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Ask the Doctor March 2013 Issue

Dear Doctor - Indoor cat wants to go outside

Letter to Tufts Veterinarians

Q I have a wonderful five-year-old cat who was rescued when she was a kitten. This year, Sophie has decided to drive me crazy by going from one door to the other and meowing constantly. She is not allowed out in my apartment complex.

I’ve had her for most of her life, and she has never acted like this. I tried walking her on a leash, but the experience was not a sucess. She doesn’t play with cat toys, so my veterinarian suggested that I adopt a kitten. (I hesitate on this, but will wait for your reply.) I’ve had more than one cat at a time, so I think I know what to expect, but at 80 years old, I have some doubts! Sophie is a very nervous cat; she hides whenever anyone comes to my house.
Elaine Binder, via Email

A Dear Elaine: It does seem that your cat has suddenly got the call of the wild and wants to be outside again as, no doubt, she once was. Why she waited this long to express her frustration with the indoor life is a mystery to me —though early springtime is usually a key time for the wanderlust of cats.

The fact that your cat’s spring fever has taken four years to emerge, however, makes me wonder if something outside has changed to attract her attention. Perhaps a new neighborhood tomcat has been giving her the eye, or a bird has made a nest in a nearby tree or bush. However, we may never know. Your veterinarian’s suggestion of getting another cat is not a bad idea as it would help divert some of your cat’s attention and energies.

Alternatively, you could try to enrich her indoor environment with climbing frames or hidey holes, while at the same time attenuating her visual access to the outdoors by screening off windows. Toys are helpful to occupy her — food puzzles are especially good — and you should exercise her for at least 30 minutes daily by getting her to chase moving things (see related article on page 7).

While it is definitely safer for cats to be kept indoors, these cats must be directly or indirectly entertained or they can go stir crazy. I wish you luck in satisfying your cat’s inner cat, and restoring peace to your household.
Nicholas Dodman, BVMS
Animal Behavior Clinic Director
Cummings School of Veterinary Medicine at Tufts University

A test for feline pancreatitis?

Q In the December 2012 issue, Catnip published an article titled: “Pancreatitis: Still a Mystery.” Over the years, I have had four cats with pancreatitis, so I’m quite experienced with this difficult disease.

I feel that the article omitted a couple of important issues. There was no mention of nausea, and nausea is a huge problem for cats with pancreatitis. Additionally, there was no mention of the blood test that is specifically used for diagnosing pancreatitis, the Spec fPL.
Linda Yacobucci, via Email

A Dear Ms. Yacobucci: I’m sorry to hear that you have had four cats with pancreatitis, and hopefully I can provide you with some information that will be useful.

First, regarding nausea: In truth, nausea is not universally present in cats with pancreatitis. In one study of 40 cats with pancreatitis, vomiting was seen in one-third of the cats, and abdominal discomfort in 25 percent. Your point is well taken, however, that if nausea is present it must be treated. We have several good medications to treat nausea in the cat to prevent their discomfort.

The blood test that you mention — feline pancreatic lipase (Spec fPL) — is controversial. The majority of reports suggesting its usefulness have been written by the doctors who developed the test.

Independent evaluation of the test has not been performed to my satisfaction. The reason this might be important is that the same authors created a previous test — the feline serum trypsin-like immunoreactivity (TLI), in the late 1990s, which they claimed in publications was an excellent test for the diagnosis of feline pancreatitis. However, when the test was independently investigated (by the University of California), its value proved to be highly questionable.

After the publication of that paper, the makers of the serum trypsin-like immunoreactivity (TLI) acknowledged the TLI test had limited value, and that now they had created a better test, the fPL. The fPL test may indeed be useful, but until it has been independently validated, I and many other experts will remain skeptical. Our experience with the TLI test is a good example of the fact that all tests — including the fPL test — need to be independently evaluated before they can be relied upon in clinical practice.
Michael Stone DVM, ACVIM
Clinical Assistant Professor Cummings School
of Veterinary Medicine at Tufts University

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