While the population of cats kept as pets in the United States increases, feline visits to the veterinarian are decreasing. According to the 2014 Bayer Care and Usage Study, 80% of the growth potential for veterinarians is in feline care. Unfortunately the majority of cat owners who participated in that survey stated that they felt that veterinary visits were stressful for their cats. In addition, cat owners are stressed themselves. There are ways to make veterinary practices more feline friendly. It is better for the cats, for owners and for the veterinary team.
The veterinary visit starts with the ride to the veterinary hospital. The owner’s choice of carrier is integral in cat’s acceptance of the carrier and the veterinary visit. The owner should choose a carrier with an inflexible floor so that the cat feels secure. Some cats prefer to hide. The owner should be encouraged to bring a large towel to cover the carrier. Carriers should have an opening in the top and the front. In addition, the carrier must be able to taken apart easily. Dumping a cat who is hanging on for dear life out of a carrier to start the veterinary exam sets a negative tone for the visit. The Catit and Sleepypod carriers are good choices. In the case of the Catit carrier where there are lots of opportunities for the cat to see out of the carrier, it is imperative to have a carrier cover.
Because stress at any point in the veterinary visit including in transit from home to the clinic predicts stress at every other point in the visit, the first step in making your practice more feline friendly is changing the way that your feline patients feel about the cat carrier. Unlike dogs, cats do not have positive experiences with travel and exposure to new environments. The only time that most cats leave the house is when they are going to the veterinarian’s office. Through classical conditioning, the cat carrier is paired with negative experiences repeatedly until even the sight of the carrier causes the cat to be fearful.
Ideally, carrier conditioning should be discussed at kitten appointments with handouts sent home to increase compliance. In kittens and older cats, the following points should be emphasized:
1. Leave the carrier out in the cat’s core area.
2. Make the carrier positive and encourage discovery by placing special toys and treats in the carrier or feeding the cat in the carrier.
3. Take the cat on occasional short rides in the carrier while encouraging a positive emotional state with delicious foods.
4. Leave a bed in the carrier.
5. Put the carrier in the type of location (on the couch, on the floor) where the cat prefers to relax.
If the cat already has a negative conditioned emotional response (CER) to the carrier, desensitization and counterconditioning will be necessary to completely change his emotional state. Desensitization and counterconditioning is a process by which the cat is slowly exposed to the stimulus (the carrier) while using a positive stimulus (food) to change the cat’s emotional state. More information on ideal cat carrier characteristics and carrier conditioning can be found at catalystcouncil.org.
Feliway has been shown to decrease stress in cats at the time of catheter placement (Kronen et al.), during hospitalization/boarding (Griffith et al.) and during examinations. Technicians and doctors can use Feliway spray on themselves, mats, blankets and towels. Diffusers can be used in the waiting room, exam room and hospitalization area. Instruct owners to spray Feliway in their cat’s carrier about 30 minutes prior to departure for the veterinary hospital to help relax the cat. For best effects with the spray, leave 20–30 minutes between application and cat exposure.
Olfactory and Auditory Environments
Sounds and smells are potent memory evoking stimuli. In addition, noxious smells and frightening sounds can cause a fear response. For those reasons, try to keep the areas where patients are housed, quiet or use classical music or white noise to drown out the sounds of the hospital. In addition, use no scent or low scent disinfectants and use positive odors such as lavender and chamomile.
The waiting room can be stressful for the cat and the owner. If possible, keep cats separated from dogs. If this is not possible, consider asking the owner to cover her cat’s carrier, put it under her chair or on her lap. Alternatively, ask her to step away from a nearby dog. If a room is available, even if the veterinarian is not ready to see the patient, consider moving the cat into a quiet room. Towels infused with pheromones can be available as well for clients who didn’t bring a carrier cover.
Whenever possible, let the cat come out of the carrier to explore the room before the examination starts because it is much less stressful for the cat to leave the carrier of his own accord than to be removed. This will also allow the veterinarian to assess the cat’s gait, respiratory rate and other grossly observable physiologic and physical parameters. The use of toys can be helpful in gait assessment as well. Instead of trying to make friends with the cat, let the cat come to you if possible while your talk to the client.
Catnip and treats can be helpful in making the examination go more smoothly by lowering the stress level of the patient. While many cats won’t eat during physical examinations some will when presented with the “right” foods. The veterinary team should be experimental and think outside the box. At our hospital cats have eaten beef liver dog treats, chicken dog treats, cheese treats and Easy Cheese. The sounds of the hospital can be suppressed by using white noise or playing classical music in the exam room.
Think of alternative places to examine the cat such as within the carrier with the carrier top removed, on a bench or on your lap. I generally recommend that the examination start from the rear instead of the front with food offered throughout. If the cat can only be examined on a table, cover the table with a non-skid mat with something that smells like the cat or the owner on top of the mat. This way, the cat has a soft surface and will not slip on the table. If medically appropriate, save the rectal temperature for last.
Whenever medically appropriate group treatments for feline boarders or inpatients to reduce handling and schedule changes which have both been shown to increase stress in cats. Cats should have a hiding spot, fleece beds and if possible shelves inside of the hospitalization or boarding cage. As mentioned above, Feliway can be useful in these situations as well having been shown to increase grooming and food intake in hospitalized cats when compared with the control group. Try to place cats in higher cages as long as it is safe for the veterinary team to remove them. This may help cats to feel less stressed as height seeking along with hiding are very common feline coping tools. Try to avoid placing cats in area where they will viewing other animals. Tailor the management of cats to their preferences. Some cats appear to be entertained by the goings on in the waiting room as long as they are safe behind glass. This can be used as enrichment for boarders. Make sure that cats can get away with a hiding spot. Towels can be an excellent way to remove fearfully aggressive cats out of the cage.
The days where cats “had” to be scruffed to collect blood are long gone. When drawing lab samples, consider using towels, non-skid mats and burrito wraps. Collection of lab samples can be done on the technician’s lap as well. To avoid artificial increases in blood pressure and blood glucose, draw samples and complete diagnostics in the examination room with the owner present whenever possible. More information can be found on catprofessional.com (VIN editor: Link not accessible 1/12/18), catalystcouncil.org and in the text Low Stress Handling and Restraint (Yin).