Letters to the editor: Even 'healthy' cats should see their veterinarian
dvm360 readers respond to a previous letter about our Cat care in crisis content.
I recently spoke with Dr. Donald Marcus about his letter, “Healthy cats aren't really in crisis,” published in the July 2014 issue of dvm360. As Dr. Marcus is a former practice owner and he and I are of a similar era, we shared many common perspectives and concerns.
While some readers may have interpreted his questions and comments as shortsighted or even blasphemous, it's likely that others share his perspective and question whether “middle-aged indoor cats” need to be seen for a wellness check annually.
Prior to our speaking and even more so now, I take a third view, one that allows for important questions like Dr. Marcus' to be asked so an evidence-based and respectful dialogue can occur among practice owners, associates and the entire veterinary community.
Dr. Marcus states on his practice website, “Once a year, you should take your pet in for a check-up. This will include a full physical exam and teeth and gum cleaning if needed.” He and I discussed this, along with the prevalence of dental disease and weight gain in young adult feline patients. Dr. Marcus recognized these common, preventable and treatable conditions in young and middle-aged cats. His comments to me suggested that his feelings about not seeing cats annually were more in the context of giving all vaccinations every year.
Mostly, I was glad Dr. Marcus and I had an opportunity to share the challenges that cats and their owners face in getting to us in the first place, and the outcomes of handling them in our practices once they do arrive. His openness to investigating resources available from CATalyst Council like the carrier video “Cats and Carriers, Friends not Foes” and the American Association of Feline Practitioners through the AAFP Guidelines, especially the Feline Friendly Handling Guidelines and Feline Life Stage Guidelines, reinforces that there is opportunity for change in thinking about what we as DVMs can do for the benefit of cats. I'm especially glad Dr. Marcus liked my example of my own practice's shift from using the words “restrain” and “restraint” to “handle” and “handling”" Change in thought leads to change in behavior.
I would like to thank Dr. Marcus for his willingness to engage with me in this discussion, and I hope other readers understand that he is facilitating an important dialogue. If everyone who had an opinion about cats just nodded their head and tacitly agreed, and then went on about their business with the same thoughts and frustrations, cats would continue to suffer.
The bottom line is not about the bottom line; it's about cats as companions needing and deserving to stay happy and healthy throughout their lives.
Jane Brunt, DVM
Owner, Cat Hospital At Towson, Baltimore
Executive director, CATalyst Council
I just read Dr. Donald Marcus' response to dvm360's "Cat care in crisis coverage" and feel compelled to respond to a question he posed: "How do you explain to clients that their 4-year-old indoor cat should be brought to your hospital for a yearly checkup?"
Dr. Marcus implies that veterinarians' main motivation is financial and not driven by the healthcare needs of the patient. Of course there is a financial incentive in seeing more patients in any medical practice. No one can dispute that fact.
However, I also know that the majority of patients I see for "routine exams" have periodontal disease at a minimum, and very often I find painful resorptive lesions on one or more teeth. There is a good deal of evidence in the literature to show that these diseases are very common in our patients and that they are serious conditions. So my answer to the question of what we tell the client is simplr: "Many cats have serious oral disease, and unless we look for it, we will not find it. If we don't see a cat for two or three years and it has resorptive lesions, it will suffer every day for those years."
We used to say that if a cat is eating and not losing weight, that's all the indication we need of good health. Those days are over. These cats need a good oral exam, and if disease is found, they need and deserve proper therapy, including dental radiography (which is another entirely important discussion) and complete, professional extraction of these painful teeth. Isn't a 70 percent or higher chance of finding serious disease enough reason to warrant at least an annual exam for all of our patients?
John Daugherty, DVM