Ask the Cat Doc: Rapid Weight Loss, Early State Kidney Disease, and More

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Welcome to our regular “Ask the Cat Doc With Dr. Lynn Bahr” segment! Once a month, Dr. Bahr answers as many of your questions as she can, and you can leave new questions for her in a comment.

Dr. Bahr is a 1991 graduate of the University of Georgia’s College of Veterinary Medicine and founder of Dezi & Roo, a company that designs, manufactures, and sells solution-based products that enhance the lives of cats and their owners. She volunteers at numerous animal-related charities and causes and serves on the Fear Free Advisory Board, the Parliamentarian of the Society of Veterinary Medical Ethics, the Cat Committee of the Pet Professional Guild, and the Alley Cat Allies’ Feline Forward Task Force.

Dr. Bahr is co-author of Indoor Cat: How to Enrich Their Lives and Expand Their World, available from Amazon.

For more information about Dezi & Roo and their unique and innovative cat toys, please visit Dezi and Roo on Etsy.

Rapid unexplained weight loss

Hello Dr., I am in a quandry. My 16 y/o male has gone from 21 pds down to less than 5 very quickly, out of the blue. He is almost a bag of bones at this point – there is just no muscle on him at all. However, he shows no outward signs of illness – he plays and runs, he is eating (not much), drinking water, peeing and pooping. He has vomited a few times lately. Now, my problem is I cannot afford testing so my vet had a phone consult with me. Based on what I told her, she said “If he is as skinny as you say, it could be renal failure”. She told me that his death could be extremely painful and if finances were a problem ( they are!) then I should think about euthanasia sooner than later. Now, obviously this was a phone consult without testing, but the fact is even if I did scrape money together for tests, I would definitely not be able to afford further treatment. I don’t want to make a rash decision – I am more attached to this cat than I can describe. Please give me your advice on how to proceed. Thank you! – Elizabeth Waterhouse

Hi Elizabeth,

I am so sorry to hear about your dilemma and understand your angst. Sudden and severe weight loss, as you have described, is always a major concern and usually indicative of a progressive illness. It could be due to kidney disease, cancer, hyperthyroidism, or a myriad of other disease processes and without diagnostics you may never know which ailment your boy is dealing with. But don’t beat yourself up over not being able to afford testing or treatment. At this stage, it probably won’t make a difference to his prognosis.

Instead, you can focus on making sure that the quality of his life remains good. I am encouraged to hear that he is still playing and acting normally. While cats often hide pain and illness, this is still a very good indication that your boy does not know how sick he is.

This would be a good time for you to discuss hospice care with your veterinarian. He may benefit from an anti-nausea medication and/or an appetite stimulant to help him eat more. Pain medications are indicated if he is showing any signs of discomfort. These can usually be dispensed without diagnostics with the goal to improve quality of life (but your veterinarian will most likely need to examine him first).

If that is not possible, then I agree with you in not making a rash decision. You will know when the time is right to seek humane euthanasia. You have taken good care of your boy and showered him with love throughout his life and that is the only thing that matters. Not the final moments or his passing.

My thoughts and prayers are with you both during this difficult time.

Early stage kidney disease

Dear doctor, question: the vet just told me that my cat Zak has early kidney disease, but that it is too early to treat. The vet says to just keep checking.
What can I do to help Zak? Maybe stop the progression of the disease in its tracks. How can it be too early to treat?
Any suggestions are greatly appreciated. Thanks! – Chela

HI Chela,

Thank you for writing in to seek help in keeping Zak happy and healthy while he lives with early kidney disease. Paws crossed; it will never progress beyond the point it is now.

There are many good resources to help you navigate this diagnosis and I encourage you to check them out. The International Renal Interest Society (IRIS) offers a wealth of resources on feline kidney disease: http://www.iris-kidney.com/ This article also offers comprehensive information: https://icatcare.org/advice/chronic-kidney-disease/

A common thread you will notice as you peruse these websites is the need to stage Zak’s kidney disease. Knowing where he stands on the IRIS scale will dictate the best available treatment options for him. It is based on his bloodwork results, so this is something you should discuss with your veterinarian. Staging his illness  will help you understand his prognosis better and allow you to better track any progression.

Once you have a better handle on what stage Zak’s kidney disease fall under, let me know if you have any other questions. I am happy to help.

Cat suddenly started attacking other cat

I have a question for the Doc. I have 2 cats and they were getting along pretty well then MS. Mida who is 11 yrs old Started too attack Sir Tiger who is 6 yrs old who has done nothing too provoke her both cats are spayed and neutered. She will growl at him and he is terrified of her. I give them a lot of attention. When I introduced them when I got him as a 14 week kitten who was feral he was in a crate so he knew she was the alpha it was fined Ms. Mida got fed first. The last 2 yrs she is nasty toward him. Don’t know what happened too her. I always had multiple cats . I am confused. – Darlene

Hi Darlene,

It is a shame that your two cats are not getting along, and I understand how that can upset you and the rest of your household.

Any sudden changes in behavior are usually indicative of something deeper going on. I have no doubt that Mida has her own reasons for turning on Tiger, but for me to find the root cause would take much more information than you have provided. This is a good situation for you to seek the help of a qualified feline behaviorist. They will be in a much better position to help you to identify the cause of this current problem in order to give workable solutions.

As a veterinarian, I would want to evaluate Mida for evidence of pain or illness. I have seen many cats experiencing chronic pain become grumpy, aggressive, and irritable, and turn on their housemates out of frustration or feelings of vulnerability. Even conditions like dental pain have the ability to make cats unhappy enough to lessen their tolerance of others around them so this is something I think you should look into.

There is always a root cause to changes in attitude but because our pets have a hard time communicating with us, we usually don’t identify the true cause. It takes being a stealth detective and I encourage you to dig deep for answers. Good luck and let me know what, if anything, you find.

Hard spot on claw

I have never heard of a horned claw. Thank you, Dr. Lynn, for talking about it and, Debbie, I hope your cat can get some relief from it. I think this might be what Pele has, or maybe it’s something different. It started with a nail that got overgrown and actually looked like a disk, that was growing into her paw pad. I had the vet trim her nails, but this little hard spot remained. It hasn’t grown and doesn’t bother her. Could this be a horned claw that I need to keep watch on or did not all of the nail come out when the vet trimmed it? I couldn’t go into the clinic at the time to ask questions because it was in the height of covid and they were only doing curbside check ins. – Janine

Hi Janine,

Thank you for your kind words and for writing in. Unfortunately, without examining Pele’s paw, I cannot tell you what the hard spot is. However, I would assume that the veterinarian that previously trimmed her claws would. If the hard spot appeared in or around the the time of the nail trim procedure, then I would put more stock on it being a scab or permanent scar from the overgrown nail than on a horned claw. But this is just a guess on my part.

Fortunately, neither or these conditions are serious and, unless Pele is showing signs of discomfort, you have no need to worry. I hope you get the clarification you are looking for once you speak with your veterinarian. And, continue to examine the length of his nails, clip them before they grow long enough to penetrate the paw pad, and keep an eye on the horned claw/scab/scar to monitor for changes.

Flea and tick control

Hi Dr. Bahr,
I would like advice about flea and tick control. Our Ernie would love to go outdoors, but with fox, coyote, and other predators in the area, I’d only considerate it if he were on a harness and leash. The problem is that I don’t want to treat him with Frontline or a similar poison for tick and flea protection. My vet suggests that I treat all three of my cats if Ernie goes outside! Do you have a suggestion for flea and tick control that would be less harmful. Thank you. – Maggie

Hi Maggie,

I think it is a wonderful idea for you to go walking with Ernie outside and know that he will be greatly enriched by the experience.

Your veterinarian’s advice is warranted and I, too, recommend all your cats be treated regularly for internal and external parasites. Even if none of them go outside it is important that they receive heartworm preventative in areas where the problem exists, since mosquitos enter homes easily.

Back in the 80’s and 90’s there were few flea and tick products that did not poison cats. They were deadly and sold everywhere. To combat flea infestations, cats were regularly dipped in pesticides that were allowed to dry on their fur, or toxic collars were put around their necks, houses were fumigated with chemical bombs which cats walked on and later licked their paws. It was a terrible period in feline history and unsuspecting owners frequently caused innocent harm to their beloved kitties just trying to keep fleas off of them and out of the home.

We have come such a long way since those dark times and the preventatives we use today are safer and more effective than ever. My experience using and recommending them has been overwhelmingly positive. While there are occasional reactions in some cats, most are minimal in severity. So, I am unsure as to how to answer your question to recommend something less harmful.

However, there are some natural ways to control flea infestations within your environment. Releasing beneficial nematodes in your yard will help treat the outside while applying diatomaceous earth on the floor and carpet will take care of the inside. Both of these regiments are safe and effective and will go a long way in helping control the problem.

I look forward to hearing back from you about Ernie’s adventures outside. I am a fan of letting cats safely outside to get fresh air, sunshine, and enrichment. I hope it goes well for you both.

Do you have a question for Dr. Bahr? Leave it in a comment and she’ll answer it in next month’s column.