4491 Forest Park Blvd. • St. Louis, Missouri 63108 • Phone: 314-652-1919 • Fax: 314-652-6207 • For Emergency Please Call AEC: 314-822-7600

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Please be informed
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health topics.

Protecting your cat from outdoor plant dangers.

The American Society for the Prevention of Cruelty to Animals (ASPCA) veterinarians and behaviorists offer you a library of solutions to improve the health and lifestyle of your feline companion.

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The following topics are common feline issues.

Chronic Renal Failure
 | Diabetes and Your Cat | Hyperthyroidism

Dr. Nieberg demonstrates insulin injection technique.Chronic Renal Failure

The kidneys of a cat can become diseased in a number of different ways. Cats can be born with congenital kidney disorders or the kidneys can become damaged due to injuries, infections, kidney stones, tumors, and toxins (such as antifreeze). While all of these conditions are life threatening, they are, luckily, all fairly uncommon. The kidney condition of cats, which is very common, is a progressive deterioration of the kidneys with no apparent underlying cause that progresses with age. We refer to this as Chronic Renal Failure (CRF). This condition is the most common cause of death in aged cats.

When deterioration of the kidneys occurs, they are not able to function normally. The kidneys have several important functions. They help clear toxic waste products from the body, keep several blood chemicals at normal levels, and control fluid balance to maintain normal hydration. They also produce a hormone necessary for the production of red blood cells and are involved in the regulation of calcium and vitamin D. In the very early stages of renal failure, the body is able to compensate and symptoms may not be evident. As the disease progresses and imbalances become more marked, symptoms such as increased thirst and urination, dehydration, loss of appetite, lethargy, weakness, and vomiting may occur. Your veterinarian will be able to assess the state of your cat’s kidney function using blood and urine tests. In some cases, veterinarians may also use x-rays, Kitten lounging on soft playgroundblood pressure measurements, ultrasound and even kidney biopsies to gain more information about kidney function.

Chronic renal failure has been considered an incurable disorder, however in the last few years kidney transplantation has become a reality in feline medicine. There are only a handful of veterinary centers in the country doing kidney transplants, the procedure is very expensive and not all cats with kidney disease are candidates for transplantation. For those reasons, most cats with CRF will not get transplants and we must regard the disease as a progressive one that we cannot cure but can manage for months to years with proper veterinary care.

One type of therapy your veterinarian may recommend is a change in diet. Several diets are formulated specifically for cats with kidney disease. They differ from other cat foods in that they have a lower protein level and modifications in the levels of several other chemicals such as potassium, phosphorus, and sodium. Your veterinarian may feel this is an important part of your cat’s therapy. An important part of the treatment for cats with more advanced disease is fluid therapy. Fluids infused through an intravenous catheter or infused subcutaneously (under the skin) help flush out waste products through the kidneys as well as restore hydration and correct certain chemical imbalances. This type of treatment does not always require hospitalization. Many cat owners learn to give their cat subcutaneous fluids at home.

Depending on what specific complications your particular cat has, your veterinarian is likely to prescribe one or more of several medications. These include blood pressure medication, potassium supplements, vitamins, iron, phosphate binders, hormones to correct anemia, and drugs to treat gastrointestinal upsets. Once chronic renal failure is diagnosed your veterinarian will want to follow your cat’s condition with regular check-ups and testing and will tailor a treatment plan specifically for you and your cat. It is hard to predict for each cat how quickly this disease will progress, but with early diagnosis and proper care, some cats can enjoy a good quality of life for several years.

Chronic Renal Failure | Diabetes and Your Cat | Hyperthyroidism

Diabetes and Your Cat

Diabetes mellitus or “sugar diabetes” is one of the human diseases which also affects cats. While not as common in cats as in people, it is not uncommon for veterinarians to diagnose and treat diabetes in middle-aged and older cats.

Diabetes results from a failure of certain cells in the pancreas to secrete enough of the hormone insulin. Insulin allows the body to breakdown sugars into energy, so in the diabetic cat the blood sugar remains too high. Over time, uncontrolled diabetes in cats will cause adverse effects to various organs of the body. The most serious consequence is that regardless of how much these cats eat they are, in effect, starving because they can’t properly process nutrients. Owners of diabetic cats may observe that their cat will lose weight even though the appetite is good. Another symptom of diabetes, which may appear even before weight loss, is an increase in thirst and urine output.

The cause of diabetes in cats is not clearly understood. In a few cases it can be traced to the use of certain drugs, which damage the pancreas. More often we don’t know the cause. The likelihood of diabetes is higher in older cats and obese cats, but any cat experiencing weight loss, increased thirst, increased urine output or increased appetite should be checked.

Your veterinarian can quickly determine if your cat is diabetic by checking blood and urine. If diabetes in a cat is not controlled it will be fatal, but it is a treatable disorder. Many cat owners are able to control their cat’s condition for years. The treatment usually entails giving insulin injections once or twice a day. There are some diabetic cats that can be controlled through diet and medication, but more often insulin injections are needed.

People are often initially reluctant to give injections to their cats, but those who undertake this task invariably find that it is far less traumatic for both the cat and the owner than they had expected. Insulin needles are very tiny and the cats usually do not react at all to getting the shots. When one begins to treat a diabetic cat, their veterinarian will go over all the procedures, including feeding instructions and symptoms of too much or too little insulin and what to do in these cases. The veterinarian will also set up a schedule of regular recheck visits to gauge how the therapy is working and to adjust the insulin dose since the need for insulin fluctuates up and down.

Chronic Renal Failure | Diabetes and Your Cat | Hyperthyroidism | Top of Page


Older cats can lose weight for a number of reasons. One frequent cause of weight loss in cats is hyperthyroidism. In this disease, one or both lobes of the thyroid gland become enlarged and secrete excessive amounts of the thyroid hormone.

The abnormally high levels of the thyroid hormone cause the cat’s metabolism to be in a hyperactive state. This results in several detrimental changes to the cat’s system. Fat and muscle are consumed for energy, resulting in weight loss. The body’s accelerated demand for oxygen increase the workload on the heart, causing heart disease and high blood pressure. Kidney and liver function can also be adversely affected by the changes in metabolism.

Hyperthyroid cats can show many different symptoms in addition to weight loss such as increased or decreased appetite, fever, increased water consumption, hyperactivity or weakness, vomiting or diarrhea, unkempt hair coat, and rapid nail growth.

Fortunately, the disease can be successfully treated, especially if it is detected in its early stages. Left untreated, total body starvation and heart failure result. Therapy for hyperthyroidism involves either medication, surgery, or radioactive iodine. Initially, most cats are given anti-thyroid medication, methimazole, to restore the thyroid levels to normal. However, although medical therapy will control the disease, it will not cure it. Surgical removal of the thyroid gland or administration of radioactive iodine are curative. The various methods of treatment are discussed in more detail below.

Food: Hill's Prescription Diets recently developed a low iodine food that has been found to be very effective in treating hyperthyroidism. It comes packaged as a dry formula and canned. If you choose to try this option, you can only feed your cat this diet. Treats must be made out of the diet. You must also start with new dishes for feeding.

This option works best in single cat households, or where it is possible to feed the cats separately. If the cat won't eat the diet, then you may choose one of the other options.

Medication: If medical therapy is chosen for long term treatment, the medication will need to be given for the rest of your cat’s life. The dose may need to be adjusted periodically as fluctuations in the levels of thyroid hormone occur. Although the drug is generally safe, side effects can occur including vomiting, loss of appetite, bleeding abnormalities, changes in blood cell counts, liver toxicity, or allergic reactions. Serious problems can be detected on routine blood work, and so while your cat is taking methimazole, we will perform blood tests every 3-4 months.

Surgery: Surgical removal of one or both lobes of the thyroid gland will remove the tissue that is secreting abnormal amounts of the thyroid hormone. Once removed, the thyroid gland is examined microscopically by a pathologist to be sure that the tissue is not cancerous. (This occurs in only a small number of cases.) The parathyroid gland is a small gland that lies in very close proximity to the thyroid gland; it controls calcium metabolism. Although it is not removed during surgery, it can sometimes temporarily shut down. For this reason, cats that have both lobes of the thyroid gland removed will have their blood calcium levels monitored for several days after surgery. Surgery is an effective means of treating hyperthyroidism. Complications are rare but can occur, and include accessory thyroid tissue or a need for thyroid or calcium supplementation.

Radioactive iodine: Radioactive iodine is injected subcutaneously. It is taken up by the thyroid gland where it selectively destroys thyroid tissue while leaving other tissues unharmed. This treatment requires special facilities, and is performed on a referral basis in St. Louis. Hospitalization is required until most of the radioactive iodine has been excreted from the cat’s body, typically about 4-5 days. Treatment with radioactive iodine is an effective means of treating hyperthyroidism. Complications are rare but can occur, and include incomplete destruction of thyroid tissue or a need for thyroid supplementation.

Chronic Renal Failure | Diabetes and Your Cat | Hyperthyroidism | Top of Page