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Questions for Dr. Shawn - General Health

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"Dear Dr. Shawn:
"My cat Sniffles doesn’t seem quite right. He’s 15 years old and has never had any health problems. Over the last few months he’s lost a small amount of weight (2 pounds) and seems to be drinking more water. His doctor has run blood and urine tests but these are normal, so I know he doesn’t have diabetes or kidney disease. His veterinarian doesn’t really have any other advice since all of his tests are normal. I know my cat and something is definitely wrong. I don’t want to watch him get worse or die. What else can I do? What do you think is going on with him?"

Answer:
”Even though his examination and lab tests are normal, there still may be something wrong. I see a number of pets in my practice just like Sniffles. The owner knows something is wrong, yet the doctor who does the initial testing fails to find a problem and dismisses the owner’s concerns. As a pet owner, I rely upon your observations even more than my own limited findings. You are with Sniffles every day and know his normal behaviors. If you think there is really something wrong then more testing must be done to find the problem.

Here’s what I would suggest. Ask your veterinarian for a referral to a specialist for a second opinion. Further testing, which may include X-rays, an ultrasound examination, specialized blood testing, or even an endoscopic exam and biopsy of the gastrointestinal system may be needed. The good news is that in cases like this, a cause is usually found. The bad news is that it will take more testing to uncover the problem. All of the “normal” diseases like kidney disease, diabetes, and thyroid disease have already been ruled out by the testing your veterinarian has already performed. Be persistent and I’m confident that the specialist will be able to help you.”


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"Dear Dr. Shawn:
”As I did last week, I’m going to continue sharing some interesting facts from the veterinary world:

As is true with people, pets, especially cats, can develop esophageal injury (usually stricture) from oral medications.

Antibiotic (usually doxycycline) pills (capsules and tablets) are most commonly incriminated. The medications irritate the esophagus when the get stuck in the folds of tissue lining the esophagus and fail to move into the stomach and intestines.

To minimize the chance of esophageal stricture, administer 1 teaspoon (5 ml) of water following the administration of any medications for pets and people.

Arthritis is a common problem in older cats, as in dogs. However, many pet owners and veterinarians do not recognize it. Many cats do not show clinical signs such as limping or lameness, which makes the diagnosis and treatment more challenging.

In one recent study, 22% of cats that were X-rayed showed radiographic evidence of arthritis (the elbows were the most commonly affected joints in this study; in dogs, the lower back and hips are most commonly affected.)

As is true with dogs, there is no correlation between radiographic signs and clinical signs.

In a prior study, 90% of radiographed cats showed arthritis.

The take home message: as with dogs, I expect most of my older feline patients suffer from arthritis. All older cats are started on joint supplements as a prevention. Any older cat exhibiting clinical signs of arthritis are placed on a variety of joint supplements, plus homeopathics and herbs. If needed, NSAID medication can be used infrequently for severe pain.”

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