What is a cat? What characteristics are different for this species than we are or dogs are? Only by better understanding our
patients can we provide better nursing care. Working with a species that has not evolved with a social structure similar to
ours provides interesting challenges to the practitioner of veterinary science working with cats. Cats are able to function
completely efficiently as a solitary creature. Cats do have complex and changing social interactions which make for a changing structure, much more intricate than that of a herd
or pack species. Cats are also small predators. This has affected their anatomic and physiologic development, which has remained
unchanged over several million years. While being predators, their size also makes them prey to other species. This aspect
affects how they respond to us in a clinic setting and deserves to be discussed further in this presentation.
Relying on the "fight or flight" or epinephrine response, they escape situations viewed as dangerous. From the perspective
of a cat, we are, and what we do is, dangerous. Accordingly, one of the great challenges we see on a daily basis is the frightened
and assertive cat. It is essential to remember at all times that this small creature feels more threatened than we do so that
we do not become frightened ourselves. Because cats are small, they try to avoid physical confrontation at all costs and attempt
to intimidate using sounds and posture as much as possible.
1. Handling the uncooperative cat: a comprehensive physical examination can usually be done using a towel as a protective
barrier. Facing the cat away from you is less threatening for him/her. Confining the cat between your legs as you sit on the
floor provides adequate persistent firm restraint that is reassuring rather than frightening.
2. Collection of blood and urine can be done by bundling a difficult cat's forelimbs, torso and head in a towel and using
the medial saphenous vein and a lateral approach for cystocentesis. This vein is also a superb choice for catheter placement
and administration of intravenous medications.
3. Blood pressure evaluation may also be done recognizing that a persistently elevated systolic value of greater than 170 or 180 mm Hg is probably represents true hypertension rather than the stress
response. If in doubt, repeat the value later on during the visit.
4. Elevated blood glucose and glucosuria may be a result of persistent stress. The diagnosis of diabetes, therefore, is dependent
on finding and elevated serum fructosamine or glycated hemoglobin.
Being largely self-dependent, cats mask illness and pain extremely well. The signals of problems are often subtle. Listening
carefully to clients when interviewing them for the history and their concerns is extremely important. Often clients detect
changes intuitively that represent real problems. This is more common, in the author's experience, than the client who is
blissfully unaware of significant health problems. By asking open-ended questions, one elicits a more detailed history than
using only specific questions. For example: starting with: "Have you noticed any changes in the contents of the litter box?",
results in a yes/no answer. Asking: "What does his stool look like?" Provides a useful answer.
One simple technique for detecting subtle changes is measuring body weight at every visit and calculating the percentage change
in body weight. By 12–15 months of age, a cat should reach their adult weight. By noting slight changes in weight, either
increases or decreases, one can follow trends and hopefully avert significant problems such as lipidosis or obesity and detect
malabsorption of nutrients or catabolism of cancer in the earlier stages. % change = previous weight – current weight previous
weight
Monitoring body weight in hospitalized cats is invaluable in helping to assess the success of rehydration efforts as well
as the adequacy of feeding. Weight gain in the face of fluid therapy without voiding could be an indicator of third space
fluid accumulation. Thus, cats in clinic on IV fluids should be weighed at least twice a day; cats boarding or otherwise in
the hospital should be weighed daily. The "grumpy" cat can be weighed in towel and, by subtracting the weight of the towel,
we get the body weight with being minimally intrusive. Other uses for scales are to evaluate volume of urine produced by knowing
the weight of the unused litter box and comparing it to the used box; a postage scale may be used to determine volume of blood
in surgical swabs.