Your Cat and Chronic Disease and Management
Effectively managing chronic disease and pain in the cat can be a serious challenge. Our goal is to help you manage your cat's chronic disease (or diseases) and pain to attain the optimal quality of life for your kitty, without making your life impossible in the process!
Categories of Chronic Disease
The definition of a "chronic disease" is a disease process that has a lengthy course in general. These can be divided into two general categories: curable and not curable. Most of the incurable disorders we see are manageable. In some cases, we won't know which category a particular diagnosis falls into until we assess response to treatment.
In a surprising number of cases, any chronic disease your cat has experienced for years may improve or resolve as a result of the single act of beginning an evolutionarily appropriate diet.
The goal for our patients is a good quality of life for as long as possible. In some terminal situations, we might not be able to comfortably manage a chronic incurable disorder to a level that provides an acceptable quality of life, and in rare cases, not at all. In those sad cases, a discussion of hospice treatments or end-of-life planning may be necessary.
Curable Chronic Diseases
Many chronic diseases we see in our new patients were considered incurable at other practices, and were managed as such. We find that many of these problems will improve or resolve once the kitty is eating a species-appropriate diet. (And yes, that means that we believe that a surprising number of common feline disorders are caused by their diet. This includes nearly all commercially available cat foods.) It is always a wonderful thing to watch many of these problems resolve, often with no intervention at all other than diet change!
There are chronic diseases that can be cured by means other than diet change, but not many. Hyperthyroidism is a good example of this.
Manageable Chronic Diseases
There are many disorders that are chronic and may be incurable, for which monitoring and management can can help your kitty achieve a good quality of life. Some of the most common include:
- Inflammatory Bowel Disease (IBD)
- Chronic Renal Insufficiency (aka "Chronic Kidney Disease" or "CKD")
- Hypertrophic Cardiomyopathy (HCM)
- High Blood Pressure ("Hypertension")
- Chronic Pancreatitis
The importance of managing an incurable disease can best be understood through an example such as hypertrophic cardiomyopathy (HCM), which is the most common heart disease in cats. HCM is not curable; it is arguably not even "treatable;" there is no known treatment that will influence a heart affected by HCM to get better. Even though cure is not an option (and perhaps more so because cure is not an option), management is very important for kitties with HCM. This disease typically progresses over time, usually (but not always) slowly. More importantly, although HCM itself cannot be cured, treatable and manageable complications of the disease can and do develop over time. For HCM, and other incurable chronic diseases, early identification and management of these complications can significantly increase the quality of life and life expectancy of your kitty.
Identifying a Chronic Disease
The first step in managing a chronic disease is diagnosing it. Cats are masters of hiding illness. Sometimes subtle signs of illness may be apparent, but many chronic diseases can become quite advanced without any recognizable change in a cat's behavior or physical appearance.
Regular periodic laboratory testing is crucial for the timely diagnosis of most feline chronic diseases.
The earlier a diagnosis can be made, the faster management can be started. Depending on the disease, treatment may not be needed initially. If disease progression or the development of complications means that therapy is needed, the sooner we start that therapy, the better for your kitty and for you!
The Key to Effective Chronic Disease Management: Monitoring
The key to effective management of most chronic diseases is regular monitoring, for both disease progression and any disease complications. Most monitoring, such as keeping track of appetite, thirst, litter box use, weight, and activity level, can be done at home. Cats with chronic diseases should get routine veterinary evaluations, including examinations and/or laboratory diagnostic testing, more frequently than a healthy cat. The optimal monitoring frequency for any individual depends on the situation, and may change over time.
Although most chronic diseases cannot be cured, secondary complications can be identified and managed to keep your kitty as comfy as possible. Prompt detection and intervention are key to a successful outcome. Talk to your feline veterinarian about what types of monitoring might be best for your cat, and how often your kitty needs to be monitored.
Just about every chronic illness will eventually progress; but progression patterns can vary widely between individuals with the same disease, and even more between one disease and another. In general, the risk of developing a chronic disease goes up with age, but younger cats are still at risk for certain chronic diseases. Once a chronic disease develops, progression can vary from minimal to rapid, which is one reason why planned periodic monitoring is so important.
Your Cat and Pain Management
Chronic pain disorders can be a real problem for cats, just as they are for people. Our most important goal is good quality of life for our patients, which often mandates chronic pain management techniques.
Many cats experience chronic pain as a result of underlying, identifiable health problems that can be addressed directly. When pain is present as the result of an identifiable, treatable, or manageable condition, the most effective approach is to identify the condition and cure it if possible, or manage it if a cure is not possible. The goal of this approach is to remove or minimize the cause of the pain.
Other cats may experience chronic pain as a result of health problems that are either incurable, or for which attempting identification and cure is financially infeasible for the cat parent. When faced with a situation like this, chronic pain management is the most important step we can take.
Types of Pain
Pain comes in different forms, and different approaches are indicated for varying kings of pain. In general, pain falls in one of two categories:
- Adaptive pain (acute pain) — Adaptive pain is pain that serves a useful purpose.
Adaptive pain is what we experience with acute injuries, illness, or surgery. Effective management of adaptive pain can prevent the development of a chronic pain disorder.
- Maladaptive pain — Maladaptive pain is pain that does not help us, that serves no useful purpose.
Maladaptive pain can result from many different chronic conditions, and is therefore more common in Senior cats. Pain impairs healing; this makes it necessary to manage chronic pain well to achieve both the best possible quality of life and the optimal chance of full healing.
Ineffective (or absent) management of acute pain may lead to neuropathic pain, a state of chronic pain that persists even after full tissue healing. Neuropathic pain can be very difficult to manage well. Preventing it by assiduous treatment of acute pain is much better for the patient. A pain-free outcome for your kitty is our goal!
We Are Here To Help
A chronic disease or pain diagnosis for your cat can be overwhelming at first, but we are here to help. We do not believe in a standard "cookie-cutter" approach for all cats. Every plan is personalized depending on rate of progression, complications, other diseases, financial constraints, ease of administering medications, and any other issues specific to your kitty and your household.
If you think your kitty might have a chronic disease or want to learn more about our pain management philosophies, please call us at (303) 500-5158.