Merck Manual

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Pet Owner Version

Routine Health Care of Cats


John A. Bukowski

, DVM, MPH, PhD;

Susan Aiello


Reviewed/Revised Jul 2011 | Modified Oct 2022
Topic Resources

Routine health care refers to the non-emergency, general care that is needed to keep your cat healthy throughout its life. This includes routine veterinary care for vaccinations, parasite control, and dental care; proper nutrition; grooming; and protection from household hazards.

Importance of Veterinary Care

Adult cats should have a complete veterinary examination at least once a year. Kittens need veterinary visits usually every 3 to 4 weeks until they are about 4 months old. Geriatric cats (older than 8 to 9 years old) should see their veterinarian twice a year or more frequently because illness is more common in older pets and should be identified sooner to provide proper treatment. Your veterinarian may recommend a wellness program for your pet, such as routine blood tests to monitor for early kidney or liver disease.

Signs of Illness

Because you are more familiar with your cat than anyone else, you should watch it carefully for subtle signs of illness that another person or even a veterinarian may miss. General signs of illness include a lack of appetite or decreased activity. Other more specific signs include vomiting and diarrhea, urinating more (or less) frequently, coughing and sneezing, or a discharge from the eyes, ears, or nose. Illness can also show up as a loss of hair or itchy areas on the skin or around the ears. Problems with the musculoskeletal system are often seen as stiffness or lameness, such as not putting weight on a leg. If your cat shows any of these signs for more than a day or two, a visit with your veterinarian is a good idea.

Giving Medication

Administering pills to a cat can be a challenge. Some cats will take a pill that is hidden in a small treat, such as a piece of tuna or chicken. However, many cats will eat the treat and spit out the medication. In these cases, you will need to learn how to administer a pill by tipping your cat’s head so that he or she is looking up (that is, at the ceiling), opening the mouth, and placing the pill directly in the back of the mouth for swallowing. Your veterinarian or veterinary technician can give you a demonstration and additional guidance. Liquid medications are sometimes prescribed, particularly for kittens. Liquids can be given via a syringe into the rear of the cat’s mouth by inserting the tip of the syringe near the back teeth on either side. Holding the cat’s head pointing partially upward can help prevent spills. Spot-on products or other topical medications are administered directly on the coat or skin. If your cat needs eye drops or ear medication, your veterinarian or veterinary technician will give you a demonstration. Regardless of the type of medication or how it is to be given, it is important to read and follow all label instructions.

Cat taking pill

Cat taking pill


Vaccination is a key component of preventive medicine in cats, just as in dogs and people. Vaccinations are given to stimulate the immune system against infection before exposure to disease. Several vaccines are routinely given to cats as the core defense against serious infectious illness (for example, panleukopenia, herpesvirus). Several others (-referred to as noncore) are important in certain regions and situations (for example, feline leukemia virus). Your veterinarian can advise which vaccines are recommended in your local area and circumstances.

Traditionally, booster vaccinations have been given every year throughout the cat’s life to ensure ongoing protection. However, the need for yearly revaccination has been questioned in recent years. Some data indicate that, after the first year of life, immunity lasts long enough so that booster vaccinations are needed only every few years. In addition, some research has suggested that local inflammation, even that associated with certain types of vaccines, can lead to fibrosarcoma in cats, which is the most common soft-tissue cancer of this species. Vaccines using killed feline leukemia virus and rabies vaccines are most commonly associated with this form of cancer. Debate over the best approach to vaccination is ongoing. Your veterinarian can advise you about the best vaccination program for your cat.

Parasite Control

Several internal and external parasites can infect cats ( see Table: Common Parasites of Cats Common Parasites of Cats Common Parasites of Cats ). Common intestinal parasites of cats include roundworms, hookworms, and tapeworms. Worm infections are often passed through eggs in feces or directly from mother to offspring through the placenta or milk. Sometimes, a secondary host is involved with infection. For example, tapeworm infections are passed through ingestion of larvae either in fleas or in tissue of infected prey (such as mice).

Intestinal worms cause damage to the digestive tract and blood loss. They also interfere with absorption of essential nutrients. Infection is diagnosed by finding worm eggs (or sometimes actual worms or worm segments) in fecal samples. Fecal samples should be tested several times in kittens, periodically (usually yearly) in all indoor cats, and at least twice a year in outdoor cats, which are especially likely to become infected with parasites.

Intestinal worms of cats usually do not cause intestinal infection in people; however, hookworm infections leading to abdominal pain and enteritis have developed in people with a weakened immune system. Roundworm larvae also have the potential to infect people; ingested larvae can wander into sensitive organs, such as the eye or into a developing fetus. Cat owners should clean all litter boxes frequently (it takes at least a week for these intestinal parasite eggs to become infective) and wash their hands thoroughly after any exposure to cat litter, feces, vomit, and other body fluids.


Cats can also become infected with protozoa, such as coccidia or Toxoplasma. These are microscopic parasites that live inside the cells of the digestive tract. Of greatest concern to cat owners is toxoplasmosis, which is transmitted directly through eggs or indirectly through infective cysts in raw meat (usually from prey animals). Toxoplasmosis usually causes only mild digestive upset in cats, but it can cause more serious illness if transmitted to people. People particularly at risk include pregnant women, young children, and those who have a weakened immune system, such as people with AIDS or those receiving chemotherapy for cancer. Ingested organisms can migrate throughout the body, causing damage to important organs (including the brain) or to a developing fetus. People at risk can prevent infection by not handling cat feces and by not eating rare or underdone meat. Cleaning cat litter should be done by someone else. All meat for consumption should be well cooked.

Other internal parasites of cats include flukes (flatworms that can infect the intestine or liver) and lungworms. Outdoor cats that hunt are prone to these infections, especially if they live or hunt near water. Aquatic animals such as snails and frogs are common hosts for the developing fluke or lungworm larvae. These infections are diagnosed by testing fecal samples.

Cats can also become infected with heartworms, which are parasites transmitted by mosquitoes. Heartworm disease is common in most of the United States. It is most commonly diagnosed with a blood test and can be prevented by administering monthly medication. There is no effective treatment for heartworm infection in cats, so prevention is critical.

External parasites of cats include fleas, ticks, mange mites, and ear mites. Monthly preventive treatments are available to control fleas and ticks and are administered as body sprays or “spot on” preparations that are placed on the skin between the shoulder blades. Mange mites can be detected by scraping the skin of infected areas for signs of mites or their eggs. Signs of mange include red, scaly areas or bald patches on the skin, or both. One type of mange called Cheyletiella is termed “walking dandruff.” This large mite causes itching along the surface of the skin, while other mange mites reside deeper inside skin layers or hair follicles. People can also become infested with the burrowing mange mites (Sarcoptes) and Cheyletiella.

Scratching, cat

Scratching, cat

Outdoor cats can also become infested with a Cuterebra larva, which is a developmental stage of a particular fly. The larvae are commonly found around rodent and rabbit holes, and they burrow under the skin of cats. This results in a large swelling under the skin, usually around the head or neck area, with a small, round breathing hole on the skin surface. Treatment consists of removing the larva and treating the resulting wound.

Dental Care

Cats need dental attention throughout their lives. You can help keep your cat’s teeth and gums in good condition by feeding dry food and following a program of professional dental cleanings performed by your veterinarian. Good dental care reduces the development of plaque which, if untreated, can progress to gingivitis and gum disease. In severe cases of dental disease, extraction is common.


Cats frequently groom themselves. Short-haired breeds usually require little brushing or bathing by their owners. Routine brushing of long-haired cats, or of cats that stop grooming because of illness, is important to remove shed hair and prevent hair mats. Brushing also limits the amount of hair that cats ingest, which helps decrease the development of hairballs. Many cats like being brushed, and grooming can be used as a reward and time of bonding. Mats should be removed with electric clippers (not scissors) to avoid cutting the skin underneath.

Your cat’s ears should be checked routinely for cleanliness. If dirt and wax build up in the ears, they can harbor organisms that may lead to infection. Your veterinarian can clean your cat’s ears safely. If cleaning is needed on a regular basis, ask your veterinarian to demonstrate how this should be done.

Healthy cats rarely need bathing. However, if bathing is required, only pet shampoos approved for use on cats should be used.

Household Hazards

Your cat must be protected from household hazards, including chemicals, pesticides, cleaning supplies, antifreeze, electrical cords, drugs, alcohol, and common house plants that may be poisonous. Curious kittens that tend to chew on almost anything are at greatest risk, and these products must be kept out of reach of all cats. Cats are especially sensitive to many medications commonly found in the average household, including aspirin, acetaminophen, ibuprofen, and cold remedies. Never give your cat any human medication unless specifically instructed by your veterinarian.

Cats and kittens should be kept away from open windows or balconies in apartments or condominiums that are multiple floors above the ground. Although agile and often able to right themselves in mid air, cats can still sustain serious injuries if they fall from a great height.


All cats should be spayed (females) or neutered (males) unless they are to be used for breeding. This prevents unwanted kittens and avoids potentially serious future medical problems, such as uterine cancer or infection. Spaying or neutering also decreases the urge to wander outside, which can result in car accidents, fights, and other injuries. Neutered male cats are also much less likely to spray urine to mark their territory. The spay or neuter procedure is usually done when cats are about 6 to 7 months old.

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