Recognizing Signs of Illness in Cats

My cat seems fine. Could there be a problem?
Although cats are predators, in nature larger predators will prey
upon them.Since sick or old animals make an easy target, any obvious
sign of illness will alert other predators that the animal is ill. Therefore,
cats have evolved to hidesigns of illness. This means that in the early
stages of illness, often the only thing that a cat owner may notice is that
the cat has become quiet and withdrawn. Unfortunately, this also means
a cat may be very sick before the owner realizes something is wrong.
Through training and experience,veterinarians may pick up subtle signs that a cat is developing a health problem, which is one of the main reasons why the American Veterinary Medical Association and other veterinary experts recommend twice yearly wellness examinations for the average adult cat. Delaying your cat’s veterinary visit until there are obvious signs of illness may mean that heroic measures will be required to treat the problem. With some understanding of how cats show symptoms of illness, you will be able to recognize warning signs and know what information you need to provide your veterinarian. 
What things I should look for?
Cats that are ill will usually show changes in overall appearance, energy level, sociability, coat appearance and amount of shedding, appetite, litter box usage, breathing, or discharges from the eyes or nose. In general, any sudden change should alert you that your cat needs veterinary attention.
What changes would I see in overall appearance?
Cats that are not feeling well may just look a little “off.” The cat might sit in a hunched position, might not move as gracefully as before, might not lift its head properly, might have a head tilt or might carry its tail in a different way than normal. Sometimes there isn't any one thing that stands out, but a variety of subtle changes. Dehydration is a common problem in cats that are not well. To see if your cat is dehydrated, gently grasp his skin near the shoulder blades, pull it up and away from the body, then let go. The skin should snap back into place right away – skin that does not snap back into place, but stays ‘tented up’ usually indicates dehydration, a condition that needs to be treated right away.Cats that have some sort of chronic illness may develop slow and subtle weight loss that is only obvious when you actually run your hands along the ribs and spine. Cats that suddenly lose weight, particularly if they were previously overweight, are usually suffering from some sort of metabolic disease such as diabetes or hyperthyroidism.
                                          What changes in sociability or energy level would                                                  indicate that my cat might be sick?
                                                         Sick cats usually become withdrawn, although this does depend on the                                                                  personality of the individual cat. Some cats become more clingy or                                                                          demanding of attention, while others just become cranky.
                                                         As a general rule, cats that are sick will have lower energy levels. The only                                                            thing you may notice is that your cat sleeps more, doesn’t play as much, or                                                            is restless. With some diseases, especially hyperthyroidism, your cat’s                                                                    energy level may actually seem to increase to the point of hyperactivity. Cats                                                          with hyperthyroidism often are restless at night and may suddenly begin                                                                  howling or waking family members up. Cats with arthritis or other joint                                                                    problems may have difficulty moving around and may no longer jump up on                                                            furniture or counters, or may change the way they do jump onto higher                                                                    surfaces. If your cat suddenly is unable to use its back legs, she should be                                                              seen by your veterinarian immediately.
What changes would I see in coat appearance and amount of shedding?
Cats that are not feeling well don’t tend to groom themselves very well. Therefore, you will usually see a messy or greasy coat, mats of fur, or clumps of loose hair. In some cases, you will see a difference in the coat’s shine or an increased amount of dandruff. Cats that are grooming themselves excessively may also have a problem. Excessive grooming may be a reaction to a skin problem such as allergies, a parasite such as fleas, mites or ringworm, pain such as that from arthritis or a bladder problem, or a response to stress. These cats might over-groom on all parts of their body, or they may lick themselves in one area so much that they develop bald spots and the skin beneath may be red and raw or may have a rash.  
What changes should I look for in appetite or thirst?
Since sick cats may eat less or eat more, or may have more or less thirst than usual, any change in appetite or thirst may be of concern. Cats with dental disease may seem to be picky about their food. Cats that have some metabolic diseases such as hyperthyroidism or diabetes mellitus may have a hearty appetite and increased thirst. Cats with liver or kidney problems often lose their appetite, but usually have  increased thirst.
If your cat has not eaten properly for 24 hours, you should seek immediate veterinary attention. Anorectic cats are prone to developing a condition called hepatic lipidosis or fatty liver disease, in which the cat’s appetite becomes completely suppressed for weeks. If fatty liver syndrome develops, the cat will require extensive medical management for several weeks to several months before things get back to normal.
What changes should I look for in the litter box?
Both diarrhea and constipation are indicators of disease in cats. Diarrhea is usually easy to recognize in the litter pan, but constipation can be more problematic to notice. Small, hard, dry stools are never normal and are often an early indication of kidney disease. Increased amounts of urine in the box are an indication of inability to properly conserve water, and may mean that your cat is developing kidney problems, liver problems or diabetes mellitus. Decreased amounts of urine in the litter box, especially if accompanied by a cat that spends more time going in and out of the box, or strains when it is in the box, indicate some sort of kidney or bladder problem. Cats with a urinary tract problem often lick excessively at their genitals. If you notice that your cat does not seem to be producing as much urine as usual, or the clumps of urine are small, you should seek immediate veterinary attention. Lack of urination is a life-threatening emergency!  
What changes should I look for in breathing?
Breathing difficulty such as shallow breathing, mouth breathing or panting may indicate a problem with the airways or lungs. Cats with breathing problems often will have a distended chest, or may be unable to sleep in a normal position. Repeated bouts of sneezing or coughing are signs of health issues.
What eye changes may be present in a sick cat?
Droopy eyelids, discharges that are green, yellow or white, squinting, pupils that are dilated or constricted, or anisocoria (one pupil dilated and the other constricted - see photo, right) are all signs that something is amiss. Cats that are sick often have elevated third eyelids – the third eyelid is located beneath the lower eyelid and in a sick cat it will cover part of the eyeball. Any abnormality with the eyes can result in blindness – if in doubt at all, DON’T DELAY seeing your veterinarian. 
Are there any other symptoms that are abnormal?
It is not normal for a healthy cat to have any discharge from the nose, debris in the ears, excessive salivation, bad breath or unusual odor from other parts of the body. Vomiting, particularly vomiting of clear foamy fluid or bile-tinged material is cause for alarm.Gums, skin or eyes that are pale may indicate anemia, while a yellow tint may indicate jaundice and a bluish tint may indicate a lack of oxygen. Delaying treatment for these disorders, even be a few hours, can be fatal.
Because signs of illness can be very subtle, if your cat does not seem right to you, then it is best to err on the side of caution and to make an appointment to take him or her in for a veterinary examination as soon as possible. If you make it a habit to give your cat a general once-over on a regular basis, you’ll have an idea of what’s normal and will be more likely to catch minor problems before they become major health issues. If your cat won’t eat for more than 24 hours, or if you notice any breathing problems, straining in litter box, or abnormalities in eyes, seek immediate veterinary attention. If you have any concerns or questions about your cat’s health, visit or call us – we are your best and most reliable resource to ensure your pet’s wellbeing and health.
This client information sheet is based on material written by: Cheryl Yuill, DVM, MSc, CVH
© Copyright 2014 LifeLearn Inc. Used and/or modified with permission under license
Alta Vista Veterinary Hospital is a Central Phoenix Animal Hospital