It happens all too often in veterinary hospitals across the country.  The Nurse says, “You’d better get in here, quick!”  So you enter an exam room to find a weeping client and a flat cat.  FLAT.  As in laying on her side, barely able to lift her head off the table. Weak and severely dehydrated.  Skinny.  Rapid shallow breathing.  Sunken eyes.  Fluttery heartbeat.  Your training tells you that this is most definitely not looking good, so you quickly begin to assess Flat Kitty, trying to figure out what has happened, before she quietly expires on the exam room table.  All the while, the client cries and tells you that Kitty has only been sick a few days.

“You have to believe me, Doctor!  She ate baby food up until just a few days ago, and she used her litterbox until last week when she stopped eating her regular food, and I checked online and a nice lady who knows a lot about cats on one of those cat forums told me to give her sugar water from an eyedropper and some vitamin C, and she took all that but it didn’t seem to help…”  So you check your records, and you see that you last saw Flat Kitty almost three years ago, when you last vaccinated her. 

At that visit three years ago, you stressed to Kitty’s Mom that it was much healthier for kitties to get their shots less often and to have fewer of them, so she gratefully accepted your recommendation to give a three year rabies vaccine and to run a titer blood test in lieu of the booster vaccine.  She was glad to hear that these are the ONLY core vaccines recommended for most cats, and that it was far better to use those “annual vaccine funds,” the ones that she was used to spending, to make sure that Kitty came in annually for a thorough physical exam.  We told her that it would given us a heads up on early health issues if we could run some baseline bloodwork every few years, so that we could treat the problems that tend to occur as cats age while they are still little problems and not big ones.  And we advised her how to upgrade Kitty’s diet with some fresh food.  “Mom” took a lot of notes during the time she spent with us, and she told us how useful the information we gave would be to her. She promised she’d run the bloodwork at her next annual visit for her then-four year old kitty.

Then she ignored all reminder cards, e-mails, and phone calls for the next three years.  Because Kitty looked just fine to her.  And you only go to the vet for shots.  Right?  If you want medical information, you can just go online.  There are any number of cat forums, and self-proclaimed “cat experts,” and out-of-a-real-job veterinarians who will diagnose your cat online and offer “treatment suggestions” that will help you out.  Right? And it’s a heck of a lot cheaper, too.  Right?

So Flat Kitty’s owner did just that.  Online, she learned about and ordered up an expensive “organic” cat food (she didn’t know that it had only one organic ingredient), subscribed to a forum that encouraged her to buy “immune herbs” for her cat (she didn’t know what was in them), and she ordered some Dandelion Tincture (ditto) online to help her cat “process environmental impurities.”  She bought a new cat bed and cat toys “designed to encourage your cat’s creativity” online, and sent a lot of cute pictures of her cat in the bed and playing with the toys to her new on-line friends.  She spent an enormous amount of time and a whole lot of money doing everything she could for her dear Kitty.  That is, everything except checking in with someone who knew enough to tell her if her cat was, in fact, a healthy cat - her veterinarian.  Someone who could tell her if Kitty would be around long enough to enjoy all the wonderful things she had done for her.

Now.  There was NO doubt it my mind, as I looked down at Flat Kitty, that she was very much loved.  Or that now, in order to save Flat Kitty’s life, I was going to have to tell her Mom that we were pretty much going to have to devote the resources of our entire hospital to Kitty for the next three or four days.  She would need an IV catheter and fluids, and a lot of bloodwork, and some X-rays, and dedicated Nurses to monitor her, and to get her to eat, and to give her medication, and to simply comfort her while she was away from home.  And this was most definitely not going to be inexpensive.  So we developed a treatment plan so that Mom would know what to expect, and she cried, and we opened a Care Credit account for her since she had spent all her “cat money” on nice cat toys and on-line health supplements for Kitty.

And we went to work to save Kitty’s life, all the while saddened by what the HECK had happened, yet again.  What happened is what happens all over the United States.  Statistics show that cat owners download just as many pictures of the cats to their phones as do dog owners.  The percentage of cat owners who love their cats “like a family member” is over 80%.  And the percentage who love their cat “like a child” is similar to the stats for dog owners.  Cat owners celebrate their pet’s birthdays, and they spend time playing with their cats, and they think about them while they are at work, and they worry about them while they are gone on vacation, and they stand there in the pet food aisle agonizing over what food would be best for their dear Kitty.  Just like dog owners do.

And they reap the rewards of having a cat.  That gentle touch on your face to tell you that it is time to get up and feed me.  The constant companionship and soft pur-r-r-r while we work at our computers or read on the couch or watch TV.  The happy cat dance when we return home.  The silly play antics, complete with sideways hop, mule kick, couch vault, bookcase ascent, and flying dive.  The moth game and the cicada game.  The sheer enjoyment of sharing your life with a small living being who is so perfectly constructed to do absolutely nothing, completely without guilt, for hours on end.  And maybe a little wishful thinking that we could do the same.

There are 10 MILLION more cats than dogs in the U.S.  Over 33% of U.S. households have at least one cat, and of these households, 47% have two or more cats.  Yet, a full third of all cat owners do not bring their cats in for annual exams, and a shocking percentage of cats NEVER see a veterinarian once they are an adult cat.  Years ago, veterinarians shared the blame.  What happened in the past that caused veterinarians to devalue cats and to turn off their cat clients? In the 70’s when I entered vet school (and please do not e-mail me with a smiley face to tell me that you weren’t born yet!) there weren’t a whole lot of female vets.  Women were strongly discouraged from entering a “man’s profession”, and many of the vets who chose to practice small animal medicine thought of cats as small dogs.  Which they most definitely are not.

So cats got “dog treatment”, and they didn’t like it, and neither did their owners.  Cats need soft voices and a soft touch, and an exam room that has been specially prepared for them (one that doesn’t smell like a big hairy dog), and people who understand that an aggressive cat is usually just a really scared cat.  Someone who owns cats themselves, and who understands what is going on inside that furry head.

Cat owners weren’t educated years ago, by their veterinarians, to know that cats are, in one very important sense, like tiny babies - they get sick quickly, and they dehydrate quickly, and then they die quickly.  Cat owners were also not educated to know that cats hide their illnesses very, very well, and usually do not present with the same signs of illness that a dog would show you, until they are extremely sick.  Cat owners weren’t educated much at all, was the problem.  Many veterinarians abdicated their cat responsibilities entirely. In many parts of the county, shelters and spay-neuter clinics stepped in to provide services to cat owners who had nowhere to turn.  They did a good job with the basics, but they operated on a shoe-string budget and charged such low fees that they didn’t have the time (or staff training) to talk to cat owners about the ongoing health needs of cats.

But times have changed, and so have veterinarians.  Our profession is now populated by veterinarians who DO understand the needs of cats and their owners.  New graduates are so overwhelmingly women that at least one vet school has set up an advertising program to bring more men into the profession.  All veterinarians receive special training in cat medicine, cat surgery, and cat behavior.    And the same veterinary supply companies that have traditionally spent lots of money educating the public about the health needs of dogs are now doing the same for cats.  So the information about healthy needs for cats is now out there.

What hasn’t changed is the perception in the minds of many cat owners that, for whatever reason, cats are not like dogs or in fact like any other pet - or even like people - in needing regular professional medical care.  Somehow, the fact doesn’t “click” that as cats age, they share with dogs and people the same set of aging changes that can negatively impact their lives.  Yet the reality is that they DO get heart disease, and liver disease, and kidney disease, and dental disease just like anyone else.  They also get their own set of cat-specific diseases: a surprisingly high incidence of thyroid problems, and diabetes, and pancreatitis, and cat-specific cancers. Another very important reality is that cats simply do not show early signs of illness like dogs and people show.  And that last reality shows up too infrequently on the radar of many cat owners!

Now.  We’re lucky at Knollwood.  We have exceptional cat-owning clients.  We’re “weird” enough (in the words of one ex-client who accused us of treating his cat like - well, like one of our own cats, by comforting it when it was scared and aggressive instead of manhandling it), and educated enough about cats and their needs to evidently make a good majority of our cat owners feel that we DO know what we are talking about.  So we do see a lot of cats, and we make sure that clients understand that indoor cats have health needs just like people who spend most of their lives working in an office.  We have special surgery and anesthetic protocols for cats, we know about their special dental needs, and we have specific pain management protocols for cats.  Dr. Mitchell lectured with vaccine expert Dr. Ron Schultz in the late 80’s and early 90’s to veterinarians and veterinary students across the U.S., and she brought Dr. Schultz’s vaccine protocols back to our practice.  In fact, we were the first practice in the entire Chicago metropolitan area to routinely offer extended-duration vaccines and titer tests to our cat owning clients.

Yet we still see cats like Flat Kitty.  That tells me that we still aren’t reaching all of our cat owners with some pretty darned important messages.  So, we’re reaching out again, and we will continue to reach out throughout this year.  We’ll be contacting you about your cats, we’ll be asking you about the cats that you may have that we don’t know about, and we’ll do our best to let you know what they need.  We’ll do it on our website and our Facebook page, and when we see you.  We’ll ask about your cats.  And if you have a cat and want us to know it, we’ll tell you what needs to be done for that kitty, and when, and how we can work with you to do it cost-effectively.  We want to be your partner in caring for your cat, no less so than for your dog or your bunny!

Did Flat Kitty make it?  Yes, she did.  She was a ketoacidotic diabetic cat, which means that she had diabetes long enough for her body to almost completely shut down.  Her kidneys were damaged, and her liver, and her eyes, and she darn near died several times during the course of her treatment.  She will require quite extraordinary care for the rest of her life and her owner is dedicated enough to do that.  I’m glad she made it.  But a part of me is beyond sad and angry, because she didn’t need to end up nearly blind and she didn’t need to have permanent kidney and liver damage, and twice daily insulin injections.  

If we had detected her disease early, before she was at the Flat Kitty stage, she’d have had an entirely different outcome.  She’d still have her eyes, and her organs would be working properly.  If we had detected her disease really, really, early, with a routine blood test, we could have told her owner that the “organic” diet she was on was, in fact, unhealthy for her,  and could have even possibly avoided the need for insulin completely, by modifying the diet to a high-fiber,  more natural diet.   She’d be a healthy cat today, still doing the bookcase ascent, the mule kick, and the moth chase. She can’t do any of those things now.

But she’s alive, and her owner is thankful for having a kitty who still gives her a gentle pat on the cheek to say “wake up and feed me”. And who purrs next to her while she works on the computer, or on the couch when she sits and reads.  And who still does a version of the “happy cat dance” when her Mom comes home everyday.  And we are all thankful for that.