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Being a cat veterinarian is like being a pediatrician. We can’t ask our
patients what’s wrong. We have to figure it out. And nowhere is the
role of a cat owner more important than at a veterinarian’s office,
where a good history can sometimes mean the difference between life and
death.
Veterinarians are faced with a variety of diagnostic challenges on a
daily basis. The ability for a veterinarian to obtain a detailed and
complete history is our most important diagnostic tool. When accurately
interpreted, this information lays the groundwork for a logical
diagnostic and therapeutic plan, and may prevent unnecessary diagnostic
testing and needless discomfort to the patient and cost to the owner.
After briefly discussing the primary complaint, veterinarians try to
obtain both objective and subjective information when gathering the
history. Examples of objective data include the signalment, the
environment, diet, and medical history.
Signalment
The signalment consists of the cat’s age, breed, and gender, including
whether the cat is neutered or spayed. This is basic, important
information. Certain illnesses tend to strike cats at certain age
ranges. For example, hyperthyroidism is a glandular condition that
causes cats to lose weight, despite a ravenous appetite. It’s an
old-age disease, rarely striking cats under the age of eight. A 13-year
old cat with weight loss and excellent appetite warrants a blood test to
evaluate thyroid function. A four-year old cat with the same signs
would be more likely to have something else, such as inflammatory bowel
disease or pancreatic insufficiency. Even if you’re not sure of the
exact age, an accurate approximation can be very useful for a
veterinarian.
Certain breeds are predisposed to certain conditions, and knowing the
breed can help veterinarians choose proper diagnostic tests. Persians
are prone to polycystic kidney disease; Abyssinians are at high risk for
renal amyloidosis; and Maine Coons are susceptible to hypertrophic
cardiomyopathy. Veterinarians must not be misled by clients who tell
their veterinarian that their cat is a Maine Coon, only to find out that
it’s a domestic longhair that “looks just like the Maine Coon in the
magazine”.
Gender provides important information as well. A female cat straining
to urinate is likely to have cystitis. A male cat straining to urinate
could have a urinary obstruction, something that can be life-threatening
if not treated promptly. Fortunately, there’s very little guesswork
when it comes to determining gender. Just lift the tail and take a
look!
Environment
Gathering environmental history is a routine, yet important part of a
cat’s history. Free roaming cats or cats that go outdoors are at much
higher risk of getting into fights with other cats, and that increases
their risk of getting cat bite abscesses or acquiring feline leukemia or
FIV. Free-roaming or recently escaped cats may have had access to
toxins or have been subject to trauma, which is unlikely in an indoor
pet.
Sometimes a travel history is important, although more so with dogs than
cats, since cats, if they do travel with the owner to another part of
the country, usually aren’t let outdoors, where they are at risk of
running away or getting lost. Still, a travel history can be important,
especially if the patient has been exposed to diseases endemic to
certain regions but not prevalent in the current environment.
Dietary history
A dietary history is more than merely determining which type and brand
of food you’re feeding. Granted, knowing the type of diet (dry, moist,
semi-moist, table food), the brand name, any types of snacks, the method
of feeding (free-choice or individual meals) and the amount is
important, but veterinarians also want to know about your cat’s appetite
and whether there has been any weight gain or weight loss. It’s helpful
if you watch your cat eat. Complete or partial anorexia is a common
reason that clients take their cat to the veterinarian. A client that
notices that their cat only chews on one side of its mouth, or has
stopped eating dry food and now will only eat canned food, is telling
the veterinarian that oral pain or discomfort may be the source of the
problem, and a thorough oral exam may be the only diagnostic test
necessary to obtain the diagnosis.
Preventive health
care status and prior medical history
Reviewing the patient’s prior medical record can give valuable
information to the veterinarian. If this is your first visit to this
particular veterinarian, it is very helpful if you know your cat’s
vaccination history, and you cat’s feline leukemia virus and feline
immunodeficiency virus status. Medical records detailing the diagnosis
or treatment of any prior or ongoing health problems are invaluable, as
the primary complaint may be a consequence of a prior medical
condition.
Once the above information is obtained, the veterinarian is ready to
delve deeper into the primary complaint. The history surrounding the
primary complaint tends to be more subjective, and this information
obtained from observant, conscientious owners can be a tremendous asset.
Veterinarians know that some owners aren’t as observant as others. Our
job is to encourage our clients to describe the cat’s problem from its
onset so that an orderly chronology is obtained. Some of the things
we’ll want to know is when the cat was last normal, whether the onset of
the clinical signs was sudden (acute) or if it developed slowly over
time (chronic), and whether the illness has responded to previous
treatment or not. For example, an itchy cat that was treated with
steroids and did not respond in the past is more likely to have food
allergy (poorly responsive to steroids) than flea allergic dermatitis
(responds rapidly to steroids).
Depending on what the primary complaint is, a veterinarian may delve
even deeper, to further help characterize the problem and better
formulate a diagnostic plan. As an example, if a client reports that
their cat has diarrhea, the veterinarian may then ask whether there’s
any blood or mucus in the stool, whether the cat has been straining in
the litterbox, or whether the cat has had any accidents in the house.
The more the client answers yes, the more likely that the diarrhea has
originated from the large intestine. This narrows down the list of
possible causes for diarrhea, and helps the veterinarian formulate a
diagnostic and therapeutic plan. Working with breeders has its
advantages. Breeders tend to be much more observant than the average
cat owner, and often come in with very detailed histories. They know
that the cat’s coat should look sleek and glossy, and are more keenly
aware when the coat looks a bit rough or unkempt. Most clients are
unable or unwilling to take their cat’s temperature at home. Breeders,
however, seem to have little problem with this. Information like this
can be a big help to a veterinarian. In the exam room, a cat may have a
borderline fever, and this can be difficult for a veterinarian to
interpret, as cats will have elevated body temperatures when they’re
nervous. If a client tells me that their cat had a fever at home, in
their comfortable surroundings, then I know that the fever I’m seeing in
the exam room is likely to be genuine, and not due to the stress of the
examination. As a veterinarian, I encourage my clients to perform their
own brief physical exam on their cats on a regular basis. This should
include a brief examination of the eyes to see that they’re bright and
clear and free of any discharge, the ears should be a healthy pink color
inside with no signs of discarge or accumulation of dark-colored wax,
and the nose should be damp and velvety to the touch and have no
discharge or crusting on the surface. The mouth should be examined
regularly, to make sure the gums are pale pink, the teeth aren’t
yellowed or covered with tartar, and that there’s no foul odor present.
Cat owners should also stroke and pat their cat often, not just because
the cat enjoys it, but to also feel for any lumps or bumps that might be
present. Feeling along the abdomen for any masses or swellings
associated with the mammary glands is also advisable, as mammary tumors,
while not as common in cats as in dogs, are much more worrisome in cats.
Behavioral changes can be difficult for veterinarians to interpret. I’ve
had many clients bring in their cat because the cat was acting
different, although on further questioning, it became apparent that the
cat wasn’t actually ill, despite the difference in behavior. Cats who
suddenly stop sleeping on the bed even though it’s been their favorite
sleeping spot for years, or normally vocal cats who lately have become
more quiet may indeed be acting differently, but these are quite likely
to be benign behavioral changes. Lethargy, hyperactivity, aggression,
growling, and urinating or defecating in inappropriate places, however,
are behavioral changes that may indicate an underlying medical problem.
When in doubt as to whether any apparently new behaviors are medically
significant or not, it’s best to err on the cautious side and report
everything to your veterinarian.
Because our patients cannot talk, veterinarians must rely on you, the
client, to speak for them. The more observant you are, the more
information you can give us. This information can go a long way toward
obtaining the proper diagnosis, allowing us to tailor a treatment plan
to put your companion quickly on the road to recovery.
Updated 2/9/06 |
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