Immune Mediated Disease

immune mediated disease

The body’s immune system is a host defense system in both people and pets. But I bet you don’t often think about your own immune system. There are several reasons the immune system is harder to wrap your head around than other body systems.

  1. You hardly know the immune system is there unless it doesn’t work. The immune system’s job is to protect you against invading organisms that might make you sick. If it is working well, you feel great. If it doesn’t work, you get the flu or the chickenpox.
  2. The immune system is all over your body. The respiratory system seems so obvious. You have a nose, a windpipe and lungs. They control respiration. Bet you can’t describe the location of the cells of your immune system, but they are strewn about in the lymph nodes, spleen, lungs, intestines, and are circulating in your blood stream.
  3. The immune system can cause serious diseases when immune cells start attacking normal cells. These diseases are classified as autoimmune diseases or immune mediated diseases.

Autoimmune Disease
An autoimmune disease is a disease where a hyperactive immune system attacks normal cells as if they were foreign organisms. A diagnosis of autoimmune disease is made when the antibody produced by the abnormal immune function can be identified in the laboratory. Examples of this in people are gluten sensitivity due to an antibody induced by dietary gluten against intestinal cells, or Type 1 diabetes where the immune system makes an antibody that attacks insulin-producing pancreatic cells. Autoimmune diseases are thought to exist in veterinary patients, but tests to confirm the diagnosis are lacking.

Immune Mediated Disease
Immune mediated disease is a disease of unknown cause, but one which is thought to be modulated by an aberrant immune response. Unlike autoimmune diseases, the antibody causing this group of diseases has not been identified. This classification describes several important dog and cat diseases. In dogs and cats, immune mediated hemolytic anemia is an example of an immune mediated disease. Dogs also suffer from immune mediated thrombocytopenia and immune mediated polyarthritis. These diseases target red blood cells, platelets and joints, respectively.

Treatment of Immune Mediated Disease
The key to treatment of immune mediated diseases is to halt the immune reaction underlying the disorder. Veterinarians use immunosuppressive medications to turn off the cells of the immune system. The first line therapy in immune mediated hemolytic anemia, thrombocytopenia and polyarthritis is prednisolone/prednisone, which is a steroid medication. Prednisolone/prednisone receives top billing because it works quickly and is inexpensive. But prednisolone/prednisone is not enough in some cases and a second immunosuppressive agent such as azathioprine, cyclosporine or mycophenylate can be added. Increasing the number of immunosuppressive agents runs the risk of turning off the immune system completely, increasing the risk for a serious infection. Dogs and cats on immunosuppressive agents need close monitoring. Once the immune disease is controlled, the medications are slowly withdrawn and the patient is carefully monitored for relapse.

In future blogs, I will discuss the specifics of some common immune mediated diseases in pets.

Everyday Medicine: The Third Eyelid

Everyday Medicine is an intermittent series of blog posts highlighting tests, treatments and procedures commonly used at AMC. Some past examples of this type of blog post include “Vital Signs” and “The Highs and Lows of Blood Sugar.”

The other day I was examining a dog’s head. As part of the exam, I pushed on the dog’s upper eyelid to examine his third eyelid. When the white structure popped out of its hiding place under the lower lid, the owner gasped, and asked about the unexpected structure in her dog’s eye.

Normal eye
Eye with third eyelid exposed
Eye with third eyelid exposed

Nictitating Membrane
Another name for the third eyelid is nictitating membrane or haw. If a sick pet has its third eyelids exposed, veterinarians might say the pet has “haws.” The medical name comes from the Latin word nictare or blink. Most animals have a nictitating membrane, but primates have only a rudimentary one. Look in the mirror and the little curved slip of tissue in the inside corner of your eye is all you have left of your nictitating membrane.

The nictitating membrane is translucent in birds, snakes and reptiles, but in dogs and cats, the membrane is opaque. Unlike the two outer eyelids, there is only one nictitating membrane and instead of moving up and down, the nictitans moves horizontally over the eye. The nictitans is part of the blink response in some animals, but not in dogs and cats, which is why I think my client was surprised about seeing something in her pet’s eye that she had not seen before. Most of the time, in a dog or cat, the nictitans is tucked behind the lower eyelid and not visible.

The nictitans has important functions to protect the eye and thus vision. It removes debris from the eye. The nictitating membrane also provides protection for the eye when animals hunt, graze, feed their young, and encounter harsh conditions like snow and wind. Behind the nictitans is a tear gland that produces about half of the tears required to keep the eye moist. And, the nictitans helps to distribute the tears over the surface of the eye.

In general, the third eyelid is not prone to disease. “Cherry eye,” or protrusion of the tear gland normally found behind the nictitans, is the most common disorder of the third eyelid. Common in certain breeds of dogs and cats, the gland can easily be sutured back into place. Since the gland produces 50% of tears, its presence is critical to promoting a healthy eye. If you notice both third eyelids are up in your pet, this abnormality suggests a systemic illness. The nictitans may also protrude when your pet is recovering from anesthesia. Finally, because the face is frequently exposed to sunlight, the nictitans can rarely develop sunlight-induced squamous cell carcinoma. This tumor might appear as a reddening or lump protruding out from under the lower lid.

Amazing how important such a small and practically invisible organ can be to your pet’s healthy vision.

Why Your Dog Smells “Doggy”

dog smell

Ask a veterinarian what is one of the best smells in the world and many will answer without a moment’s hesitation: puppy breath. Hardly anyone can resist the fresh scent of a new puppy, kind of like the smell of a new car. But, as your dog grows up, he loses that delightful smell and sometimes can smell, well, a bit like a dog. Doggy smells may indicate a problem needing more than just a dog deodorant. Consider the following problems if you whiff the dog smell.

Hound Halitosis
While your dog is always kissable, a bad case of hound halitosis may make you want to avoid a smooch from your pooch. Doggy breath is not normal and is a sign of tooth or gum disease. Daily brushing and special dental products can help. But your dog may need a professional cleaning to eliminate the smell. Keep in mind, bad breath has been included as one of the 10 warning signs of pet cancer. A serious case of bad breath should send you and your dog to the veterinarian’s office pronto.

Stinky Ears
First you notice your dog scratching at his head and then you catch a stench wafting from his ears. Ear infections are one of the most common reasons dogs see their veterinarian and frequently are associated with a bad smell. Flip up the ear flap. If your dog winches, has a red flap or gook coming from the ear canal, you may be dealing with an ear infection as the source of the unpleasant doggy smell. Both bacteria and yeast can be at the root of stinky ears. Your veterinarian can do testing to identify the culprit and prescribe the appropriate medication.

Reeking Rumps
The anal sacs sit on the right and left sides between the layers of muscles making up the anal sphincter. Each one has a duct traveling out from the sac to the skin. Why dogs (and cats too) have this anatomic structure is somewhat of a mystery. Why about 10% of dogs have recurrent impactions and infections of the anal glands is also a mystery. There is no question however, that the smell of anal sac secretions can clear out large areas of a veterinary clinic and send the assistants running for room deodorizer. When your dog slides his rump on the floor or licks that area excessively, he may be trying to telling you he has an anal gland problem.

If your Fido is a bit fragrant don’t worry, a trip to veterinarian can have him smelling as fresh as a bunch of daisies.

Why Would I Want to Take My Pet to a Veterinary Teaching Hospital? 7 AMC Myths Dispelled

animal medical centerPet families have many choices when it comes to pet healthcare providers. In New York City, the neighborhood veterinarian is convenient for routine care, but emergency and specialty care may require travel. In addition to the inconvenience of travel, pet families may be apprehensive about coming to a large, teaching hospital like AMC, where, in addition to the inconvenience of travel, they perceive students will “practice” on their pets. Here are some common myths about veterinary care at a teaching hospital.

Myth #1: It’s not a big deal that we have AMC here in NYC. Aren’t veterinary teaching hospitals everywhere?
While many veterinary specialty hospitals have interns, those that sponsor training programs to train specialists and have education as a component of their mission like AMC are not so common. Veterinary teaching hospitals at colleges of veterinary medicine offer residencies to train specialists, but there are only 30 colleges of veterinary medicine in the United States. Some other large hospitals, similar to AMC, are well known for their residency training programs, but overall, less than 20% of residency training programs occur outside colleges of veterinary medicine.

Myth #2: AMC is “rich;” it has a lot of money, more than a regular hospital.
When it comes to money, AMC provides different types of services resulting in higher expenses and increased overhead compared to a neighborhood veterinary clinic.

Unlike most other hospitals, AMC, as part of our non-profit mission:

  • Provides low/no cost treatment for guide dogs, rescue animals needing specialty care, military dogs, pets of senior citizens, and other qualified individuals.
  • Operates 24/7, compared to the daytime schedule most neighborhood clinics use.
  • Incurs the cost of training residents and interns.
  • Conducts research to help improve veterinary care.

Myth #3: If I go to a teaching hospital, doctors and students will experiment on my pet for training purposes.
AMC does not induce disease for research and does not maintain any laboratory animals for research. We study naturally occurring disease in our patients and offer opportunities for pets to participate in clinical trials. Participation is strictly voluntary and requires the family’s permission.

Who will you meet at AMC?

  • Staff Doctor: Part of the permanent faculty, has completed all training, and may be a board certified specialist.
  • Resident: Has graduated from veterinary school, is licensed, and is completing training (residency) to become a board certified specialist.
  • Intern: Has graduated from veterinary school, is licensed, and is spending 12 months rotating throughout the hospital to gain valuable experience. About half the AMC interns go on to residency training.
  • Veterinary Student: Not yet graduated from veterinary school, these visiting students are observing at AMC, many in hopes of securing an internship.

Myth #4: Getting taken care of by residents and interns means I’ll get sub-par treatment.
AMC staff doctors believe that working with interns and residents holds them to a higher standard of performance. Interns and residents constantly ask questions and the staff must be up on the latest tests and treatments to stay one step of head of them. Yes, they do learn on the job, but only with staff doctor oversight. I guarantee you will be happier with the next generation of veterinarians who have had the opportunity to pursue post-graduate training than a generation without hands on experience.

Myth #5: A doctor who is also a teacher has less time for me, the client.
Teaching takes the time of the staff doctor, not the client. Staff doctors discuss cases before and after clinic time. Training interns and residents actually translates into more time for the pet and their family since they can return phone calls, answer emails, and refill prescriptions more quickly than a solo practitioner can. Hearing medical information from a variety of healthcare team members helps to increase understanding and thus client satisfaction.

Myth #6: Why should I care whether or not AMC conducts research?
Here are three reasons to care:

  1. Research helps the doctors and staff to be better educated about newly available treatments for your pet’s condition.
  2. Your pet could be in a study that benefits his health and contributes to the discovery of a cure.
  3. Knowing your hospital is trying to improve the health of our country is a very positive thing. AMC cares about all animals, not just those we take care of on 62nd Street.

Myth #7: No one chooses an AMC over a community hospital for standard care.
On the contrary, many patients prefer AMC for primary and standard care, knowing that their pet has a primary care veterinarian who can reach out to any of our board certified specialists when the need arises.

Six Characteristics of Clients that Improve Their Pet’s Healthcare

Dr. Phil Fox with a patientVeterinarians spend as much time working with their patient’s human as much as they do with their animal patients. Sometimes, pet families can help increase the quality of their pet’s medical care by modifying their uniquely human behavior. Here are six traits which you can modify to improve your pet’s healthcare.

1. Patience
Your pet is the sickest pet you have, but it may not be the sickest pet on your veterinarian’s patient list. Trust your veterinarian if she says today is busy and tomorrow I have time to take care of your Fluffy. You want her to have adequate time to assess and diagnose, not do a slap-dash job because you are a noodge.

2. Talking
Don’t get me wrong, veterinarians need you to speak for your pet, but occasionally take a breath so we can ask a question based on your description of your pet’s condition. Remember to ask us if we have anything to tell you and give us a chance to talk about test results, new prescriptions and ongoing care.

3. Ask the right person
Most veterinarians are jacks-of-all trades and can splint a broken leg or treat heart failure. But when it comes to scheduling appointments that job is better left for the receptionist. Certain other tasks, like nail trims and mat removal will be assigned to a well-trained veterinary assistant. Your veterinarian’s time is best spent providing medical care.

4. Stick with the SOP
Veterinary hospitals have standard operating procedures. These procedure ensure all pets have a temperature taken, are weighed for accurate medication dosing and the blood samples are drawn and submitted correctly to the lab. Allowing the nurse to draw blood or have the aide take the pet to be weighed, prevents these critical steps of the examination from being missed and optimizing your pet’s healthcare.

5. Allow shaving
Allowing hair clipping is a variation on the theme “Stick with the SOP” because for many procedures, shaving is an SOP. Hair can be the enemy of high quality medical care. Hair lowers the resolution of ultrasound and may obscure accurate interpretation of the ultrasound images. Hair collects dirt and bacteria. Shaving and cleaning the skin is necessary to visual a blood vessel and cleanse the skin prior to IV catheter placement. If your pet is sick enough to need an IV catheter, you certainly want him to have the best chance of getting better.

6. Timeliness
Please arrive 15 minutes before your appointment to allow the receptionist to confirm you contact information. If you are running behind, call ahead and give the office a heads up on your ETA. I am sure your veterinarian will try his best to accommodate traffic and other unforeseen delays, but he is not a magician and a thorough examination takes a set amount of time. Don’t let your tardiness give your pet the short-shrift.

Sometimes your behavior needs to be less than optimal. For example, you have the top show Poodle in the country and the big dog show is next week, if your veterinarian can, she will work around the need to shave. If you forget and ask your veterinarian about a non-medical issue, listen when he recommends asking the nurse/receptionist or kennel aide about that issue. That request is so all patients can receive our full attention and optimal healthcare.

New Guidelines for Feline Hyperthyroidism Published

thyroid catThe American Association of Feline Practitioners (AAFP) recently issued practice guideline for the diagnosis and management of feline hyperthyroidism. For my last blog post of June, which is the ASPCA’s Adopt a Shelter Cat Month, I thought a brief review of these new guidelines would be of interest to cat families.

Hyperthyroidism is the most common endocrine disease in cats over 10 years of age. Every veterinarian caring for feline patients has more than one patient with hyperthyroidism. The thyroid gland controls metabolism and when it is over active in cats with hyperthyroidism, everything about the cat’s metabolism is turned on. Hyperthyroid cats are more active, burn more calories, eat more food, use the litter box more often, groom excessively and are more vocal than a normal cat.

Grouping Cats with Thyroid Disease
The expert panel authoring the guidelines developed six classifications of cats based on history, physical examination and blood tests. Each group has a different monitoring or therapeutic plan:

  1. Cats with obvious hyperthyroidism and an elevated thyroid hormone level. These cats need immediate treatment.
  2. Cats with clinical signs of hyperthyroidism but without an elevated thyroid hormone level. These cats may need additional testing.
  3. Cats with an enlarged thyroid but normal thyroid hormone levels. These cats need routine monitoring of thyroid hormone levels every six months.
  4. Cats with an elevated thyroid hormone level but without clinical signs of hyperthyroidism. These cats need ongoing monitoring every six months as they may have early hyperthyroidism.
  5. Cats with probable thyroid disease but with another disease, such as chronic kidney disease, that lowers the thyroid hormone level. These cats need more sophisticated blood tests.
  6. Normal cats with no evidence of thyroid disease. Reassess thyroid hormone levels during routine preventive care visits.

Treatment Options for Hyperthyroidism
The expert panel identified four different treatment options available for hyperthyroid cats. The selection of one treatment over another should be made based on each individual cat’s health issues.

  1. Surgical removal of the thyroid gland
  2. Radioactive iodine therapy
  3. Oral or transdermal anti-thyroid medication
  4. Iodine restricted therapeutic diet

Myths about Hyperthyroidism
The expert panel also did some myth busting based on the currently available scientific evidence. At this time, there is no evidence to indicate medications used to treat hyperthyroidism or that the disease itself causes kidney failure. The hyperthyroid state causes an increase in blood flowing through the kidneys.  When hyperthyroidism is successfully treated, the blood flow decreases and kidney values on a blood panel may increase. The hyperthyroid state masks kidney disease.

Radioactive iodine therapy requires quarantine of the treated cat until radioactivity abates. While separation from their family may be stressful to some cats, surgical removal of the thyroid gland, diet change and daily administration of medication for years can also be stressful.

The panel evaluated the various treatments for hyperthyroidism and found them to be similar. The difference is treatments like surgery or radioactive iodine are paid for all at one time, and the cost of medications and therapeutic diets are spread out over time. 

Successful Treatment of Hyperthyroidism
Eighty-three to 99% of cats with hyperthyroidism can be successfully treated, but if untreated, hyperthyroidism can be fatal. For more information about hyperthyroidism in cats, the AAFP has created an informative a client brochure.

Feeding Your Cat for Optimal Health

cats eating AMCNYJune is the ASPCA’s Adopt a Shelter Cat Month and I am hoping many families will be welcoming a new furry feline into their home this month. To help new cat owners learn about the needs of cats, this month’s blogs are dedicated to feline topics – this week to nutrition.

Use a Reliable Source of Information About Feline Nutrition
Your veterinarian’s website, the website of a college of veterinary medicine, or an organization like the World Small Animal Veterinary Association’s (WSAVA) Global Nutrition Committee are excellent sources of information about feline nutrition. The WSAVA has a feline specific set of guidelines for internet based nutritional information, or the American Academy of Veterinary Nutrition’s resource page.

cat body conditionFeed to Maintain an Ideal Body Condition
Veterinarians discuss ideal body condition rather than a specific ideal weight since some slinky Siamese cats should weigh five pounds and a beefy Maine Coon cat, 15 pounds. The image on the right shows a cat with an ideal body condition. Notice you can see a waistline when looking at your cat from the top and a can feel the ribs if you put your hands on the cat. The loss of a waistline means your cat should lose weight and visualization of the ribs suggests more food is in order.

Feed a Complete and Balanced Diet
A “complete and balanced” diet will say exactly that on the pet food label. The label also indicates the life stage for which the food is appropriate: kitten, puppy, adult, senior. Obviously you should choose the appropriate one for your pet. Some pet foods and treats are not complete and balanced and the label will indicate these foods are “intended for intermittent or supplemental feeding only.” Occasionally, treats are formulated to be “complete and balanced” and that will be indicated on the label, as well. Veterinarians define supplemental feeding as less than 10% of the daily calorie requirement.

Think Twice About Feeding Raw Food
Being totally honest, I am nervous about the safety of raw food diets, specifically raw animal protein sources. Raw fruits, vegetables and vegetable protein sources are usually safe when eaten raw. We cook protein, specifically meat, to protect against certain food borne illnesses, like Salmonella, Campylobacter and Toxoplasma. Raw food must be handled carefully, since it poses a significant health risk to both pets and humans, especially children and immunocompromised individuals. After handling raw food diets, hands and food preparation surfaces and cat bowls must be washed with hot soapy water or in the dishwasher to avoid spreading any infectious agents. Raw diets may not be appropriate in homes with small children and immunocompromised individuals. Here is more on protecting your pets against foodborne illness.

Feed Carbs…Or Not
I am bringing this up because it is currently an area of great controversy in feline nutrition. There are proponents of zero carbs and proponents of carbs for cats. The former argue cats are strict carnivores and the latter provide data indicating cats can utilize the nutrients provided by grains and starches. Some veterinary research indicates treatment of feline diabetes requires a high fiber (high carbohydrate diet) and others a high protein diet. Since the currently available data is conflicting, I suggest cat owners rely on the expert advice of their veterinarian for recommendations on the optimal food for your individual cat, including dietary carbohydrate content.

Giving Indoor Cats Outdoor Time

adopt a shelter cat monthJune is the ASPCA’s Adopt a Shelter Cat Month and I am hoping many cats will get a forever home during this month. In a prior blog, I made a case for making your cat an indoor animal for safety reasons. But to help all the new cat owners get ready for their new furry friend and to inspire current cat owners to enrich their cat’s lives, I have some suggestions on how to safely bring the great outdoors to your indoor cat.

Cat Harness and Leash
The simple method of giving your indoor cat outdoor time is a leash and harness. Notice, I did not say a collar because cats can slip out of a collar and also many harnesses. One snug, but comfortable looking harness is the Kitty Holster, made of cotton and with a top zipper closure, it appears very secure for a walk outdoors with your cat.

Cat Gazebo
Using the search words “cat gazebo” or “cat enclosure,” I found a number of outdoor play spaces that can easily and quickly be set up in your backyard or on your deck. I would choose a cat tent with a roof or canopy to provide shade on a sunny day. Because cats love to climb, I would also select one with a built in perch or two. Some cat gazebos are very elaborate and become an integral part of your outdoor living room.

cat connectorCat Connector
While nearly all of the products I identified to bring your indoor cat outdoors require you to transport your cat to the structure, I did find one system where your cat can have free access to her outdoor space. Using a connector kit that looks something like a dryer hose, the cat can exit the house via the tube installed into a window and end up in the outdoor cat condo, giving your cat total independence.

Cat Run
Another search term that identified some nice outdoor spaces for cats was “cat run.” Cat runs come in both vertical and horizontal versions which can be zipped together to form a large outdoor space for more than one cat at a time. The cat runs I found collapse into a small carrying case, making them portable for a traveling cat.

cat solariumCat Solarium
Fitting into a window like a window air conditioning unit, the cat solarium creates a cat sized bay window hovering over your yard. The windows on three sides give your cat a panoramic view of the great outdoors.

Bring Your Cat Closer to the Outdoors
If you don’t have a yard for a cat gazebo or your persnickety condo board won’t allow a solarium, consider bringing your cat closer to nature with a window hammock, a carpet covered window sill extender or a hanging window basket cat perch.

Whether you choose a solarium, a gazebo or just a window hammock, your cat will now be able to safely enjoy the great outdoors.

Understanding Cat Tail “Language”

cats | animal medical centerJune is the ASPCA’s Adopt a Shelter Cat Month, and June 4 was International Hug Your Cat Day. I need no better reasons to write a blog on cat “language” than those two cat celebrations.

Cat Talk
Some cat words are universally used by cats and understood by humans. For example, consider the wail emitted by your cat when you accidently step on their toes as they dance under your feet in the kitchen; you can hear that sound from another room and immediately know some kitty toes got crunched. How about the cat morning alarm sound which is readily translated to: “Get up you slug and serve breakfast!” Everyone knows purring is the sound of a happy, contented cat. Veterinarians quickly recognize the yowl of a male cat with a urinary obstruction. Certain cats have a large vocabulary, trilling and chirping about their day when you come home.

Cat Body Language
A recent scientific study demonstrated changes in facial features are one way a cat exhibits pain. But observing your cat’s tail may be the best method of listening to what your cat is trying to tell you.

Tail Straight Up
A happy cat has its tail straight up when it greets you at the door. This should be the normal position of your cat’s tail most of the time because she telling you what a good mood she is in. Some happy cats will wave their straight up tail back and forth, not like the wag of a dog, but more like the wave of Queen Elizabeth.

Tail Straight Out
This tail position is usually seen when your cat is crouched low to the ground in attack mode. The ancestral cat hunted for food. In order to disguise their intentions to their intended lunch, cats crouched low to avoid being sensed by their prey. Your cat probably exhibits this behavior when you bring out a new fur mouse or when hunting your slippers or another cat.

Tail Puffed Up
Bigger is better when you are facing enemies and the wild beast in your cat comes out when they are frightened by a strange human or the neighbor’s drooly dog. The tail puffs up as part of the “fight or flight response” mediated by adrenaline in an effort to say, “I am big and bad. Go away.”

Tail Flicking
When your cat is flicking her tail, leave her alone and teach your children to do the same. Tail flicking is your cat’s way of saying, “I am angry and about to go ballistic.” Remove the cause of her anger and steer clear until she calms down or someone could really get hurt.

Tail Injuries and Illness
Doors inflict a number of injuries on tails: lacerations, fractures and degloving (scraping) injuries. These are reasonably easy to recognize. A tail that is not moving may indicate a neurologic disorder. Tails can also develop tumors. If your cat holds her tail in a strange way, she is telling you a visit to the veterinarian is in order. Tail amputation may be the recommended treatment for certain diseases of the tail. Here is more information about tail amputations.

Pay close attention to the tail language of your cat as she may have something important to tell you!

Can You Recognize Pain in Your Cat?

At least every day, if not more often, I am asked by a worried cat family, “Is my cat in pain?” This is probably a more difficult question for me to answer than the other one I hear every day, “Why did my cat get cancer?

Signs of Pain
Many of the current recommendations to identifying pain in pets are based on behavioral changes. Reluctance to jump, walk or move in general can be a sign of pain, as is the more obvious limping. I worry about pain in my feline patients when a cat with a robust appetite suddenly does not lobby for 40 Temptations™ on a daily basis. Changes in posture and sleep can signify pain. Veterinarians interpret a cat snoozing in a curled up position as non-painful and a wide awake stretched out cat as a painful one.

Pain Guidelines
The World Small Animal Veterinary Association Global Pain Council, an international panel of pain management experts has also developed a series of guidelines for veterinary practitioners. There is also a scientifically validated pain scale for cats, in both Brazilian Portuguese and English. This scale is designed to give similar results between different observers helping veterinarians everywhere to take better care of cats. These guidelines help us to recognize, assess and treat pain. But they don’t help cat owners much since they are designed to be used by medical professionals.

Your Cat’s Face May Have the Answer
A recently published study from the Journal of Small Animal Practice studied the facial expressions of painful cats. The veterinary researchers at the School of Veterinary Medicine at the University of Glasgow, Scotland, measured distances between various facial landmarks on photographs of painful cats. Analysis of the measurements determined changes in ear position and mouth distance were the best predictors of pain. They then used the information to make a graphic of cat faces that could be used to accurately identify painful cats. The graphic is the cute cat faces illustrating this blog. Although more work is necessary to validate the utility of the cat face graphic, ultimately, the system of pain assessment could become a very simple method of assessing pain in your cat.

Concerned your cat is painful? Check with your veterinarian. Sometimes veterinarian’s trial a cat on pain medication as a way to identify painful cats and put them back on the road to good health.

Image: Journal of Small Animal Practice, December 2014