How to Help Your Cat Live Longer with Dr. Kevin Toman

Your cat isn’t “fine” just because they’re quiet! Cats are built to hide pain, and that’s exactly why so many chronic issues like kidney disease, dental disease, arthritis, hypertension, and even heart disease get missed until they explode into a crisis.

I sit down with veterinarian Dr. Kevin Toman, who has 40 years in practice and now focuses on pet longevity science, to talk about how to help cats not only live longer but live better. We dig into the subtle at-home signals that matter most, why litter box changes often point to medical problems, and how simple diagnostics like SDMA, urinalysis, blood pressure checks, and the Pro-BNP test can act as an early warning system. If you’ve ever wondered whether your cat’s “aging” is actually treatable pain, this conversation gives you a practical framework.

We also tackle the confusing stuff: supplement hype versus evidence, nutrition marketing that targets humans instead of feline biology, and the most reliable longevity lever most households can actually implement: calorie control paired with better enrichment. Then we get into hypertrophic cardiomyopathy (HCM), a condition Dr. Toman says may affect up to one in six cats, and what’s changed recently with rapamycin and other prescription longevity drugs. We close with clear, actionable steps and the kinds of “why” questions to ask your vet so your cat’s care fits their real risk.

If you found this helpful, subscribe, share the episode with another cat guardian, and leave a rating or review so more people can find the show. What’s one health topic you want us to go deeper on next?

Transcript

Welcome And What We Cover

Kristiina Wilson 0:00

Welcome back to Hiss and Tell. In today's episode, I'm joined by veterinarian Dr. Kevin Toman, and we're going to talk all about helping cats not just live longer, but live better. We dive into feline longevity, early signs of chronic disease, HCM, nutrition myths, dental health, supplements, and everyday changes that we as cat guardians can make to support healthier, happier lives.

Kristiina Wilson 0:22

Our conversation is about prevention, quality of life, and what truly matters is our cats' age. I think you'll learn a lot from this episode. And if you enjoy it, please take a moment to rate and review the podcast. It helps more cat guardians find us. All right, let's go. Welcome to another episode of Hiss and Tell. I am your host, Kristiina Wilson, and with me today is Dr. Kevin. He has been a vet for 40 years and he currently specializes in pet longevity science. Welcome, Kevin.

Dr Kevin 0:53

Well, thank you very much, Kristiina

Dr Kevin 0:54

. I've listened to a couple of your episodes, and I really appreciate what you're doing for all us cat lovers out there.

Kristiina Wilson 1:00

I'm so glad to hear that. So can you tell me a little bit about who you are, the space that you work in, what it is that you're that you're up to?

Longevity Means Quality Of Life

Dr Kevin 1:09

Sure. I have been a veterinarian since the dark old ages of 1986 when I graduated from UC Davis. And so over that 40-year career, I spent much of my time in California and Colorado, generally in small animal practices, sometimes in the more rural areas of those states. And as part of that, I, you know, I was the de facto emergency vet. And so I saw a lot of kitties from ranging from everything from hit by car to cat abscesses to the dental disease, by golly, on a daily basis. But about 10 years or so ago, I began specializing in pet longevity. And so I currently operate a telemedicine consulting business called WWW, helping petslive longer.com. And the the tools that I have at my disposal are concierge consults via telemedicine for your clients. I offer a list of supplements that are proven by 40 years of veterinary practice and prescription longevity drugs like rapamycin, acarbos, and our friend Felixon to treat uh hypertrophic cardiomyopathy in the kitties we love.

Kristiina Wilson 2:15

All right, cool. So for you, what do you think living longer actually means for a cat? And how do we make sure that living longer also means living well?

Dr Kevin 2:26

That's the key. You hit the nail right on the head in your first couple minutes of this podcast. The honest truth, Christina, is you and I should care less about how about lifespan and more about quality of life.

Speaker 2 2:39

Right.

Dr Kevin 2:39

Now, if we can combine them both, that's even better. And the analogy that I always use is unfortunately that of my own mother, who was a smoker for all of her life and so ran into the smoking, all the smoking disease issues, including lung cancer. And she spent the last two years of her life laying in bed. She was bedridden because that lung cancer had spread to her hip. And I would submit to you that that extra two years of life offered my mother no benefit because she was not enjoying her life. She had no quality of life. And so if you and I can extrapolate from that lesson into the care of the kittens and cats that we love, they'll be a lot better off for it.

Kristiina Wilson 3:19

Yeah, I I agree. I think for most of us who are watching parents or grandparents who are elderly or going through serious health issues, I think we've probably confronted similar things and it is difficult.

Dr Kevin 3:32

Cats' lives are much compressed, you know. And so, you know, on the one hand, we we can love them with all our hearts while they're with us, but on the other hand, we know that instead of the 77, 78 years that my mother lived, I mean, we have to you and I have to get all our love and we have to wedge that into, you know, 14 or 16 or 18 years of life.

How Cat Care Has Changed

Kristiina Wilson 3:50

Yeah, it's true. So if you look at cats today versus 40 years ago when you started practicing, what are we doing today that's good? And then what are we still kind of missing?

Dr Kevin 4:01

Well, I think that the veterinary medicine has improved. I think veterinarians like me are probably a little bit smarter now than we were back in the day about the diseases and how best to treat them. I think that I'm I'm gonna argue both ways in terms of cat diets, and we can talk more about that. But really just the understanding of, I think perhaps the biggest advantage to cats these days is just we have a better understanding of their mental and their emotional needs, you know, centered around when to keep them inside and what and you know, how best to offer them the stimulation and and the happiness that they that every cat should have. And so I'm gonna backtrack to the statement I made about diet because you and I can talk about the ways that diets have improved over the years, and then I can argue in the very same breath that all the time you and I see the the the cat diets with cream on the top and gravy and and everything that's designed to sell you and me. One of the most common health issues that I see in the cat population is obesity. And so therefore I see a higher incidence of diabetes, I see a higher incidence of cancer, and I see a higher incidence of arthritic pain.

Kristiina Wilson 5:08

Yeah. Yeah, that absolutely makes sense. And I think you really hit on something that I think a lot of people may not realize is that the marketing about cat food is so clearly skewed towards humans and is absolutely has no bearing on what is really good for cats or what cats might actually enjoy. It's just crazy that it's so heavily. I mean, obviously we're the ones spending the money, but it's really so heavily marketed towards what would be palatable or enjoyable looking for people, which is 100% correct. Yeah, we're not the ones enjoying it. Uh, you know, except for I think I've seen a few crazy clips on on TikTok of people who eat cat food. But you know, good luck to them and their endeavors. Uh, that's not most of us.

Why Vet Care Feels Broken

Dr Kevin 5:50

How to girl.

Kristiina Wilson 5:51

Yeah. So you mentioned relationship-driven care. What does that actually look like for people at home?

Dr Kevin 5:58

Well, I'm gonna lead with something that's hard for me to say, Christina. Uh-huh. And that is that I believe veterinary medicine, as it's currently being practiced, is broken. And I say that because for many pet parents, every time they go into one veterinary clinic, they're seeing a different doctor. And that's clearly not in their best interest. It's not in the best interest of their their I say that because veterinarians, many veterinarians are are employed by corporate businesses these days, and those corporate businesses enforce a 20-minute maximum office visit. So you don't have time to sit and talk about the pink elephants behind you. You don't have time to to sit and learn about Christina and and what you guys are doing for fun and games. You're really put in a situation where a new veterinarian spends the first five or ten minutes of a of a 20-minute office visit trying to figure out exactly what has gone on in your pet's health past, trying to diagnose an immediate disease and offer you an immediate solution. But the reality, I'm gonna say this categorically, I think that the best medicine, Christina, is relationship-based, where I recognize you guys and your kitty when you walk in the door. Where I can say, yeah, I mean, last year we did a dental, so we may not have to worry about that this year. Or remember when we had to sew up your kitty's abscess or whatever the case may be. So that and then we can move forward and look not just at your current at your cat's current health, but also use whatever time it takes, whether it be 20 minutes, an hour, two hours, whatever, to look not just at the next month of your cat's health, but trying to develop a plan for the next year or two years or six years down the road. That takes both knowledge and the time to use it. That takes a relationship.

Kristiina Wilson 7:49

No, I totally agree. And I actually see that in the histories of a lot of my patients in my practice. You know, some of my intake questions are obviously who's your vet? Who's your, you know, who do you normally see at the veterinary veterinary practice? And so many of these practices are owned not open only by corporations, but by private equity, which then is creating a whole host of other issues and things like you just said, where every time they're going in, they're seeing a different veterinarian and often a very new veterinarian, people who are just coming out of school, who maybe haven't received as much training or they're not being supervised in the the way that they maybe should right off the bat. And it it can be hard to hear a lot of these stories. But I also am wondering what are the alternatives, especially when you live in, I'll say in our community, there are only there are no more small practices. They have been purchased all by a VCA or a bond or a, you know, any of these huge corporate vets. So we actually take our cats two and a half, three hours back into New York City to see our beloved old vet who's amazing and she's the the best vet I've ever met in my life.

Speaker 2 8:57

Yeah.

Kristiina Wilson 8:58

But I think for a lot of people that they can't necessarily do something like that. So how would somebody begin to build a relationship, you know, with a vet when they're caught in this kind of corporate cycle?

Dr Kevin 9:12

Well, and so you have to understand that I have a horse in this race, Christina.

Kristiina Wilson 9:17

Yeah.

Telemedicine And Getting Lab Work

Dr Kevin 9:17

My first answer is let's talk. Let's, you know, if you have a kitty that is, especially if you're starting to run into HCM or kidney disease or chronic pain, there's value in chatting with somebody like me because I can build that relationship with you. Now, yes, it is over Zoom, it is via email, it is via text or whatever the case may be, but I am the veterinarian that could offer you that guidance. So now setting that aside, the reality is that it is, it's very hard. Um so I would tell you that I think that the very best way to build those relationships within a veterinary practice are to look for, as you suggest, the non-corporate businesses, you know, the veterinarians, the veterinary clinics that are in fact owned by a veterinarian instead of by a large corporate entity of one type or another. The second best would probably be to align yourself with an AHA-based clinic, American Animal Hospital Association or AAHA, because they conform to it to some pretty rigorous standards. And all the practices that I've had have been AHA practices. It takes it takes a lot of work to maintain that. And amongst that work are specific practices centered around around relationship building and specific practices around record keeping to ensure that the same records are available to each doc. And so I do believe that, as you suggest, a true private enterprise veterinary clinic is the best, and AHA practices would be second.

Kristiina Wilson 10:46

Yeah, that's good advice. This is just for my own curiosity, but when you're working with clients over Zoom during doing telemedicine, how are you getting blood work? How are you doing any of that stuff? Are you sending them then to a private practice veterinarian to do that? Or how does that happen?

Dr Kevin 11:04

That's the second great question you posed. So my telemedicine-based practice makes it difficult to draw blood. You know, I can't draw blood from kitties in Connecticut, for instance, sure from my home here in California. And so it's interesting that you asked that question because there is a network of house call veterinarians that is forming, and I'm working with them to see what kind of coverage they can give me so that in Connecticut or in Colorado or in North Dakota, maybe there's a house call veterinarian in your area who could draw the lab work that I need to best assess your pet. The other approach, however, more commonly at this point, is just simply to enlist your local veterinarian in the in the game so that if your cat needs their kidneys checked or their heart checked or whatever the case may be via a blood test, I specify exactly what blood test you you need to run. You go ahead and take your kitty into the vet, say, listen, this is the test XYZ that I need. You get the answers from them, you and I share the answers, but here's the difference. Then you and I sit and talk about what those answers mean in not just in terms of your cat's current health, but also over the longer term.

Early Disease Signs Cats Hide

Kristiina Wilson 12:15

Yep, that makes sense. Makes a lot of sense. So sort of going back to to our earlier discussion, um, talking about aging and chronic disease, what are their earliest signs of aging and chronic disease in cats that that most people might miss?

Dr Kevin 12:30

You know, the hardest part is our cats are so dang stubborn and so so used to masking disease or masking pain that honestly it can be a real pain. It can be very difficult to catch disease early in the game for our cats. Right. And so that's why a schmo like me, I mean, you know, dogs are much much simpler. I think humans are probably the worst, you know. If you have a kid or you're, you know, somebody's insensitive and they come in crying or limping, you know by definition that they have a pain in their foot. But and dogs are to a large extent like that as well. But cats on a le on an evolutionary basis understand that if they show pain, they automatically become prey rather than predator. And so there's an evolutionary component to cats not showing disease, not showing discomfort. And so, in all candor, Christina, that's where my blood tests, my urine tests come in handy. Because now we're at a point with where with one blood test, I can pretty accurately tell you whether your cat has heart disease without taking x-rays, without doing the echo exams, et cetera, with the right urine test or the right blood test. I can assess your cat's kidney disease long before you start seeing the weight loss, the poor hair coat, the vomiting that accompanies kidney disease. So it really becomes a combination of physical examination findings and lab work to act as a true early warning system for the cats we love.

Kristiina Wilson 13:54

Right. Is there anything that you would recommend people look out for at home? Switching where they're sleeping, sleeping more, sleeping less, eating less, you know, high hiding. I mean, these are kind of examples of maybe more pain than in a simple like beginning of chronic disease.

Dr Kevin 14:13

But no, you're absolutely correct. There's nobody who will know a cat better than that cat's parents.

Speaker 2 14:20

Right.

Dr Kevin 14:21

So if you, you know, uh we can break this down just by virtue of the examples that you used. You know, if you see your cat slowing down, they don't want to jump on the counters anymore. They don't want to jump on the back of the sofa anymore, then it's safe to assume that they are running into orthopedic pain.

Speaker 2 14:39

Right.

Dental Disease As The Biggest Lever

Dr Kevin 14:39

If on the other hand, they've never jumped on the sofa and now all of a sudden they're they're constantly up there, they're, you know, running circles around the room, then you and I have to think of diseases like thyroid problems, hyperthyroidism. So if all of a sudden they're not eating as well as you and I would like, then the question really becomes, is it an oral problem? Because dental disease is rampant among cats. It's the single Let me be clear about this. Dental disease is probably the single biggest lever that you as a pet parent have to address in helping your cat live their longest life. So if your cat is not eating well, is it because they feel miserable all over, which would make us think about kidney disease or whatever? Or are they painful in their mouth? And there is no clear, many times there's no clear answer to that.

Kristiina Wilson 15:28

Right. Yeah, that's true. But because I'm really interested in in supplementation for cats, and I know that this is something that's in your wheelhouse. We just started giving Kevin, our cat Kevin, who has FIV, and he had very bad stomatitis that resulted in him having to have his teeth fully out, and that still did not fully relieve the stomatitis. Okay, he's stable um after several years on um on pre for many years. But his vet recently recommended that he start supplementation of that like beef beef tallow supplement.

Dr Kevin 16:03

So I think I mean there's a lot of bullshit out on the human market, uh out in the veteran market around supplements. And feel free to edit that if you choose. No, and so I only carry 15 or 16 supplements, but I can tell you exactly why I carry them and exactly what pet will benefit from them.

Speaker 2 16:22

Sure.

Supplements That Help And Hype

Dr Kevin 16:22

But, you know, things like glucosamine and chondroitin, the dasiquin or cosequin products that you and I use, Christina, for 20 years, have been disproven. Study after study tells us they just simply don't work to help a cat's arthritic joints. Now, there are supplements that you and I can speak to very directly that have been proven to work for those painful cats. But part of what a pet parent needs to understand is that just because a product is on Chewy, or just because, unfortunately, even because your veterinarian recommends it, does not necessarily mean that that supplement that you're that you're considering is really good or healthy at all for you for your cat. And but there are supplements that are proven to benefit kitties, you know, simple things like lysine for you know chronic herpes viral infections. If we're talking about arthritic pets, you know, undenatured type 2 collagen or UC, this is the easiest thing in the world to give to your cats because you don't have to give it as a pill. You can open these little pills and sprinkle the powder over your food and the cat will never look back at this. Uh, fish oil, well, most cats love fish oil, and it has a variety of benefits. And so, although I can't speak to your particular beef tallow product, the reality is I am a supplement kid. And the question is, can you and I find proven supplements that will benefit your cat? And if that's the case, I am 100% in.

Kristiina Wilson 17:47

Yes. So the supplement that she had us get is called one TDC.

Dr Kevin 17:52

Okay.

Kristiina Wilson 17:53

It's untetradecanol. Yeah.

Dr Kevin 17:56

Yeah, and that's been proven more for more for dental disease than for mobility. Yes, exactly. Yeah, we think that it it does help to reduce inflammation. And you know, cats being cats, what would work well for one of your 14 or 18? I can't remember.

Kristiina Wilson 18:11

Fifteen. Fifteen cats, I know.

Dr Kevin 18:13

So what might work well for Kevin, one cat in your in your in your family home, may not work well for three others. But the reality is that if you and I are using science-based products that are proven safe, you know, that's there's only one way to know, and that's to try them. And I'm a firm believer in using natural products where we can, as opposed to prescription drugs like prednisone, for instance.

Kristiina Wilson 18:35

Same. I'm really trying to back back him down because he's been on the prednisolone for so long that was needed for that acute stomatitis, that now that he seems to be in a recovery period to back him down and see if this supplement can do something to help keep that inflammation down. And he's already on all of our cats over six, we keep them on a fish oil supplement just because of arthritis. And we want them to, you know, feel nice and loosey-goosey. And like again, it's not gonna hurt anything. So if they're taking some fish oil and it works, great. If it doesn't work, fine, they're just getting some extra, you know, oil in their food.

Dr Kevin 19:12

There you go. So I appreciate your knowledge.

Kristiina Wilson 19:16

I think that there was new literature out on L lysine not being as effective, and maybe that is was just for when people are giving it to cats who are having like a coronavirus or a Khaleesi virus infection, because I know people do tend to give it for those instances as well. And I I guess it came out that it was not effective for those.

Dr Kevin 19:36

And the reality is that here's the dilemma that you and I have, Christine. I I mean, we if your kitty goes in, if you take Kevin the cat in for recurrent conjunctivitis, recurrent red eyes, there are a variety of different things, ranging from allergies to dust, uh, to you know, a number of different physical problems. And included in that are the viral upper respiratory diseases, like herpes or caliche, et cetera. The hard part is that those viral upper respiratory diseases are pretty difficult to differentiate, you know, pretty t difficult to tell whether you're dealing with herpes or caliche without spending a lot of money, and sometimes even when you do spend a lot of money. So, you know, the the value of lysine is it's been proven against herpes virus, but the reality is that many folks are gonna use it anytime they have a cat with red eyes. And the good news is it's it's fine. It won't it won't create any problems for them, but we have to understand that by definition, it's not gonna be as effective as we'd like.

Kristiina Wilson 20:34

Sure. That makes sense. And it it also makes sense that it helps pet parents to feel as though they're doing something.

Dr Kevin 20:41

Absolutely. And that counts. That counts.

Litter Box Clues And Urinary Emergencies

Kristiina Wilson 20:43

Absolutely. Exactly. Exactly. So are there behavioral changes that are often dismissed by vets that or that you know of, but that are actually like red flags for for cats, especially?

Dr Kevin 20:55

Well, yeah, I mean, I think that that behavioral changes are sometimes the best way for us to assess our cats, to be honest with you, rather than physical for all the reasons that we talked about. Now, you and I can separate out vomiting, I suppose, and there are several different reasons for that.

Speaker 2 21:10

Right.

Dr Kevin 21:10

But by the time you and I see a cat actually limping or actually hiding, usually there have been weeks of of kind of um of buildup to that.

Speaker 2 21:20

Right.

Dr Kevin 21:20

And so, you know, we talked about the cat who's more reluctant to jump than they used to be, or or sometimes in the case of thyroid disease, more active than normal. But these things count. And so the more clues that you can look at in terms of your cat's thirst, in terms of your, I mean, you know, again, thirst goes either way. If it's diminished thirst, many times you have to worry about kidney disease. Increased thirst, you worry about diabetes. And so there's really kind of a list, an algorithm that you can look at at home to determine whether your cat is healthy or not. But behavioral changes count, whether they be vocalizing, you know, helping you as you're cooking versus not helping. Helping you when you're cooking. You know, drinking water out of the bathroom sink versus not drinking water out of the bathroom sink. Eating a full meal versus not eating a full meal. I mean, they're all over the place, but you have to you have to love your cat. You have to be conscious about them because you uh let me repeat what I told you earlier. In my mind, no veterinarian will ever know your cat as well as a beloving cat parent will.

Kristiina Wilson 22:21

Yeah, it's true. I I would add to that list toileting changes because I think I see a lot in my practice of people coming to me and being like, Oh, my cat is having house soiling issues, especially pooping on the floor. And people are saying, oh, the cat's spiteful, you know, they're just mad at me. This is the cat, you know, being a jerk. Whereas in reality, I'd say 90% of those cases are medical. If it's if it's a sudden thing. Yeah. And in it, it is really difficult sometimes to convince uh clients that this is something that they really need to go see their veterinarian about, that there's there's something going on.

Dr Kevin 23:00

No, Christina, you're you're a hundred percent correct. And and I mean, in general, and listen, I don't pretend to have your level of expertise when it comes to behavior, but in general, in my experience, if cats are pissed at you and me, they're gonna very directly, they're gonna target your shoes or your underwear drawer or your socks or your jacket that's laying on the sofa. This is not gonna be indiscriminate pooping or peeing, where one time they poop in the kitchen, the next time they poop in the family room, next time they poop in the hall.

Speaker 2 23:31

Yeah.

Dr Kevin 23:31

If you're seeing those kind of changes, you know, then that A, is it diarrhea? I mean, because sometimes when you gotta go, you gotta go, whether you walk on two legs or four. But if it's if it's firm poop, then I start thinking about many times either abdominal pain or actually, as funny as it sounds, orthopedic pain, because it hurts it hurts to hunker down and assume the position for some of these cats. So a lot of times it's easier for them not to be crude about it, but just to squeeze a poop out as they're walking rather than hunker down and assume that defecation posture.

Kristiina Wilson 24:04

Absolutely.

Dr Kevin 24:04

The same thing applies to kitties with urination problems. I mean, if generally if they're pissed at you, you're gonna know it because you know your underwear drawer is gonna be the one that pays the price, not your partner in crimes, or whatever the case may be. But if they're peeing all over the place, especially, let me repeat this, especially as a male cat, that can become an emergency very quickly, guys.

Kristiina Wilson 24:27

And so if you Well, especially if they're not peeing. If they're entering and exiting and not peeing, that's when it's really serious.

Dr Kevin 24:35

If you see, you know, if you see your male cat kind of hunkering and trying to pee and then moving a few steps and hunkering and trying to pee, that is a bona fide 24-hour-a-day emergency because I have seen cats who were unable to pee by virtue of urinary crystals in their in their bladder that passed down into their little male cat urethras, and I've seen them rupture their bladder and die. So this is nothing I mean, all of us can sympathize with the pain of an overfull bladder. I've been there, I'll bet you have, Christina, and our cats just simply don't have the ability to tell us. So you're absolutely right. When it comes to urinary and defecation behavior, you know, simple little things can can be a big clue in terms of your kitty's health.

Kristiina Wilson 25:17

Yeah. And I'm I'm a huge advocate because I'm a dork for data collection and data harvesting. And so, especially in a household with this many cats, right? It's it's very necessary. I always say to people who live in uh multi-cat households, especially if you have more than two to three cats, it's great to put motion sensor cameras in front of your litter boxes so that way you can see if your cats, especially male cats, but even female cats, if they're entering and exiting a lot, are they straining? Are they vocalizing when they're going to the bathroom? Are they entering and not producing anything? It's not the most fun thing every night to go through and review the footage, but it is very helpful. And then that way I'm able to really have a handle on the general health and well-being in the house, see what the patterns are.

Dr Kevin 26:03

That's a great thought. Great thought.

Kristiina Wilson 26:06

Really helpful, and especially when I get a behavior case for house soiling. This is the first thing that I tend to ask people to do if they've gotten a clean bill of health from their veterinarian, is to set up a camera system so that we can see exactly what's going on. And it can be very cheap, but it really gives you a lot of data, not necessarily data that people want, but it's data that I think is interesting.

Dr Kevin 26:28

So I fully agree. I fully agree.

HCM Explained And Early Screening

Kristiina Wilson 26:31

I'm a dork. So pivoting from bathroom stuff. Um, I know that we talked about HCM. So for listeners who may not be familiar, can you explain what hypertrophic cardiomyopathy in simple terms is, please?

Dr Kevin 26:45

Sure. Sure. Well, let's start with uh the basics there. Hypertrophic just means your muscle's getting bigger, you know, like uh like Christina or me when I'm lifting weights. Hopefully my my biceps get bigger. And that and that's that process is called hypertrophy. Now, cardiomyopathy tells us that the cardio means heart, and the opathy part means that you got a problem. So putting it all together, hypertrophic cardiomyopathy is a problem of the heart caused by muscle overgrowth. And the bottom line is that, and this typically affects the left joint ventricle, which is the primary pumping chamber of the heart, because it's the one that drives blood from your heart into your kidneys and to your legs and to your brain and every other component of your anatomy other than your lungs. And so what happens with hypertrophic cardiomyopathy is that the heart walls get thicker and thicker in that left ventricle, and that prevents it from fully expanding and fully contracting. It just doesn't have the flexibility to go ahead and eject as much blood. Now, this disease affects one out of six cats worldwide, and if untreated, it will cause their death. So let me be clear about that. You know, you you look at your 15 cats in there, and two and a half of those cats are are likely to develop hypertrophic cardiomyopathy over the course of their lives. Now, the good news is we think we can diagnose it pretty early with a simple blood test called Pro-BNP.

Speaker 2 28:18

Yep.

Dr Kevin 28:19

And lots of times that will tell us before the disease is ever found by me listening to it with a uh stethoscope or anything like that. And here's the most important part about HCM. That is that, you know, I've been in veterinary practice for just over 40 years at this point. And for 38 years of that practice, Christina, if I told you that your cat had HCM, what I was really telling you to do is to go down to your nearest Home Depot and buy a shovel and start digging a hole in your backyard. Because we for 38 years in veterinary practice, we had no effective way to treat HCM. But about two years ago, that changed. And there's a longevity drug, a longevity molecule called rapamycin, which I take as an aside and which I prescribe many times for preventive longevity in dogs. But this particular molecule called rapamycin has been proven to slow, stop, or occasionally even reverse the changes of HCM and allow our cats to live happily ever after. Now it doesn't work for every cat, but it works about 80% of the time. And that's clearly a lot better than my handing you a shovel and telling you to go out and spend some quality time in the backyard.

Kristiina Wilson 29:40

Absolutely. What age does this usually strike cats and are there early warning signs? Is it something that is usually kind of silent until it isn't?

Dr Kevin 29:49

All of the above, unfortunately. And I'm I'm trying not to make light of it. But, you know, I I am dealing with probably 200 HCM cats right now in my practice. And they are, I mean, while most of them, Christina, are in that 9, 10, 11, 12, 13-year-old demographic, I've I have one and two-year-old cats under treatment as well. And many times these fall into specific breeds like sphinx cats, like short hairs that have an actual gene that sets the table for hypertrophic cardiomyopathy. Maine coons are another breed that gets HCM all the time. And so the younger cats are typically one of these breeds that has a genetic predisposition to this disease. But we think again, we think that pretty much one out of six cats will develop it just by a virtue of aging. And so you really have some very young cats affected, but you also have the a majority of older cats affected.

Kristiina Wilson 30:48

Maine coons just kind of have a predisposition to heart issues generally, like they have congestive heart failure more frequently. And I had a main coon who had congestive heart failure, but he did great on LASIKs for a bajillion years that would even come every night to be like, You forgot my pill, dummy, and tell me. Yeah, but the short.

Dr Kevin 31:06

I mean, it's it's it's well worth discussing with your veterinarian. And if you're, you know, if if you have, you know, a main coon or I mean, there are a lot of different breeds of cats that have specific health issues. But if you have a main coon or a sphinx or a short hair, I would suggest to you that even as young as two or three years of age, ask your vet to draw a simple blood test on your kitty. Submit the pro-BNP, which simply checks for stress in your cat's art muscle. It's easy, it's cheaper for you than having X-rays and echo studies done and this and that. It's not, it's just a needle poke for your kitty. But if your cat's heart comes back as stressed, if your pro-BNP comes back as abnormal, then you have to go, you have to go looking. And you know, I'm happy to help you through my longevity practice, but the reality is you need to find a veterinarian who can walk you through the diagnostics necessary to help you understand whether it's HCM or another disease affecting your cat's heart.

Kristiina Wilson 32:04

Okay. Um, do stress and environment impact heart disease in cats at all, or is it really all genetic?

Dr Kevin 32:12

No, absolutely. I mean, you know, sometimes, Christina, it's just the shit that happens as we age, you know, let's be clear. And so there's no way to prevent that. But it's not rocket science to understand that if you have a multi-cat family and one cat is always stressed, one cat is always getting the snot beat out of him or out of her, that that cat's blood pressure is probably increased on an ongoing basis. And one of the things we know that absolutely sets the table for HCM is high blood pressure or hypertension. And, you know, so as I'll I'll make another PSA here as as as we move on through our conversation, and that is that I'm every cat parent, listen, it's your responsibility, you guys, to ask your veterinarian to check your cat's blood pressure at least once a year after the year, after about five years of age. Because what we're finding, the more we look for high blood pressure in cats, the more we find. And there's nothing more heartbreaking than to have a cat who's visual one night. They're jumping onto and off the furniture, they're chasing the laser, they're chasing the ball, and to wake up the next morning and your cat is permanently blind. And the most common reason for that is high blood pressure. Veterinarians hate to take it because it's a pain in the ass, to be honest with you. You're trying to adapt human blood pressure or dog blood pressure machines to cats. Cats are always stressed. Sometimes they're swatting at you, but they're that's a very high yield test. So please, if you're in it to win it with your cat, please have your veterinarian check your kitty's blood pressure.

Kristiina Wilson 33:46

That's a great PSA. I think a lot of people, number one, don't know that that's even a thing, that you can have your cat's blood pressure taken and that it's something that your regular vet can and should be doing. Also, this is another question for my own personal edification. So I'm just filling up my podcast with my own questions. If you give your cats a pre-vet visit anti-anxiety medication like a gabapentin or a trazodone or a trazepentin, as I have to give for Kevin, for example, who's really uh not loving going to the vet, is that going to seriously affect or impact their his blood pressure reading?

Dr Kevin 34:26

Yeah, it can. It can artificially, I mean, so cat blood pressure can go either way, can't it? I mean, cats get so stressed going into a clinic that and a cat with normal blood pressure can look like it's just coming off the charts.

Speaker 2 34:37

Right.

Dr Kevin 34:37

And the flip side to it is that if you drugs, if you use drugs to settle that down, you may get an artificially low setting. And so one of the things, in all honesty, Christina, that we're starting to do with our longevity clients is I'm starting to send you blood pressure testing equipment at home. And I ask for a couple hundred bucks as a deposit, send it to you for a week. These are simple things that you can do. And most cats are vastly less stressed, vastly more amenable to having you put a blood pressure cuff on their arm than having your veterinarian and strange surroundings after a car ride. So that's one of the things that we're we're doing. We're we're pushing hard to develop. I mean, I have a couple of blood pressure machines that are already in circulation for that purpose because you're not the only one to worry about that.

Kristiina Wilson 35:21

Yeah. No, that's great to hear. I love the idea of, especially for cats, more at-home vet visits for when it's appropriate. That's what we used to do when we were still in New York City, is we would have the vet come twice a year and just see everybody and just get it all done in one day, but it was so much easier for everyone. Unfortunately, now where we are, that's not a service that anyone offers. So you talked about rapamycin. Can you tell a little bit about what it is and how it's being used in cats?

Dr Kevin 35:51

Yeah, absolutely. So rapamycin is a medication that was found on Easter Island. And the the native name for Easter Island is Rappa-Nui. So rapa, the rapa component of rapamycin comes from its origin there. But originally it was introduced as an immune suppressive molecule in in human medicine. So that if I, Christina, gave you my kidney, you might have to take rapamycin or other immune suppressant drugs to prevent your body from rejecting my kidney.

Speaker 2 36:23

Okay.

Dr Kevin 36:24

However, along the way, we learned that patients who were on rapamycin lived longer than we expected them to do so. And so that led to increasing studies around in the human ranks about what happens if you just take rapamycin. And what we found is that in mammal species, every in every mammal species studied to date, rapamycin increases lifespan by up to 14% without any other intervention. And so, you know, that that's a pretty amazing statement. And how does that why does that work? Rapamycin acts in three different ways. It acts to reduce cancer incidence, it acts to support heart function, as we've already talked about with HCM, and it acts to reduce inflammation, which helps prevent kidney disease and arthritic pain. And that's kind of a big three right now. And so if you're asking me why cat parents use it, it's 99%, well, 95% of them, Christina, are using it in the setting of HCM. But 5% and growing are using it in pr as a preventive in their younger cats because it is such a safe molecule. We don't see any side effects from it. We really don't. And so if you're looking for a good way to help extend your cat's life by reducing cancer incidence and supporting cardiac function and reducing arthritic pain, rapamycin is a great choice for you. A little bit expensive, but the reality is there's no more effective molecule at this point in time to help your cat live live our longest life.

Kristiina Wilson 37:54

Does it have any interactions with anything that your cats might be taking as well?

Dr Kevin 37:59

No, not. I mean, in in theory, it uses if if your kitty is on cyclosporin, if your kitty is on a tenolol, in theory, it is metabolized by the same pathway that these drugs are metabolized through. So that if your if if your metabolic pathway sees more rapamycin, there is the theoretical chance that the cyclosporin or tinolol levels could build up in your kitty's blood higher than normal. But I would tell you that from a uh practical perspective, we just haven't seen any problems with it. We see three to four percent of cats that develop diarrhea or loose poop on it, but almost without fail, Christina, within three or four treatments, because these are just given one tab once a week.

Speaker 2 38:41

Okay.

Dr Kevin 38:42

Within three to four weeks, that solves itself itself without any further therapy.

Kristiina Wilson 38:47

That's cool. All right. I will have to look into that.

Dr Kevin 38:50

Uh yeah, you should. You should. I mean, you real it's uh it's an interesting it is the best approach right now to to help your cat to minimize the the arc of HCM in your kitties and also to improve their life, lifespan. So listen, five years from now we might be going down a different rabbit hole to use your phrase, but the reality and if so, you know, if the science changes, I will change too. But as it stands right now, rapamycin is the the single biggest tool in our longevity gun for cats.

Kristiina Wilson 39:20

That's cool to know. And I mean the thing about science is that it's always changing, right? But then we just have to change with it.

Nutrition Myths And Calorie Reduction

Speaker 2 39:25

So that's okay.

Kristiina Wilson 39:27

So I want to pivot and talk a little bit about nutrition because I think nutrition is a very confusing space for cat guardians. I get a lot of requests to talk about it. That is not my space of expertise. Uh but are there any myths that you would like to clear up? How do you think someone could feed for longevity without like getting too crazy about it? Are there good upgrades that people could make? Like, what's your spiel on nutrition?

Dr Kevin 39:54

The fun part is the cats kind of ruin my spiel. Every time I give a spiel, cats ruin it. And so I'm gonna tell you that in general terms, I think that the fresher the food you and I use, the fewer preservatives, the fewer artificial ingredients, the longer you and I will live, the longer our dogs will live, and the longer our cats will live. Now, the hard part is that you and your dogs are easier to make that sale to than many cats. Many cats are very um, you know, they may be food motivated, but they only like one food or they only like one flavor. And that can really become difficult for us because I'm gonna tell you that in a perfect world, you know, if if if if I was cooking specifically for my cat, I mean, that that'd probably the best would be to home cook for my cat, you know, just uh with a little olive oil and some fish or some poultry or whatever the case may be, a combination of veg veggies and fruits. But, you know, cats really aren't aren't built like that. And so I'm gonna tell you that across the board, the things that I would avoid are all the artificial flavorings, everything that anything that looks like a gravy, I'm not gonna give to my cat.

Kristiina Wilson 41:07

Anything that looks like cheese in it?

Dr Kevin 41:09

Yeah, any, right. You took the words right out of my mouth. Any cheese or cream product, I'm just not gonna give to my cat. If I want to give them cheese or or cream, I'm gonna give it to them out of at, you know, I'm gonna cut a little chunk off a cheese wheel, or I'm gonna give it to give them milk. I'm not gonna rely on somebody on some manufacturer's representation of what that should look like. Because as Christina, she made a very astute observation a little bit a little while ago, and there are more diets, more cat diets are designed to sell pet parents than are designed to be healthy for our cats. And so I know you asked for the specific ingredients and the like, and I'm gonna I'm gonna weasel a little bit on you there. Okay, but I'm gonna am going to make this statement. The biggest way, the the one way that has been proven to to help an individual live longer, whether that individual is a fish or an elephant or a cat or a seal or a dog, is to reduce their calorie intake. And so so many of the pro of the patients that I see come in as fat cats that are setting themselves uh up for arthritic disease, setting themselves up for cancer, for kidney problems, for arthritis. And the the easiest way for you to extend your cat's life and oh, by the way, save five, 10, 15% of your food budget money is to feed them less.

Kristiina Wilson 42:28

Yeah, I I agree. And I I think that number one, I think a lot of pet guardians may equate giving treats and food with quality time spent rather than doing other enrichment activities. And so maybe instead of giving those extra treats or that extra food, we could translate that that time into let's play for 20 minutes. Let's do run around the hall house for 20 minutes. Better for both of you. Exact, exactly, right? And that could really be the way that you're showing your affection rather than as just dispensing treats. I also want to say that I do think that the math for figuring out the caloric intake that your cat needs can be very daunting for people. I'm usually incredibly anti-AI, but I will say that Chat GPT can be good for this use only for plugging in because there doesn't seem to be any kind of like doing the math like generator online anywhere for figuring out specifically my cat weighs 15 pounds, I want them to weigh 12 pounds. They eat this food, which has this many cakeals, this is the you know, crude protein, putting in all the bits and saying my cat is sedentary, my cat is actually very like runs around. You can use AI for that formula, and it will give you a very good breakdown of what you should feed your cat. Again, probably not dry food, but for how much you should feed your cat, and it does. It in a way that you're not going to want to rip your hair out.

Home Setup To Reduce Joint Impact

Dr Kevin 44:04

So, yeah, as we as we head towards closing here, let me just make a make a few recommendations. Kind of give you a boilerplate, kind of a framework that many of your pet parents could use to assess their cat's lifestyle, their health, and how we could improve it. So I'm going to start with, you know, just by recirculating, retracing our path back to diet. You know, I mean, the look in general, less food is better. Right. Look to avoid all the artificial ingredients. Anything that was designed to sell you, please avoid it for the sake of your cat. And then when it comes to lifestyle, certainly your kitty, whether they be inside or out, needs exercise. But we have to look at what their traffic pattern is. You know, you have to understand that cats are typically 12 to 14 inches tall. If they're running up and down the stairs all day long, that's not very similar to you and me doing box jumps at our local gym. You know, I'm six foot. That'd be like me jumping three or four foot on a repeated basis and jumping back down again.

Speaker 2 45:00

Right.

Vaccines, Risk, And Smarter Scheduling

Preventive Testing And Final Takeaways

Dr Kevin 45:01

Repeated stairs can be very difficult for a cat to handle longer term. The same thing about jumping onto and off of furniture. While e jumping up is relatively easier for cats, if you have a tile floor, for instance, think about the impact that they're putting on their little wrists and elbows as they jump down. So whatever you can do to minimize the jumping and the stairs in your kitty's environment, or at least to pad those areas will be a benefit in terms of their survival. We haven't really talked yet about dental disease, but I would tell you that one of the very best ways, and I mentioned it earlier, probably the single best way for you as a pet parent to extend your cat's lifespan is to set them up for at least yearly anesthetic dentals, not non-anesthetic dentals, anesthetic dentals that will allow your veterinarian to take x-rays of every tooth in their body to diagnose any periodontal disease that's bet present and treat or extract the tooth if needed. That's the only way to solve it. But if you're not dealing with periodontal disease through anesthetic dentals, you're setting your cat up for the toothache of all toothaches. And Christina can speak very directly to that with her cat, Kevin's history of stomatitis. Yes. But you're also creating a situation where the oral bacteria are going to worsen your cat's heart function. They're going to worsen your cat's painful joints, they're going to worsen your cat's kidney disease. So the one thing that you and your veterinarian could work more closely at, almost across the board, is always dental care. Now here's the deal. I'm going to give you a trade-off here because spend more money on your cat's dental care, but spend less money day in and day out on their vaccines. Why is this so important? Now listen, I'm not discounting. Every cat should get rabies, and we can talk more about that if you wish. But the reality is that for the average inside cat, there's a real question as to whether they should be vaccinated against leukemia and the F V R C P, the Dissipro complex, on anything resembling a yearly basis. Now, maybe we look at it every second, every third, every fourth year. Why is this? Because I, as a veterinarian, have inadvertently killed at least seven cats that I know of by vaccinating them through my 40-year career. How did that happen? Cats are notorious for developing skin cancer at the site of any puncture through their skin. Now, that can certainly be your neighbor's cat, you know, as part of a cat fight, but it can absolutely be the vaccine needle that I just injected your cat with. And if I'm if I'm vaccinating your cat against a disease that they are not being exposed to, I question that. The Latin word for that may very well be malpractice. And, you know, taking that to the next step, why does your veterinarian give your cat rabies vaccines way down at the bottom of their right hind foot? And why do they give leukemia vaccines way down at the bottom of their left hind foot? When a schmo like me, 40 years ago, I just scruffed them and gave them a vaccine kind of in between their shoulder blades. Why do we do that? Because if a cat develops skin cancer at the side of that rabies or at the side of that leukemia vaccine, it's easier to amputate the leg than to deal with the cancer up on the on the trunk or the thorax. So let me rephrase that question. Why would we be considering amputation in a in a cat for a non-essential vaccine? There's a disconnect in there someplace for me. So moving right along, because I'm not done yet, Christina. But the next thing I would talk about is just simply diagnostic tests. You know, if you have a male cat, you really ought to be checking his urine a couple times a year because you're worried about their urinary pH, you're worried about the crystals that Christina has spoken about already. In any cat, you ought to be getting blood pressure, boys and girls, because I mean there's nothing more heartbreaking than waking up with a blind cat. And I've seen that happen time and time again. You know, as your cats age, let's check their pro BNP to assess their heart function. Let's check their SDMA to check their kidney function. And, you know, if if hypertrophic cardiomyopathy or if your cat's longevity is a player for you, let's talk about prescription longevity drugs. They all have a place. Don't skip straight to prescription longevity drugs. Let's address your cat's diet. Let's address their lifestyle, let's address the supplements, let's address the veterinary care. But prescription longevity drugs have a huge role as well. Boom. That's a that that is longevity science for cats rolled up into one.

Kristiina Wilson 49:47

If there was one little change that listeners could make today, what do you think that that people should do for their cats?

Dr Kevin 49:55

I clearly heard you say one. I'm gonna give you three.

Speaker 2 49:59

Okay.

Dr Kevin 50:00

I'm gonna say, listen, pay attention to your cat's diet for all the different reasons that we've talked about. I'm gonna say, ask your veterinarian why U H Y. When they make a recommendation around a particular food, when they make a recommendation around a particular vaccine, ask them why my cat, why this applies to my cat. And listen very closely to that answer. Some of them may not be able to answer that for you. It may just be corporate policy. And then the third part of things is just understand that cats are, they make a living by hiding things from you and me. And so there is a role for the dental care. There is a role for diagnostics if you and I want to help our kitties live longer.

Kristiina Wilson 50:45

All right. Well, thank you so much, Dr. Kevin, for being on the podcast and for all of your insight that I'm sure is going to be very valuable for all of our listeners. And I will be excited to have you back on for part two, where I can continue to pepper you with annoying questions about cats.

Free Vet Call And Closing

Dr Kevin 51:00

You know, I understand part of that's just self-deprecating, but the reality is I've I love this. You know, I mean, I'm we're all in this together. And so I want to mention one last thing. And you spoke about my website, www.helpingpetslivelonger.com. But I would also tell you that we are in all in this together. And so I have a second website set up for podcast listeners, and it is www.freevetcall.com. And it's just a one-page website, Christine, and it links directly to my personal calendar. And if your listeners want to hit freevetcall.com, they uh will set up a 10 or 15-minute consult. There's no charge for it whatsoever. But you know, if you have questions about your cat's teeth or their vaccines or you know, whatever, whatever comes down the road, I'll be happy to help you, including advice on the prescription drugs that Christina and I have spoken about today. I love my cats. I love my dog. I know you guys too. Let's work together to keep them around for as long as we can.

Kristiina Wilson 52:01

I agree. Thank you so much. That's that is such a lovely resource, and I'm sure that people will take you up on it. And um, for everyone listening, I will link to both of those websites in the show notes so you can find them easily. And um, thank you again so much. It was so nice to talk to you.

Dr Kevin 52:16

Christina, I loved our time together. I I appreciate everything you're doing for the cats of the world, and I look forward to our next visit.

Kristiina Wilson 52:23

Likewise. Thanks so much for listening to the show. If you're looking for one-on-one support with behavior issues like litter box problems, aggression, anxiety, or multicat dynamics, you can find me through my behavior consulting business, Catitude Adjustment, at catitude-adjustment.com. If you like the episode, please consider leaving a rating or review. It really helps us grow. For more episodes, show notes, and resources, head to Hissandtell Podcast.com. Huge thanks to Cat Beats for the music, and I'll see you next time.