The value of regular exams

The last time I saw Rosie (not her real name) was three years ago. At that time she was a plump middle-aged cat in good health. Her owner brought her to the clinic one morning a few weeks ago, worried because she had stopped eating. Emaciated and weak, her body weight had gone from 14 pounds the last time we saw her to just under seven pounds. She was dehydrated and had trouble keeping her head up. Her heart was racing and I detected a heart murmur. In addition, there was a nodule in her neck in the area where the thyroid gland is located.

Her owner explained that he hadn’t thought to bring her in for regular checkups because she was a house cat and had seemed healthy, but now something was terribly wrong. He was aware that she had lost weight but thought it was because he had changed foods.

The combination of her age, extreme weight loss, and clinical signs made me strongly suspect an overactive thyroid as the cause, although I could not rule out other conditions such as diabetes, kidney failure, or cancer. I took blood and urine samples to send to the lab, gave her fluids to correct her dehydration, and gave her the first dose of medication for a thyroid condition, even though I wouldn’t have the test results until later that afternoon.

My suspicion was confirmed. Her thyroid level was over four times the upper limit of normal. Unfortunately, there was also a tremendous elevation of an enzyme indicating muscle destruction that can occur with extreme and prolonged thyroid elevation. Her disease had reached a stage that we refer to as thyrotoxicosis. Unfortunately it was too late to help poor Rosie, who died that night.

Another patient, Bucky, was a healthy middle-aged cat when his owners adopted him. As time passed he developed several problems. The first was diabetes. Overweight cats, like overweight humans, are particularly susceptible. I started Bucky on insulin injections and a special diet. A few cats who are diagnosed and treated early in the disease can revert to normal so that they no longer need insulin, and Bucky was one of the lucky few. A couple of years later he became hyperthyroid. That was easily brought under control with the appropriate medication. A couple of years after that his kidney function was beginning to falter, a common problem in elderly cats. I switched him to a special kidney diet and gave him medication for his kidney-related high blood pressure and he did well. He lived happily with people who adored him as long as he had a good quality of life. Bucky was 21 when his family finally had to say goodbye to him.

Regular exams are an important part of routine care, especially as our animals age. And while it’s true that house cats don’t have to deal with the dangers of cars, wild predators, or infections from fights with other cats, they are just as susceptible to dental disease, heart problems, and a myriad of age-related maladies. Some conditions are preventable, others may be treatable.

Changes may be subtle, so that they are not easily noticed, especially in the early stages. Rosie’s thyroid disease would have been easily controlled if we had diagnosed it before she became critically ill. The same is true of other problems such as heart disease, kidney insufficiency, diabetes, and other endocrine problems. We recommend regular blood testing in animals that are middle aged or older. The test panel evaluates blood sugar, liver and kidney function, thyroid, and other systems.

The list of treatable conditions gets longer as veterinary medicine matures. Regular exams and monitoring are essential keys to keeping our pets healthy as long as possible.