An opinionated feline in Edmonton, Canada who lived with a retired cat behaviourist, Greyce provided behavioral advice to cats in need until her death in July 2014. Because her entries are useful even today, the blog remains posted.

Monday, April 4, 2011

Newcomer Hampers Sick Cat's Recovery

Dear Greyce,


I am in trouble – BIG trouble.

For the past two weeks I have been very ill with Irritable Bowel Disease. So ill in fact that I have had to stay in the hospital, have lots of tests and medicines, and specialist attention. I’m home now but am having problems recovering.

Yes Greyce, I know you don’t give medical advice BUT it all started with the arrival of a new kitten.


It’s a long story. So please be patient.

Introducing Myself
I am a 10-year old, neutered male with short, tiger-like fur (black, grey and brown) on my body and white on my face, paws and neck. And I have a black beauty mark on my nose. My handsome looks are complemented by a social catsonality. I like humans and usually greet them at the door, though they say I sometimes have a bit of an attitude (whatever that means). I’m curious.
I like to play, especially when Themselves throw a ball that I can chase. For a cat my age, I have lots of energy. I also have a plush wolf that brings out my wild side; I like to mount it.
My Former Cat Companion: Fifi

When I was a very young kitten, I joined my current household (two adult humans, along with a daughter who moved out years ago) as a companion for the resident cat, Fifi. At first she wasn’t too keen on having me around, especially since I would sneak up and pounce on her. She was afraid of everything!

To tell you the truth, Greyce, she didn’t really like me; but I liked her.

In December she was taken to the vet because she was losing weight. A combination of hyperthyroidism and a bad heart meant she was not long for this world. And in January, she died.

I missed her.
I lay around all the time, looking sad and bewildered. So Themselves decided to get a kitten to be my new companion in February - about a month after Fifi died.

The Newcomer: Gracie

The newcomer is Gracie. She is a six-month-old, spayed female with medium-length grey fur and looks like a Russian Blue (sort of like you, Greyce). I think she was a feral kitten, socialized at a foster home. At first she was like Fifi, very scared of everything - even her reflection in the mirror. Now she is very bold.

How We Met

Gracie was in my house for about a month before we were introduced. She stayed in her purrsonal room (an upstairs bedroom) with the door closed and she was quite scared. I didn’t even know she was there at first.

I got to smell things she lay on. And then I saw her paw come out from under the door one day and was curious.

Herself then put Gracie in the living room and closed the glass doors. I saw her and wanted to meet her. We sniffed each other a bit. It was a calm meeting.

After a few such visits, Herself let us run around together. So I’d say this was in early March.

By this time, Gracie was no longer a frightened kitten. Bold as brass if I may say so. And playful.

I liked her in the beginning, but she had way too much energy for me. We would chase each other but I’d become exhausted. She wouldn’t leave me alone and even scratched my nose!
I couldn’t get any peace. We have different feeding stations (in different locations) and different litter boxes (also in different locations), but she is always trying to steal my food and visit me when I use my box. She is like a shadow I cannot shake!

Then she discovered the cat door which allows access to my very private retreat – the basement (to which Fifi NEVER entered).

Wait for it Greyce, it gets worse! We began to be left out together overnight. Even though we stampeded about, no one came to my rescue. I was SO tired.

These invasions of my privacy started to bug me. So I got pretty fresh and mounted her, in an attempt to get her to leave me alone.

My Illness

By mid-March I became quite ill. And this was strange because I’ve always been a healthy cat.

What happened was simply this: Themselves went out for the day and left me with Gracie. By the time they returned late that night, I had been vomiting all day.

Since then I’ve bounced back and forth between the hospital, the vet, the specialist and home. That’s how I was diagnosed with Irritable Bowel Disease – a surprise to all because I’ve always been healthy.

Fortunately my medications are gels rubbed into my ears so I don’t have any nasty liquids to taste. I can’t bring myself to eat a full meal. I’ve lost a lot of weight and if I don’t regain my appetite, I will have to have a feeding tube. And that means a return to the hospital.

I’m tired and scared and agitated. Car rides to the hospital stress me further.

To top it off, one of the vets suggested that the stress of dealing with Gracie made me ill. Themselves were advised to find a temporary new home for her, until I am well. But they don’t seem to be having much luck.

Our Current Routine

The humans rise around 7:00 a.m. Gracie stays in her room (a top floor bedroom) overnight. Once I came home from the hospital, I was confined to Themselves’ bedroom (also on top floor) with them overnight. But I’ve changed my mind, since they left the basement door open so I can have the run of the entire house. I prefurr to stay down there.

They try to get me to eat something. Frankly Greyce I don’t have much appetite. I eat very little dry food. And I will only take wet food if I am hand-fed. And then I return to my favourite chair and blanket in the basement where it is dark and quiet. I sleep there all day, purrhaps getting up a couple of time to come upstairs – and hopefully to have Themselves take me outside for a break – something I very much like.

Herself is in and out of my home during the day. When she is away, I have the run of the house and Gracie stays in her purrsonal room. When Herself returns, she lets Gracie and me take turns in having the run of the house – depending upon which one of us is awake.

Himself’s schedule is more predictable: out of the house from 7:30 or 8:00 a.m., returning around 7:00 p.m.
On the weekends, Themselves are at home most of the time.

By the way, Gracie is going crazy being cooped up in a room! And she's hard to capture once it's time to put her back. (I saw her a few days ago, through the glass door in the living room and growled at her for the first time ever.)

And I’m a changed man, too. The only things that bring me joy are going outside and being brushed by Herself. My voracious appetite is a thing of the past. And I don’t want to play – at all!

Themselves are feeling guilty about everything: very, very guilty.

Greyce, we can’t go on this way. What should I do?

With distress,

Tommy



Dear Tommy,

About Irritable Bowel Disease

First for the benefit of other readers, I want to briefly describe Irritable Bowel Disease (IBD).

Cats with IBD show any of a number of symptoms: diarrhea, vomiting, (both of which can be ongoing or intermittent), weight loss, pooping more often but with less stool, stool with mucus or blood, depression, refusal to eat, refusal to poop in the litter box, and/or fever.

Just because you have a symptoms on this list, does NOT mean you have IBD. There are many other medical problems which share symptoms. IBD is definitively diagnosed based on a biopsy. (Don’t confuse it with IBS which stands for Irritable Bowel Syndrome and is something else entirely.) And that is why it is VERY important to consult with your veterinarian.

As regular readers know, from time to time, I ask a particular cat to share information about his stool quantity and quality (colour, shape, etc.). I do so in case there might be a medical issue that has escaped his purrson’s attention. There are times when a behavioural problem (like peeing outside the box or suddenly becoming aggressive) has a medical basis. And that is why your first line of defense is a veterinary consultation.

Even a quick phone call to your vet just to rule out the possibility of a medical cause is an important first step. After all, it is a full-time job for me to be a marvelous cat, let alone try to be a veterinarian.

Okay, back to the topic: IBD is really a group of chronic gastrointestinal disorders for which there is treatment but not a cure. This means two things: 1) that once you have the disease it will be with you for the rest of your life, and 2) that it may be named differently depending upon which part of the gastrointestinal system is involved (large and/or small intestine, and/or stomach).

The usual treatment involves a change in diet (because some of us are sensitive to food antigens), as well as medications (immunosuppressants and antibiotics). It may take some time before you find a food you tolerate well and/or medication types and dosages that work for you. Other therapies may complement this approach.

If you are a cat with IBD, it is very important that you follow your veterinarian’s advice carefully; NEVER stop your medication without your vet’s advice because stopping it too soon is one of the most common mistakes that can be made. And all that will result is a flare-up and the need for more (and purrhaps stronger) medication.

And while this goes without saying, I will say it again: If you are a cat who takes any nutraceutical, herbal or homeopathic remedy, or health food additive, you MUST let your vet know because it can affect your treatment (even when you no longer show active signs of the disease).

Causes of IBD
No one really knows what causes IBD: 1) Genetics might be involved; 2) possibly your diet; 3) infection may play a part, along with 4) any problems with the immune system you might have. We do know it is more common in those of us who are of middle age or older (such as yourself).

Does stress play a role? Yes and no. Stress is not listed as a potential cause. But because we know that stress affects the immune system and its ability to keep you healthy, it could indirectly ‘put you over the top’.

So Tommy it may very well be that you were already pre-disposed to IBD. For all we know, it could have been creeping up on you for some time before it reared its ugly head. Then the combination of the loss of your beloved companion followed rather quickly by the rather quick and harried introduction of a new one, could have been too much for your system to handle.

Whatever. You are in good hands, medically speaking. So tell Themselves to stop wallowing in guilt. The most important things they can do for you are: 1) to learn why things went wrong in the first place (not disease-wise but Gracie-wise), and 2) to implement a plan to put things right.

Why Things Went Wrong

Like all creatures, we become less resilient with age. Some of us remain mentally agile for a very long time, though our physical bodies show the wear and tear of time. And energy levels wane.

We acknowledge two major stressors, followed in close sequence: Fifi’s death and Gracie’s introduction.

The problems are twofold:

1. There is a large discrepancy in the energy levels between Gracie and yourself. This is a recipe for exhaustion, irritation and fighting.

It is a common mistake that humans make, to select a kitten as a companion for an older cat. Their reasoning usually is as follows: “Muffin is so sad that Poopsie died. He needs some pep. A kitten will perk him up.” This reasoning is the equivalent of saying, “Grandma (age 56 – which is about your age converted to human years) is sad that Grandpa died. Let’s get her a foster child around the age of 2. That will perk her up!”

In other words, what they don’t take into account is the age difference and the huge energy difference it can entail. They are used to you being the younger, more energetic cat in the household. They forget that your current energy level is considerably less than that of any kitten.

So we need to find ways to help Gracie burn up her energy, as well as ways to give you badly-needed peace and privacy. Your use of space and your privacy requirements need to be respected, most especially because your loss of control over your territory is extremely stressful. Bottom line: Any change in territory can stress out any cat.

2. The introduction process began well but escalated too quickly. Themselves made the very common human mistake of assuming that because the first few times together went well, then all would be well.

Many cats put on a good show for the first while. And then humans think I am crazy to tell them to slow down and continue to take it slow. So they ignore my instructions and proceed on their merry way.

Two or three months later, when the cats show any of a host of symptoms that require veterinary attention (and sometimes stitches from a bitter fight), they realize that the chances of a happy family are rapidly disappearing.

So we need to start over and proceed very, very s-l-o-w-l-y.

As the much older and resident cat, etiquette requires that you get prefurrence. You set the pace of the introduction.

There is no guarantee that Gracie and you will ever be good friends. What we are hoping to achieve is an atmosphere of tolerance and mutual respect.

Action Plan

Your vet has suggested placing Gracie outside your home, on a temporary basis.

Don’t forget to look at the options: 1) returning her to the foster home for a while; 2) boarding her with a relative or close friend who knows and likes cats AND doesn’t have cats at home, or 3) boarding her in a high-end cat boarding facility (such as the one shown in this link) - one with spacious rooms, not cages; and common play areas; and lots of attention.

If none of these options prove viable, then you need to improve the current time-sharing arrangement NOW.

Continue to Time-Share Your Space

Time-sharing will enable you to have greater control over your territory. And it will establish a pattern of certainty within which you can relax.

You have gotten Gracie out of the way, for the most part by confining her to a bedroom for her exclusive use. There she MUST have access to a litter box, a water dish, and food.

The installation of a cat window seat would be an asset in her room –just make sure there is some way for her to jump up to it (like having a box from which she could jump – or a dresser or some such). It will allow her a view AND height reduces anxiety in a cat, so it should help her chill out.

She also needs toys to keep her occupied. As a young kitten, she is more likely to engage in solitary play than any self-respecting older cat – such as you. Have Themselves read my entries, Guys Just Wanna Have Fun and Stimulating Ideas, and act accordingly.

For the next while and I mean long while (NOT a few days or even a few weeks), she MUST be kept out of your sight. If you are disturbed by the sight of her through the crack in the bottom of the bedroom door, then have Themselves block it with a towel, draft stopper or a long wedge of cardboard. No peeking!

You have your basement retreat for your exclusive use. In it you must have access to a litter box, food bowl, and water dish. Don’t forget a favourite toy or two.

NOTE: In both cases, I want your regular food dishes, water bowls and litter boxes to stay where they are. I don’t want your regular territory disturbed. Instead I want each of you to have an additional food dish, water bowl and litter box.

When you are in the basement, you MUST have guaranteed privacy. Can the pet door be locked so that once you are downstairs, no other cat can enter?

Over the longer term, consider the installation of an electronic pet door instead. With this, you’d wear a collar with an electronic chip in it that can open the door; or if you have a microchip, then some of the doors can be rigged to respond to your purrsonal identification chip number. Either way, it’s like having a door key. Since Gracie wouldn’t have a key, she couldn’t come in. Such doors can be rigged to allow you private access into the basement, but enable any cat to leave the basement (should something happen at some time and she get caught downstairs).

Later on, consider the installation of an electronic cat door to the mud room. Keep your main litter box there and consider installing a set of food and water bowls – some distance from the box, of course. That way you have privacy for all your most important needs.

When you are in the basement (or in a part of the house to which Gracie cannot have access), she can be let out to roam as long as it doesn’t distract you. I understand her permission to roam usually occurs when you are asleep.

Follow the very first part of my entry, May I Present? A Cat! We will concentrate only on introduction by smell and ONLY by smells she might leave when she gets to roam around the house while you are otherwise engaged.

When she is out and about, it is very important that you NOT be able to see her through those glass doors! If necessary, install thick paper or cardboard over those glass doors (up to the top of a cat’s eye view) so that neither of you sees the other – even if by accident. A smell trail is all the evidence you need at this point.

NO visual contact until much, much later. I wouldn’t even consider such a thing until you are eating normally (or your new normal which may be a somewhat reduced through strong, appetite from what you had) for two weeks straight!

For You: Calm Things Down

Obviously there is a new household routine now that you are home. It may vary between the weekday and the weekend. But otherwise, I’d prefurr it to be set for the next month or longer, depending on your healing process.

For Themselves, this means: no vacations away from home, no disruptions to the household, no overnight guests, and no visits by babies or toddlers who just have to pet the pussy cat, no trips to Barbados leaving you with a pet sitter. You need certainty in order to relax.
To help calm you in the face of Gracie’s smell trail, I recommend the installation of a Feliway diffuser (see entry, What Good Is Feliway? ) if you haven’t done so already. One in your private basement retreat and one in the area of the house you most commonly will share with her (somewhere on the main floor?).

And remind me later – much later – to tell you about how height might work to manage Gracie’s access to you.

Since your energy is low and you are not feeling well, I will not recommend play sessions. Your lack of interest in play tells me that you are saving your energy for healing.

Instead, I want you to have touch therapy sessions. Consult the entries (See entries, Meditative Stroking and Touching the Sadness).

The biggest problem with touch therapy will be your purrsons, who love you dearly and are most upset by what has happened. They can easily transfer their distress to you in less than smooth hand motions, constricted breathing or a more rapid than usual heart rate. The MUST chill out.

We cats are very sensitive to heart rate, respiratory rate and other non-verbal cues given by our purrsons. So when they are near you, and most especially when you are touching, I want them to relax.

Have them take breathing lessons:
1. Make sure they take ten breathes as slowly and as comfortably as they can.


2. Have them focus on the diaphragm – a football-shaped muscle just below the rib cage that singers and athletes use to enhance their performances. Pushing the muscle down makes the stomach go out like a balloon. Allowing the muscle to come back up near the ribs, makes the stomach go flat like a balloon with all the air let out of it. It is not quite the same as forcing your stomach out and in, and it takes a bit of practice. And it is definitely not the same as the chest breathing many humans do, where the chest expands and the shoulders rise and then fall.
I like to lie on Herself’s tummy when she does it, so I get a free ride.


3. Intention is everything. Make sure they focus just on the breathing and not on the laundry, what’s for dinner, or a recent phone conversation. The point is to shut down the chattering mind and the best way to trick it, is to have them fully concentrate on their breath
For example, this simple act enables Herself to focus just on the moment (rather than worrying about so many other things) and in doing so, she also focuses on moi. And I DO feel the difference – even when I am in the room with her and not on top of or beside her.


4. Get them used to doing this for periods of time, say starting with three minutes and working up to 20. We do this for 20 minutes a day, by which time Herself feels relaxed and invigorated (quite a combo).


For Gracie: Reduce Her Energy Levels with Daily Play

Gracie MUST have at least two or three 15-minute play sessions a day – in addition to solitary play. If you are out and about while these occur, make sure another human is around to distract you from her bedroom door. Ditto if she is out and about and you are confined.

I have already mentioned some suitable toys for solitary play. But I also want to emphasize the importance of interactive play because this will help her chill. See my entry, The Aloof Cat (scroll down for toy and play ideas. Also letting her work on a food puzzle.
For Themselves: Let Go of the Guilt

This is a very stressful period for you all. And your humans are taking it hard. They will need to let go of obligations and routines in order to focus on your family unit and your healing process. Moreover, they will need some time to chill out themselves.

Suggest that they take short breaks during the day. Even a short walk, a coffee outside the home, or window shopping, can provide respite. And at least weekly, they need to have a longer break where they can focus on something fun, and definitely something other than their worries about Gracie and you.

Important Supplementary Notes

I wanted to add some points about things that you mentioned that seem to cause Themselves concern – mostly particularly your choice of retreat and your eating habits.
Your Current Prefurrences

I like your choice a basement retreat. It is quiet so you are not disturbed and you can easily detect if predators are lurking about. And it is dark, so predators cannot get you. In other words, when we don’t feel at all well, we seek out dark, quiet protected spots because they are safe. And that sense of safety allows us to rest in peace and let healing take place.
Humans who become frantic and try to encourage us to locate elsewhere do us a dis-service. From their point of view there is nothing nice about a dark room below the ground. To us, it is the ideal spa retreat.
I also like your idea of some outdoor time. Exposure to natural daylight and the healing power of the sun can work wonders. And the opportunity to enjoy freeze breezes is very settling to even the most touchy stomach. There is something about the outdoors that is most therapeutic. So weather-permitting, encourage an available human to take you outside. The break could be great therapy for you both.

Your Feeding Prefurrences

At present you have a limited appetite.

I consulted with Herself (who suffers from gastrointestinal problems from time to time). During her last bout, she wasn’t interested in food much. She survived on small doses of tapioca pudding and the occasional poached egg – for several weeks.

It took quite a while for her to become interested in other food. And even a while longer for her to want to eat anything in sufficient quantity. It was very much a back-and-forth thing: a more hearty meal followed by a lack of interest followed by a great snack, etc. So maybe this will be the case with you.

You like being hand-fed. Many of us like to be hand-fed when we are ill. When we are exhausted or in pain, eating becomes a great effort. Having someone make tiny (pea-sized or so) hamburgers out of wet food is ideal. Besides, making the patties warms the food to room temperature which releases its scent and flavour much more.

Make sure that any leftovers are refrigerated (but brought to room temperature before being served to you) and stored in a glass jar (not plastic which retains odours and not a can which gives food a metallic taste after a while). Any leftovers remaining after about four days or so should be thrown out. Fresh taste is where it’s at.

And there is something about the bond created when someone we love gently (and without forcing us) encourages us to eat. It really makes a difference.

As your appetite improves, you may find yourself interested in wet food pudding: wet food mixed with enough water to make it like a creamed soup. This is one of my favourites.

As for your dry food:Tell Herself to avoid the most common, appetite-ruining mistakes. Put only a small amount in the dish at a time (no more than 1/3 of a cup unless you are already eating that quantity up!).

Once a day, empty the bowl and rinse it out in VERY hot water and dry it. Then add fresh food.

If you have leftovers (and they have only been out a day) then top the fresh food with them. The reason is that manufacturers spray fats over the surfaces of dry food to arouse the senses. But fats exposed to air start to become rancid. And even very slightly rancid food can turn a sensitive appetite off.
Water. Are you a still water or a running water man? Just make sure your water is fresh every day (unless it is an aerated fountain). Again, dump out the bowl and refill with fresh water. If you prefurr cold, add an ice cube or two.
Now this is a very LONG letter and you may have questions. Don’t hesitate to ask because I want to help you, Tommy, in whatever way I can.
This is a challenging time for all of you. I wish Themselves, Gracie and you the very best.
Yours,

Greyce