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Monday, August 1, 2005

Diabetic Kitty May Have Other Serious Problems

By Dr. Jeff Nichol
For the Journal
    ASK THE VET:
Q: My 15-year-old diabetic cat got a scratch behind her ear. She continued to scratch at it, turning it into a gaping wound. A vet gave us antibiotic ointment and got it healed. She opened it up again. We're now dealing with an e-collar. After three tries at leaving it on for 4-6 weeks, whenever we take it off she opens it again. Will her e-collar become a permanent part of her dress, or is it her diabetes that prevents this from healing?
    Dr. Nichol: Your kitty may have serious problems. Diabetes that is not well controlled can cause skin infections that lead to poor wound healing. Some diabetic cats also have a disease of the adrenal glands called Cushing's syndrome. Cushing's causes thin, fragile skin. It's also possible that the antibiotic ointment may be entirely to blame.
    Check the label. Many prescription ointments contain a corticosteroid (like triamcinolone, dexamethasone, or hydrocortisone) to reduce inflammation. Unfortunately these topical steroids can delay healing if used long term. Provided that your cat's diabetes is well controlled and stable, and she is otherwise healthy, simply discontinuing the ointment could solve her problem.
    Diabetic cats have special needs, especially if they also have the high levels of the hormone cortisol that is seen in Cushing's syndrome. Not only do these kitties struggle with skin disease, they may drink and urinate excessively, and develop liver and joint disease. To be safe, your cat needs a follow-up exam and current lab work. Sorry this is complicated. While most diabetic cats do OK with careful feeding and insulin dosing, those with concurrent Cushing's syndrome usually need surgery of the adrenal glands to get lasting relief.
   
Q: We have a 10-year-old wonderfully sensitive Doberman. Whenever there is a thunderstorm, lightning, a change in air pressure, firecrackers or fireworks, Momo starts shaking and tries to get behind cabinets, dressers, in corners or climb into my lap. I have tried Rescue Remedy, Clomacalm and used massage and healing touch methods. These techniques have not worked. After coming home one night to a broken cabinet and china, I resorted to a tranquilizer called acepromazine. This calms him down, but makes him groggy.
    Dr. Nichol: Momo is not alone. Fear of loud noises is a common phobia that only worsens if left untreated. Medications can help, but alone they are never enough. To succeed, your boy also needs careful behavior modification.
    Just two weeks ago, at the International Veterinary Behavior Meeting in Minneapolis, I was shown new research on desensitizing dogs like Momo. A CD of the fearful noises, played frequently at low volume, along with DAP (a calming pheromone available at pet supply stores), has shown promise. The metal foil lined "Storm Defender Cape" also was evaluated. An interesting idea but results were mixed. But the tranquilizer acepromazine is a "chemical straitjacket" that should always be avoided because an affected dog is still highly anxious but incapable of moving.
    With professional supervision Momo has a good chance of improving, but handled incorrectly he can actually get worse. These are tricky problems. Let me know if you need guidance.
   
Dr. Jeff Nichol cares for pets with behavior and health disorders at VCA Wyoming Animal Hospital in Albuquerque. Contact Dr. Nichol on his Web site, www.drjeffnichol.com (click Submit?); or 1300 Wyoming NE, Albuquerque, NM 87112. Unpublished letters may not be answered individually.