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| Dr Susan Little with Zanzibar. |
When
it comes to all things feline, Dr Susan Little is one of the big players on the
international field. She is the owner of Bytown and Merivale Cat Hospitals inOttawa, Canada. She
serves on the board of the American Association of Feline Practitioners and the National Board of VeterinaryMedical Examiners.
She
is also am the editor and co-author for two textbooks: The Cat – Clinical Medicine and Management (2012) and August’sConsultations in Feline Internal Medicine volume 7 (2016) . She is visiting Australia later this year to talk at the Centre forVeterinary Education’s Feline Medicine conference. Two
topics she will be discussing in detail include feline pain and feeding the
anorexic feline patient. Despite her hectic travel schedule, she took some time
out to share her thoughts with SAT.
What motivated you to become a feline
specialist?
I’ve
always been primarily interested in cats, and entered feline-only practice not
long after graduation. It was a logical step to pursue board certification in
feline medicine to help develop my skills and my career.
Why is feline pain challenging to
recognise?
Cats
are skilled at hiding their signs of illness and pain as part of their survival
mechanism. Their signs of pain are therefore different and often subtler than
those seen in dogs and people. In addition, pet owners have a different
relationship with their cat than with their dog; it’s often less interactive
especially in terms of exercise and feeding, so that lethargy and decreased
appetite are not noticed as quickly in a sick cat as they are in a sick dog.
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| Cats and kittens can be very hard to read. |
How do you identify/quantify feline
pain in your practice?
Unfortunately,
there are few validated pain scoring systems available for cats. For
musculoskeletal pain, I recommend the Feline Musculoskeletal Pain Index from
Dr. Duncan Lascelles at North Caroline State. For acute pain scoring, I recommend the Glasgow Composite Measure Pain Scale
for cats.
How can we do better in terms of
recognising pain?
I
think it’s important for veterinary practices to adopt a pain scoring system
and to train all staff that are involved in patient care to recognize pain in
cats and use the scoring systems.
Do you believe vets treat feline pain
adequately?
Studies
in different countries have consistently shown that cats receive less analgesic
treatment than dogs and veterinarians view analgesia for cats differently. We
have a long way to go to improve the delivery of analgesia for cats!
Currently in Australia we have an
increased range of analgesia options for cats, the most commonly used being
non-steroidal anti-inflammatory drugs and opioids. What range of analgesics do
you use?
While
we have a limited range of licensed products available for cats in most
countries, pain management should always be multi-modal. Drugs from different
classes can be combined (such as NSAIDs and opioids) and other options, such as
local or regional analgesia can be used in many cases. There is no ‘one size
fits all’ when it comes to pain management – it should be individualized to the
patient and the procedure or disease.
How has your management of feline pain
evolved?
The
introduction of pain scoring systems as well as improved knowledge about
analgesic drug (and non-drug) options for cats has changed the face of feline
medicine for the better.
Why is anorexia such a common problem
in feline patients?
Many
cats are fed free choice so that owners actually do not know how much their pet
eats each day. Therefore, it can take some time before decreased appetite is
noticed by the owner. In most veterinary hospitals, the actual food/caloric
intake of hospitalized patients is not measured.
What underlying conditions are most
frequently associated with anorexia?
Stress
and pain are common causes of decreased appetite in cats that is often overlooked.
Disease in almost any body system can affect appetite, including dental or oral
disease, gastrointestinal disease, urinary system, etc.
Is there a place for using appetite
stimulants in cats and when do you usually use these?
Appetite
stimulants tend to work best for cats that are hyporexic (versus anorexic) and
that have not been off their food for very long. Food intake should always be
measured in patients treated with appetite stimulants so that the next level of
intervention can be employed (such as a feeding tube) if they are not
successful.
Is there a problem with the types of
foods being offered to cats in veterinary hospitals?
Cats
that are sick or stressed will benefit from being fed familiar foods so it is
often useful to ask the owner to bring food from home.
What can vets and vet nurses do to
stimulate cats to eat or increase the chances that they will eat?
A
calm and quiet environment can be very helpful as well as hand-feeding or
coaxing. Pain prevents many cats from eating, so it should be addressed. It’s
also important to recognize and treat nausea before trying to feed a cat to
avoid food aversion. Providing an optimal cage environment including a place to
hide may encourage shy cats to eat.
Thank you, Dr Little, for sharing your feline wisdom. If you want to
catch Dr Little while she is Down Under, she will be speaking at the Valentine
Charlton Feline Conference in Melbourne from June 20 to 23. Register here.
