Low-Stress Handling Plan for Fearful, Aggressive Cats

This handling plan is for cats that have already been identified as needing sedation for examinations, diagnostics, and treatment. These patients have already shown warning signs of an imminent cat bite: 

• Sudden dilation of pupils

• Piloerection

• Fast, jerky swishing of tail

• Swatting with paws

• Vocalization (eg, yowling, shrieking, spitting)

• Direct eye contact coupled with open mouth vocalizations

Patients displaying these behaviors can harm the veterinary team if immediately removed from the carrier. In addition, the patient’s experience will be much more stressful if his or her only sense of protection (ie, the carrier) is taken away. 

When handling fearfully aggressive patients, remember that these cats are not mean, bad, or evil. Empathy is key for supporting stressed patients and their owners. Owners of fearful cats are often just as stressed as their cats, and they frequently do not bring their cat to the practice until it is too late to put a preventive plan in place.

Handling Plan 

To minimize the patient’s stress and maximize the safety of team members, use the following tips for sedating with protective contact. Remember that sedation doses may need to be adjusted based on the individual patient’s arousal level and illness severity.

1. Prepare at home. 

Coach the owners to help the cat feel more comfortable in the carrier and in the car. Remember that stress before the patient arrives is a big factor in his or her behavior in the examination room.

Ask the owner to get a mesh carrier that has ample mesh on all sides and can open from both ends as well as the top. The carrier should be somewhat compressible and should not be overly large compared with the cat. If the carrier is much bigger than the cat, ask the client to spray a rolled towel with Feliway and place it in the carrier to keep the cat on one side of the carrier, close to the mesh. Feliway may also be used when transferring the cat to the car; have the client spray a towel with Feliway and cover the carrier for the duration of the ride to the practice.

If the owners are able to medicate the cat, and medication is appropriate for that particular patient, have the client give premedication (eg, 50-100 mg gabapentin) at home. Have the client administer a test dose at home to see how the cat responds and to determine whether a higher dose is needed before the visit.

2. Prepare the practice environment. 

Consider the following steps when preparing for the patient’s arrival. 

• Prepare a quiet examination room that can be darkened.

• Have classical music playing softly in the background.

• Ensure all sedation medications and supplies needed for the examination are ready.

When the appointment time comes, meet the owner and patient at the car or the front door. Escort them directly to the examination room to avoid lobby time, which will make these patients more fearful. Ask the clients to remain in the examination room to provide extra social support for their cat until he or she is fully sedated.

3. Execute the plan.

Have the owner place the still-covered carrier on the examination table. The veterinary nurse can then pull the carrier to him or her and compresses it so the cat is squeezed against the mesh on the opposite side. A towel can be used to protect the veterinary nurse, if needed.

The intramuscular (IM) injection is quickly delivered through the mesh. This does take some practice to be able to inject quickly and efficiently through the mesh, so consider practicing on a stuffed animal first. Be sure to use a luer lock syringe to avoid losing the drug.

Once the injection has been administered, cover the carrier, turn down the lights, make sure calming music is playing, and give the patient adequate time to become sedate.

After the patient is adequately sedate, complete the examination, diagnostics, and treatment. The patient may then be returned to the carrier, where sedation can be reversed and the cat can recover.

4. Chart everything.

Remember to keep track of the following items.

• The patient’s likes/dislikes

• The patient’s behavior triggers

• Drugs and dosages used

• What went well

• Recommendations for the next visit