Help! Why is My Cat Peeing Outside of the Litterbox?

It can be frustrating for pet parents to deal with their cat peeing outside of the litterbox without knowing why it is happening. There may be an underlying behavioral or medical problem, and a visit to your veterinarian can help distinguish the two. Sometimes, treatment is implemented and the issue resolves, but other times it can take some time and patience.

Feline Lower Urinary Tract Disease (FLUTD)

FLUTD is a term describing all of the urinary issues that can be attributed to a medical cause. Urinary tract infections, bladder stones, bladder inflammation, or urethral obstruction can all result in urinary issues. You may notice your cat urinating more frequently, passing blood in the urine, or straining to urinate. Your cat may even cry out when urinating or fail to pass urine at all! If you are noticing any of these signs, you should seek veterinary care.

Once at your veterinarian, he or she will do a thorough physical exam, will collect a urine sample, and may perform imaging, such as an x-ray or ultrasound. If these tests show that bacteria and inflammation are present within the bladder, your cat will be given appropriate medications for treatment. If the urinary tract infection is not resolving, it may be necessary to collect a sterile sample to better target antibiotic therapy. If bladder stones are seen, surgery may be necessary to remove them. Obstructions may be relieved by passing a urinary catheter or in severe cases, surgery may also be necessary. Cats with obstructions may need to be hospitalized for several days.

Once the underlying cause has been addressed and resolved, switching your cat to a diet formulated for urinary health and reducing stress in the environment may be recommended for long-term management. Consult with your veterinarian prior to making any changes to your cat’s diet.

Stress-Related Behaviors

Once all possible medical reasons have been ruled out, behavioral modification may be necessary. Cats can become easily stressed or anxious especially in multi-cat households where there may be conflict present. Altering the environment through renovations or addition of a new baby can also cause stress to your cat, which can manifest as inappropriate urination. A few strategies can be helpful to try to eliminate these behaviors.

Providing vertical space, such as with shelving or cat trees is also helpful to keep cats active and engaged. Adding another litterbox to the home and cleaning it daily may also help.

Inappropriate urination can be frustrating for pet parents. The first step in getting to the bottom of this behavior is to see your veterinarian who will be happy to discuss possible causes and treatment options.

Wait…my dog has fleas?!

Summer is upon us, and that means more pets are arriving to the animal hospital with allergies and corresponding clinical signs.  Oftentimes, their itchy skin and hair loss is related to fleas. These small parasites are frequently found outdoors and can jump on your dog while he or she is sunbathing, taking a walk, or playing ball. An allergic reaction to the saliva can occur in sensitive dogs when a flea bites, leading to intense itching, hair loss, and inflamed skin. This can be incredibly uncomfortable!

If your dog is experiencing itchy skin or losing hair, it is best to see a veterinarian for a thorough physical exam. A flea comb will be used to identify any live fleas or flea dirt (feces of fleas). The most common distribution of hair loss and inflamed skin secondary to flea allergies is on the rear end near the tail base and down the hind legs.  Absence of fleas or flea dirt does not necessarily rule out flea allergy dermatitis. When your dog goes outside, a flea can still jump on, bite, and trigger a reaction. However, the flea will generally not stick around and cause additional issues if your dog is current on monthly prevention.

Flea prevention is essential year-round to prevent infestations and these secondary signs in your dog. Be sure any other pets in your household are also up to date on flea prevention! Fleas can be difficult to treat due to their extended life cycle. Schedule a visit with your pet’s veterinarian if you have any questions or concerns about fleas.

Atopic Dermatitis in Dogs

Environmental allergies are seasonal and occur most commonly in the spring and summer when there is an abundance of pollen and other allergens. This condition is medically referred to as atopic dermatitis.  

First, it is important to differentiate atopic dermatitis from food or flea allergies. To learn more about these other allergies, you may read my previous blog post. Atopic dermatitis usually affects a dog’s belly, paws, muzzle, or ears. Dogs suffering from this condition are usually brought to the animal hospital because they have started to itch, lose hair, or chew their paws. Additional presenting complaints may include watery eyes, sneezing episodes, or malodorous skin. Common environmental allergens are pollen, dust, molds, hay, and grass, among others.

There are specific tests available through your veterinarian to pinpoint the exact allergens your dog is sensitive to. One test is serological and consists of submitting a blood sample to detect antibodies against more than a dozen potential allergens. Intradermal skin testing is also an option, which consists of injecting a small volume of allergen within the skin and assessing whether any swelling or redness results.

Many treatment options are available to provide your dog relief from allergies. In dogs that are only mildly affected, antihistamines or medicated shampoos may be effective. These medications reduce the histamine response that occurs from allergies but must be administered frequently to maintain their effect. Medicated shampoos can have anti-inflammatory, anti-pruritic, and antimicrobial properties. Often, they are used in combination with another therapy. Check with your veterinarian to determine the right course of treatment for your pet’s condition.

Steroid injections can provide immediate relief from itchy skin and inflammation. The relief is usually short-lived and lasts about two weeks. They are useful in providing short-term relief while your veterinarian determines a long-term treatment strategy.

Two medications–Apoquel and Cytopoint— have been specifically formulated to combat allergies. Cytopoint is a subcutaneous injection that starts working within 24 hours and lasts 4-8 weeks. It works to block a specific inflammatory cytokine involved in the itch pathway. Apoquel is an oral medication that also targets the itch pathway and begins working within 4 hours. Monitoring bloodwork with long-term use of Apoquel is generally recommended.

In severely affected dogs, immunotherapy injections may be necessary. They can provide long-term relief since they slowly build up tolerance to specific allergens. This therapy consists of a series of subcutaneous injections that each contain increased doses of the allergen. Injections are continued until an adequate dose is given to provide immunotolerance. This means your dog’s immune system will no longer react to the allergen causing issues. The goal of this therapy is similar to that of vaccines, which primes the immune system against certain diseases.

The prognosis for dogs affected by allergies is good, but it can require lifelong treatment to reduce clinical signs and ensure your dog is comfortable. Your pet’s veterinarian is the best source for information regarding allergies that may be present.

Understanding Canine Hypothyroidism

Hypothyroidism in dogs occurs when there are decreased levels of thyroid hormones present within the body. It is common in middle-aged to older dogs. These hormones are important for maintaining heart rate, a healthy hair coat, energy levels, ideal body condition, and normal body temperature.  

What causes it?

The pituitary gland secretes thyroid stimulating hormone (TSH) which stimulates the thyroid gland to produce T3 and T4 (thyroid hormones). When there is a problem along this pathway, low levels of thyroid hormone can occur. The most common cause of hypothyroidism is lymphocytic thyroiditis, which means that the immune system is attacking the thyroid gland and causing inflammation and destruction. Atrophy of the thyroid gland may also occur as dogs age. A tumor within the pituitary gland that prevents TSH from being produced is another possible cause, but it is much less common than primary thyroid disease.

What are the clinical signs?

Since thyroid hormones are important for metabolism, dogs typically experience weight gain despite a normal diet. Hypothyroid dogs will often have fat accumulating along their hind ends, shoulders, or neck regions. Low heart rate, lethargy, and abnormal hair coat (shedding, hairless areas, dandruff, thickened skin) are often found. Hypothyroid dogs also cannot regulate their body temperature as efficiently and are often heat-seekers.

How is it diagnosed?

Often, this disease is detected through annual wellness bloodwork when T4 levels are checked. If results indicate a low T4, hypothyroidism should be considered. However, many non-thyroidal illnesses can cause low T4 levels so it is important to decipher these based on clinical signs and additional testing. In dogs where hypothyroidism is suspected due to a low T4, a comprehensive thyroid panel can be submitted. If the values in this panel match what is expected in a hypothyroid dog, your veterinarian can make the diagnosis. High cholesterol and high triglyceride levels are often found on bloodwork as well.

What is the treatment?

Treatment consists of supplementation of thyroxine (T4). This is a relatively inexpensive medication that is given orally every day. Hypothyroid dogs must be regularly monitored while receiving this medication to ensure the dosing is appropriate to maintain normal thyroid hormone levels. Consult your veterinarian for treatment options.

What is the prognosis?

As long as regular monitoring is performed via bloodwork and veterinary visits, the prognosis is generally good for dogs receiving supplementation.

Dog Vaccines

Vaccines are administered to prevent specific diseases throughout your dog’s life. Core and non-core vaccines are important to ensure your dog stays protected and healthy!

Core Vaccines

Rabies
Rabies is a zoonotic viral disease that is transmitted through the saliva of infected dogs, specifically when they bite. It causes severe neurological dysfunction and death. It is important that your dog stays up to date on this vaccine to protect him or her. The rabies vaccine is given to puppies between 12-16 weeks of age. The first vaccine is good for one year.  Every booster after that is good for 1-3 years depending on state laws.

Distemper (DAPP)
Canine distemper is also a viral disease that causes gastrointestinal, neurological, and respiratory signs. It is spread through bodily fluids, and young, unvaccinated puppies are most susceptible. The distemper vaccine is given between 6-9 weeks of age and boostered every 3 weeks until your dog is 16 weeks of age. It is repeated at regular intervals because maternal antibodies are still present in young puppies and can interfere with their immune responses to vaccines. By 16 weeks of age, all the maternal antibodies should have disappeared, and your puppy should have mounted a sufficient immune response to be protected. The distemper vaccine is administered again at one year of age and then every 3 years.

Non-Core Vaccines

Bordetella
Bordetella is a type of bacterium that can cause infectious tracheobronchitis (kennel cough) in dogs that come in contact with each other, such as during grooming, daycare, or boarding. As the name describes, this disease results in upper respiratory signs. The first dose is given intranasally for a localized immune response, and boosters are given either intranasally or subcutaneously thereafter. Boosters are done every 6 months-1 year depending on your dog’s exposure level and your veterinarian’s preference.

Leptospirosis
Leptospirosis is a type of spirochete bacterium that is transmitted through contact with infected wildlife urine or puddles. It is zoonotic and most commonly causes kidney and liver disease. This vaccine can be combined with the second distemper vaccine booster or given individually. It is boostered 3-4 weeks after the initial dose and then yearly.

Lyme
Lyme disease is caused by a bacterium known as Borrelia burgdorferi. It is transmitted by tick bites and causes kidney and joint disease. This vaccine is administered at 12 weeks of age with a booster 3-4 weeks later. It is then given yearly to at-risk dogs.

Influenza
There are currently two strains of influenza seen in dogs. Influenza causes upper respiratory signs similar to what we see in people. It is highly contagious among dogs coming in close contact with one another. The vaccine can be administered as early as 8 weeks of age and then is boostered 3-4 weeks later.

You should consult your veterinarian to determine the recommended vaccines and schedule for your unique dog!

Why is My Pet Coughing?

Coughing can be caused from a variety of medical conditions. We will discuss the most common reasons why you may have noticed a cough develop in your dog or cat recently.

Heart Disease

Let’s first discuss heart disease, which can be congenital or acquired. Hearing a heart murmur can provide the first clue that heart disease is present. Murmurs occur when there are valvular abnormalities within the heart. Over time, the heart can become progressively damaged and lead to congestive heart failure. If the left side of the heart is affected, fluid may back up into the lungs and produce a wet or productive cough.

Heartworm Disease

Dogs and cats that have contracted heartworm disease may also develop a cough. This can be due to an anaphylactic reaction to heartworm microfilaria or progressive damage to the pulmonary artery and right atrium, where heartworms become lodged.

Lung disease

Parasites and inflammation are a few lung issues we can see in our patients. Coughing may worsen during spring and summer when environmental allergens cause inflammation within the bronchioles (bronchitis). In cats, asthma is fairly common and results in difficulty breathing and a non-productive cough likely secondary to environmental allergens as well. In addition, primary lung tumors or metastatic disease can reduce lung capacity and lead to breathing abnormalities and coughing that may expel blood.

Infection

Dogs and cats can contract bacterial, fungal, or viral infections that may lead to upper respiratory signs. Pneumonia results in lung consolidation and a productive cough, whereas many viruses result in a dry cough. Unvaccinated dogs are at risk for contracting kennel cough or distemper by coming in contact with a virus and/or bacteria. Cats may also develop upper respiratory tract infections due to underlying viral or bacterial disease.

Upper Respiratory Disease

Older, large breed dogs can develop laryngeal paralysis, which is a nerve defect that causes the larynx to become partially closed. This results in noisy breathing and a dry cough. In contrast, small breed dogs are predisposed to tracheal collapse where the cartilage within their tracheas weakens and the lumen becomes smaller. A “honking” cough is characteristic of this disease and can often be elicited upon tracheal stimulation.

Your veterinarian can perform diagnostics, such as bloodwork and chest radiographs (x-rays) to determine the underlying cause of a cough and formulate an appropriate treatment plan for your pet.

Leptospirosis in Dogs & Zoonotic Risks

When you take your dog to the veterinarian for vaccines, you may wonder why he or she needs a leptospirosis vaccine. Leptospirosis is a zoonotic disease, which means it can transfer from animals to people and cause similar sickness in both species.

What is it?

Leptospirosis is an infection caused by a type of spirochete bacteria. Dogs most commonly contract this disease by coming into contact with infected urine of other dogs and wildlife. It may be transmitted by contaminated surfaces in the environment as well. The spirochetes cause infection by penetrating mucus membranes or damaged skin and then spreading to tissues via the bloodstream. They replicate rapidly within many different organ systems, and serum antibodies will typically clear the infection. However, even when antibodies are present, the spirochetes can persist and replicate within the kidneys for several years, remaining infectious when eliminated in the urine.

What are the clinical signs?

Infected dogs often have fevers early in the disease process. Other clinical signs may include muscle pain, lack of appetite, vomiting, uveitis (eye inflammation), hematuria ( blood-tinged urine), fever, increased thirst and urination, or petechia (small skin hemorrhages). In advanced stages, outward signs of liver and kidney disease may be seen, including the presence of icterus (yellowing of the mucus membranes and sclera) and poor perfusion or inflammation of the blood vessels.

How is it diagnosed?

When leptospirosis is suspected, dogs should be placed in isolation to avoid the spread of disease while a diagnosis is confirmed. Your veterinarian will want to perform bloodwork and check the urine for signs of infection. We may see increased kidney and liver values, changes in white blood cell counts, and low platelets depending on the stage of disease. A SNAP test or serum titers can be performed to check for exposure to and antibodies against leptospirosis, respectively. However both of these tests do not tell us whether your dog has an active infection. They simply tell us that exposure has occurred at some point in his or her life. Performing PCR on the urine can detect an active infection and is most useful in diagnosis.

How is it treated?

Penicillin can be administered to eliminate the acute phase of infection for 3-5 days. This treatment is followed by an additional antibiotic, such as doxycycline, for 3-5 weeks to eliminate the bacteria that remain within the kidneys. In some cases, your dog may need to be hospitalized on fluid therapy to help flush the kidneys and to replenish any fluid losses that may have occurred through increased urination or vomiting. Infected dogs will need to be isolated until the infection has fully cleared.

Is it zoonotic?

Leptospirosis is zoonotic, which means it can be transmitted from infected animals to humans. This mode of transmission is less common than people becoming infected from environmental exposure, but it is still possible. The infection may cause fever, joint pain, and other flu-like symptoms in humans. It can also cause abortions in pregnant women. Treatment is largely supportive care with hospitalization on intravenous fluids, antibiotics, and liver protectants.

Is it preventable?

Since there is a zoonotic risk, it is important to vaccinate your dog against this infection to protect both of you. Vaccinations should be updated annually for full protection in at-risk dogs. In addition, reducing your dog’s exposure to puddles or other areas where wildlife or canine urine may be present can help prevent this infection.

Why Does My Pet Need Wellness Exams?

We recommend wellness exams every 6 months to one year depending on the age and condition of your pet. At these visits, we perform a thorough physical exam and take a history on how your pet has been doing since his or her last visit and see if any new concerns have developed. During the physical exam, we check your pet’s eyes, ears, nose, mouth and teeth, lymph nodes, skin and coat, heart, lungs, abdomen, joints, and temperature. A thorough exam allows us to catch any abnormalities that may have developed and inform you of our findings. Based upon these findings and the history, we may recommend additional testing.

Ideally, bloodwork should be performed at least yearly and within a month of any anesthetic procedures. Bloodwork can tell us a great deal of vital information about the health of your pet. There are two large blood panels that are commonly performed during a wellness visit if we deem them appropriate. You may have heard of a Complete Blood Count (CBC) or a serum chemistry panel.

A CBC provides information on your pet’s cell counts, including red blood cells, white blood cells, and platelets. This test allows us to detect signs of infection, anemia, low platelets, dehydration, stress, and blood parasites, just to name a few. A serum chemistry panel provides a look at internal organ function, including kidneys and liver. We can see the levels of electrolytes, detect muscle damage, diagnose endocrine dysfunction, and recognize kidney or liver disease with this test.

Heartworm antigen tests are also a common component of wellness visits. Heartworm disease is a preventable disease and identified with a few drops of blood. This test is done at least yearly but preferable every 6 months. This is because it takes about 6 months for an adult heartworm to produce the microfilaria that we detect using this test. This is more useful in dogs where disease can be identified and treated. Cats have more occult infections that may be difficult to detect. This is why year-round heartworm prevention is extremely important in both cats and dogs.

Urinalysis may also be performed at a wellness visit, especially for geriatric patients. We can detect urinary crystals, urinary tract infections, and signs of endocrine or kidney dysfunction with this test. We can also test the acidity and detect blood, bilirubin, hemoglobin, or myoglobin in the urine.

You can see that a wellness exam provides a wealth of information and establishes a relationship between you, your pet, and your veterinarian. Because your pets cannot speak to us and tell us something is wrong, wellness and preventative care is essential to catch any abnormalities early on and treat them to help your pets live long, healthy lives.