Yes, Cats Really Do Get Heartworm. The Story of Fergus

Until I met Fergus, I must admit that despite the fact that I knew feline heartworm existed I had little first -hand experience with the disease. Fergus presented one spring morning on the emergency service. The owners had woken to find him recumbent, now he was inches from dying. The staff and doctors that day jumped into action and over the next 24 hours he gradually stabilized. The owners reported that they had adopted him a few months ago from a rescue organization. He had been tested for the feline viral diseases and vaccinated. He was neutered and just beginning to adjust to his new home. Fergus was not allowed outdoors, outdoor cats are more likely than indoor cats to meet with various inexplicable catastrophic events, and until that morning he appeared to be doing very well.

Whenever a cat is presented in such critical condition, with multiple organ systems affected, it is common for us to check their viral status along with serum chemistries and a CBC. Feline viral diseases can be stealthy, but devastating, and cats that test negative 4 weeks earlier can be positive the next month. We tested Fergus’s blood for FELV(Feline Leukemia) and FIV(Feline Immunodeficiency Virus) and also for heartworm antigen. He tested positive for one, heartworm disease.

Feline Heartworm Disease is diagnosed less often in cats since the parasite does not survive as successfully in the cat as it does in the dog. Cats are also less likely to have circulating microfilaria which means that they are less likely to spread the disease. At this time we are unsure why this is the case. Feline heartworm disease can also be challenging to diagnose and can present in many different ways. Because the parasite does not thrive in the cat as it does in the dog, some cats may remain unaffected by a heartworm infection and never demonstrate any clinical signs.
However, when a cat does become ill, the infection can be devastating, even fatal, affecting their heart, lungs, liver and kidneys. Some cats may be mildly affected, demonstrating respiratory signs. Any cat that has evidence of lung disease (like Feline Asthma), coughing or other respiratory signs, should be tested for heartworm. Of course, heart murmurs and cardiac dysfunction, and liver failure can also occur as a results of the adult worms damaging the heart and occluding vessels. Also, gastrointestinal upsets and vomiting can be signs associated with the disease.

Unfortunately for Fergus , he basically had every conceivable clinical sign. He had vomiting, diarrhea, kidney dysfunction, anemia and eventually a heart murmur and heart failure along with an allergic pneumonitis (an inflammation of the lungs), all developing within 24 hours time. His infection had been present for months, but now he was experiencing the devastating consequences of a successful infection. It took Fergus almost a week of intensive care to recover. At one point some of the adult worms moved (we were actually able to see and document this on cardiac ultrasound, an echocardiogram) and lodged across his tricuspid valve, a heart valve between the atrium and ventricle on the right side of the heart. This led to cardiac dysfunction and failure. At that point things looked grim, Fergus was placed on cardiac medications and just when we thought the battle was lost the worm moved (again we documented this on ultrasound). Fergus began feeling better and eventually returned home.

Feline heartworm and its associated illnesses have not been a commonly diagnosed condition in veterinary medicine, so there is sparse data regarding survival rates and successful treatment plans. Published reports at this time usually include as few as 5 to 50 patients from which to draw conclusions. Small study groups may lead to poorly representative information regarding a disease. One study did find that cats like Fergus, if they survive the first 24 hours of their illness, have approximately a 60% chance of surviving that crisis and returning home. A study looking at 50 cats with heartworm disease, the median survival times as 4 years post diagnosis.

Over the next year Fergus will need to be closely monitored to continue to manage his disease as best as we possibly can. Unlike dogs, there is no treatment that has proven successful in eradicating an adult heartworm infection in the cat. Heartworm infected canine patients can be treated with medications that kill the adult worms. In most cases the medication, although strong, can be well tolerated. In the cat there is a high mortality associated with adulticide therapy and there appears to be little benefit from being treated. Surgery can be utilized to remove the adult worms, but again the risks and the mortality (death) rate is very high vs little apparent benefit. When cats have heartworm infections we have to carefully treat the consequences of the infection and place them on a monthly heartworm preventative. The adult heartworms will not live as long in the cats as they do in dogs and will eventually die off.
Feline heartworm preventative is available in pills, chewable tablets and topical solutions for your cat. Particularly if you cat goes outside, contact your veterinarian to discuss what product would be best suited for your cat.

Read more about feline and canine heartworm disease at www.heartwormsociety.org

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Some Recent Toxins and Hazards Seen On The Emergency Service

Recently, one of our clients emailed a warning regarding Cocoa Shell Mulch. I really thought this wasn't s problem anymore, since a few years ago it was quite popular and dogs were getting sick and dying from the mulch back then. Evidently it is now being marketed as a repellent to cats, evidently cats are the bane of every gardener, which is news to me. So, this is the mulch to use for your nasty cat problem. Unfortunately, if you have dogs, the mulch has the same toxin in it as does chocolate, Theobromine, and it is sweet and appetizing to dogs (although it is toxic to cats, they are much less likely to eat the mulch). Thebromine in adequate quantities is fatal to dogs and that is what happened to our client's friend's dog. After mulching their gardens the previous day their dog had a seizure and died.
The Cocoa Mulch can be purchased at all the home supply and garden stores. Not only be sure that you avoid using this product in your yard, but also warn your neighbors since often our pets 'share' our neighbors yard as well.

With Mothers Day this weekend, please be aware that lillies of all variety are toxic to cats. Even the pollen is toxic. The toxicity causes renal failure and if not addressed early or if a large amount of toxin is ingested, it can be fatal. We have already seen at least 2 cases at our hospital this spring.If you think your cat has eaten or been playing with a lilly plant or flower, please have it evaluated by a veterinarian immediately.

There are a few traumatic events that tend to be more prevalent this time of year, first is what we call the 'Big Dog, Little Dog' or BDLD. With the advent of neighborhoods that do not have traditional fencing, dogs tend to wander and not all of them are well socialized. Unfortunately, the little dog gets the worst of the injuries and at times they are fatal. The best solutions to this problem are fencing, leashes, collars, responsible dog owners and adequate dog training and socialization.

Other injuries we have recently seen are the golf club or baseball bat to the head injury. It's pretty self-explanatory how this accident happens, happy dog, ball, you know the rest. Best solution, don't have your dog out playing golf or baseball with you.

Finally, have a great Spring. Get out there with your dog, take the cat out for a walk (on a leash), smell the flowers, and be safe!

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A Response To A Negative Review On The Internet

Veterinary Care Specialists and VCS Pets First are small concerns. We are really a family here and the hospital was built and organized with the idea of being a more intimate, ‘patient care intense’ veterinary hospital. We never had ambitions to be big, but we strive to be very good at what we do. I think that we achieve that goal and I am very proud of the support staff and doctors that make our office a caring and professional place.

Veterinarians don’t typically spend 4 + years in college seeking an advanced degree to get rich. We are among the crazy folks that get all that schooling because we really believe in and like what we do. So, when someone says we did not provide adequate care or they were unhappy with our performance we tend to get upset. We take it personally, because we put so much of ourselves into our work.

So recently a client, John Whitt, posted a review of VCS on the internet that was less than stellar. He made a lot of inaccurate claims like ’VCS is the only emergency clinic within a 50 mile radius’, there are actually 3+ Veterinary ER clinics within a 50 mile radius of us, and he felt we provided an excessive estimate for his pets care and, after all, his dog is better now, without all that expense. He neglected to mention that the medications that have helped his dog get better were prescribed by us and without our assistance in that regard his dog may not be doing as well as he is today.

Here is the problem with this situation and this owners thought process. First, their dog, by their admission, had been injured days earlier and was very ill. They had been treating the dog at home with injections of medications, some of which are not appropriate for dogs. The dog had seriously infected bite wounds that were extensive and potentially life threatening. Second, we did what we are ethically bound to do, the very best we can on behalf of the patient. Not to trivialize the problem, but to be sure that the patient’s pain was managed, it’s infections treated and it was protected from the septicemia and organ damage that can occur from chronic deep seeded wounds and certain medications that he received. We also were obliged to provide a plan to debride (surgically cleaning) these wounds so they might heal quickly and by healing more quickly, keep the patient more comfortable. Unfortunately, that plan was costly.

This is the hard part for us to swallow, the owners got angry. Not because we did not care for their dog, we did. We ultimately gave the owners antibiotics and pain medication for their dog. We functioned well within the constraints that they applied to us. But they were upset we gave them a quote for the pet’s very best care. They didn’t understand that we cannot gamble with their pet’s health. It was their option to decline our best plan. Also, they apparently became upset because their pet was lucky enough to get better using a very conservative treatment plan. They’ve even sent emails, sort of flaunting their pet’s success, like that makes us wrong. It doesn’t, it just makes their dog very fortunate. With the years of experience we have and the years of education we’ve received, we realize all the potential outcomes for injuries like their dog sustained and we know how to best manage these wounds, the Whitt’s pet was lucky, pure and simple, he beat the odds, and we are happy for the dog and the owners.

So here is the bottom line for all you pet owners out there that will bring your pet to the vets with a serious health problem: 1. Expect that veterinarian to provide the very best plan for your pets care, 2. If you either don’t want to pursue that plan or cannot afford that plan, don’t get angry, your veterinarian should respect your limitations, whether philosophical or financial, and provide another, more acceptable plan, then, 3. Institute that plan and be very happy if it all works out, and lastly, 4. Don’t be mad if you are offered the very best care possible for your pet, that is what every pet and owner deserves.

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