About 10 years ago in the middle of May, I was working as a veterinarian in a large, urban, cats-only practice. First thing one morning I was asked to see a patient new to the practice, and when I walked in the room, I was greeted not with pleasantries, but with a staccato burst of verbal gunfire. Suffice it to say that this client was pissed.
“I’m getting really tired of this. For the last five years at exactly this week, I’m at some veterinarian’s office with him,” the young man sputtered, disdainfully looking at the large, orange short-haired kitty who was squatting and trying desperately to produce a few drops of urine on the exam table.
The patient’s history was fairly typical of what is called feline lower urinary tract disease (FLUTD, or what used to be known as FUS if you’re of a certain age): The symptoms started about eight hours before the appointment and throughout his sleepless night, the client heard his feline companion scratching in the litter box multiple times an hour, obviously in discomfort and producing a scant few drops of blood-tinged urine. Having gone through this ordeal before, the client knew that as long as Garfield was producing even a few drops of urine, things had not yet ramped up for a 3 a.m. emergency hospital visit. He also knew that at 8 a.m. he would be at some veterinary hospital seeking help. It was obvious that he was tiring of this annual routine.
As I started my exam, I looked at the client and asked, “So, what happened six years ago this week?” I thought the question was innocent and pertinent, but at first the client didn’t see it that way.
“Nothing happened...,” Garfield’s human began to say, until I could see that after quickly searching the depths of his not-so-long-term memory, something had been extricated: the proverbial light bulb went off and his tone softened.
“Oh, wow, six years ago this week Garfield and I drove from California to Chicago and he screamed the whole way.” Obviously, the ride was so traumatic for Garfield that each year on its anniversary, it was as if his body’s internal calendar had big, red “X’s” through the second week of May. The ride was forever imprinted on his mind and bladder.
That interchange with Mr. California-to-Chicago-Alone-in-a-Car-for-Three-Days-with-an-Unhappy-Cat was one of those “Eureka!” moments in veterinary medicine, when one is able to connect the dots, help the patient (Garfield did get better quickly with some conservative interventions) and educate the client on what’s happening. Moving forward, I was able to work with both the client and the kitty and the following year, Garfield sailed through that second week of May without a problem.
FLUTD has a stress-related component. Veterinarians typically see these cats after a boyfriend or girlfriend has moved in, or out, or the family has returned from vacation, or a chair has been moved from one corner of the living room to another. Cats are like that. It’s also true that there is a seasonal component to the disorder, with an uptick in cases at changes of season, particularly late winter-early spring.
Garfield’s case reinforced my belief that there is a definite body-mind component to the health and illness in our companion animals. That’s not to say that there is always a direct connection from their minds to their various body systems; correlation is not causation, as veterinarians like to say. However, body-mind medicine, as it’s called, is no longer considered woo-woo in human medicine. A recent article from the American Psychiatric Association’s annual meeting showed that patients with post-traumatic stress disorder (PTSD) had documented changes to the endothelial cells that line the blood vessels and heart, so they were at greater risk for heart attacks. What we think and feel can actually change our bodies, so why wouldn’t it be the case for our animal friends as well?
Veterinarians are increasingly open to recognizing that our companion animals’ health depends, often to a great degree, on their psychological well-being. It’s as if our dogs, cats, guinea pigs, feathered friends and cherished creepy crawlies are emotional sponges, taking in the environment for better or worse.
In that same cats-only practice where I met Garfield, our patients almost to an individual lived in glass, steel and concrete towers and encased as they were in their urban aeries never so much as felt a natural breeze, touched grass or saw a bird. Those cats were some of the sickest patients I have ever seen. Could it be that these cats, removed from even the simplest feline pleasures in life, albeit in the company of caring but often truly harried people, became so stressed themselves that the result was often not having just one, but two, three or even four diseases, sometimes showing themselves all at once? It’s worth considering.
While stress has been linked time and again with various diseases, emotional support and tender loving care also can make a difference in the lives of our beloved four-leggers. After leaving the urban practice, I hung up a shingle in a suburb where I met Buddy. He was the companion of two elderly African-American sisters who were church nurses. Their jobs at church were to administer to those who had been “slain by the Spirit” during services and they took their roles seriously, coming to their weekday appointments with me dressed in nurses uniforms, right down to the bulky white oxfords, always carrying well-worn Bibles.
After an exhaustive work-up, Buddy had been diagnosed with a truly wicked liver lymphoma, and the internist gave a poor prognosis. His companions came to me and begged me to administer chemotherapy. We spent most of the first appointment discussing the pros and cons of treatment, but the sisters wanted to try. What, they asked, was the harm? After all, we could always stop.
And so treatment began. Buddy was not the easiest patient in the world, but over time, he, the staff and I got into a routine where chemotherapy could be administered without much wear and tear on all concerned. The weeks ticked by and Buddy kept on ticking. Months passed and then Buddy achieved his one-year anniversary of remission. Soon, we had passed the 18-month mark and Buddy was feeling good, fat, and sassy. Each time I returned him to the sisters after treatment, month after month, I saw them hunched over their Bibles in the waiting room, deep in prayer. Finally, I asked the question that had been rolling around in my head for awhile: Might they be doing something that could be considered unusual to account for his nearly miraculous recovery and response?
Without hesitation, they spoke in unison, “Why, of course, Dr. Gaspar, Buddy’s on the Sunday night prayer chain on the radio!” Indeed, that Sunday night, as I tuned in to the small gospel station in northwest Indiana, I heard the preacher start the roll call of “folks who are needing our prayers.” And eventually, Buddy and the clients’ surname was read out loud, with the exhortation, “Buddy’s doin’ real well, thanks to your prayers, folks, so please keep praying for him that his cancer stays away.” There was no mention that Buddy was a cat. He was just another individual with an illness who needed support.
Eventually, Buddy succumbed to renal failure, not cancer. When I tell this story to veterinary colleagues, many scoff. It’s certainly true that some patients exceed expectations for their disease and often have significant remissions. Buddy, they say, was in that lucky subset.
But I see things differently and believe that against significant odds, Buddy's body benefited from the love and care of his human family who tried to move heaven and earth on his behalf. It's important to remember that their care was in the best sense "holistic": They pursued the most advanced treatment available and made sure that he was emotionally supported, too. I have also known many patients whose families loved them to the moon and back and pursued the best treatment only to have less-than-optimal outcomes. However, even for those cats and dogs, I think the love, tenderness, and devotion they received mattered. I still like to believe that love triumphs.