Dear Doctor - January 2013
Letter to Tufts Veterinarians
Concerns about cats and husband’s health condition
Q We have nine rescue cats ranging from one to nine years old. Five go in and out during the day and all are in at night. I change the litter boxes at an outside sink. Here’s my problem: My husband has been placed on the liver transplant list. The estimated time for waiting is two years, but that could change.
We are being pressured by family members to find new homes for the cats. The concern is that after the transplant, his anti-rejection drugs will suppress his immune system. The only comment from the medical center he goes to is that Bartonella, the organism that causes cat scratch fever, should be looked into and that was in answer to my question about cats. They have said nothing so far about dander, hair, etc. from the cats affecting the recovery period.
Our cats give us great pleasure and comfort. I’m 70, my husband is 65 and we live alone in our own house. Have there been any studies on about cats and liver transplant patients? Anything you can provide in the way of information would be helpful.
Dear Nancy: First, best of luck to your husband. Owners reap health and financial benefits (from lower health care costs) in addition to companionship from having a family pet. It would be a shame to deprive you and your husband of those benefits. Many veterinarians support the health benefits of pet ownership, and I certainly do as well.
Patients who have received organ transplants are more likely than most people to get diseases from animals. However, simple tips can be followed to reduce the risk of getting sick after contact with animals. Wash hands thoroughly with running water and soap after handling animals. Pets should be fed only commercial pet foods. If eggs, poultry or meat products are given as supplements, they should be well-cooked.
Keep your cats indoors, if possible. Do not let your husband clean out the litter box. Please perform that duty on a daily basis. Do not place litter boxes in kitchens, dining rooms, or other areas where food is prepared and eaten. Practice flea and tick prevention. If your pet is ill, seek veterinary care as soon as possible. The Centers for Disease Control (CDC) has additional information specifically for transplant patients at www.cdc.gov/healthypets/bonemarrow_transplant.htm.
I will address your question about Bartonella, the bacterial agent that causes Cat Scratch disease. Bartonella may be cultured from a large percentage of cats in the United States and only rarely causes signs of illness in the cats themselves. However, Bartonella may be transmitted to, and cause serious illness in, humans. The bacterium is thought to be transmitted through scratches, licks and flea bites.
Recommendations from the CDC include avoiding “rough play” with cats, especially kittens. This includes any activity that may lead to cat scratches and bites. Wash cat bites and scratches immediately and thoroughly with running water and soap. Do not allow cats to lick open wounds, and control fleas.
Testing for the presence of Bartonella in cats is problematic. Since there is no therapy that completely eliminates Bartonella infection, I choose not to test, but instead assume all cats are positive, and follow the above recommendations. Although there will always be a risk of acquiring infection from cats, I personally believe the benefit of pet ownership to be greater than the risk of infection. However, you and your husband must decide for yourselves.
Best of luck to you and your pets.
Michael Stone, DVM, ACVIM
Clinical Assistant Professor
Cummings School of Veterinary
Medicine at Tufts University