Feline 911: Top 10 Feline Emergencies

Cats can be maddeningly subtle in giving clues about underlying illnesses. But there are situations where a kitty needs emergency care. Common sense tells us that certain emergencies need no explanation: The kitty hit by a car, the one who falls from a height, the cat who is chronically vomiting or the one who is having difficulty breathing, a companion animal with a broken leg and the kitty who has not eaten in two days all should be seen by an emergency hospital. As a feline specialist, I have developed the following list of 10 other and often lesser-known feline health problems that require emergency care. No ifs, ands or buts about these. Familiarize yourself with problems listed and their signs and symptoms. If your kitty exhibits any of them, please take your feline friend without delay to the nearest emergency hospital. His or her life often depends on you making the right decision:

Urethral obstruction. 
Male cats can develop blockage of their urethra (the tube through which urine passes from the bladder to the outside environment). These cats often make frequent trips to the cat box, strain and produce only a small amount of urine and may cry out in pain as they attempt to urinate. As the problem progresses, the kitty becomes lethargic, may vomit and refuses to eat. Sometimes these cats are erroneously “diagnosed” by their family members as being constipated, due to their posturing in the cat box. As the number of hours pass that the kitty cannot urinate, the kidneys begin to shut down, potassium (an electrolyte) dangerously increases and the heart itself can be affected. Cats with these signs need to be seen as quickly as possible, as even 12 hours of obstruction may be enough to cause a painful death to the patient. Very rarely, female cats can have urinary tract obstructions from small stones.

Lily ingestion.
No doubt about it, these flowers are graceful and beautiful, but daylilies, Stargazer, Easter and Tiger lilies (to name a few) are deadly to cats. In fact, all parts of the lily plant: Pollen, stamens, petals and leaves can be deadly. Cats who are poisoned by munching on a lily petal or brushing up against a lily plant and ingesting the pollen quickly suffer from kidney failure. Treatment includes activated charcoal and 48 hours of intravenous fluid therapy. Cats who are presented to the veterinarian within 18 hours of ingestion typically recover, although the kidneys may not return to normal for months.

Acetominophen (Tylenol, Excedrin, Anacin) ingestion.
Tylenol is deadly to cats and no amount is safe. Unfortunately, well-meaning humans unknowingly poison their cats with administration of this medication. Swelling of the face is typically seen within hours of ingestion and the color of the blood turns from red to brown in these patients. Treatment is available and an antidote (n-acetylcysteine) can be life-saving. No OTC (over the counter) medication should ever be given to a cat unless the veterinarian specifically authorizes its use.

Rat and mouse poison ingestion.
Cats are generally discriminating in what they will eat and won’t ingest these poisons. However, a cat can be poisoned by eating a mouse or rat that died of rodenticide poisoning. Most of these products work by interfering with normal blood clotting. However, newer products can interrupt normal functioning of calcium in the body. Depending upon the severity of clinical signs (which typically involves bleeding from the oral cavity, in the feces or the urine), hospitalization for a blood transfusion, Vitamin K1 therapy (to help restore normal clotting) and even fresh frozen plasma may be necessary.

Anti-freeze (ethylene glycol) ingestion.
Outdoor cats can be poisoned by this chemical if they drink contaminated water or get the product on their paws or fur and lick it off. Indoor cats may find anti-freeze containers in a basement or storage shed. The sweet taste of this product often is attractive to cats. There are three stages to anti-freeze poisoning: In the first stage, the kitty may appear “drunk” and the gait may be abnormal. The patient then progresses to renal failure, due the formation of calcium oxalate crystals (oxalate is a by-product of the metabolism of ethylene glycol) in the kidneys. Treatment needs to begin quickly (within the first six hours) for the cat’s life to be saved.

String foreign body.
String, yarn, ribbon, dental floss and tinsel can all be deadly to cats. Once swallowed, a small portion of these objects often gets wrapped around the base on the kitty’s tongue and the rest makes its way into the intestines. While there, the string begins to cut or saw into the intestines, causing pain, infection of the abdominal cavity (peritonitis) and overwhelming infection (sepsis). Surgery is typically required to remove the string from the intestinal loops and many times a portion of the intestines needs to be removed, due to trauma from the string. These patients often become lethargic, refuse to eat and begin vomiting. A cat who has been seen swallowing a string or a cat who has a piece of string or (commonly) tinsel hanging from his or her anus needs to be seen by a veterinarian as soon as possible. Please don’t pull the string.

Sudden loss of use of the hindlegs.
Cats with underlying heart muscle disease (typically hypertrophic or restrictive cardiomyopathy) can form clots in their hearts from which small pieces break off. The most common place for the small clots to end up is at the terminal aorta, the large vessel which supplies blood to the abdomen. Cats who have suffered a TEME (thromboembolic episode or “saddle thrombus”) suddenly lose control of their hindlimbs, are typically howling in great pain and often have difficulty breathing because they are in acute heart failure. Prognosis for these kitties depends on the extent of the underlying heart disease and response to treatment. Cats can have TEME’s to the arteries that supply the kidneys as well as to the right front leg.

A diabetic who isn’t “quite right.”
Within the last five years, our knowledge of successful treatment of diabetic cats has dramatically increased. Feeding low-carb canned diets, avoiding dry food, availability and understanding of several newer insulins (especially Lantus) and teaching clients to do in-home blood glucose curves on their cats (easier than you think!) have all contributed to better regulation and sometimes remission for our diabetic cats. If your diabetic cat isn’t acting normally (having either a ravenous appetite or no appetite; lethargic; vomiting; or drinking either an excessive amount of water or avoiding the water bowl), a trip to the emergency service needs to take place. Diabetic cats can be over-dosed on insulin, but some diabetic cats also present critically ill with diabetic ketoacidosis. These cats are very ill, often have breath that smells like acetone (nail polish remover) and require prompt emergency treatment. Cats with ketoacidosis often have underlying pancreatitis (inflammation of the pancreas), cholangiohepatitis (infection or inflammation of the liver and bile duct system) or infection. Ketones are diagnosed by checking a urinalysis or by placing a drop of the kitty’s serum on the ketone pad of the urine dipstick.

Sudden blindness.
Cats (typically older ) with persistently elevated and untreated high blood pressure often present with sudden blindness. In many cases, the clients are unaware that their cats have high blood pressure. Most cats with high blood pressure have concurrent kidney disease or hyperthyroidism. However, a small subset of cats can develop hypertension (and are at risk for blindness) without evident of any other disease. Cats with sudden blindness (often with blood in the anterior chamber of the eye, so it is visible to the client) need to be seen so that the blood pressure can be measured and appropriate medication be given. Prognosis is good for return to vision, if the problem is promptly recognized. It should be noted that any cat with one or both eyes that look abnormal should be evaluated by a veterinarian as soon as possible.

Sick newly adopted/purchased kitten.
These little ones often get sick quickly and need prompt attention to save their lives. Kittens who are not eating well can develop low blood sugar (hypoglycemia); those who have not been appropriately vaccinated can develop panleukopenia (distemper). Kittens with distemper often have very low white blood cell counts and are at risk of overwhelming infection. They also can have fever, gastrointestinal signs, including vomiting and diarrhea. Some kittens develop pneumonia. Dehydration happens quickly in kittens and death can occur rapidly. 

I hope that this list has familiarized you with some of the problems that can occur quickly in cats and demand a prompt medical response. You know your kitty better than anyone, so if he or she isn’t looking or acting normally, please get them into the carrier and take them to the emergency clinic. I don’t think you’ll regret it.