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I watched Anastasia walk. Ears? Fine. Eyes? Normal. Teeth? Perfect.

Michelle-JasnyMichelle Gerhard Jasny, V.M.D. has been practicing veterinary medicine on the Vineyard since 1982 and writing the Visiting Vet column for more than 25 years. She lives and works in West Tisbury. She can be reached at drjasny@comcast.net.

As usual, I started my morning perusing the day’s schedule. Although we computerized decades ago, I have never let go of my good old-fashioned, spiral-bound, paper appointment book, where we scrawl in good old-fashioned number two pencil — owner’s name, pet’s name, species, reason for visit, phone number. The day looked fairly routine. Recheck cat with hyperthyroidism. Lyme booster. Annual physical. House call to cat at assisted living residence. Dog with red eye. Cat with head tilt. I paused. Who had the head tilt? A 13-year-old Russian Blue cross named Anastasia whom I had known since she was a little four-pound kitten.

Holding the head angled to one side is referred to by veterinarians as a “head tilt.” It can be a symptom of a wide range of problems, from the benign to the life-threatening. Head tilts in cats usually fall into three categories. The first group is cats experiencing discomfort around the head or neck from things like ear infections, bite wounds, abscesses, or dental disease. In these cases, the animals are just intermittently tilting their heads in response to pain or itchiness, such as that caused by the teensy ear mite, Otodectes cynotis.

Okay, some people say they can see these mites with the naked eye, but to my 59-year-old peepers, ear mites are microscopic. (Dogs rarely get ear mites but they do get frequent bacterial or and/or yeast ear infections, which may lead to skin infection that spreads down the neck or across the side of the face. They will often rub their faces on the floor and shake their heads vigorously. Cats are less melodramatic.) Your veterinarian can diagnose and treat ear mites, abscesses, skin and external ear infections easily.

Many cats will also tip their heads when eating a particularly hard or chewy item. This may indicate oral pain, so your veterinarian will want to take a good look in your cat’s mouth, but for some cats it is just a normal, idiosyncratic feeding behavior. The key point is that with all  these conditions, these cats can and will hold their heads in a normal position at least some of the time, and careful examination reveals a demonstrable cause for their behavior.

If Anastasia’s head tilt is truly constant, then the problem is probably in her vestibular system, the body’s balance mechanism that helps an animal know which way is up. The middle and inner ear comprise the peripheral vestibular system which then connects via the eighth cranial nerve to the central vestibular system in the brain. It is not always easy to determine if the problem is peripheral or central. Symptoms of peripheral vestibular disease may include persistent head tilt (always to the same side), rhythmic horizontal or rotary flicking of the eyes called nystagmus, walking in circles, falling to one side, an uncoordinated gait called ataxia, and vomiting. It can be caused by trauma to or infection of the middle or inner ear, nasopharyngeal polyps, tumors, or drugs that are damaging to the inner ear, but in cats far and away the most common type of peripheral balance disorder is idiopathic feline vestibular syndrome.

The pathophysiology of feline vestibular syndrome is unknown, hence the term “idiopathic.” It comes on very quickly, often in the matter of a couple of hours. Most common in older cats,  any age may be affected. It occurs more frequently in late summer and early fall, though no one knows why, but can happen any time of year. When an owner sees their kitty suddenly staggering around, walking in circles, sometimes unable to stand, it is not surprising that they assume the worse, but feline vestibular disease is actually no big deal.

For the first one to two days, cats may feel “seasick,” leading to loss of appetite, nausea, and vomiting, but this usually resolves quickly. Diagnosis is made based on the history, clinical signs, and ruling out other problems. You can do every test in the book, from blood work to X-rays to MRI, and they will all be normal. There is no specific treatment, although in severe cases your veterinarian may prescribe anti-nausea medications such as Dramamine ® or Antivert ® but no mediation of any kind has been found to alter the course of the disease. The most important thing is nursing care, keeping Anastasia in a safe, protected environment and providing easy access to food and water until the signs resolve. Most cats start improving within days and recover completely over several weeks.

This doesn’t mean that if your cat is staggering around, you can skip a visit to the vet. There are many serious problems with similar signs, and you need a professional to assess the situation. Central vestibular disease can be the result of head trauma, infections, brain tumors, even “stroke,” though that is rare in cats.

Signs of central balance disorders are very similar to those of peripheral disease but may include weakness on one side of the body and proprioceptive deficits. (Proprioception is the ability to sense the body’s position, motion, and equilibrium. In other words, to know where your feet are.) Animals with central disease may have altered mental status, seeming depressed or even stuporous. With peripheral disease, Anastasia might be disoriented but she would still be completely alert and responsive.

When our little Russian princess arrived, I realized the main reason for her visit was simply her annual physical and rabies vaccination. She waltzed out of her carrier, head completely straight. “Tell me about the head tilt,” I asked, looking her over.

Well, it seems her dad likes to hand feed Anastasia delicious little tidbits. Her owners noticed she would tilt her head to one side as she licked the proffered treat. I watched Anastasia walk. Ears? Fine. Eyes? Normal. Teeth? Perfect.

“I think she’s just a dainty eater,” I concluded, inwardly laughing at myself for having spent my morning worrying about those two words, “head tilt,” scrawled in my appointment book in good old-fashioned number two pencil.

When pets die suddenly owners may attribute it to a “heart attack,” but dogs and cats don’t really get heart attacks.

I got an unexpected crash course in a few aspects of human cardiology recently when I started experiencing tightness in my chest. At first I convinced myself it was asthma, but knowing my family history of heart disease, and knowing the signs of a heart attack can be very vague in women, and knowing too many folks who ignored those warning signs with dire consequences, I eventually went to the emergency room at the Martha’s Vineyard Hospital. Four hours later, my X-rays, ECG, and blood work showed no abnormalities and I felt better, but Dr. Zack was sternly adamant. I could go home now, but must go to Mass General ASAP for a nuclear stress test, an evaluation that involves injecting radioactive dye, then taking images of the heart before and after exercise. These pictures would allow cardiologists to see if any areas of my heart muscle weren’t getting adequate blood flow.

While making travel plans, I thought about cardiac disease in dogs and cats. It’s not uncommon when pets die suddenly for owners to attribute it to a “heart attack.” But dogs and cats don’t really get heart attacks, we tell them. Before we go further, a brief disclaimer.  Damn it, Jim, I’m a veterinarian, not a cardiologist. (Okay, please dismiss all Star Trek references as a side effect of my recent illness.)

Seriously. I’m not a cardiologist, but to the best of my understanding, in human medicine what people refer to as “heart attack,” is an acute myocardial infarction. Acute means it comes on suddenly. Myocardial means “of the heart muscle.” Infarction is tissue damage or death caused by lack of oxygen due to an obstruction of that tissue’s blood supply. So a human heart attack, a.k.a. acute myocardial infarction, is caused by sudden blockage of one or more of the coronary arteries leading to damage or death of part of the heart muscle.

Sudden death. It happens to pets now and then. One day your dog or cat, Valentine,  seems perfectly normal. The next, he keels over and dies. It can be devastating for owners, who urgently want explanations for such unexpected losses. Many people’s thoughts go immediately to poison, especially if Valentine goes outside unattended, but most toxins an animal is likely to encounter around here, such as rat poison and antifreeze, will typically cause clinical signs of illness before an animal dies. “He must have had a heart attack,” is another common conclusion. Wrong. Dogs and cats generally do not get coronary artery disease and thus do not get myocardial infarctions. Perhaps it’s their diet, lifestyle, or just genetics, but they appear to be resistant to this particular cardiac problem. That is not to say there aren’t other conditions that can lead to sudden death.

A sidebar on terminology. The term postmortem is short for postmortem examination, the dissection of a deceased body. It comes from the Latin post, meaning after, and mors, meaning death.  Another term for a postmortem on a human being is autopsy. This word comes from the Greek auto, meaning self, and opsis, meaning sight, or eyes. Thus autopsia meaning eyewitness, or seeing with one’s own eyes. The word autopsy was first used to describe the act of dissecting a cadaver to determine cause of death in around 1670 and is technically reserved for when this is done on human remains. For nonhuman animals, the proper term is necropsy, from the Greek nekros, meaning dead body. The point of all this being that if your pet, Valentine, bites the dust unexpectedly, your veterinarian is probably not going to be able to tell you why without performing a postmortem examination, correctly called a necropsy.

One cardiac condition often proposed to explain sudden death in dogs and cats is ruptured chordae tendineae, fibromuscular cords of tissue inside the heart that connect little mounds called the papillary muscles to the heart valves. They are sometimes poetically referred to as the “heart strings.”  If Valentine ruptures one of these heart strings, it can result in sudden death. Theoretically this occurs primarily when there is underlying disease of the heart valve, but we rarely get the opportunity to do a necropsy and/or postmortem laboratory diagnostics to get definitive answers. Perhaps Valentine died of a ruptured brain aneurysm. An aneurysm is a blood vessel with thinning walls that cause it to bulge abnormally. It can suddenly burst, leading to fatal hemorrhage. Even when we do perform necropsies, we rarely examine the brain, so this is another theory we seldom get to prove.

Other common fatal conditions are easier to demonstrate. Middle-aged large breed dogs are particularly prone to a form of cancer called hemgiosarcoma. There tumors affect the spleen or the heart and can often lead to sudden, fatal internal hemorrhage. Presumptive diagnosis can be made by simply tapping the abdomen, or pericardial sac, depending on the location of the tumor, with a needle and syringe and seeing if there is free blood in these places. Other causes of sudden death can include ruptured spleen from trauma such as being hit by a car, electrocution from biting electrical wires, acute conduction disturbances in the heart causing fatal arrhythmias, electrolytes imbalances from adrenal gland disease, and a variety of genetic problems Valentine might be born with but which don’t cause visible symptoms until he suddenly expires.

By the time I got to Boston, I had fairly constant angina. After an abnormal stress test, they quickly admitted me to the ER, then the cardiac ward. Three days later, I was given what they call “conscious sedation,” and cardiologists placed two stents via an artery in my arm into my coronary arteries, restoring adequate blood flow to the affected part of my heart. Amazing technology. The main thing I remember was the cardiologist yelling at me to stop asking so many questions. I guess I was curious. I know I was lucky. My heart gave me warning. No actual heart attack. No sudden death. Just gratitude.

Celia-cat.jpg
Celia, the shelter’s mascot and lobby cat, is very sweet and hypnotically beautiful.
Daisy-cat.jpg
Daisy is a large, loveable lady, who likes children.
Diva-cat.jpg
Diva is a female calico who was found near the State Police barracks in Oak Bluffs.
Penny-cat.jpg
Penny is an 18-year-old female who is very sweet and friendly. An easy keeper.
Steve-gerbil.jpg
Steve, a guinea pig, is looking for a nice family to take him home.
Tortellini-cat.jpg
Tortellini is a spayed female stray found in Vineyard Haven. A real cuddler, we think she is approximately 5 years old. She is very friendly.
Conrad.jpg
Conrad.
unnamed-cat

The following animals are currently available for adoption, with descriptions courtesy of the respective organizations.There are three facilities on the Island that offer animals for adoption: the Animal Shelter of Martha’s Vineyard (ASMV) in Edgartown, Martha’s Vineyard Helping Homeless Animals (MVHHA) in Oak Bluffs, and Angels Helping Animals Worldwide.

For more information about ASMV, call 508-627-8662 or search them on Facebook.

For more information about MVHHA, call 508-560-6046 or email kymcyr@comcast.net.

For more information about Angels Helping Animals Worldwide, search the group on Facebook.

At ASMV

With the exception of kittens, all animals have been spayed/neutered and are up-to-date on all vaccinations.

Celia, the shelter’s mascot and lobby cat, is very sweet and hypnotically beautiful.

Diva is a female calico who was found near the State Police barracks in Oak Bluffs.

Penny is an 18-year-old female who is very sweet and friendly. An easy keeper.

Tortellini is a spayed female stray found in Vineyard Haven. A real cuddler, we think she is approximately 5 years old. She is very friendly.

Daisy is a large, loveable lady, who likes children.

Steve, a guinea pig, is looking for a nice family to take him home.

At M.V. Helping Homeless Animals

Hannah’s owners moved so she has been on her own for three years. She’s at the Tisbury pound now but will soon be at MVHHA, and the veterinarian believes her to be 10 years old. Though she is missing a tail, she’s very sweet and would love a home to call her own.

At Angels Helping Animals Worldwide

Conrad

Jackson loves television commercials, especially one for Beggin' Strips. — Photo Courtesy of Cathy Walthers
Lily ritually tosses her Mr. Furry in the loo.
Lily ritually tosses her Mr. Furry in the loo.

My cat, Lily, has a couple of out-of-the-ordinary habits. The first is her extreme preference for drinking water from a running faucet. Sometimes, to the amusement of visitors who might be rinsing a plate in the kitchen sink, she’ll race over, leap to the counter, crawl beneath their arms, and start lapping away at the running stream. When she’s thirsty and no one is at the sink, she’ll plant herself at its edge and get mouthy at you until you come over and turn on the tap. Either that or just stare you down until you do same.

Cats drinking from running taps is not unheard of. (There is, for example, a popular YouTube video of a cat that sticks its entire head under the stream of water and drinks the droplets that run off its fur and into its mouth.) I figure it’s some kind of throwback to cats’ ancestors’ lives in the wild, where moving water in creeks and brooks was a likely thirst-quencher.

But Lily does something else that I’ve never heard of. It involves “Mr. Furry” – her stuffed mouse.  (Actually, there have been multiple Mr. Furrys over the years). Covered in real fur, Mr. Furry is as close as Lily – a West Tisbury indoor cat – can get to genuine prey. Whenever I break out a new Mr. Furry, Lily goes wild, tearing around the house with it for a good 10 minutes. But inevitably, and usually within a half an hour, I find it in the same place: the downstairs bathroom john. Her motives are a mystery. Perhaps she’s trying to drown it? Or wash it? Or perhaps she’s decided she’s killed it and wants to dispose of it neatly. Or maybe she’s figured out that this Mr. Furry, like all his predecessors, is a fake piece of crap, so she’s putting him in the crapper. Who knows?

I polled some other Islanders to see whether they had pets with quirky habits, and in most cases the answer was yes. Here is a sampling of what I learned.

April

April takes TV a little too seriously.
April takes TV a little too seriously.

April is a six-year-old toy poodle owned by long-time seasonal Vineyard Haven residents Tom and Melissa Rogers. Whenever a doorbell rings on the television, April races to the front door and barks like crazy, positioning herself on the staircase landing opposite the door so she’s at eye level with the handle. While this on its own is somewhat quirky but not unknown in the dog world, what makes April’s case exceptional is that April does not live, nor has she ever lived, in a house with a doorbell. The only doorbell April has ever heard has been on the television. What gives? Has knowing what the doorbell means become a genetic trait in dogs? Or has April learned what it means from paying close attention to TV shows?

Jackson

Jackson also has a TV habit.
Jackson also has a TV habit.

Another dog with a TV habit is Jackson, a five-year-old English Shepherd owned by Chilmark year-rounders Cathy Walthers, David Kelliher, and their son James Kelliher. Jackson especially enjoys commercials with animals in them. Any and all animals interest him, be they other dogs, cats, lions, or ducks, though he’s especially fond of an ad for the dog treats “Beggin Strips,” since that one features both dogs and treats.

“If Jackson is in another room and hears the jingle for one of the ads he likes, he runs into the TV room to watch it,” says Ms. Walthers. Also, she adds, he’s developed a new habit of running in circles whenever he hears clapping and cheering on the television. “During football games, he drives us all a bit crazy.”

Leuco

Leuco, practicing for her career in the circus.
Leuco, practicing for her career in the circus.

Leuco wants to be in the circus. A five-year-old Portuguese Water Dog owned by Nicole Galland of West Tisbury and her husband, Billy Meleady, Leuco never fails to obey the command “jump!” But such encouragement is unnecessary. Leuco hasn’t met a playground swing she didn’t want to bound over, or a tire swing she didn’t want to shoot through, “especially if there are people watching,” says Ms. Galland. Leuco adores jungle gyms, racing up the ramps or stairs, traversing their upper walkways and tunnels, and finally, taking the slide down, only to double back to the beginning to do it all over again. “And again, and again,” says Ms. Galland, “until I stop her.”

On walks, Leuco creates her own obstacle courses, leaping up onto high sea walls, climbing small ladders onto docks, jumping over anything and everything. One of her favorite found props is a discarded staircase lying on its side on one of her beach walks. Though there is plenty of space to walk around it in the sand, Leuco runs over it from one end to the other, lifting her legs high to clear the protruding steps like a football player training on the tires.

But Leuco isn’t all boundless enthusiasm. When she senses that her owners are about to leave for awhile, she goes on a hunger strike. If they give her dinner before leaving, she won’t eat it until they return home, even if it’s several hours later. It’s the same when they try to distract her with a treat. “She takes it in her mouth,” says Ms. Galland, “looks up at me with accusing eyes, and then drops it to the floor with a disgusted toss of her head. She won’t eat it until we get back. I think she believes that her refusal to eat is the magic that forces us to return.”

Gizmo

Unlike Leuco, a certain yearling guinea pig in Vineyard Haven never refuses to eat. The rodent, whose owners prefer to keep his identity secret, especially loves lettuce. An observant creature, he has figured out the sequence of events that lead up to his being given a snack. So now, every time someone in the house opens the refrigerator, he starts squealing – “Wee! Wee! Wee! Wee!” He can’t see the refrigerator, but he’s learned the sound it makes being opened, and he won’t stop squealing until he gets some greens. Evidently he also did this when he was at the Animal Shelter of Martha’s Vineyard in Edgartown before he was adopted by his family. Refrigerators may not all sound exactly the same when they’re opened, but they must sound similar enough for a lettuce-loving rodent to make the connection.

Owl and Honey Bunny

Owl, a 14-year-old female cat belonging to Mark and Kim Baumhofer of West Tisbury, has recently taken a shine to the family’s 8-year-old female rabbit, Honey Bunny. The Baumhofers first noticed

Owl the cat and Honey Bunny often switch places.
Owl the cat and Honey Bunny often switch places.

this blossoming affection last Christmas when a guest was staying in the den, where Honey Bunny’s cage normally resides. When the rabbit was moved to a daughter’s bedroom for the holidays, Owl started hanging out on the bed in that room. After Christmas, when Honey Bunny moved back to the den, so did Owl. When the bunny is let out of his cage to stretch his legs, Owl often goes into the cage and curls up to sleep. At other times, the rabbit will hop up onto one of the den’s two armchairs, and Owl will hop up onto the other, “and they sit there like a couple of old grandmothers all evening,” says Kim Baumhofer. One has to wonder whether a cat named “Owl” might have something of an identity crisis; perhaps she’s decided that she’s neither – she’s a rabbit.

Carhartt

Carhartt, the Baumhofers’ eight-year-old Boxer, started out as Mark’s dog, going to work with him every day, following him around the house in the evenings. When Mark, a builder, first got a job to which he couldn’t bring Carhartt, the dog stayed home with Kim. When Mark came home at night, and both he and Kim were in the same room, Carhartt was

Carhatt the Boxer is torn between Baumhofers.
Carhatt the Boxer is torn between Baumhofers.

there with them. But when one member of the couple went upstairs and the other stayed downstairs, Carhartt was torn. He solved the problem by settling down on the landing half-way up the stairs, and remaining there until one member of the couple joined the other on either floor. Now, when Mark can take the dog to work, Carhartt becomes Mark’s dog again, but when Mark’s at a site where Carhartt can’t go, the dog “turns to the Kimmie side,” says Mark, dividing his loyalties equally by waiting on the landing until both Baumhofers are on the same floor, and also by spending some part of each at-home-with-Kim day sitting outside staring down the driveway, watching for Mark’s return.

Readers: Got a quirky pet story of your own for a future All About Pets? Write to Laura Roosevelt at ldroosevelt@gmail.com.