Numerous studies have been conducted in an attempt to understand the characteristics of animals at risk of being brought to an animal shelter as well as the characteristics of owners who relinquish their pets and their reasons for doing so (Miller et al. 1996; Patronek et al. 1996; Salman et al. 1998; New et al. 1999; Scarlett et al. 1999; New et al. 2000; Salman et al. 2000; Kass et al. 2001; Shore et al. 2003; Casey et al. 2009). Reasons for relinquishment reported in the literature cover a variety of personal and animal factors These include moving, the landlord not allowing a pet, too many animals in the household or inadequate facilities, personal problems, the cost of pet maintenance, and unrealistic or unmet expectations regarding the pet’s behavior or needs. An allergic family member, house soiling, and incompatibility with other pets in the home were also frequently cited reasons for cats (Salman et al. 1998). In one study, nearly half of owners did not plan to acquire the cat they eventually relinquished to an animal shelter (Miller et al. 1996). Please refer Chapter 3 for more detailed information on relinquishment.

Various risk factors for relinquishment of cats to animal shelters have also been reported. These include potentially modifiable factors such as being intact, being kept outdoors, and the cat not meeting the owner’s expectations as to its role in the household, inappropriate care expectations, and a lack of knowledge of cat behavior (Patronek et al. 1996). A history of living in a home with one or more other pets, regardless of species, was strikingly associated with an increase in relinquishment for behavioral reasons; 71% of cats relinquished solely for behavioral reasons compared to 45% of cats relinquished for reasons other than behavioral reasons had previously lived in a home with another pet (Salman et al. 2000). Although younger cats have been reported to be at greater risk for relinquishment in some studies, others have found that cats were typically owned for 1–2 years. This longer time period may give shelters a greater opportunity to intervene and keep that pet in the home.

Behavioral problems are among the most common reasons for cats to be relinquished to shelters by their owners. In one study, more than a quarter of owners relinquishing cats indicated at least one behavioral problem as the reason: at least one behavioral reason was indicated for 28% of cats relinquished and was the sole reason for 19% of single-reason feline relinquishments (Salman et al. 2000). Another study found that 18% of cats presented to shelters for euthanasia (rather than adoption) were relinquished specifically for a behavioral problem, most commonly inappropriate elimination or aggression (Kass et al. 2001). The most common behavioral problems reported in cats relinquished to shelters for adoption appear to be similar across studies and include house soiling or inappropriate elimination, aggression towards humans, destructive behavior such as scratching the furniture, fearfulness, and problematic interactions with other pets in the home (Miller et al. 1996; Salman et al. 2000). Lower rates of relinquishment for behavioral reasons have been reported in the UK but for similar problems (Casey et al. 2009). The reader is directed to Chapter 3 for a more detailed discussion regarding behavioral problems and relinquishment.

Gathering information: questionnaires and interviews

A minimum database of information must be obtained for every animal entering a shelter and included as part of the animal’s individual record. This includes information about the circumstances under which the animal arrived at the shelter, specific animal characteristics, medical and behavioral examinations, treatments and procedures, and information about the disposition of the animal. Specific requirements are prescribed by state and local laws but usually represent an absolute minimum of information that must be recorded. A signed release form should be obtained from every person bringing an animal to the shelter. This should include the date of intake, the name and contact information for the person bringing the animal(s) to the shelter, and a basic description and identifier for each animal. When possible, identification verifying the individual’s identity should be obtained. Wording in the release form must include a statement that the person signing is the legal owner or authorized agent, and that the individual is waiving all rights to ownership or that the animal has been found as a stray and is being turned over to the shelter, thereby allowing the organization to make decisions regarding care and eventual outcome. For reasons of rabies control, the person should be asked to indicate whether or not the animal has bitten a person or other animal within the last 10 days. Many shelters also include a waiver of liability and hold harmless clause in the same document. Sample forms have been published (AHA 2010) and some software packages designed for animal shelters generate templates. It is strongly recommended that an attorney review these documents whether an organization is utilizing an existing template or developing their own.

In addition to the aforementioned, information on the cat’s history, including medical and behavioral observations and concerns, should be obtained at the time of intake for every cat. Past behavior is generally the best predictor of future behavior. As such, a cat’s behavior in their previous home may provide important clues as to how they are likely to behave in a new home. The history and observations can also be helpful in the timely identification of more subtle underlying health problems. While this historical information is often requested of owners relinquishing their pets, it should also be requested for stray animals as well as those returned from foster homes. Although it may be limited compared to what information an owner of several years duration could provide, this information is extremely important to obtain and can greatly assist the shelter in identifying and providing appropriate animal care that meets the individual cat’s needs.

Most individuals bringing a stray cat or kitten(s) to an animal shelter will be able to provide at least some basic information regarding health and behavior. In many instances, the finder will have spent some time interacting with the cat and may have taken it into his home for a period of days or even weeks before bringing the cat to the shelter. Even a person who has only spent a few hours with the cat has a greater insight than the shelter does and may be able to provide information on the cat’s appetite and dietary preferences, activity level, and response to handling. They may also have information regarding the cat’s health and behavior in a variety of contexts that may be impossible to obtain from in-shelter observations or behavioral assessments. For example, the finder may have observed the cat in the neighborhood for a period of time before capturing and bringing the animal to the shelter or may have brought the cat into their home for a period of time. These observations provide invaluable insight into the cat’s behavior with strangers and, if they were present in the household, their interactions with children and other pets. Regardless of source, this previous history provides important information necessary to provide appropriate care that meets the animal’s needs. There is some concern that the information obtained from intake questionnaires may be inaccurate or misleading, particularly as it pertains to a pet’s behavior in the home. This may be a result of misinterpretation or unintentional mischaracterization of a cat’s behavior by the former owner. Many individuals do not have a thorough understanding of feline body language and behavior, and this may be more likely among those people relinquishing their cat(s) to an animal shelter. For example, individuals surrendering a cat were more likely to have a knowledge deficit regarding certain aspects of cat behavior and to believe that cats misbehave out of spite (New et al. 2000). Refer to the section “Behavioral interventions and resources” in Chapter 3 for more information.

Inaccurate or misleading histories may also result from the intentional withholding of information by the owner about problematic or undesirable behaviors in an attempt to increase the chances that their pet will be made available for adoption and rehomed. There is limited evidence that this phenomenon does occur amongst individuals relinquishing dogs with significant behavior concerns such as owner directed aggression. A study was conducted to evaluate the truthfulness of information provided by owners relinquishing a dog. Investigators found that people who were told that the information would be kept confidential and not used for adoption purposes were significantly more likely to report some types of aggression, certain fears, or separation-related behaviors than people who were told that information would be shared and used in the decision-making process (Segurson et al. 2005). This was observed for owner-directed and dog-directed aggression as well as for stranger-directed and nonsocial fear. Interestingly, there was no difference in the reporting of stranger-directed aggression between the two groups, which may be because stranger-directed aggression was not perceived by owners as a negative behavior and may even be desirable to some individuals.

Thus it does appear that relinquishers may be less than truthful about moderate to severe intensity concerning behaviors exhibited by the pet in their home if they believe it could have a negative impact on the adoptability of that animal. It is unknown whether owners also withhold information that they perceive may negatively influence their cat’s likelihood of adoption but it is reasonable to assume that human behavior is likely to be similar regardless of the type of animal being relinquished. As such, the information obtained from such questionnaires should not be discounted but instead must be carefully evaluated.

It is important to realize that information obtained at the time of intake may differ depending on the way in which it is solicited. Information from questionnaires is likely to be more limited and perhaps less accurate than that obtained from in-depth interviews and counseling done on a one-on-one basis with a staff member or volunteer. As such, it is ideal to obtain a thorough behavioral history via personal interviews, but written questionnaires are acceptable as well (Newbury et al. 2010). Interview situations should be set up so as to facilitate an honest conversation and allow individuals to provide more complete answers to the questions posed. Staff should be nonjudgmental, supportive, and patient and should have strong communication and interpersonal skills. Because of the inherently stressful and emotional nature of the relinquishment process and the fact that many people bringing animals to a shelter feel guilty and stigmatized, these interviews should be conducted in private to minimize the risk of nondisclosure that may occur if interviews are conducted in front of other members of the public or even staff or volunteers. Additional follow-up questions may be necessary to uncover all of the reasons for relinquishment, to identify all aspects of a pet’s behavior that may be problematic, and to clarify the individual’s interpretation of the behaviors. Regardless of the format by which the information is solicited, the process should be standardized to ensure that as much relevant information about the cat is captured as possible. A sample written questionnaire is shown in Figure 10.1. This type of instrument could also be adapted to provide a semi-structured format for personal interviews.

The waiting area

People bringing cats to most animal shelters will spend a period of time interacting with staff and/or volunteers at a front desk or intake area. There may be a significant wait time to begin and ultimately complete the intake process. The manner in which the process is completed and how long it takes will vary depending on the type of organization (e.g., limited admission or open admission), whether or not incoming animals are accepted at all times or by appointment only, the volume of animals handled by the shelter, and staffing levels. It is critical that the waiting area is appealing to both humans and animals and functions in such a way as to facilitate the various steps of the intake process that must occur. Ideally, shelters are designed with an area for the intake and handling of newly arrived animals that is separate from areas used to process adoptions and return pets to their owners. Procedures should be put in place that minimize the stress experienced by cats from the moment they enter the sheltering facility and even earlier whenever possible. Transport times should be minimized wherever possible as doing so may enhance the cats’ ability to adapt to the shelter environment (McCune 1992).

For many cats, the experience leading up to the arrival at the shelter can be a source of extreme stress. Consider the effort sometimes required to capture, physically restrain, and then place a cat in a carrier, which itself is often associated with negative experiences. This is further compounded by the stress resulting from transport to the shelter, whether by an owner, Good Samaritan, or animal control officer. At best, transport is an unfamiliar, uncomfortable experience. At worst, it is associated with negative emotions from previous traumatic episodes. Upon arrival, cats are then introduced to an unfamiliar, uncomfortable and frightening environment with various sounds, odors, and sights they are not used to. Cats’ unique and heightened senses of hearing, smell, and vision along with their high sensitivity to tactile stimulation makes this experience all the more intense. The proximity to strange people and other animals serves as an additional source of stress, particularly for those cats that are unsocialized to or that have had prior negative interactions with people, other cats, or dogs.

Cats tend to be creatures of habit and are most comfortable in the environment they are used to. As a result, arrival in this unfamiliar and often overstimulating environment often results in a fearful response by the cat which may be characterized by aggressive behaviors (Griffin & Hume 2006; Rodan 2010). The experiences leading up to and during intake can have a profound effect on the cat’s behavior, health, and well-being (Griffin 2013). Stressful and negative experiences may hinder or even prevent successful acclimation to the shelter environment and result in increased anxiety and mental suffering, which can ultimately affect the cat’s disposition (Newbury et al. 2010).

Typically, the waiting area at the front counter or intake desk will be the first exposure that an animal has to the shelter. This first impression is extremely important and can set the stage for subsequent experiences the cat may have. This area should be as calm, quiet, and relaxing as possible. Facilities and practices that put cats in close proximity to dogs, particularly when they are confined without the ability to escape, are profoundly stressful and must be avoided (Figure 10.2). Ideally, waiting areas for individuals bringing cats to the shelter would be separate from waiting areas for those coming with dogs or other species; high stress levels and elevated urine cortisol-to-creatinine ratios have been found in cats with high dog-exposure levels (McCobb et al. 2005). Although this setup rarely exists, it is possible to create a better environment for cats upon arrival at the shelter by reducing auditory and visual contact with dogs and other animals that may also be present in the immediate vicinity. A permanent or temporary partition can be used to create separate functional waiting spaces for cats and dogs. For shelters that schedule intake or other services by appointment, separate times can be set aside for cats and dogs to alleviate stress on all parties. Regardless of the strategies used, all shelters should take steps to minimize cats’ exposure to dogs starting at the time of intake and extending through their stay.

All animals must be restrained upon arrival to the shelter. Larger dogs should be on a leash while smaller dogs, cats, and other small mammals should be safely confined in a crate. The shelter should have ample leashes and carriers for those animals arriving at the shelter without appropriate restraint. If it becomes necessary to transfer the cat from the carrier used for transport to the shelter to a different carrier owned by the receiving organization, this must be done in a quiet, secure area to reduce stress and minimize the risk of injury or escape.

Because cats instinctively feel more secure when perched at a high point (Griffin 2013), every area where cats may wait in carriers should have sufficient chairs, shelving, or counter space to prevent carriers from being placed at or near the level of the floor. Stressed cats have been shown to make greater efforts to hide, and one study investigating the effects of unpredictable caretaking schedules found a negative correlation between hiding behavior and cortisol levels. The authors found that cats that hid more tended to have lower average cortisol levels (Carlstead et al. 1993). The ability to hide is thought to be one of the most important coping mechanisms used by cats; providing cover and a visual barrier is a strategy that can be easily used throughout the shelter to mitigate stress. Towels, sheets, or other coverings should be kept behind the front counter or in an easily accessible location so that cat cages can be covered while awaiting completion of the intake process and for initial movement of the cat through the shelter. This is important for all cats but is particularly critical for feral cats and those arriving at the shelter in wire traps. An example of such an arrangement is shown in Figure 10.3.

Auditory input should be minimized to the extent possible from both animal and nonanimal sources such as fans, phones, and loud-speakers. The noise from barking dogs is particularly stressful for cats and must be minimized; moving animals from the waiting area as quickly as possible, judicious use of visual barriers, strategic location of the waiting area, and acoustic baffling can all be helpful in keeping sound levels as low as possible. Soothing background music may be helpful (Rodan et al. 2011), but should not be played at excessive volumes or continuously throughout all areas of the shelter; cats should experience a minimum of several hours of quiet time each day.

Pheromones can be utilized in waiting areas and throughout the shelter as an additional step to help calm cats. These are chemical substances that are used as a form of communication to trigger a social or sexual response between members of the same species. They are detected by a specialized part of the olfactory system known as the vomeronasal organ (sometimes also called Jacobson’s organ) where they bind with a chemical-specific receptor. Because these receptors are highly specific they generally bind or respond to only one pheromone and are only found in the species that produces that pheromone. As a result, pheromones and pheromone products will only have an effect on one particular species; dog appeasing pheromone, for example, will not have any effect on cats.

Synthetic feline facial pheromones have been investigated in a small number of studies. These are commercially available (e.g., Feliway) as either plug-in diffusers or sprays. The diffuser form plugs in to an electrical outlet and provides detectable levels of the pheromone for about a month in areas up to approximately 600 ft² (Figure 10.4). Higher concentrations, which may increase efficacy, may be achieved with the spray form of the product when applied directly onto towels or surfaces near the cat as needed. Limited data exists to show that use of these products may have beneficial effects with regards to stress reduction in pet cats. These may include reducing stress, anxiety, and marking behavior in cats being introduced to a new environment or during travel (Gaultier et al. 1998), calming cats (as assessed by their body and leg positions) during intravenous catheterization (Kronen et al. 2006), and increasing food intake of hospitalized cats (Griffith et al. 2000) when provided in conjunction with the ability to hide. The American Association of Feline Practitioners (AAFP) recommends the use of synthetic pheromones for cats in their practice guidelines on feline handling, nursing care, and environmental needs (Rodan et al. 2011; Carney et al. 2012; Ellis et al. 2013).

There is a lack of consensus as to whether the use of synthetic pheromones is effective for stress reduction in shelter housed cats and its use has not been well-studied in this population. These products are likely to be most beneficial when used on conjunction with other techniques as part of a comprehensive plan to reduce stress and provide an enriched environment. This author recommends that shelters use the spray on carriers and in transport vehicles as well as on cage coverings and bedding provided to cats, including those given to individuals to cover their cat’s cage while waiting to complete the intake process. A similar recommendation may also be made to individuals transporting cats to the shelter to use prior to arrival.

Timely handling of arriving animals to reduce crowding in the waiting room and overstimulation is also important. As stated previously, waiting time to complete the intake process should be kept to a minimum as it has been suggested to have an impact on cats’ stress levels and ability to adapt to housing typically found in most shelter environments (e.g., single cage housing) (McCune 1992). Shelter staff should also be trained to consider the behavior and stress level of animals arriving at the shelter when completing intake procedures for new arrivals in order to triage cases for priority of admittance. Critically ill or injured animals must be given priority to allow for timely veterinary care, administration of pain relief, and/or humane euthanasia to relieve suffering. Similarly, triage decisions should also consider the behavior and stress levels of animals awaiting intake. Aggressive, unruly, or otherwise disruptive animals should be quickly admitted to reduce the negative impacts of their behavior on other animals. Fearful, fractious, and otherwise highly stressed animals should also be given high priority for completion of the intake process.

Handling

Gentle, humane, skilled handling is necessary during all portions of the medical intake process. In addition to the effects of handling, the location and timing of these procedures can have a great influence on the behavior and stress levels of the cats. Medical intake procedures are intended to identify and treat any medical issues in a timely fashion and to administer vaccinations as close to the time of admittance as possible in order to allow for the development of a sufficient immune response prior to disease exposure. These procedures are critical to relieving suffering and maintaining and improving the physical health of cats arriving at shelters but must be done with a holistic view as to their impacts on all aspects of animal health. As such, consideration must be given to stress reduction and behavioral concerns. Although some degree of tractability and cooperation is necessary to allow delivery of these medical treatments, it is behaviorally normal and expected that cats may be fearful and fractious given the highly stressful environment they are being handled in (Patronek & Lacroix 2001). Humane handling that allows for delivery of medical care with minimal stress is critical. Consistent, positive interactions with caretakers have been shown to reduce stress in shelter cats. It is critical that these interactions are positive from the start of the sheltering experience and throughout the cat’s stay (Rochlitz et al. 1998; Gourkow & Fraser 2006), particularly for young kittens still in their critical socialization period between 2 and 8 weeks of age. Interactions that occur during this time, also known as the “sensitive” period, will have a pronounced impact on future adult behavior. Positive experiences with a variety of people, cats, and other animals as well as different environmental settings are necessary for a kitten to grow into a socialized, friendly cat (Radosta 2011).

Alleviating fear and stress is also a critical component of any medical program because of the adverse effects on physical health and well-being that may occur. Abnormal findings on physical examination such as an elevated heart rate, increased respiratory rate, dilated pupils, elevated body temperature, high blood pressure, and unusual urination or defection can all be the result of stress but may be difficult to distinguish from underlying illness or injury. This is particularly challenging in cats with an unknown history and other abnormal but possibly related findings on examination. Additionally, the physiological effects are not limited to physical exam findings only. Fear and stress may cause abnormalities in parameters such as white blood cell counts and blood glucose levels that can be challenging to distinguish from underlying disease. Thus, the clinical appearance of a stressed cat may result in unnecessary diagnostic procedures or treatments and may ultimately lead to a decision to euthanize for suspected health concerns.

The exam room should be quiet, well-lit, and stocked with all necessary supplies to ensure the process is as efficient as possible. Tasty food treats, such as freeze-dried liver, canned spray cheese, baby food (without any onions or garlic listed in the ingredients), or tuna fish should be available. These can be offered to cats during the examination as a distraction unless a specific medical contraindication exists or the cat is too young to ingest the foodstuffs (e.g., neonatal kittens), as shown in Figure 10.5. The room should be free of chairs and other objects that the cat may hide under if she/he escapes. The process needed to retrieve a fearful cat from such places can be both challenging and extremely stressful and creates an unnecessary risk of injury to both cat and human. The room and all surfaces within it that may come into direct or indirect contact with the cats must be made of durable, nonporous materials that can be cleaned and disinfected between animals or that can be replaced in between animals and either laundered (e.g., bedding) or disposed of. This is of particular concern in intake areas because they represent a potential common source of exposure for all cats. The risk is heightened in intake areas because all cats, including those who are clinically or subclinically ill and contagious to other animals as well as those that are naïve and do not have any immunity against pathogens they may subsequently be exposed to, can come into indirect contact with each other through contaminated surfaces, equipment, and other fomites. In larger shelters, it is ideal to dedicate an exam area for cats, separate from that used for dogs. Synthetic pheromone diffusers or sprays can be utilized as described in the section on the intake waiting area.

Cats must be removed from the carrier or trap with care. Pulling the cat from the transport enclosure or “dumping” him out on to the table should be avoided at all costs. In most cases, it is easier and always far more humane to remove the top from the carrier and then lift the cat out with a towel or allow him to remain in the bottom portion of the cage and examine him there. Enclosures that are difficult to remove cats from with minimal stress should be avoided. Cats in traps or other transport carriers who are not overly fractious or aggressive but cannot be taken out of the enclosure by removing the top can be transferred into a more suitable carrier and then examined. Although this may seem like an extra step or unnecessary procedure, it often makes the entire examination and vaccination process go much more quickly and smoother as the cat remains calmer and more tractable.

The surface of an examination table is very unappealing to most cats, in particular, because of the typically cold surface and lack of traction. This can easily be remedied by placing a towel or blanket on the surface before removing the cat from the carrier or trap. Using the cage covering that arrived with the cat when she/he was transported from the waiting area to the exam room helps ensure that the cat will be placed on a suitable surface without creating an unnecessary burden of laundry for staff and volunteers. This same item can also be placed in the primary enclosure with the cat once medical intake is complete and she/he is transferred to the holding cage. Additional towels and blankets should be available to facilitate restraint and to allow the cat to hide its head during the examination, vaccination, and other procedures. Handling that gives the cat the ability to partially hide and light, gentle restraint should be utilized remembering the old adage “The best restraint is the least restraint.” The use of food diversions may also reduce stress and facilitate handling. Restraint strategies need to be tailored to the individual animal and the procedures that need to be performed but must always be as humane as possible, using the least restraint necessary in terms of both intensity and duration to accomplish the necessary procedures without injury to cat or person (Newbury et al. 2010). Staff and volunteers should move slowly and calmly, avoiding jerky and abrupt movements that may startle or frighten the cat. Direct eye contact should be minimized, as it can be perceived as a threat, but angled eye contact and slow blinking may provide reassurance to the cat (Rodan 2010).

Sufficient restraint for one cat may be excessive for another, yet inadequate for a third. Although cats prefer to flee rather than fight, the restraint imposed during an examination may result in an outburst of fractious or aggressive behavior preceded only by slight changes in body posture, tail position, and facial expression; the reader is referred to Chapter 2 for an in-depth discussion of feline body language. Understanding feline body language and behavior and being attentive to these subtle signals given by the cat will help prevent undue stress and reduce the risk of escape or injury. Good technique and practice in handling and restraining cats of a variety of behaviors and temperaments is critical for staff and volunteers in a shelter setting, and training must be required in advance of this responsibility and on a continual basis. A number of excellent resources on low-stress handling exist and should be utilized in the development of training materials for staff and volunteers (Yin 2009; Rodan 2010; Rodan et al. 2011).

Cats are very sensitive to being overly restrained and excessive or forceful handling is more likely to result in increased fear and aggressive behavior (Newbury et al. 2010). Once overstimulated and stressed, the fearful or aggressive cat may remain reactive for a prolonged period of time. If sufficient time is not permitted to allow the cat to calm down, he may become even more reactive if handled again (Griffin & Hume 2006). Cats should not be automatically scruffed and/or stretched as a means of restraint. Scruffing should be avoided whenever possible and should not be used as the main restraint technique for cats. At the same time, animals should not be allowed to squirm or get loose. Many cats can be gently restrained in place with the use of a towel and the pressure of a hand on the front of the cat’s chest or nape of the neck without scruffing, such as is shown in Figure 10.6. Providing a cat with the ability to hide its head under a towel or in the crook of the examiner’s arm is often the most effective strategy. Even more invasive procedures such as drawing blood may be accomplished with light restraint and the use of towels to lightly wrap the cat and cover the head. Scruffing should be utilized only for those cats when it will cause the animal to relax and allow restraint, and must be done utilizing the proper technique (Yin 2009). Lifting the cat or suspending its body weight with a scruffing technique is unnecessary and likely painful, and is not condoned in the AAFP and ISFM Feline-Friendly Handling Guidelines (2011).

Restraint equipment can be extremely helpful in handling fearful and fractious cats but must be used judiciously, safely, and only when necessary; it is not an excuse for rough handling. All restraint equipments must be maintained in good working order and utilized by staff members who have received training on its appropriate use. Thick leather “bite gloves” may be helpful to reduce the risk of injury from scratches but should not be relied upon to prevent bites. They must used in conjunction with other techniques to adequately restrain the cat, such as wrapping with a towel or the use of a net. Cone or nylon muzzles or Elizabethan collars may be helpful to reduce bites, but different techniques should be used if the cat becomes tense or agitated as a result of the muzzle. In the author’s experience, covering the cat’s head with a towel or blanket is better tolerated and more effective than the use of purpose-designed cat muzzles. The use of control poles (sometimes referred to as rabies or catch poles) for the capture and restraint of cats, particularly for lifting or carrying, is considered inhumane and such use is unacceptable (Newbury et al. 2010). Humane traps, wire squeeze cages, or nets should be utilized for extremely fractious or feral cats or those who are otherwise unaccustomed to handling in order to permit humane restraint and the administration of chemical restraint prior to handling.

It is unacceptable to use physical force as punishment or in anger (Newbury et al. 2010) and verbal punishment should be avoided as well. Excessive use of force beyond what is necessary for self-defense or the protection of others is never appropriate. This includes but is not limited to aggressive acts such as striking an animal on the head or other sensitive body parts, striking an animal with an object, choking, shaking, or otherwise attempting to inflict fear or pain on the animal (Patronek & Lacroix 2001). Prolonged or repeated struggling should be avoided. If the cat is not amenable to the restraint technique being utilized, the handler must reevaluate the situation and decide on the most appropriate option. This may include correcting the technique being utilized or changing to a different restraint position, obtaining assistance from a more skilled handler or with the benefit of a second set of hands, temporarily postponing the procedure to allow the cat time to calm down, or utilizing chemical restraint (Yin 2009).

Continuing to escalate the level of restraint used on a fearful or fractious cat can create a situation where the cat suddenly “explodes” and can no longer be handled without a significant amount of time to calm down. It is far better to recognize the potential for this to occur and either delay continued handling until the cat is less stressed and more tractable or to use sedatives. Waiting until the cat is so aroused and overexcited that handling is no longer possible is never recommended; it creates undue stress and will require the use of greater amounts of drugs to override the circulating catecholamines, thereby increasing the risk of adverse events. Numerous protocols exist for sedation of cats, including both controlled substances and non-controlled but prescription-only medications, and the reader is referred to standard veterinary anesthesia texts for drug options and doses. Regardless of the protocols utilized, all medications and treatments must only be administered with adequate veterinary supervision, and all drugs must be stored, logged, and dispensed in accordance with federal, state, and local requirements.

Medical procedures

Every animal must have an individual record created at the time of entry to shelter. The specific requirements for content of the record and length of time for which it must be retained are typically specified by local and state laws pertaining to the operations of animal shelters as well as those covering the practice of veterinary medicine (often referred to as the veterinary practice act). At a minimum, the record must contain all relevant information for that animal including a unique identifier; species, breed, age, gender, and spay/neuter status; physical description of the animal including any identification; date and type of intake (stray, owner surrender, seized, etc.); contact information for the person bringing the animal to the shelter as well as the geographic location for any found animals; any available information provided by an owner or finder regarding that animal’s physical or behavioral condition and history. This record must contain documentation of all examinations, medical treatments, or procedures and all behavioral assessments, treatments, and interventions that are performed. All records must be updated with the date of departure from the shelter, final disposition type (adoption, transfer, return to owner, euthanasia, etc.), and contact information for the person or organization receiving the animal following release from the shelter. Computer-generated or paper records are permissible but must be kept up to date. A record-keeping system must be utilized that allows for review of individual animal information as well as aggregate information such as total annual intake, live release rate, or incidence rates for various infectious diseases in an easily accessed format.

Identification and physical description

The examination should start with a thorough inspection of the animal for any forms of identification, including collars and tags, microchips, and tattoos. Scanning for a microchip multiple times using proper scanning technique and a scanner capable of reading all microchip frequencies is strongly recommended to increase the chances of detection (Lord et al. 2008a, b). Animals should be checked for identification at the time of intake as well as multiple times throughout the shelter stay and again prior to disposition. If any identification is found, the details must be recorded in the animal’s record and attempts should be made as soon as possible to investigate the contact information in order to return the cat to its home in a timely fashion.

All cats must have some form of identification that indicates at least the unique identifier (e.g., number and/or name) assigned at the time of entry. Additional information, such as the date of intake, may also be included depending on the individual shelters needs. Identification may be provided by implantation of a microchip or, more commonly, a neckband or collar and tags such as that shown in Figure 10.7. In addition to the identification present on the individual animal, corresponding information must also be included on the animal’s cage or group enclosure.

A complete and accurate physical description must be recorded for each animal and should contain as much detail as possible. This includes a description of the cat’s coat, distinguishing physical characteristics (e.g., bobbed tail, declawed, missing an eye, etc.), and body weight. The age, gender, and reproductive status of the cat must also be determined as precisely as possible. Because of significant variability with which people describe the appearance of cats, photographs, including both close-up and full body views, are strongly recommended to facilitate efforts to reunite lost cats with their owners as well as to promote cats for adoption. Regardless of whether or not photographs are used, a complete description using standard, acceptable terminology indicating the cat’s predominant breed(s) and coat color and pattern should be included in the record. An example of a coat color chart can be found on the University of Florida’s shelter medicine program website (Griffin 2011).

Initial housing considerations

The history, physical exam findings, and behavior of the cat will inform staff as to which housing options are most appropriate for that individual. Housing should be segregated based on the animal’s species, age, health, behavior, and reproductive status (Newbury et al. 2010). Animals with evidence of contagious disease must be isolated from the general population to reduce the risk of disease transmission. Special accommodations, such as additional soft bedding for animals with arthritis or orthopedic injuries, must be provided for individual animals based on their specific needs. Ideally, cats who are badly injured, suffering from severe illness, have chronic medical conditions that require intensive monitoring, or who are recovering from surgeries other than routine spay and neuter should not be routinely housed in shelters unless the facility has a veterinary clinic with sufficient staff to provide for their needs. If humane care cannot be provided in the shelter, arrangements must be made for treatment at a private veterinary facility or for humane euthanasia if treatment is not available.

The ideal housing and management strategy for orphaned kittens, neonates, or lactating queens is to place them in foster care as soon as possible. Kittens too young to be adopted (e.g., typically under 8 weeks of age) should be considered too young to remain in the shelter unless a separate specialized nursery facility exists that is capable of delivering the necessary care. It is difficult if not impossible to meet these animals’ physical and behavioral needs in most shelter facilities. The risk of infectious disease exposure, vaccinal interference of maternal antibodies, and the highly stressful nature of the shelter environment are all significant risks to the physical health and well-being of underage kittens. Additionally, the difficulty in ensuring adequate positive interactions with a variety of people and other animals during these kittens’ critical socialization period is a significant barrier to continued care in the shelter at this young age. When immediate transfer to foster is not possible, however, adequate arrangements must be made for temporary care in the shelter. Nursing queens and their litters should be housed in a separate area away from adult cats (and especially away from isolation areas where sick cats are treated). Housing units should be made of non-porous surfaces that can withstand regular cleaning and disinfection procedures. The primary enclosures should permit care and cleaning without removal of the animals in order to minimize disease transmission and reduce stress. Extra bedding and blankets should be provided to keep the enclosure comfortable and warm (Figure 10.8).

The behavior observed during intake and the initial medical examination provides important information regarding housing and handling needs for that cat. Aggressive, very shy, or fearful or otherwise distressed cats should have special accommodations made to meet their behavioral needs, prevent escape, and limit the risk of injury to both cat and staff and volunteers. They should be housed in a quiet area of the shelter and be assigned consistent, dedicated caretakers who are knowledgeable about cat behavior and comfortable with handling cats across the spectrum of stress, fear, and aggression. Handling and care of certain cats may need to be restricted to staff only. The provision of hiding areas is particularly important for these cats. Shelters should consider using commercially available hiding enclosures that allow cats to cope with the stress of confinement and facilitate safe handling and transport in the shelter (e.g., feral cat dens; Figure 10.9). Very fractious animals may need to be housed in compartmentalized cages that allow for caretaking without handling or removing the cat from its cage. Appropriate notations should be made in the medical record and signage indicating relevant observed behaviors, and any necessary precautions should be clearly displayed on the cat’s enclosure. The reader is directed to Chapters 11 and 12 for a detailed discussion on housing and enrichment considerations for cats.

Physiological response to stress

The emotional strain that results from the adverse circumstances faced by a cat in an animal shelter has real physiological effects on the body, leading to a myriad of physical and behavioral signs and potential abnormalities. Two major pathways are activated in response to stress: the sympathetic branch of the autonomic nervous system is immediately stimulated, and with time, the hypothalamic-pituitary-adrenal axis (HPA) becomes activated as well.

Stimulation of the sympathetic nervous system leads to the secretion of epinephrine and norepinephrine. These hormones, collectively referred to as catecholamines, are commonly known as the “fight or flight” hormones because they prepare the body for action. Stress is thought to be the most potent stimulus for their release (Griffin & Hume 2006) and can quickly result in elevated levels of these hormones. Increases in epinephrine and norepinephrine produce physical changes such as increased heart rate and respiratory rate, elevated blood pressure, and dilated pupils. While the changes induced by the catecholamines are short lived and hormone levels quickly return to normal once the stress subsides, they can easily be triggered again just a short time later. As a result, it is likely that highly stressed cats experience these physiological changes many times each day in a typical shelter environment.

Chronic stress leads to HPA activation and an increase in the circulating levels of cortisol, a natural steroid. Cortisol, in turn, has numerous physiological effects on nearly every system in the body. Of particular concern in the animal shelter environment with a high risk of exposure to infectious organisms is the lowered immunity and increased susceptibility to infection that can occur as a result of HPA activation. Stress-induced changes to circulating cortisol levels and the HPA axis are more complicated and longer lasting than the temporary elevations of catecholamines. Because the HPA is a more complicated system relying on positive and negative feedback loops, changes happen on a slower scale than those seen in the sympathetic nervous system. Cortisol levels, for example, will remain elevated for a longer period of time than epinephrine or norepinephrine once a stressor is eliminated. In the face of an ongoing stressor, cortisol secretion will actually be gradually reduced over time but the entire HPA axis remains “primed.” As a result, chronically stressed animals have a greater sensitivity to novel stressors.

Impact of stress on health and behavior

In addition to the more immediate physical changes already described, physical and behavioral ailments may develop as a result of stress that can further diminish animal health and welfare and may confuse the diagnosis of infectious diseases. Physical abnormalities that may be detected in stressed cats include but are not limited to hypertension, insulin resistance, diminished appetite, vomiting, diarrhea, stranguria (straining to urinate), or pollakiuria (frequent urination often in small amounts), unkempt or ungroomed appearance, lethargy, depression, and withdrawal. Stress is a known trigger for recrudescence of feline herpesvirus-1 infections (Gaskell & Povey 1977) and higher stress levels have also been linked to a decreased length of time before a cat develops an upper respiratory infection (Dybdall et al. 2007). Highly stressed animals are not only more likely to become ill but are also more likely to develop severe clinical signs, show poorer response to treatment, and to remain ill for longer periods of time. In multiple studies, cats euthanized for poor health were more stressed than those with successful live outcomes (Gourkow & Fraser 2006). The reader is directed to Chapter 4 for a more detailed discussion of the impact of stress on animal health.

Stress will impact behavior as well. Highly stressed animals may act in unexpected or unpredictable ways, increasing the risk of injuries such as bites or scratches to humans, which may directly or indirectly decrease their chances at adoption. They may act fearful and fractious or withdrawn and hesitant to interact with people. Such behavioral changes compromise welfare and may ultimately lead to euthanasia in the setting of an animal shelter. Chronic stress may also result in chronic anxiety, lack of physical activity, and social and mental withdrawal further reducing well-being and quality of life and lessening chances of adoption. Cats housed for prolonged periods of time in one shelter exhibited decreased activity levels, ate less frequently, and had a greater tendency toward agonistic encounters with other cats (Gouveia et al. 2011). Not surprisingly, cats determined to be suitable for adoption have lower stress ratings than cats determined unsuitable for adoption (Dybdall et al. 2007). When cats are made available for adoption regardless of stress levels, less stressed and more active cats are more likely to be selected by adopters than highly stressed withdrawn cats (Fantuzzi et al. 2010). It is important to recognize that chronic stress experienced by a cat during his or her shelter stay may impact behavior in the new home and possibly the success of that placement. Further investigation is needed in this area.

Determining cat stress levels

From a practical point of view in most settings, particularly in animal shelters, assessment of a cat’s stress level will be based on their behavior. Several studies of stress levels in shelter cats or cats housed under similar conditions have been described using various behavioral indicators (Kessler & Turner 1997; Rochlitz et al. 1998; Kessler & Turner 1999a, b; Ottway & Hawkins 2003; McCobb et al. 2005). Because behavior reflects internal states, the observation of cats for abnormal behaviors in conjunction with an assessment of body language can provide a means to quickly assess a cat’s stress level without invasive or expensive measures. High levels of stress are associated with suppression of normal exploratory and play behaviors and chronic stress lead to inactivity, withdrawal, and depression. Decreases in hiding behavior have been associated with decreases in urine cortisol-to-creatinine ratios in cats at a quarantine facility (Rochlitz et al. 1998). Similarly, stressed cats with higher urine cortisol-to-creatinine ratios showed lower levels of activity than their less-stressed counterparts (Carlstead et al. 1993).

While physiological data may be ideal, the measurement of serum, urinary, or fecal cortisol levels is seldom practical in these settings. Collection of blood samples from cats is invasive and stressful, which can influence the reliability of such results. Additionally, serum cortisol levels in kittens may not be reliable (Reisner et al. 1994) as an indicator of stress as reported results have been below normal adult levels in most kittens, including those who showed fearful or aggressive responses to handling and restraint. Urinary cortisol-to-creatinine ratios have been described and validated in cats as a noninvasive method (Carlstead et al. 1992); they are the most commonly utilized physiological correlate of stress for domestic and exotic felids. Because the cortisol concentration in the urine provides an indication of the mean plasma concentration at the time the urine was produced, this test provides an indirect means of assessing the cortisol levels in blood without requiring invasive collection techniques. The measurement of cortisol levels in fecal samples has also been described in domestic cats and is a valid, noninvasive technique (Graham & Brown 1996; Schatz & Palme 2001).

A system for assigning stress scores has been developed for cats in animal shelters and can be used to more objectively define a cat’s level of stress (Kessler & Turner 1997) than individual or nonstandardized observations. This Cat-Stress-Score tool is frequently used by researchers as a consistent qualitative method for assessing the level of stress experienced by a cat. The tool uses a matrix of body postures and behaviors and scores cats on a scale from 1 to 7, ranging from “completely relaxed (1)” to “terrified (7).” Unfortunately, there has been a lack of validation between the Cat-Stress-Score and physiologic indicators of stress, such as urine cortisol-to-creatinine ratio, which may be due to the difficulty in recognizing and adjusting for feigned sleep (e.g., a cat that appears to be sleeping but is not, remaining vigilant and alert) using this scale. Despite the lack of correlation with physiologic indicators, Cat-Stress-Scores are amongst the most commonly reported measures and comparison of the numerous studies in which the assessment tool has been used does provide valuable information on the various factors influencing cat stress levels. Furthermore, there may be benefit in using such a tool in conjunction with additional behavioral information, particularly when this information is collected at multiple time points, to aid in a more accurate determination of the cat’s overall (rather than minute to minute) stress level.