Topics covered:

• How to assess your cat
• Feeding
• Medicating
• Wound care
• TLC and wellbeing
• Monitoring
• When to contact your vet

How to assess your cat for signs of ill health
Observe your cat from a distance

Record the breathing (respiratory) rate: -
Normal - Smooth, even and effortless breaths at 15-30 breaths per minute.
Note any changes in depth of respiration and how the cat is breathing. For example, is the breathing laboured.
Common reasons for an increased respiratory rate:-

• Heart failure
• Stress   
• Pain    
• Lung problems e.g. pneumonia                
• Pyrexia (high temperature)                   
• Endocrine disorders e.g. Hyperthyroidism

Check the colour of the mucous membranes (MM’s) and capillary refill time (CRT): -
Gently lift up your cats lip and look at the colour of the gums. To check the CRT press your thumb onto the gums (this will stop the blood filling the capillaries under your thumb) and then after 2 seconds remove your thumb. The area of gum should quickly return to its original colour as the blood re-enters the capillaries. The normal time for this to happen is less than 2 seconds. More than 2 seconds suggests poor circulation or dehydration.

Normal - Pale pink MM’s and CRT <2 secs
Pale - Anaemia, shock
Purple/ blue - Hypoxic (lack of oxygen)

Take your cat’s pulse/ heart rate
You can easily take your cats heart rate by gently placing your hands just behind his/her front legs and towards the bottom of your cat rib cage. By applying gentle pressure you should be able to feel the heart beat. You should count the number of beats over a period of 15 seconds and then times that by 4 to give you a heart rate over 1 minute.
The easiest pulse to find on your cat is the femoral pulse. This is located on the inside of your cats hind limb and can be found by placing you hand around your cats thigh and applying gentle to moderate pressure just behind your cats thigh muscle with your fingers. This can take some practice but once found should be counted over 15 seconds and then multiplied by 4. The pulse rate should be the same a the heart rate.

Normal values: -  110 - 180 beats per minute

Common causes of a raised pulse/ heart rate: -

• Heart problems
• Stress
• Pain       
• Pyrexia                
• Endocrine disorders e.g. Hyperthyroidism 

Take your cats temperature: -

• If using a mercury thermometer, shake the mercury down to the base.
• Lubricate the thermometer with KY jelly or “Vaseline”
• Gently insert the thermometer 3cm into the rectum and hold it there for 1 minute
• Remove the thermometer, wipe off the lubricant with a swab and take the reading.

Normal values: - 38 - 38.5˚C

Common causes of a high temperature: -

• Infection
• Pain              

Common causes of a low temperature: -

• Shock   
• Inflammation                 
• Hot environmental temperature
• Cold environmental temperature and lack of mobility
• Thermometer stuck in poo!

How to reduce your cat’s temperature: -

Take care not to reduce your cats temperature too low or too rapidly!

• Reduce environmental temperature
• Apply cool face cloths/ towels
• Apply an ice pack wrapped in a towel to sites that are swollen and inflamed

How to increase your cat’s temperature: -

Take care not to overheat your cat!

• Increase environmental temperature e.g. move the cat into a warm room
• Place bubble wrap/ foil around your cat – these are very good insulators and conform well
• Take care when using heat pads/lamps and hot water bottles – These are very prone to becoming too hot and if your cat is immobile then burns are likely to occur. When hot water bottles cool down they draw the heat away from the animal therefore having the reverse effect.

Checking your cats hydration

Daily water requirement: - 50mls/kg

Cats receiving a moist diet will obtain most, if not all, of their daily requirements in their food.

Signs of dehydration: -

• Skin tenting 
• Sunken eyes 
• Dry/tacky mucous membranes
• Dehydrated cats will often be generally depressed and lethargic, stop grooming and lose their appetite

Common causes of polydipsia (increase in thirst): -

• Renal failure 
• Hyperthyroidism
• Diabetes mellitus (“sugar diabetes”)
• Drugs – diuretics e.g. frusemide

If your cat seems very thirsty it can be a good idea to measure your cats water intake. This can easily be done by giving your cat a measured amount of water and then re-measuring it at 8 hour intervals up until 24 hours later.
Collecting a urine sample from your cat and taking it to the vet to be tested can also be very useful. As long as your cat will use a litter tray this is also easy to do. You will need to keep your cat in for a day and supply your cat with a clean litter tray. Instead of filling it with normal cat litter it should be filled with non-absorbable litter. This can usually be supplied at your veterinary practice but if this is not available then using aquarium pebbles, usually sold at a pet shop, is a good alternative. Once your cat has produced a sample you can then transfer it into a sterile sample pot with a syringe, both of which can be supplied by your vet.
N.B. Do not put a urine sample into an empty jam jar. Even after cleaning it can still contain traces of sugar which will give a false glucose result when testing the urine. 

Feeding

Why nutrition is important: -

• Supply of essential nutrients
• Growth
• Reproduction
• Avoid body catabolism (breakdown of body structures) 
• Maintain immune function and ability to fight disease
• Energy                                                                                      

Reasons to be concerned about your cat’s appetite

- Anorexia - Lack of or no appetite. Causes include pain, infection, inflammation, change of diet etc.
- Polyphagia - Increased appetite. Causes include endocrine disorders such as diabetes mellitus and hyperthyroidism.
- Dysphagia - Difficulty in eating. Causes include pain in the mouth due to dental disease


How to encourage your cat to eat: -

Offer different foods: -

Tinned/wet foods e.g. pouches
Tinned/wet foods are very palatable. They are usually complete foods which means they have been specifically balanced to provide all the nutrition your cat needs. They will obtain most of their daily water requirement from wet foods but water should still be offered at all times. Because wet foods are made up of 75% water, they can help increase a cats water intake. This is a particular advantage for cats with urinary tract problems as an increased amount of urine production reduces the chance of crystal and stone formation. Wet foods are easy to eat and so are more accepted by cats after oral surgery and cats that are weak.

Dry foods
Dry cat foods are also very palatable. If feeding your cat a dry food make sure that it is a complete food as many are complementary and so do not meet all your cats nutritional requirements. Complementary foods should only be given as a treat. Some dry foods are designed to reduce tartar build up onto the teeth but dry foods should not be used immediately after oral surgery.

Liquid foods
Liquid foods are very palatable and are usually complete diets. They are very energy dense and so are ideal for convalescing cats and cats with a reduced appetite. Liquid foods can be lapped and so are ideal for cats post-oral surgery. Cats can also be hand fed and syringed easily with liquid diets.

Prescription diets
Prescription diets are foods that have been prescribed by your vet to help with a specific problem/disease. These diets are not available from a pet shop or supermarket as they are specially formulated for a particular problem and should not be given to a cat without that problem. Whilst on this diet, your cat will require regular monitoring by a veterinary surgeon just the same as if your cat is on a longterm medication. Some prescription diets are not as palatable as a “normal” diet and so it can sometimes be difficult to introduce a prescription diet to your cat. However dry prescription diets are generally accepted more readily by cats than the wet form. As with any new diet, gradual introduction by mixing small amounts of food with your cats usual diet will usually make acceptance quicker and less likely to cause digestive upsets.

Human foods
When trying to encourage an anorexic cat to eat it is common for people to offer their cat some of their own food. Whilst cooked fish or chicken can be a good idea to stimulate your cats appetite some human foods are not ideal. Foods containing onions e.g. baby foods which contain onion powder are very unsuitable for your cat and although they may be palatable, can be very toxic and life threatening if ingested by a cat.

Ways to encourage your cat to eat

Cats have a very sensitive sense of smell and so warming the food to increase the aroma will encourage your cat to eat. If your cat has any discharges around the nose and mouth these should be bathed away first before offering any food.

If your cat is feeling nauseous then surrounding your cat with many foods and/or giving large quantities can increase the nausea. Offer one tablespoonful at a time and choosing your cats favourite bowl or plate will also encourage your cat to eat.

One of the best ways to encourage your cat to eat is by handfeeding. This helps by stimulating the cat and works particularly well if done by a familiar person. Handfeeding provides minimal stress to your cat and is very rewarding for you.

If all else fails, your vet can prescribe appetite stimulants. These can work very well but should be accompanied by the above techniques.

Assisted feeding

Encouraging your cat to eat is not always successful and in some cases the above techniques are not effective or desirable. In these cases assisted feeding will be necessary. There are several techniques widely used, these are: -

Syringe feeding
Syringe feeding can be quite stressful for your cat as food is forced into the mouth and there is a risk of inhalation of the food. It can also be quite messy and stressful for you if your cat refuses to swallow or becomes distressed with this procedure.

Naso-oesophageal feeding
Naso-oesophageal feeding is where a small tube is placed through the nose down to the distal (lower) oesophagus (food pipe). The tube is secured with tape onto the cats nose and then onto an elizabethan collar which the cat will wear. An anaesthetic is not required and the tube is generally tolerated well by cats. Feeding is not stressful for you or your cat and your cats calorie requirement can easily be met using a liquid diet. Even with the tube in place your cat will be able to eat normally and so it is easy to tell when it is safe to remove the tube.

PEG tube feeding
A Percutaneous Endoscopic Gastrostomy (PEG) tube is a tube that is placed from the outside of the cats abdomen, straight into its stomach using an endoscope. Your cat will need an anaesthetic for placement and removal of the tube but once in place it is usually tolerated very well. Feeding is very easy, safe, pain free and causes minimal stress to you and your cat. Your cats calorie requirement can easily be met using a liquid diet and medications can also be given through the tube. As with the naso-oesophageal tube, your cat can still eat normally and so the decision to remove the tube can be easily and safely made.

Medicating

Medicating your cat can be a real challenge. For more information on how to successfuly administer a tablet, click here...

If you still find it difficult to give a tablet orally you can also try the following methods:

• Use a pill popper
• Crush the tablet into food – Note: -Some tablets e.g. enteric coated tablets should not be split or crushed
• Multiple tablets can be put into a gelatine capsule and given as one.
• Capsules can be opened up and have the contents emptied into food – Check with the vet before doing this as some capsules are designed to dissolve at a certain time in the digestive tract.

Wound care

All wounds should be checked at least twice daily for signs of inflammation, swelling, discharge and pain. Wounds that need to be cleaned can be bathed using a salt water solution of 1 teaspoon of salt in 1 pint of warm water.
Skin and wounds at risk of urine scalding for example, incontinent cats, should have Vaseline applied twice a day as a barrier cream to prevent this.

Monitoring

Cats should have their urine and faecal output monitored as this can give you important information about your cats condition.

Urine: - On average cats should urinate once every 12 hours. No signs of straining or discomfort should be observed and reasonable amounts (12 –24mls per 12 hours) of urine should be passed at once. The urine should be pale yellow in colour and clear.
Infrequent amounts of concentrated urine may indicate dehydration whilst a cat that is straining to pass urine or passing bloody urine may suggest cystitis or a urinary blockage (see when to contact your vet).

Faeces: - Faeces should be passed every 24-36 hours. The colour, consistency and amount should be noted along with any signs of straining.
Cats that are infrequently straining to pass hard dry faeces could indicate constipation possibly due to dehydration or there may be a mechanical problem with the digestive tract. Faeces containing fresh blood may be seen in cats with colitis (inflammation of the lower digestive tract) whilst faeces with dark/old blood may be seen in cats with disease affecting the stomach or small intestine.

TLC and wellbeing

If your cat is caged, isolated or has to wear an elizabethan collar it will not be able to carry out its normal feline behaviour. In particular cats that have to wear an elizabethan collar will be unable to groom and sometimes have difficulty in eating and drinking. Cats that have been hospitalised in a cage will not be able to stretch and move around freely which will not only depress your cat but will slow gut motility. All cats should be given a “time out” period each day, whether this is removing the elizabethan collar to allow grooming, letting your cat out of the cage so it can stretch or taking it out in a carrier to allow your cat to get some fresh air. This will not only provide great stimulation for your cat but aid in a quicker recovery. All “time out” periods should be observed at all times especially as an elizabethan collar will be being used to prevent licking and overgrooming of a certain area which will still need to be prevented during this time.
Some cats will also appreciate grooming and cats that are mobile can be taken into the garden on a harness if required and safe to do so.
Longhaired cats suffering from diarrhoea will sometimes benefit from having a tail bandage applied. This will stop your cats tail from constantly being soiled and will make it easier for you to clean your cat. Your vet should apply tail bandages, as they can be quite difficult to stay on without bandaging too tightly.

When to contact your vet

When there seems to be a problem with your cat it can be quite difficult to know at what point to contact your vet. Below are guidelines to help you assess your cat: -

Immediately
- Any sign of respiratory distress – breathing with the mouth open, laboured or rapid breathing
- Collapse
- If the colour of the mucous membranes are very pale, yellow or blue tinged
- If any toxin has been eaten
- Continuous vomiting
- Pain when passing or straining to pass urine, especially if there is little or no production
- Bloody urine
- Any wound which is very inflamed, swollen, painful and discharging
- If a known diabetic is showing signs of disorientation, twitching or restlessness
- Any seizuring animal (especially if seizuring for more than 2 minutes)
- If a lactating queen shows any signs of twitching, disorientation, restlessness and excessive vocalisation
- If your cat seems in pain
- If your cat suddenly loses its vision
- If your cat becomes paralysed in one or more legs

Within 12 hours
- Excessively high or low temperature (usually combined with lethargy)
- Urine has not been passed for 12 hours but with no straining or showing any desire to pass urine
- Straining to pass faeces on more than 1 occasion
- Large amounts of blood (fresh or old) in the faeces on 1 occasion or small amounts frequently
- If your cat hasn’t drunk for 24 hours – sooner if he/she seems unwell

Within 24 hours
- If your cat has not eaten within 24hours – sooner if your cat seems unwell or has a known medical problem
- Diarrhoea that has failed to clear after 24 hour starvation followed by the introduction of a bland diet e.g.   fish/chicken

Within 48 hours
- Excessive drinking for more than 24 hours but otherwise seems well – see advice on measuring water intake
- Excessive eating for more than several days, especially if losing weight
- No faeces passed for 2 days