to her first heat (around six months of age) has only 9 percent of the risk of mammary tumor development that an unspayed cat does. If a cat is spayed after six months, but before one year, the risk is 14 percent compared with an unspayed cat. After a year (or two heat cycles), spaying offers no reduction in the risk of future tumor development.

    Symptoms

    Cats have four pairs of mammary glands: the four on the left side form the left chain, and the four on the right comprise the right chain. The glands are numbered one to four, with gland 1 being closest to the head and gland 4 being closest to the tail. Most cats with mammary tumors are brought to the veterinarian after the owner notices a lump associated with the mammary gland(s). Sometimes, however, the lump is detected by the veterinarian during a routine physical examination. Cats may have a tumor involving a single gland or multiple glands.

    Diagnosis and treatment

    Diagnosis is made by discovering the presence of a mammary mass on physical examination. Mammary tumors should be removed surgically. There is no way to determine whether a mammary tumor is benign or malignant solely from the visual appearance of the tumor. In dogs, 50 percent of these tumors are benign. Of the 50 percent that are malignant, half of them can be removed completely, resulting in a cure. The other half will either recur or metastasize (spread to other parts of the body) following surgery. In cats, the picture is grimmer: approximately 86 percent of tumors are malignant. Because most affected cats are elderly, a full presurgical evaluation of the patient is important. A complete blood count, serum biochemistry panel, thyroid evaluation, and urinalysis should be performed. Radiographs should be taken as well, to determine if the cancer has already spread to the lungs at the time of surgery. If the cancer has spread, surgery won't be curative and it may be best to cancel the surgery and instead focus all efforts on supportive care to keep the cat comfortable. If the tumor is ulcerated and bleeding or infected, it may be necessary to proceed with surgery even if the tumor has already spread to the lungs or elsewhere.

    The goal of surgery is to remove the entire tumor by the simplest procedure possible. Single tumors may be removed by a mammectomy-removal of the entire mammary gland. If tumors are present in multiple glands, they may be removed individually, or via a chain mastectomy in which the entire chain of mammary glands is removed via one long incision. Again, the choice of procedure depends on ease of removal of all affected tissue. Because each gland within a mammary chain is connected to each other by lymphatic vessels, some surgeons feel that a radical chain mastectomy is the procedure of choice, even if only one tumor is detected, since mammary tumors initially spread via the lymphatic vessels. There are differing opinions regarding the efficacy of chemotherapy for feline mammary gland tumors. Some veterinary oncologists recommend chemotherapy as adjunct therapy in cats whose tumors show evidence of invasion into the blood vessels or lymphatic vessels. Others recommend chemotherapy in all cases, given the high metastatic potential of feline mammary tumors. A consultation with a veterinary oncologist would be prudent to assess whether a particular cat is an appropriate candidate for postsurgical chemotherapy.Prognosis depends on several factors, the most important being the size of the tumor at the time of diagnosis. If the tumor is less than 2 centimeters in diameter, the prognosis is better; cats often survive more than three years. Tumors larger than 3 centimeters are associated with a survival time of only four to six months. These statistics clearly illustrate what has essentially become common knowledge regarding cancer in people and animals: early detection is of paramount importance.

    Cat with mammary cancer being prepared for surgery.

    Three Treatment Options for Cancer

    Once cancer is diagnosed, there are three common treatment options: surgery, chemotherapy, or radiation.

    Surgery:

    Surgery affords the best chance a cure by removing the affected tissue. Surgery is curative only if the cancer hasn't already spread and if the affected area can be removed completely. For cancers such as leukemia, which involves the bloodstream, surgery is obviously not an option.

    Radiation:

    Radiation is an option for localized tumors that cannot be treated surgically or were treated surgically but all of cancerous tissue could not be removed. Radiation works by aiming a penetrating beam of high-energy gamma rays or streams of radioactive particles at the tumor. When irradiated, the DNA of the cancer cells is fatally damaged; cancer cells can no longer divide and spread, so they die. Some cancers are very susceptible to radiation treatment whereas others are resistant. Anesthesia is necessary, so that the cat is completely immobile and the radiation or particle beam can be precisely focused onto the tumor. The equipment necessary for radiation treatment is expensive and highly specialized and is only available at universities or referral centers. Side effects of radiation are usually temporary and can vary depending on the area of the body being irradiated. Redness and irritation at the site of radiation are the most common. Hair loss at the site of irradiation is often seen. Although the lost hair usually grows back, the hair color may change. If radiation is administered to areas in or near the mouth, the oral tissues may become inflamed or irritated, and the cat may become reluctant to eat and/or drink. These cats may need to be handfed or have a feeding tube inserted. Radiation administered to areas near the eye may result in the vision being affected, or the cat may experience a reduction in tear production. There is always some risk associated with the anesthesia necessary for radiation treatment; however, the duration of anesthesia is usually short and cats are monitored closely throughout the procedure. Radiation therapy can be exceedingly expensive, and many cat owners find this option to be cost prohibitive.

    Chemotherapy:

    Chemotherapy is another common option, especially for cancers involving several body sites or at sites that aren't amenable to surgery or radiation. Although many veterinary chemotherapy drugs are the same as those used for humans, they're not given with the same expectations. Chemotherapy for animals is not intended to be curative. The goal is to reduce the number of cancer cells and slow the progression of disease for as long as possible while maintaining good quality of life. Therefore the drugs are typically not used in the high concentration in cats than they are in people, which means that most cats tolerate chemotherapy very well. Chemo drugs are still potent, however, and cats must be monitored for side effects such as vomiting, diarrhea, and poor appetite. Generalized hair loss is uncommon, but shaved hair (shaved for intravenous catheter placement or surgery) is slower to grow back, and cats may lose their whiskers.

    Squamous Cell Carcinoma

    Squamous cell carcinoma (SCC) accounts for 15 percent of all feline skin tumors. These tumors usually involve light or unpigmented skin. Sun exposure increases the risk of developing SCC. The most common locations are the hairless area of the nose, the eyelids, and ears. Older cats are at higher risk; the mean age for affected cats is twelve years. Siamese cats, with their pigmented skin, are less likely to develop SCC than other breeds. A more common-and more devastating-scenario is when SCC affects a cat's mouth. Oral SCC is the most common oral malignancy in cats. Its occurrence is often disastrous, as oral SCC is much worse than the skin form. The oral tissues that are commonly involved include the tonsils, the tongue, the gums, and the mandible (lower jaw bone).

    Symptoms

    The most common symptoms of oral SCC in cats are difficulty or inability to eat and/or groom. Cats may drool if the tumor prevents proper closure of the mouth. The saliva may be tinged with blood if the tumor becomes ulcerated. A foul odor from the mouth may be present if the tumor becomes infected. If the upper or lower jaw is the primary site of the tumor, a swelling on the face may be noted before clinical signs develop. The primary symptom of the cutaneous (skin) form of SCC is the presence of a mass on the skin, mainly on the face or ears. In many cases, the mass will ulcerate and appear as a sore that fails to heal.

    Diagnosis and treatment

    Squamous cell carcinomas are diagnosed by biopsy of the affected tissues. This requires anesthesia. SCC of the skin is often amenable to treatment. Surgery, radiation therapy, and intralesional chemotherapy (in which the drug is injected directly into the tumor) have all been shown effective in treating this cancer. Unfortunately, most cases (95 percent) of oral SCC are diagnosed only after the cat is showing overt clinical signs. Treatment of oral SCC is often unrewarding. Thus far, surgery has offered the best chance for survival but most of the time the disease has progressed too far for surgery to be of any benefit. Chemotherapy, like other treatment, has mostly been ineffective. However, Palladia, a new FDA-approved drug for treatment of some canine cancers has shown some promise in slowing the growth of oral SCC in cats.

    Cats with pale fur and skin are at an increased risk for squamous cell carcinoma.

    From The Cat Bible, Copyright by Sandy Robins, licensed through ContentOro, Inc and used by arrangement with I-5 Press

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