Cats Herd You

I spent a lot of last week at the country’s largest veterinary conference, the North American Veterinary Community (NAVC) Conference. There was so much information there that I took over 200 pages of longhand notes, and I’ll be sharing things I learned with you over the months to come.

For now, I wanted to share the highlights of the trip. Due to a no-photography rule during the educational sessions, I have less photos from this event than I had hoped, so please bear with a lot of text!

Just looking over the list of feline educational sessions, I think this must have been The Year of the Kidney. Of course, it isn’t entirely surprising considering how many cats have chronic kidney disease (CKD). Rooms I estimated holding about 700 seats were packed to overflowing with veterinary professionals wanting to know more about what to do with the results of the new SDMA test that detects kidney disease earlier than the familiar tests for a cat’s creatinine levels.

One of the most interesting talks was about treatment of Chronic Kidney Disease by Garry Norsworthy. He started his talk by saying, “It’s a great time to own and treat old cats!” He believes that an abnormal creatinine level should be redefined downward, and he explained that since chronic kidney disease is a progressive disease, it is happening far earlier than we realize in our cats. By age 3, 30% of cats are in what the International Renal Interest Society (IRIS) considers stage 2 kidney disease.  By age 6, that number rises to 40% of cats! With new information like this available, don’t be surprised if we see a “midlife screening” recommended for cats soon. Dr. Norsworthy also talked about how commercial kidney diets are cutting back too much protein that senior cats need, and how phosphorous binders can help alleviate concerns about feeding a higher protein diet. He has a scientific paper being published soon, and I can’t wait to read more details!

It’s also striking to see that not all of the lectures agree on things, even in the same conference, especially when it comes to nutrition. I heard three different outlooks on nutrition for cats with chronic kidney disease from veterinarians with active cat practices, veterinarians working for the pet food industry, and holistic veterinarians. It just goes to show that despite all of them looking at the science and evidence, it’s still possible to come to different conclusions.

The American Association of Feline Practitioners sponsored a full day of sessions at the conference. They were mostly about behavioral issues, but there was an interesting talk that used a complicated case study to illustrate how veterinarians partner with behaviorist to figure out whether a cat’s issue is medical or behavioral. One of the things I took away from the case study in that session was how many times during the cat’s illness the client said no to consulting a behaviorist, which set back the process of finding help for their cat.

I was super-excited to finally hear Dr. Tony Buffington speak. He did a tremendous amount of research about cats and lower urinary tract issues, and he was responsible for naming the idiopathic form of those related issues Pandora syndrome. The research that his lab did about the impact of stress on cats is groundbreaking, and during the two hours I heard him lecture, a light bulb must have come on over my head a dozen times, especially when he talked about how early life experiences shape stress responses in later life. In the break between lecture hours, the vet sitting next to me said, “This is the one thing I dread having to tell clients about the most. They always get defensive or angry. The first time I had to tell a client, I was in vet school. She yelled at me for an hour that she wasn’t stressing out her cat!”

Overall, the most important message I took away from the conference is that the veterinary community really wants to partner with clients to help their pets, but they can’t always figure out how to establish that partnership in a meaningful way. I overheard so many vets who were checking on difficult cases back at home from the conference, promising to try to find experts to help the pets in their care. But I also overheard other vets making it clear that they don’t trust that we, the clients, can get the medicines they prescribe into our cats at home to help make them better. I would be frustrated in that situation, so I can only imagine how they must feel. We have to find a way to be better partners with our veterinarians for the health of our cats, and that’s something I want to explore more closely.

Like many conventions, NAVC has an expo. It is so big that it is split across two different hotels conference centers. I wasn’t too excited about the expo, since last year it was all veterinary products I couldn’t relate to very much. ICU cages and cremation systems are important, but they aren’t something I have an educated opinion about.

This year, I noticed a lot more consumer products at the expo. It was great to see Dr. Elsey’s and Sleepypod there talking to vets because until now, it seemed like vets were learning about these products from their clients. (My vet was perplexed about how to open a Sleepypod the first time I brought a cat in for a visit in one!) It will be interesting to see whether this kind of change translates into a change of direction for veterinary product recommendations and products they sell from their practices.

I wanted to close with some general observations. First: the event is huge. This sign, posted near the doors, shows how big.

I met vets from as far away as Europe attending, and there were quite a few in military uniforms. (Did you know the military had vets? I didn’t!) The group attending seemed to be over 50% female. I realize they aren’t necessarily representative of all veterinarians everywhere, but seeing that representation of women in a profession that was 98% male in 1960 and has evolved to be majority female was really neat!

The other thing I saw was that vets want to know more about cats. I know there are times that I worry that vets and veterinary research are focused just on dogs, since dogs make the majority of the vet visits. Seeing 500+ seat rooms overflowing with people who wanted to hear information about at health was really encouraging. Now it’s our job as the ultimate decisionmakers about our cats’ health to be sure that our cats can take advantage of these advances in knowledge.