Transform Your Aging Cat's Life Today!

Embark on a journey into the realm of senior cat care with Dr. Sugerman and renowned feline expert Dr. Petra Černá. From unraveling the mysteries of age-related cognitive decline to exploring cutting-edge treatments and environmental modifications, this episode offers a roadmap to enhancing your senior cat's quality of life. Whether you're seeking solutions for nighttime vocalization or curious about the latest advancements in feline healthcare, join us for a conversation that celebrates the joys of caring for aging feline companions. 

In this episode you will: 

• Understand the signs of cognitive dysfunction in senior cats
• Discover practical strategies for managing nighttime vocalization
• Learn about effective environmental modifications to improve your cat's quality of life
• Explore innovative treatment options for age-related cognitive decline
• Gain insights into common behavioral changes in senior cats and how to address them
• Hear heartwarming stories and expert advice from Dr. Petra Černá
• Find out how to optimize your senior cat's well-being and happiness

Resources:
Dr. Černá 's Instagram
Crazy Cat Vet Website

Transcript

Dr. Sugerman: 0:00

So what happens when your feline friends start showing signs of aging? Today on Vetsplanation we're tackling the crucial yet often overlooked topic of senior cat care. It is more than just a few extra naps. We're delving deep into the nuts and bolts of what it really means to take care of a senior cat. From adjusting their diet to ensuring their environment is as comfortable as possible, we've got the expert advice, and real life experience from the Crazy Cat Vet herself, Dr. Černá. I'm your host, Dr. Sugerman, and this is Vetsplanation, the podcast that helps you understand your pets. Tune in and discover how to make the golden years of your beloved cat as fulfilling and joyful as possible. Let's embark on this journey together and ensure our aging companions receive the love and care they've always given us. Hey everybody, welcome back to Vetsplanation. So today I wanted to do something a little bit different. A lot of people are talking right now about fostering kittens and kitten care. And I think that's great, but we also have this subset of cats that are really important as well, we have to not forget about our senior cats. So our crazy cat vet, Dr. Černá is here to help us with that. Dr. Černá, can you give me just a little bit of a background for you real quick for the people who have not heard our last episode?

Dr. Petra Černá: 1:19

Yeah, absolutely. So hello everybody. I am Dr. Černá. I'm actually originally from Europe a small country called Czech Republic. And I am very passionate about feline medicine and cats. I've actually been working and actually been breeding cats for about almost 20 years. I actually just got a litter of kittens yesterday.

Dr. Sugerman: 1:40

Yeah, so cute.

Dr. Petra Černá: 1:41

I know. I love kittens so much, but I am also very passionate about senior care. So my favorite cat is just about to turn 10 this July, so there will be a big, Bellina's gonna have a big birthday party.

Dr. Sugerman: 1:56

Very nice.

Dr. Petra Černá: 1:57

Yes, I'm already like inviting people and telling everybody that there will be hats with Bellina's face on it and everybody will have to wear them.

Dr. Sugerman: 2:06

That's amazing.

Dr. Petra Černá: 2:06

Yeah. I, of course, Belina is the love of my life and she's been with me since she was a kitten, so about four months old, she's aging now and we definitely need to make some changes in the house and really watch her closely because my aim is that she's going to make it to at least 30.

Dr. Sugerman: 2:24

Of course. Yeah, exactly.

Dr. Petra Černá: 2:26

Yeah, there is no way I'm actually just cuddling her here. She's just sitting here next to me now.

Dr. Sugerman: 2:33

You had mentioned that she was 10 years old. Can you start out by telling me like how old is a geriatric or a senior cat?

Dr. Petra Černá: 2:40

Yeah, absolutely. We always looked at that and it's always hard to make it into human years, of course, because humans, we age differently. So for cats being about 10, I think, we would be looking at her being somewhere, probably in her like fifties, sixties. So it's, she's definitely, unfortunately getting a little bit older I can see her maybe slowing a little bit down and she's losing some of that muscle mass on her hind legs and she's not as active as she used to be. There are so many things we actually can do for these older cats to still give them a great quality of life.

Dr. Sugerman: 3:17

Absolutely. You mentioned that she was like losing her muscle and stuff. What other things do we normally see with cats as they age?

Dr. Petra Černá: 3:24

Yeah, it's very similar actually to humans as well. So cats can have decreased hearing, they definitely can have, you know, I'm getting my wrinkles and my skin elasticity is also getting more. So it's good they're actually the same. They don't really get the wrinkles like humans do, but they definitely can have decreased skin elasticity.

Dr. Sugerman: 3:43

What do you mean? What do you mean by the skin elasticity real quick?

Dr. Petra Černá: 3:46

Yeah, so their collagen is actually in the skin might not be as great as when she was young in the past, which also can mean that, for example, if she was to get injured her healing could be potentially prolonged, because, older people, same like older cats, they heal much slower than, for example, the kids or kittens.

Dr. Sugerman: 4:07

Absolutely. And also too like, when you tent up their skin, like people know to tent up their skin to see if they are dehydrated. And so that definitely changes for our senior cats then, right?

Dr. Petra Černá: 4:17

Absolutely. Yeah. Because normally when you lift the skin up, it just goes down in all those like young healthy cats. Of course, if you're dehydrated, it's a bit slower, but for these older cats, it can just be slower, just the way they are because of the decreased collagen in their skin. But also they are much easier to get dehydrated because they develop other diseases that I'm happy to talk about soon as well.

Dr. Sugerman: 4:42

Perfect. And then also the musculature, like what happens with their muscle? Why do they lose so much muscle?

Dr. Petra Černá: 4:48

Yeah, I think it's same like we see with older people as well. So unfortunately, as cats age one is the thing that they also become a little bit less mobile. So they're not exercising those muscles as much and they can be slowly losing weight as well. And unfortunately, because of that also potentially their muscle, because the muscles need a lot of activity, nutrients, and everything to keep in a good shape. And when you're getting older, you potentially might be developing some osteoarthritis and just moving a little bit less, so that can cause the muscle mass loss as well.

Dr. Sugerman: 5:22

Got it. And you had mentioned that they have hearing loss. Do you see a lot of sight loss as well?

Dr. Petra Černá: 5:28

Absolutely. So they can definitely have some impaired vision as well. I think it's very important to differentiate if cats just are slowly, gradually seeing a little bit less worse than they used to versus like acutely not seeing because that could be actually sign of, for example, high blood pressure and then becoming blind.

Dr. Sugerman: 5:48

Okay. And with just talking about high blood pressure and stuff, I think it's really important for them to be able to get into their regular veterinarian pretty frequently. How often would you say that should happen, and what should be done when they're at the regular vet?

Dr. Petra Černá: 6:01

Yeah, I think this is a great question. And I'm always really advocating for cats, especially senior cats to come into the hospital a little bit more often. At least I would say twice a year just to get their blood pressure checked and weight check as well. If we have at home like some, anxious cats that potentially do not love coming to the vet, which, I love seeing all the cats, but not all cats love seeing me. So this can be challenging. I think it's a great way to maybe buying those baby scales. So I have actually one at home and all my cats, they get at least every three to four months, their weight checked just to make sure they're not developing obesity, but also that they are definitely, especially my older cats at home, that they are not losing too much weight. So that's, I think a great way to measure that at home.

Dr. Sugerman: 6:47

That is really fantastic way, actually, because I know a lot of people, you're seeing them every day. So you don't see that gradual weight loss. So I think that's a great way of doing that. Just weighing them every couple of months.

Dr. Petra Černá: 6:57

Yeah, and because for me as a vet it makes a huge difference knowing that a cat has lost, for example, and now I'm gonna be very European and using my kilograms and grams, but for example, 300 grams, so like 0.3 kilograms. And you can, I dunno how much it is in pounds right now,

Dr. Sugerman: 7:14

Roughly a pound ish, a little less than a pound. Yeah.

Dr. Petra Černá: 7:19

Yeah, over a year, then for example, a cat that loses two, three pounds, over a period of two or three months. So that's definitely something to keep in mind. So this is very important for me as a veterinarian to help me differentiate what might be going on with the cat, depending on how much weight they lose in over the period of time as well.

Dr. Sugerman: 7:39

Yeah, I think also having it in the house too is great because let's say they go to your clinic It may not be the same weight as at my clinic because our scales might be slightly off. So being very consistent weighing on a baby scale at home really will help with that.

Dr. Petra Černá: 7:54

Absolutely. And usually what I do with my patients, when I send them home I tell owners how much they weigh. So when they get the baby scale within the next few days, they can weigh them at the same time. So we know about where we are when we start and how it differs from my scale.

Dr. Sugerman: 8:11

And then you mentioned about blood pressure how blood pressure is really important. So why is that so important?

Dr. Petra Černá: 8:16

Yeah, absolutely. So cats can develop multiple diseases, especially senior cats. So for example, about 10 percent of cats over age of 10 can go and develop hyperthyroidism. So that is very challenging because these cats can develop secondary high blood pressure as well. And then for some of these cats, unfortunately, they can also develop chronic kidney disease, which is probably the most common disease we see in our senior cats. And that can cause high blood pressure in pets as well. So, very, very important that we really monitor cats over at least, I would say 7, 8, but definitely over the age of 10, that we really monitor them closely for their high blood pressures. Because sadly, I have seen too many cats that just come in our urgent care or ER that suddenly go blind because they have not had any blood pressure monitoring throughout their senior age and their blood pressure was too high for too long. And what happens, what we call eyes are, we call it the organ of target damage. So what happens there is the high blood pressure is actually affecting the vessels in their eyes. And it can cause bleeding. It can cause potentially the detachment of their retina, which is the back part of the eye. So, our caregivers cannot actually see it

Dr. Sugerman: 9:36

Yeah. And when you say bleeding, you mean bleeding into the eyes, not outside, right?

Dr. Petra Černá: 9:41

Exactly. So they develop bleeding at the back of their eyes. So again, it's something that we just cannot see with our own eyes. We need like a special device that we use to a special lens and then special light to do what we call a retinal exam to look at the back of the cat's eye, which is so beautiful by the way.

Dr. Sugerman: 9:59

It is very cool to see yes.

Dr. Petra Černá: 10:01

Yeah.

Dr. Sugerman: 10:02

Yeah. And I would agree. That's definitely one of the top things that I see in the ER. I see a lot of older cats that come in for kidney problems, hyperthyroidism, and also just vocalizing. Just walking around the house and meowing at things. And then we do more diagnostics, look at their blood pressure and we find out it's really high. And I see a lot of them blind. And people don't realize that because they get around the house just fine. They know their house, but now you put them into an environment like a vet hospital that they don't know. And I have them walk around and suddenly they're, running into things or they don't see you when you put your hand up to them. I think this is just like really subtle things that people don't realize and why it's so important for them to get that done on a routine basis.

Dr. Petra Černá: 10:44

Yeah, absolutely. And I think, it's definitely challenging. Like my cats don't love coming to the hospital either. I feel like I always, try to do everything the right way. So they are as less stressed as possible, but they just don't love it there. So no cat loves going to the hospital. I hate going to human doctors as well.

Dr. Sugerman: 11:02

Is there something we can do for those cats that don't like coming to the hospital?

Dr. Petra Černá: 11:06

Yeah, absolutely. There are so many things we can actually do. I think this would be probably another whole an hour talk. But I think the most important things are, for example, having a good carrier for the cats, making sure we just don't bring up the carrier the second they need to go to the vet because cats can actually associate that. So I've seen a lot of people now actually buying these soft carriers and the cats actually use it as their bed at home during normal day. And then they come with it to the vet as well when they need to. Because there's definitely a lot of, there's a lot of, I always feel like the vet visit starts at home. So there's definitely a lot of things we can do. Just thinking how we drive to the hospital, right? Not having loud music, making sure that it's a very calm way for the cat. And then coming to the hospital, making sure we try to, use those cat friendly clinics or places where cats can actually be waiting separately from dogs. Because I think worst thing is one time I had one of my clients who wanted to check in and even though in our hospital, you can actually put the cats on the top counter with the carriers. They put the kitty down on the floor with her carrier and a dog came smelled the cat and the cat was just so upset and I actually had to send the patient home and have them reschedule because he was just too stressed for us to do anything. So definitely so many little things we can think of just to make it more friendly for our pets. And there are medications as well that vets can prescribe for cats at home already for owners to give medications before they even start coming to the hospital.

Dr. Sugerman: 12:44

At our hospital, we actually have a whole section in the back that's just for cats. We have an enclosed room. And, since it's an ER a lot of times we'll ask them if we can bring them and keep their pet in the back, in the cat only area, which I know people get a little bit upset about because they want to stay with their cat, but really we're doing it just to make sure that cat doesn't get stressed out by all the loud barking dogs and all the noises in the front lobby. It's a very quiet area and I think that some people can ask that as well from their vet. Is there an area that you can keep them in until I'm ready for my appointment?

Dr. Petra Černá: 13:16

Exactly. And I think actually, when we were still dealing with the COVID pandemic, most owners were waiting in the car with their pets, which I feel like was actually quite helpful. So I think if you go to the vet that doesn't have a separate waiting area or separate space where the cats could be kept until it is the time of the appointment. I think just also waiting in the car, going to check in and just waiting with your cat in the car and telling the receptionist or the front desk that, please give me a call when it's our time to come in, if there are a lot of barking dogs, I don't see why anybody would be upset to do this because happy cat definitely makes my life way easier.

Dr. Sugerman: 13:54

Exactly. Yes, I'd much rather have a happier cat, and I always have a hard time because I'm in a very stressful situation in the ER, but I want to try to keep those cats as happy as possible so we can do as many things as possible for them. And then with doing as many things like I do a lot of blood work when they come in. Do you think that's a pretty important thing for routine stuff for them?

Dr. Petra Černá: 14:14

Absolutely. So definitely checking, first we always do the blood pressure because we want that to be as accurate as possible and cats are already stressed at hospital. So the blood pressure can be a little bit higher from the stress. And then potentially the next steps would be, of course, after that, getting blood work. We usually look at their, what we call, complete blood cell count or hematology, where we are actually looking at their white and red blood cells, because these older cats can develop anemia very often from different diseases.

Dr. Sugerman: 14:45

What's anemia real quick?

Dr. Petra Černá: 14:46

Yeah, anemia. So it means that you don't have enough red blood cells circulating around, so it can make you quite tired. It can make you sleepy. If you have very severe anemia, cats very often actually go around and they start licking floors or licking walls or bathroom tiles or eating their litter as well. So that's one of the common signs of anemia as well. And they are..

Dr. Sugerman: 15:08

So. So, pica essentially, right?

Dr. Petra Černá: 15:11

Yeah, exactly. Yeah, absolutely. And there are of course different types of anemia, but cats very often develop anemia actually secondary to their chronic kidney disease.

Dr. Sugerman: 15:20

Yeah.

Dr. Petra Černá: 15:21

Yeah, which is actually a blood test we can do for, so we call it serum biochemistry. So it's a special test we do. And then we look at your cat's liver enzymes. We look at your cat's kidney values. We look at your cat's what we call electrolytes. So there are things like potassium and sodium, for example, that we want to check as well. But I think the most important one usually is the kidney values in these patients. And I always recommend that we monitor their what we call total thyroxine levels or T4 for their hyperthyroidism.

Dr. Sugerman: 15:55

Perfect. And then what about a urinalysis? Is that pretty important for them as well?

Dr. Petra Černá: 15:58

Oh, I love that you are asking these questions because I actually don't think there is no such thing as a minimum database or what we call like the minimum you should do. And I think urine analysis should always be part of that. Because, for example, when we are looking at the kidney values, one of the parameters in blood called creatinine can go high. But there are other possibilities and not just kidneys that can make that high. So I think getting the urine analysis and actually looking how well the kidneys can concentrate urine and looking at what we call the urine specific gravity. So it's a kind of a magical number that we get to try to see how we can use, for example, a refractometer to look at that. It's like a special device where you put drop of urine and you look against the light and it tells you what is the concentrating ability of your cat's kidneys, because I think that's definitely a very important thing to do for these cats.

Dr. Sugerman: 16:54

Yeah, I think that could be a huge difference. I will see a lot of people who had blood work done, but not a urinalysis. And they think that the patient is in kidney failure, but really, when we get the urinalysis, we find it's not, maybe it's like pyelonephritis, which is an infection of the kidneys, rather than actually in kidney failure.

Dr. Petra Černá: 17:13

Yeah, and potentially these cats could also be dehydrated, right? So they're are older cats and especially I think you see that a lot in your ER that a lot of patients have not been well, they can be dehydrated and that can cause the increase in the creatinine or in one of these blood parameters too.

Dr. Sugerman: 17:30

Do you see a lot of people using the SDMA test as well?

Dr. Petra Černá: 17:34

Yeah, that's actually a great question. I think there is a great value to it in patients that are, for example, very skinny because of the muscle mass loss that we see in those older cats. Because the creatinine is actually affected quite a lot by muscle mass. So it can sometimes be falsely low and patient could still have a quite severe kidney disease. So we usually would recommend it for those senior cats that are quite skinny, have comorbidities like hyperthyroidism, for example, that make them go even skinnier or diabetes. I think for those patients, it's definitely a great way to help us diagnose them. I do not see it done like as a gold standard for every patient that comes through because it's usually a send out test.

Dr. Sugerman: 18:21

Oh, we actually have one in house.

Dr. Petra Černá: 18:23

Oh, really?

Dr. Sugerman: 18:24

Yeah.

Dr. Petra Černá: 18:25

Yeah. We have to, that's wonderful. We actually have to send it out. Yeah. Yeah. Lucky you.

Dr. Sugerman: 18:30

Yeah. And then what about some other things? What about dental care? I see that a lot in our older cats that people come in a lot on ER saying that their mouth hurts. So what is some pretty standard senior dental care look like?

Dr. Petra Černá: 18:43

Yeah, I think that's very important as well. My 10 year old, actually, she's also a brachycephalic cat. So she is..

Dr. Sugerman: 18:50

What's a brachycephalic cat?

Dr. Petra Černá: 18:51

It means that she has this flat face, so very short, flat nose. And so she's more predisposed because of her face or head anatomy. She's more predisposed to developing dental disease. So she actually gets dental kind of cleaning, but sometimes also need some extractions every about two to three years. So we are actually very proactive about that. I think it's very hard to clean cat's teeth, of course, but they actually, sell these like different shapes of kibbles that actually the dry food so they could help potentially with getting some of the plaque off but I think probably for cats the best way is really to, you know, go see someone who specializes in dental care for these cats because they can really look at your cat's teeth and evaluate if it's something that potentially might need even some extractions as well because cats can develop what we call a resorptive lesions, so their teeth can go quite bad and we cannot see it on the outside. We really need like dental radiographs to diagnose those and those can be quite painful for the cats. And yeah, so things to watch out for actually, cats tend not to completely stop eating when they have dental disease. But the important thing is they tend to have a different preference. So watching if your cat is chewing more on one side or suddenly like all her life or his life, they loved dry food and suddenly they just want to eat canned food. Or changing their food preferences or really focusing on chewing one side versus the other is more things that we definitely should watch out for.

Dr. Sugerman: 20:23

Yeah, I do talk a lot about that because a lot of people come in saying they're not eating. And so therefore I think it's a tooth problem. Unfortunately, most of the time they are still eating. This is usually something else that's going on.

Dr. Petra Černá: 20:34

Yeah, unfortunately it is. I completely agree with that.

Dr. Sugerman: 20:38

Yeah. So you had mentioned like dental type foods. Is there other really good foods for senior cats?

Dr. Petra Černá: 20:45

That's a great question. So we try, because of the high prevalence of the chronic kidney disease in cats, we usually try when they get over a certain age and it really depends on their blood work as well. But we potentially try changing their diets to more kind of senior care diet. So if you imagine like kittens growing up, they have high protein needs, so their diets are actually much higher in proteins. While then in cats, we try to limit their protein intake because of their kidneys, and also potentially limit their phosphorus in foods as well. So I think these senior kind of care diets can be very helpful for cats.

Dr. Sugerman: 21:24

Yeah. And should you be looking for ones that specifically talk about like dental care stuff as well with it?

Dr. Petra Černá: 21:31

Potentially, I think it's very hard to completely just avoid doing like dental cleanings and extractions if the patients need it. And we will not fix an already existing dental disease with the diet, but I think it's a good way to potentially prevent it as well. But senior cats being senior cats, they have a lot of comorbidities. So I wish there was one magic diet that would fit all, but unfortunately nutrition is a very complex issue. And especially in our senior cats, because I sometimes have cats that have chronic kidney disease, need lower protein, and then they have diabetes and they need lower carbohydrates. So it's always finding a really tight, sometimes even balance for these patients.

Dr. Sugerman: 22:15

Yeah, do you recommend like any supplements or anything then as well as the diet?

Dr. Petra Černá: 22:21

That's a wonderful question. I actually try avoiding supplements quite a lot because in this country especially, there's no regulation for supplements. So I can go, and I think I mentioned it. I don't know if in the last podcast, but I really could just go on the market tomorrow with the magical supplement for cats. It's going to make them live to their 30. Nobody's gonna check what I'm putting into these supplements. I don't have, yeah, I don't have to have any studies, not showing that they're beneficial, but not even any studies showing that they are not harming the pets. Which is quite fascinating. So I'm always very careful with supplements. I think there are definitely some good supplements potentially to use. For example when patients have chronic kidney disease, they get constipated. So there are ways to definitely start working with like laxatives or Miralax, for example, or some probiotics for these patients to help with their, they can develop these uremic toxins because their kidneys cannot process all the protein and other things. They can potentially start having more of these toxins and reabsorbing them in their colon, which is the large intestine if they are constipated. So I think there are definitely good supplements out there, but I think I am always very careful before prescribe or like recommending any.

Dr. Sugerman: 23:49

Do you have any that you do recommend like any of like probiotics or anything that you more specifically recommend.

Dr. Petra Černá: 23:55

Absolutely. Being a very cat oriented person and a cat friendly. I usually use the, and I don't know if it's okay to say the brand and stuff, but..

Dr. Sugerman: 24:07

Pretty sure it is.

Dr. Petra Černá: 24:08

Okay. Okay. for the FortiFlora ones are usually pretty good because they can be mixed into the food, so we can avoid pilling cats because that definitely can be stressful for them as well. And the FortiFlora actually quite palatable to cats, so it has a pretty good taste. Some cats will still not eat it at all. But I think for most of them, I think they prefer that over to, for example, being pilled once a day.

Dr. Sugerman: 24:34

Absolutely. I do get a lot of people who ask can I just put my own probiotics on their food?

Dr. Petra Černá: 24:41

Yeah. A great question and actually our kind of microbiome is very different to dogs and to cats as well. So we would actually, ideally, really want to just be using like a cat probiotics. There are some that they are like made for cats and for dogs. And when you actually look at it, they don't differ almost at all. And yeah, so it is definitely, I think probiotics are a huge thing. And now the microbiome or all the good bacteria living in our gastrointestinal tract and elsewhere are asked because there's also the skin microbiome. And yeah, so it's, I think it's a now hot topic

Dr. Sugerman: 25:17

Oh, yes.

Dr. Petra Černá: 25:19

It's being discussed quite a lot as well. But otherwise for supplements I do not have that many that I would be like using regularly.

Dr. Sugerman: 25:28

What about like Omega 3s? I know that's a very popular question as well.

Dr. Petra Černá: 25:32

Yeah. I usually would be recommending these in a form of a fish oil. So we definitely could be using fish oils. There are some brands potentially that have been tested a little bit more than the others. I think it's a great way, especially for cats with osteoarthritis, for example. We could, and we use it also for their skin. So it's a definitely a great supplement. Cats sometimes can develop diarrhea on it. They can not eat as great as well. So it can cause some gastrointestinal upset. So we just have to be careful and I usually start them at very low doses and build them up towards the dose they need and the doses differ very much between osteoarthritis or if you have diabetes and your lipids are too high in your blood. So very different dosing as well. So I think again, there is a lot of research now on kind of fish oil use in veterinary medicine and the dosages are very different for different diseases. So it's not just oh, give one spoon or tablespoon or one pump of the fish oil and it'll fix all. Yeah. Yeah.

Dr. Sugerman: 26:33

Yeah, I didn't even think about the diabetes one. That's a great thing to be thinking about because I'm always like, Oh, it says on the back of the package exactly how much you should give. So it's super interesting to think about the differences that each one of these cats really needs and to tailor it to them.

Dr. Petra Černá: 26:48

Exactly. For example, for osteoarthritis, the doses tend to be like higher compared to if we have like high triglycerides in blood and for example for miniature schnauzers, when we would use that for their high, because they're predisposed to having high lipids, triglycerides or hypothyroidism as well. I actually have seen a lot of cats on steroids, corticosteroids, like prednisolone, develop hypertriglyceridemia, so I've been putting those on fish oil to help with that as well.

Dr. Sugerman: 27:17

Interesting. Yeah. Is there anything else you wanted to talk about medically before we talk about like at home stuff?

Dr. Petra Černá: 27:24

Yeah, absolutely. I would just like to mention that I think it's really important to really monitor your cats and their drinking, their food intake, their water intake, how much they're urinating, just to see because with some diseases, cats can develop increased drinking and increased urination. Sometimes they can go really hungry and then, still not be gaining any weight, which is, for example, a sign of diabetes or hyperthyroidism. My 10 year old now, I've just been like noticing she starts to drink a little bit more, but we've just done full blood work and urine analysis, so if you're gonna recheck that in a month and if it's still normal, I'll probably will need to do like an abdomen ultrasound to check if her adrenals and everything else is okay, because I'm very paranoid about her health, so I definitely might be watching her a little bit too much, but there are really important things to watch for. Especially with their water and food intake and their urination and defecation. And those older cats, I would really ask the caregivers to focus on how the cats are actually pooping and like we have these what we call fecal scores. So if it's actually dry and hard, those cats can be more prone to constipation. They could be more prone to dehydration. And one, it's not comfortable to be constipated, it can lead to severe medical problems. I am sure you see a lot of constipated cats in an ER.

Dr. Sugerman: 28:50

Lots of them, unfortunately.

Dr. Petra Černá: 28:52

Yes. And it can be quite expensive to deal with that as well. While noticing it and bringing those cats earlier to the vet and just starting them on some maybe a new diet or potentially things like Miralax that can really help these cats a lot would be important. So really watching them, maybe not as much as I do, but definitely watching them quite a lot. They actually are selling this. The automatic litter box now and it actually weighs the cats like daily.

Dr. Sugerman: 29:22

Okay, I've heard about this, yeah.

Dr. Petra Černá: 29:24

Yeah. And you can buy these like scales that are under the litter box and weigh your cats as well. They are now microchip feeders, so you can monitor how much your cats eat. I'm really wanting, there is a actually water bottle that monitors how much your cat drinks. But unfortunately, my cats are too spoiled and we have like water fountain on each floor and two downstairs actually. I don't think they would drink because this is like a still water and I don't think either of my cats would actually drink from it. So I'm really hoping the second someone develops monitoring water fountain, we are getting it.

Dr. Sugerman: 29:58

Yeah, exactly. I know they also make things like, so you have, if you have multiple cats in the household, like I have a cat who's three and I have a cat who's, I think, eight now and I have a cat who's about 14 now. So I know that they also make like feeding bowls that will attach a collar special for them so that only that cat can go in there so you can monitor their food intake as well.

Dr. Petra Černá: 30:20

Yeah, exactly. Or they work just with microchip. Interesting thing though. I was just giving a lecture at our CSU care conference last weekend. And I mentioned this. And then these people came to me after my lecture and they were like, yeah, it's so great we've had it too, but our old slim cat is so nice and kind to the big chubby cat that she just moves to the side and he can still squeeze in there and eat with her. So they actually put like a little ball within the microchip feeder ball so it's just so tiny that only one cat for sure can eat from it.

Dr. Sugerman: 30:57

That's funny. I didn't even know that could happen.

Dr. Petra Černá: 31:00

I know me neither. I was like, I always recommend this and no one has ever complained about it. And then they came to me and so they sent me some pictures. I was, it was so cute. So she was like there, but she just moved a little bit to the side so he could still fit in.

Dr. Sugerman: 31:15

I could definitely see one of my cats doing that.

Dr. Petra Černá: 31:17

Yeah.

Dr. Sugerman: 31:18

Yeah, they're sneaky.

Dr. Petra Černá: 31:20

Yeah, exactly. They're very smart.

Dr. Sugerman: 31:22

Also, what do you think about monitoring other things? Like, where they lay? If they prefer the warmth versus the cold or laying in the window more like those kind of things.

Dr. Petra Černá: 31:31

Yeah. And I think just monitoring that because older cats is actually extremely common for them to have a degenerative joint disease. And they can definitely change their activity level. So for example, a cat that used to absolutely love to sleep on a window might not be sleeping there now. And it's not because she doesn't love sleeping on the window, but it's too painful for her to actually get up to the window. I have a lot of clients who actually build stairs or little ramps for the cats to still get to the bed, get to the window. And there are a lot of environmental adjustments we could actually do at home for these cats. So definitely monitoring the activities. I've had a cat that was my patient for several years and just like about last year, caregivers were very concerned that she was just staying downstairs and not wanting to come up. And so we diagnosed her with degenerative joint disease and started treatment for that. And actually after six months, where they were actually really considering her quality of life because she was just like not moving too much, with the right medication she actually started like running around like almost like a kitten again. So it was really beautiful to see.

Dr. Sugerman: 32:41

Nice. What other environmental things can we do to help them then, for our senior cats?

Dr. Petra Černá: 32:46

Yeah, I think senior cats, that's why I feel like I'm so close to my cat patients, because I think in my, either my future or my past life, I definitely was there or will be a cat because I love soft pads, warm beds. I have a heating pad in my bed. And I even in summer use it. So cats definitely. They love to be warm. They love to be soft. So I actually just watched a video on degenerative joint disease and pain in senior cats yesterday, and they were showing how there actually was a kitten that just love to like always be at the kitchen counter. So they built her like little stairs to the kitchen counter. And then she had a special soft bed there next to her water bowl. So also like maybe moving, for example, let's say the cat loves to be in the bedroom or loves to be in the living room. So moving what we call their like most common resources. So food, litter boxes, and everything, moving all of that into one space. So there's suddenly the cat doesn't have to go upstairs every time she needs to pee, right? Or going downstairs every time she wants to poop, because then she's going to poop outside of the litter box. Because it might be just too painful for her, and it's not worth for her to go up and down the stairs just to go and use the litter box. Or they stop eating because, we have dogs in the house and the cat food bowls are so high and it's not comfortable for them to jump up anymore. So they definitely can have decreased food intake from that as well. And all these different types of water bowls or food bowls that we can have them elevated so the cats don't have to bend their neck when they have degenerative joint disease in their spine. Or using very low litter boxes because there was like a this litter box that I saw on the internet and it actually had a hole on the top so..

Dr. Sugerman: 34:33

So they jump into it. Yeah.

Dr. Petra Černá: 34:35

I know, and yeah. Would I love not to have the litter all over my house? Probably. But imagine those senior cats having to jump up, then jump down and jump up again. I wouldn't bother with that, so I would probably just prefer going, I don't know, pee in my owner's shoes.

Dr. Sugerman: 34:51

Yeah, exactly. Even those ones that have a big lip on it, I think are still really difficult for them to get into.

Dr. Petra Černá: 34:57

Yeah, absolutely. And, cats can also develop what we called cognitive dysfunction or dementia. So I think it's very underdiagnosed disease in cats. And having had a cat with dementia myself and having to take care of her, things are very challenging. Like she started meowing middle of the night because she was lost in my living room. Back then I was a poor intern who literally had it was the two kind of bedroom, but it was like one bedroom because it was in UK. So it's like a one bedroom. It was a one bedroom, a living room and like a tiny kitchen. So it was so small, but she still managed to get lost there. So then like middle of the night, I just would have to go get her, bring her to bed and just, so these definitely can be challenging and it can be very stressful times for the caregivers and for the pets as well.

Dr. Sugerman: 35:49

Is there anything that can be done for some of these cats who do have dementia?

Dr. Petra Černá: 35:53

Absolutely. So a lot of the times it's a lot about the environmental modifications and trying to actually understand. Why do cats have increased vocalization? I actually did a study on this where we were asking owners or clients with patients that had a cognitive decline or dementia. Actually, why did they think their cat was crying? And sometimes it was because the cat wanted more attention. So I know it's not always the best thing 4am in the morning that your cat suddenly wants to cuddle. So there are potentially medications we could give them. Like I've used melatonin in cats to make them a little bit more sleepless through the night or gabapentin to again make them a little bit more steady throughout the night. So they are a calmer as well. But some, for example, caregivers would say that the cats were meowing because they were hungry. So one of my actually previous bosses and my mentor's cat, she would he would meow three times a night wanting to eat and then they gave him this timed microchip feeder and he just went and ate, and he got used to that and it has helped a lot. So it's small things really that can potentially help these cats.

Dr. Sugerman: 37:06

Those all sound like really fantastic things to work on. I have, I do have one patient who she had come to me about her cat vocalizing in the night as well and really could not figure it out. She actually thought that he was blocked, so had a urinary blockage because he had one in the past and so she kept bringing him in and poor thing, she'd have to bring him in the middle of the night. But luckily he wasn't blocked and we started to figure out it's more that he most likely has dementia and using the gabapentin is what I used. That really helped a lot for him.

Dr. Petra Černá: 37:34

Yeah, I think there are definitely a lot of ways to help these cats, and definitely like coming with some puzzle toys as well to keep them a little bit entertained and active as well, or potentially really changing even those litter boxes. I had one that just hated to go we had a little bit higher litter box. I had to get a second one. It was very low at the bottom because pain definitely can cause the increased vocalization. So, it might not just be one thing. They might be painful. So helping with that is a big thing as well. Or like you said, we really need to check blood pressures in these patients because that can definitely cause the increased vocalization as well.

Dr. Sugerman: 38:14

Yeah, and are there other things to do to help keep them active? I'm assuming we want to keep them more active than sedentary. Is that right?

Dr. Petra Černá: 38:22

Yeah, I think it's always great. So I think I love those puzzle feeders. I love other puzzle toys that we could potentially use for those cats. It really depends because if they have degree of the degenerative joint disease, it would be really important for them to first get their pain managed. But otherwise, you know, I just bought this cat wheel as well.

Dr. Sugerman: 38:42

Oh, yes. I've heard a lot about this.

Dr. Petra Černá: 38:43

Yeah. I know they haven't used it yet. Most of my cats are pedigree cats. They're not as smart as the smart domestic short hair cats, but I'm still hoping someone will eventually use it because a lot of my friends have that and the cats just love using it. So there are definitely ways. If the cats used to go outdoors, maybe it might be just good idea to put those GPS trackers on them because these older cats cognitive decline, they can get lost even inside the house, so they can get lost outside. So definitely maybe just making sure we have good trackers on those. So if they get lost, we can find them.

Dr. Sugerman: 39:18

I know a lot of people have been using the Apple air tags on their collars, which I think is fantastic. So you can at least get to an area where they potentially could be.

Dr. Petra Černá: 39:28

Yeah, absolutely. I actually have seen that in a couple of my patients as well. It's great. Yeah.

Dr. Sugerman: 39:34

What do you think about using heating pads for them? I know you mentioned that you love heating pads, but I've seen people that have put a heating pad and a bed over the heating pad in areas that they like to lay. What do you think about that?

Dr. Petra Černá: 39:46

Yeah, I think it's great as long as we are careful that the cats don't lay directly on the heating pads, because these older cats, if they lay on it all day, they definitely could end up with some burns as well. So we just have to be careful and making sure that, they are warm and we can be using those heating pads, but just making sure there is some protective layer between the cat skin and the heating pad itself actually is important.

Dr. Sugerman: 40:11

Is there anything else you wanted to mention about just like at home stuff with them?

Dr. Petra Černá: 40:15

It's a great question. I think really just watching these cats and just making sure we are really aware of all the change behavioral changes that are happening so we can approach those because for example, if you are then worried and you come to me, I will be asking you a lot of questions. Does your cat jump up? Does your cat jump down? How fast does your cat go up the stairs? How far do they go down the stairs? Because all of these things are really important for us. And I think it's really a lot of watching them and just observing them for a couple days. And there are great online resources with like questionnaires, for example..

Dr. Sugerman: 40:53

I was going to ask about that. Yeah.

Dr. Petra Černá: 40:55

Yeah, for degenerative joint disease. And so we can maybe share some resources for those if potentially the caregivers would like to look at those as well.

Dr. Sugerman: 41:05

Yeah, I think that's that would be a really helpful resource. I was wondering if you actually had it at the university there. People don't think about all the questions. And then now you have to think about it when you're under stress at the vet clinic, and you only have this very short amount of time. So I think having these questionnaires ready to go beforehand, you can send it to the vet beforehand so they can see all these things and then have more time to talk in the exam.

Dr. Petra Černá: 41:28

Yeah, I think it's a wonderful idea. I know our dermatologists, for like dermatology, like they have these like long questionnaires about everything. And I think we really need like a good validated questionnaire for quality of life in cats. So I think it's one of my passions and I've been talking to a couple people about this because I really feel like we need this. Very much because we always forget to ask questions and especially in cats. Sometimes these changes can be quite subtle and we might not immediately see them. So really knowing what we are asking about is important. And sometimes, I think it's a great idea to ask these in advance so you can fill them before you come to the vet. Because then, nobody has that much time, we are focusing on the cat there, and then we might forget things for sure.

Dr. Sugerman: 42:19

Yeah, and it could be something really important that we wouldn't even have thought of, like going down the stairs fast versus going slow or yeah, I will typically ask about jumping up. Are they having a hard time jumping up? But I wouldn't think necessarily about the stairs.

Dr. Petra Černá: 42:31

Yeah exactly. And you know, sometimes there are no stairs, so it's a different story. But yeah, so I think it's important. Sometimes cats can, when they get more older, they can get more agitated with other cats in the house as well. My patience has never been great, but the older I get, I think, the worse it gets. And just small things can really agitate me much more than they used to. And it's same with our senior cats as well. So even like interactions with other cats in the house are really important as well. And yeah, I just think these days we have so many options for senior cats that we can do. So I hate when either veterinarians or the caregivers, Oh, the cats old. And I'm like, age is not a disease. I have plenty of my patients that live to almost 20, sometimes even above 20. So age is definitely not a disease. And senior cats is why I love working with them. They have their challenges. They have so many comorbidities and for a lot of. Vets, caregivers, it can be very challenging to, manage all of these at the same time, but there are actually really good ways, like medications, but just the environmental modifications and everything that we can make a really good quality of life for these cats for many more years.

Dr. Sugerman: 43:50

Absolutely. I do find a lot of people who are talking about a lot of end of life stuff. Unfortunately, I get a lot of that in the ER, and I do think that's one of the biggest things I hear from the older cats is they're just old and it's really hard for them to get around and they're pooping in the house and I think just like those regular vet visits where they can talk to somebody about like how to help prevent all of these things and modifications that they can do can really help with that because I definitely see cats who are older, like 15, 16 still live to 22, even with some of those diseases that they have, with having hyperthyroidism or having kidney problems. I had a cat who I think he lived to 18, if I remember correctly. And he had kidney problems since he was about 12.

Dr. Petra Černá: 44:36

Yeah. Exactly. And they definitely, cats, they are fascinating creatures. They want to be here. And I think it's really important the sooner we diagnose these diseases, usually the milder they are and the better we can manage longterm. And there definitely is a way sometimes they have, terminal cancers, for example, and we just need to talk about palliation and really just making them comfortable. But a lot of the times they are diseases that we can treat for years and years. And I think feline medicine is changing a lot and there are definitely a lot of things we can do for our cats to really give them a good quality of life because that's always our main goal, right? There is no point in cats living here until 20, if they're painful and miserable, for example. But I think about the house soiling you mentioned, no cat is really mean to a point that it wakes up in the morning and says, I want to make my owner upset today and I'm just going to go and pee and poop around the house. It's their way to say us that something's going on. They're not happy either with other cats in the house or they are painful or they are sick or there's something going on with them. Nobody, no cat just wakes up in the morning and says, let's just make my owner upset today. That's not their life goal.. Their life goal is to sleep and eat and have a good life.

Dr. Sugerman: 45:56

Right. They're not going to be like vindictive. They're really just, they really just want to be.

Dr. Petra Černá: 46:01

Exactly. They just want to be here like mine, just Bellina now. And still she's purring here and that's a life goal, life dream. I just want to like, enjoy the sun, enjoy my food and sleep for most of the day. And get my human slave to, to pet me and feed me. Yeah. So they definitely are not vindictive. They're not mean, so they don't do it because they want to make us upset. They do it because they're telling us something is going on.

Dr. Sugerman: 46:29

Was there anything else you wanted to add to all this fantastic information that you've shared so far?

Dr. Petra Černá: 46:34

No, I think I think that's probably all. Yeah.

Dr. Sugerman: 46:37

All right. Perfect. So I wanted to ask you what your favorite cat breed was.

Dr. Petra Černá: 46:42

Oh my God. This is so hard. Oh my God. I have three different breeds at home now. So the love of my life, she is the smush or flat face cat. She's an exotic short hair. I've been breeding British short hairs for almost 20 years, so I definitely love those. And now I have three Ragdolls as well. But if I had to actually choose a cat that I do not have that I very much love, I definitely love Abyssinian cats a lot.

Dr. Sugerman: 47:11

They're very pretty.

Dr. Petra Černá: 47:12

Yes, and Siamese, but they are just very.. Siamese are vocal, vocal I do not mind that much, but Siamese are very human dependent cats and with me working 12, 14 hours a day and not being home and traveling a lot for work, they wouldn't be happy cats with me. I actually used to own a Siamese in the past and I had to find her a new home because she was just not a happy cat with my lifestyle. And Abyssinians, a friend of mine actually breeds them and I always tell him that. Five of my British short hairs will not still equal one of his Abyssinians, because they are, they're crazy cats, but my god, they are one of the smartest cats I know.

Dr. Sugerman: 47:52

They would use your wheel.

Dr. Petra Černá: 47:54

For sure, and I'm a cat judge too, so I go a lot and judge on cat shows, and they always go and give you those like head bumps and kisses, and they're just wonderful cats. And also my very first cat was actually a red tabby domestic short hair, and I still keep dreaming about getting one soon. So I think my next cat actually is going to be a red tabby or red tabby and white boy.

Dr. Sugerman: 48:21

Nice. Yeah, we have three cats, but I don't know, they're just domestic shorthairs. But..

Dr. Petra Černá: 48:27

I never say just, I absolutely love domestic shorthairs.

Dr. Sugerman: 48:30

Oh, I love

Dr. Petra Černá: 48:31

Yeah. Yeah.

Dr. Sugerman: 48:32

We're just three different colors. That's all

Dr. Petra Černá: 48:34

Oh, what colors do you have?

Dr. Sugerman: 48:35

We have a grayish brownish tabby and then a gray and white cat and a she looks like a Himalayan cat.

Dr. Petra Černá: 48:45

So color pointed. Yeah. Yeah. Yeah. I love those too. My ragdolls are of course with blue eyes and everything, but yeah, I dream right now. I dream about the red tabby and white boy. Yeah.

Dr. Sugerman: 48:59

All right. Perfect. Thank you, Dr. Černá. We appreciate you always so much for coming on and talking about cats. Cause that's, I feel like I talk a lot about dogs and dog diseases cause I see so many dogs that come into the ER, but it's really helpful for a lot of preventative things for people to hear about these cat things and especially for senior cats.

Dr. Petra Černá: 49:17

I love that too. It was a pleasure. I always love talking about cats.

Dr. Sugerman: 49:20

Perfect. All right. Thank you everybody. And next week, I believe we're talking about heartworm disease and we will see you then. Thanks. Thank you again to Dr. Černá, the Crazy Cat Vet, for all of her expertise on cats. We really appreciate everything that she does for them. People don't know this, but she even has extra certificates specifically in cat care itself. So we really appreciate her insights and all of the care that she gives to her cats as well. So from all of

49:47

the

Dr. Sugerman: 49:47

cat parents out there, thank you to her. Also, thank you to Shawn Hyberg for doing our editing for our podcast and Kelly Dwyer for doing our website. In the next coming weeks, you're going to be hearing from a couple of people, including Dr. Z about heartworm disease. We're going to be talking to a veterinary ophthalmologist about eye care in animals. And we'll also be talking to Dr. Černá again for another cat specific topic. Thank you again everybody, and we will see you next week.