What you don’t see can hurt your cat…and you too

This is the second of 16 student posts, guest-authored by Eileen Ball.

The beauty of dogs and cats as companions is that we don’t have to raise them to go out into the world and be successful.  As pet parents we can set the household “rules” according to what works for us and get on with enjoying our pets; hopefully for many years.   According 2011-2012 APPA National Pet Owners Survey cats have now surpassed dogs as the most common household pets in the United States.  Despite this fact  the same survey reports that in 2010 only 30% of US veterinary patients were cats.  As a companion animal veterinarian I find these statistics alarming and I fear that many well-intentioned pet owners are simply unaware of the risks that can accompany the joys of cat ownership.

A common perception is that indoor cats don’t need veterinary care.  In this sentence there two big factors that need to be addressed.  The first, and for me the most obvious, is that indoor cats need veterinary care too!  In a bit I’ll get to explaining that even without outdoor threats,  such as motor vehicles and big dogs, indoor cats and their owners face almost as many dangers as their outdoor brethren.    The other part of the eleven word sentence at the start of this paragraph that requires definition is the concept of “indoor cat.”    During my ten years as a practicing veterinarian I had many a conversation with an owner that started with the question “Is Fluffy indoor or outdoor?”  Followed by the owner confidently responding “indoor.”  As we moved forward in our discussion and I asked more about how Fluffy spent her day I’d often learn that Fluffy had access to the yard or deck and often spent long periods of time there.  There were alternative versions of the discussion where Fluffy didn’t physically go outside but the dog did as well as scenarios where mice, birds or bats came indoors even though they weren’t invited.  The reality is that In order for a cat to be considered 100%  indoor it would need to live in a biosphere.

So why should you take your indoor cat to the veterinarian on at least a yearly basis?   The first and most important reason is that your cat has the potential to carry parasites and diseases that can be transmitted to you and your family.  These include but are not limited to:  hookworms, roundworms, fleas, ticks, ringworm and Rabies.  According to the CDC approximately 14% of the US population has been infected with a type of roundworm called Toxocara.  Indoor cats are a potential source of exposure as they generally use litter boxes and they frequently contact surfaces such as countertops, bathroom vanities, kitchen tables and bedding.  Many cat owners have the misunderstanding that because their cats do not go outdoors they are not at risk.  This is simply not true.  There are lots of indoor/outdoor parasite sources such as mice, rats, other pets and people.  Hookworm and roundworm infections are easily and safely prevented with a variety of medications.  Your veterinarian can run a simple fecal test to see if your cat is infected with these or other parasites.  Another concern for cat owners is the transmission of a type of bacteria called Bartonella.   In most cases infected cats will show no symptoms, although in some it may cause gum disease, conjunctivitis (swollen membranes around the eyes) or respiratory disease.  Bartonella can spread from cats to humans.  It is the causative agent of Cat Scratch Disease in people.  Cats often get this bacteria from fleas and they can transmit it to humans via bites and scratches.  While parasites and Bartonella are a significant risk for healthy humans in those who don’t have a fully functioning immune system the risk is magnified even further.

The most important disease that you can protect your indoor cat from is Rabies.  This is a virus that is spread via saliva and is almost always deadly.  Rabies infection is common in skunks, raccoons, foxes and bats.  A bat getting into the house through an open window or a chimney is a very real risk for any animal or person in your house.  If you should happen to find a bat in the house with your cat (or other pets) you must assume that they were bitten.  Because of the thick fur that cats have it can be impossible to see a small bite wound.  Depending on local laws you may be required to vaccinate your cat for Rabies every 1-3 years.

There are other conditions such as ringworm and toxoplasmosis that cats can have without showing any signs.  People with healthy immune systems are not likely to show symptoms if they are exposed to these parasites but for others with HIV, cancer, pregnancy or a suppressed immune system serious consequences can occur.  When I think of ringworm without symptoms I always recall one of my patients, Miss Kitty, who was loved and adored by her entire family.  Miss Kitty and her humans were originally from Hawaii and had moved to Virginia where I was in practice.  Since Miss Kitty couldn’t travel from mainland US to Hawaii without quarantine the relatives in Hawaii decided to come to Virginia for Christmas.  Miss Kitty’s human grandmother happened to have breast cancer and was undergoing radiation.  The family had a great holiday.  Shortly after her return to Hawaii the grandmother developed circular, itchy scabs on her skin.  Her MD diagnosed it as ringworm and asked if she had any pets.  The grandmother said “no” and the MD presumed she had picked it up from the environment and started treating her.  It was a couple months later in conversation with Miss Kitty’s owner that I’d inquired about the holiday visit and the grandmother’s health.  Miss Kitty’s owner described the wonderful time that they’d had and mentioned that the grandmother had enjoyed the trip except for her persistent skin lesions.  A bell went off in my head and I decided to test Miss Kitty’s hair for ringworm.  Sure enough even though she’d never had a problem with her skin Miss Kitty was positive for ringworm.  Based on the species we cultured the grandmother’s MD was able to change treatment and get her skin cleared up quickly.

Finally, as most people who have shared their lives with both dogs and cats will agree, cats are not small dogs.  While the process of domestication for both dogs and cats has been ongoing for thousands of years it is estimated that the dog started the process 9-10,000 years before the cat.  For this reason cats tend to display a “survival of the fittest” instinct that we don’t see in dogs. Because of this instinct cats generally aren’t transparent when they don’t feel well.  Some cats are prone to chronic heart, thyroid  and kidney diseases that can often be detected with a thorough examination and some bloodwork.  Although most of these chronic conditions can’t be cured, with good veterinary guidance they can be well managed and allow you to share many happy years with your cat.

If your cat hasn’t been to the veterinarian in awhile I hope you will consider scheduling an appointment.  This can not only make life longer and better for your cat it can also protect you and your family from serious disease.


American Pet Products Association 2011-2012 Pet Owners Survey








Bartonella Spp. In Pets and Effect on Human Health,  Chomel et al. Vol. 12 number 3, March 2006,  www.cdc.gov/eid














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