Expert: Ali - 3/20/2009

Question
Ali, I am a nurse in a nursing home.  We have 2 cats that live there.  They are brother and sister and are 10 years old.  I care for them as far as feeding them and cleaning their litter box.  They have lived there  2 1/2 years.  Both cats adjusted well and have appeared very happy.  Jodie is a female siamese /tabby mix.  She has a sensitive stomach and has had issues with vomiting.  I only found out recently that she vomits almost daily since she moved in!  No hairballs, generally whole pieces of food.  A couple weeks ago I found that she had vomited several times on a resident's bed & deficated on the bed.  She had never deficated outside of the box before. (The resident whose bed she soiled is her favorite resident.  Jodie sleeps with her nightly and spends most of her time with her.  This resident is a cat-lover who adores Jodie).  I brought her to the vet where they hydrated her and started her on a trial of an antacid medication.  She also got her teeth cleaned a couple days later and had one pulled.  The vet thought she may had been vomiting because of tooth pain preventing her from chewing her food well.  Things seemed to have improved greatly.  Now for two consecutive days she has vomited and deficated in other rooms.  (Stool is formed. Not loose)  I realize she will need to be seen by the vet again.  I can get help from the vet to rule out physical illnesses.  My question to you is what if the deficating is purely behavioral? I have read your responses to similar questions but Jodie's situation is unique. There are so many factors that I cannot control due to Jodie living in a nursing home.  There are plants that she can (and does) eat.  I cannot move her box or her food.  They are near eachother but they always have been.  Type of litter has not changed.  The only obvious change is that a resident she liked moved away (not her favorite), but she could be upset for reasons I don't know of.  I'm committed to helping her.   Karen

Answer
Karen,


As promised I have enclosed the response from a holistic vet in the Ask the Vet portion of this site.
Subject: House soiling in a "nursing home cat"
Volunteer Expert: Dr. Christina Chambreau

Question:
Dr. Chambreau,

I am an expert in the cat category and I have many years experience in dealing with common behavioral challenges that can happen with house cats. I recently received a  request for help from a nurse in a nursing home, one of their 10 year old cats, Jodie has been soiling residents' beds. The nurse who cares for Jodie and her brother informed me that Jodie has a long history of vomiting whole pieces of food daily, about 2 1/2 years or so which is how long the cats have been living in the nursing home. This led to a trip to the vet where Jodie had her teeth cleaned and an infected tooth extracted, the vet suspected that Jodie had difficulty chewing her food which led to her vomiting so along with the dental care and extraction Jodie was also prescribed an antacid to relieve any tummy upsets. Since Jodie's been back at work she's been defecating on the beds of different residents, including her favorite resident that she spends most of her time with. Unfortunately due to the fact that there are so many people in this environment and the fact that Jodie can't be watched or have her environment controlled as closely as your average feline living at home by making little changes I'm not sure what to offer. I want so much to help this special cat and her caregiver because this cat is providing a valuable source of friendship, unconditional acceptance to the residents, but I'm at a loss. I offered some basic ideas which included asking about whether Jodie was more likely to soil on the bed of an incontinent resident and I did ask if it was possible to add another litter box - Jodie and her brother are both in residence at the nursing home and I've found that you can never have too many litter pans in a multiple cat home, in fact I usually recommend 1 litter box per cat plus one in instances where a cat isn't house soiling. I also asked whether it was possible for Jodie to have gotten ahold of medications, foods or objects she shouldn't be ingesting either accidentally or at the hands of kind, misguided cat loving residents. My own vet is a holistic practitioner so I know how important the tiny details of a situation can be, I really hope that I've provided enough information for you to get a handle on the situation and possibly offer this nurse and nursing home kitty some special help. I did recommend that the nurse consider seeking the assistance of a holistic vet and trying out some Bach's Rescue Remedy to see if that makes a difference, it's one of those "can't hurt, might help" remedies so I figured it would be something to try...I really hope that you can find the time to help out in this special situation, I'd really appreciate it if you could....I would also like to know if it would be okay for me to refer this nurse to you so that you can help her directly instead of going through me, she may not be aware that such a wonderful holistic practitioner is available on this site and since she's a nurse she may not be aware that alternative therapies can provide stunning results with cats and their human caregivers.

Answer:
Good for you, Ali, for working with holistic modalities. I will include here what I usually send every questioner. What I can offer in a one hit on line, even with all the great details you've given me will not cure this cat. Pass on this email to her and she can find a holistic practitioner, maybe even me, with whom to work. There are some very good acupuncture points (GV 20 and more) that can help if it behavioral. The first step is to restrict the cat to one or two room with her own box there and to discontinue any medicines. Frankly, if she were open to it, I would suggest contacting an intuitive to find out why the cat is doing this. I bet this would be useful to you with many cats in your practice. Love to have you come to some of my classes, or set up some classes where you live. Love to speak directly with you about mutually empowering possibilities - 410-771-4968 or email Healthyanimals@aol.com. So, in general and for this cat:

When I only had my conventional veterinary training, I would also be very frustrated by problems like this. Now that the multitude of holistic modalities is available, I can tell you to never give up. Try one after the other, and record the changes with each.

Please go to my web site and sign up for the soon to appear newsletter - www.ChristinaChambreau.com. On the products page, there are many great supplements.

If you were trained in different healing modalities (see below - YOU BE THE HEALER) you could help by using Reiki, T-Touch, HTA, flower essences, supplements, homeopathy and more.

Now, since you asked a holistic veterinarian, I have several questions for you since everyone has a different relationship with their cherished companion animals.
In addition to healing the current problem,
What are you willing to do to have your pet live a very long and healthy life?
Are you willing to think differently?
Are you willing to do some work when your animal is not sick to maintain health?
Are you interested in saving money on your veterinary bills?

If the answer if yes:
1. Take Classes. 2. Read. 3. Explore on the internet. 4. Find an integrative practitioner.
5. Learn healing methods you can do yourself. 6. Use the fewest chemicals

Start with reading these, or go directly to FIND A HEALER, below.
7 KEYS TO HEALTHY ANIMALS
1. Know the current level of health. Most health problems are the result of an underlying energy imbalance.  As we cure animals of "disease", we find that other things we thought were normal go away.  Your goal is for your animal to have great energy, no doggy odor, no hairball vomiting, little shedding, a glowing coat and many more. Go to the Academy of Veterinary Homeopathy for a complete list of these signs. In young animals, these apparently "normal" problems may be the only indications to start exploring new options for lifestyle or treatment.  Buy the Healthy Animal's Journal (www.HealthyAnimalsJournal.com) so you can see how these early warning symptoms and obvious ill symptoms change over time.  

2. Feed the best. What are the best diets for people or animals -- the most processed or the freshest, most organic?  The best ingredients should be the most consciously raised - local, organic vegetables, free ranging protein sources.  Briefly, the best diet for dogs and cats is raw meat including raw bones, pureed raw and cooked vegetables and a few supplements (Calcium if no bones are eaten is critical). Start as young kittens and puppies or at whatever age you read this (Brighthaven.org, a cat sanctuary switches 16 years old and older cats to raw meat diet and some have lived to 27 and 30). Second best is same quality, but cooked.  Even grocery store quality meat and vegetables are much better than most processed foods. Commercial raw food diets can be great to medium quality. Every animal needs and wants a different combination at different times in their lives, just as we do. With any food, observe each of your animals for the effect that food has on them. NEVER feed DRY food to cats - even as treats.

3. Vaccinate the least. Researchers in conventional veterinary medicine agree that we vaccinate too often, in too many combinations, and that this level of vaccination, while preventing epidemics, is harmful to the health of susceptible animals.  The AVMA now recommends that cats and dogs only be vaccinated every 3 years.  On-going studies show that antibodies are high 10 and 16 years later, so I recommend just a few baby shots then only rabies as needed to be legal. The insert in vaccine packages says “Give only to healthy animals”, so if your animal is ill in any way, or undergoing treatment, they should not be vaccinated. Vaccinated animals often develop many chronic conditions including cancer. A wonderful list serve on vaccines, their harm and alternatives is at yahoo groups. To register, go to jstsayno2vaccs-subscribe@yahoogroups.com

4. Use the fewest chemicals. Each animal is an individual and will respond differently to heartworm, flea and tick preventatives. Some are very sensitive to chemicals used in the yard or the house. Chemicals in foods can cause allergic type reactions. Healthy yards have lots of weeds. House cleaners can be made from foods and microfibril cloths clean like a charm. Healthy animals never get fleas and ticks.   

5. Understand how animals become ill and how they heal. First there is an energetic imbalance (they are just not right), then functional (the dog is itchy), then inflamed (skin is red, infected, swollen and hot) and finally tissue changes (thick, black skin). Results of any treatment can be no change, amelioration (current symptoms disappear with no other improvements, then return), suppression (current symptoms disappear and they become more ill) or a cure (everything about the animal to begins to improve, especially the overall energy level.)  
Keeping a journal is critical to determine what treatments are helping problems to become less frequent and less severe. You can stand firm with what you feel is working even if your professional disagrees and change approaches when needed.
Www.HealthyAnimalsJournal.com is a great one to use.

6. Learn different healing approaches. There are many different ways to stimulate your healing that you never need to give up trying. Flower essences, essential oils, homeopathy, acupuncture, massage, Reiki and chiropractic are a few. Classes are found through your health food store, by phone or on-line.

7. Select the best healers for each animal's health team. Most people want a veterinarian (preferably integrative) and an energy healer. You decide what needs to be tried next for your animal. When you realize the animal is not improving – seek different care.

FIND A HEALER
I strongly recommend finding an integrative veterinarian with whom to work. This is a person trained in many different approaches, including using conventional drugs only when absolutely needed. Working with one can increase the chance that your cherished companion  can live a long and healthy life. There are good ones and great ones, and a few that really are not even holistic. Go to www.VetAdviceLine.com and read the article in the library about selecting and working with a holistic veterinarian. There are other great articles there, as well.
You can go to the web sites for each type of holistic practice and use their referral list to find one near to you:
1. Acupuncture and Chinese medicine: www.IVAS.org & www.TCVM.com
2. Homeopath (these can often help you by phone if no other holistic practitioners are nearby that you like): www.theAVH.org
3. Chiropractor - www.animalchiropractic.org
4. Wide range of other treatments: www.AHVMA.org, American Holistic Veterinary Medical Association
The drawback with the above web sites is they become outdated quickly. If you wish some help selecting the very best practitioner for your animal’s problem or to discuss the best options with a holistic veterinarian by phone, call the Veterinary Advice Line (They may answer the phone “Legal Advice Line or My Professional Advice”, because they do that as well as veterinary advice), speak directly with a veterinarian who can help you find the best local holistic practitioner. 866-4-VETNOW ($35.00)
To become a homeopathic patient of Dr. Chambreau (me), email HealthyAnimals@aol.com for a handout on my practice or view it on my web site.

There are also lots of practitioners and approaches that are used by trained people that you can find by searching the Internet.

YOU BE THE HEALER  

I also strongly recommend getting some training in understanding the wide range of approaches to health so you can be in charge of what you choose for treatments for your animals. This would include only vaccinating when young except for legally required Rabies (Do you get measles, mumps and polio every year of your life?  Did you know the package inserts say to only vaccinate healthy animals?) and exploring feeding fresh foods, not processed. What is best for you to eat – junky processed foods, or locally grown, fresh foods? Also, you can learn Reiki (which can take the "bad" out of vaccines and any needed drugs, or even make food healthier), massage, HTA, TTouch, flower essence therapy, aromatherapy, and many more things you can do to help heal your animals. In addition to classes (see below), there are many very good list serves filled with people experienced with not vaccinating and feeding raw meat diets. Go to yahoogroups.com and look for “Just say no 2 vaccs” and “Raw Paws”. As with human nutrition, there are many different opinions, so you need to experiment and see what makes your animals more or less healthy. Keeping a journal can help you decide what is working and what is not working (www.HealthyAnimalsJournal.com).

www.ChristinaChambreau.com has a listing of courses taught by her and others that may help you. You can do searches online for the many other classes and lectures available. Go to www.theAVH.org for classes every November as part of the annual conference.

Healthy Animal Update is an emailed newsletter that is occasionally sent out – to sign up – go to www.ChristinaChambreau.com. While there check out classes and products.

Good Health and looking forward to seeing you/hearing you in some of my classes.
Dr. Chambreau


REIKI - would be good for all the nursing homoe residents and staff to learn for people and animal health.  Imagine if every residence trained residents in Reiki and they could offer it to the local community to heal people and animals as lower cost since their needs are met:
From the book, Healthy Animal's Journal - "Reiki: Personally, I think every person who lives with or works with animals must know at least Level I Reiki. The practitioner places her hands upon the animal (or it can be done from a distance as some animals are too sensitive for direct touch) with the intent for healing to occur. The energy flows through the healer into the animal. This is based on directly applying Chi (energy) to rebalance the energy field so it no longer needs to produce the physical symptoms. It is a very good adjunct to any healing modality, especially to relieve pain and inflammation. It also "takes the bad out of" things. By doing Reiki on smelly water in restaurants I have been able to drink sweet tasting and smelling water. Use Reiki anytime that you must give injections, vaccines, drugs, flea or heartworm drugs, or other substances with potential toxicity. Do you work in a grooming salon, or kennel, or veterinary clinic, or barn or anywhere animals are being seen? Use your Reiki on any treatments to be given and to calm the animals. People have reported getting animals to eat by doing Reiki on their food.  http://www.reiki.org  . Get a free treatment at www.interdimensionalhealing.com. Great information on Reiki - http://www.reikicourse.orgKathleen Prasad is a wonderful teacher and works with my favorite sanctuary and holistic education center, BrightHaven www.brighthaven.org . Kathleen leads a free monthly telechat for anyone trained in Reiki and using it with animals. http://www.animalreikisource.com/ If you cannot find a Reiki Class near you (same class for people and animals as it connects you through an "attunement" to the healing energy of the universe, making you a channel of healing), three groups offer long distance, free, attunements. http://theholisticcare.com/forums/viewtopic.php?f=6&t=13" http://theholisticcare.com/forums/viewtopic.php?f=6&t=13, http://www.freereikiattunement.com   Another group that offers Reiki attunements, classes and training on-line www.ReikiBlessings.com and animal classes, too www.animalhealers.homestead.com/  



LISTS SERVES TO HELP YOU LEARN TO FEED THE BEST - these are for dogs, but there a few for cats if you search.

I do not personally know all of these, so use your common sense.

http://groups.yahoo.com/group/rawfeeding/

http://groups.yahoo.com/group/DogHealth/

http://groups.yahoo.com/group/CarnivoreFeed-Supplier/

http://groups.yahoo.com/group/dogmentor/

http://groups.yahoo.com/group/RawChat/

http://groups.yahoo.com/group/SeniorRawFeeding/

http://groups.yahoo.com/group/rawbreeder/

http://groups.yahoo.com/group/RawPup/

http://groups.yahoo.com/group/BasicRaw/

And if you are really stuck on a specific issue
http://groups.yahoo.com/group/rawissues/

There is also a list of lists where other raw feeding lists can be found.  Many are breed specific, location specific or subject specific.

http://www.barfers.com/barflists.html


EARLY WARNING SIGNS OF ILLNESS FOR DOGS AND CATS

Most health problems are the result of an underlying energy imbalance, made worse from poor diet and vaccination.  They are rarely acute diseases (except injuries). Therefore, you may find that the problem does not clear up as you expect or it recurs. If so, you are dealing with an underlying predisposition to illness, and these clues to underlying ill health will help you select a remedy and monitor the results.  As we cure animals of "disease", we find
that certain other "NORMAL" things go away, too.  Do not be satisfied until most of the following symptoms are gone.  In young, apparently healthy animals, these apparently "normal" problems may be the only indications to start treatment. This is only the beginning of a list - as more animals are cured we will find new levels of health. Tracking these is easy when you use the Healthy Animal's Journal by Dr. Christina Chambreau (www.HealthyAnimalsJournal.com)

SKIN: doggy smell; attracts fleas a lot; dry, oily, lack-luster coat;
excessive shedding; not grooming,    ear problems - waxy, oily, itchy, recurrent mites; eye discharge, tearing, or matter in corner of eyes; raised third eyelid; spots appearing on iris; "freckles" appearing on face; whiskers falling out; fragile, thickened, distorted claws that are painful or sensitive to trim.
BEHAVIOR: Fears(of loud noises, thunder, wind, people, animals, life); too timid; too rough or aggressive (even at play); too hard to train; barks too much and too long; suspicious nature; biting    when petted too long; hysteria when restrained; clumsy; indolent; licking or sucking things or people too much; not using litter box or not covering stool.
DIGESTIVE: Bad breath; tarter accumulation; loss of teeth; poor appetite; craving weird things(rubber    bands, plastic, dirt, cat litter, paper, dogs eating dog or cat stools, rocks, sticks...); sensitivity to milk;    thirst - a super healthy cat on non dry food will drink at most once a week; red gum line; vomiting often, even hairballs more than a few times a year; mucous on stools; tendency to diarrhea with least    change of diet; obesity;  anal gland problems; recurrent parasites.
STIFFNESS when getting up, early hip dysplasia; tires easily in hot or cold weather; can no longer jump up on counters, or go up or down steps.
TEMPERATURE: Low grade fevers - Normal for healthy cats and dogs is
100-101.5.
AGE & REPRODUCTION: Should live a long life (Shepards 17 years, Danes 12, cats 24). should be able    conceive easily, deliver normally, and not pass on "genetic breed" problems.
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Please find my original answer to your question attached below the solid line....I did some research and I'm waiting for an answer back from a holistic vet. Hopefully I'll be able to go ahead and refer you over to this practitioner so that she can help you and Jodie directly. I must admit that it's very important to me to find a way to help Jodie as I'm well aware that she helps people in tough situations every day...This question is a bit outside my experience, I usually deal with cats living in private homes who develop behavioral issues and as you've pointed out controlling the environment in a nursing home is a bit more challenging...I will let you know immediately if the holistic vet has anything to offer beyond what I've already mentioned and I've asked if it's okay to refer you directly to her...Provided that the holistic vet is okay with me referring you to her I will do so and you guys can work out the best way to help this kitty. I'm glad that Jodie has someone so committed to helping her continue to be a friend to the sick and the elderly residents in the nursing home. As I said before I will do absolutely everything that I can to help out such a special cat....

_____________________________________________________________________

Things are very different for cats living in an institutional environment than they are for cats living in private homes. The environment is much faster paced, there's turn over in the staff and residents and people are in a rush to get everything done. It's possible that Jodie is simply having a tough time coping with the environment for any number of reasons. I would urge you to have Jodie seen by the vet again to find out what's causing her vomiting and defecating outside of the litter box. Given the fact that Jodie is in her late 50's in human terms it's possible that there are health issues which haven't been detected yet. It might be well worth having the veterinarian do a complete pre-anesthetic blood test as this will help him/her to fully understand how Jodie's major organ systems are functioning. Sometimes older cats develop dementia, but I think Jodie's a little young for that, it's something to rule out with the vet. Since you mentioned that Jodie lives in a nursing home I have to ask about the possibility that she's managed to ingest medications meant for human residents, I don't know how likely it is, but it's something to consider.

It's well worth mentioning that Jodie may be the type of kitty who needs to have more than one litter box. Keeping food as far away from the litter boxes as possible can also help to discourage soiling outside of the litter box. I'd strongly recommend washing soiled clothing and bedding that has urine or feces on it as you normally would except for the addition of an enzymatic cleaner such as Petzyme. You can purchase Petzyme by the gallon in the dog section of Petsmart and adding it to sheets, clothing, etc that Jodie has soiled will remove the stain and odor permanently. In terms of behavioral issues since you mention that Jodie lives in a nursing home I wanted to find out whether she's soiling predominantly in rooms where the resident is incontinent? She may be responding to smelling urine/feces the only way that she knows how to, by contributing to it....If this is the case is it possible for Jodie to be on duty during the daytime and put into an easy to clean room for the night when residents are more likely to be unaware of soiled bedding? Another thing to consider is that Jodie may be so sensitive to the stressful environment that she lives in that she's come to a point of physically showing that stress. It's possible that Jodie isn't cut out for life in an institutional environment, but I'm certainly willing to try and help out as much as possible to keep Jodie in her current home because I realize the value of her service to the residents.

If there's no medical cause for these behaviors you can try a homeopathic remedy called Bach's Rescue Remedy which is a blend of flower essences designed to calm and reassure. Rescue Remedy is used by people seeking relief from anxiety as well as being used by veterinarians and pet parents seeking to provide relief from anxiety, trauma, fear or similar emotional states for their pet companions. Rescue Remedy can be administered by placing 5-7 drops into Jodie's fresh bowl of water each morning or you can gently rub 1 drop of this remedy onto the relatively bald area in front of her ears. Do be careful not to get any Rescue Remedy into Jodie's ears because the flower essences are preserved in grape alcohol which can sting if she's been scratching or has any irritation in her ears. You may also want to consider seeking out the assistance of a holistic veterinarian, this is a practitioner that's trained in conventional medicine as well as one or more alternative therapies such as homeopathy, acupuncture or massage to name a few. Often times alternative therapies can help restore balance to a cat and I've seen some amazing things happen when the right therapy is given. I'm going to take some more time, do some research specifically about cats living in nursing homes and see what I can find out that might help the situation.