Expert: Jessica - 10/1/2010

Question
QUESTION: Hi,
My cat is a 3 year old orange tabby, and he has some health problems. First
off, when we rescued him as a kitten it became apparent that he had genetic
gum disease, which has only gotten worse. We have taken him to the vet
countless times and they have not been able to fix it, though they diagnosed
it. Also, the reason for my question is my concern for his heart. Even at just 3
years, he seems to have slowed down greatly, and it has been this way since
he was about 1 and a half years old. Several times in the past year we have
found him coughing and gagging, like a hairball, only he never coughed
anything up. After that, he just lies sprawled on the floor for hours panting
heavily without moving, even if we try to move him around, but then he
eventually gets over it. Also, he has very little tolerance for exercise, and after
just a few minutes of running around, he gets exhausted and pants like crazy,
but refuses water. The vet suggested we see a cardiologist for him, and we
have a call into one, but in the meantime it can't hurt to hear some ideas. Do
you have any idea what is going on? Thank You! Jeff

ANSWER: Hi Jeff,

I would be suspicious of heart problems, too.  The most common type of heart disease in cats is Hypertrophic Cardiomyopathy.  This is caused by a thickening and inflexibility of the heart muscles.  This results in an inadequate amount of blood being pumped through the kitty's system, so he doesn't get as much oxygen as he should when he exerts himself, and he can feel easily tired.  The heart also becomes enlarged and can cause the coughing.  At times, it leads to a secondary problem called Congestive Heart Failure, which is fluid surrounding the heart.  

Congestive Heart Failure can be present for other reasons and will cause the same kinds of symptoms as Hypertrophic Cardiomyopathy, but the treatments are different.  So it's important for a cardiologist to sort out whether heart problems are present, and if so, which kind.

Also, I would suggest having a heartworm test done.  Feline heartworm is being found to be more common than we realize, and even indoor cats have become infected.  There is a blood test available, and while it has its limitations, it may be valuable in helping to diagnose your cat.  

When his heart problems are all sorted out, you may want to consider having his teeth pulled.  Cats with chronic gum problems, called stomatitis, often have a full resolution once all the teeth are removed from the mouth.  This is because the problem is due to an immune response to bacteria, which are abundant in plaque.  The body attacks the soft tissues of the mouth anywhere that plaque comes in contact with them.  When plaque is unable to form on the teeth near the gumline, the problem is usually solved.  I've had numerous cats with the condition and tried every treatment from antibiotics to steroids to mouth rinses, and nothing has worked, but removing the teeth solves the problem every time.

Best of luck!

Jessica


---------- FOLLOW-UP ----------

QUESTION: Thanks for the quick response! Another thing i forgot to mention is that as he is
an orange tabby, he has pink paws and ears. Lately, it seems his ears paws and
nose have become extremely pink and he licks his paws all of the time. He also
gains and loses weight all the time. Finally, i would have his teeth removed, but
he is so picky about food and already has so much trouble eating.

ANSWER: Surprisingly, cats with tooth and gum issues have a lot more trouble eating WITH teeth than without.  It's so painful for them, that they become finicky eaters, and they often drop food from their mouths in pain.  Once the teeth come out, the gums heal up, and they easily pick up and swallow their food without chewing (cats only chomp their food 2-5 times, anyway).  Cats without teeth go on to eat canned food or dry, provided they're given soft food for a few days post-surgery while their gums heal.

As for the extreme pink color of his paws and nose, this can be a sign of physical stress.  His constant licking of his paws can be a sign of emotional stress but might also indicate itching, and redness is consistent with this, too.  Some auto-immune diseases, such as discoid lupus, can cause paw pad redness, swelling, and discomfort that leads to licking.  The nose is also often affected.  Cats with one auto-immune disease, like lupus, are likely to have a second, such as stomatitis.  There are several other causes, as well.  

You should bring your cat's paw problems to the attention of your vet.  If it appears to be auto immune in nature, an immune suppressant might be recommended.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your help! Just a few more questions. First, is it
possible that it could be affecting his personality? Because he has pretty
much always been pretty independent, but still sweet. He is very
tempermental though, so if hes lying down and i sit near him, he moves
away. He likes affection on his terms. He doesnt mid being carried, but
hates to be held in place, an prefers petting. Could this be because of
whatever is wrong with him? In his first year he was much more
affectionate, nibbling at my nose and chasing my feet. This behavior has
slowly decreased to now, when he rarely shows affection unless we just
return home from a vacation. Over the past few days, he looks very
irritated all the time, with his ears flattened or at half mast all the time.
Finally, he is sometimes mean to our younger abbysinian, and if she
comes to close to him when they play he hisses at her? What do u think?

Answer
Behavioral changes are almost always due to illnesses or stress, and I think in this case, a physical illness is a very likely cause.  His apparent breathing troubles and his mouth pain would each be enough to cause him enough discomfort to cause social withdrawal and irritability.  Fortunately, cats typically return to their happy-go-lucky states once underlying medical problems are resolved.  When the behavior is believed to be stress-related, anti-depressants may help.