25th Anniversary Open House

25th Anniversary Open House

This year marks our 25 Year Anniversary and we want to celebrate with YOU! We will be hosting an anniversary party Sunday, November 13th from 1pm-3pm. Please join us for some fun, socialization with our doctors and staff, as well as some learning experiences for some of our services we offer.

We will be creating an event for this shortly, so please see our event to RSVP or email us at [email protected]

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Does Your Estate Planning Include Your Kitty?

This is updated from an earlier two part article

estate planning and your catWe all love our pets and want them to be loved and cared for, but what if your pets outlive you? Can you truly count on someone to take them in or make good decisions about care? This article previously appeared in the Orange County Register and if you didn’t read it or haven’t made any provisions, please read more …

I have thought about Pet Estate Planning quite a bit over the past year.  It started during an office visit I had with a wonderful client who told me he was having a surgical procedure that he might not survive.  I wasn’t sure when the surgery was being performed but a few days after the office visit, I was very sad to hear that he had died. He lived with many cats and fortunately he had made plans to have his sons take care of these animals.  They followed through with his wishes, but it has been a lot of work for them.

Have you done any formal pet estate planning?  Chances are that you haven’t.  What would happen to your pets if you died?  If you lived alone, animal control services in the area where you live would pick up your pets if you died.  They would then contact family to see if anyone was willing to care for the pets.  If they couldn’t find someone and if your pets were adoptable, they would try to place them.  If the pets were old, sick, or had behavior issues that would make placement difficult, then the pets could face euthanasia.  Think of how stressful, scary, and potentially life threatening this situation could be for your pets.  For this article, I interviewed two attorneys, a rescue organization, and two centers that offer “retirement” homes for cats.  Planning for your pet’s care in your absence is something you should definitely consider.

“You cannot automatically count on family members to take over your pet’s care,” says Colleen McCammon, president of the Animal Assistance League of Orange County.  Pet and family member health issues, other pet’s in the home, pet restrictions where someone lives, and pet behavior issues all complicate whether a family member could take in your pet.  Although family members might come out of the woodwork when money and property are at stake when a relative dies, there is not much interest in the pets that are left behind.  This makes me think about a former client, a single woman, who died of breast cancer in her 40’s.  She was a successful person who owned a condo and two cats.  She had wrongly assumed that her relatives were going to take her cats.  She did not have any formal documents drawn up, and when she died, her family wanted to euthanize her cats.  They were excited though about selling her condo and getting the proceeds.  Fortunately a friend of hers interceded and found new homes for the cats.

Brian Chew, an attorney in Irvine, counsels his clients to be concerned about their pets in their general estate planning.  He recommends creating a Pet Trust provision in your Revocable Living Trust.  A Pet Trust is a formal way to ensure pet care.  The trust would be administered by an assigned Pet Trustee, and this individual would need to be informed and aware of their assignment.  If they don’t do their job, the trust is hard to enforce.  You can also nominate a Pet Trust enforcer (someone other than the Pet Trustee) to help ensure that the funds are used on behalf of the pet.

California Probate Code states that “A pet cannot be a beneficiary under a Will.”  You cannot leave millions of dollars to your pet as was the case with New York billionaire Leona Helmsley when she left $12 million to her Maltese named Trouble in 2007.  Provisions to provide for a pet in a will are not legally enforceable in California.

“Provision for the care of a pet can be made by establishing a trust, by making a conditional gift, or by coupling an outright gift with a precatory request that the gift be used for the care of the pet.  If a trust is established, it is an honorary trust and cannot be enforced, since there is no beneficiary to enforce it,” says attorney Ronald Wiksell of Santa Ana.  He recommends making a gift to a named beneficiary, who will actually assume care of the pet, and coupling it with the care request using the following verbage:

“I give the sum of __________ (specify amount) to ____________(name of beneficiary).  It is my wish and I request that __________(name of beneficiary) protect and care for my ____________(description and name of pet) in the same manner as I have done during my lifetime.  This request is precatory only, and not mandatory.”

Estate planning needs to cover you, any spouse, children, and pets.   Attorney Brian Chew thinks there are three main points to consider:

  1. Who is in charge and are there backups? These are the trustees, guardians, or beneficiaries and you need to talk to these people so they know they are being named.
  2. How much? For your pets you need to think about current pets and their expenses and how much is needed to cover future health care as they age. What happens to any residual funds that have been allocated to pet care after the pet dies?  Specify a charity?
  3. Backup plan – Should you purchase pet insurance? Will the trustee be able to live in the same place as your pets? Do you need to pay for the trustee’s moving or living expenses? In addition to estate planning if you die, what would happen if you became incapacitated and could no longer care for your pet?

How much money should you think about allotting for cat care?   Probably about $1500 per year of the pet’s additional life expectancy.  As cats age, their healthcare needs and costs rise.  An average cat lives 15-17 years.

One organization that frequently counsels families who have lost loved ones and don’t know what to do with the surviving pets is the Animal Assistance League of Orange County.  AALOC has their own no kill facility in Midway City, licensed for 50 dogs and 85 cats.  The Animal Assistance League of Orange County works closely with Orange County Animal Services but is a separate entity.  This organization helps with pet adoptions and with providing education to the public through a Help Line.  If someone dies and AALOC is sent photos, a bio on the pet, and health history; they will do their best to help place the pet.  If a purebred pet needs placement, they work with specific purebred rescue groups.  They do not have a formal pet estate program, but if their facility was properly designated in a trust, they would take in the pet.  They do not have a set monetary contribution for care.  For more information go to http://aaloc.org/ or call 714-891-7387.

There are two Orange County organizations that offer retirement facilities for cats—The Blue Bell Foundation (www.bluebellcats.org) and The National Cat Protection Society (www.natcat.org).   They both have established programs for taking in cats whose owners can no longer care for them.  If you are interested in one of these groups as an option for cat care, you would need to work with your estate planning attorney and the organization directly to properly set up the terms.  You would want to visit the facilities and feel comfortable about their work.

Although they are non-profits and run on donations, these organizations have expenses including staff, food, facility maintenance, vet care, and drugs in order to provide high quality care.  They will provide reasonable long term medical treatments to their feline residents but would not provide services such as kidney transplants, chemotherapy, or radioactive iodine therapy.   A cat that needed these services would require additional funding as part of a residency agreement.

It’s fantastic that there are special organizations that can help when an owner can no longer care for their cat.  Your friends, family, and local animal control services will do what they can, but the best way to make sure that things are handled properly is to work with a estate planning lawyer and make formal arrangements ahead of time.  You can designate funds and a pet beneficiary or you can retire your cat to facilities such as The Blue Bell Foundation and The National Cat Protection Society.  A hand written “will” won’t legally suffice when it comes to pet care.

After I did the research for this column, I know that I have some work to do to plan for my own cat’s future.  I hope that this information helps you plan for your cat’s future.

Copyright © 2015 The Cat Care Clinic

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Could My Cat Have Worms

Sylvester’s mom called in a panic. Her adorable black and white kitten had some strange-looking material stuck in the hair under his tail. She described it as some hard, light tan granules. When we asked her if the pieces looked like sesame seeds, she responded, “Yes.” She was a new cat owner and this was her first experience observing tapeworm segments.

We advised her not to worry, that what she was describing sounded like dried tapeworm segments and there were a couple of very safe and effective products with which to treat Sylvester. She was surprised to find out that even though her kitten had been treated for worms before she got him, he had worms. Sylvester was an indoor kitten and ate a regular premium diet.

Sylvester had been adopted through a rescue group, and he had been exposed to fleas prior to going to his new home. Although he had been treated for fleas by his foster owner, his treatments had been several months earlier. The most common way for cats to develop tapeworms is by ingesting fleas when they groom themselves. We suspected that this was how Sylvester got his tapeworms.

Tapeworms are frequently found in cats, especially in patients that have had fleas. The tapeworm, like other intestinal worms, has a life cycle that requires an intermediate host to develop into an infectious parasite. Dipylidium caninum is the name of the most common tapeworm found in cats. The pieces of tapeworm that pass in the feces or crawl out of the anus are called proglottids. Eggs are released from these segments into the environment. Fleas ingest the eggs, which develop into a larvae within the flea. When a cat ingests a flea carrying a tapeworm larvae, the larvae will develop into a mature worm in about a month. The head of the adult worms attaches to the lining of the intestines and the worm body, made up of proglottids, can become several inches long. As the worm matures, the proglottids are released, and the cycle begins again.

Cats do not transmit tapeworms to humans. A person would have to eat a flea carrying a tapeworm larvae to become infected.

There is another genus of tapeworms called Taenia that are carried by birds, rodents and reptiles. Cats can become infected with these tapeworms if they hunt and eat prey.

Fortunately, tapeworms don’t make cats sick and don’t cause weight loss. Sometimes they will cause mild anal irritation and cats will lick more under their tails. Tapeworms are most commonly diagnosed when owners observe live worms, which look like wiggly grains of rice on the feces, or when they see the dried segments in the bedding or on the pet. It is not common to see tapeworm eggs when fecal testing cats in a veterinary clinic.

Other worms that can infect cats are roundworms, hookworms and whipworms. These worms are more often found in kittens and cause diarrhea, weight loss and gastrointestinal upset. Diagnosis of these worms is made when eggs are found during fecal testing at your vet clinic. Cats with heavy worm infestations can vomit worms or pass them in their stools.

Worm treatment is easy, and cats tolerate the drugs that are used very well. There are a variety of medications; dosing is based on your kitten or cat’s weight and the type of worm(s) present. A couple of years ago a topical, spot-on product called Profender was developed that is effective against feline GI-tract worms including tapeworms. This product does not kill fleas but is applied similarly to spot-on flea products and is available through your veterinarian. I think it is the easiest treatment to use.

Thinking about intestinal worms is unpleasant, but being aware of them is an important part of cat ownership. All kittens should have fecal testing for parasites. They should be treated for worms at least twice, two weeks apart, and more frequently if reinfestation with worms is likely. Indoor living, flea control and good litter box hygiene reduce the risk of worms. Cats that get fleas, eat raw meat, hunt or go outside should be treated for worms at least twice a year, as well as in between if any signs of worms are seen. Ask your veterinarian if you have more questions about gastrointestinal worms.

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How to Scratch Your Kitty’s Itch

Lick, scratch, thump, thump – your kitty is keeping you up at night because he is itchy and cannot relax. You question why you let him sleep in your bed in the first place. You try to discourage him, but you can only redirect him for a short time before he starts up again. Lick, scratch, thump, thump. This is a frustrating and familiar experience, if you have an itchy kitty.

Cats itch for a variety of reasons, and the severity of the itching can range from a little excessive grooming to the creation of open sores and red, bald spots on their bodies.

Last month I attended the International Society of Feline Medicine conference in Porto, Portugal. Veterinarians from 35 countries were in attendance. Itchy kitties were featured in a session presented by a well-known boarded veterinary dermatologist. I treat itchy kitties every day, so it’s always good to hear other perspectives and see if new treatments are available.

One of the main challenges with itchy kitties is that a variety of causes all create the same clinical signs. Cats that have fleas might look similar to cats that have environmental allergies. Cats cannot tell us what is aggravating their itchiness, so we have to be detectives and get good histories and perform thorough exams.

Every itchy kitty needs to be checked for fleas. I am often told by owners that their cat never goes outside, so it would be impossible for him to have fleas. I take out my trusty flea comb, take a few strokes, and find the evidence of the black, peppery flea dirt and even live fleas in the cat’s coat. In these situations, owners are horrified that fleas have gotten into their home.

Fleas are very pesky. They can come in through screens, hitchhike on your clothes, or come in inadvertently by visitors who have pets. The good news is that fleas are the most treatable and curable cause of itching, since we have so many effective products to rid our pets of them. Make sure that you use a product that is specifically labeled for cats, and ask your vet for advice.

Fleas aren’t the only parasite that causes cats to itch. Skin mites, ear mites and feline lice are other bugs that cat live on your cat and cause problems. A simple test called a skin scrape helps identify skin mites. Microscopic examination of ear swabs and an exam of the ears will identify ear mites.

Lice are usually large enough to be seen in the coat or picked up by a tape impression of the coat. A skin mite called Demodex gatoi can be difficult to find. To rule out fleas and D. gatoi as causes of itchiness, a six-week trial with weekly application of a product containing imidaclopid and moxidectin is recommended.

Fungal infections cause itchy skin. To check cats for the most common ringworm fungus, a special black light called a Wood’s lamp is used to screen the coat, then a culture is taken of potentially infected hairs. The culture can take up to two weeks to grow. Malassezia is a yeast infection that can be found on the skin and may be seen when ear swabs or skin impressions are examined microscopically. Fungal infections are treated with antifungal shampoos, dips, mousses and oral medication.

Bacterial infections of the skin cause itchiness. These infections don’t always look bad and may be superficial but require treatment for two to four weeks to resolve. Medicated baths, special disinfectant mousses and rinses and injectable or oral antibiotics are used to treat skin infections.

When parasitic, fungal and bacterial causes are ruled out as the reason for your cat’s itchy skin, a food allergy may be considered. Studies have shown that only 10 percent of cats actually have food allergies, and many that have food allergies also have gastrointestinal signs, not just itchy skin. It is difficult to test for food allergies. Tests for antibodies to certain food proteins in the blood are available; sensitivities to one or more of these ingredients would indicate they are somthing to avoid. Independent research hasn’t clearly supported these findings.

Historically beef, dairy, and fish have been considered the most allergenic proteins in cat foods. In the veterinary world, there hasn’t been much research into whether gluten, soy, GMOs or other grains cause food allergies.

The standard way to determine the presence of a food allergy in cats is with an elimination diet that contains a “novel” or hydrolized protein, one the cat has never eaten before or that is broken down so the body doesn’t recognize it. It is becoming harder and harder to find novel proteins since all pet food manufacturers are jumping on the bandwagon to offer more unique foods.

When unique proteins (duck, venison, rabbit) are part of a diet with other proteins (chicken meal, fish broth, etc.) or manufactured at a plant where other proteins are mixed into foods without strict cleaning practices between food batches, the diet is no longer hypoallergenic. If a cat has a food allergy, he will generally have an improvement with his itchiness within six to eight weeks of an exclusive and complete diet change.

The last and potentially most common causes of itchiness in cats are environmental allergies/atopy or immune-mediated diseases. Allergy testing does exist for cats. Intradermal skin testing is considered the gold standard and involves injecting small amounts of allergens under the skin and looking for an inflammatory response.

This type of testing is not routinely performed in cats. Blood tests looking for IgE antibodies to allergens are often used. Cats, like people, can be allergic to numerous items including molds, house dust mites, ants, tress, grasses, and weeds. Even indoor cats can be allergic to things that grow outdoors around their homes. If specific allergens are identified, hyposensitization injections or oral immunotherapy serums can be used.

Steroids, antihistamines, and cyclosporine are all drugs that decrease itchiness, especially when caused by allergies. Allergies are managed but not cured, so long-term therapy is needed in most feline patients. The goal is using the lowest dosing of medications to control the itchiness. Long- term use of certain medications can have side effects, so in severely affected patients, several different types of treatments may be combined to lower doses and achieve better results.

It is important to work up the cause of itchiness in a cat so that he is treated properly. This often takes more than one visit to your vet, several tests, and potentially some therapeutic trials to see what works the best for controlling the itching.

If you have an itchy kitty, be patient and see if there is an underlying problem such as parasites or an infection that can be cured before just treating his symptoms. You’ll get a better night’s sleep if your feline friend is resting comfortably and doesn’t need to scratch. You’ll also be a lot happier when he is comfortable.

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Delicate ‍Kitty ‍Issue Help

You may not be able to relate to this, but some cat owners get very excited when they observe that their ‍kitty has passed a normal bowel movement. There are numerous elimination ‍issues in cats, and knowing the difference between urination and defecation problems is important. Each process has a slightly different posture and outcome, and if you are unsure of what you are observing, you should consult with your veterinarian.

Mookie became my patient about 2 1/2 years ago when I saw her as a second opinion for constipation and lameness. She was 13 years old and had been treated previously at two other veterinary hospitals for these ‍issues. Mookie’s owner reported that the ‍kit‍‍ty would loudly vocalize when she was having problems with passing stool. I knew right away on exam that she was full of firm stool. I did not initially observe Mookie’s lameness, but as my exam continued she showed discomfort with her left ankle. A review of X-rays taken elsewhere showed a fracture of her left ankle that had improved with splinting of her leg.

She was given some pain reliever and I was able to remove the impacted stool. Once cats develop constipation the condition can progress to a disease called megacolon. Cats with megacolon have damaged muscles in their colons that no longer contract properly to expel stool. I wasn’t sure whether Mookie had megacolon yet.

There are several theories about how to treat chronic constipation, but from experience, I avoid using diets that are high in fiber and produce dry stools. Mookie was currently eating one of these diets, Prescription Diet w/d. I instead recommended an exclusively canned diet that was high in protein and easily digestible. I sent her home with some anti-inflammatory medication to be sure her sensitive ankle was not affecting her ability to posture to defecate, and recommended using overthe-counter human Miralax as a stool softener. We also tried her on a drug called cisapride, which helps stimulate some cats to defecate.

I was disappointed when Mookie’s owner called back a couple of days later to report that Mookie still was not defecating normally on her own. She came in for a recheck and required an enema to clean out her colon. It appeared that Mookie unfortunately had megacolon and would need other treatment. We changed her medication to a compounded drug called tegaserod and increased her stool softener. We continued to encourage her to eat canned food, but her preference was dry.

We didn’t see Mookie for about 10 months. During this time, her owner discontinued her tegaserod. Her constipation recurred about a month later and she ended up in an emergency clinic getting enemas. Mookie was hard to medicate and was eating some dry food, so it was hard for her owner to comply with our recommendations. It took a couple of weeks and an increase of her tegaserod to get her defecation under control. We sent home some individual “pet enemas” – syringes prefilled with dioctyl sodium sulfosuccinate, which stimulates defecation – and told the owner she was to use these if Mookie needed help. We spoke to her owner about keeping Mookie happy and active at home and trying to reduce anything that might be causing stress. Stress can worsen constipation, and Mookie didn’t like the dog in the home.

Mookie did well again for many months until the tegaserod became unavailable, and we had to find another way to manage her megacolon. I had been using some dry veterinary food called Royal Canin Fiber Responsive Diet with some other constipated/ megacolon patients and seeing some amazing responses. We switched Mookie to this and continued her Miralax. So far, she is doing very well on this treatment plan. I’m keeping my fingers crossed that this will help her long-term.

Constipation is seen frequently in cats, and it can be caused by a variety of problems including obesity, pain, stress, arthritis, back problems, kidney disease, dehydration, diet and litter box ‍issues. Many cats can be well managed with diet, but others need stool softeners, other medications and behavior modification. Non-responsive megacolon cats can require a big surgery called a subtotal colectomy that removes most of the colon to help them pass stool.

If constipation is not an isolated event with your cat, be sure to consult with your veterinarian to keep it from becoming a chronic and painful problem.

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