Dear Doctor – January 2016

A cat with worsening breath; can I feed dog food to my cat?; digestive issues of a senior cat


Advice for bad breath
Q My nine-year-old cat’s breath has always been slightly unpleasant, but it has become noticeable worse over the past few months. I would like to know what might be causing this, and if there’s anything I should be doing.
Natalia Brown

A Dear Natalia: There are many possible causes for bad breath in cats, and many of the reasons are the same as they are for humans. Primary causes can include dental diseases, foreign material stuck in the mouth or ulceration of the mouth. However, there are also more severe causes, like oral tumors, lung disease and kidney disease.

For that reason, it’s very important that you schedule an appointment with your veterinarian in the near future to diagnose your cat — and hopefully rule out the more serious conditions. Your veterinarian will likely ask if you have noticed other symptoms, such as oral discharge, and any changes in eating habits or behavior.

Remember: The cat’s owner can truly be the “eyes and ears” of the veterinarian, noticing subtle things at home that may be extremely helpful and informative during the brief visit at the clinic.

If your cat receives a clean bill of health, you may consider changing his diet or using a feline finger toothbrush daily or every other day to help freshen his breath.
Michael Stone, DVM, ACVIM
Clinical Assistant Professor
Cummings School of Veterinary
Medicine at Tufts University


Feeding dog food to cats
Q My husband and I live in an elderly community with plenty of pet lovers. Our neighbor recently lost her toy breed dog, and offered to give us a case of small cans of dog food to feed our two cats.

We are living on a fixed income as retirees, and wouldn’t object to a couple of weeks of free food! But we wanted to first make sure that the dog food — an expensive, premium brand — would be safe for our cats. Please advise.
Lily Doppel

A Dear Lily: Great question! None of us likes to see food go to waste, but unfortunately dog food is not a safe option for your cats. Cats have higher requirements for protein than dogs (higher protein dog diets are low protein for cats), and also require some nutrients, such as taurine, that dogs can make and thus are rarely supplemented in dog food.

Cats that are fed dog food can develop serious health problems due to inadequate protein, taurine or other nutrients. Additionally, there are ingredients in some dog foods and treats that are safe for dogs that can make cats sick.

Perhaps you can give the food to a friend with a dog, or donate it to a local shelter.
Cailin Heinze, VMD, MS, DACVN
Assistant Professor of Nutrition
Cummings School of Veterinary
Medicine at Tufts University

Digestive issues of a senior cat
Q My cat Gypsy is 15 years old and has been experiencing digestive problems and persistent diarrhea. She has lost five pounds in the past few months and I cannot seem to control her loose bowels. I have tried two different enzymes and I have been giving her probiotics that are made with Alaskan salmon oil. So far, her problem still persists.

She has been tested for thyroid problems and possible blood conditions and received X-rays, but my veterinarian didn’t find anything. I hate to see Gypsy dwindle away like this. She rarely leaves the room where I keep her the litter box, and she is lethargic. Also, she is always hungry, yet it seems as though she cannot retain any nourishment.
Stanley Louiston

A Dear Stanley: Fortunately, Gypsy has the rare combination of weight loss despite excessive appetite. There are a few diseases that cause that combination of signs: diabetes, hyperthyroidism, lack of digestive enzymes and disease of the small intestine. Treatment is available for each of these conditions.

I will presume that diabetes and hyperthyroidism have been excluded because of the normal blood tests. Lack of digestive enzymes can be tested with a blood test called trypsin-like immunoreactivity (TLI, for short). This condition (lack of digestive enzymes) is extremely rare and I will therefore discuss the final condition (disease of the small intestine) as the most likely culprit.

All food must be absorbed in the small intestine. Without absorption, food merely passes through the body causing diarrhea and weight loss. Several different small intestinal diseases are known — with food intolerance, inflammation and cancer being the most common.

An accurate diagnosis would often include an X-ray of the lungs, ultrasound of the intestine and biopsy of the small intestine. Biopsies may be obtained through surgical or endoscopic methods. Results often guide the most effective therapy. One particular condition you should be aware of is small cell lymphoma of the small intestinal tract. This form of cancer — quite common in elderly cats — is actually a very benign cancer with a good prognosis. With appropriate therapy, most cats live one to two years after the diagnosis is made.

You should discuss further diagnostics with your veterinarian. You may be offered consultation with a veterinary internal medicine specialist who has advanced training in the diagnosis and treatment of intestinal diseases. If you cannot afford extensive diagnostics, I would consider the submission of a blood serum trypsin like immunoreactivity (TLI) and if normal, treatment for small cell lymphoma of the intestine.
Michael Stone, DVM, ACVIM
Clinical Assistant Professor
Cummings School of Veterinary
Medicine at Tufts University


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