With the dog producing milk and sometimes mothering soft toys or pillows like Rosie in the illustration. So what should you do when this happens?

A Female Dog’s Normal Reproductive Cycle

Before talking about treatment, let’s explain the dog’s natural estrus cycle. The female dog comes into season approximately every 6 to 8 months, though this period becomes more erratic with age and is somewhat irregular when cycles first begin, and can come at longer intervals in certain breeds. 

When female dogs get older (say, seven or older), they do not stop cycling; there is nothing similar to menopause. Instead, as mentioned, cycles become irregular and long periods of time (years) can pass between cycles.

The second phase of the cycle is called estrus, which is characterized by the change in the character of the vaginal discharge from bloody to straw-colored. At this time, the female begins to allow the male to mount. It is classically the change from proestrus to estrus when ovulation occurs, and the female is most fertile. 

When the puppies are ready for birth, the corpus luteum is rapidly destroyed in a completely different hormonal sequence of events.

If she is not pregnant, the corpus luteum will simply wear out gradually and she will go back into the period of hormonal inactivity in which she spends the bulk of her time. This process of the corpus luteum wearing out in the absence of pregnancy takes at least 70 days, starting at the time of ovulation.  

Remember, during the 70+ days she has an active corpus luteum, her body essentially thinks she is pregnant and proceeds accordingly.

All the hormones are present; only the puppies are missing. If she is actually pregnant, the corpus luteum lasts through the 63 days of pregnancy. When the puppies are ready for birth, the corpus luteum is rapidly destroyed in a completely different hormonal sequence of events. Because the female dog is hormonally pregnant for 70 days after ovulation, one could say false pregnancy is a normal part of the cycle. We only treat it as a disease when it becomes extreme or fails to resolve naturally.

Clinical False Pregnancy

When false pregnancy persists, it can be a nuisance. The female dog can show the following signs:

• Nesting
• Mothering inanimate objects
• Lactating (giving milk)
• Abdominal distension
• She can even appear to go into labor.

Some female dogs are very sensitive to the hormonal fluctuations of their cycle. Diagnosis is made by history and physical examination rather than by blood test (though a blood test can be used to determine if she is actually pregnant or not). The key is to find symptoms of pregnancy in a female dog who is not pregnant. Symptoms generally become noticeable 6 to 12 weeks after estrus.

Treatment

If a more aggressive approach is needed, a diuretic such as furosemide can be prescribed. The idea is that mild dehydration will end the lactation.

Some people may want to try water deprivation, but this is potentially dangerous and should not be attempted without specific veterinary guidance.

If the above medication does not work, hormonal medications can be used. Progesterone can be used, but after the course of medication is complete, the false pregnancy recurs, so this is not a good choice. Estrogens are also not a good choice as they bring the dog back into estrus (vaginal discharge, attracting males, etc.). A week’s course of the male hormone mibolerone has generally been successful, but this medication is no longer available.

Hormones that inhibit prolactin (the hormone of milk production) are currently the best choices when medications are needed. Bromocriptine can be obtained from a compounding pharmacy and is given until lactation ceases (about a week or two). An upset stomach is not unusual with this medication. Cabergoline has fewer side effects and is given similarly but tends to be more expensive. Both these medications will cause abortion if the dog actually turns out to be pregnant, so it is important to be sure. A third medication called metergoline works a little differently to reduce prolactin but can also be used to end false pregnancy. Approximately 4-5 days of treatment are needed to stop the lactation and get things back to normal. Supplementing with vitamin B6 has been found to be helpful in regressing the false pregnancy as well.

A blood test can reliably detect canine pregnancy after 30 days from the breeding date. Ask your veterinarian about this test if you are not sure whether your dog is pregnant.

Spay during False Pregnancy?

It might seem like a good idea to spay the female to end the false pregnancy, as spaying will remove the ovaries and the corpora lutea they carry.

Unfortunately, this does not end the prolactin production from the pituitary gland so spaying may actually prolong the false pregnancy. Spaying during the diestrus period described above can actually trigger a false pregnancy. It is best to wait until the false pregnancy is over and then spay her to prevent future episodes. It is best to spay well after the 70-day diestrus period to avoid triggering a false pregnancy.

The resulting inflammation may target the GI tract or other organ systems, but in dogs and cats, the skin is frequently included in this immunologic activity.

Cats itch around the face or neck, which produces scabs and hair loss. In dogs, signs include facial itching, foot or limb chewing, itchy anal area, and recurrent ear infections.

Many people erroneously assume itching due to food allergy requires a recent diet change of some sort. In fact, the opposite is true.

Food allergies require time to develop; most animals have been eating the offending food for years with no trouble.

What Kind of Allergy?

Diagnosing and treating allergic skin disease and its secondary infections make up a large proportion of cases seen in small animal practice.  Pets can be allergic to insect bites (fleas are not inherently itchy unless the pet is allergic to flea bites), airborne proteins (such as molds, pollens, and dust mite parts), or foods. Pets can and often do have multiple allergies, adding together to make them itchy. The skin infections that come from scratching perpetuate the itching. To solve the problem, the infection must be cleared up and the offending allergen(s) removed from the pet’s world.

There is controversy about how common food allergy is in dogs and cats. Some experts feel it is relatively rare, while others feel is much more common than we realize. It is hard to tell because there is no simple test for food allergy, and the skin lesion distribution is difficult to distinguish from that of airborne allergy, which is frequently concurrent in the same patient.

So what are our clues that a pet has a food allergy? There are several hints:

• The itching is not seasonal (this is hard to tell in areas that do not freeze during winter).
• Itching started when the pet was less than six months of age or greater than five to six years of age.
• No response to treatment for sarcoptic mange (a condition with a similar itchy skin pattern).
• Corticosteroids have not helped manage the itching. Corticosteroids may or may not work on food allergy itching but they almost always work for other allergies.
• There are accompanying intestinal signs like vomiting or diarrhea. These are seen in 30 percent of food allergic pets.
• The lesion distribution is compatible with food allergy, especially if an itchy anal area and/or recurrent ear infections are involved.

Any of the above findings or observations warrant the pursuit of food allergy.

Please note that several of the above criteria relate to what you observe at home. Trouble results when the veterinarian must speak to different family members about the pet and there is disagreement in their observations. It is best to have one person, preferably the one who has the most contact with the pet, be the spokesperson and make the relevant judgments.

The Flea Factor

The short answer is not to waste money on these tests. Blood tests for allergy can detect antibodies against certain food proteins, but this does not necessarily mean the pet has an allergy. It may mean nothing more than the pet has eaten that type of protein before. Furthermore, the pet’s body may alter a food protein during digestion, and it is the altered protein that generates the allergy. There is no predicting how a protein could be altered and thus no test can be devised for altered proteins. Laboratory tests are simply not valid for determining if a pet has an allergy to a certain type of food.

Hypoallergenic Diet Trial

To determine whether or not a food allergy or intolerance is causing the skin problem, a hypoallergenic diet is fed for a set period. If the pet recovers, the original diet is fed for up to two weeks to see if itching resumes. (Actually, exposure to an allergen generally leads to itching within 12 hours, but it takes two weeks to be completely sure.)

If we see recovery with the test diet and itch with the original diet, then food allergy is diagnosed, and the pet is returned to either the test diet or another appropriate commercial food indefinitely.

There is no other way to determine if a pet has a food allergy. Blood tests are not useful.

Before reviewing diet strategies for this process, here are some additional concerns:

• The diet must be strict (meaning the pet should not have any other protein sources besides the test protein). This includes rawhides and chew toys, flavored chewable medications (these will need to be changed for unflavored tablets) and vitamins, and treats.
• All family members must be on board with the trial. No one should be giving the pet other foods or treats when no one else is looking.
• It is probably best for all animals in the house to be fed the test protein so as not to have food-sharing issues.
• Itching must be managed during the trial in a way that the results of the trial are not foiled.
• Diet trials often span a season change period. If a dog has a pollen allergy and winter comes during the period of the diet trial, it may appear that the diet worked when, in fact, the seasons simply changed. This is why a diet challenge is important at the end, even if the pet is doing well.
• The diet trial will take eight weeks. Most animals will respond in three to four weeks, but to be sure, you will need to feed the test diet for two months.

What Is a Good Hypoallergenic Diet?

There are two approaches to test diets: novel protein and hydrolyzed protein. Traditionally, a novel protein is used. This is a diet with a single protein source that the patient has never eaten before. It typically takes years to become allergic to a food protein so the patient should not be allergic to something new.

Fortunately, many pet food companies have discerned the need for diets using unusual protein and carbohydrate sources with a minimum of additives. Foods can be obtained based on venison and potato, fish and potato, egg and rice, duck and pea, and even kangaroo. Diets used for allergy trials must contain one protein and one carbohydrate source, and neither can be something the pet has had before. Recently, several diets that include duck, venison, and so on have been released to the general market. Be aware of foods that contain these ingredients because these ingredients will not be useable for future diet trials if they are ever used in the pet’s regular food.

It is important that no unnecessary medications are given during the diet trial. No edible chew toys (such as rawhides or bones) should be given. Treats must be based on the same food sources as the test diet. (Beware of rice cakes, though, as wheat is commonly used as a filler.) Chewable heartworm preventives should be replaced with tablets or topicals.

Over-the-Counter Food? Therapeutic Diet? Home Cooked?

Recently several pet food companies have released single protein diets for over-the-counter sales. These tend to cost less than the therapeutic diets available from your veterinarian’s office directly. While these diets are attractive, they are probably not a good choice for an actual diet trial. Immunological tests on these foods found that many of them contain additional proteins (probable contaminants from prior batches in the pet food factory). These impurities could defeat a diet trial which is hard enough to perform without such issues. The therapeutic diets did not have these contaminants.

Home cooking is a fine alternative to commercially prepared foods for the diet trial. The problem is that the test diets will most likely not be balanced but for the 2 months or so of testing, this should not be a problem. Home cooking is a bit of an inconvenience, but for the right person, it is a good choice. Ideally, a nutritionist should be involved in designing the diet. Recipes for appropriate diets can be purchased through BalanceIt, Petdiets.com or by any nutritionist listed at the American College of Veterinary Nutrition website.

The Hydrolyzed Protein Method

Several therapeutic diets are made from hydrolyzed proteins. This means that a conventional protein source is used but the protein is broken down into molecules too small to excite the immune system. There are various hydrolyzed diets on the market; discuss with your veterinarian which is best for your pet.

Trial Diet Timeframe

Studies have shown that 80 percent of dogs will have shown a response by 4 to 6 weeks on the diet, but by extending the diet to 8 weeks, 90 percent will respond. The Labrador retriever and cocker spaniel appear to require longer trials. Most veterinary dermatologists recommend 8 to 12 weeks, which is a long time to be strict on the diet, but that is the only way to detect food allergic dogs.

What To Do if the Diet Is Successful?

To confirm food allergy, return to the original food; itching generally resumes within 14 days if food allergy was truly the reason for the itchy skin. Many people do not want to take a chance of returning to itching if the patient is doing well; it is not unreasonable to simply stay with the test diet if the pet remains free of symptoms. Often it is difficult to remember 10 to 12 weeks later how itchy the dog used to be before the diet trial. The diet challenge helps make it more obvious whether the diet trial has worked or not.

It is possible to more specifically determine the identity of the offending foods after the pet is well. To do this, a pure protein source (such as cooked chicken, tofu, wheat flour, or any other single food) is added to the test diet with each feeding. If the pet begins to itch within two weeks, then that protein source represents one of the pet’s allergens. Return to the test diet until the itching stops, and try another pure protein source. If no itching results after two weeks of feeding a test protein, the pet is not allergic to this protein.

What To Do if the Diet Is Unsuccessful?

Assuming secondary skin infections have been controlled, an unsuccessful food trial is strongly suggestive that an inhalant allergy is a primary problem, but some other considerations should at least be mentioned:

1. Are you certain that the dog received no other food or substances orally during the trial?
2. Was sarcoptic mange ruled out?
3. Your pet may require a longer diet trial. Are you certain regarding the factor that pointed toward the food allergy?

If your pet has not been biopsied, now may be a good time. If an inhalant allergy has risen to the top of the list, symptomatic relief either via medication, baths with specific shampoos, or allergy shots will likely be necessary. Chronic itchiness can be extremely uncomfortable and prompt relief is our goal as well as yours.

The declaw surgery is an instant permanent solution to these problems; however, it is popularly held that a number of adverse conditions result from declawing, possibly including chronic pain for the cat. Pet owners need an understanding all of the alternative options involved as well as what the actual facts are regarding this procedure. 

The American Veterinary Medical Association policy regarding declawing is: The AVMA discourages the declawing (onychectomy) of cats as an elective procedure and supports non-surgical alternatives to the procedure. The AVMA respects the veterinarian’s right to use professional judgment when deciding how to best protect their individual patients’ health and welfare. Therefore, it is incumbent upon the veterinarian to counsel the owner about the natural scratching behavior of cats, the alternatives to surgery, as well as the details of the procedure itself and subsequent potential complications. Onychectomy is a surgical amputation and if performed, multi-modal perioperative pain management must be utilized.

Alternatives to Declaw Surgery to Try First

Scratching is a natural behavior of cats, which makes it difficult to modify. The usual goal is to transfer the cat’s scratching instinct to a scratching post or other scratching toy; it is virtually impossible to control the desire to scratch completely. Some cats take quickly to alternative scratching surfaces while other cats require time-consuming training. 

Training tips include:

• The cat can be punished for furniture scratching attempts but it is important that the cat cannot connect the punishment with the person administering it (otherwise the cat will simply learn not to scratch while that person is watching). Yelling, spanking, or shaking a can with pennies in it is too directly associated with the person rather than the act of scratching. A water squirt bottle is better but only if the cat does not see where the squirt comes from. Booby traps can be set up using balloons. If mouse traps are used, it is vital that they be turned upside-down so that the cat cannot possibly catch a foot in the trap. Stacked traps can be set up so that they pop upward when tripped, making a surprising noise. In this way, punishment can still be carried out when the owner is not at home. The idea is to convince the cat that the furniture piece is not a good area for scratching and that the appropriate scratch toy can be used with no adverse experience.

Many owners are not excited about putting mousetraps up against their living room furniture, upholstering in aluminum foil, or decorating sofas and chairs with balloons. It is easy to see why a surgical solution would be attractive. Fortunately, there are more options.

Nail Trimming

For some cats, simply keeping the nails short is adequate control but many people do not know how to trim their cat’s nails. In fact, the non-pigmented nail of a cat makes it easy to see where not to cut. This video on YouTube shows exactly what to do. 

Blunt Acrylic Nail Caps

• Some cats are not in the least discouraged from scratching by these caps and are able to simply scratch larger holes in the upholstery.

Surgical Declaw (Onychiectomy)

Despite our best efforts to deflect scratching or decrease claw sharpness, sometimes nothing works and an immediate, permanent solution is needed. It is important to consider that the declaw surgery alters the cat permanently and should not be done if alternative methods are effective. The cat will need some special care during the post-operative healing period: special litter, pain medication, and some activity restriction as he/she will have tender feet for a week or two after surgery. The declawed cat should be forever indoors or outdoors only with supervision as they will no longer have the ability to defend themselves against dogs or other cats.

There is a great deal of controversy regarding this procedure and it has been legally restricted in many areas. Few veterinary surgeries encounter as much bias as the declaw, and a political has movement emerged. Some concerns are valid and some less so. Before making a declaw decision, it is important to review the arguments and find your own perspective. Here are some of the issues.

• The declaw is viewed by many as performing an unethical surgical alteration of a companion animal for the sake of convenience. This is frequently countered by the idea that convenience is not the issue but that the relationship between the pet and its owner is at stake. If that relationship fails, a much bigger life quality issue is at stake including relinquishing the cat to the shelter where euthanasia is a real possibility.
  
• Chronic pain may result from alterations in the foot anatomy and that long-term arthritis is promoted. While there may be truth to this, it is important to realize that 90% of cats over age 10 have arthritis in at least one joint. While it is certainly better to prevent arthritis in a cat’s senior years if we can, we still need the cat to get to its senior years. Arthritis can be treated; euthanasia cannot.
  
• Some people believe that a cat’s indoor only lifestyle is not humane because it is not natural, or an indoor only lifestyle may be impractical because of other people or other animals coming and going in the home. It is true that a declawed cat should become an indoor only pet for its own protection.
  
• There is belief that the procedure is performed too casually and that alternatives are not properly given consideration. Regardless of one’s feelings are on whether to declaw a cat, the fact remains that we are talking about a permanent alteration with a potential for negative ramifications later on. This procedure is not to be done lightly and it is important to at least attempt some of the alternatives discussed above.

Research has been conducted to sort out truth from political propaganda. The AVMA has an excellent source where this research has been collated and the concerns are addressed. Here are some conclusions but feel free to examine the AVMA’s information on your own. 

Myth #1:  After declawing, a cat is likely to become fearful or experience behavior changes, impairing an affectionate relationship with his owner.

Numerous scientific studies have been unable to document any behavior changes post-declaw. In fact, in one survey 70 percent of owners of declawed cats reported an improved relationship with their cat after the procedure.  

Myth #2:  A declawed cat cannot climb trees.

Declawed cats are not as effective at climbing trees as cats with claws, but declawing does not prevent tree climbing. That said, declawed cats should be kept indoors where they do not need claws to assist in self-defense. 

Myth #3:  A declawed cat cannot catch prey.

Declawed cats are not as effective at catching prey as cats with claws but declawing does not prevent effective hunting. 

Myth #4:  A declawed cat has lost its ability to defend itself and should not be allowed outside.

This one is true. Without claws, a cat has indeed lost an important part of his defense system. Declawed cats should be housed indoors only. 

Myth #5:  Declawed cats are more likely to bite since they can no longer claw.

Declawed cats do not seem to realize they have no claws. They will continue to scratch ineffectively as if they did not know the difference. As for biting, there have been some studies that show an increased tendency to bite in declawed cats while other studies have not shown that. The trouble in interpreting this information is that one of the reasons cats are declawed is to control aggression. Cats that are aggressive, even in play, are more likely to be declawed to at least remove the claw portion of the human hazard. The same cat is still perfectly able to bite and will continue to bite. Studies on cats that bite after declaw have not explored whether the same cats were biting before the declaw so conclusions are difficult to draw.

Myth #6:  The post-operative period involves tremendous pain.

Pain management techniques have improved greatly in recent years and include regional nerve blocks eliminating pain completely from the feet during the first few days of healing, fentanyl pain relief patches, as well as injectable and oral medications. This means that a declawed cat should be comfortable in the recovery period. 

That said, if proper pain relief is not practiced, the declawed cat will have sore feet after surgery. The larger the cat, the more discomfort there is and reluctance to bear weight.  

The recovery period should not last longer than a week or so. Healing should be complete by two weeks. Pain after this recovery period is not normal or expected in any way and if a declawed cat seems to be uncomfortable or lame, a recheck appointment is definitely needed. 

If you plan to declaw your cat, you may want to ask your veterinarian about the pain relief plan they expect to utilize so you know what to expect. 

Myth #7:  A declawed cat will not use a litter box again.

It is important that litter not get impacted in the declaw incisions during the recovery period. Shredded paper is the usual recommendation during recovery and some cats simply will not use shredded paper. The recycled newspaper litters are an excellent alternative. The only litter problem one might expect would be lack of acceptance of a new litter during the recovery period. Declawed cats do not lose their litter box instinct.

Declaw Methods

Three techniques are commonly used for permanent declaw surgery: the Resco or clipper blade method; the disarticulation method; and the Laser declaw.

Resco/Clipper Blade Method

This is probably the most common method used by veterinarians to declaw cats as it is associated with the fastest surgery time. It involves the use of a sterile nail trimmer to cut through the bone of the third digit of the toe. The cat loses the part of the bone from which the claw grows. The incision is either sewn closed with suture material or closed in surgical glue.

What to Expect / Possible Complications

• Patients commonly spend at least one night in the hospital for bandaging, monitoring for bleeding and pain assessment.
  
• Some spotting of blood is normal from the toes during the first few days at home (beware if you have white carpeting).
  
• Shredded paper or pelleted recycled newspaper litter is recommended during the healing period. Conventional clay or sand litters can impact inside the tiny incisions and cause infections.
  
• Pain medication is essential, especially for larger or older cats who have more weight to carry on their tender healing toes. The amount of weight carried on the feet (the size of the cat) is the biggest factor in post-operative pain. There are numerous regimens employed for declaw pain control.
  
• Occasionally not enough of the third bone is removed and the claw regrows. When this occurs, infection is generally inevitable and the remaining bone must be removed. This is not a potential complication when the disarticulation method is employed.
  
• A study by Martell-Moran et al published in the Journal of Feline Medicine and Surgery in 2017 found that cats declawed with this method had more back pain later in life than disarticulated cats or undeclared cats.

Disarticulation Method

1. Because the entire third bone is removed, there is a zero possibility of the claw growing back; however, the cut ligaments allow for a subtle drop in the way the foot is held. Most owners do not notice this change in posture.
   
2. Two nights in the hospital are required for this procedure (one night with bandages and one without).
   
3. Some spotting of blood from the toes is normal during the first few days at home (be aware of this with white carpeting).
   
4. Shredded paper or pelleted recycled newspaper litter  is recommended for 10 days after surgery. Conventional clay or sand litters can impact the tiny incisions and cause infections.
   
5. Pain medication is a good idea, especially for larger or older cats. The amount of weight carried on the feet (the size of the cat) is the biggest factor in post-operative pain. I recommend the use of the fentanyl patch for post-op pain control as well as pre-operative local blocks to the feet for pain control.
   
6. Occasionally not enough of the third bone is removed and the claw regrows. When this occurs, infection is generally inevitable and the remaining bone must be removed.
   
7. If the ungual crest of the nail is not removed (the area from which the claw grows), the claw may be able to partly grow back and a second surgery will be needed.

The Laser Declaw: Another Way to Disarticulate

Recently, the laser declaw has received a great deal of attention. In this surgery, a laser rather than a scalpel blade is used to disarticulate the third toe bone. Advantages of laser surgery include virtually no bleeding during surgery or afterwards, possibly less post-operative pain, and in many cases, no bandages.

The downside is the expense of the equipment. The cost of the laser equipment itself is $20,000 to $40,000. To justify such an expense, the laser must be able to generate substantial revenue for the hospital. This means that the cost of the laser declaw to the pet owner is likely to exceed the price of the conventional declaw by an additional $50 to $150 dollars.

Tendonectomy: A Surgical Alternative to Declawing

This surgical procedure has emerged as an alternative to the bone removing declaws. Here, a tendon is cut on the underside of each toe to prevent grasping motions. The claws remain but the cat cannot extend them.

What to Expect / Possible Complications

• Because the incisions needed for this procedure are so small, the recovery is minimal. No bandages, no special litter, no blood spotting. There are usually no stitches to remove and the tiny incisions are closed in surgical glue.
  
• Because the cat can no longer make grasping motions, the claws will naturally grow in a circular manner into the foot pads causing pain and infection unless the owner is able to trim the nails on a regular basis. The tendonectomy patient will require life-long regular nail-clipping. This may not be practical in an aggressive cat and may not be the right choice for an owner seeking a low-maintenance pet.
  
• The August 1, 1998 issue of the Journal of the American Veterinary Medical Association reports a study to compare the long- and short-term complications of tendonectomy vs. those of traditional declaw. Owner satisfaction with both procedures was also measured. While cats who received the tendonectomy showed significantly lower pain scores immediately post operatively, both procedures showed an equal frequency of other complications (bleeding, lameness, and infection). The number of days it took for a cat to walk normally again was not different between the declawed cats and the tendonectomy cats. There was no significant difference between the percentage of owners satisfied with declaw versus the percentage of owners satisfied with tendonectomy. In a 2001 survey, more people were satisfied with the declaw over tendonectomy.

1. Next, have the nail trimmers nearby when you are interacting with your cat. This interaction may be a play session or a time when your cat is comfortably settled on your lap accepting treats. You do not need to move the nail trimmers around, just have them within view of your cat when they are near you.
   
2. Let your cat see you lift and put down the nail trimmers. If your cat enjoys lying on your lap, you can have the nail trimmers near, pick them up and put them down, then feed your cat a treat.
   
3. Practice bringing the nail trimmers to your cat’s foot, then moving them away and giving your cat a treat. If your cat is too stressed about this step, only bring the nail trimmers part way to your cat’s foot before putting them back down and giving a treat.
   
4. After your cat has learned to tolerate a single nail being isolated and examined with the trimmers nearby, cut the toenail. Then begin adding toes to individual sessions until you can cut multiple toenails in one session.

Overall, you want your cat to feel as comfortable, safe, and relaxed as possible when getting their nails trimmed. Work with your veterinarian and staff to make nail trims at home and at the clinic the most positive experience possible for your cat.

There always seems to be the occasional cat for which the traditional therapies do not seem to be appropriate.

1. Radiotherapy is not an insignificant expense and may be financially out of reach. 
2. Some cats simply will not take oral medications. 
3. The compounded ear ointments do not always work. 
4. Some owners are simply unable to give medications twice daily indefinitely with meaningful regularity. 
5. Some cats have a concurrent illness that precludes methimazole or simply does not tolerate its side effects.

Hill’s Pet Nutrition has developed such a diet, called y/d, and it has been an alternative to the more traditional therapies since 2011. The diet is available in both dry and canned formulations in some regions. Always consult with your veterinarian before changing your pet’s therapeutic diet.

How Long do you Have to Feed the Diet for the Cat Not to be Hyperthyroid Anymore?

Several studies have been done, and hundreds of cats have been evaluated. Many cats will have normal thyroid levels in the first two months of diet use; however, a full response can take up to 12 weeks. By 12 weeks on the diet, 90% will show normal thyroid levels. The diet is ineffective in approximately 10% of cats eating it.

Can a Cat Have any Treats While on this Diet?

Unfortunately, there are no acceptable treats. Feeding ANY thing other than the therapeutic diet could interfere with the effectiveness of treatment. Foods or treats meant for other pets in the home should be kept away from a cat on this form of therapy. Also, hyperthyroid cats who roam outside may be eating any number of things out in the world. It is unlikely that their diet can be controlled enough for this form of therapy to be effective. In fact, if the cat on y/d is still hyperthyroid after eight weeks, it can be assumed that the cat is finding another iodine source. The cat might simply be cheating on the diet, getting extra iodine in medication or in drinking water, or even from the surface of a food bowl.

Can Other Cats in the Household Eat this Diet Safely?

After over a decade of Y/d diet availability, it appears that normal cats may safely eat Y/d diet. No reactions or problems were found when the diet was experimentally fed exclusively to normal cats for a two-year period. Further, no issues have come up in the pet-owning population. If multiple cats are present in the home and feeding separately is problematic, it should be fine to feed all the cats the iodine-restricted diet.

The manufacturer suggests taking a week to transition the cat from his normal food to this one, not because of the iodine issue but because it is always a good idea to avoid an abrupt food change. After the transition is complete, Hills recommends a thyroid level, kidney parameters, a recheck exam, and a urine specific gravity (test for urine concentration) after four weeks and again after eight weeks on a Y/d diet. If your cat is still not showing a normal thyroid level in eight weeks, it is worth going out to 12 weeks and evaluating one more time. After your cat has achieved a normal thyroid level, an exam, and blood work should be performed every six months.

In cats with concurrent kidney disease, lab work is recommended after two, four, and eight weeks on the diet and every three to four months thereafter.

What about Switching a Cat on Methimazole Over to the Diet?

The manufacturer recommends simply switching from medication to diet directly with no transitional period. Simply discontinue the medication and start the diet.

Methimazole, surgery, and radiotherapy are well-reviewed effective therapies for feline hyperthyroidism. Where this diet fits in the picture and whether it should replace traditional therapy or be considered an acceptable last resort remains to be seen over time.

The Virus Itself

The feline distemper virus amounts to a single strand of DNA surrounded by a protein coating. It is extremely stable in the environment, which leads to its characterization as ubiquitous (everywhere). It can last a year indoors at room temperature. It survives freezing as well as treatment with such common disinfectants as alcohol and iodine. Fortunately, soaking a surface in bleach (diluted 1 part bleach in 32 parts water) for 10 minutes will kill it.

Virtually every cat in the world will be exposed to this virus to some extent because the virus lives all around us.

Infection occurs when the virus enters the body through the mouth or nose. Whether illness results or not depends on the immunity in the victim vs. the number of individual virus particles (i.e. the amount of virus) entering the body.

The feline distemper virus is a parvovirus. Many people are familiar with this term as parvovirus infection is a very real concern for dogs, especially puppies. In fact, canine parvovirus is closely related to the feline distemper virus and much of the information regarding canine parvovirus holds true for feline distemper. The feline distemper virus, however, is more difficult to remove from the environment and more lethal in its victims than its canine counterpart.

Infection and Disease

An infected cat sheds large amounts of virus in all body secretions, including feces, vomit, urine, saliva, and mucus. The virus persists long after evidence of the original body secretion has faded away. The virus enters the victim’s body and proceeds to seek and infect rapidly dividing cells. The lymph nodes in the throat are first to be affected and from there, over the next two to seven days, the virus rushes to the bone marrow and intestine.

In the bone marrow, the virus suppresses the production of the entire white blood cell line, hence the term panleukopenia (literally, “all-white-shortage”). White blood cells are the immune cells needed to fight the infection, and without them, the victim is completely vulnerable to the advance of the virus. In other words, the first order of the virus’s business is to eliminate its host’s defenses. From there, it continues to the intestinal tract. 

There, the virus infects the intestinal cells, causing ulceration leading to diarrhea and life-threatening dehydration as well as bacterial infection as the barrier between the body and intestinal bacteria is lost. The patient dies from either dehydration or secondary bacterial infection. The infection can be so rapidly overwhelming that death occurs before the vomiting and diarrhea even begin.

Because most cats are exposed to this virus to some extent, it is unusual for a kitten to have no immunity whatsoever. Furthermore, the vaccine is so effective that even one dose can provide long-lasting protection. As a result, infection is largely limited to unvaccinated younger animals kept in groups such as a colony of barn cats, feral cats, or even a group of shelter cats. Viral numbers (the amount of virus) must be large enough to overwhelm a cat’s partial immunity, but once virus-laden diarrhea begins to gather in the environment, those large numbers can be reached. Death of sick cats is typically considered to be 90%, though it has been said that a kitten who survives the first 5 days is likely to survive the infection.

Recovered kittens are considered contagious for six weeks following recovery.

Cerebellar Hypoplasia

Without a normal cerebellum, the kitten is born with marked intentional tremors: whenever he focuses on purposeful movement, he tremors so much that normal movement is impossible. Such kittens are called wobbly cats and are notably abnormal but are considered to have good life quality and can be kept as pets as long as they are looked after.

Diagnosis of Infection

Any kitten with fever, appetite loss, diarrhea, and/or vomiting is a suspect for feline distemper. Classically, a white blood cell count shows almost no white blood cells; there are few causes of white cell counts this low and the infection can be considered confirmed.

If a dead kitten is available for necropsy (that’s an autopsy in animals), the infection is readily confirmed by laboratory tissue analysis as there are unique tissue findings in feline distemper.

Virus isolation, PCR testing, and antibody level measurement are also potential tests for feline distemper.

Treatment

An infected cat can recover if the cat can be kept alive until the immune system recovers from the panleukopenia and can throw off the infection. This means that invading intestinal bacteria must be kept at bay with antibiotics and aggressive fluid therapy must control dehydration. Hospitalization is required as fluids and medications must be given intravenously. Blood sugar must be supported as well and control of pain, nausea, and hypothermia is crucial. This is essentially the same therapy as for canine parvovirus infection, though the feline experience seems to be more lethal. There is little chance of survival without hospitalization.

Recovery

If a cat is lucky enough to recover from this infection, generally, no permanent damage is retained, and the cat goes on with lifetime immunity.

• Virus is shed for up to six weeks after recovery.

Disinfecting the environment after infection is a huge challenge; the best protection for newly introduced cats will be vaccination. That said, bleach diluted 1:32 in water with a 10-minute contact time will kill the distemper virus, so it would be prudent to bleach any surfaces that can be bleached. 

Prevention

Vaccination after age 12 weeks is generally effective in generating immunity against this infection, though immunity gained from mother’s milk may inactivate the vaccine through age 14 to 16 weeks. Most vaccine protocols call for at least two doses of vaccine to be given 2-4 weeks apart with the last dose being received at or after age 14 weeks. There are some vaccines that are approved for single-dose effectiveness depending on the age of the kitten.

• Vaccination, at least with a live vaccine, should be avoided during pregnancy as cerebellar hypoplasia (see above) can result in the kittens.

Vaccination is generally given every one to three years depending on the protocol of the animal hospital. Vaccination can be given as an injection (either modified live or killed virus vaccine) in the right front leg area or can be presented as a nose drop.

Killed virus vaccine has been associated with vaccination-associated fibrosarcoma (an aggressive cancer) in rare individuals. Research is continuing in this area; however, the killed virus vaccine has largely been replaced by a modified live virus vaccine, which is not felt to have this problem.

“Litter-training” Cats

At about three to four weeks old, kittens begin to play, explore, and dig in loose, soft materials like dirt or litter. This exploratory behavior soon leads them to eliminate in these areas. “Litter-training” a cat is not like house-training a dog. Taking a cat to the box and moving their paws in the litter is unnecessary and may create negative associations with the box or you. Instead, provide an acceptable, accessible litterbox based on the criteria described below, determining what is acceptable and accessible from the cat’s point of view, not yours.

Consider the following factors when setting up your litterbox for the best experience for you and your cat(s):

Size Matters

Bigger is better when it comes to litterbox size. Cats prefer a box with enough space to dig, cover their waste, and turn around without touching the sides. A general rule of thumb is that the box should be 1 1/2 times the length of the cat from their nose to the base of their tail.

Litter Depth and Type

Some caregivers believe that adding more litter reduces the need for frequent cleaning. Wild cats prefer areas with just a few loose particles for making small scrapes, not several inches of dirt. Therefore, two to three inches of litter is sufficient, allowing cats to cover their waste without sinking in. Long-haired cats may prefer even less litter or a smooth surface. A dirty litter box is a common reason for cats to eliminate outside the box, so adding extra litter does not replace the need for regular scooping and cleaning.

Most cats prefer fine-grained litter because it has a softer feel. Clumping litter is usually finer-grained than typical clay litter. High-quality, dust-free clay litter is also relatively small-grained and may be perfectly acceptable. Non-scented, clay-clumping litter is often the best choice, as some cats may not like crystals, pellets, or wood shavings.

Avoid changing types or brands once you find a litter your cat likes. Buying generic, the least expensive, or whatever brand is on sale may lead to problems. Some cat litter is developed more with the caregiver’s needs in mind rather than the cat’s. Many cats are put off by the smell of scented or odor-repellant litter, so placing a room deodorizer or air freshener near the litterbox might be objectionable. A thin layer of baking soda on the bottom of the litter box can help absorb odors without deterring the cat. If the litterbox is kept clean, odor should not be a problem.

Location is Key

Caregivers often place the litterbox in out-of-the-way locations to minimize odor and litter tracking around the house. Common placements include the basement, next to an appliance, in the garage, or on an unfinished, cold cement floor. While convenient for caregivers, these setups can be less than ideal from the cat’s perspective.

For example, young kittens may not be able to navigate long flights of steep stairs in time to use the bathroom, and newly introduced adult cats may initially forget where the box is located. Cats can also be startled if a furnace or washer-dryer suddenly turns on while they are using the box. Additionally, some cats prefer to scratch the area around their litterbox and may find a cold cement floor unappealing or uncomfortable.

To minimize the risk of your cat finding an alternative, more convenient toilet, always place litterboxes in quiet, low-traffic areas with easy access and escape routes. Make sure there is at least one box per level of the house, and keep them away from your cat’s food and water stations. One compromise is to place the box in a closet; if you do this, wedge the door open from both sides to prevent your cat from being trapped inside or outside. If the box is on a smooth, slick, or cold surface, consider placing a small throw rug underneath it.

Types of Litter Boxes

Litterboxes come in many shapes and sizes, and while larger is generally better, each cat may have individual preferences. Open boxes are typically preferred over covered boxes, although they provide less privacy. Hooded boxes offer privacy but can have poor air circulation, which might deter some cats. Self-cleaning boxes can be convenient but might scare others. Just like with location, offering different types of litterboxes helps cater to each cat’s unique needs.

Maintenance

Litterboxes must be kept consistently clean. To meet the needs of the most discriminating cat, feces should be scooped out of the box daily. How often you change the litter depends on the number of cats and the number of boxes you have. Twice a week is a general guideline, but depending on the circumstances, the litter may need to be changed every other day or only once a week. If you notice an odor from the box or if much of the litter is wet or clumped, it is probably more than time for a change. Do not use strong-smelling chemicals or cleaning products when washing the box. The smell of vinegar, bleach, or pine cleaners may cause your cat to avoid the box. Washing with soap and water should be sufficient.

Liners

Some cats don’t mind having a liner in the box, while others do. You may need to see if your cat is bothered by a liner in the box. If you use a liner, make sure it is anchored in place well so it cannot easily catch your cat’s claws or be pulled down into the litter.

If Problems Develop

Elderly or arthritic cats might benefit from ramps or a lower-sided box. For cats that tend to kick litter out, use high-sided boxes and consider placing a litter-trapping mat under the box. Some cats might be sensitive to certain box materials or odors. If your cat stops using the litterbox, your first call should always be to your veterinarian. Many medical conditions can cause a change in litterbox habits, and these possibilities must be considered first. If your veterinarian determines your cat is healthy, the cause may be behavioral. When resolving house-soiling behavior in cats, environmental changes are often needed, and punishment is never the answer. For more assistance, contact a veterinary behaviorist or animal behavior professional who is knowledgeable and experienced in working with cats.

The transition process often involves much more than just plunking down a new food item.  Time, patience and tricks are often required.

One reason that cats like dry food so much is because the pet food companies do not play fair when manufacturing this sub-optimal food source.  They coat the kibble with extremely enticing animal digest sprays that are very pleasing to a cat – making a poor quality diet very desirable to the target animal.

In addition to the aforementioned coating of dry food with animal digests, another issue is one of a crunchy texture, which is very different from canned food.  Cats are very resistant to such a drastic change in the texture of their food.

If you are convinced that getting your cat off of dry food is the way to go, read on for some tips on how to accomplish this.

The key is to do it slowly and with patience and incorporate various tricks for the stubborn cats. The most important issue is actually making the change, not how fast you accomplish it. 

I must say that my cats tested every ounce of patience I had over a 3+ month period of time during their transition from dry to canned food.  They had been on dry food their entire lives and did not recognize canned food as food.  My cats ranged in age from 2 years to 10 years at the time of the transition.

The single biggest mistake I see people make time and again is to say that their cat “won’t touch” the new food and then panic and fill up the bowl with dry food.  In many cases, it is simply not that easy to get cats off of dry food.

There are two categories of cats – those that will eat canned food and those that will be extremely resistant to eating anything other than dry food.  If your cat falls into the first category, lucky you. These cats will take to it with the attitude of “finally – an appropriate diet for my species.” In this case, if your cat has been on all dry food, or only receives canned food as an occasional ‘treat,’ start by feeding canned food in increasing amounts.  Gradually decrease the dry, taking about a week to fully switch the cat over to 100 percent canned food.

Some cats may experience softer stools during the transition.  I do not worry if this happens and tend to ‘ride it out.’  If diarrhea results from the diet change you will either need to experiment with different canned foods or slow the transition down and do it over a period of several weeks.

Note that in over 40 years spent in this profession, I have never met a cat that needed dry food to stay healthy but some need to be transitioned more slowly than others.

The average cat should eat about 180 – 220 calories per day which will be found in 5-6 ounces of the average canned food.

However, note that high protein/low fat/low carb foods like Weruva Paw Lickin’ Chicken and some Tiki Cat varieties are very low in calories (see the Cat Food Composition chart, far right column) so you will need to feed much more than 5-6 ounces which can get quite expensive.

The necessary daily caloric intake should be split between 3 to 4 meals/day (or just free-fed if they are not overweight).

When determining how much you should be feeding your cat once transitioned to canned food, keep it simple.  Too fat?  Feed less.  Too thin?  Feed more.

Now….for the stubborn cats……

If you are unlucky like I was, and your cat does not recognize the fact that he is a carnivore and would live a healthier life if eating canned food, (or a homemade diet) then you will have some work to do.  Some cats that have been on dry food for their entire life will be quite resistant to the diet change and may take several weeks or longer to make the transition to a healthier diet.

For ‘resistant-to-change’ cats, you will need to use the normal sensation of hunger to help with the transition. For this reason, it is very important to stop free-feeding dry food.  This is the first, and very critical, step.  You need to establish set mealtimes. They are not going to try anything new if their bowl of junk food is in front of them 24/7.

Cats do not need food available at all times. It really is okay for them to experience a hunger pain!  That said, it was very hard for me to listen to my cats begging for food even though I was strong in my conviction that I was heading them in the best direction for optimal health. It truly was a stressful time for me and them.  Actually, I think it was harder on me!

This is where many people fail and just give in and fill up the dry food bowl.  There were a few times when I had to call my ‘sponsor’ and was instructed to “just leave the house if you can’t take looking into those eyes!”  I left the house. Those pitiful little cries of “I have not had food for two WHOLE hours!” were hard to take.  But, lo and behold, they were just fine when I returned.  Not one cat had died from hunger.

On the other hand, do not attempt to withhold food for long periods of time (greater than 24 hours) with the hope that your cat will choose the new food.  You need to ‘convince’ them that a high quality canned food  really is good for them, rather than to try starving them into it – which does not work anyway.  Allowing a cat to go without food – especially an overweight cat – for a long period of time (greater than 48 hours) can be quite dangerous and may result in hepatic lipidosis (fatty liver disease).

Hepatic lipidosis can also develop when a cat consumes 50 percent or less of his daily caloric requirements over a period of many days.  The definition of “many” varies from cat-to-cat.  For this reason it is important to understand that you need to have some idea of the calories from canned food combined with the calories from dry food that your cat is consuming on a daily basis while you are implementing the transition to canned food.

I have never seen a cat develop hepatic lipidosis when consuming at least 15 calories per pound per day. This number is figured on lean body weight, not fat weight.

If your cat weighs 18 pounds but really should weigh 12 pounds, please make sure that he is consuming about 180 calories per day.  (12 pounds lean body mass X 15 calories/pound/day = about 180 calories/day)

In reality, the cat in the above example would probably be completely safe at only 150 calories per day.

If you have a small female cat that should only weigh 9 pounds, please make sure that she is consuming at least 135 calories per day.

Canned foods never list the calorie content on the can but many dry foods do list this information on the bag.  A rough guideline for the calorie content of most canned foods that are 78 percent moisture is about 30 calories per ounce, but can range from 20 to 40 calories/ounce as shown by the chart linked above.

Most cats will lose some weight during the transition to canned food.  Given that a very high percentage of cats are overweight to begin with, this is a favorable result of the diet change – as long as they do not lose too much weight too fast.  A cat should never lose more than one to two percent of body weight per week.

I highly suggest that all cat caregivers weigh their cats periodically, especially if they are over 10 years of age.  This will help ensure a safe transition to a healthier diet and, in general, weight loss is often the first sign of ill health for any reason.  I make it a point to weigh my cats at least once each month, especially since they are now over 10 years of age.

Here is a scale that is reasonably priced:  Salter Baby and Toddler scale. It weighs to the nearest half ounce and has a ‘hold’ button on it that helps obtain an accurate weight even for a cat that is moving around a bit.

Here is another scale that may be even better because its base is as long as the scale.  Red Cross Baby Scale. This is important for cats that are trained to walk onto it otherwise, scales like the Salter one linked above may tip.  This would scare the cat and harm the scale.

All of my cats lost weight during the three months that it took to switch them to canned but none of them became too thin. They slimmed down to a nice lean body weight – losing fat while maintaining their muscle mass.  They also became much more active.

If your cat is overweight, please see the feline obesity article.

Resign yourself to the fact that you will be very frustrated at times and you will be wasting canned food as they turn up their nose at it.  Also, you may want to immediately switch your cat to a dry food that has fewer calories from carbohydrates than most dry foods. Talk to your veterinarian about specific brands.

The low-carb dry foods are very high in fat and therefore are very calorie dense.  These foods must be portion-controlled, otherwise your cat may end up gaining weight.  Let’s presume that a certain dry food has 612 calories per cup.  One quarter of a cup contains 153 calories so be very careful to pay attention to how much of these high calorie dry foods you feed.

The caloric needs of an average cat can range between 150 to 250 calories/day depending on their lean body weight and activity level.

The low-carb dry foods are also very high in phosphorus.  This is especially detrimental for cats with compromised kidney function.

And, of course, these low-carb dry foods are water-depleted – just like all dry foods – putting your cat at risk for serious urinary tract problems.  They are also cooked at high temperatures in order to dry them out.

I do not recommend these dry foods for long-term feeding for all of the reasons stated above. Please use them only as transition diets.

Be sure to stay away from any “light” varieties since those types of foods are very high in carbohydrates.

Here are some various tricks for the stubborn ones.

Keep in mind that different tricks work on different cats:

1. If your cat has been eating dry food on a free-choice basis, take up the food and establish a schedule of 2 to 3 times per day feedings.  I really do prefer just twice-daily feedings when trying to transition them.  A normal, healthy hunger response after 12 hours goes a long way to convince them to try something new.
   
2. If you want to take the transition very slowly, you can feed the amount that your cat normally consumes in a 24 hour period – split up into two feedings to get him used to meal feeding.  Many people, however, are unsure as to how much their free-fed cat really eats so I would start off by figuring out the calories that your cat needs to maintain his weight if he does not need to lose any weight.
   
3. Leave the dry food down for 20 minutes, and then remove any uneaten portion.  Repeat in 8 to 12 hours depending on if you are feeding two or three times per day.  During the first few days of transitioning to a set schedule, you can offer canned food during the dry food meals, or in-between meals.  The stubborn ones, however, will not touch it. Do not despair – all cats will eventually eat canned food if their caregiver is determined, methodical, and patient enough.  Once your cat is on a schedule, you will notice that he is more enthusiastic about food during his proper mealtimes and will be much more inclined to try something new. 
   
4. Again, most cats only need 150 to 250 calories/day. The dry food bag should tell you how many calories are in a cup of food but if it does not, you can call the company.      
   
5. Once the cat has transitioned to canned food, I prefer to either free-feed them (if they are not too fat) or to put out a meal 3 to 4 times per day. Small cats in the wild eat 8 to 10 small meals per day. I do not worry about leaving canned food out for up to 12 hours at a time. Keep in mind that a lion is not going to eat his entire prey immediately.
   
6. Once you have established scheduled mealtimes, you will most likely need to start feeding a bit less at each mealtime in order to get the normal sensation of hunger to work in your favor.  Again, we are trying to use the normal sensation of hunger to help us out.  We are not trying to starve the cat into the diet change.       
   
7. Once your cat is on a schedule of meal-feeding instead of free-feeding, try feeding a meal of canned food only. If he will not eat it – and the very stubborn ones won’t, try not to get frustrated – and do not put down dry food.  Try some of the other tips listed below.  If he still will not eat the canned food, let him get a bit hungrier.  Offer the canned again in a couple of hours, or just leave it out.  Some cats will be more apt to try something new if they keep walking by it and seeing/smelling it.  Try a different brand/flavor or a different ‘trick.’  Once it has been about 18 hours since he has eaten anything, give him just a small amount (1/4 of a cup) of his dry food – keeping track of his daily caloric intake.
   
8. Remember to be patient.      
    
9. Exercising your cat with a tassel toy before feeding can also help stimulate his appetite.  
        
10. Cats’ noses are much more sensitive than ours are.  They can smell the dry food in the cupboards.  I suggest either putting it in the refrigerator or putting it in a tightly sealed container.  If they can smell it, they will hold out for it.  Some people recommend getting it out of your house completely, but this is not possible when you are dealing with a very stubborn cat that needs a bit of time and patience to make the transition happen. 
         
11. The following worked for my cats:  Sprinkle a very small amount of tuna – or any other favorite treat (some cats do not like fish and would prefer cooked chicken) – on top of the canned food and then once they are eating this, start pressing it into the top of the new food. (The “light” tuna is better than the fancy white tuna because it has a stronger smell.  Or, Trader Joe’s makes a Cat Tuna that is very stinky.)  Be careful to decrease the amount of fish as soon as possible.  Health problems can occur with a predominantly fish-based diet.  Plus, you do not want to create a situation where your cat will only eat very fishy foods.   
       
12. Make sure that any refrigerated canned food is warmed up a bit.  Cats prefer their food at ‘mouse body temperature.
    
13. Try offering some cooked (or raw – whole meats, rinsed well or partially baked) chicken or meat baby food.  One of the goals is to get your cat used to eating food that does not crunch.  He needs to get used to a different texture.  Also, chicken is a great source of protein to point him in the proper direction toward a high protein, low carbohydrate diet. If he eats the chicken, he may head right into eating canned food.  Then again….he may not.
    
14. Try sprinkling some parmesan cheese on the canned food.  Most cats love parmesan cheese and this trick has been very successful for me.
    
15. Try a product called FortiFlora, feline version. Most cats LOVE FortiFlora and this has recently become my favorite trick.  This is a probiotic made by Purina but you are not going to use it for its probiotic properties. You are just going to use it as a flavor enhancer. The base ingredient in FortiFlora is animal digest – the very substance that makes dry food so very enticing to cats. The directions say to use one package per day – and you can use this much if you want to – but this amount is not usually necessary.  You may only need about 1/4 of a package, or much less, with part mixed into the food and part sprinkled on top of the food just as you would use salt and pepper on your own food.
    
16. FortiFlora can be purchased online but an easier product to find is Temptations treats.  I trap a lot of feral cats for spaying/neutering purposes and this is one of the best baits that I can use. These tasty treats can be found at most pet stores.  Put a few in a plastic baggie and crush them with a hammer.  Use the crushed treats as described for the FortiFlora above.
    
17. There are numerous freeze dried meat treats on the market that you can also sprinkle on top of the canned food.  Halo’s Liv A Littles is a popular choice.
    
18. Speaking of texture, a common question is “can I just soak the dry food in water?”  I hedge more than just a bit at this question.  Dry food often has a very high bacterial content.  Mold is also often found in dry food.  Both organisms flourish in moist environments. There have been many deaths of dogs and cats secondary to eating mold mycotoxins, vomitoxins and aflatoxins that often contaminate the grains found in dry food.  If you want to try the trick of wetting down the dry food to alter the texture, please leave it out for only 20-30 minutes then discard it.       
    
19. Try dipping some dry food pieces in the juice from the canned food. Some cats may refuse to eat it if the dry food even touches the canned food.  But if he will eat it with a bit of canned juice on it, try the ‘chip and dip’ trick.  Scoop up a tiny bit of canned food onto the piece of dry food. Put them on a separate plate from his small portion of dry food.  Some cats will eat their small portion of dry and then go investigate the dry food with a tiny bit of canned on it.
    
20. Going one step further, try adding a few small pieces of the canned food to the small portion of dry food.  Your cat may pick around the canned food but will get used to the smell – and texture – even if he does not eat any pieces of the new food.
    
21. Crush some dry food and sprinkle it on the top of the canned food.
    
22. If you do not think it will upset your cat, try gently rubbing a bit of canned food or juice on the cat’s gums  This may get him interested in the taste and texture of the new food – but do it gently.  You do not want to make this a stressful situation and create a food aversion.  (This trick is commonly used to get just-weaned kittens used to eating canned food.
    
23. If you do not think it will upset your cat, use your finger to put a tiny bit of canned food or juice on his paw for him to lick off.  This has not worked for me in the two cats I have tried it on, but it is another idea.  Make sure you do it without stressing your cat.  Again, you do not want to create a food aversion. 
          
24. If you have a multiple cat household, some cats like to eat alone in a less stressful environment, so you may need to take these cats into a separate, quiet room to think about the error of their ways – their carbohydrate/dry food addiction. Once in a quiet setting, away from the other cats, two of my cats would eat canned food/tuna ‘meatballs’ by hand.  Not from a bowl, mind you, but only from my hand. I’m not sure who was being trained. They did eventually start eating from a bowl after a few hand feedings.
    
25. Try various brands and flavors of canned foods.  Try Friskies, 9-Lives, Fancy Feast, etc.  Many cats prefer the foods that are all by-products and turn their noses up when offered the by-product-free diets like Wellness, etc. You can worry about feeding a a different canned food later if you want to and you can always mix different types of food together.  The initial goal is just to get your cat used to eating canned food and not dry kibble.  And remember what I said above. I would much rather see a cat eating a canned food like Friskies, 9-Lives, or Fancy Feast rather than any dry food.
    
26. Syringe-feeding is also another option but has to be done with finesse and patience so as to avoid a food aversion.  If you choose to syringe-feed, your goal is not to feed him a full meal.  Sometimes just syringing a 1-2 cc’s can ‘jump-start’ your cat into eating the canned food – maybe not the first time but it will at least get him to taste the new food and experience a foreign texture. The best way to syringe-feed is to kneel on the floor with your cat between your legs so he is facing the same way as you are.  Then, using a small (1cc/TB) syringe, slip it in the side of his mouth and give about 1/2 cc at a time.  He may spit it out but you are just trying to get him used to the taste and texture, not stress him.
    
27. Few canned foods will make it through the tip of a syringe but human meat baby food works well for this trick. You can also water it down a bit if you need to.
    
28. If you want to use canned cat food instead of baby food, you will need to cut the end off of the syringe so that the opening is as big as the barrel.  Make sure that the tip is smooth.  If you do not want to cut the tip of the syringe off, you will need to puree a pate (versus chunks) type of food.  I puree Wellness for this.  I run it through the blender with a small amount of water (about 3-4 tablespoons/5.5 ounce can).  Then I strain it to remove anything big enough to clog the small tip of the syringe.  Wellness is also a balanced diet, unlike human baby food.
    
29. Even though human baby food is not a balanced diet for long-term use, it is a great tool that can be used to help transition a cat to a texture that he is not used to.     
     
30. I did have to take drastic measures for a foster cat named Molly.  She was dangerously obese (20 lbs – double what she should have weighed) and would not eat canned food even after two weeks of syringe-feeding her.  She needed to go in for a dental so while she was under general anesthesia, I put in a feeding tube. This took the stress off of both of us.  After two weeks of feeding her via the tube she started licking the canned food from my fingers then suddenly decided it was time to eat it.  She then started to finally lose weight.  Before the 7-pound weight loss, she could barely walk, could not clean herself, and was quite possibly headed for diabetes.
    
31. Don’t give up.  One of my barn cats ate dry food for the first 12 years of her life.  She would never touch the canned food that the other cats ate. Then, one day, she found her ‘inner carnivore’ and started eating canned food out of the blue!  I was shocked.  That was 4 years ago and she has been on a 100 percent canned food diet since she made the switch.

These are just a few tricks that you can try.  Different tricks work on different cats.  The key is to be patient.  Remember, it took me three months to get my cats on 100 percent canned food.  Most cats, however, will not take this long.

Cytauxzoon felis infection is highly seasonal and takes place in spring and early summer when the tick population is active.

What is Cytauxzoon felis?

Cytauxzoon (pronounced “sight-oz-o-un”) organisms are blood parasites that were first recognized in Africa as a parasite of antelopes and other ruminants. Cytauxzoon organisms were not discovered in the U.S. until 1976, when Cytauxzoon felis was first described as a feline blood parasite affecting and killing cats from forested areas.  Initially, there was concern that livestock were soon to be next as this was a ruminant infection as far as anyone knew, but research showed only cats could be infected. It appears that in the U.S., the natural host of this infection is the bobcat, where most of the time, the infection is minor, and it is only the domestic cat for whom infection is a disaster.

Cytauxzoon felis is a single-celled organism that infects both the blood and tissues of the cat. The blood cell stage of the parasite called a piroplasm, is not particularly harmful; it is the tissue stage, called a schizont, that is the problem. The schizont infects immune cells that line blood vessels, which causes them to swell and block off the blood vessels in which they reside. Any tissue that has blood vessels (which is basically every tissue in the body) can be affected, but most symptoms seem to relate to the resulting red blood cell destruction and inflammation. Symptoms start small with listlessness and fever but quickly progress to jaundice, spleen enlargement, pain, and death within one week with a two to three-week incubation period from the time of initial infection.

How do Cats get this Infection?‘

The organisms are home to the immune cells lining the blood vessels as described above, and if the host lives long enough, the schizonts will eventually produce offspring (the piroplasms). Bobcats do not get sick during this process. It is the local bobcat population that infects the local tick population.

Cats cannot be infected without a tick bite.

How is the Diagnosis Made?

The cat typically has a fever, with or without jaundice, and is brought to the veterinarian for evaluation. In most cases, the piroplasms are fairly obvious when the blood sample is evaluated. Because the tissue phase of the infection with the schizonts comes first and the blood infection with piroplasms comes after, it is possible that at the time the blood is tested no piroplasms are yet present. Because of the rapid progression of the infection, piroplasms will likely be seen in a few days if they are not at first, so sometimes a second blood evaluation is needed.

Because piroplasms sometimes have variable sizes, they are sometimes mistaken for Mycoplasma hemofelis, a much more treatable infection.

Cytauxzoon organisms are larger and have a thick “dot” on their ring shape.

If the diagnosis is to be made post-mortem (after death), it is usually easy to find the schizonts in many body tissues.

A milder strain of Cytauxzoon felis seems to have emerged in west Arkansas and east Oklahoma, where a number of cats have survived without treatment (as do most bobcats). These cats continue to have piroplasms in their blood but seem to have no effect from this. It is yet unknown how this is able to happen. (Different strains of Cytauxzoon, effective medication, and genetics are all theories.)

Prevention

Since mortality is quite high with this infection and treatment is still highly investigational, prevention is paramount. The most effective prevention is to keep the cat indoors where there is no tick exposure. The next best prevention is to use a tick control product on the cat; note that there are not nearly as many tick products for cats as there are for dogs. Most canine tick products are toxic to cats and cannot be safely used so meticulous label reading is crucial. Just because a product works on fleas definitely does not mean it also works on ticks and the feline label is needed to ensure safety. New products are being approved and released every year, so ask your veterinarian.

Besides the haired parts of the skin, these tumors can be seen at the lip margins, the eyelids, the anus/rectum, the vulva, and the prepuce of the penis (the fold of skin covering the penis). A specific, poorly understood form of cutaneous lymphoma seems to occur near the hock, which is the ankle of a back leg. A cat can also have skin tumors and lymphoma elsewhere in the body at the same time; often it’s seen in the lymph nodes, gastrointestinal tract, liver, spleen, kidneys, mouth, or nasal passages. As with non-cutaneous lymphoma in cats, each case is different.

The disease is complex and there are several forms of it. Unfortunately, there is no overall consensus from the veterinary community on what the best course of action is in any individual cat.

The cause is unknown in most cases. Feline leukemia virus and feline immunodeficiency virus can cause lymphoma in cats, but don’t seem to be involved in most cases of cutaneous lymphoma. Lymphoma in cats can rarely happen at a vaccine site, but most vaccine-associated tumors are other kinds of cancer, not lymphoma.

Cutaneous lymphoma can look like skin nodules, masses, ulcers, or just areas of skin that are flaky, bald, or changed in color. Some of the skin tumors can be large.  As time goes on, the skin often becomes thick, red, ulcerated, and may ooze fluid. Cats can also have signs of internal disease such as swollen lymph nodes, a lack of appetite, weight loss, vomiting, diarrhea, and general weakness.

For diagnosis, a piece of tissue is taken from the skin tumor, usually with either a biopsy or a fine needle aspirate. It is examined under the microscope. Cutaneous lymphoma can look like some other skin diseases, so enough testing must be done to ensure accuracy. Blood tests and a urinalysis may be needed. More tests like X-rays, ultrasound, or tissue samples may be used to see if other organs besides the skin are involved.

Treatment is much like other cancers. Surgery can sometimes remove skin masses or lesions. This surgery can be useful to get tissue to make the diagnosis. If the cat is lucky and the lymphoma is ONLY at one place on the skin, surgery may also help for treatment, but this situation is rare. It’s much more common for lymphoma to involve lots of different organs at once. Even if only the skin is affected, there are usually too many sites for surgery to help.

Chemotherapy is the main form of treatment for that reason as it can help multiple areas of the body at once. If all goes well, it can be really effective at reducing the lesions even in a short time, although this result may not last. Radiation may occasionally be helpful for skin lesions occurring in just one spot. Rarely, cases with lymphoma in multiple spots on the skin have also been treated with a superficial form of radiation that treats the skin without affecting deeper organs. Corticosteroids pills such as prednisolone are often part of chemotherapy for cutaneous lymphoma. If the corticosteroids are used by themselves when more effective therapy isn’t an option, they may give some temporary relief.

Sadly, there is no cure and the long-term prognosis is poor. However, chemotherapy can slow progression and temporarily improve a cat’s quality of life. On average, cats treated for cutaneous lymphoma will only survive for less than a year. Some cats live longer, though, and cats whose disease starts out at only one spot might be likely to do better.