Written by: Judy Karnia, DVM
Any time a member of your feline family has a medical problem it can be scary and confusing. Hopefully though, your veterinarian can diagnose the problem and start treatment to make your cat feel better. Many times, however, our patients have more than one problem that may or may not be related to each other. It is not uncommon to see a 14-year-old patient with hyperthyroidism, chronic kidney disease, heart disease, dental disease and arthritis, all causing some amount of suffering in the cat. Even younger patients can have multiple problems. If a patient has not been examined in a few years, the veterinarian may be diagnosing all of these problems at one time. Because cats are so good at hiding their problems, you may not even be aware that each problem has developed. Indeed, it may be the combination of problems that finally caused the cat to appear obviously unwell.
How We Diagnose Health Problems in Cats
Addressing multiple medical problems frequently means using a number of tools to help us figure out what is going on with your cat. Some medical problems can be seen on exam but usually, in order to be fully diagnosed and understood, some tests or procedures will be needed. Typically the first step is a blood and urine panel that can evaluate for problems with organs, diabetes, immune system disorders, and anemia. In many cases however , we will use more specialized blood tests to accurately explain a problem. In addition to these specific blood and urine tests imaging such as x-rays and ultrasound may be needed. Radiographs and ultrasound can be vital to looking into the body to find the underlying cause of medical problems. Assessing all of these multiple results together helps your veterinarian to have a more complete picture and make better treatment recommendations. For example, in dental disease the true severity of the problem is rarely diagnosed completely until the mouth is examined under anesthesia and radiographs are taken.
How We Treat Cats with Multiple Health Problems
Once treatment is started, many of these tests need to be repeated on a regular basis to evaluate how well the treatment is working and to assess for any side effects from the treatments and ongoing changes. This may need to be done monthly at first or every 4-6 months if the cat’s condition is stable. For example, hyperthyroidism (overactive thyroid gland) can greatly affect the cat’s kidneys and heart. If the thyroid medication dose is too high, the thyroid level can become too low, which worsens kidney disease. Treating hyperthyroidism can improve heart function so heart medications may need to be altered. If the blood tests are not repeated, there is no way to know if the medication dose is helping enough or is having any adverse effects. Many medications cause potent reactions in the body. Regular monitoring ensures that those medications are doing what they are supposed to rather than actually doing harm.
It can be overwhelming for the client to understand each problem and the needed diagnostic tests and treatments. Sometimes, we need to take a one-step-at-a-time approach to address all of the problems. Creating a chart for medications and notes on how the cat is doing each day has helped many of our clients. Clients should also feel comfortable asking whatever questions they have, calling or emailing the clinic, even for what may seem minor concerns. Changes in appetite, activity level, urine or stool quality and any vomiting should be reported to your veterinarian, especially if these occur after a change in medications.
Our goal is to give our patients a good quality of life free of pain and distress for as long as possible. By addressing all of their problems and monitoring their treatment, we can work with our clients to achieve this.