Puppy Hypoglycemia

Glucose is the blood sugar that circulates around the body and it is the principle nutrient that your body’s cells use for energy. The liver stores extra sugar in the form of a starch called glycogen. Your body can then use this glycogen to make extra blood sugar between meals to keep the levels of sugar in the blood stable.

Livers of toy breed puppies aren’t very good at making glycogen. This means that they are susceptible to having their blood sugar drop if they don’t eat. This drop in blood sugar can be severe. Their livers are usually able to make normal levels of glycogen by the time they are 12 weeks or so.

Signs of hypoglycemia include:

Lethargy, excessive tiredness, “drunken” appearance or walk, confusion, weakness, sedation, panting, coma, death

What needs to be done?

Hypoglycemia is an EMERGENCY and MUST BE SEEN right away. If it is after hours, please take your puppy to your local animal emergency hospital. Additional blood sugar must be administered and the blood sugar has to be checked frequently over the next 12 hours.

When you first notice a change in behavior at home, you can immediately offer food. If the puppy is too tired to eat, a small amount of corn syrup, maple syrup, or honey can be smeared on the gums. This is absorbed across the gums and can sometimes “wake them up” enough to eat. Either way – this puppy needs to be seen by a veterinarian!

How can I prevent hypoglycemia?

One major misconception is that feeding more sugar (like honey or syrup) to the puppy will avoid hypoglycemia. Sugars are used very quickly and do NOT help keep blood sugar stable. Additional sugar does not hurt the puppy, but is not helping.

The most important thing you can do is increase the frequency of feeding. Fats, fiber, and proteins will help keep the blood sugar stable between feedings. Toy breed puppies should ALWAYS HAVE ACCESS TO FOOD. Most toy breed puppies eat very little to begin with, so it is not the quantity, but the frequency that is so important. Some puppies do best when offered small amounts of food (a tablespoon of wet food for instance) five or six times daily. There should always be a small amount of a small, dry kibble to eat.

AMH

Cat in a Can

Canned food - Why is this important?

Most cat foods have a fairly high percentage of their calories that come from carbohydrates. I'm talking about excellent, outstanding foods here, not mega-merchant crap. Carbohydrate sources are inexpensive, highly digestible, and shelf stable. They provide good nutrition and we have made good use of them in our foods. Carbohydrate sources include rice, corn, wheat, and oat for the most part. Each of these can be fantastic energy sources.

BUT -

IF we are correct about cats requiring a lower carbohydrate diet, the best way BY FAR to do this is with canned food. Kibble is a baked product, right? It requires flour and water. So you simply can't get a kibble with low carbohydrates. It's against their nature.

Canned, on the other hand, allows more flexibility to play with it and as a result, canned foods are nearly always lower in carbohydrates than their dry counterparts.

What about my cat's teeth? I thought hard food was required for dental health?

We used to think that. As it turns out - it really doesn't matter. Canned or dry - pretty much the same dental issues.

Why people don't like canned food:

It stinks

It has to be put down fresh (I can't leave for a day and just leave a bowl full of food.)

My cat won't eat it

It produces too much packaging waste

All of these are true. Cats are texture driven, and if they have always eaten dry foods, it is very possible that they will refuse wet foods. It requires a period of time for them to adjust if you have to switch to canned foods. You must keep the food fresh and canned food tends to stink more. Oh well.

The other reason behind encouraging canned foods:

Water! Remember my post on the miracle nature of water? Most cats don't drink enough. Their genetic code is still left behind from their desert ancestors, and they just don't feel the need for water.

But water does all kinds of critical things for cats - the most important of which is that it keeps their urinary output high and that is one of the single most important aspects of treating lower urinary tract disease in cats.

So am I advocating canned food diets in cats? Probably :) The jury is still out regarding some of these points, but I think they make sense. Canned diets are probably going to be the best choice for any cat with diabetes, obesity, kidney disease or lower urinary tract disease.

Don't stress if your cat won't eat canned food, though. Some cats just won't.

And now for the disclaimer:

FEED THE CAT, NOT THE BAG OR THE BLOG! If your cat looks great, feels great, is a normal weight, and is doing well on the food they are on - there's probably no reason to change. BUT - if not, talk to your veterinarian. There are a lot of good foods out there.

Don't hesitate to feed wet food, though. Canned food will NOT do any harm if the formula is appropriate for the cat (kidney cats need therapeutic kidney diets, for instance). You would have no argument from me if you wanted to feed your cat canned food exclusively. Probably a good idea for most all cats. We'll see if the veterinary community still feels this way in five years...

AMH

Cats and Carbs

I recently attended a veterinary conference in Kansas City and was REALLY excited to get to hear one of the clinical professors from Texas A&M talk about feline nutrition, obesity, and diabetes. This is cool stuff. Cats are bad about storing mesenteric fat. This is the belly fat. Fat that gets packed around the intestines, kidneys, and liver. This is where most human men (including ME) tend to pack the fat in. So this is a subject close to my heart (or at least close to my pancreas).

Mesenteric fat is uber bad. Fat in the belly pushes up on your chest and stomach and causes difficulty breathing and stomach reflux simply because of its bulk. It also makes it difficult for blood to circulate around the lower half of the body and helps drive up blood pressure. As if all that wasn't bad enough, we have now found that mesenteric fat cells are also capable of producing lots of their very own hormones as well. But wait - it gets worse. Most of the hormones that these fat cells make actually encourage more fat production, cause inflammatory changes in the body, and increase appetite! How horrible is that!

Feline nutritional requirements:

It is becoming more and more apparent that cats have a much higher requirement for protein than we once thought. It is also becoming more apparent that cats have a much LOWER tolerance of carbohydrates than we thought. This probably goes back to the fact that cats are true carnivores and their prey are only made up of a relatively small amount of carbohydrate with the remainder being made up of fats and proteins. Our domestication and inbreeding of cats has muddied the nutritional waters, but the basic genetic code is still pretty close. Wild felids (cats) don't normally eat much carbohydrate.

So is too much carbohydrate bad for a cat? THAT is the big question right now. There is some good research that would suggest that increased consumption of carbohydrates actually encourage deposition of abdominal fat and upset the pancreas in cats. Remember that abdominal fat is the worst kind of fat.

So should we eliminate or severely restrict carbohydrates for our cats? NO! ABSOLUTELY NOT! Carbohydrates are essential to life. Severe restrictions in carbohydrate intake are known to be bad. The discussion here is all about balance. The best balance for a cat is different than the best balance for a dog. (And this assumes that we're talking about a 'normal' adult cat or dog. In cases of illness, very young, very old then everything changes.)

Here's MY OPINION based on what I've been presented: I think it is reasonable that we are feeding more carbohydrate than we should. It could start to explain quite a few things. I see waaaay to much obesity, diabetes, lower urinary tract disease, and renal disease in cats. I KNOW our current nutrition isn't perfect. It's damn good, but we've been missing something. I believe increased belly fat is absolutely associated with lots of bad disease. If increased carbohydrates are, in fact, the main cause of the increased belly fat, then we need to change up how we feed our kitties.

What am I recommending to my patients?
First things first - FEED THE CAT, NOT THE BAG. If your cat is an ideal weight with ideal body condition, then keep feeding whatever you're feeding.
However, in cases of obesity, pancreatitis or diabetes I am leaning towards lower carbohydrate, higher protein foods unless concurrent illness in the patient tells me not to. (Diabetic cat in kidney failure, for instance.)

Next post, I'll build on this discussion and talk about canned foods for cats and why that might actually be the best way to feed your kitty.

AMH

Herbicides and Lymphoma

I guess I'll continue with my cancer theme here and briefly comment on a question I was asked the other day.

Do herbicides cause cancer?

Like all things - it's controversial. There has been some good work done to show that the herbicide 2,4-D is associated with an increased risk of lymphoma in dogs. There's also lots of work to suggest otherwise. (2,4-D is, by the way, a cousin of Agent Orange.)

As I mentioned in my post on cancer development, there is rarely ONE thing you can blame for causing a particular cancer. This is especially true for lymphoma. Genetics, chemical exposures, foods, and hormones are all associated. So the truth probably is that 2,4-D can probably cause cancer in a predisposed individual, but may not in another individual if all other things are equal.

I'm a believer that exposure to environmental chemicals like herbicides HAS to be related to our increased incidence of cancers (in general). Which ones to blame? That's the sticky part! I don't know. But since there is good research that shows 2,4-D is a likely suspect, I try to avoid it as much as physically possible.

AMH

18, 19, 20... Wow that's a lot of toes!

It's always dangerous to refer to something as "normal" or "abnormal." Normal is in the eye of the beholder, right? Instead, I will employ the word "typical" when discussing supernumeray feline phalanges.

In otherwords... Polydactyl cats.

When I was a new graduate I practiced in New England. I didn't appreciate it at the time, but there were a LOT of polydactyl cats in Connecticut. I did some research into this and it appears that polydactyl cats originated in England, probably in Wales. The genetics quickly found their way to Boston. The appearance of polydactylism around the New World appears to be related to when various governments began trade with Boston. Most sailors considered polydactyl cats lucky and they were therefore regular stow-aways on trade ships.

Remember - domestic cats, like horses, did not exist in the Americas until the dang europeans brought them. Horses became fairly popular, but I don't know how the native peoples felt about cats. My guess was that after we killed them all with Smallpox and stole their land, they were pretty reluctant to embrace our feline friends. Horses could be ridden and used to carry things for you. On the other hand, have you ever tried to get a cat to do anything USEFUL? Maybe if THEY WANT to do it or they think it's their idea, but they sure as hell won't do it because you ASKED them to do it. The phrase pack cat just doesn't sound as useful as pack mule.

But I digress...

The typical cat has 5 toes on each front foot and 4 on each rear. Grand total = 18. Anything more than this is polydactyl. Even if it's only one extra. Usually cats are polydactylier than just one extra toe and they are usually symmetrical. Most all of these guys are polydactyl on the front feet only.

The extra toes can sometimes be used as opposable thumbs. My nephew cat Thomas (named for Tom Thumb, not Tom Cat) uses his thumbs to play and catch with. He's practically simian with the things. I'm surprised he hasn't learned how to open the door with them.

The extra toes aren't always attached to the wrist by good bony joints. Sometimes the toes are kind of "floppy" and other times they are fully functional. The wrist is designed to have tendons and ligaments for 5 digits. Anything more than that and there usually isn't enough anatomy to go around.

I've had one person tell me that all polydactyl cats came from Hemmingway's house in Florida. Nope. He had a particular fondness for them and most of his cats were polydactyl, but that's all.

FYI - the current Guiness Record holder has 28 toes. That's impressive!

AMH