Low-Stress Patient-Centric Practices: Cats

Part 2 of 2-part series

A visit to the veterinary practice can be unpleasant or even traumatic for many cats, who often become upset, distressed, and difficult to handle. Clients whose cats are difficult may hesitate to take them to the veterinarian during the early stages of a medical problem and the problem worsens. Practices should ensure every cat has the least stressful experience possible and gets the medical care needed, while helping veterinary team members stay safe.

At Home

Making the veterinary visit low stress begins at home when the owner tries to put the cat into the carrier. Give clients the following tips:

• Bring out the carrier about 2 weeks before the appointment, rather than the day of the visit, and frequently leave treats inside. Cats may habituate to the presence of a carrier that is left where they often spend time.

• If the cat will not enter the carrier voluntarily, spread out a small sheet where the cat rests; to get the cat into the carrier, bring the sheet corners and sides together, creating a bag, and put the cat in the carrier wrapped in the sheet.

Waiting Room

If possible, keep cats and dogs apart by providing separate waiting areas or using a visual barrier or screen so cats are not directly exposed to any dogs. As with owners of anxious dogs, the client care team can suggest the client and cat wait in the car, provided the cat is not in critical condition, until a team member lets the client know an examination room is ready. Covering the carrier with towels sprayed with pheromones may help reduce the cat’s stress because the cover eliminates the visual stimuli and the pheromones may have a calming effect.^1-3

Examination Room

The examination room can be the most stressful part of the practice visit, so always treat cats where they are most comfortable. Consider these tips:

• Allow a calm cat to leave the carrier on his or her own. 

• Avoid tipping the cat out of the carrier.

• Unscrew and remove the top of the carrier, and if possible, examine the cat in the bottom half to minimize stress (ie, handling/restraining is reduced, cats may feel more comfortable in a partially enclosed area). 

• If the cat needs to be examined on the table, a yoga mat or blanket may make him or her feel more comfortable and secure.

• Use tables with built-in scales, which are the least stressful way to weigh cats; however, if these are not available, infant scales are a good option because they can be brought into the examination room and the cat is moved around less. If using a floor scale or the waiting room scale, weigh the cat in the carrier before entering the examination room, weigh the empty carrier once the cat is out, and calculate the cat’s weight by subtracting the weight of the empty carrier from the total weight. Remember to also weigh any material in the carrier (eg, pad, sheet, blanket). Write the empty weight on the carrier to have a permanent record.

• Use pheromone sprays or diffusers in examination rooms. Sprays should be used in advance to allow the alcohol in the spray to evaporate. Classical music may help set a calming tone.⁴

• If possible, reserve an examination room for cats only.

• If medically acceptable, offer high-value treats (eg, canned tuna, dried fish, canned cat food, chicken or turkey baby food) to help distract or desensitize the cat and create a positive association with the veterinary visit. Always confirm first with the client that the cat has no food sensitivities.

• Consider omitting the more stressful parts of the examination (eg, rectal temperature) if a cat appears tense or anxious. (See Signs of Stress.) Covering the cat’s head with a towel or wrapping him or her in a towel can provide gentle restraint. 

• Move slowly and calmly. Some cats may do better if the examination is performed from behind. If the cat has a known painful area, examine that part last. Any sign of stress suggests the time and method of the examination should be reevaluated.

• To make injections less painful, use a fresh needle after loading the vaccine or medication into a syringe because the original needle will be dulled by going through the stopper and may cause more pain.

• Consider muzzles, which can help keep the veterinary team safe, but remember they can be stressful for cats because they obstruct vision and prevent cats from defending themselves. Some cats may become defensively aggressive at a future visit as a result. If possible, sedating the cat on a future visit may be preferable to a muzzle.

• If continuing the examination safely seems impossible, talk to the client about continuing another day. Suggest using nutritional supplements and diets with calming ingredients (eg, l-theanine, α-casozepine)^5-7 and/or pharmaceuticals (eg, gabapentin, trazodone, lorazepam)⁸ at home to decrease the cat’s stress before the next visit. Returning another day is always preferable but not always possible. If returning is not an option, injectable sedatives may be indicated, although ideally the cat should be fasted if sedation is used.

Leaving the Practice

Ensure a low-stress departure for the cat with these recommendations:

• Put a carrier that was taken apart back together before letting the cat walk into it.

• If the cat is still in the carrier, cover him or her with a lightweight towel before replacing the top half, which will make the experience less frightening for the cat.

• If dogs are present in the checkout area when the client is paying the bill, he or she can:

• Leave the cat in the carrier in the examination room. 

• Place the carrier on a table out of any dog’s reach.

• Return the cat in the carrier to the air-conditioned or heated car.

Conclusion

Keeping a veterinary visit low stress will help make cats less difficult when they return to the practice, build the client–patient–veterinary team bond, and help keep the veterinary team safe.