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To Pee or Not to Pee, That is the Question: Feline Lower Urinary Tract Disease

Shakespear cat Feline Lower Urinary Tract Disease, or FLUTD, is a multifactorial disease condition that affects many domestic cats; in fact, up to 10% of all cats treated in emergency hospitals are affected with FLUTD. FLUTD describes a constellation of clinical signs rather than a specific disease, ergo any cat presenting with difficulty urinating can be said to “have FLUTD.” The list of FLUTD causes grows every year as more and more research is conducted in the field and many individual cases of FLUTD have more than a single cause. The two most common causes are FIC (feline idiopathic cystitis) and urolithiasis (stones in the urinary tract); bacterial infections, cancer, behavioral issues, neurologic deficits, and conformation abnormalities can all play a role in FLUTD. Severe cases of FLUTD can cause complete urinary tract obstruction, which is a life-threatening emergency.

FIC can often be frustrating for owners because it is an idiopathic disease process, meaning that there is no identifiable cause. Cats with FIC often experience painful inflammation of the lining of the bladder, which leads to spasms of the urethra and difficulty urinating. The signs of FIC are very similar to a bacterial urinary tract infection: straining to urinate, yowling while urinating, passing small volumes of blood-tinged urine, and having accidents outside of the litter box. FIC is often diagnosed by first ruling out other possibilities, like a bacterial bladder infection. Your veterinarian may suggest a urinalysis with a urine culture to make sure that there are no white blood cells or bacteria in the urine. The urinalysis will also provide important information about kidney function and hydration status that will guide your veterinarian to develop a treatment plan for your kitty.

Urolithiasis is another common contributor to FLUTD and one with which many cat owners (especially those with male cats) are already familiar. Stones form in the urinary bladder for a number of reasons but diet, genetics, and bacterial bladder infections are all important components. Small stones (similar in size to sand) may pass through the urethra without obstructing the passage of urine. Larger stones or conglomerates of sand and mucous can become lodged in the urethra and prevent your cat from urinating. When this occurs, it is a life-threatening emergency that can lead to severe electrolyte disorders and even bladder rupture.

If you suspect that your cat has FLUTD, it is advised to have your cat seen by a veterinarian as soon as possible. The veterinarian will perform a thorough physical exam on your cat and recommend a course of diagnostics and treatment. Blood work is often recommended to rule out abnormalities in electrolytes and will indicate if your cat has any systemic infection, inflammation, or organ dysfunction. A urine sample may be collected via cystocentesis, which is a process by which urine is collected directly from the bladder with a needle placed through the belly. This will allow your veterinarian to rule out bacterial infection and look at the urine sediment to check for crystals, red blood cells, and signs of kidney disease.

In cases of obstruction, a urinary catheter is usually placed to remove the obstructing material from the urethra and relieve the pressure on the urinary bladder. The catheter is often left in place for at least 24 hours while the inflammation of the urethra decreases, which reduces your cat’s risk of re-obstructing. Cats who require a urinary catheter are kept in the hospital on intravenous fluids and medications to relieve pain and prevent urethral spasm. The type of crystal/stone or lack thereof found in the urine can direct your veterinarian as to the cause of the obstruction and indicate if dietary or lifestyle changes are needed.

If you have any concerns about your cat’s urination habits, having a discussion with your veterinarian is the best course of action. If you are worried that your cat has a urinary tract obstruction, it is recommended to have your cat seen immediately. Pet Specialists is open 24 hours a day, 7 days a week to help with any of your pets’ needs.

Vomiting, Diarrhea, and Table Scraps for the Holidays

TksgvgDogTurkey During the holiday season, you may find that one or more of your pets has an upset stomach. Vomiting and diarrhea are common reactions to stress from traveling or new visitors in the home and dietary changes from table scraps or trash can diving after holiday meals. In many cases, the upset stomach will resolve on its own without requiring a trip to see your veterinarian, but if it does not, you may find yourself discussing pancreatitis. The following will help you as a pet owner understand this disease and what you should expect when working with your veterinarian to treat it.
Pancreatitis, or inflammation of the pancreas, is a common reason for pets to present to their veterinarian or to an emergency clinic. The pancreas is an organ that lies near the stomach and intestines and produces enzymes that aid in digestion and utilization of nutrients from the diet, like lipase and insulin. Pancreatitis is the most common pancreatic disease in small animal patients. While it is much more prevalent in dogs, it can occur in cats as well. There are two types of pancreatitis: acute (arising suddenly) and chronic (persisting over a long period of time). However, both types are diagnosed and treated similarly.
There are a myriad of causes of pancreatitis, and most cases are considered idiopathic—meaning that the cause is never identified. Dietary indiscretion, or “garbage can gut,” is one of the most common identified causes. Table scraps rich in fat like cheese, gristle, turkey carcasses, and pork, can trigger a bout of pancreatitis. Blunt trauma, like falling from a high place or being hit by a car, has also been associated with pancreatitis.  Certain types of bacterial, parasitic, or viral infections are also associated with pancreatitis. A very small number of pets may react unfavorably to certain classes of drugs and develop pancreatitis secondary to administration of those drugs.
When the pancreas becomes inflamed, it leaks digestive enzymes into the surrounding tissue. These enzymes break down healthy tissues and cause more inflammation. This process can be very painful, and pets with pancreatitis often present with profound abdominal discomfort and pain. Vomiting, diarrhea, dehydration, lethargy, weakness, and loss of appetite are also common presentations of pancreatitis. The severity of signs is often directly correlated with the degree of inflammation in the pancreas, ergo less severe cases will present with less severe clinical signs.
Coming to a diagnosis of pancreatitis often involves careful investigation of your pet’s history, physical examination, lab work, and imaging findings. It is important to rule out other causes of vomiting and diarrhea, like foreign body obstruction, so your veterinarian may recommend x-rays of your pet’s abdomen. A CBC (complete blood count) and blood chemistry panel will allow your veterinarian to examine the function of your pet’s organs, like the kidneys and the liver. Tests looking for pancreatic lipase (PLi- an enzyme secreted by the pancreas) in the blood can help support a diagnosis of pancreatitis, but the most definitive diagnosis can be made after examining your pet’s abdomen via ultrasound and noting inflammation in the pancreas.
When treating pancreatitis, your veterinarian will likely recommend hospitalizing your pet. This allows your pet to receive intravenous fluids, pain medications, anti-nausea medications, and other supportive care measures. There is no medication to “cure” pancreatitis. Pets usually recover with supportive in-hospital care and time to allow the inflammation to resolve. The severity of inflammation and thus severity of signs will determine how long and how aggressive the supportive care will need to be. Having pancreatitis once makes a pet predisposed to developing it again at some point in their life, so it is important to follow your veterinarian’s diet recommendations once your pet is discharged from the hospital.

Liver Disease in Pets

The liver is one of the body’s greatest multi-taskers; it commands the majority of metabolic functions in the body, manufactures proteins and glucose, metabolizes waste products in the blood, and produces the contents of the gall bladder to aid in digestion. With such a critical role in maintaining health and well-being, it is no surprise that when the liver is injured, the results can be serious and far-reaching.

Acute and chronic liver diseases are commonly encountered in veterinary medicine. Acute liver disease is usually the result of ingesting toxins (certain species of mushrooms, xylitol, Sago palm– for a full list of household and environmental toxins please visit ASPCA’s website:, drug reactions, or infectious diseases. These conditions can present as general illness with relatively non-specific signs like vomiting, fever, lethargy, loss of appetite, diarrhea, or neurological problems like stumbling and loss of balance. Your veterinarian can run a blood panel to check for elevation in liver enzymes and determine if your pet’s signs are a result of liver injury. As soon as liver injury has been identified supportive care will be started. In most cases the severity of injury will dictate the aggressiveness of the treatment. The liver has a tremendous capacity for regeneration, but time is needed for it to recover so acute liver injury often involves lengthy hospital stays, serial blood testing, intravenous fluids, medications, and special feeding procedures.

Chronic liver disease is becoming more common as the life span of the pet population increases. Signs of chronic liver disease are similar to acute liver disease but are slower in onset and may appear gradually over the period of several months; weight loss, increased thirst, and increased urination may also indicate chronic liver problems. Identifying chronic liver disease often entails a full work-up including blood and urine testing, abdominal ultrasound, and even liver biopsies and culture, in some cases. Treatment for chronic disease focuses on supporting the liver with antioxidants like milk thistle extract, vitamin E, and SAMe. Because many chronic liver diseases have a strong immune-mediated component treatment may require immunosuppressive drugs, like cyclosporine or prednisone. Your veterinarian may also recommend special prescription diets that are lower in protein and copper than commercial dog food, which lessens the metabolic burden on the liver and reduces the amount of waste products in the bloodstream.

Since organ transplants are not commonly performed in veterinary patients, early diagnosis and liver specific supportive care makes the largest impact on extending these patients lives. The veterinary community will continue to pursue new and innovative treatment options for patients with liver disease. Currently, there is research being conducted on the efficacy of stem cells in treating chronic liver disease, and we are interested to see the results. If your pet is suspected of having liver disease or has been diagnosed with liver disease our internal medicine and emergency medicine team at Pet Specialists of Monterey is here to help.


Flea Season: The California Myth


Summertime on the Central Coast– sunshine, surf, and… fleas?

Fleas are a part of pet life in California. An effective, year-round flea control plan is essential to protect your pet and your home from infestations. Unlike many parts of the country, our winters are mild enough that flea populations can survive and reproduce all year long.

For most pets, a flea bite triggers a mild temporary itch, but some pets can develop severe allergies to flea saliva. Flea allergy dermatitis can result in redness, flakiness, hair loss, and injuries from your pet scratching himself/herself. Many owners of flea-allergic pets are unaware that their animal is flea-allergic because they never see fleas on their pet. However, for flea-allergic pets, even a single bite is enough to ignite a reaction that can last for several days. Even for non-flea-allergic pets, fleas can pose a hazard to their well-being. Fleas can carry tapeworms, which are passed to pets when they ingest fleas while grooming. Some flea populations carry blood parasites that are transferred to dogs and cats during bites. In cases of large flea burdens, varying degrees of anemia can occur. Occasionally, some cats and dogs will have such a severe flea anemia that they will require one or more blood transfusions to survive.

Fortunately, there are several convenient and effective flea control products on the market today. The product currently recommended for dogs by dermatologists is Comfortis®, a monthly chewable tablet that kills fleas within minutes. The active ingredient in Comfortis is spinosad – a safe and effective insecticide that won the EPA’s Presidential Green Chemistry Challenge in 1999 and is approved for use in organic farming. Oral flea control medications like Comfortis can be preferable to spot-on topical treatments because they cannot be washed or rubbed off, they maintain their efficacy more reliably between doses, and flea populations have not yet developed resistance to their active ingredients.

The Red Cross Pet First Aid App

The Red Cross Pet First Aid App

We know you love your cats and dogs like family, so we know you love to keep them happy, healthy, and safe.  We here to provide great service and quality medicine in the Monterey Bay but realize you sometimes take your furry family members on vacation and we might not be the closest provider of care for your pet.  With the new Red Cross Pet First Aid App, you can locate the nearest AHAA certified hospital to your location. AHAA certification promotes good medicine and good hospitals. With this app you can locate a hospital that lives up to the same standards as Pet Specialists of Monterey with a few taps on your smart phone or tablet!  The app also features an array of videos, CPR “how-tos”, common toxic substance lists, and step-by-step advice to help you help your pet.  You can locate a pet-friendly hotel, track your pet’s vet appointments, and load Pet Specialists of Monterey’s contact information to be available anytime you need us (which is of course, 24/7)!  We have high hopes for the versatility of this app and the power it provides to you as the protector of your pets health, so follow the link below and check it out!

Pet First Aid

Happy Halloween

photo(3) Happy Halloween from the Pet Specialists of Monterey

On a holiday where candy abounds and trick or treaters fill the streets don’t forget to protect your furry family members from the fun and festivities.

Lock up the candy tight, keep your kitties indoors well before it gets dark, and as always we are here if you need us.

Halloween Dangers

Pet Poison Helpline Warns Pet Owners about Halloween Dangers

The Most Prevalent Toxic Substances

A record-setting 70 percent of Americans celebrated Halloween in 2011, according to the U.S. Census Bureau. Unfortunately, it was also a very busy time at Pet Poison Helpline. During the week surrounding Halloween in 2011, call volumes increased by 21 percent, making it one of the call center’s busiest weeks on record. Pet Poison Helpline is a 24-hour animal poison control service that assists pet owners, veterinarians and veterinary technicians who are treating potentially poisoned pets.“Every year during the week of Halloween our call center gets busy, but never at the levels we experienced in 2011,” said Ahna Brutlag, DVM, MS, DABT, DABVT associate director at Pet Poison Helpline. “Many of the cases we handled were for dogs that ingested Halloween candy – the most common denominator being chocolate. By being cognizant of potential hazards, pet owners can help reduce the likelihood of pet poisonings this Halloween.” 

The most common Halloween hazards for pets are chocolate, candy overindulgence, raisins, candy wrappers, glow sticks and jewelry and candles.

  • Chocolate – Of all candies, chocolate poses the biggest Halloween “threat” to dogs. Many dogs are attracted to the smell of chocolate, making it a significant threat for massive ingestion. The darker and more bitter the chocolate, the more poisonous it is. Methylxanthines are the chemicals in chocolate that are dangerous to pets, and they are more concentrated in darker chocolates. A single ounce of Baker’s chocolate can make a 50-pound dog very sick. Milk chocolate and white chocolate are less dangerous, but should still be kept out of the reach of pets.  If you think your dog may have ingested chocolate, signs to watch for include vomiting, diarrhea, lethargy,  agitation, increased thirst, an elevated heart rate, and in severe cases, seizures.
  • Candy and sweets overindulgence – Candy and other sweet foods – especially those containing poisonous xylitol – can also be poisonous to pets. Large ingestions of sugary, high-fat candy and sweets can lead to pancreatitis in pets. Potentially fatal, pancreatitis is inflammation of the pancreas and very painful. Pet owners should be aware that clinical signs of pancreatitis may not present for several days after ingestion. Signs include a decreased appetite, vomiting, diarrhea, lethargy, abdominal pain, and potentially, kidney or organ damage.
  • Raisins – Mini-boxes of raisins can be a healthy treat for trick-or-treaters, but they are extremely poisonous to dogs! Raisins are so dangerous that they deserve the same pet-proofing treatment as chocolate – stored in secure containers far from their reach. Dogs can experience kidney failure after ingesting very small amounts of raisins (including similar products with grapes and currants too). For this reason, any ingestion should be treated as a potential poisoning. Signs of raisin or grape poisoning include vomiting, nausea, decreased appetite, lethargy, abdominal pain, excessive or decreased thirst and urination, bad breath, and rapid onset kidney failure.
  • Candy wrappers – When pets get into candy, they can eat the wrappers too. Ingestion of foil and cellophane wrappers can sometimes cause a life-threatening bowel obstruction, which may require surgery to correct. Watch for vomiting, decreased appetite, not defecating, straining to defecate, or lethargy. X-rays or even ultrasound may be necessary to diagnose this problem.
  • Glow sticks and glow jewelry – Due to their curious nature, cats often accidentally ingest glow sticks and jewelry because they are bright and fun to chew. While not usually life-threatening, the contents can cause mouth pain and irritation, as well as profuse drooling and foaming. If your cat chews on glow jewelry, offer a tasty snack to help remove the product from the mouth. Bathing the chemical off the fur is important too, as grooming can contribute to further poisoning.
  • Costumes – If you put a costume on your pet, make sure it doesn’t impair his vision, movement or air intake. If it has metallic beads, snaps or other small pieces, be aware that these pieces, especially those that contain zinc and lead, can result in serious poisoning if ingested. Also, before thinking about dying or coloring your pet’s fur, consult with your veterinarian, as some products can be very harmful to pets, even if it’s labeled non-toxic to humans.
  • Candles – Curious noses and wagging tails have a way of finding lit candles. Keep candles out of your pet’s reach to prevent accidental thermal injury or burns.



This Halloween, please keep your pets safe. If you think your pet has ingested something poisonous, the veterinary and toxicology experts at Pet Poison Helpline suggest that it’s always easier, less expensive, and safer for your pet to be treated earlier, versus when he’s showing severe symptoms. Pet Poison Helpline is the most cost-effective animal poison control center in North America at only $39 per call, including unlimited follow-up consultations.

About Pet Poison Helpline Pet Poison Helpline, an animal poison control center based out of Minneapolis, is available 24 hours, seven days a week for pet owners and veterinary professionals that require assistance treating a potentially poisoned pet. The staff provides treatment advice for poisoning cases of all species, including dogs, cats, birds, small mammals, large animals and exotic species. As the most cost-effective option for animal poison control care, Pet Poison Helpline’s fee of $39 per incident includes follow-up consultation for the duration of the poison case. Pet Poison Helpline is available in North America by calling 800-213-6680. Additional information can be found online at Poison Helpline has an iPhone application with an extensive database of plants, chemicals, foods and drugs that are poisonous to pets. A powerful indexing feature allows users to search for toxins and includes full-color photos for identifying poisonous plants and substances. With a direct dial feature to Pet Poison Helpline, the app is called “Pet Poison Help,” and is available on iTunes.