Pearls of Wisdom 2016

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American Association of Feline Practitioners 2016 Conference
November 3-6, 2016 – Washington, DC
Feline Behavior and Respiratory Diseases

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Friday – November 4, 2016

Fantastic Felines – Understanding Their Natural Behavior, Dr. Sarah Heath

  1. Understanding feline communication and the social behavior that drives it, will offer cat owners a good foundation for a fulfilling relationship with their pet. One area in which there is a fundamental difference between humans and cats is in their social structure. Humans are socially obligate animals with a real need for social interaction and a desire to minimize confrontation within the group. In contrast cats have a co-operative social system, which places more emphasis on the importance of territory and less on the availability of con-specifics.
  2. Cats have some fundamental behavioral requirements which include: A sensation of control; Free and immediate access to important resources when required; The provision of privacy; The ability to escape from or avoid potential stress.

Understanding Feline Emotions, Dr. Sarah Heath

  1. Successful behavioural treatment relies on identifying the underlying emotion and considering all of the factors that affect it, including the animal and its history, the physical environment and the social environment.
  2. Emotional stability depends on self-confidence of the individual and provision of an environment which meets the basic behavioural and environmental needs of the species.

Meeting Environmental Needs: Setting Up the Home for Success, Dr. Sarah Ellis

  1. Veterinarians have a key role in helping owners setting up their home in a manner than promotes positive welfare in their cats and avoids the occurrence of behavior problems. By incorporating an environmental audit, they can identify where advice needs to be tailored.
  2. Advice should focus on five key areas: ensuring the cat has ample safe places, providing multiple and separated key environmental resources, providing opportunity for play and predatory behaviors, providing positive consistent and predictable human-cat social interaction, and providing an environment that respects the importance of olfactory and chemical communication to the cat.

Feline Indoor Elimination Issues: How to Investigate & Treat, Dr. Sarah Heath

  1. Elimination problems often cause owners a great deal of embarrassment and it is important for practice staff to tackle the issue with sensitivity and understanding. It is essential to determine a cause and differentiate between problems which are rooted in communication and those that are a direct result of elimination.
  2. It is important to approach these cases with a thorough understanding of normal elimination behavior. If we appreciate the requirements of cats when they are toileting we can better prepare the domestic environment to meet those requirements and better understand why things go wrong.

Lunch & Learn – Feline Pain: Don’t Let Acute Become Chronic!, Dr. Robin Downing

  1. Hypothermia contributes to acute pain in cats due to decreased metabolic function, decreased efficacy of pain drugs, and prolonged recovery.  This can make their overall pain experience worse.
  2. An appropriate acute pain management plan for felines must be based on how much pain a particular procedure will induce.  Multi-modal–reaching for medications that complement one another–creates a far more effective strategy than single drug therapy and allows for smaller doses of each agent. 
  3. Simbadol® is complements both NSAIDs and gabapentin in the perioperative pain management plan. It is feline specific, delivered once per day (up to three days), given subcutaneously (less painful than IM), and well-tolerated. This is an important addition to feline pain management plans.

Handling Cats Effectively in Practice, Dr. Sarah Heath

  1. Cats are commonly lacking in appropriate habituation for veterinary procedures and since the primary feline defense strategy is avoidance this decreases their inherent tolerance of close physical contact. Handling cats in a way that restricts their perceived level of control over the situation will exacerbate feelings of confinement and increase the likelihood of repulsion responses being selected as a means of dealing with the apparent threat from veterinary staff.
  2. Breaking the examination process down into small stages and allowing the cat to recover between them decreases the risk of exceeding its threshold of tolerance. Learning to read feline body language and facial expressions is essential if veterinary personnel are going to avoid unnecessary conflict. Paying attention to subtle changes in ear position or body tension can help to avoid injury and while temporarily suspending handling and allowing the cat to return to a calm emotional state may appear to delay proceedings it will actually be very beneficial in the long run.

Inter-cat Aggression in Multi-cat Households, Dr. Sarah Heath

  1. The most important consideration in multi-cat households is the issue of social compatibility and while cats may co-exist under the same roof that does not necessarily mean that they belong to the same social grouping. Cats do not share important resources between social groups and yet in multi-cat households they are regularly expected to share resting places, feeding stations and watering holes even though their social behaviour indicates that they consider themselves to be causal housemates rather than members of the same family.
  2. Passive conflict manifested by staring, posturing and keeping distance from one another can easily be overlooked and when these signs are not recognised the ensuing physical confrontation can sometimes appear unprovoked and intense.

I Understand You, But Do You Understand Me? Feline Communication & Its Implications for Human-cat Interaction, Dr. Sarah Ellis

  1. Communication exhibited in different contexts can appear very similar in presentation but may have very different meanings, for example, purring occurs in situations where a cat is experiencing positive emotions and in situations where a cat is experiencing negative emotions. Similarly, communication in the same context can often look very different at different time points or between different cats.
  2. While much of cat-cat interaction is similar to that of cat-cat communication, eg, allo-rubbing, it is important to know where the differences are and act accordingly, for example, while bonded cats may wrap tails, research has shown cats often respond negatively to being touched at the base of the tail.

Behavioral Preparation for a Veterinary Examination: Educating Your Owners, Dr. Sarah Ellis

  1. In order to help cats to cope with a veterinary examination, owners can be guided to teach cats to cope with (and even enjoy) ‘dummy’ examinations at home using the training principles of operant conditioning and systematic desensitization and counter conditioning.
  2. Training should involve presenting the cat with dilute versions of the stimuli the cat will experience in the veterinary clinic while at home. The cat should be rewarded for behaving in a relaxed manner. For example, to teach a cat to cope with having its mouth opened to examine its teeth, successive approximations of this behaviour should be practised at home and rewards such as food treats given for remaining calm. The first step might simply just be touching the cat’s lip for a second then giving the cat a treat and then building up gradually to touching the lip for a few seconds, then lifting the lip and eventually opening the mouth.

Senior Cats: Medical Disorders & Behavioral Signs, Dr. Gary Landsberg

  1. Any change in behavior especially in a senior pet may be the first or only indication of an underlying medical problem of virtually any organ system.  Therefore for the health and welfare of their pet, owners must be counselled to advise the veterinary practice of any change in behavior, as early diagnosis provides the best opportunity to resolve the condition, slow the decline and potentially increase longevity. 

Feisty Felines: Kitten Development & Problem Prevention, Dr. Gary Landsberg

  1. Kitten owners given preventive counselling advice at the veterinary clinic, have significantly fewer feline behavior problems and more desirable behaviors one year later and reduced risk of relinquishment.  Guidance most focus on understanding and providing for the behavioral needs of the cat and reinforcing desirable behaviors as virtually all of the rambunctious, destructive and potentially injurious behaviors of young cats arise from a lack of outlets for normal feline behavior.    

Identifying Common Triggers for Undesirable Behaviors, Dr. Amy Pike

  1. Thorough history taking is the first step in identifying the triggers for behavior problems. When presented with any problem, as veterinarians we need to do our medical due diligence which includes a physical examination and additional diagnostics, if warranted, in order to rule out a medical underpinning for the behavior.
  2. Once a medical etiology has been ruled out, we must next determine if the behavior is a normal part of the feline ethogram, but unwanted by the owner, or an abnormal/aberrant behavior. Addressing the feline and human concerns of the problematic behavior will then lead us to be able to create an effective treatment plan.

Creating Effective Treatment Plans, Dr. Amy Pike

  1. When treating behavior problems, identify and remove the triggers and factors that may be maintaining the behavior, Identify the goals of the owner(s), lay out realistic expectations for change, and triage the triggers and problems from most important to least in order of both safety and necessity.
  2. Management and avoidance can often result in high levels of successful treatment, but decreasing the patient’s emotional arousal may be necessary as well. Arousal, fear, and anxiety can be treated with a combination of environmental enrichment, products and medication to round out a complete and effective treatment plan.

Saturday – November 5, 2016

Getting Pets-to-Vets: Tools, Strategies, & Training for the Cat, Dr. Theresa DePorter

  1. Veterinary visits are on the decline and owners report the number one obstacle is the carrier. Helping cats feel safer in the carrier promotes better veterinary care and overall health by helping cats get to the veterinarian.
  2. Cats learn by positive reinforcement and can learn to perform specific tasks and follow cues. By building their skills, facilitating communication and promoting the human animal relationship, we can help cats get to the veterinarian.

Use of Products & Medications for Long-term Modification of Feline Behavior, Dr. Theresa DePorter

  1. Medications or supplements may influence feline behavior by acting on serotonin and GABA receptors.
  2. Knowing the expected period of effect for psychotropic medications is useful when determining the appropriate application and assessing for efficacy. Medications such as alprazolam, trazodone or gabapentin may be beneficial to prevent distress and arousal when administered prior to stressful situations such as veterinary visits.
  3. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline may be more beneficial with fewer side effects than older and more familiar medications such as amitriptyline or clomipramine.
  4. Judicious use of psychotropic medications will improve the quality of life for feline patients: both at home and at the veterinary clinic.

To Scratch or Not to Scratch: That is the Question, Dr. Theresa DePorter

  1. Based on an internet survey study, the ideal scratching post to recommend to a cat owner to help prevent inappropriate scratching is one that includes rope as a substrate, has a vertical scratching surface, is 3 feet or higher, has two or more levels and has a base width of between 1 and 3 ft. Owners who reward their cat for scratching the desired post can increase their cat’s use of the intended scratching post.

Stress & Feline Medicine, Drs. Sarah Ellis and Ilona Rodan

  1. The relationship between stress and disease is inter-related – while chronic stress can be a significant cause of disease, acute stress can hinder diagnosis of disease. Likewise, both acute and chronic distress can arise as a direct (eg, pain) result and indirect result (eg, caused by having to administer medication or hospitalization) of various disease processes.
  2. The veterinarian plays an important role in diagnosing chronic stress – drawing on and integrating information from the cat’s social and physical environment at home, its interactions and relationship with its owner, its physical presentation and complete medical history will provide the most accurate assessment of the levels of stress a cat may be experiencing.

Sound, Mind, & Body: Complex Relationship Between Mental & Physical Health, Dr. Valarie Tynes

  1. Fear and anxiety related behavior problems (mental or emotional illness) can lead to chronic stress which can lead to physical illness.
  2. Conversely, many chronic medical conditions can lead to anxiety, resulting in mental or emotional health problems.
  3. Mental and physical health are inextricably linked requiring an ability to at least recognize, diagnose and treat both to some degree. Treatment will often be unsuccessful if both the mental and the physical issues are not addressed.

From Ticks to Turkeys to Tabbies: The Science of Semiochemicals, Dr. Valarie Tynes

  1. Research into semiochemical communication has been going on for decades and continues to reveal the myriad of ways in which an understanding of chemical communication can aid us in caring for animals.
  2. Pheromones provide us with a safe and effective way of communicating natural messages to cats that can aid us when dealing with unwanted behaviors.

Feline Orofacial Pain Syndrome (FOPS), Dr. Sarah Heath

  1. Diagnostic work up of affected cats includes ruling out predisposing medical problems, especially dental disease. It is also important to explore the history for possible psychological factors, e.g. stress from multi-cat household, and implement appropriate management. Neurological examination, MRI and CSF analysis are normal in cases of FOPS however they are useful to rule out other causes of trigeminal disease.
  2. Treatment is multifactorial incorporating treatment of any underlying dental or systemic disease, effective analgesia and appropriate behavioural modification, including provision of a suitable physical and social environment taking into account feline behavioural and environmental needs.

Behavioral Considerations in Feline Obesity and Weight Loss Cases, Dr. Sarah Heath

  1. There are some very important differences between the feline and human approaches to food both in terms of the pattern of feeding behavior and the social significance of food for the respective species. The main features of feline feeding are:
    • the need for exploration to locate a food source
    • the division of feeding into multiple small periods of consumption throughout the day
    • the time consuming nature of food consumption over a 24-hour period
    • the presence of self-regulation of food intake
    • the desire to eat alone
  2. It is important to establish feeding as a positive and non-compromised activity and to work to reduce the risk of chronic stress related to other issues such as social incompatibility, restricted access to resources, lack of privacy etc. Chronic stress is debilitating in both a behavioral and a medical context and is a risk factor for physical disease as well as behavioral disorders, both of which may be associated with the onset of anorexia or obesity. 

Behavioral Dermatology in Cats, Dr. Gary Landsberg

  1. For self-traumatic skin disorders including overgrooming, hyperesthesia, and tail mutilation, a diagnosis of compulsive disorder can be effectively treated with a combination of behavior therapy together with the use of selective serotonin reuptake inhibitors or clomipramine.  However, for each of these presentations, underlying neurologic, dermatologic or painful conditions must first be ruled out as they are equally and in some case more likely to be the cause of these signs.

Urine Marking, Dr. Gary Landsberg

  1. In order to effectively treat urine marking in cats, it is first essential to differentiate urine marking in which the cat deposits urine on vertical surfaces to cover the area as a form of social communication, and not due to inappropriate elimination (toileting or periuria) where the pet is choosing to eliminate in locations outside of its box.  Both urine marking and housesoiling can have underlying medical problems that first must be ruled out as a possible cause.  Drug therapy with clomipramine or fluoxetine is highly effective at controlling most cases of urine marking; however, resolution requires identification and treatment of the underlying stressors.   

Behavioral Adaptations to Chronic Pain, Dr. Lisa Moses

  1. Because chronic pain may be difficult or impossible to diagnose on a physical exam or during a relatively short observation period in the clinic setting, owner and veterinarian observed behavioral changes are the key to diagnosis and response to treatment in chronic pain states.
  2. Even subtle changes in behavior (like changes in sleeping location and reduced grooming over focal areas of the body) are relevant to chronic pain diagnosis. Owners are frequently aware of these changes, but may be unable to interpret the cause or significance of the changes. They may not report these changes unless specifically asked about particular behaviors. 

Behavior Changes in the Geriatric Patient: Is it Pain or is it Dementia?, Dr. Lisa Moses

  1. Behavior changes in geriatric cats are often multifactorial. The high incidence of co-morbidities in geriatric patients means that it is unlikely behavior changes are due only to one cause. A thorough history and medical work up is imperative to uncover less obvious causes of behavior changes
  2. Pain and dementia have a complex interaction in the brain. Pain can be the cause of exacerbations of dementia and dementia provoked anxiety can worsen pain perception. Treatment of chronic pain may significantly improve dementia behaviors and treatment of anxiety can improve pain control.      

Understanding Cat Behavior in the Shelter, Dr. Brenda Griffin

  1. Training staff to accurately observe and interpret feline body language and behavior (i.e., to carefully observe what cats DO and DO NOT DO) is the key to ensuring humane care, good health, and supporting positive outcomes for shelter cats.
  2. From the moment a cat enters the shelter, steps should be taken to reduce stress and fear.

Housing for Health, Safety, & Welfare: Parts 1 & 2, Dr. Brenda Griffin

  1. Traditional cage housing is too restrictive to meet the behavioral needs of cats.
  2. Housing should always include a comfortable resting area and allow cats to engage in species typical behaviors while ensuring freedom from fear and distress.
  3. Signs of social incompatibility may seem subtle to the inexperienced observer, but the resultant stress can be tremendous for cats.
  4. When cats are well adjusted and housing and husbandry meets their behavioral needs, they display a wide variety of normal behaviors including a good appetite and activity level, sociability, grooming, appropriate play behavior and restful sleeping.

Enrichment FUN with Shelter Cats, Dr. Brenda Griffin

  1. Enrichment is not an optional task that can be neglected on busy days, but a core component of daily routine animal care.
  2. Simple, inexpensive enrichment activities provide opportunities for “cats to be cats” and reduce stress for cats and humans alike.

Is This Cat Really Feral?, Dr. Brenda Griffin

  1. It can be challenging to differentiate truly feral cats from those that are tame but fearful and reactive—this is because all cats, regardless of their socialization status, experience stress and fear and express it in the same ways.
  2. Providing time for acclimation in a quiet, positive, predictable environment as well as carefully introducing “gentling” techniques can help socialized cats to acclimate and “show their true colors”.

Keeping Cats in Their Homes, Dr. Brenda Griffin

  1. Practitioners who are knowledgeable about risk factors and reasons for relinquishment of cats to shelters have the potential to “save” the lives of many of their patients.
  2. Promoting behavioral wellness, pet ID, and spay-neuter services can serve to keep cats in their homes, in the veterinary practice, and out of local shelters.

Lunch & Learn – The Skinny Cat, Dr. Peter Kintzer

  1. Many diseases of which weight loss is a clinical sign are more common in older cats. A complete diagnostic workup is crucial because these pets may have abnormalities in multiple body systems.
  2. Both body condition score and muscle condition score must be assessed when evaluating the skinny cat.

Sunday – November 6, 2016

Feline Bronchitis & Asthma Including Use of Inhaled Medications, Dr. Philip Padrid

  1. Asthma can be diagnosed by exclusion of other common causes of cough and wheeze and immediate response to high dose prednisolone.
  2. Without treatment asthma may come and go, be severe or cause minimal signs while bronchitis is a steadily worsening disorder.

Chronic Nasal Disease in Cats, Dr. Philip Padrid

  1. Bacterial infection is never the primary cause of chronic rhinitis in cats.
  2. Chronic lymphocytic plasmacytic rhinitis can be thought of as “inflammatory bowel disease” of the nose and treated appropriately by a combination of antibiotics decongestants and inhaled corticosteroids.

Approach to the Coughing Cat, Dr. Laura Nafe

  1. While feline asthma and chronic bronchitis are the most common causes of feline cough, every effort should be made to rule-in or rule-out other differential diagnoses (especially infectious disease), as these other conditions may worsen with glucocorticoid therapy and require specific treatment.
  2. The most useful diagnostics when evaluating the cat with cough are thoracic radiographs (3-views) and an airway wash (bronchoalveolar lavage). 

Approach to Feline Respiratory Distress, Dr. Laura Nafe

  1. When the feline patient presents in respiratory distress, clinicians should take time to step back and observe the patient breathing, as the respiratory pattern can provide valuable clues as to the respiratory localization of disease and eventual diagnosis.
  2. Stabilization of the cat in respiratory distress should focus on oxygen therapy, minimizing stress, a sedative agent, and managing the underlying cause (when possible). 

Anesthesia & Respiratory Disease, Dr. Laura Nafe

  1. While anesthesia can potentially decompensate a feline patient with respiratory disease, it is often necessary to determine the diagnosis, optimizing therapeutic management.  With appropriate preparation, resources and experienced personnel, safe anesthesia is achievable in these patients.
  2. Premedication, bronchodilators (when indicated), preoxygenation, and SpO2 and end-tidal CO2 monitoring are all important components of anesthetizing the feline respiratory patient.

Pleural Disease in Cats: State of the Art, Dr. Philip Padrid

  1. It takes 30cc air/kg bw to cause significant clinical signs of respiratory compromise.
  2. Use of “Lights: criteria i.e.; LDH measurement in pleural fluid is the most accurate first step in determining the cause of pleural effusion.

Identifying Sepsis in Cats: Focus on Thoracic Disease, Dr. Amy DeClue

  1. Intrathoracic forms of sepsis in the cat include pyothorax, pneumonia and infectious pericarditis.  Pneumonia and infectious pericarditis are rare in the cat.  If an intrathoracic form of sepsis is suspected, pyothorax should be the top differential diagnosis.
  2. Along with classical findings of sepsis like fever or hypothermia, bradycardia, leukocytosis or leukopenia, left shift or toxic changes to neutrophils, the finding of short, shallow inspiratory dyspnea, muffled lung sounds in the dependent lung fields, evidence of pleural effusion on imaging should alert the clinician to the possibility of a pyothorax. 

Diagnostic Evaluation of Pulmonary Disease, Dr. Amy DeClue

  1. Minimally invasive diagnostic testing like physical examination and imaging can help localize and focus differential lists for feline pulmonary disease.
  2. Blind bronchoalveolar lavage and fine needle aspiration of the lunch are inexpensive, easy ways to collect cells from the lung for cytology and culture.
  3. Inhaled glucocorticoids could be used in place of systemic glucocorticoids to minimize systemic side effects while controlling airway inflammation in cats with asthma or chronic bronchitis.

Lunch & Learn – Update on Feline Adverse Food Reactions, Dr. Klaus Loft

  1. If the owner cannot do a strict diet trial for 60-90 days… then do not even start the process. There is not reliable serology and/or skin testing for food allergy in cats (or dogs). Always complete the diet trial with a diet challenge with previously feed foods for 1 to 21 days.
  2. http://dogcathomeprepareddiet.com/diet_and_skin_disease.html#dog (home cooked diet trial options)… always recommend an alternative balanced diet (i.e. hydrolyzed commercial diet options or veterinary grade single protein/carbohydrate commercial pet foods).
  3. www.Raynenutrution.com (highly palatable novel protein diet option, their diets have been PCR tested for protein contamination).

Environmental Enrichment for Indoor Cats: Maximizing Your Home to Better Meet Your Cat’s Needs, Ms. Ingrid Johnson

  1. Boredom, frustration, and environmental stressors such as not being able to successfully control resources are the root of the majority of feline “behavior problems.” We can change our homes from glorified cages to feline wonderlands by introducing novelty and by allowing cats to make behavioral choices and control their access to resources.
  2. Enrichment is not just about toys! It is about the whole cat and fulfilling their innate need to climb, hunt, scratch, mark, play, groom and safely rest. If these needs are met in a creative, ever-changing way, humans can give cats the safety and security of an indoor-only lifestyle while providing the stimulation and enrichment of an outdoor life. 

Feline Foraging Toys: How to Implement, Motivate, & Stage the Difficulty Level, Ms. Ingrid Johnson

  1. Cats eat nine to 16 meals per day and prefer to hunt and eat alone. Foraging offers a more natural feeding style for confined cats and allows them to control their resources, thereby reducing environmental stress. It also provides mental enrichment through the development of problem-solving skills and offers an outlet for their hunting instinct and prey drive.
  2. Foraging provides physical and mental enrichment and can address a multitude of medical and behavioral problems including cat-to-cat aggression, human-directed aggression, competitiveness for resources, boredom, attention-seeking behaviors, and over-grooming. Food puzzles can serve as a great diet plan for overweight cats and help prevent obesity in healthy cats.

Behavioral Aspects of Common Feline Diseases: What a Cat Does May Tell You What it Has, Dr. Hazel Carney

  1. Because illness puts a cat at risk for becoming prey, sick cats will adjust their behaviors so as not to show evidence of illness.  Consequently, unless an owner knows a cat’s daily routines and recognize very subtle behavior changes, the cat’s illness may progress significantly before the owner presents the cat for treatment.
  2. If you understand the pathophysiology of common feline diseases you can both predict and understand behavior changes that occur with the diseases.  You can also better guide owners through the “whys” and “what to expect” aspects of the progression and management of the diseases.

The Piddling Pussycat: Is it Physical, Mental or Both?, Dr. Hazel Carney

  1. Feline idiopathic cystitis occurs most often in cats that have a combination of the genetic tendency toward timidity, incomplete socialization experiences and a stressful life-style. The cat will produce inflammatory chemicals that damage both the bladder and other organs.  The inflammation once present is very difficult to control and drug therapy alone is inadequate.
  2. Unless veterinary health teams address both the behavioral and medical aspects of FIC the cat will continue to suffer. But if the team helps an owner to optimize the cat’s litter box, fulfill the cat’s environmental and social needs and understand the multiple aspects of the disease, over 80% of the patients will significantly improve.

Scientific Explanations of Unique Cat Behaviors, Dr. Hazel Carney

  1. All feline behaviors likely have some scientific explanation but research has not yet elucidated all the science so some cat behaviors remain a big mysteries. Most cat behaviors improve the cat’s chances of survival by allowing them to recognize dangers and escape them. Some behaviors will be self-soothing to the cat or gain them food or pleasant attention.
  2. Cats behave in response to a given situation, whether good or bad, based on a combination of their prior experiences in similar situations, their temperament and their level of fear. They don’t act out of spite or get even or act guilty neither do they play hero; but rather, because they recognize odors, body language, actions of people and sounds, they react in a way that is safest to themselves and sometimes such as when they alert an owner to an impending disaster, also safest to the owner.  

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