How to get the most from the feline physical examination – Lessons learned from cats (Proceedings)
Cats are masters at hiding illness, so that clinicians must become expert at uncovering illness with a thorough medical history and feline-specific physical examination. Obtaining a medical history is easier than ever in today's electronic world. Clinicians can take advantage of multimedia tools to collect information, ranging from an email containing a basic signalment to videos of a particular behavior. The value of designing questionnaires that are tailored to specific needs, such as a wellness exam for a geriatric cat or an examination of a sick cat, is well established. These questionnaires can be supplied to the client to fill out in advance of an appointment, thereby saving time and improving collection of detailed data. These questionnaires are especially valuable when the owner cannot be present for the appointment (e.g., "drop-offs").
Medical history taking is an art and a learned skill. The process of taking a history should be consistent and comprehensive, but adaptable. The best responses from owners come from open-ended questions, rather than questions that elicit a simple "yes" or "no" (e.g., "How has Fluffy been doing since the last visit?"). The clinician should repeat key information relayed by the client to ensure accuracy and demonstrate attention to detail and a caring attitude. It can be very helpful to collect videos of common medically related behaviors (such as a coughing cat or a female in estrus) to show owners when they are unsure how to describe their cat's behavior. In turn, most owners can readily make short videos of behaviors that occur at home and either post the video to an internet site or email it to the clinician for viewing.
Communication styles vary by age group, and are influenced by other factors. Some elderly owners will require more time and a sympathetic listening style to relay their concerns. An abbreviated and more focused set of interview questions may be more effective in eliciting necessary information. For many cat owners, it is helpful to encourage them to write down questions in advance. Younger cat owners readily utilize social media and will be more comfortable using familiar communication methods, such as email and internet tools. At the end of the history and physical examination, the owner should be encouraged to ask more questions with an open and inviting query, such as "What questions do you have for me?" If the patient has complicated problems, it may be more productive to invite the owner to ask questions periodically during the interview and examination, rather than at the end.A basic part of the medical history is the signalment (i.e., age, breed, gender, reproductive status). Categorizing feline patients by life stage helps the clinician focus on specific wellness, behavior and disease concerns. The AAFP-AAHA Feline Life Stage Guidelines recommend the following categories and detail the concerns associated with each:1
• Kitten: up to 6 months of age
• Junior: 7 months to 2 years
• Adult/Prime: 3 to 6 years
• Mature: 7 to 10 years
• Senior: 11 to 14 years
• Geriatric: 15 years and older