September 2022

In this VETgirl online veterinary continuing education blog sponsored by Royal Canin, Dr. Ilona Rodan, DVM, DABVP (Feline Medicine) will review how veterinary professionals should interact with our feline patients during veterinary visits in our clinic!

Please note the opinions in this blog are the expressed opinion of the author and not directly endorsed by VETgirl.

How to interact with the cat during the veterinary visit

By Dr. Ilona Rodan, DVM, DABVP (Feline Medicine)

Have you ever been bitten or scratched by a cat during your veterinary career? I assume the vast majority of you, if not all, have. But it doesn’t have to be this way and you have the power to prevent injuries or vastly reduce them in the veterinary practice. Recent evidence proves how best to interact with cats. In November of this year, updated evidence-based guidelines on feline veterinary interactions will be published by the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine, further increasing feline welfare and human safety during veterinary visits. This blog will provide you with a preview of some of the tips. Stay tuned for more information in November.

Partnering with owners
A critical step is to recognize that the cat’s distress starts at home with the carrier, the client’s stress, and transport. Pain, illness, changes within the home, intercat tensions and other issues further affect the cat’s emotional state and behavioral responses at the practice. Stressors are stacking up for the cat well before they reach us! To reduce these stressors, invite caregivers to be partners in their cat’s healthcare team, making veterinary visits easier on their cat, caregivers, and us!

Educate veterinary team members and clients about the benefits of carrier training. This one step reduces stress during transport, increases positive emotions demonstrated by increased searching for food rewards during the veterinary visit, and significantly shortened examination times.(1,2) Carrier training uses positive reinforcement so that cats learn to enter the carrier voluntarily at home, enhancing feline welfare.(1,2) Start with a plan in your practice to educate clients to carrier train their cats. You can send them to your website, develop your own handout, or add links to the AAFP website, www.catvets.com, and/or the AAFP owner website, www.catfriendlyhomes. Don’t forget to explain the benefits and that it is the cat’s choice to enter the carrier. Most of the time, it is simple to carrier train cats – place and keep an opened carrier with a soft blanket for bedding in a room the cat likes to spend time in. Toss or place the cat’s preferred treats toward and into the carrier, with closer approximations to the carrier over a few days and usually not more than 2 weeks. Positively reinforce as the cat gets closer to and subsequently enters the carrier. Patience is important as it is the cat’s choice to move closer to and then to enter the carrier. Some cats may need more gradual steps, but most do well with this approach.

Think also about which cats would benefit from gabapentin given as an anti-anxiety medication. May practices are using it now, but it helps to know the peak effect is 2-3 hours prior to stressors.(3,4) It also works best if given at home. Educate clients to give the anxiolytic prior to the first stressor associated with the visit. Another important tip is to prescribe buprenorphine transmucosally to be given at home to existing patients with degenerative joint disease or other chronic pain and in addition to the chronic pain management to prevent exacerbation of pain associated with the visit.

Understanding cats as a species and individuals
As solitary hunters and survivors, cats need a sense of control, safety, and choice. Hiding is an important coping strategy, especially in an environment that cats perceive to be unfamiliar or threatening.(5-8) Good options are the bottom half of the carrier, a high-sided cat bed, a small pet scale with sides, or loose towels or blankets, both for outpatients and cats remaining at the practice. Let the cat choose where it prefers to hide. Confident cats may instead choose to perch to monitor the environment. If not fearful or showing other protective emotions, cats benefit from favored treats. Ask owners to bring their favorites, and keep a variety of treats in stock, including lickable treats.

Why are some cats so easy to work with while others are not? Their resilience or ability to cope is based on genetics, what he or she learned from the queen, and previous experiences, especially during 2-7 weeks of age. The cat’s sociability to humans and other species depends on these and other life experiences. Kittens that don’t have positive experiences with a variety of people between 2-7 weeks of age are more fearful during veterinary visits.(9) Also, even one negative experience during a veterinary visit can cause a cat to be highly reactive during future veterinary visits and even at home!(10,11)

Non-physical interactions first
As we begin our physical examination from a distance, also assess the cat’s emotional state and behavioral responses before starting physical interactions. Pain is an emotion as well as a physical condition and we can start our pain assessment before every touching the cat. We can also assess whether the cat is curious or calm, whether fearful or demonstrating other protective emotions. Depending on this assessment, develop the best plan for this individual cat.

“Slow blink” in their direction (12) without direct eye contact or towering over the cat. Get down to their level and extend a soft hand in the cat’s direction. It’s always best if the cat approaches you, as human-feline interactions are of longer duration when they have the choice to approach a person and shorter when a person approaches them.(13) Never corner the cat. Use treats or toys to distract and/or reinforce engaging behavior. Place treats near where the cat is (e.g., in front of the carrier) rather than asking the cat to eat them from your hand.

Physical interactions
Cats have preferred areas for touch, especially over the facial glands, which produce the facial pheromones that are used in facial rubbing and marking.(14,15) These are the temporal gland (between ears and eyes where fur is often thinner), the cheek glands, around the corners of the mouth, and the submandibular or chin area.(15) Pet or massage over these areas in the fur’s direction for a short period, then assess the cat’s response. If positive, continue. Avoid touch over the base of the tail and belly.

Examine the cat in the location he or she prefers. Examination and even some procedures can be performed in the bottom half of the carrier or other hiding option. Evidence proves that cats struggle less and examinations take a shorter length of time if cats have the choice to sit, stand, or lay down, and move around when compared to tight restraint (holding limbs in lateral position). (11) Cats also do better in the preferred positions when compared to scruffing and clipnosis.(17) In fact, the only equipment needed to interact with a cat are hiding options and loose towels or blankets placed around the cat!

Prevent injury, increased protective emotions, and future unpleasant visit
Plan on what to do if you cannot safely handle a cat – this is not just for you, but also the cat! Options are sedation for ill cats or if clients won’t reschedule the appointment, waiting 1-2 hours to see if the cat calms down, or rescheduling the appointment, educating clients about carrier training, and prescribing gabapentin to give pre-visits. Prevention of protective emotions must extend to the caregiver and the overall care continuum. Once daily or less frequent administration when appropriate is ideal, and gel caps can be used to combine medications. Giving medication in treats reduces patient and caregiver stress, enhancing the human-animal bond. Royal Canin Feline Pill Assist are highly palatable and well accepted pill wraps. For cats that refuse pill wraps, recommend rewarding cats after administering medications with a lickable treat.

References:
1. Pratsch L, Mohr N, Palme R, et al. Carrier training cats reduces stress on transport to a veterinary practice. Appl Anim Behav Sci 2018; 206: 64–74.
2. Gruen ME, Thomson AE, Clary GP, et al. Conditioning laboratory cats to handling and transport. Lab Anim (NY) 2013; 42: 385–389.
3. van Haaften K, Forsythe L, Stelow E, et al. Effects of a single preappointment dose of Gabapentin on signs of stress in Cats during transportation and veterinary examination. Javma; 251.
4. Pankratz KE, Ferris KK, Griffith EH, et al. Use of single-dose oral gabapentin to attenuate fear responses in cage-trap confined community cats: a double-blind, placebo-controlled field trial. J Feline Med Surg 2018; 20: 535–543.
5. Carlstead K, Brown JL, Strawn W. Behavioral and physiological correlates of stress in laboratory cats. Appl Anim Behav Sci 1993; 38: 143–158.
6. Kry K, Casey R. The effect of hiding enrichment on stress levels and behaviour of domestic cats (Felis sylvestris catus) in a shelter setting and the implications for adoption potential. Anim Welf 2007; 16: 375–383.
7. Vinke CM, Godijn LM, van der Leij WJR. Will a hiding box provide stress reduction for shelter cats? Appl Anim Behav Sci 2014; 160: 86–93.
8. Ellis JJ, Stryhn H, Spears J, et al. Environmental enrichment choices of shelter cats. Behav Processes 2017; 141: 291–296.
9. McCune S. The impact of paternity and early socialisation on the development of cats’ behaviour to people and novel objects. Appl Anim Behav Sci 1995; 45: 109–124.
10. Lloyd JKF. Minimising stress for patients in the veterinary hospital: Why it is important and what can be done about it. Vet Sci; 4.
11. Turner DC. The Mechanics of Social Interactions Between Cats and Their Owners. Front Vet Sci 2021; 8: 1–6.
12. Humphrey T, Proops L, Forman J, et al. The role of cat eye narrowing movements in cat–human communication. Sci Rep 2020; 10: 1–8.
13. Turner DC, Stammbach-Geering K. Owner assistment and the ethology of human-cat relationships. In: Pets, Benefits and Practice. 1990, pp. 25–30.
14. Soennichsen S, Chamove AS. Responses of cats to petting by humans. Anthrozoos 2002; 15: 258–265.
15. Ellis SLH, Thompson H, Guijarro C, et al. The influence of body region, handler familiarity and order of region handled on the domestic cat’s response to being stroked. Appl Anim Behav Sci 2015; 173: 60–67.
16. Moody CM, Picketts VA, Mason GJ, Dewey CE, Niel L. Can you handle it? Validating negative responses to restraint in cats. Appl Anim Behav Sci. (2018) 204:94–100. 10.1016/j.applanim.2018.04.012
17. Moody CM, Mason GJ, Dewey CE, et al. Getting a grip: cats respond negatively to scruffing and clips. Vet Rec.

Today’s VETgirl blog is sponsored by Royal Canin. Recommend multifunction Royal Canin Urinary SO® + Calm complete and balanced adult cat food to help support a healthy urinary tract while providing calming nutrients for cats facing stress. Learn more at my.royalcanin.com.

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  1. Great read ! Did not know Gabapentin could be used as an anxiolytic to make the veterniary expierence more stress free for the cat. Will definitely keep this blog post in mind when handling cats and interacting with their owners in the future.

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