Cats are notoriously stoic. It’s rare for them to show any obvious sign of illness. “As a general rule, any major or sudden change in a cat’s usual activities and patterns requires some investigation,” says Wendy Christensen, author of Outwitting Cats: Tips, Tricks and Techniques for Persuading the Felines in Your Life That What YOU Want is also What THEY Want (The Lyons Press).

Here’s an inside look at clues that your cat may be under the weather:

Pay attention to unexplained weight changes
A pound or two for a cat is the equivalent of 10 or 20 pounds for us. And, if the weight change is rapid, the situation calls for veterinary attention, warns Christensen. A sudden gain or loss may signal cancer, kidney and liver disease, hyperthyroidism and several other conditions. 

Note changes in eating habits, too

If your pet turns up its nose after a few bites, it might simply be that new food you bought. “But disinterest in eating can also happen when a cat is under stress — maybe some change is happening in your household — experiencing tooth pain or tongue ulcers, dealing with hot or humid weather, or battling something more serious such as an upper respiratory problem, kidney failure, liver disease, diabetes, bowel disease, heart disease, cancer or feline leukemia,” according to Christensen. So if your cat’s food cutback or refusal to eat lasts longer than a day, call your vet. 

Be aware of drinking and urinating patterns 
These activities can indicate how well the kidneys are functioning. Often, excess drinking and urinating are the first signs of chronic kidney disease, since the kidneys may not be properly filtering toxins. “With veterinary care, diet adjustment and possibly medication, chronic kidney disease is a manageable condition, but it’s best to catch it early,” says Christensen.

Note elimination patterns
If your cat is eliminating outside its litter box, or in significantly smaller amounts, larger amounts than normal, or voiding blood, it may be a sign of medical or behavioral issues. See a vet for an evaluation. “Feline elimination problems, unaddressed,” warns Christensen, “tend to get worse, not better.”

Be aware of head shaking and ear scratching
This can indicate ear mites (a parasite) or a bacterial or fungal infection — a veterinarian can tell the difference. Don’t try to diagnose this yourself, urges Christensen. “If it’s mites and you treat for infection, your entire house can quickly be infested.”

Don’t ignore kitty halitosis
Persistent bad breath can point to a variety of illnesses, including kidney failure and gastrointestinal problems. It’s not just a cosmetic issue, says Christensen. It needs veterinary attention.

Note changes in vocalization
A silent cat who suddenly cries and calls at all hours, or a talky cat who’s suddenly mute, may be experiencing pain, stress or confusion. Pay your vet a visit.

Changes in sight
Take quick action if your cat bumps into things, has dilated pupils, and seems ill-at-ease in familiar environments. All of these symptoms can indicate sudden blindness, says Christensen. Contact your veterinarian immediately.Visiting a veterinarian can sometimes feel like you’ve taken a trip to a non-English speaking country. Terms like “gastritis” and “enteritis” may roll off your doctor’s tongue while you and your cat sit listening equally puzzled. While most vets take the time to explain such terminology, there are instances when they may lapse into conversation that is best suited to medical conferences and peer reviewed journals. You can meet your vet halfway, however, by promoting better dialogue while learning to think more in vet speak.

Don’t Feel Intimidated
While waiting in a room to see your vet, you may see one or more impressive degrees framed on the walls. These could be next to posters describing seemingly impossible-to-pronounce conditions. Despite the potential for intimidation, Thomas Carpenter, DVM, president of the American Animal Hospital Association, said that you should remember that your veterinarian likely has a lot in common with you. “He or she may have one or more treasured pets,” said Dr. Carpenter. “Feel free to ask as many questions as necessary, as that’s what your vet might do in your position.”

Know Your Sci-Speak Comfort Level
When reading the paper, do you pore over health stories? Maybe science was your favorite subject in school, or you work in a related profession. On the other hand, your brain could tune out medical terminology as some kind of alien verbiage. Dr. Carpenter said that when training and advising vets, he tells them to be aware that some people want to hear a lot of science, while others don’t. It could just be that your own veterinarian misjudged your level of comfort on such matters. Diplomatically let your vet know what type of discussion best works for you.

Maximize Your Vet’s Staff
Some of the best sources of information are often underutilized, according to Dr. Carpenter. These are the staff members who work with your vet. “Think about it,” he said. “When you go to see your family doctor, you probably wind up asking more questions of the nurse and staff than you do of your doctor.” He assured that most personnel at veterinary office are very well trained and are open to answering questions. Although busy themselves, they might also have a bit more time than your vet does to explain complex conditions, prescribed drugs and other issues related to your cat’s health. Dr. Carpenter said they could also sometimes open the door to further discussions with your vet, if needed.

Read Up
Even if you have a great rapport with your vet and his or her staff, it never hurts to read up on feline health matters, particularly those that may directly concern your pet or might soon. The American Animal Hospital Association has a number of related articles at its site, Healthy Pet. Your vet’s office may be able to provide you with brochures on common conditions.

In the meantime, to help decipher some common technical terms that you might run across while conducting such investigations, here is a mini dictionary:

Asymptomatic — without symptoms

Blocked urethra — blockage of the urinary passage

Bronchi — the main passages that allow air to move in and out of your cat’s lungs

Bronchitis — an inflammation of your cat’s lung airways; usually indicated by a cough

Colitis — inflammation of your cat’s colonConjunctivitis — inflammation of the eyelid lining

Cyst — a fluid filled sac

Enteritis — inflammation of the intestines

Eosinophilic granuloma — an ulcer, or swelling, usually on your cat’s lip

FCV — stands for “feline calicivirus,” a virus that can cause symptoms much like the common cold
Panleukopenia — also known as feline distemper – this highly contagious viral disease can affect multiple internal tissues and organs

FIP — feline infectious peritonitis is a progressive and ultimately fatal disease causes by a coronavirus

FVRV — stands for “feline viral rhinotracheitis virus,” a virus that can cause a severe version of cat “flu”

Flukes — a type of intestinal parasiteGastritis — inflammation of the stomach wall, that can cause vomiting

Gingivitis — gum inflammation

Hemorrhage — loss of blood from a blood vessel that can occur either internally or externally

Lymph nodes — small organs where immune system responses are launched

Metritis — infection and inflammation of a cat’s uterus

Peritonitis — when the lining of your cat’s abdominal cavity becomes inflamed due to any number of reasons, including infection

Pleurisy — inflammation of the inner lining of the chest cavity that can lead to fluid build-up making breathing difficult for your cat

Pneumonia — inflammation of the lungs caused by a number of different agents, such as bacteria, viruses and fungi

Ranula — a blister-like swelling beneath one or both sides of your cat’s tongue

Rectal prolapse — when the rectum turns inside out due to diarrhea or straining

Thrombosis — a blood clot

One of the biggest controversies in companion animal medicine today surrounds the use of vaccinations in companion animals.

Vaccines were developed initially to protect animals against deadly contagious diseases. Many diseases that were fairly common such as canine distemper, canine parvo, and feline panleukopenia are seen much less frequently today as a result of the intense efforts by the veterinary profession to vaccinate against them. In the case of rabies, the effort to routinely vaccinate dogs that began in the 1950s also dramatically reduced the incidence of cases of human rabies in this country. In some cases, vaccinations have been wildly successful in decreasing, if not practically eliminating the incidence of some diseases. In small animal medicine, vaccines have traditionally been developed against diseases caused by viruses, bacteria and fungi. In newer developments, vaccines have been developed against protozoans like Giardia as well.

Now it seems that vaccines are developed almost routinely in response to diseases regardless of how common they are or whether or not they have a fatal outcome. In fact, vaccine use is so widespread that most veterinary practices send reminder cards to clients to schedule appointments for their pets based solely on their vaccination schedule.

Although it was well known that vaccines do cause reactions or have side effects, until recently it was thought that they were fairly rare, minor and treatable when they occurred, and far outweighed by their benefits. It is now believed that reactions may be more common and serious, and because of this concern, the debate has heated up about the judicious and appropriate use of vaccination.

How do vaccines work?
Vaccination, or active immunization, refers to the production of an active immune response in the body. Vaccination works by stimulating the immune system with either a weakened (modified-live or attenuated) or killed form of the disease organism itself. Vaccines are thus classified as modified-live or killed. The weakened or killed disease organism is referred to as an antigen. The body’s reaction to the introduction of the foreign antigen in the form of a vaccine injection is to mount a humoral (antibodies or immunoglobulins) or cell-mediated response. This is the defense system the body normally uses against disease. When the body encounters the real disease later on, it is already prepared to defend itself because of the prior exposure to the vaccine strain of disease. (It is important that the vaccine strain of disease closely match the actual disease strain.) If vaccination was successful in preparing the immune system, the range of response to infection can range from no clinical symptoms at all to mild disease.Immune responses that are stimulated by modified-live vaccines occur faster and last longer than those from killed vaccines.

The drawback is that modified-live vaccines have been known to cause disease in weakened, immune-compromised or otherwise debilitated animals. Killed vaccines are technically safer because they can’t cause disease, but the response takes longer and doesn’t last as long. Killed vaccines also require the use of adjuvants which are irritants designed to prolong and enhance the immune response. These adjuvants are under investigation for a possible association with serious vaccine reactions.Vaccination works best in a healthy, unstressed animal. It takes about 7 days for the body to produce its response. Although most vaccines are given by injection, there are intranasal vaccines that are given as eye and nose drops.

Because these vaccines are following the natural route of infection of respiratory diseases, the immune response may be produced much faster, within 72 hours, and last longer.It is important to understand that vaccines do not make sick animals well, cure disease or prevent animals from becoming infected with the disease organism. They prevent serious illness only if the vaccine is given far enough ahead of the disease exposure for the animal’s own immune system to produce a quick defense before too much damage is done. Concurrent vaccination with or after disease exposure, a problem commonly encountered in shelters, is likely to result in vaccination failure.

The current vaccination controversy
There are several questions being asked about the costs/risks/benefits of vaccinating companion animals and the safety of the vaccines. Should animals be vaccinated against diseases that respond readily to therapy or that are not very common if it places the animal at risk for serious side effects? The questions most commonly asked relate specifically to: 

The number of vaccines in use
The number of vaccines available to veterinarians has skyrocketed in the last thirty years. The antigens have been combined into multivalent vaccines that allow one convenient injection to be given against several diseases, such as the common 5 in 1 DHLPP (distemper, hepatitis, leptospirosis, parainfluenza, parvo) dog vaccine. Questions have been raised about the effectiveness of these vaccines as well as the need for all the various components. Some other canine vaccines include Corona, Lyme, Heartworm, Bordetella, Ringworm, and Giardia.

The need to vaccinate against mild diseases that respond readily to treatment
The use of some of the vaccines has been questioned when diseases such as corona are not only low in incidence, but also fairly mild, usually require no treatment or are easy to treat when they do occur.

The fact that some vaccines are limited in their effectiveness.
Some vaccines are limited in their effectiveness, such as the Feline Infectious Peritonitis (FIP) vaccine for cats, and not recommended for general use.

Vaccinations may interfere with later disease testing
Lyme Disease is difficult to diagnose in animals that have been vaccinated against the disease. It is also generally not as serious in dogs as it is in people. It responds readily to antibiotics in the early stages of the disease, yet treatment may be delayed because of the problems associated with diagnosis in vaccinated animals. Some veterinarians have questioned the need for a Lyme vaccine at all.

The need for annual boosters.
In human medicine many vaccines confer long term, if not lifelong immunity. The search for explanations about the need for annual boosters in animals led many to the conclusion that the manufacturer’s recommendations may have been arbitrary and not based on duration of immunity studies at all. No one seemed to know exactly how long an animal would still be considered protected after vaccination. The studies now being conducted to find out how long an immune response can last in a vaccinated animal have revealed that many of the common vaccines confer “immunity” for several years if properly administered. In some cases, the titer may be taken instead of giving a booster. A titer is a blood test that will reveal the level of antibodies found in the blood. This functions as a measure of the immune response, although some would argue that the only true test of immunity is to “challenge” the animal with the disease and see if the animal becomes ill.

The safety of the vaccines.
The debate about the safety of vaccines became very heated when a possible link between cat vaccinations and a certain form of a deadly cancer known as fibrosarcoma was discovered. It was also suspected that autoimmune hemolytic anemia in some dogs might have one of its links to vaccinations. Intensified research into the production of safer vaccines began largely as a result of the concerns about these two serious problems. In the meantime, veterinary immunologists, epidemiologists, internists and research specialists are examining the way vaccinations are given and proposing new protocol