Chronic Disease & Management

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.

Many disorders are chronic and may be incurable, for which monitoring and management 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)
• Arthritis
• 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.

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 you!

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 healthy cats. 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.