Diet-Related Canine Heart Disease

dog diets

Last week, the United States Food and Drug Administration (FDA) announced an investigation into diet-related heart disease in dogs.

I suspect most dog families would be surprised to learn diet may play a role in the development of heart disease in their favorite fur baby. Here is a summary of the FDA announcement.

Heart Disease in Dogs
Veterinarians diagnose three main types of heart disease in dogs. The most common is degeneration of the valves between the chambers of the heart, leading to congestive heart failure. The least common form is congenital heart abnormalities. This form of heart disease might be considered a birth defect. The third form of canine heart disease is an abnormality of the heart muscle called dilated cardiomyopathy (DCM).

Dilated Cardiomyopathy
Canine DCM is a disease of a dog’s heart muscle and results in an enlarged heart that can easily be seen with a chest x-ray. The enlargement is due to thinning of the heart muscle, making the pumping action of the heart ineffective. The heart valves become leaky, leading to a buildup of fluids in the chest and abdomen. Like heart valve disease, DCM often results in congestive heart failure. Breeds that are typically more frequently affected by DCM include large and giant breed dogs, such as Great Danes, Boxers, Newfoundlands, Irish Wolfhounds, Saint Bernards, and Doberman Pinschers. There are also two small breed dogs prone to DCM, American and English Cocker Spaniels. The underlying cause of DCM is not truly known, but is thought to have a genetic component because of the strong breed associations. If caught early, heart function may improve in some cases that are not linked to genetics.

This Type is Different
The FDA initiated the investigation last week because the dogs recently identified with DCM are breeds not appearing on the list above. The cases that have been reported to the FDA have included Golden and Labrador Retrievers, Whippets, a Shih Tzu, a Bulldog, and Miniature Schnauzers, as well as mixed breed dogs. The other common finding in the recently diagnosed dogs is their diet. When the families of the dogs recently diagnosed with DCM were interviewed, they reported their dog’s diet contained potatoes or multiple legumes such as peas, lentils, other “pulses” (seeds of legumes), and their protein, starch and fiber derivatives early in the ingredient list, indicating that they are main ingredients. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for time periods ranging from months to years. High levels of legumes or potatoes appear to be more common in diets labeled as “grain-free,” but it is not yet known how these ingredients are linked to cases of DCM.

If You Are Worried About Your Dog or Your Dog’s Diet
Check with your dog’s veterinarian before changing his diet. The FDA encourages pet owners and veterinary professionals to report cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators. Please see “How to Report a Pet Food Complaint” for additional instructions.

Immune Mediated Thrombocytopenia

immune mediated thrombocytopenia

I recently wrote about the concept of immune disease – those disorders where the immune system goes haywire and attacks normal cells in the body. In a more recent blog, I wrote about one of the important canine immune diseases, immune mediated hemolytic anemia (IMHA). Today’s blog post focuses on a disease similar to IMHA, immune mediated thrombocytopenia (ITP or IMTP).

Defining ITP
The cell targeted by the out of control immune system in ITP is the platelet or blood clotting cell. The platelet is a powerhouse of coagulation. Under the microscope, a platelet is the smallest of the blood cells, yet the sticky platelet provides the first level of defense against hemorrhage. Platelets are in a large part responsible for the formation of a scab when you cut your skin while chopping vegetables or scrape your knee in a bike accident. Dogs, and the rare cat, with ITP can’t form a blood clot if nicked by the groomer because the immune system has destroyed their platelets. The lack of platelets can also result in spontaneous hemorrhage.

Recognizing ITP
You, as the healthcare advocate for your pet, may be the first one to recognize clinical signs of ITP. The hallmark of a low platelet count is little pinpoint hemorrhages on the skin, in the mouth or on the whites of the eyes. Hemorrhage may occur internally making the stool dark like tar or the urine bloody. One of my patients with ITP recently relapsed and came to the ER with a bloody nose. But, not every pet with a low platelet count or bleeding has ITP.

Causes of ITP
There are many other causes of low platelets that must be investigated before a diagnosis of ITP is made. Infectious disease tops the list of potential diagnoses for low platelets. Diseases transmitted by ticks top the list. Ehrlichiosis, Rocky Mountain spotted fever and Anaplasmosis may resemble ITP, but some readily available laboratory testing can quickly identify these diseases. Cancer, especially lymphoma or hemangiosarcoma can cause low platelet counts. Occasionally a reaction to a drug like an antibiotic can cause ITP. When a veterinarian cannot find an underlying cause of a low platelet count and a diagnostic evaluation is unremarkable, by the process of elimination, the diagnosis is ITP.

Treatment of ITP
Even though the blood cell affected in ITP is different than in IMHA, the treatment is similar since the overactive immune system needs to be suppressed to prevent more platelets from being destroyed. The first line therapy involves the use of drugs like prednisone to suppress the immune system. A chemotherapy drug, vincristine, when administered to dogs with ITP increases platelet release from the bone marrow and helps normalize their platelet count faster and shortens hospital stay. Dogs are often hospitalized for several days in case hemorrhage is severe enough to warrant blood transfusion. Most dogs recover from ITP, but some require additional drugs to suppress the immune system long term.

Other diseases affecting the immune system include polyarthritis and a variety of immune mediated skin diseases which will be the topic of a future blog post.

Heatstroke

heatstroke

It’s that time of year when the Animal Medical Center’s ER prepares to see dogs and cats with heatstroke. Heatstroke occurs when the ambient temperature overwhelms the body’s cooling mechanisms. Both heat and humidity contribute to the development of heatstroke. When humidity is high, pets cannot cool themselves by panting, a form of evaporative cooling. When the air is full of water, evaporation from panting occurs slowly and cannot keep the body temperature in a safe range.

Too Hot
The normal body temperature of dogs and cats is 100-102°F. AMC’s ER does not become concerned when a fever is as high as 104 or 105°F. Heatstroke is a body temperature 106-108°F. When the body gets that hot, multiple organs begin to fail.

Hot Pets
While heatstroke can happen to any pet, certain dogs are at greater risk. Snub-nosed dogs are unable to use evaporative cooling via panting as well as dogs with longer noses, and thus are a greater risk of developing heatstroke. Dark-coated dogs, golden retrievers, Labrador retrievers, overweight dogs, and those not acclimated to the heat are also at increased risk.

Heatstroke Symptoms
Hot skin, vomiting, panting, distress collapse, incoordination, and loss of consciousness are all indicators of heatstroke. If your pet is developing heatstroke, you will notice nonstop panting, hot, red skin and weakness. This may progress to incoordination, collapse and loss of consciousness. At the first hint of heatstroke, head to your local animal ER.

Head to the Animal ER
If you suspect heatstroke, go immediately to the closest animal ER, do not delay. Experts say trying to cool your pet off on your own wastes valuable time. But, if on your way out the door you can grab ice packs or frozen food from your freezer, put the frozen food on your pet in the car on the way to the ER.

Heat Injury
The extent of illness may not be apparent upon arrival in the ER. Heatstroke is a multi-organ system disorder. Pets experience circulatory shock from fluid loss from panting. Heat damages normal tissues like the brain and other vital organs. Damaged brain neurons cannot be replaced and may result in cognitive decline following an episode of heatstroke. Abnormalities in blood clotting and kidney function may not become apparent until hours after arrival in the ER.

Tips to Prevent Heatstroke
Preventing heatstroke is critical since data indicates half of pets suffering from heatstroke don’t recover.

1. Don’t exercise in heat of the day, only early or late. Heatstroke occurs most often in the afternoon.
2. Don’t leave pet in a hot car, even with the windows cracked. In one study, a hot car was the number one cause of heatstroke.
3. Provide access to cold water. Consider choosing a water bowl designed to keep water cool or add ice cubes to the bowl.
4. Provide shade with an umbrella or a covered kennel.
5. Try out a cooling jacket or mat.

Click for more suggestions on keeping your dog cool during the hot summer months.

Fun Feline Facts

cats playing

For my final blog post of Adopt A [Shelter] Cat Month, I am going to be less medical and more fun. To that end, I am going to share with you my latest collection of fun feline facts.

Purring Pussycats
One of the most endearing qualities of cats is their ability to purr. In my mind, there is nothing better than a cat on my lap, snuggled in and purring away. Everyone can recognize purring, but I suspect few can define it. In Mammal Review, purring is defined as a continuous sound produced on alternating (pulmonic) egressive (breathing out) and ingressive (breathing in) airstream. Purring results from neural oscillation – neurons which turn on and off rapidly causing rhythmic contraction of the laryngeal muscles 20-30 times per second. Based on the above definition of purring, not all felines can purr. Those that do not purr are those that roar: the lion, tiger, jaguar, and leopard. All other felidae can purr.

Are Right-Handed Cats Nicer?
This is really two fun facts rolled into one. First, did you even consider your cat could be right or left handed? Probably not. But in a recent study in the International Journal of Neuroscience, female cats exhibited right handedness more than males when tested with a food reaching test. About 10% of all cats were ambidextrous. Although an ambidextrous cat might sound intriguing, a behavioral study found ambidextrous cats less affectionate and more aggressive than righty or lefty cats. Strongly right or left-pawed cats were determined to be more confident and affectionate than those with weaker paw preference.

Are Cats or Dogs Smarter?
The answer to this question is open to a great deal of bias depending on your affinity for felines or canines. Scientists have tried to answer this question with data rather than their heart. In a study published in Frontiers in Neuroanatomy, researchers found dogs possess about 530 million neurons in the cortex, while cats have about 250 million. Neurons in the brain often go unused, so just having more neurons does not necessarily make dogs smarter. In fact, when you think about cats, they are phenomenal hunters and can easily out hunt humans with their neuron-loaded brains. So the number of neurons in the cat brain is not necessarily related to intelligence; the answer may lie in the function of each of those neurons. This quote from Dr. Brian Hare at the Duke University Canine Cognition Center answers the question thoughtfully. “Asking which species is smarter is like asking if a hammer is a better tool than a screwdriver. Each tool is designed for a specific problem, so of course it depends on the problem we are trying to solve.”

Are you coming late to Adopt A [Shelter] Cat Month? Did you miss the first three feline-focused blog posts? Catch up here:

  • Lifestyle Factors Related to Feline Obesity
  • Explaining the FVRCP in Feline Vaccines
  • Alternatives to Catnip

Catnip and its Alternatives

catnip

June is Adopt a [Shelter] Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is catnip and other plants cat families can use to enrich their cat’s home environment.

Catnip
Those of us who have had more than a few cats in their lifetime know not all cats react to the herb Nepeta cataria, colloquially known as catnip. Passion for catnip depends on a cat’s age and genes. Kittens less than about 8 weeks of age do not respond to catnip. In the population of cats at large, 25% of cats are not genetically programmed to respond to neptalactone, the substance in catnip that induces a kitty high – rolling, rubbing, sniffing, and chewing. Since not all cats enjoy a catnip high, a recent article in BMC Veterinary Research provides some suggestions of other plants which your cat may safely enjoy.

Silver Vine (Actinidia polygama)
This plant, also known as cat plant, is native to China and Japan. The plant can grow to a height of six feet and has pretty white flowers. Nearly 80% of cats responded positively to sliver vine. I found several products on pet websites containing silver vine, including sticks and dried leaves. In case you have a green thumb, you can also purchase seed packets to be used in a do-it-yourself cat garden.

Tatarian Honeysuckle (Lonicera tatarica)
You might find this Siberian import in your yard or nearby woods as it is considered a noxious and invasive species. Tatarian honeysuckle is a bush with pretty pink flowers found in hardy to Zone 3 areas. Some feline-centric websites offer honeysuckle sticks for your cat. Fifty percent of cats appear to enjoy the olfactory stimulation provided by honeysuckle.

Valerian (Valeriana officinalis)
Valerian-based products can easily be found in health food stores because the plant has a long history as an herbal therapy for promoting sleep. About half of cats given valerian root have a positive response. Directions on how to grow Valerian in your garden and prepare the roots for your cat can be found here. Both you and your cat will enjoy this plant since the flowers are dramatic balls of white flowers which will be lovely in a vase on your table.

Catnip, silver vine, Tatarian honeysuckle and valerian all provide safe olfactory entertainment for your cat, but not every houseplant or flower is feline-friendly. Check this list of plants toxic to cats and avoid having them in your home.

Explaining the FVRCP in Feline Vaccines

cat vaccine

June is Adopt a [Shelter] Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is one of the “core” feline vaccinations, FVRCP.

Vaccines for cats are categorized as core and non-core. Core means veterinary infectious disease and public health experts recommend all cats receive vaccines considered core. Rabies vaccine is considered a core vaccine for both dogs and cats. The other core vaccine for cats is FVRCP or feline viral rhinotracheitis, calici virus, and panleukopenia. The rhinotracheitis virus and calicivirus are the top two causes of feline upper respiratory infections. The panleukopenia virus causes a severe viral diarrhea.

Basis for the Core Designation
One of the reasons FVRCP is considered a core vaccine for cats is there are no specific treatments for feline viral rhinotracheitis, calcivirus or panleukopenia virus. The diseases must run their course and veterinarians can only treat symptoms: fluids for dehydration, antibiotics for secondary bacterial infections, eye ointments for corneal ulcers. It’s better to prevent these diseases with vaccination than to have your cat suffer from one of these debilitating viral infections. Should you fall in love with a shelter cat suffering from an upper respiratory infection due to rhinotracheitis virus and calicivirus, the cat is likely to make a full recovery and become a lovable member of the family.

The FVR
Feline viral rhinotracheitis is caused by a herpes virus. Similar to herpes virus infections in humans, once a cat is infected with a herpes virus, the virus will lay dormant until a cat is stressed and then clinical signs can flare up. Clinical signs of rhinotracheitis include lethargy, sneezing, conjunctivitis, and ocular and nasal discharge. Severe cases can have corneal ulcers and pneumonia. Young kittens are often the most severely affected.

The C
Feline calicivirus causes clinical signs similar to rhinotracheitis, but much milder. Cats with an upper respiratory infection due to calicivirus are likely to develop oral ulcers, especially of the tongue. Some cats develop joint inflammation leading to lameness but the lameness lasts only 1-2 days. Occasionally, a more virulent strain of calicivirus circulates in feline populations resulting in severe systemic disease.

The P
Panleukopenia is the medical way to say “a very low white blood cell count.” Closely related to the better known canine parvovirus, the feline panleukopenia virus infects the rapidly dividing cells of the bone marrow and intestinal tract. The impact on the bone marrow is a low white blood cell count which leaves panleukopenia virus-infected cats open to severe infection. Infection of the gut cells leads to severe diarrhea. Once a cat is infected with the panleukopenia virus, successfully treating this disease becomes very difficult. Fortunately, vaccination works well to prevent panleukopenia.

As part of your family’s celebration of June’s Adopt a [Shelter] Cat Month, check with your cat’s veterinarian about the need for FVRCP vaccination for your cat, the best type of vaccine and the schedule of administration.

Lifestyle Factors Related to Feline Obesity

Buster Brown

June is Adopt-A-Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is obesity.

I saw one of my favorite patients the other day. Okay, I admit, all my patients are my favorite. Buster Brown is a mink-coated Tonkinese cat, just a bit over one year of age. Because he is young and healthy, I haven’t seen him since before he was neutered and was a bit shocked when I put him on the scale. He had gained three pounds during the five months since I had last seen him. When his family saw the numbers on the scale, they asked, “How did this happen?” Below, I have outlined a few of the contributing factors to feline obesity that cat families can use to keep their furry friend at an ideal body condition.

But My Cat is Big-Boned
You are right, the significance of weight gain depends somewhat on the size of your cat. A slinky Siamese can gain less weight and still have a good body condition than the king of cats, the Maine Coon, but adding three pounds is probably too much for just about any cat. When I assessed Buster B’s body condition score, a scale which looks at a cat’s distribution of fat in various parts of the body, he scored 8/9, which is considered obese for a cat of his size.

Fixing Him, Even Though He’s Not Broken
Although Buster B is extremely handsome, he is a pet and was not going to make babies. Thus, he was neutered before he had a chance to start spraying urine on the furniture or drapes. Male cats that have not been “fixed” have very stinky urine and for that reason, pet cats are typically neutered. Neutering is a known risk factor for obesity in cats and portion control is a good practice after neutering. Decreasing a cat’s food intake by approximately one-third after neutering surgery is a good rule of thumb to prevent unwanted weight gain.

He Likes Crunchies and I Hate Those Smelly Cans in the Fridge
I am with you on this point. Cats like what they like and I find those little cans of congealed salmon and tuna pate revolting sitting next to my kale and organic chicken breasts. But, a diet of more than 50% dry food has been shown to be associated with obesity. If you feed your cat dry food fed free choice, without regard for portion control, your kitty can pack on the pounds. Ditto for treats; limit how many your cat consumes per day since snacking predisposes cats to obesity.

Kitty Gymnasium
In a recent scientific study published in Preventive Veterinary Medicine, risk factors for obesity in cats at two years of age were identified. Cats kept indoors were more likely to be overweight or obese. I suspect this is related to exercise or the lack of it in a confined space like your apartment. While research indicating cat calisthenics helps to keep weight off is lacking, exercising your cat with a laser light, fishing pole toy or encouraging them to run up and down the stairs can’t hurt. Better yet, provide a cat tree for climbing as cats love to be up high.

One third to one-half of American cats are considered overweight or obese. Be proactive and keep your kitty slim and trim by controlling his food portions, including some canned food in his diet, and making sure he gets plenty of exercise.

Canine Influenza Q&A 2018

dog flu

Recently the Gothamist, an online New York City-centric news site, reported on a canine influenza outbreak centered in the borough of Brooklyn; although veterinarians expect the outbreak to expand to other boroughs. Compared to diseases like rabies and distemper, canine influenza is a relatively new disease, first described in 2005. Because many dogs have never been exposed to canine influenza, they have no immunity and the disease can spread like wildfire through entire neighborhoods. Drawing on prior blog posts, I will answer common questions about canine influenza.

What causes canine influenza?
Canine influenza is a viral disease, and two different strains of canine flu virus have been described – the original H3N8 and H3N2, first described in 2015.

What are the symptoms of canine influenza?
Canine influenza causes an upper respiratory illness with runny eyes, sneezing, and a runny nose. Most dogs with the flu have a cough. If the flu causes a fever, dogs typically are not very energetic. Occasionally, dog flu progresses to pneumonia which can be life-threatening. This list of clinical signs is not specific for canine influenza and could be due to a bacterial infection or allergies.

How do dogs get the flu?
Dog flu spreads when the virus is coughed or sneezed into the environment or onto an uninfected dog. Keeping your dog away from other dogs will help to protect them against contracting canine influenza. Humans can transport the virus on their hands or clothing. The virus is wily because dogs can transmit the virus before showing clinical signs and continue to shed the virus after clinical signs have resolved. This means a dog that looks healthy could give the flu to your dog.

Can dogs get flu shots?
Humans get flu shots in the fall because influenza in humans is seasonal. Since I am writing about canine influenza in May, you have probably guessed canine influenza is not seasonal and can occur any time of the year. The canine influenza virus does not change annually like the human flu virus and vaccines against both H3N8 and H3N2 are available from veterinarians year round.

All of us at the Animal Medical Center wish the flu-stricken dogs in Brooklyn a speedy recovery and hope all healthy dogs stay that way!

Planes, Trains and Automobiles: Summertime Travel Tips for Pets

pet travel

Pet travel has been all over the news these past months from the changes in service animal travel regulations to the errant shipping of pets to destinations other than their planned one. Seems like there has been a new pet travel crisis reported daily. Managing pet travel from the veterinary standpoint has been challenging too. Airline travel forms are being changed so quickly that if pet families print the form a few days before their trip, the forms are no longer valid when the pet gets to the airport. Here are some tips for smoothing out the bumps in pet travel.

Travel to Rabies-Free Countries
Orchestrating travel with your pet to a foreign country can be one of the most complex organizational tasks ever involving negotiating the airline’s rules and government regulations. Rabies-free countries pose the greatest challenge as many require not only proof of rabies vaccination, but laboratory documentation of protective titers based on a blood test. Most of the rabies-free countries are island nations with complex rules about pet travel.

Although Hawaii is not a foreign country, its pet travel regulations rival those of England and Australia. I started in April working on administering the proper vaccines and submitting the blood tests for a patient of mine hoping to make a trip to Hawaii in August. The take home message here is to keep your pet’s rabies vaccination up to date and start early if you plan to fly internationally with your pet. Requirements for vaccinations other than rabies vary between countries, so be sure your pet has the required vaccines administered well in advance of travel.

Automobile Safety
The classic American vacation involves piling the whole family, including the pets, into the car and driving to the beach, mountains or a National Park. Before you load up, make sure your pet is safely secured in her seat. Pet should not be allowed to roam free in the car because in a crash, your pet becomes a free flying projectile capable of injuring a person riding in the car or sustaining severe injuries themselves. Your pet should be in a crate in the back seat or cargo area and the carrier should be secured to the child restraint loops between the seat and backrest. If your pet must sit on the seat, be sure to use a harness to prevent them from becoming a distraction when you are driving.

The Center for Pet Safety certifies products based on safety testing using animal crash test dummies. They also author independent safety standards to keep your pets safe. The Center for Pet Safety website lists products meeting their standards to keep your pets safe during a road trip vacation.

Riding the Rails
Just like the airlines, Amtrak has rules about pet travel, so be sure to read the fine print on their website before riding the rails with your pet. Your pet will need a reservation and will have to pay a fee to travel on Amtrak. The California Zephyr from Chicago to San Francisco is out if you are traveling with Fluffy or Fido since pets can only travel on trips less than seven hours. My current foster kittens, Nathaniel and Nino, would not be welcome on Amtrak since they are only 20 days old and pets must be eight weeks of age to travel on the train. Not all trains accept pets, so be sure to plan your travel schedule around trains accepting pet passengers.

If there is one unifying theme for pet travel it is to plan ahead. Get your pet’s travel papers in order and double check exactly which forms you need, investigate pet-friendly accommodations, and make airline reservations well in advance to ensure your pet will be allowed to board.

Is Your Pet’s Water Bowl Half Empty? Disorders of Water Drinking

cat drinking water

A common reason pet families bring their pets to the veterinarians at the Animal Medical Center is an increase in water consumption, or polydipsia in doctor speak. If the pet family doesn’t mention water consumption, the veterinarian will usually ask about any changes in water drinking habits. In today’s post, I outline some of the more common causes of increased water drinking. While an increase in water consumption may signal a serious medical condition, sometimes the increase is a normal physiologic condition.

Too Much In Or Too Much Out?
Increased drinking can occur because of excessive loss of fluid in the urine or because of a condition that increases the stimulus to drink water. The former is much more common and, from a veterinary perspective, much easier to diagnose than the latter.

Drugs
A number of drugs frequently prescribed for dogs and cats increases water intake. They include: prednisone (or any steroid), phenobarbital and Lasix® (furosemide), which is a diuretic. Obviously, Lasix® increases urine output, causing your pet to drink more water. Similarly, steroids impact the kidney’s ability to conserve water resulting in increased thirst. Why phenobarbital, an antiseizure medication causes polydipsia is unknown.

Hot Dogs, Cool Cats
On a hot day, your dog pants to cool off. Panting evaporates saliva from the mouth, but leaves your dog very thirsty to replenish the body’s water supply. Fever will do the same thing. Your dog or cat loses body fluids through panting or their sweaty little paws and they will drink more to compensate.

Food
Increased water intake frequently happens with a diet change for your pet. Canned food is approximately 75-80% water. Switching from a canned diet to a dry diet will cause a noticeable increase in water drinking. Swap your pet’s canned food for dry and your dog or cat will need to replace the water previously consumed in food by drinking more. Switch from dry food to canned food and you will notice you need to fill the water bowl less often.

A prescription diet to dissolve bladder stones works in part because it has been formulated to promote water consumption. Increasing urine production lowers the concentration of stone-forming minerals in the urine and dissolves the bladder stones. The stone-dissolving diet contains low concentrations of minerals found in bladder stones and must be used under the guidance of a veterinarian and with proper patient monitoring.

Pyometra
In unspayed female dogs, pyometra, or a severe uterine infection, causes increased loss of fluid through the kidney and a compensatory increase in water consumption. The bacterium associated with pyometra is E. coli. This bacterium produces a toxin that impairs the kidney’s ability to regulate water and increases urine output. Female dogs with pyometra often come to the veterinary clinic because the family notices an increase in water intake in response to the increased urine output.

Other well-known diseases associated with increased water intake include: Cushing’s diseasediabeteskidney disease, and feline hyperthyroidism.

If you think your pet is drinking more water than normal, see your veterinarian as soon as possible and take along a urine sample from your pet. Your vet will thank you.