They are a great help, and I’m not going to tell you not to use them. But I want you to be careful.

What Is A Lick Mat?

A lick mat is a textured flat surface made out of rubber, usually with suction cups to attach it to the floor. The pattern on the top is designed to trap food and make it hard to eat quickly. The aim is to get dogs and cats to spend their time in licking instead of other unwanted behaviours, or to alleviate boredom and anxiety. Unlike other slow feeders, licky mats promote licking behaviour, instead of food seeking or foraging.

Uses For A LickiMat 

The uses being promoted for the LickiMat® on their website include:

• Entertainment & distraction
• Reduction of anxiety & stress 
• Boredom buster 
• Slow feeding
• Raw feeding
• Environmental enrichment
• Improving oral health

Some of these uses make a lot of sense. A lick mat is a great way to get a dog to tolerate unpleasant situations like bathing, grooming, nail clipping and vet visits. That’s only so long as your dog is highly food-motivated.

You could also use it as an aid to crate training and getting your dog accustomed to car trips. It’s also a great way to alleviate stress in temporary situations, like fireworks and thunderstorms, or owners leaving the house.

So what’s the problem? Firstly, some of the claims make little or no sense.

Do Lick Mats Improve Oral Health?

LickiMat’s manufacturers claim that by stimulating saliva production it can clean the tongue, teeth and gums. Well, as someone who is well-acquainted with the literature on what actually keeps pets’ mouths clean, this statement lacks any basis in fact.

In fact, the sorts of treats being used on these mats should logically make periodontal disease worse, not better. Always remember that periodontal disease in dogs and cats follows the same course as it does in humans: you wouldn’t expect your teeth to be better by licking peanut butter off a rubber tray either.

What about the claim that scraping the tongue freshens your pet’s breath? Ludicrous. I’ve been a vet for close to 30 years, and I’ve never yet seen bad breath caused by tongues!

Are Lick Mats Calming?

One of my major concerns not just with lick mats but more generally is the contrast between being busy and being happy. While I think these products are great for preventing anxiety in stressful situations, it’s a big claim to say that such products improve anxiety that’s already present. As with my complaints about Adaptil and Feliway, such claims might stop dog and cat owners choosing remedies that actually help them.

Beware the manufacturer claim that “the extended licking action promoted by LickiMat releases a calming hormone”. So far there’s no evidence for anxiety reduction with lick mats or any ‘hormone’ being released. Yes, a mat might keep them busy and less prone to expressing anxious behaviours, but that’s not the same thing.

These two complaints are minor quibbles compared with my concerns about safety. Here are two ways.

Intestinal Obstruction & Hygiene

In the past month we have seen two animals need veterinary attention as a result of lick mats.

The first is a dog called Murphy. He was left alone with a lick mat for just a moment, and promptly chewed it up and swallowed it. Thankfully his owners immediately saw what happened and brought him down. That’s his vomit in the picture at the start.

The second is Tex the cat. He ate a piece of his lick mat without anyone noticing. When he started vomiting, his owner realised what was wrong. That’s his x-ray below; the white rectangle in his belly is the piece, now blocking his intestines.

There’s also a picture above of that piece matched with the rest of the mat, after we took it out. Without major surgery, he would have been in a lot of trouble. The same could have been true for Murphy of course.

This should come as no surprise. Vets have always said that anything flavoured like food, but not digestible is extremely dangerous. So here’s the newly updated list:

• corn cobs
• satay sticks
• icecream sticks
• meat wrapping
• cooked bones
• lick mats

How To Use Lick Mats More Safely

“You must fully train your dog before leaving her/him alone with a LickiMat.” So say LickiMat.

These products are being promoted for pets left home alone, which in my view is madness. In the general enthusiasm for anything new, we’ve forgotten some basic rules.

It is my strong view that no dog should be left alone with a lick mat. Even after ‘training’, whatever that is. There’s no telling when a dog will get frustrated and just chew it up. Cats might be at a lower risk, but Tex shows us it can still happen, especially with the softer silicone products.

Another thing: watch out that these mats are properly cleaned after each use. This is particularly important if you’re using them with raw food. It would be smart to buy ones that are dishwasher safe.

What Can I Use Instead Of A Lick Mat?

I’m not opposed to using food as a distraction when they need to be left. If you do, I recommend slow feeder bowls, Kong Wobblers, Bobalots and Nina Ottoson products with long track records of proven safety. Or you can hide food around the house or garden.

To be fair, LickiMat make a ‘Tuff’ version, and even a keeper tray to make chewing harder. But I have seen both the red and black rubber Kongs destroyed and know only too well how destructive a determined dog can be.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

1. A poorer recognition of the signs of arthritis in cats and therefore lower demand
2. The smaller market and financial benefit to drug companies (dogs visit the vet at least twice as much as cats)
3. The difficulty in giving medications to cats
4. The increased risk due to the prevalence of kidney disease

Now, in 2023 we are witnessing the appearance of a wholly new approach to treatment that might overcome many of these concerns.

These are exciting times, but we also need to be cautious and realistic. You’ll see in this article that it is by no means a silver bullet. However, with Solensia there is real hope for cats that we have a new and effective tool to improve their quality of life.

What is Solensia?

Solensia is a trade name for frunevetmab in Australia. It neutralises nerve growth factor (NGF), which has been shown to be involved in the perception of pain. As a monoclonal antibody, it has the potential to be highly specific to its target, and block it almost completely.

In Australia, Solensia has been registered for the alleviation of pain associated with osteoarthritis in cats.

How Well Does It Work & How Quickly?

In our clinic, we have seen some cats benefit greatly after starting Solensia, but what does the evidence say? The results of a single placebo-controlled study conducted by the parent company are shown here and referenced below.

There are three important things to note here:

1. All arthritis treatments show a caregiver placebo effect, but for this particular product, it is especially large
2. The difference between the two groups is statistically significant for Months 1 and 2, so we are confident that Solensia is helping at least some cats
3. Unquestionably, there will be many others who receive insufficient benefit and require different arthritis remedies

My view is that the large placebo effect is a direct result of the difficulty we have in correctly identifying signs of pain in cats. However, it is also possible that it only brings benefit to a minority. Our own experience is that Solensia can be very effective in some cats, but hard to judge as well.

A further clue that anti-NGF treatments are helpful is in the clearer results we see for the canine equivalent, Beransa.

Based on laboratory studies, a positive response would be expected to appear at around day 6.

Solensia Dosage & How Often

Solensia is given by vets at a dose of 7 mg by subcutaneous injection for cats between 2.5kg and 7kg.. Above this, two vials are needed but I would suspect that most of these cats would benefit more from weight loss. If desired, the dose is repeated every month. It is generally recommended to try at least two doses before deciding whether it is effective enough.

NGF is important for foetal and juvenile development. Therefore, Solensia must not be used in breeding, pregnant or lactating cats, or those less than 12 months of age.

Human Health Risks

Similarly, pregnant women, women trying to conceive, and breastfeeding women should take extreme care to avoid accidental self injection or needle stick injuries. To be safe, it is best that they take no part in giving the injection or even holding their pet.

Just to be clear, a treated cat poses no risk to humans.

Solensia Side Effects

Up to 10% of cats given the injection showed signs of hypersensitivity such as skin itching, hair loss, and dermatitis. When this occurs, it is advised to stop the treatment. The itch does not respond well to normal treatments for dermatitis until the injection is stopped

If you read the comments section below, you will see that it is dominated by reports of adverse skin effects. In our clinic we have indeed seen a few reactions, but not much more than the reported 10%. My view on this is that although the rate here appears much higher, owners with affected cats will be more likely to post than those with no problems.

In other ways, our prior experience with monoclonal antibodies like Cytopoint shows us that they are much safer than traditional drugs like anti-inflammatories. This is because as naturally occurring proteins, they require minimal metabolism or detoxification by the liver or kidneys.

It is therefore likely that Solensia can be used at normal doses in cats with kidney disease, unlike anti-inflammatories which become more dangerous. However, until there are studies of their use with liver or kidney disease, caution is still advisable in these cats.

Solensia appears safe when used in combination with other drugs, and at the time of vaccination. The only concern with using multiple treatments could be that if an adverse effect occurs, you may not be able to work out which one caused it.

How Much Does Solensia Cost?

The cost in 2023 for a single injection of Solensia is around $90. This is in the same region as the higher priced anti-inflammatory drugs.

Our experience so far is that for some cats, it maintains their quality of life when other choices fail. It can also be used when other treatments aren’t safe enough to use and for those cats that owners cannot easily medicate. In summary, we believe is worth a try if costs allow.

Anyone who has an arthritic cat knows that we still aren’t doing enough for them. The development of monoclonal antibodies brings us just one step closer, and just might give us more time to enjoy our lovely old cats.

Therefore, talk to your vet about whether it might be good for your cat.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

So it was with great hope that here in Australia we awaited the arrival of Purina’s new food designed to reduce human allergies to cats and kittens. Imagine the possible benefits if it works:

• More people being able to enjoy the company of cats
• More cat rescue and less rehoming
• Better relationships for allergic partners of cat owners

But could it also be too good to be true? If it encourages people who can’t keep cats to get them, surely this will be a backwards step instead. I found my first Devon Rex in an animal shelter where she’d been dumped for just this reason.

I’m going to take you through the science behind Purina LiveClear® as impartially as I can. By the end, you’ll have a good idea of what to expect if you try it.

How Purina LiveClear Works

It starts with the major cat allergen of humans: Fel d 1. This complex protein is found in the saliva, sebaceous glands, skin and fur of cats. It’s very stable, and can easily become airborne, from where it causes all the usual signs of allergy in people: sneezing, runny eyes, asthma etc

Cats probably spread most of the Fel d 1 around by licking their coat. So the people at Purina thought: what if we developed a food that blocks the Fel d 1 from the saliva?

It’s actually very clever.

They expose chickens to cat allergens and collect their eggs. These then contain high levels of anti-Fel d 1 antibody. The egg proteins are sprayed onto cat biscuits so that cats end up having antibodies to their own allergen in their saliva. Theoretically then, when they groom themselves, the Fel d 1 is taken out and inactivated.

As an aside, it’s worth noting that in the trials the food was fed continuously, which makes sense when you see how it works. However, as any vet knows, it can be hard to do this without having a fat cat.

Does Purina LiveClear Reduce Allergens?

According to Purina’s own research, cats who eat LiveClear have a 47% reduction in allergen on their coat. And this is true, if a little oversimplified.

The reality is the graph here. It shows the same cats divided into four groups based on how much allergen they had in their coat. You can see that the top 25% have a lot more than the rest. You can also see that the actual levels vary for all of them week by week.

In fact, a look at the original paper shows that even these data points are averages of substantial individual variation.

Of course what matters most is how this translates to its effect on people. Is an average 47% reduction enough, and does the weekly variation make a difference?

Does LiveClear Reduce Human Allergy?

To give Purina some credit, they could have stopped here, but they went on do do human trials. They exposed people affected by cat allergy to blankets from cats fed either a control food or LiveClear. The study was double-blind, meaning that neither the researchers or test subjects knew which was which.

In other words, a high-quality piece of work. Sadly for Purina and cat allergy sufferers everywhere, the results were disappointing.

The following table shows the P-values for each symptom. Values less than 0.05 are generally regarded as significant. As you can see, there were no significant differences between reaction levels to blankets from treated or untreated cats.

Difference Between LiveClear & Control Food In Allergy Symptoms

Hang On- Purina Said It Worked!

Actually, there were differences found when the results were compared with earlier known exposure (i.e. no longer blinded). This should be yet another demonstration of the enduring power of the placebo effect. And yet that’s not what was said.

While I honestly think that LiveClear will help some people, using an unblinded allergen exposure as a comparison is not the way to find the proof.

Well, you might say, if the subjects felt better, does it matter whether it was a placebo effect or not?* That’s an ethical discussion for another day. What we really need is a good blinded study using cats in their own homes to get closest to the real world scenario.

So Is Purina LiveClear Worth It?

The evidence so far suggests that Purina LiveClear is an unreliable way to reduce cat allergy symptoms in the home. I certainly would not recommend that allergic people plan on having cats based on this intervention alone.

Despite this, I applaud the company for such an innovative approach, and I’m not writing the food off completely either. For just as some cats will produce unacceptably high Fel 1 d levels, others are likely to respond well, especially combined with other approaches. You won’t know unless you try.

If you already live with a cat, but are allergic, or have an allergic partner, then there’s not a whole lot to lose. LiveClear is clearly as safe as any other cat or kitten food. If it doesn’t help, all you’ve done is bought a more expensive version!

Related: The Shaky Evidence For Feliway In Cats | Other Ways To Reduce Household Feline Allergens

* Strictly speaking, this is a nocebo effect, where the known allergen exposure is likely to have increased the subjects’ perception of symptoms. Then compared to the lower tested levels later, a significant difference appears. Clear? No, I didn’t think so!

Sources

Bonnet, B., Messaoudi, K., Jacomet, F., Michaud, E., Fauquert, J. L., Caillaud, D., & Evrard, B. (2018). An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. Allergy, Asthma & Clinical Immunology, 14(1), 1-9

Pezzali, J. G., Smith, S. C., & Aldrich, C. G. (2018). An overview of the effect of diet on the allergenicity of cats to susceptible humans. SOJ Vet Sci, 4, 1-9

Ramadour, M., Birnbaum, J., Magalon, C., Lanteaume, A., Charpin, D., & Vervloet, D. (1998). Cat sex differences in major allergen production (Fel d 1). Journal of allergy and clinical immunology, 101(2), 282-284

Satyaraj, E., Gardner, C., Filipi, I., Cramer, K., & Sherrill, S. (2019). Reduction of active Fel d1 from cats using an antiFel d1 egg IgY antibody. Immunity, inflammation and disease, 7(2), 68-73

Wedner, J. H., Mantia, T., Satyaraj, E., Gardner, C., Al-Hammadi, N., & Sherrill, S. (2021). Feeding cats egg product with polyclonal-anti-Fel d1 antibodies decreases environmental Fel d1 and allergic response: A proof of concept study. J Allergy Infect Dis, 2(1), 1-8

Minoxidil : A Baldness Treatment

Minoxidil has become extremely popular due to its ability to stimulate hair regrowth on the scalp of people. It was originally marketed as Rogaine, but is now available as an over the counter generic in liquid, foam and shampoo forms.

When cats lick even a tiny amount, it causes vomiting, drooling, low blood pressure, severe illness and often death. Because the product is applied to the skin, it can easily come into contact with cats either directly, by licking the area, or even from pillows.

I first discovered this toxin one year ago after a report from the Animal Poison Control Center that you can read here. In their list of the top causes of poisoning deaths in cats, it included a drug I had never heard of.

If I didn’t know about it, it meant many other vets didn’t either, and very few cat owners.

The message is simple: if you use minoxidil in any form, be extremely careful:

• Clean up areas carefully after use, especially spills or stray drops
• Do not allow your cat to come into contact with treated areas of skin
• Prevent access to bedrooms 
• Clean sheets and pillowcases frequently

PPD: A Hair Dye Ingredient

Para-phenylenediamine (PPD) is a fixative found in many hair dyes and henna temporary tattoos. It causes a deeper, longer lasting and more intense colour. Oral ingestion leads to intravascular hemolysis, rhabdomyolysis, myoglobinuria and acute renal failure. 

In other words, this means massive destruction of red blood cells and muscle cells. The release of their contents into the circulation causes downstream kidney damage. This is the same process you sometimes hear about with overexercise in hot conditions. 

I only heard about this toxin last week, but I saw a case a year ago that I’m now convinced was caused by it. 

Mimi’s Acute Renal Injury

Mimi’s owners came to me for a second opinion after he was diagnosed with acute kidney failure. The interesting thing is that despite an extensive search for the toxin, it was never found. However, due to the timing, Mimi‘s owners strongly suspected that a hair dye had caused it.

At the time, I conducted a search to the best of my abilities and found no link between dyes and poisoning. The case remained a mystery. Mimi survived only thanks to heroic efforts by his owners and a number of veterinary teams.

Knowledge of the toxicity of PPD is well known in human medical circles, but no documented cases of poisoning exist in animals. It’s likely that the lack of evidence is due to a lack of recognition, not occurrence. Like in Mimi’s case, it’s near impossible to prove a particular toxin causes kidney failure due to the delay between poisoning and diagnosis.

Once again, prevention is about minimising exposure:

• Use hair dyes and hennas without PPD if possible
• Use dyes and hennas in a well-ventilated place where your cat cannot join you
• After completion, clean up any spills and splashes carefully
• Rinse basins, baths and showers thoroughly since cats often like to lick these areas after use
• Don’t allow your cat to lick the dyed areas

Diclofenac (Voltaren)

A third common cause of cat poisoning deaths is the human use of potent anti-inflammatories. Once again, the risk is mainly from products applied to the skin. Products like Voltaren gel contain diclofenac, which even in small quantities will cause kidney failure.

Cats are likely to be poisoned either by licking the treated areas, or getting spilt product on their paws or coat. In addition to the methods above, prevention should also include covering the treated areas with clothing and keeping the products in a secure place.

The Common Link

All three of these toxins show us how susceptible cats are to household poisoning. This is for three reasons:

1. Cats are naturally inquisitive and will seek out and investigate new things
2. Cat seem inherently sensitive to a wide range of chemicals
3. Anything that contacts the outside of a cat will invariably be licked off and swallowed

The third point means we should add a final form of prevention: if anything not known to be safe gets on your cat’s coat or paws, you will need to give them a bath. This is not a decision taken lightly, but it may be life-saving.

Moreover, I would be careful about any medicines, dyes or other household chemicals, regardless of whether they contain diclofenac, minoxidil or PPD*. If we are learning one thing, it’s that cats will show us just how toxic a chemical can be.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Sources

Anuradha, S., Arora, S., Mehrotra, S., Arora, A., & Kar, P. (2004). Acute renal failure following para‐phenylenediamine (PPD) poisoning: a case report and review. Renal failure, 26(3), 329-332

Tater, K. C., Gwaltney-Brant, S., & Wismer, T. (2021). Topical Minoxidil Exposures and Toxicoses in Dogs and Cats: 211 Cases (2001–2019). Journal of the American Animal Hospital Association, 57(5), 225-231

* Just look at the ingredient list for a non-PPD containing hair dye for example: how many of these do you think have been tested in cats? Cetearyl Alcohol, Ammonium Hydroxide, Glyceryl Stearate, Ceteareth-20, Toluene-2,5-Diamine Sulfate, Octyldodecanol, Sodium Laureth Sulfate, Ethanolamine, Sodium Cetearyl Sulfate, Fragrance, 2-Methylresorcinol, Resorcinol, Serine, Sodium Sulfite, Oleic Acid, Potassium Stearate, Glycerin, Tetrasodium EDTA, m-Aminophenol, Carbomer, Linalool, Potassium Hydroxide, Citronellol, Ascorbic Acid, Butylphenyl Methylpropional, Linoleamidopropyl PG-Dimonium Chloride Phosphate, Propylene Glycol, Sodium Sulfate, Hexyl Salicylate, 2-Amino-3-Hydroxypyridine, Hydrogen Peroxide, PEG-40 Castor Oil, Disodium Pyrophosphate, Disodium EDTA, Sodium Benzoate, Phosphoric Acid, Behentrimonium Chloride, Dimethicone, Amodimethicone/Morpholinomethyl Silsesquioxane Copolymer, Magnesium Citrate, Magnesium Chloride, Hydrolyzed Keratin, Polyquaternium-37, Macadamia Ternifolia Seed Oil, Panthenol, Isopropyl Myristate, Citric Acid, Phenoxyethanol, Stearamidopropyl Dimethylamine, Isopropyl Alcohol, Sodium Methylparaben, Dicaprylyl Carbonate, Laureth-23, Laureth-4, Sodium Hydroxide, Hexyl Cinnamal, Benzyl Salicylate, Benzyl Alcohol, Limonene, Lauryl Glucoside, Trideceth-5, Salicylic Acid.

However, for this to happen, you need to know what to look for, and act quickly.

How To Tell If Your Cat Has Poor Vision

Here are the common signs of vision loss or blindness in cats:

• Bumping into things they should be able to see
• Dilated pupils (large black eyes)
• Sudden anxiety about moving around or going outside
• Crying or aimless wandering
• Blood in the eye or a cloudy eye

The cat pictured above has a dilated pupil, but even that is not as wide as we typically see in a blind eye. Often you can barely see any of the usual yellow or green iris colour.

The actual cause of blindness does not always come on as suddenly as it seems. Cats can cope very well with poor vision and it’s often only when the lights go out completely that you will notice.

The Causes Of Sudden Blindness In Cats

There is a long list of possible causes of blindness in adult cats, of which only two are common.

• Hypertension
• Anterior uveitis
• Damage to the eye or its nerve supply
• Tumours anywhere along the vision pathways
• Progressive retinal atrophy or PRA
• Cataracts
• Glaucoma

Of these, eye damage can be from head trauma secondary to car injury or lacerations from cat fights. PRA is a genetic disease causing retinal degeneration, and only likely in young purebreeds (I saw my first ever case just last week in a Toyger). Tumours are rare (often iris melanoma) and cataracts and glaucoma even rarer (these diseases are explained here).

Of the two common causes, anterior uveitis is seen as a red, painful or cloudy eye that’s no longer clear inside. The cause is usually an immune response to infections like FIV, FIP or toxoplasmosis. It needs to be treated quickly to avoid blindness but is usually quite obvious.

The one I want to focus on in depth is feline hypertension. This is the most likely reason for sudden blindness in older cats and its effects are often reversible.

How Hypertension Causes Blindness

Hypertension, or raised blood pressure, is common in old cats. It’s often secondary to kidney disease or hyperthyroidism, but also occurs on its own. If untreated, it can cause two things to happen the eye:

1. The retina (the light sensitive layer) separates from the rest of the back of the eye. This is retinal detachment.
2. Blood vessels burst leading to bleeding inside the eye or on the retina. The blood then blocks vision.

The picture shows a severe case of retinal detachment. You can see a widely dilated yellow pupil, and the greenish bulging retina in the middle.

Treatment Of Hypertension

My experience is this: if retinal detachment is detected while the retina is only partly peeled away, it will reattach once the blood pressure is controlled. In other words, cats who are brought in as soon as the problem is noted have a very good chance of their vision being restored.

When we see a disease known to be linked with hypertension, we will measure blood pressure. I saw such a cat a few weeks ago with blood in the eye. Within a few hours we had tested her and started her on antihypertensive medication. Her blood pressure is now normal, and she’s made a full recovery.

Medication for high blood pressure in cats is only once daily, cheap and generally very effective. Of course, we always check the response after a few weeks just to be sure.

So the take home message is not to overlook even the slightest hint of eyesight problems. While cats can live happily even after losing their sight, for many of them, it never needs to happen.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Important Note to Cat Owners: This page was written early in the treatment of FIP, when knowledge and access to drugs was scarce. Today, your own vet is fully capable of administering the treatment and saving your cat. For the best up to date information on treatment protocols and drug availability in Australia, please visit the page of Turramurra Veterinary Hospital.

Back at the start I supported you when you were breaking the law. I even put my reputation on the line and stood up for you against threats of prosecution. My attitude was “let them try; they wouldn’t dare.”

For back then if it wasn’t for you, many cats with FIP would have died. You provided an essential link between desperate cat owners and an illegal, yet life-saving drug. You allowed vets to offer their support without having to procure the drug themselves and risk their careers.

For this I will always be grateful. But there was still the problem of the law.

The issue with GS being illegal wasn’t so much the risk to vets or cat owners. It was that not enough people would ever hear about it. Most cats with FIP were still dying, because neither their owners nor their vets knew any different.

I was flat out treating FIP cats back then, but I knew I was seeing only the tip of the iceberg. There’s nothing heroic in saving only a few when you know the rest are missing out. But it was the best we could do.

That’s why I was ecstatic when some very clever people developed a legal alternative: compounded TGA-approved remdesivir. Australia may have even been the first, all thanks to them. Suddenly we could talk freely, share our experiences and read about FIP treatment in national vet publications.

Update: We now also have access to pharmaceutical-grade legal GS- 441524 tablets. These are around 2/3 the price of remdesivir injections, and easier to give for most cats.

At the time I thanked the providers of GS such as you, and bid them farewell. With all gratitude, your job was done, and a brighter future dawned of treatment for all. At least this was what I hoped.

At the same time I feared the opposite: that your enterprise would have too much momentum, self-belief and financial commitment to just shut up shop. And this is what has actually happened. What was once a blessing has become a curse.

Now every time I start a new cat with FIP on treatment, I have the same discussions. Once cat owners get given the diagnosis and start researching, they still find you. Except now you say things like:

• GS works better than remdesivir
• GS is safer
• GS is cheaper

None of these, by the way, are true. New survival rates are at least as good, costs much the same, and the BOVA remdesivir we use stings far, far less. The best that can be hoped for with GS is equivalence, which itself is big ask for a drug that has no quality control or oversight. And one which still requires owners to break the law and hope no-one notices.

You who were once happy to work with vets have made yourself into our opposition. You appear to want FIP cats to be split off from the veterinary mainstream. And judging by your Facebook posts, you are quite successful at doing it.

It’s not just that your treatment is no better. Owners of newly diagnosed cats need tremendous levels of hands-on support to learn to give the injections effectively over the 84 day course. You cannot offer that. Your drug cannot be claimed back on pet insurance either.

I don’t know if you have a financial incentive, but I hope not. And before I get the understandable accusation of hypocrisy, hear this: I am in the possibly unique position of having had a significant drop in my income due to remdesivir. After all, I was probably the only Adelaide vet working with cats on GS, and now everyone uses remdesivir.

By continuing when you should have stopped you are fighting the future and defending the indefensible. Your law breaking is no longer excusable now that it’s not in the best interests of cats or their owners.

You need to end this. Preferably while I can still remember that gratitude.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Note: this in no way is a criticism of the use of GS in countries without a reliable and economical supply of remdesivir. I am happy to engage in an open online debate in the comments section below but not via private messages.

It’s called a staring coat.

What Is A Staring Coat?

A staring coat is when the tips of a cat’s hair start to stick together, probably due to a buildup of grease. The hair doesn’t form a smooth ‘shell’ any more but is separated into rows or tiny clumps. It gives the coat a spiky, clumping appearance.

A staring coat happens very quickly when a cat stops grooming adequately. Every cat owner knows how much time their cat spends licking themselves, plus rolling and dust bathing. What they may not know is just how important these behaviours are.

While the staring coat isn’t a major health concern in its own right, it significantly reduces the insulating effect. It will also be associated with a buildup of dead hair, and increased parasite numbers in untreated cats. When this happens even a simple flea infestation can be serious.

The main issue with an ungroomed coat is that it might be a sign of something worse.

Why Do Staring Coats Occur?

There are six reasons why a cat might not be grooming enough:

• Sickness: any illness will reduce the amount of effort a cat can put into their coat, often before other signs occur
• Pain: musculoskeletal pain will reduce a cat’s flexibility, which is why a staring coat is a common sign of arthritis
• Dental disease: a cat with a sore mouth will not groom as effectively
• Stress: unhappy or anxious cats don’t spend time on ‘luxury’ behaviours like grooming (so you should be flattered that Tibby always wants to lick herself all over when she gets on your lap!)
• Age: good grooming habits sometimes take a few months to develop, and so some kittens under 6 months old can have staring coats despite being in good health
• Obesity: I’ve written before how dandruff is often associated with obesity, and staring coats are just the same: excess weight causes an inability to groom properly

What To Do If You Cat’s Hair Is Spiky Or Matted

If your cat’s coat looks like any of these pictures, ask yourself if it has always been this way. If it hasn’t then you need to get your cat a checkup.

This kitten looks fine, right? That’s true from the front, but his coat is the one in the earlier photos. He’s actually fighting a respiratory infection.

Almost all cats with staring coats have something that needs attention. Anxiety is very treatable, as is weight control, as is arthritis in cats.

Some might be normal, but we won’t know this without a physical or possibly blood tests. The purpose of this article isn’t to tell you what’s wrong, it’s to tell you there’s an abnormality and it needs investigation!

To finish up, here are a few more pictures taken all within a few days. Staring coats are everywhere when you look. However, I still don’t know why they ‘stare’- any ideas?

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Here I’m going to give you a very simple trick to recognise when a cat is struggling to breathe. If you do it successfully, your cat will probably be OK.

How To Tell If A Cat Has Breathing Problems

Unlike dogs who are regularly exercised, cats can hide respiratory distress for a long time. But there’s one thing they can’t hide: the fact that they are breathing faster and faster.

A sleeping or a resting respiratory rate greater than 30 breaths per minute is almost always abnormal. This is usually the earliest and most sensitive sign of breathing problems. The problem is that it isn’t natural for cat owners to notice.

This is often the only sign. However, sometimes you might also see:

• open-mouth breathing
• noisy, raspy or wheezy breathing
• frequent coughing or hacking
• obvious chest or stomach heaving
• upright, tense posture

Cats with breathing trouble usually can’t breathe when lying down. The picture above shows the typical posture of such a cat: hunched and upright, not relaxed.

In contrast, even young healthy cats can have rapid or heaving respiration, or even breathe with their mouth open. However, this should only happen for a few minutes after vigorous exercise, and never at rest.

How To Measure Resting Respiratory Rate

The trick is to understand that the rate of breathing changes with activity or stress. Therefore, it can’t be done just any time and you need to know what to look for.

Resting Respiratory Rate should be measured when your cat is at their most relaxed. They need to be unstimulated and preferably even asleep. This is when they are breathing at the slowest they can, and this is what you measure.

Now count the number of breaths over 60 seconds. Most cats have a normal value between 15 and 25, but this can be higher in hot conditions.

If you can’t see your cat breathing at all (but they are alive!) then the rate should be OK. Cats with respiratory issues usually have more laboured or heavy breathing which is easier to see.

What Causes Laboured Breathing?

These are the most common three reasons for a cat to be consistently breathing faster than 30 breaths per minute:

• heart disease
• chest infections
• asthma

They all need urgent attention, but they all can be treated.

I’m not expecting cat owners to watch their cats breathing every day, but whenever you suspect a problem it’s a great thing to do. For certain cases (like cats with heart murmurs), it’s something I ask owners to do as an early warning.

By spotting a subtle increase in your cat’s respiratory rate, you’ll take what would have been a dire emergency and make it just another health problem.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

When there’s a lack of hard evidence, we only have experience to go by. So I’ll use mine to help you answer the key questions put to me by cat owners.

What Is A Hairball?

A hairball, or more technically a trichobezoar, is a hard pellet of matted hair found in the gastrointestinal tract. They occur due to hair being swallowed during the normal grooming process, which then accumulates in the stomach.

Eventually the hairball gets to a size where it is vomited up. Such an example is pictured here, surrounded by food. A hairball is much more rarely passed in the faeces.

It’s difficult to know if hairballs are normal or abnormal. My view is that they are an inevitable consequence of grooming. Our task is to prevent them from causing problems.

Help! My Cat Just Vomited A Hairball!

If a cat vomits up hairballs frequently, you need to consider four possibilities:

1. That the hairball is a normal accumulation of hair vomited up at the right time
2. That the hairball is caused by health problems
3. That the hairball is causing health problems
4. That your cat is vomiting for another reason, and with it comes the resident hairball

In my experience, point 4 (the hairball as an innocent bystander) accounts for most of the cases I see. To help you recognise it, let’s go through the other three possibilities.

1. How Often Do Cats Throw Up Hairballs?

A cat passing hairballs normally will:

• Vomit no more than weekly
• Have a single rapid effortless vomit, and be immediately hungry afterwards
• Have no other health problems

2. When Hairballs Are Secondary To Illness

Underlying health problems that could lead to hairball problems are mainly of the skin or gastrointestinal tract.

Skin problems mostly relate to what we call overgrooming. Historically, this has been labelled a psychological problem, but the more we know the more we understand it’s usually a response to itchy skin. If your cat’s coat does not look healthy, click here for a deep dive into the causes of overgrooming in cats.

Gastrointestinal problems are a mixed bag, ranging from parasites to allergies to food responsive disease. Again, if your cat vomits more frequently, is underweight or has loose stools, click here for a discussion of the possible causes.

3. How To Know If A Cat Has A Hairball Stuck

A cat with a hairball large enough to cause problems will usually only have the following symptoms:

• Frequent unproductive vomiting
• Poor or no appetite

However, these signs are vague and caused much more often by other serious conditions.

Therefore, unless your vet can feel a lump in your cat’s belly, they need to consider all the causes of vomiting in cats, plus those of not eating. And given how often people confuse coughing and vomiting in cats, don’t rule this out either

A clue that looking for a hairball might be a good idea can come from the patient’s history. These cats are more likely to:

• have a history of hairball problems
• have a highly shedding coat like the one above
• have a long coat
• be an older cat

4. When Hairballs Aren’t The Cause

Vomiting is probably the number one sign of a sick cat, and has hundreds of possible causes. Many of these cats will have identical risk factors to those prone to hairballs, just to make it harder.

Most of the cats I see who are brought to me for a hairball problem actually have a vomiting problem. Probably top of the list is pancreatitis because it’s so hard to diagnose. It’s just that there’s often a hairball in their stomach when they vomit.

Therefore, there’s no good alternative to a thorough workup, usually via blood testing and ultrasound examination to begin. Only once we draw a blank might we be prepared to blame the hairball itself.

How to Help A Cat Pass A Hairball

If a cat’s problems are caused by a hairball, you can try to help it pass. Don’t do this unless you’re absolutely sure, as you will waste valuable time.

Please note that cats do not commonly pass hairballs in their litter tray. I am personally dubious that cat laxatives like the one pictured here actually do very much. However, if your cat is bright, happy and eating, there’s probably no harm in trying.

Just follow the instructions on the package. I am not aware of any other remedy that might work. However, these products are most useful for prevention anyway.

How To Prevent Hairballs In Cats

Unlike the unreliability of treating a hairball, there are effective ways to prevent them forming.

The first is to remove as much dead hair as possible before your cat does. This will require daily brushing with a slicker brush or similar. If you started while your cat was a kitten, they will usually enjoy it.

It’s messy. I had a cat like this once, and I kept an old theatre gown near my armchair to protect my clothes.

The second is diet. Royal Canin, Hills and no doubt others make effective hairball preventing diets. They work by removing the hair from the stomach before it balls up. Most use either cellulose fibre or psyllium.

The third, of course, are hairball treatment products like pictured above.

Can A Hairball Kill A Cat?

I have seen two cats who would have died without their hairballs being surgically removed. That’s not many over 27 years but it does happen.

For these cats, their owners agreed that the risk was too high to ever let it happen again. Therefore, we took the nuclear option: clipping.

Every six months for life, these cats were booked in for a full shave under sedation. It kept them free of problems, even if they did look a bit strange.

But the main way a hairball can cause death is through inaction. This study contains one cat who died through a delay in treatment and another who was euthanased due to a mistaken belief it was a tumour. And there are also those cats where a much more serious vomiting or coughing problem is written off as ‘hairballs’.

I hope all this helps, no matter whether you have a minor or major problem. But in closing I’ll repeat: hairballs are more often suspected than actual culprits. Keep an open mind!

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Note that this article is not about lumps on the skin of cats. Those need a checkup at the vet to know what they are.

Five cats were presented to a veterinary teaching hospital with abdominal masses that could be felt during a routine exam. They all had the classic signs of intestinal obstruction: vomiting, listlessness and not eating.

The two eldest cats died. One, because her owner thought it was cancer and had her put down. The other, due to a delay in treatment, most likely due to a similarly fatalistic attitude.

The diagnosis in these five cases was a hairball. A thoroughly treatable problem.

Types Of Stomach Lumps In Cats

Part of the problem here is a lack of good quality information. I can find no research paper which looks at how common different lumps of cats are. So this list is based on my experience alone.

Hairballs

There are sporadic reports in the literature of hairballs causing gastrointestinal obstructions, and I have seen them too. Risk factors might include:

• A long coat
• Skin and coat problems
• Poor health for another reason

It’s worth noting that the cat who was euthanased had none of these risk factors. And the big danger with a hairball is that it feels exactly the same as a tumour.

Visit this page to read about hairball treatment and prevention, but in only a few minutes you’ll know how to recognise one.

Feline Infectious Peritonitis

You can read about FIP in more detail here, but one of its forms causes abdominal masses or tummy lumps. Clues that lumps in the belly might be caused by this dry form of FIP are:

• a young cat
• a persistent fever
• a longer course of illness

Once again, these are only generalisations. I have seen FIP in older cats with no fever too.

Followers of this blog will know that there have been recent and exciting changes to how we treat FIP. What was once a death sentence is now survivable for the majority of cats. All the more reason to get that diagnosis.

Lymphoma

Lymphoma is a tumour of one of the cells of the immune system. This is probably the diagnosis we fear the most, because it’s mostly a death sentence. Attempts at treatment are often very disappointing.

It’s true that abdominal lymphoma is one of the most common cancers of cats but there’s no way you can be certain just by feeling it. And I only see a few cases a year, much less than I see FIP.

Other Abdominal Masses

Of course, the abdomen is a complex place, and so there are many other less likely causes of lumps in the belly. Here are just some:

• Tumours arising from any of the organs or tissues
• Foreign bodies like surgical swabs, grass seeds or swallowed string
• Enlarged kidneys from ureteral blockage secondary to stones

Diagnosis Of Abdominal Masses

There’s one test that should be able to distinguish between all these causes: ultrasound. It’s neither difficult, invasive nor terribly expensive.

• A hairball will show itself as a mass inside the stomach or intestine containing large amounts of gas
• FIP mostly causes many irregular masses in the mesentery between the intestines
• Lymphoma can be the same, or a single larger mass like pictured, and easily diagnosed by ultrasound-guided needle biopsy
• Enlarged kidneys, abscesses or other tumours are usually just as obvious

Some vets may prefer to do CT, MRI or even exploratory surgery. All of these are good, and a whole lot better than not trying at all.

Going back to that paper at the start, it’s important to look at who published it. Although they don’t say so, most or all of those cats were probably referred from other vets. Whenever I read this I always think: “great, but referral is only the tip of the iceberg”.

Many more cats could have had similar experiences at private veterinarians and we would never know. But against this very negative outlook is a very positive one.

20 years have passed since this study was published. In that time ultrasound has gone from a referral procedure to one that nearly every vet practice can do well.

Therefore, despite my warnings, I’m confident that we aren’t euthanasing many cats with hairballs any more. But it requires a positive attitude, too!

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

The paper I mentioned was:
Barrs, V. R., Beatty, J. A., Tisdall, P. L. C., Hunt, G. B., Gunew, M., Nicoll, R. G., & Malik, R. (1999). Intestinal obstruction by trichobezoars in five cats. Journal of Feline Medicine and Surgery, 1(4), 199-207