Get cattitude! Practice tips to make your practice cat friendly (Proceedings)

Aug 01, 2011

What/who is a cat? Introduction

What characteristics make this species different from us or from dogs? By understanding our feline patients better, we can provide a better experience and environment for them. The basis of working cooperatively with cats is empathy based on an understanding of their nature and behaviours and trying to imagine what their experience is like. We are taught a lot about how to perform techniques, how to make a diagnosis and what therapies are appropriate, but oftentimes this objectifies the patient. Our own experiences as a patient in the human health care system hopefully include caring and competent professionals but may also include feeling less than cherished as unique individuals. Do we feel cared for or merely "processed" in a professional and polite manner? Is the person interacting with you truly empathic or only sympathetic? Are WE processing our patients, checking them off in our minds or on the day sheet as we "complete" the procedure or office call? And what about the environment? Are hospital gowns and paper covered examination beds designed for our comfort or for the healthcare team? Are stainless steel cages and tables designed for the comfort of our patients or for ease of disinfection, height and durability?

Working with a species that has not evolved with a social structure similar to ours provides interesting challenges to the veterinary practitioner when 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. While cats can live alone or as part of a community, the allocation of space is based on resource availability. And even with plenty of prey available, cats hunt alone and eat alone. For us to work with cats in a way that they feel secure and are willing to cooperate with, we have to try to imagine what it is like to be a cat. In these presentations, we will try to look at cats in a different way and think about how to adjust our interactions and the physical space to reduce the strangeness and threat that cats appear to experience in the veterinary clinic.

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. Some examples of practical applications of what we will discuss include:
     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. Feliway, a synthetic analog of a facial pheromone produced by cats has, in general, a calming effect on cats. Spray it into kennels and carriers and even on your clothing before handling an anxious cat. Let the substance evaporate for a few minutes before placing kitty into the sprayed space. Plugging the diffuser form of Feliway into treatment and hospitalization areas as well as reception and consultation rooms can help patients relax.
     5. 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.