Cat ‘Breast Cancer’: Mammary Disease

Dr. Trisha Joyce, a veterinarian for New York City Veterinary Specialists, knows how lethal mammary disease -- cancer of the mammary glands -- can be in cats. The first case of mammary cancer she saw was with a cat that was brought in with a lump. “We removed the tumor and the cat was fine. Six months later, the couple and the cat were back. Another tumor had appeared. This one had ulcerated, and it was too late to treat it.”

Since that time, Joyce has counseled cat owners on how to prevent and detect mammary disease, and how to proceed once it’s been diagnosed. Below, she shares her advice on each of these.

Risk Factors
Mammary cancer is the third most common cancer among cats, and it is also one of the most preventable. “First and foremost, spay your cat,” says Joyce. Kittens spayed before they are 6 months old have a 91-percent reduction in their risk of developing the disease. Kittens spayed before they are 1 year old have an 86-percent risk reduction. In contrast, cats spayed before the age of 2 have only an 11-percent reduction, with no reduction of risk at all after age 2.

Mammary tumors are most commonly found in unspayed cats between 10 and 12 years old. Siamese cats are more likely to develop the disease, and the onset is typically earlier. Male cats very rarely develop mammary cancer, although it can happen -- and is usually aggressive when it does.

When Joyce meets owners of unspayed cats, she encourages them to perform regular mammary exams at home. The idea is similar to the self-exams that women are taught to perform by their gynecologists in order to become familiar with their own breast tissue. “If you know how your cat’s mammary glands feel when they’re free of tumors, it’s easier to catch a growth if one develops,” she says. The tumors are not painful to the touch, though cats that don’t like to be stroked may try to get away.

To examine your fluffy friend, run your hand over the fatty tissue around her nipple. “Just rubbing the belly is too superficial. Squeeze the tissue a little, almost like milking a cow. You’re looking for a lump like a little hard pea, or sometimes bigger,” says Joyce. Finding a lump is a good reason to visit the veterinarian as soon as possible: Doctors estimate that as many as 90 percent of mammary tumors in cats are malignant.

Other than these telltale lumps, mammary cancer is asymptomatic in its early stages. If it metastasizes, the cat may go on to develop health problems related to where the cancer has spread.

Diagnosis and Prognosis
Because feline mammary tumors are so likely to be malignant, prompt removal of the entire mammary chain on the effected side is most veterinarians’ treatment of choice. Mammary surgery is less complicated than mastectomy in women, as a cat’s breast tissue is outside of the muscle layer. Prognosis is best the earlier the cancer is caught, and the smaller the tumor is. Surgery yields a disease-free year for 50 percent of cats, while almost one-third of cats will go two years without the development of additional tumors. Surgery is often followed by a course of chemotherapy.

In advanced cancers that have metastasized, surgery may still be performed to reduce the impact of the tumor and improve quality of life. Sometimes, though, a metastasized mammary tumor means it’s time to let your cat go. “The tumors can become ulcerative, making just moving around extremely uncomfortable, or if they spread to the lungs or the bones and make breathing or walking very hard, the most humane option may be euthanizing,” says Joyce.

Mammary cancer in felines is fairly common, but it is also preventable, and most often not immediately fatal. With early detection, surgery and chemotherapy, your cat may have additional good years to spend with her loved ones.

Coping With the Loss of a Cat

Dealing with the death of a cat is difficult for any owner -- no matter the age of your pet.

Dr. Trisha Joyce of New York City Veterinary Specialists, and Dr. Wallace Sife, a clinical psychologist and founder of the Association for Pet Loss and Bereavement (APLB), offer advice on managing the end, grieving and moving on.

End-of-life Decision-making
While a small percentage of cats may die peacefully at home from old age, most pet owners will at some point be faced with the decision to end their cat’s suffering. “Sometimes it’s an uncomplicated decision -- say an animal stops making red blood cells,” says Joyce. “But just as often it’s a slow process, like gradual kidney disease. The cat still has a good day every once in a while.” In the latter situation, Joyce recommends the following:

·         Make a list of the things your cat enjoys, like sunbathing or spending relaxed time with the family. Consider whether it still engages in any of these.

·         Give yourself an objective measure -- a point at which you will let the pet go. For example, “Once my cat’s weight has dropped to X number of pounds, I will put him down.”

·         Seek guidance from your veterinarian and other pet owners who have had to make a similar difficult decision. The APLB’s website offers chat rooms addressing the topic.

“Owners will say to me ‘I can’t kill my cat,’ but that’s not what euthanizing is,” says Joyce. “I think of it as releasing the animal. It’s the last and most selfless decision we make for a pet we have cherished and cared for.”

Memorializing a Beloved Cat

Deciding how to mark a cat’s passing is a very personal decision. Some pet owners choose the formality of a proper funeral in a pet cemetery, and others cremate and scatter their pet’s ashes. Many veterinary hospitals offer to create a clay imprint of a cat’s paw as a keepsake.

Sife suggests making a contribution to an animal group in your pet’s name, planting a tree in its honor, volunteering with shelter animals or setting up a memorial on the APLB’s website. “We’ll light a candle for the cat each year on the anniversary of its death,” he says.

Coping in the Aftermath

Everyone deals with loss differently, although cat owners can expect to go through the same stages of grief as anyone who’s experienced the loss of a loved one. Sife suggests reading one of the many books on the topic, including his own, The Loss of a Pet. “The pain is unavoidable, but a book can help to normalize the experience,” he says.

Most important may simply be allowing yourself to grieve. “It can be hard because society doesn’t allow public grieving as much with pets. People feel less comfortable saying ‘I’m going to take a day off of work because I just put my cat to sleep,’ but it’s legitimate,” says Joyce. She adds that some of her clients have found support groups for people who find they need more comfort than they are getting from friends.

Adopting a New Companion

While a pet can never be replaced, at some point many cat lovers may want to bring home a new pet. Sife advises against seeking out a look-alike. “That may be a way of refusing to accept the loss,” he says. Joyce also advises waiting until the raw part has passed.

If you’re thinking about getting a new cat, consider adopting a stray cat from a local shelter. Saving the life of a cat without a home can be one more way to honor the memory of one that’s passed.

Why Healthy Cats Sometimes Act Sick

While he was completing his final year of veterinary school, Dr. Tony Buffington started noticing a relationship between stressful events or environments and evidence of certain “sickness behaviors” in cats. He happened upon a paper in the journal Feline Practice that detailed an increase in the number of cats suffering urinary tract disease symptoms in the San Fernando Valley, Calif., area during the aftermath of the quake. The paper theorized that the stress of the quake and subsequent aftershocks played a role in the symptoms.

Cats Stressed Sick
Buffington, a professor of veterinary clinical sciences at Ohio State University, recently led a team that observed a group of healthy cats and a group of chronically ill cats under controlled, enriched environments. The ill cats had a condition called feline interstitial cystitis, which is characterized by recurring discomfort or pain in the bladder, and an urgent and frequent need to urinate. The researchers occasionally took cats out of their environments, or otherwise disrupted their schedule. As the authors reported in a recent issue of the Journal of the American Veterinary Medical Association, the periods of prolonged enrichment eased the symptoms of the sick cats. During the brief periods of disruption, however, the healthy cats were just as likely as the sick cats to exhibit sickness behaviors.

Buffington says the findings provide two unique insights. One is confirmation that fairly simple environmental changes can lead to physical symptoms in healthy cats. “Happy cats are healthy cats, and their environment plays a role in that,” he says. “From the point of view of being a good pet owner, wise owners know what an enriched environment is and create it for their animals. That way, their animal stays healthy longer. There’s now good evidence for this.”

Second is the fact that the enriched environments took what were essentially lost causes and more or less cured them. “What surprised me most is that the affected cats were donated to us because they had such severe symptoms that they were going to be euthanized,” says Buffington. “But by changing their environment, we were able to resolve those symptoms. They were not completely cured, but by the end of six months their sickness behaviors were indistinguishable from those of healthy cats.”

How to Make an Enriched Environment
Creating one of these enriched environments is not terribly complicated, according to Dr. E’Lise Christensen Bell, an animal behaviorist at NYC Veterinary Specialists. In fact, many cat owners may only require a few additional steps from their current situation. She suggests doing the following:

  • Keep the day structured so that approximately the same feeding, play session, petting session, and litter box cleaning times are in place. Regularity of schedule is crucial.
  • Set up games and hunting activities for your cat throughout the day, such as rotating food-dispensing toys daily, hiding toys in boxes for your cat to find, setting up bird feeders outside for your cat to view, conducting training sessions and more.
  • Make sure your cat has easy access to hiding areas, such as small boxes or elevated, soft-surface resting spots.

Buffington notes that not all cats are going to respond the same. Some are more adaptable than others to unpredictable environments. He’s also sensitive to cat owners who may feel they are being told they’re not good caretakers, and stresses that veterinary professionals are themselves in the process of learning the importance of his team’s findings. “We veterinary professionals have assumed the authority to tell you that you should keep your cats inside, so we also shoulder the responsibility to tell people how to do it right,” he explains. “Having the right evidence-based advice is the best preventative healthcare you can do.”

Is Your Cat at Risk for Diabetes?

Many people know someone who has diabetes, but did you know that this someone could be your cat? “Diabetes is pretty common in middle-aged cats,” says Dr. Katy Nelson, a Virginia-based emergency veterinarian. “Cats tend to develop type 2 diabetes: Their cells stop responding to insulin. Just like with type 2 diabetes in older people, you can induce remission by modifying what they eat and how much they weigh.”

Below, Nelson explains the signs and treatment of diabetes mellitus (aka “sugar diabetes”) in felines.

Diabetes Mellitus in Cats
Humans get two types of diabetes (type 1 and 2), and so do pets. Cats are far more likely to develop type 2, which results from genetic factors as well as being inactive and overweight. As many as one in 50 cats are diabetic, and incidence seems to be increasing with growing numbers of obese, inactive house cats.  

Studies have shown that almost half of all healthy cats will develop impaired glucose tolerance -- a risk factor for diabetes -- when they increase their body weight by around 40 percent. Neutered male cats older than 8 years are at highest risk, as are cats that have had pancreatitis. For cats 8 years and older, incidence of diabetes increases to one in 10.

Symptoms of Cat Diabetes
“PU/PD,” says Nelson, referring to polyuria (urinating a lot) and polydipsia (drinking a lot). “All of a sudden, you can’t keep the water bowl full, and the animal is going outside of the litter box.” Sudden weight change -- loss or gain -- and vomiting and diarrhea are also possible symptoms.

“The symptoms are pretty non-specific. We commonly have people bring their cats in when they’re acting strange, drinking and peeing a lot. The worst case scenario is in multi-cat households, where owners have a harder time identifying PU/PD,” she says. “I’ve seen cats get brought in after collapsing in diabetic ketoacidosis, which is essentially when they’ve been hyperglycemic for so long that the muscle and organ tissue starts to break down. This is a veterinary emergency.”

How Is Cat Diabetes Treated?
There is no cure for cat diabetes. However, it can go into remission with insulin treatment and proper diet. Even when this is not the case, diabetes can be managed in order to maintain a pet’s quality of life. The treatment for cat diabetes is three-part:

  • Insulin “This is No. 1,” says Nelson. “Diabetic remission is about good regulation early on, particularly with a new type of insulin called glargine.” Typically, cats should be injected twice daily, at fairly precise 12-hour intervals. Oral medication can also be administered to some healthy diabetic cats, but this is less likely to be effective than insulin. The cat may not even notice the small needle, if administered in the scruff of the neck while the cat is eating.
  • Diet Nelson recommends canned food because of its high-protein, low-carbohydrate content. “It can work wonders. Along with insulin therapy, it can induce remission within one to two months if you do things the right way,” she says. Cats with diabetes need their meals to be delivered on a consistent schedule as well.
Your veterinarian should supervise your cat’s workout regimen along with its insulin and diet. Many doctors will recommend that you take five minutes a few times each day for active play with your cat. You can also place small meals around your home to encourage your cat to do some walking.

Ringworm: The Leading Cause of Cat Skin Disease

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A highly contagious and persistent skin disease, ringworm can be difficult to diagnose. Cats can act as carriers without ever showing signs of the disease, which can also be transmitted to humans. The disease is a particular problem in shelters and catteries.

“It’s a frustrating, challenging disease,” notes Dr. Duffy Jones, who recently diagnosed a cat in his Atlanta practice. “Not every cat shows clinical signs. Sometimes we’ll see it on the person and find it on the cat later.”

What Is Ringworm?

Often mistaken for a worm or parasite, ringworm is actually a hardy fungal infection, says Dr. Amber Andersen, a veterinarian pursuing a masters degree in public health. Ringworm can be spread through direct contact or through contact with things an infected cat touches, such as bedding.

Kittens, elderly cats, cats with compromised immune systems and long-haired felines are more vulnerable to ringworm, according to Andersen. Likewise, children, the elderly and people with compromised immune systems are also more susceptible. If left untreated, ringworm can lead to secondary bacterial infections.

How to Prevent Ringworm in Cats

Experts recommend following this checklist:

  • Monitor your cat. Brush your cat at least once a week, examining its skin and coat, says Andersen. Look for hair loss or lesions around your cat’s nose, ears and face, advises Jones. A circular, red hairless area is a symptom of ringworm. Don’t forget to examine hard-to-reach places, such as your cat’s stomach. Monitor vulnerable cats, such as kittens or senior cats, more frequently.
  • Clean up your cat’s area. Remove dust and debris each week from your cat’s sleeping area and from your entire home. Wash bedding regularly, says Andersen.
  • Keep your cat indoors. Outdoor cats can be exposed to ringworm in the environment.
  • Carefully introduce new cats. Take special precautions if you bring home a kitten. Make sure a veterinarian first examines the kitten. In general, don’t allow new cats to sleep around your face, and wash your hands carefully after handling, advises Jones.

If Your Cat Gets Ringworm …
It can take up to four weeks to develop the culture that veterinarians use to diagnose ringworm. If your veterinarian suspects ringworm, he or she will likely recommend immediate treatment. Jones dips cats in a lime sulfur shampoo. “The cats hate it and it smells terrible, but it’s very, very safe. Eighty to 90 percent of cases will clear with the dip,” says Jones. Oral drugs can cause stomach upset, so the dip is better. Your cat may also be treated with a topical ointment, says Andersen.

You should also do the following:

  • Have your other cats checked. Since ringworm spreads so easily, have all your cats examined if you live in a multi-cat household.
  • Vacuum rugs and floors daily. Discard vacuum bags or clean your vacuum frequently. Instead of dust mopping, use a wet mop with disposable pads. “The wet mops tend to pick up spores better,” says Jones.
  • Bleach or steam-clean surfaces. Andersen recommends a solution of 1 1/2 cups bleach to 1 gallon of water. Jones recommends steam-cleaning carpets and fabric-covered furniture.
  • Wash cat bedding and clothing. Hot water, bleach and detergent will help remove spores. Consider discarding fabric items and purchasing new bedding.
  • Confine your cat. Keep your cat in a small, easily cleaned space, such as a bathroom, for two weeks after treatment begins.
  • Throw away toys. Toss toys, scratching posts and brushes. Spores can live for up to a year in the environment, so you want to rid your home of anything that might harbor the fungus.
  • Don’t sleep with your kitty for a while. Avoid allowing your cat to share your bed until the ringworm issue is resolved.

“Ringworm is much more common than you would think,” says Andersen. And while it’s relatively benign compared to many other things, it can pose problems for some vulnerable people and animals.”