Top 5 Medical Problems of Outdoor Cats

Free-roaming felines may live a tough life marked by parasitic infections and trauma.

Parasites your outdoor cat brings into the house may put you at risk. By: Jorge Gonzalez

Last week I posted on the common maladies of indoor cats. Outdoor cats get their turn now.

The outdoor cats I see come in 2 varieties. There are the indoor/outdoor cats who get veterinary care and have a good home but go outside. And then there are the “good ol’ barn cats” or the strays who pretty much fend for themselves.

Here are the top 5 problems I see in our roaming, philandering fleabag felines.

1. Parasites

Kitties who live outdoors share their bodies with lots of other little creatures: parasites.

  • Endoparasites live inside the body, invading the GI tract, the lungs and the heart.
  • Ectoparasites live on the outer body, invading the skin and the ears.

When a cat has GI parasites (roundworms, hookworms, tapeworms), their symptoms usually include vomiting and/or diarrhea, weight loss and anorexia. Some of these parasites can also create a cough because they migrate through the lungs.

Identified by a fecal test, these buggers are treated with drugs called anthelmintics. Unfortunately, many outdoor cats don’t get the benefit of being “wormed” and live their lives with parasites. Although many adult cats can live with a certain burden of parasites, a heavy worm burden in young kittens or immunocompromised cats can be life-threatening.

Parasites such as lungworm and heartworm are also prevalent in outdoor cats and more endemic in some areas of the country more than others. Many of these cats suffer from a cough, but the damage done to the lungs can be life-threatening in some cats.

Lungworms can be treated with the proper anthelmintic medication. Heartworm is not easily treated in the cat, but the cough and lung damage it causes can be helped with medications. These cats usually present as having “asthma.”

2. Fleas and Other Ectoparasites

Outdoor cats can have fleas even in Alaska. They can also have ear mites, lice, ticks and, less commonly, maggots or cuterebra.

Some cats tolerate fleas and the like, and learn to live with them. Others are super sensitive, scratching themselves, giving themselves swollen ears and living very uncomfortable lives. It goes without saying that some of these parasites are a risk to you and your home environment as well.

Once identified, all of these ectoparasites can be treated, but the cat may need other supportive treatment as well. Medications to stop the itch and treat the skin or ear infections take time and a dedicated human. That good ol’ barn cat needs some TLC to get better.

Fleas are also the biggest source of tapeworms and can transmit blood parasites. If your cat goes outside, I believe in treating fleas proactively every month. House cats can also get fleas from other animals who go out, from hunting rodents in the house or by spending time near outdoor areas. Talk to your veterinarian about risk and prevention.

Outdoor cats may contract FeLV and FIV via fights with other outdoor felines who are infected. By: hkase

3. Retroviruses: FeLV and FIV

Your outdoor cat can contract these serious viruses from other infected cats. Kittens can contract them from the mother. Adult cats contract the viruses from another cat either by friendly grooming, unfriendly contact (such as cat bites and fights), sharing dishes and food, and any other contact with bodily fluids.

Cat bites are a big cause of feline immunodeficiency virus (FIV) transmission. Tomcats who fight inflict deep puncture wounds, and the saliva from the infected cat transmits the virus to an opponent.

Vaccinating your cat against feline leukemia (FeLV) is helpful but not 100% protective. The FIV vaccine is much more controversial.

Cats can live with these viruses for several years before becoming sick. FeLV is a more serious disease and usually causes severe anemia, tumors (lymphoma) and other syndromes associated with immunosuppression. FIV cats may live long lives without symptoms, but the virus can also create an acquired immunodeficiency syndrome with associated health problems.

Keeping your cat away from infected cats is the best way to prevent transmission of retroviruses, but this is virtually impossible if your cat goes outside.

4. Trauma

An outside cat is at great risk for trauma. They face wild predators, other cats and vehicles. They get caught in fences, locked up in garages or outbuildings, fall from high places — the list goes on.

Lots of clients talk themselves into a false sense of security by thinking their indoor/outdoor cat “just stays by the house.” At some point, most of these sensible or street-savvy kitties get into some kind of trouble. If you let your cat outdoors, you must be willing to accept the consequences. All outdoor cats are at risk for trauma.

Do you know where your outdoor cat goes?:

5. Vomiting

Just like our house cats, outdoor cats can suffer from many diseases and syndromes that cause vomiting, not to mention the fact that they are at risk for eating many disgusting or toxic things.

Diagnosis and Treatment

An outdoor cat that comes to me sick or vomiting is a true challenge because the differential list (causes of the illness) is very long indeed. Particularly if our vagabond cat about town has not been to the vet recently or ever, I have to start from scratch.

  • Has Wildling lost weight? How much and in what period of time?
  • What is the FeLV/FIV status of Targaryen? Even if previously tested negative, he could have contracted one of these viruses recently from a warring enemy.
  • What does Dragon eat? Assume anything.
  • How long has Jon Snow been sick? Since last winter? Depending on how little the human sees Jon, this question often can’t be answered.

Unfortunately, these kitties are often on the budget health plan. There is still a population of barn cats out there who are not considered true pets by their humans. A “stray” might be brought in by a Good Samaritan who has “fed him through the winter,” but “he’s not really my cat.”

So say Jamie is brought in — flea-infested, coughing and sneezing; an old wound on his paw; thin and not eating the food Mrs. Human has been offering him this week. An estimate for a FeLV/FIV test, other blood work, X-rays, wound treatment and other supportive care as indicated can shock Mrs. Human. Add to this the cost of flea medication, ear mite treatment and worming. Did I mention he’s not neutered and is now under a rabies quarantine?

Oh, boy — Jamie might not live to see next season. This might be time for one of my fabulous technicians or myself to adopt him or get help from our terrific regional shelter or the state program. No wonder most of us in the veterinary world have at least 5 cats.

When at all possible, keep your kitty close to you in their own kingdom.


This pet health content was written by a veterinarian, Dr. Debora Lichtenberg, VMD. It was last reviewed Sept. 6, 2017.

Dr. Debora Lichtenberg, VMD

View posts by Dr. Debora Lichtenberg, VMD
Dr. Debora Lichtenberg, VMD, is a small animal and exotics veterinarian who has split her time between a veterinary practice in Pelham, Massachusetts, and her studio in New York City. Dr. Lichtenberg is a graduate of the University of Pennsylvania School of Veterinary Medicine with 30 years of experience. Her special interests are soft tissue surgery and oncology.

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