Many flea
treatments are fairly powerful, which makes using them on a sick cat a big
decision. However, fleas can make a cat uncomfortable and a severe
infestation may even cause
anaemia, so the problem must be addressed.
Sometimes
garlic added to food is recommended to control fleas, but since garlic is
associated with Heinz body anaemia (see
Which Foods to Feed),
I would not follow this advice.
Dr M Dryden of Kansas State University, associate professor of parasitology and a
well-known flea researcher, states ""There is no data available to
substantiate the efficacy and safety of herbal flea preventatives. There's
been one study on the use of garlic as a flea preventative and it showed
nothing."
Fleas: Over The Counter Products
Don't waste your money on over the counter treatments - they rarely work
but may still have severe side effects. The
US Environmental Protection Agency
has investigated thousands of problems arising from the use of Hartz
products, for
example. In 2010
The US Environmental Protection Agency
increased restrictions on flea and tick products in the USA and Canada.
In the UK, the
Feline Advisory Bureau reports that there have been hundreds of cases
of cats being poisoned by permethrin-based flea treatments intended for
dogs. Never use a product containing permethrin on a cat.
Flea collars in particular are useless, plus they expose the
cat to toxins 24/7 - not a good idea for a sick cat. Products containing
essential oils should also be avoided - they are toxic to cats, who lack the pathways to
metabolise them.
Fleas: Prescription Products
I suggest you obtain an effective treatment from the vet; if you do this,
you can also take the added precaution of asking your vet if it is safe to
use the product on your particular cat. The four most commonly recommended
products are Frontline, Advantage, Revolution and Capstar. Use the weakest
product you can that will do the trick. I have always used Frontline, and
have found it very effective, but my cats only get fleas very occasionally
so I have never needed to use any product on an ongoing basis.
The manufacturer of Revolution (known as Stronghold in the UK)
specifically cautions against using Revolution (Stronghold) on sick cats.
Bayer, the manufacturer of Advantage,
offers a similar warning for its product. In Seizure disorders in dogs and cats, Dr RM
Clemmons from The Neurology Service at the University of Florida's
Veterinary Medical Teaching Hospital mentions that Advantage and Program
"appear to lower the seizure threshold and make seizure disorders more
difficult to control", so I would not use them on a cat who has had a
seizure or who is at risk of
seizures.
Capstar is given in pill form and
is safe enough to give to very young kittens, so you could ask your vet if
it might be suitable for your CKD cat. Unfortunately it only kills
existing fleas, it does not act as a preventative.
In fact, you
don't necessarily have to apply flea products directly on your CKD cat. If
you have other, healthy companion animals, try applying the commercial
preparation you choose only to the other family animals, and use a flea
comb on all the animals every day, including the CKD cat; be sure to treat
your carpets too with a cat-safe preparation, since the fleas will live in
them and can re-infest your cat. Eventually you should find all the
animals are free of fleas, even the CKD cat. I did this using Frontline,
and we did get rid of the fleas, though we do not get fleas often anyway,
only about every eighteen months (yes, despite having long-haired,
indoor-outdoor cats!). Because of this, I do not treat my cats month in,
month out, I only treat them when they actually have fleas; if you live in
a relatively flea-free area, you may wish to consider this approach.
However you treat your cats, you should also treat the environment in
order to get completely rid of the problem.
University of Kentucky Entomology
explains more about this. In the UK I have used Acclaim
without any problems.
Veterinary Partner compares
Revolution (Stronghold), Advantage and Frontline.
Treatments containing glucosamine and chondroitin, such as Cosequin, are
usually safe for CKD cats; I found Cosequin did help Harpsie's arthritis
to some extent, although according to
The Mayo Clinic, it has been known to
raise blood pressure temporarily in some human patients, and some patients
have developed
proteinuria.
The increase in blood pressure may be because some of these products have
a sodium base. Be careful about using such products in a CKD cat and
try to obtain a product without a sodium base if possible.
Adequan
Some people have also had success with Adequan, which is an injectible
treatment, although this is a relatively new treatment for cats (it is
actually only approved for dogs) and many vets will not be familiar with
using it in this way.
Mar Vista Vet reports that when
large doses were given to dogs, the dogs developed large kidneys. They
therefore recommend being cautious when using Adequan in patients with
CKD.
Meloxicam (Metacam)
Meloxicam
(Metacam)
is a non-steroidal anti-inflammatory drug
(NSAID) available in both injectible and liquid
(oral) form. It is not recommended for CKD cats because it may
cause kidney injury. You can read more about it on the
Antibiotics and Painkillers
page.
Acupuncture
Longer-term, we had extraordinary success treating Harpsie's
arthritis with acupuncture. There is more information on acupuncture on
the Holistic Treatments page.
Harpsie's Website
has additional information on treating arthritis, including more
about his acupuncture sessions.
Heat Pads
Heat pads are a good idea for arthritic cats, particularly in cold or
damp weather. A heat pad is a small flat
heated pad with a fleecy cover - it looks like a little flat cat-sized
bed. You just plug the heat pad into the mains and then the pad stays at
the chosen temperature constantly, unlike a hot water bottle. You must of
course keep an eye on your cat while he or she is using this since it is
electrical equipment, but certainly we never had any problems with
overheating, and Harpsie used his almost constantly in winter.
Boots in UK sells a
heat pad for £20.95 -
this is similar to the one we used for Thomas when he had anaemia.
Cognitive Dysfunction (Senility
or Feline Alzheimers) Back to Page Index
Howling, especially at night, is quite common in CKD cats. There are a
number of possible causes, see
Index of
Symptoms and Treatments.
Unfortunately this may sometimes be a symptom of an old-age related
problem known as cognitive dysfunction (sometimes referred to as feline Alzheimers). My vet told me that sometimes old cats wake up and feel a
little confused, are not sure where they are, so they howl for
reassurance; once they hear your voice, they feel comforted and will
usually stop howling. Certainly both Tanya and Thomas were night howlers
with no obvious reason for it (apart, in Thomas's case, from a keen desire
to go outside at all hours!), and if we spoke to them they usually
stopped.
Geriatric cats and cognitive dysfunction syndrome
(2008) Gunn-Moore DA, is a presentation to the 33rd World Small Animal
Veterinary Association Congress about the diagnosis and treatment of
cognitive dysfunction in cats.
In humans, a lack of Vitamin B12 has been associated with cognitive
dysfunction. Supplementing
Vitamin B12
in the form of methylcobalamin is therefore worth considering.
Aktivait
Aktivait, a nutraceutical containing
essential fatty acids and
antioxidants, has been
found in one trial to help dogs with cognitive dysfunction. I have heard
from one vet who has also found it helpful in cats with this condition. A
couple of people on
Tanya's CRF Support Group have found it helpful too.
Vetscriptions in the UK sells Aktivait
and will ship to other countries. Make sure you buy the feline version,
the canine version contains alpha lipoic acid, which is toxic to cats.
Vet on the Web has an article by Sarah
Heath, a veterinary behaviourist, who explains more about cognitive
dysfunction and the use of Aktivait.
Selegiline (Anipryl)
A drug called selegeline or selegiline (Anipryl) is sometimes used to
treat cognitive dysfunction in dogs, but the treatment is still
experimental in cats, and may be contraindicated for cats with CKD.
Mar Vista Vet has some information on the use of selegiline in
animals.
Pet Place also has information about selegiline
use in animals (no need to register to read the article, just click on
Close at the bottom of the irritating pop-up).
talks about the experiences of one cat who participated in a study into
the use of selegiline in cats.
Novifit
Novifit is another product which is
intended to help with cognitive dsyfunction. It contains
S-AdenosylMethionine (SAMe), an antioxidant which is also used to treat
cats with liver disease.
The caution details on a feline vaccine packet state that the vaccine is for administration to healthy cats
only. CKD cats are by definition not healthy, so I would not recommend
vaccinations. Once Thomas had been diagnosed, my vet said she did not
recommend giving him vaccinations, so we stopped.
If you are in the USA, the
American Association of Feline Practitioners
now
recommends that the standard FVRCP vaccination only needs to be
given every three years; so if your cat has been vaccinated in the last
three years, you probably do not have any decision to make. This does not
apply to Europe, Australia or New Zealand, where normally different
vaccines are used which are only valid for a year.
As far as rabies is concerned, although a few US states only require the
rabies vaccine to be given every three years, in others you may be
required by law to have your cat vaccinated against rabies annually. In
these states, you may be able to obtain an exemption if your vet confirms
your cat should not be vaccinated for health reasons. The
American Veterinary Medical Association
has a form available which your vet can fill in and send to the
relevant authorities.
Choosing not to vaccinate in the UK can be problematic if your cat ever
goes to a cattery, because catteries usually insist upon vaccinations. I
asked my vet to write a letter to say vaccinations were not appropriate
for Harpsie, and the cattery accepted this and allowed Harpsie to stay
without recent vaccinations.
Of course, you may not be so much concerned about meeting legal
requirements as anxious that your cat should have some protection against
the diseases in question, particularly since s/he will be making regular
visits to the vet, and may be exposed to illnesses there which could be of
concern in view of the weakened immune status of a CKD
cat. Most cats who have received vaccinations in the past will have some
degree of residual benefit anyway, but if you are particularly concerned,
you could have their vaccine titres checked (blood is taken and sent away
to a specialist laboratory) to see how much protection they still have;
although it should be remembered that titres only show a level of
antibodies, and it is not always easy to know what level of antibodies can
provide sufficient protection from a practical perspective. I suggest you
discuss with your vet the best approach for your particular cat.
Colorado State University is currently
working on a new test which will determine whether a cat needs to be
vaccinated or whether previous vaccinations are still offering protection.
There is some research that indicates a very tentative
link between standard vaccinations and the development of CKD; please see
the Causes
of CKD page for more information on this and about the
recommendation that intranasal vaccines be used where possible.
Feline vaccine side effects (2012) is a
presentation by Dr Lappin to the 84th Western Veterinary Conference,
in which he states that core vaccines should continue to be given to
healthy cats in accordance with the AAFP guidelines mentioned above.
Feline vaccination protocols (2002) is a
paper presented by Dr Richard Ford to the WSAVA Congress 2002 which
mentions the risk of using rabies vaccines containing adjuvants, which
have been associated with a particular form of cancer.
