Gulf Coast Scratching Post

Specialized veterinary care for your cat!

The Ten Subtle Signs of Illness

Sick Cat

Cats are not self-sufficient, but rather their signs of sickness are subtle, and consist of changes to their normal behaviors 

The Ten Subtle Signs of Sickness

  1. Inappropriate elimination
  2. Changes in interaction
  3. Changes in activity
  4. Changes in sleeping habits
  5. Changes in food and water consumption
  6. Unexplained weight loss or gain
  7. Changes in grooming
  8. Signs of stress
  9. Changes in vocalization
  10. Bad breath

Because cats are adept at hiding illness, cats are often sicker than dogs by the time they are brought to a veterinarian.  Also, it is a fact that many veterinarians prefer woking with dogs and find cat diseases more challenging to diagnose and treat (Bayer Healthcare/AAFP: Veterinary Care Usage Study III: feline findings.)

The best thing that you can do for your cat is to recognize the subtle signs of sickness and seek veterinary care early.  As a member of the AAFP Cat Friendly Practice Advisory Council, Dr. Norrell has been recognized as a veterinarian who has expertise in finding clues through a thorough medical history and physical examination and understands that many behavior problems are a consequence of feline stress or illness.  Misunderstanding the cat and the connection between stress, illness and behavior can often lead to surrender and/or unnecessary euthanasia.   

What We Learn When We Examine Your Cat

cat exam

Cats can't tell us where it hurts or why they don't feel right so we have to do some detective work to piece together the clues and find out what is wrong.  You know your cat better than anyone, so we ask you for as much information as you can give us about their well-being, any signs of ill health, and any changes in their behavior that will help to tell us wheter they are well and happy, or whether there is a problem.  Then we use the physical examination to give us more information to look for hidden problems.  


the examination has two parts: the "hands off" and the "hands-on" parts.  

Hands Off Examination

As soon as you and your cat enter the room, Doctor Norrell starts assessing your cat from a distance.  We do this while we are saying Hello; and while you are telling us how your cat is doing at home.  

You and your cat may not be aware of this part of the examination, but we are looking at the way our cat breathes, sits, stands, and walks; how it reacts to its new environment and to any noises it hears.  

What We Are Looking At

Demeanor: Is the cat alert and as aware of its surroundings as it should be?  If not, is that because it is feeling too ill to react normally, or because it is in pain? Or is in not seeing or hearing as well as it should?

At Rest: When the cat is sitting in the carrier or at rest in the room, we are looking to see if it is sitting in a natural position. Is it underweight or overweight, and does its coat have a normal shine? Is there any increase in breathing noise, rate or effort? Are the cat’s eyes and nose clean, are the ears pricked up, and is the face symmetrical?

Movement: We encourage the cat to walk around the room. This helps the cat feel at ease, but it is also a valuable part of the “hands off” examination. 

Is the cat lame or weak? Is it holding its tail in an normal position? Can it find its way around or is there a problem with its vision or co-ordination? Does it want to explore, or find a hiding place, or is it feeling too ill or weak to want to move?

Hands On Examination 

This starts with a brief top to toe check of the major body systems, followed by a more detailed look at any areas that are giving trouble. 

Head and Neck: Are the ears, eyes and nose clean? Are the whites of the eyes white, and are the pupils symmetrical and responding to the light? Do the backs of the eyes look normal? Are the insides of the mouth and the eyelids a healthy pink? Does the breath smell (more than usual!), and are the teeth and gums clean and healthy?

  • Are the lymph nodes in the neck a normal size, is their any pain when the throat is gently handles; does this trigger any coughing or retching?
  • In older cats we also feel the neck carefully to see if either of the thyroid glands are enlarged. 

The Skin and Fur: Is the coat shiny with no “dandruff”? Are there any bald patches or any scabs under the fur? Are there dark black flecks in the coat indicating that the cat has fleas?

Chest: We watch the cat to see if the breathing is more rapid or labored than it should be. Then we use a stethoscope to listen to the heart and to the lungs, although if the cat is purring we won’t be able to hear anything very useful!

  • The heart beat should be regular and at a rate of between 120 and 180 beats per minutes. Each heart beat has two sounds separated by a tiny pause. A heart murmur is a faint sound that fills the gap between the two heart sounds and indicates turbulent blood flow within the heart.
  • Lung sounds should be faint, but just audible over all parts of the chest. Louder lung sounds can indicate bronchitis, pneumonia, or heart failure. Absence of lungs sounds means there is something between the lungs and the chest wall-it might be fluid or tissue, or free air but whatever It is it shouldn’t be there.

Tummy: When we examine the cat’s tummy we can feel the outline of the larger internal organs – the liver, kidneys, spleen, intestines, and bladder. We can check that each is the right size and can identify any sites of internal pain. We also feel all around the abdomen to identify any lumps that might indicate cancer. 

WARNING: If your cat is overweight we won’t be able to feel all these things. 



What Can We Do to Help?

Most cats don’t like being at the veterinary practice and they don’t like being examined. We understand this and always try to minimize their stress.

Little Things Can Make a Big Difference

We have longer than standard appointments so that we can give your cat time to adjust to us, and we can take a little extra time to handle your cat with the utmost care.

Coming out: We encourage your cat to come out of the carrier by themselves, or we take the carrier apart so that we don’t need to haul your cat out of its safe spot.

In the room: We allow your cat time to explore the room and if the table is too frightening we examine your cat on the seat, on the floor, or even on your lap (if you and your cat are comfortable with that).

The examination: Cats don’t like being stared at, so we do as much as we can with your cat facing away from us, and when we need to look at the face we look from the side not head-on.  We avoid doing uncomfortable things when we can, so we only look down the ears when our initial external check tells us we need to. Likewise, we only take your cat’s temperature if its behavior suggests a fever, and we use the slimmest, quickest, and most comfortable thermometer that we can!