In Persians cats, the diseases of concern include polycystic kidney disease, entropion, blocked tear ducts, dental disorders, wry mouth, idiopathic facial dermatitis and hypertrophic cardiomyopathy. Here’s what you should know about these disorders:
Hypertrophic Cardiomyopathy (HCM)
HCM is a progressive heart disease in which the heart becomes thickened and fails to relax normally. As a result, the heart cannot fill adequately with blood, and dynamics involving heart-pumping action change and congestive heart failure eventually occurs. Sometimes blood clots form, traveling to and causing blockages in other sites, particularly the hind quarters, resulting in sudden rear-end paralysis. Although HCM can be an “old age” disease, a hereditary form can occur in young cats, often but not exclusively between the ages of 6 months to 3 years.
Clinical signs. Respiratory distress (troubled, labored or quickened breathing), reduced appetite, lethargy, sudden rear-end paralysis. “But often cats are asymptomatic for quite some time,” explains Patti Iampietro, VMD, a practitioner at Best Friends Animal Society (the largest animal sanctuary in the United States, located in Kanab, Utah). “Commonly, the disease is discovered on a routine exam when the vet hears a heart murmur,” she explains.
Management. Although there’s no cure for HCM, proper management can ease the burden of the heart, extending both the quality and quantity of life. Depending upon the severity at diagnosis, various heart medications are prescribed to improve cardiac function, remove fluids from the lungs and thin the blood, Iampietro says. Follow-up exams with the veterinarian are important to monitor disease progression, effectiveness of the medications, and to make sure the medications don’t cause any adverse side effects. “We often have to tweak the medications, depending how the cat responds,” Iampietro says.
Owners should monitor the cat for signs of adverse side effects (inappetence, vomiting and changes in water intake) and should limit stress. “Don’t let the dog or toddler chase the cat around, and keep the cat indoors,” Iampietro warns. Should the cat exhibit signs of respiratory distress, it should be taken immediately to the veterinarian for emergency treatment.
Prognosis. The hereditary form of HCM tends to be aggressive. “In general, this is a pretty severe disease,” Iampietro says. If a young cat develops HCM, the prognosis is about 6 to 12 months, depending upon the degree of severity when diagnosed.”
Polycystic Kidney Disease (PKD)
PKD is a progressive, inherited kidney disorder in which a large number of cysts form in the kidneys. Present at birth, the cysts are initially small in size, but gradually enlarge as the cat ages, eventually impacting kidney function and leading to kidney failure. “Typically, animals are young to mature adults between 3 to 10 years when signs first appear,” says Jessica M. Quimby, D.V.M., a small animal internal medicine resident at the Veterinary Medical Center at Colorado State University.
Clinical signs. Weight loss, poor hair coat, decreased appetite, and increased drinking and urination. Upon examination, the veterinarian may find dehydration, large kidneys, pale gums, mouth odor and mouth ulcers. “Labwork may reveal elevated kidney values, poorly concentrated urine, high phosphorus levels or anemia,” Quimby notes.
Management. PKD cannot be reversed or halted through therapy, although supportive treatments can make the cat feel better and improve its quality of life. “Treatments include specially formulated diets to help decrease the workload on the kidneys and to balance electrolytes, antacids to help with stomach upset, fluids to help correct dehydration, appetite stimulants, phosphate binders if the phosphorus is high, hormone therapy to help balance calcium and phosphorus, and injections to help regenerate blood cells if anemia is severe,” Quimby says.
Alternatively, owners can opt for a feline kidney transplant, an expensive procedure available at a handful of veterinary referral centers. Cats that receive kidney transplants must be regularly monitored and remain on immunosuppression drugs for the rest of their lives.
Prognosis. PKD is progressive, with many cats eventually succumbing to death from kidney failure. “It cannot be predicted how long a cat will live with management,” Quimby says. Survival rates for cats that undergo kidney transplants varies, ranging from several months to many years.
Idiopathic Facial Dermatitis
Idiopathic facial dermatitis is a poorly understood, chronic skin disease that affects the face. The cause is unknown, although a genetic basis is suspected. “It causes very unpleasant facial lesions that can progress rapidly and become severe,” says Susan Little, D.V.M., owner of Bytown Cat Hospital in Ottawa, Ontario, Canada, and president of the Winn Feline Foundation. “It’s uncomfortable, falling into the category of ‘won’t kill you, but will make you miserable’ type of disease,” she says.
Clinical signs. Generally, it first appears at a young age (usually under the age of 2 years) and consists of black discharge around the eyes and nose, redness, swelling, hair loss, self-trauma, and sometimes ear inflammation. Often, the dermatitis forms a “butterfly” pattern around the eyes and across the nose, Little says.
Management. “Unfortunately, there’s no definitive treatment,” Little says. “Typically, cats initially respond to corticosteroids, but become refractory (meaning stubborn, difficult) and are then given cyclosporine (an immunosuppressant drug). Usually they must stay on medication for life.”
Prognosis. Idiopathic facial dermatitis tends to be chronic, usually worsens over time despite therapy and is generally resistant to long-term resolution. “The cats that do the best are the cases that have some contributing factors that we can treat, such as fungal or bacterial infection,” Little says.
Entropion is a condition in which the rim of the eyelid curls inward. As a result, the eyelid hairs and lashes rub against the cornea, causing irritation and damage. The eyelid can also cover up and block the tear ducts, which maintain eye moisture and protect the cornea. Entropion occurs in either upper or lower eyelids, in one or both eyes. It’s often caused by a congenital malformity, such as excess nasal or skin folds, but entropion can also occur from trauma or other eye disorders.
Clinical signs. Squinting, excess tearing, reddened eye and eye discharge. “The owner usually notices an odd appearance to the eye,” notes Jean Duddy, D.V.M., of the Angell Animal Medical Center in Boston, Massachusetts. “It’s often picked up on the annual exam at the veterinarian’s office.” The congenital form occurs in immature cats; secondary entropion can occur at any age.
Treatment. Protocol depends on severity, cause and age of the cat. If the veterinarian determines the entropion is a secondary condition in response to another disorder, the underlying condition needs to be corrected. “In minor cases where the entropion is a congenital defect and tearing is the only problem, no treatment is needed. For cats where the eyelid inversion causes corneal ulcers, surgical correction to remove excess eyelid folds is recommended,” Duddy explains. “In young cats, that’s often a two-stage process: First a vet will use sutures to temporarily tack the eyelids out of the way while the cat grows and develops normal, full-size facial features. Later, depending on the severity of the condition, it my need surgery to remove the extra tissue.” For cats with multiple abnormalities in the same eye, Duddy says a combination of surgery and medical management may be needed. In these cases, an ophthalmologist should be consulted.
Prognosis. Excellent, with appropriate treatment.
Blocked Tear Ducts
Blocked tear ducts are most commonly the result of inflammation and scarring of the opening or ducts. “It’s often due to previous eye infections,” Duddy says. “But could be caused by a congenital malformation.”
Clinical signs. Tearing. Occasional skin irritation is secondary to the tearing. “The signs occur after the tear duct totally blocks, so it can occur at any age,” Duddy reports.
Treatment: “Most blocked tear ducts are just managed by keeping the areas as clean and dry as possible, with ointments sometimes used cosmetically to decrease staining,” Duddy says. “Sometimes the vet can flush the blocked ducts to try to clear the blockage, but often heavy sedation or anesthesia is needed and usually, because of the scarring involved in these small ducts, success is rare.”
Prognosis. Seldom cured, but blocked tear ducts are rarely a severe medical problem and the cat can live comfortably with the condition.
Dental disorders can sometimes occur as a consequence of the Persian’s compressed, brachycephalic (flat) face. Brachy cats have the same size and same number of teeth as a normal-faced cat, but with a shortened jaw. Additionally, a brachy cat’s smaller upper jaw can likewise result in crowded, malpositioned teeth. Crowding favors the accumulation of plaque bacteria, which leads to periodontal disease if left untreated, periodontal disease invites painful mouth infections, infection of vital body organs and tooth loss.
In some cases, malpositioned teeth protrude into the opposite gums or lips. Abnormal tooth-on-tooth contact, excessive tooth wear or tooth trauma, abnormal or painful chewing, and prevention of mouth closure can also occur.
Clinical signs. Loose, crooked, or crowded teeth; bad breath; bleeding gums; chewing on one side of the mouth; cocking the head while eating; food falling out of the side of the mouth while eating. “Most often, these problems are first noticed when the cat is between 14 to 24 weeks of age,” says Bill Gengler, D.V.M., Dipl. AVDC, associate dean of clinical affairs and director of the Veterinary Medical Teaching Hospital, at the University of Wisconsin-Madison School of Veterinary Medicine. “This is the age when the cat sheds its deciduous [baby] teeth and its permanent teeth come in.”
Treatment. If overcrowding isn’t causing pain or excessive tooth wear or trauma, the most important thing is keeping periodontal disease under control. Daily toothbrushing and regular, professional dental cleanings will remove plaque and tartar,” Gengler says. Also helpful: dental diets and dental chews (assist in removal of plaque), and oral rinses or sprays (contain enzymes that reduce plaque or plaque-causing bacteria). “Some water additives have been shown to reduce tartar formation, but the safety of water additives still needs to be proven,” Gengler adds.
In cases where malpositioning is or could lead to additional problem is the simplest and most common means of correction, extracting of non-strategic teeth, Gengler says. “Strategic teeth can be orthodontically moved or crown-shortened. Moving teeth involves placing into the cat’s mouth a fixed biteplate and retainer, usually for 6 to 18 weeks. Crown-shortening refers to cutting off and shortening the tooth so the tooth doesn’t make inappropriate contact with the opposite jaw when the jaw closes. Crown-shortening must always be done by properly trained veterinarians using appropriate endodontic therapy under sterile surgical conditions.”
Prognosis. Depends upon the severity of the problem. “If there isn’t severe damage to dental tissue, once you extract, move or shorten the tooth, the prognosis is usually very good,” Gengler says. “However, if the teeth have undergone significant damage or periodontal disease is well established and bone around the tooth is lost, that creates lifelong problems unless extensive periodontal therapy is provided.”
Also known as wry bite, this condition occurs when the lower jaw undergoes an abnormal deviation to one side as it grows. This malformation sometimes causes some of the teeth to strike the palate or the lip of the animal. “The condition is most often genetic, but trauma to the young kitten may also cause the jaw to develop asymmetrically. When trauma isn’t the cause, these cats shouldn’t be used for show or breeding,” Gengler says.
Clinical signs. A twisted or curved lower jaw in the growing cat, cats are often unable to completely close the mouth.
Treatment. “Minor cases can be treated through teeth adjustment to prevent soft tissue contact or excessive tooth wear,” Gengler says. “This may involve extraction or moving teeth with an orthodontic appliance. With very severe cases, the jaw can be surgically cut and repositioned.”
Prognosis. Depends on the severity of the defect, but in most cases, a comfortable bite can be achieved, Gengler says.
Although the odds are that your Persian will live a long and healthy life, you can increase those odds by maintaining a good wellness program:
- Vaccinating against disease per your veterinarian’s recommendation
- Providing appropriate parasite protection
- Maintaining a good diet
- Keeping weight under control
- Keeping skin and coat clean and well-groomed
- Providing regular at-home and professional dental care
- Scheduling regular veterinary exams (especially as your cat ages)
- Arranging for a veterinary consultation or checkup if you notice any changes in your Persian’s health or behavior
Remember, paying attention to changes in your Persian’s behavior and staying on top of developing problems via early diagnosis and treatment often yields the best prognosis by either correcting a problem before it becomes severe or permanent, or for life-ending diseases, by helping slow disease progression and extending your cat’s remaining months or years.