PET DISEASES

Feline Infectious Peritonitis (FIP) is a common disease in young cats in HK. The disease  is caused by a virus called corona virus and if it develops into the full blown disease, is fatal.

Most strains of feline corona virus are not too serious, which means that they do not cause disease, and are referred to as feline enteric corona virus. Cats infected with a feline corona virus generally do not show any symptoms during the initial viral infection except for possibly a mild diarrhoea or upper respiratory infection. In a small percent of infected cats (less than 10%),  by a mutation of the virus, the infection progresses into clinical FIP. The virus is then referred to as feline infectious peritonitis virus (FIP). With the assistance of the antibodies that are supposed to protect the cat, white blood cells are infected with virus, and these cells then transport the virus throughout the cat's body. An inflammatory reaction occurs around vessels in the tissues where these infected cells locate, often in the abdomen.

Risk factors for cat:
Any cat that carries the corona virus is potentially at risk of developing FIP. A cat with a weak or malfunctioning immune system is more likely to pick up the disease and develop the full blown FIP syndrome. In practice, we only really see the disease in cats less than two years of age and more than 80% will show the symptoms within their first year. The virus is shed in the saliva and stool. Almost all cases of transmission are from an infected (carrier) mother to her kittens. If it's going to develop the full blown syndrome of FIP, it has probably already contracted the virus from its mother. We also see the disease more commonly in multiple cat households.

Symptoms of FIP
Cats that have been initially exposed to the feline corona virus usually show no obvious symptoms. Some cats may show mild upper respiratory symptoms such as sneezing and runny eyes. Other cats may experience a few days of diarrhoea. Only a small percentage of cats that are exposed to the feline corona virus develop FIP, and this usually shows itself within a month or two, or as long as two years.

There are two major forms of FIP, 'wet' and 'dry' form. Generally, cats will exhibit the signs of the 'dry' form FIP more slowly than the 'wet' form. Symptoms generally include chronic weight loss, depression, anaemia, and a persistent fever that does not respond to antibiotic therapy and a yellow colour to the skin and mucous membranes.

The 'wet' form of FIP is more common and characterized by an accumulation of fluid in the abdomen and in the chest. Early in the disease, the cat may exhibit similar symptoms to the dry form, including weight loss, anorexia, and depression. The wet form of the disease often progresses rapidly, and the cat may develop a swollen belly due to fluid accumulation in the abdomen. When the fluid accumulation becomes excessive, it may become difficult for the cat to breathe normally.

Diagnosis:
FIP can be difficult to diagnose because each cat can display different symptoms that are similar to those of many other diseases, especially liver disease.　We will use a combination of symptoms, age, and a general blood test to help us diagnose FIP. There is a corona virus test, but this is not very accurate, because many cats may have antibodies to corona virus and not develop the FIP syndrome. We will still use this test as a negative test will rule out FIP.

Treatment and Prognosis:
Unfortunately, there is no known cure or effective treatment for FIP at this time. Some treatments may induce short-term remissions in a small percentage of cats; however, FIP is a fatal disease. Treatment is generally aimed at supportive care, such as good nursing care and nutrition, and alleviating the inflammatory response of the disease. Cats with FIP are often treated with corticosteroids and antibiotics. Supportive care may also include fluid therapy and draining accumulated fluids. You must understand that this is a fatal disease and we will recommend euthanasia when your cats quality of life is deteriorating.

There is a vaccine that has been produced for FIP. We do not use this vaccine at our clinic as it is not effective in preventing the disease in the cats most at risk.

FIV is a very slow virus that can live in your cat for many years before it effects your cat's immune system.  The infection eventually leads to a state of immune deficiency that hinders the cat's ability to protect itself against other infections. The same bacteria, viruses, protozoa, and fungi that may be found in the everyday environment - where they usually do not affect healthy animals - can cause severe illness in those with weakened immune systems. These secondary infections are responsible for many of the diseases associated with FIV. This is also what happens in human immunodeficiency virus.

How can my cat get infected?
The primary mode of transmission is through bite wounds. Thus a cat that goes out and fights with other cats, especially non de-sexed males and cats in multi-cat households are most likely to become exposed. On rare occasions infection is transmitted from an infected mother cat to her kittens, usually during passage through the birth canal or when the newborn kittens ingest infected milk. Sexual contact is of no real concern in cats.

Symptoms:
Early in  the disease, the virus moves to the lymph nodes, resulting in a generalized but usually temporary enlargement of the lymph nodes, often accompanied by fever. The owner will often not notice this stage of the disease especially in a long haired cat. Your cat may then remain quite healthy for a considerable period of time, even many years until the immune system has been destroyed enough to allow other simple infections to become serious. You may start to see any of the following:

	Poor coat condition
	Fever
	Inflammation of the gums and mouth
	Infections of the skin,
	Infections of the urinary bladder
	Infections of the upper respiratory tract.
	Persistent diarrhoea can also be a problem
	A variety of eye conditions
	Slow but progressive weight loss
	Various kinds of cancer may start to show
	Seizures, behaviour changes and other neurological disorders may be displayed as the brain and nerve cells are destroyed

Diagnosis:
We will do a FIV blood test at our clinics in cats that are suspicious.

Negative results

A negative test result indicates that antibodies directed against FIV have not been detected, and, in most cases, this implies that the cat is not infected. Nevertheless, it takes eight to 12 weeks after infection (and sometimes even longer) before detectable levels of antibody appear, so if the test is performed during this interval, inaccurate results might be obtained. Therefore, antibody-negative cats with either an unknown or a known exposure to FIV-infected cats　should be retested a minimum of 60 days after their most recent exposure in order to allow adequate time for development of antibodies.

On very rare occasions, cats in the later stages of FIV infection may test negative because their immune systems are so compromised that they no longer produce detectable levels of antibody.

When do we test your cat for FIV:

	If your cat has never been tested and we are suspicious of infection
	If your cat is sick with symptoms that are common to FIV, even if it tested free of infection in the past but subsequent exposure can't be ruled out
	When cats are newly adopted and entering a multi- cat household
	If your cat has recently been exposed to an infected cat
	If you're considering vaccinating with an FIV vaccine

Vaccination:
The only sure way to protect cats is to prevent their exposure to the virus. Cat bites are the major way infection is transmitted this can only occur in multi-cat households or if your cat goes outside. In HK we see more FIV in the New Territories and outlying islands as more cats are free to roam outside. If you have a multi-cat household that is free of FIV please make sure that you only bring in new cats that are tested FIV negative.
Vaccines to help protect against FIV infection are now available. However, not all vaccinated cats will be protected by the vaccine, so preventing exposure will remain important. In addition, vaccination may have an impact on future FIV test results. It is important that you discuss the advantages and disadvantages of vaccination with your veterinarian to help you decide whether FIV vaccines should be administered to your cat. You should only need to vaccinate your cat against FIV if it is in the high risk group.

You have a FIV positive cat:

	FIV-infected cats should be confined indoors to prevent the spread of FIV
	FIV-infected cats should be spayed or neutered
	They should be fed nutritionally complete and balanced diets to maintain general health and a strong immune system
	Wellness visits for FIV-infected cats should be scheduled with us at least every six months. a physical examination of all body systems will be performed. We will pay special attention to the health of the gums, eyes, skin, and lymph nodes. Your cat's weight will be measured accurately and recorded, because weight loss is often the first sign of deterioration. A complete blood count, serum biochemical analysis, and a urine analysis should be performed annually. Your cats white cell count is meaningful to us and this generally drops as the disease progresses
	Your home monitoring is important to us and you will need to let us know if there is any deterioration or changes in your cat's health and behavior
	There is no evidence from controlled scientific studies to show that the drugs used for HIV in humans have any benefit to the longevity of your cat's life.Your cat may live months or years once the symptoms of FIV begin to show. You cannot catch HIV or AIDS from a cat that is infected with FIV. Although the virus is quite similar to human HIV, the virus is species specific and will only infect cats. The way the virus works to destroy the immune system is quite similar in humans and cats

Your cat may live months or years once the symptoms of FIV begin to show.

You cannot catch HIV or AIDS from a cat that is infected with FIV

Although the virus is quite similar to human HIV, the virus is species specific and will only infect cats. The way the virus works to destroy the immune system is quite similar in humans and cats.

Obesity in cats is very common in HK. In my experience about half the cats I see are overweight and about 20% of all cats are clinically obese. A cat is a natural hunter and in nature will be very active, especially at night catching small prey quite a few times in an evening. Natural food for a cat will include insects, small mammals like mice and small birds. Thus frequent small meals are eaten and considerable physical effort is used up in order to hunt down their prey. I have captured many wild cats and these are remarkably well muscled with zero excess fat. Furthermore, we are not feeding them their natural diet. Many cats are fed dry biscuits only. A cat's natural food is actually fresh body tissues from birds, rodents and insects which are high in protein fat and water content. The dry food they get at home has a very low moisture and protein content and high in carbohydrates.

I would have to say that here in HK our cats are lazy. They generally have poor muscle tone and almost all will have excess fat accumulation. Basically they take in more calories than there bodies use for exercise and the excess calories are stored in fat depots around the body.

An obese cat is not a healthy animal.  They expose themselves to liver disease and diabetes. The excess weight puts extra stress on the joints and they become inflamed leading to degenerative joint disease. We will recommend that you do further blood and urine tests.

When you come for your annual check up, we may determine that your cat is overweight and recommend a diet program. It can be dangerous for your cat to lose to much weight to quickly and our trained nurses will discuss a diet plan that will involve the whole family cooperating. A diet plan for a severely obese cat can last up to eight months.

Please remember that a cat is a carnivore and needs a high proportion of animal protein in its diet. An adult cat requires twice as much protein as a dog. I have had some clients who are vegetarians and had been feeding their cats a vegetarian diet. Needless to say these cats were presented to me in a very poor condition.

Get your cat some toys that he can chase after. A feather toy at the end of a string can keep you and your cat entertained for hours and is a great way to bond with your cat and get him exercised at the same time. I have even seen cats chasing after a laser pointer. Please let me know if you have any other games that work well for you and your cat that we can share with our clients.

Fatty liver disease is quite common in middle aged overweight cats. A cat's liver is not efficient in metabolising body fats and this clog up the liver when too much fat arrives at the same time. This occurs when a fat cat stops eating.
 

	A previously overweight cat stops eating for whatever reason
	Lacking food, the body starts sending fat to the liver to process into lipoproteins for fuel. These fats come from all the other fatty depots in the body. Most fat is stored in the abdomen
	Cats' livers are not terribly efficient at processing fat, and much of the fat is stored in the liver cells.
	Left untreated, eventually the liver fails and the cat dies

Whatever the cause, the symptoms are common: A previously overweight older cat suddenly becomes anorexic (quits eating), loses weight, and may salivate excessively or vomit. The cat may become very lethargic and may show jaundice (yellowing of eyes, mucous membranes and skin). However, anorexia and weight loss can also be symptoms of other diseases, such as liver cancer or pancreatic disease, and FLS (Fatty Liver Syndrome) can only be accurately diagnosed conclusively through tests. A complete blood profile may indicate increased liver enzymes, and the diagnosis can be confirmed with a liver biopsy done under light sedation. We will use a special biopsy needle to take a liver sample through the skin. We will use our ultrasound machine to guide the biopsy needle to the correct place.

Fatty liver disease has a good prognosis if we catch it in time:
The treatment for Fatty Liver Disease is dietary, and works quite well in reversing the condition if diagnosed early. The idea is to force feed the cat enough nutrients to reverse the metabolic malfunction that caused the condition in the first place. We have powerful appetite stimulating drugs and if necessary we may even need to hospitalize your cat with an oesophageal feeding tube in place. We will then feed a small amount of liquid food down the tube several times daily. It may take as long as a few weeks before the cat can be offered food normally, to test his appetite. We have sometimes had to leave a feeding tube in for over a month. we usually use food with very high water content such as Hills a/d or Royal Canin Recovery tin food for force feeding.

Please note that this disease can only occur in a cat that is initially overweight. Thus prevention is better than cure. Please keep your cat healthy, lean and well exercised.

Cardiomyopathy means damaged heart muscle. In cats this can take two forms, dilated cardiomyopathy(DCM) and hypertrophic cardiomyopathy(HCM).
DCM is very rare now in cats. It is caused by a nutritional deficiency in Taurine. This chemical is now available in all commercial cat foods and I havn't diagnosed this condition for many years now.DCM is when the heart muscle weakens and the heart chamber dilates.
HCM is however this most common form of heart disease we are now seeing in cats. The heart muscle thickens and the heart chamber gets smaller. Thus only a small amount of blood can be pumped out with each contraction of the heart muscle. Also the muscle becomes fibrotic(less elastic) and this further complicates the problem. The blood flow is congested and we see the symptoms of congestive heart failure. The cause of HCM is not completely understood at this stage. It may be associated with early exposure to a viral disease or have a genetic(inherited) cause. Ragdoll and Maincoon breeds are most commonly affected. In humans this disease is genetic and genetic markers can determine if you will get this disease.

Symptoms:
Although the damage to the heart may have been there for some time, the symptoms will appear quite quickly. In cats, we do not see coughing like in dogs, but breathlessness, lethargy and poor appetite. The symptoms we see in cats are due to a build up of venous blood pressure causing fluids to leak out into the lungs and surrounding tissues. This condition may also cause a clot to form in the heart resulting in sudden painful paralysis in the hindquarters or even sudden death.

Diagnosis:
To confirm our diagnosis, we will do an ultrasound scan, to measure the size of the heart chambers and the thickness of the heart muscle. We may also do chest X-rays and an electrocardiogram( ECG). This disease is also associated with an increase in blood pressure and we will measure this.
A complete blood test is also important. The poor circulation of blood will also cause other organs, especially the kidney to fail.

Treatment:
there is no cure for this disease. The treatment will help the stress on the heart and alleviate the symptoms. We will use drugs to dilate the blood vessels that leave the heart, also drugs that drop the blood pressure. Remember blood clots can easily form in the heart chambers with this condition and drugs preventing blood clots will also be used.
If we see on the X-ray a build up of fluids in the lungs, then we will use drugs to remove these fluids.
If the heart rate is excessively high, I will use a drug to slow the rate down.
Remember, your cat can suddenly die at any time from cardiomyopathy.

Flutd is one of the most common and frustrating diseases I see in cats. You may notice anyone or combination of the following symptoms:

i.    Frequent trips to the litter tray

ii.   Pain or crying when trying to urinate

iii.  Excessive licking of the genital area

iv.  Blood in the urine

v.   Excessive time trying to urinate

vi.  Trying to urinate with no urine production

You will need to bring your cat to us for an examination when you see any of these symptoms. This can sometimes be an emergency as your cats bladder may be blocked. Generally we will examine the urine, send a sample to the lab for bacterial culture and do a blood test. We may also recommend an X-ray or ultrasound of the bladder to rule out the presence of urinary stones and tumours.

The most common cause of flutd in cats younger than ten years old is what we call idiopathic (unknown cause) cystitis.  Stress is believed to play a big role in this disease and may be associated with rivalry between cats in a household. We recommend that you have a separate litter tray for each cat and one more. The litter trays must be kept very clean. The condition itself is also painful and this will result in vicious circle of pain and stress. Furthermore a lot of these patients are eating dry food. These cats are not consuming enough water and urine production is diminished. Your cat needs to produce a lot of urine to flush out the bladder and reduce the chance of crystal production. Also all the tissue debris that form in an inflamed bladder will be flushed out. These tissue debris are the most common cause of a plug that can block your cats penis. I cannot stress enough the importance of feeding a high moisture diet in the control of urinary tract disease.

When we examine your cats urine, we may also see crystals. Crystals can cause a lot of pain and irritation in the urinary tract. It is important that we examine a fresh urine sample immediately under the microscope as crystals will start forming after thirty minutes and we will get an inaccurate picture of what is happening in the bladder. We will also look for the presence of inflammatory cells, tumour cells and cells that may indicate renal disease. This urine sample you cannot collect for us as we do really need a very fresh sample. Our nurse will also measure the specific gravity(SG) of the urine which is an indication of the kidneys ability to concentrate the urine. The most effective way to control crystal formation is by flushing out the bladder and this can only be done by increasing your cats water intake. Feeding a wet(canned) food is the most effective way to do this.

Bladder infection:
Bacterial infection of a cats bladder is can only be diagnosed by collecting a sterile urine sample directly from the bladder. We may need to sedate your cat for this procedure as we place a needle directly into the bladder to retrieve the uncontaminated sample. The urine will be cultured and the lab will inform us of the best antibiotic to use. Generally in the unlikely case of a bacterial infection, a course of antibiotics for up to three weeks may be prescribed.

Feline Herpes virus is very common in HK. In my experience, most cats actually do pick up this infection, usually as kittens and will carry the virus for the rest of there lives. The virus ( Feline Herpes Virus type 1) causes the symptoms we see in the disease Feline Rhinotracheatis. This is just a complex medical term for cat flu. Other pathogens that cause cat flu are Calicivirus and Chlamydia. By far the most common cause of cat flu in HK is caused by Herpes virus type1.

Symptoms:
The symptoms we see are most common and severe in kittens and cats with compromised immune systems (stress and other viral infections). Mild symptoms may just be seen as sneezing and runny eyes but this can deteriorate to severe eye infections and ulcerations with the possible loss of an eye. In very young kittens, permanent eye and eyelid damage may result. Also, severe nasal congestion, fever, pneumonia, dehydration and anorexia.

Treatment:
Depending on how severe the disease, we may treat your cat as an outpatient with special antibiotics and immune stimulation or if severe we will need to hospitalise him. You will also need to apply antiviral eye drops a few times each day.  
The basis of treatment is to help the cats own immune system control the infection and also prevent any other secondary infections. With this disease they can lose their appetite easily because they can't smell their food and also can become dehydrated very quickly. We can use special drugs to stimulate their appetite and if really necessary insert a special feeding tube and iv fluids.

Vaccination:
The routine vaccination that your kitten has will provide protection against herpes virus. It is important to note that many kittens have already contracted the virus by the time the they are presented for vaccination. Also once a cat is infected, it will carry herpes virus for life and this virus may express itself occasionally during the cats life in times of stress. The vaccine will not prevent the disease, but will help alleviate the symptoms.
 

Chronic gingivitis and stomatitis can cause severe pain. The animal's behaviour may change - irritability, aggressiveness, depression or reclusiveness may be seen. The cat may drool excessively, have difficulty eating or not eat at all. Some cats will go up to the dish as though they are very hungry (which they are) and then run from the food dish because eating is so painful. They will often have bad breath (halitosis) and may not be grooming themselves adequately. Their gums bleed very easily.

Diagnosis:
During the physical exam, which may need to be done under anaesthesia to do it well, multiple lesions are seen. We will see severe inflammation of the gums and even ulcerations and bleeding. The lesions can be on the gums, roof of the mouth, back of the mouth, tongue, or lips. The gums near the molars are more severely affected and even the back of the throat.
At our clinic we will take individual X-rays of the upper and lower jaw to evaluate the level of periodontal disease. We may consider a biopsy of the gums if we suspect a tumour.

Treatment:
First, let us review what plaque is. Bacteria play a major role in the formation of plaque. Bacteria live on remnants of food in the mouth. When bacteria combine with saliva and food debris in the channel between the tooth and gum, plaque forms and accumulates on the tooth. When bacteria continue to grow in the plaque and, as calcium salts are deposited, the plaque hardens to become a limestone-like material called tartar.

We will need to perform a dental procedure on your cat. This is done under general anaesthetic and the tartar is removed with an ultrasound scaler and the teeth polished. The gums of some cats have an allergic type reaction to tartar and it is essential you keep the teeth absolutely clean. We sometimes have to do this dental procedure every 6 months. In a small percentage of cats, nothing can help except to remove all the back teeth.  

Some cats that have viral diseases that influence the immune system like FIV also seem to have an increased incidence of gingivitis. We will recommend a FIV test on cats with severe symptoms.

Your cat will be sent home on a course of antibiotics. Immune suppressive drugs may also be used in severe cases. You may also be required to apply an antiseptic to your cats teeth and some prescription diets can be tried to prevent plaque formation.
 

IBD is seen as chronic bouts of vomiting and diarrhoea in your cat. This can cause chronic weight loss and dehydration and untreated can be life threatening. It is seen most commonly in middle age and older cats. IBD describes a group of chronic gastrointestinal disorders. The cause of IBD is unknown, but the microscopic changes in the tissues imply that immunologic and or allergic factors play an important role. the most common form of IBD in cats is called lymphocytic-plasmacytic enterocolitis. We also see eosinophilic, neutrophilic, and granulomatous enterocolitis. These are antibody producing cells and inflammatory cells. Enterocolitis means the inflammation of the small and large intestine.

Diagnosis:
We will do various blood tests, stool examination, ultrasound and x-rays if necessary. However, the only way to really diagnose this disease is to take a biopsy of the intestine and send it to a histopathologist.  We will need to do a surgical procedure to do this test.

Treatment:
A combination of dietary management and medical therapy will successfully manage IBD in most cats. Because there is no single best treatment, we may need to try several different combinations in order to determine the best therapy for your cat. We may also have to use special drugs that will suppress your cats immune system.

Dietary Management:
It is quite difficult to find a diet that is best suited to your cats condition. We may try a special prescription diet first. It sometimes takes quite a few weeks before we know if it is working or not. Sometimes a home cooked meal can work. We will start with a source of protein that your cat has never tried before like kangaroo, ostrich or lamb.

Medical Therapy:
Corticosteroids are commonly used to treat cats with IBD. This is usually given orally and cats tolerate these drugs very well. There is also a long acting injectable form for owners who struggle with dosing tabs. A course of antibiotics is usually also prescribed and is very helpful.
If none of these medications successfully control the signs, more potent immunosuppressive drugs may be necessary, but they necessitate closer monitoring by one of our vets.

Prognosis:
It is rarely possible to cure inflammatory bowel disease, but most cases can be satisfactorily controlled by medication and dietary management. Relapses can occur if the treatment regimen is not followed completely.
 

We frequently diagnose cancer in cats at our clinics. The most common types of cancer we see are lymphoma, squamous cell carcinoma, mammary tumours  and bone cancer.
Cancer is a broad description for any condition whereby certain body cells will divide abnormally to form lumps and growths. A cancer or tumour may be benign or malignant. A benign tumour will grow slowly and not spread to other parts of the body. These can easily be removed by a surgical procedure. Malignant tumours on the other hand are aggressive, fast growing and spread into the surrounding tissues and other parts of the body quite quickly. The prognosis for these tumours is poor and they may be controlled by surgery, chemotherapy and radiation therapy.

I strongly recommend you have your cat spayed at 6-8months of age. This will significantly reduce the chance of malignant breast cancer.

Lymphoma is the most common malignant cancer we see and I will spend some time discussing this as we can, with chemotherapy, improve your cats quality of life for quite a while.

Lymphoma:

Lymphocytes are white cells that are found all over the body and especially concentrated in lymph nodes and also the liver, kidney, spleen and bone marrow. Lymphoma results when these cells start to divide uncontrollably and we will classify the tumour according to its location. For example mediastinal or gastrointestinal lymphoma.
In younger cats this may be caused by feline leukemia virus, however this is quite rare now in HK.
We now see this tumour quite commonly in middle age to older cats.

Diagnosis:
you may notice that your cat has been losing weight, vomiting, poor appetite, breathing with difficulty or just listless. Sometimes you will see no symptoms and on your annual visit to the vet clinic for a check up, we will feel an abnormal lump in the abdomen.
We may request X-rays, ultrasound, blood test or even an exploratory laporotomy(open the abdomen surgically) to look for the lump. We may take a biopsy and a needle aspirate to evaluate the cells under the microscope. These cells can also be typed by a histopathologist as B or T cells which will also give us an indication of the prognosis.

Treatment:
Lymphoma is a type of tumour that in some cases can respond very well to chemotherapy. Some people worry about chemotherapy and the side effects that it may cause. However the aim of chemotherapy in animals is to maintain the best quality of life with minimal side effects.

There are possible side effects, so close monitoring is essential and prompt action required if any side effects are seen. However, provided that these precautions are taken, most cats tolerate these drugs very well with very minimal side effects.
We will decide on a specific protocol for your cat. Usually there will be two phases of therapy. First the induction phase whereby your cat will need weekly intravenous drugs for about two months. After that we will continue a protocol of maintenance every three weeks. This maintenance protocol generally will continue for the rest of his life. The drugs we commonly use are vincristine, cyclophosphmide and prednisilone. These drugs will suppress the bodies bone marrow and we will do a regular blood test to make sure the healthy blood cells remain within normal levels.

Prognosis:
without chemotherapy, the prognosis is poor and your cat will usually die within a month. With chemotherapy your cats quality of life will be significantly improved and the length of life extended. Depending on the aggressiveness of the tumour, remission may last for up to a year or more. Some tumours are so aggressive they do not respond to the therapy. We will see a response to treatment within two weeks. The tumour will become smaller and your cat will appear much happier.
Some people do not wish for there cats to get chemotherapy. I strongly recommend that you try for at least a couple of weeks and see how your cat responds before quitting.