section epub:type=”chapter” id=”c0002″ role=”doc-chapter”> Jane E. Brunt Despite the increased popularity of and knowledge about cats, they often do not receive adequate health care. Reasons for this disparity include the difficulty of transporting cats, a lack of awareness regarding cats’ basic medical needs, a failure to recognize signs of illness, and the misperception that cats can take care of themselves. Fortunately, since 2008, several organizations around the world have worked to create preventive care protocols for cats and develop educational resources to improve the ‘cat-friendliness’ of veterinary practices. Cat-friendly; handling; examination room; cat carrier; equipment; housing The need to improve medical care for cats was first acknowledged by the American Association of Feline Practitioners (AAFP; https://www.catvets.com) in the early 1970s. Since that time, increasing membership and programming in AAFP and other feline-oriented veterinary organizations, coupled with growth in the companion cat population, has allowed the areas of feline medicine and surgery to become increasingly mainstream and available through traditional companion animal veterinary hospitals and clinics, as well as feline-exclusive veterinary facilities. The addition of board certification for feline medicine specialists through the American Board of Veterinary Practitioners (ABVP; http://abvp.com) and Cat Healthy protocols written by ABVP members in Canada (http://www.cathealthy.ca) have further elevated the field of feline medicine. Information is available for diverse audiences from an increasing number of feline-specific scientific journals, curated continuing education opportunities, consumer publications, and educational programs offered in various formats (e.g., in person events, live online events, online on demand, and traditional print). Efforts to increase feline scientific research have been undertaken by foundations such as EveryCat Health Foundation (formerly the Winn Feline Foundation; http://everycat.org), Morris Animal Foundation (http://www.morrisanimalfoundation.org), and the Cornell Feline Health Center (http://www.vet.cornell.edu/fhc). Similarly, the American Veterinary Medical Association (AVMA; https://www.avma.org) and American Pet Products Association (https://www.americanpetproducts.org) conduct market research on pet owners on an ongoing basis. Despite the increased popularity of and knowledge about cats, statistics collected between 1996 and 2006 in the United States showed that veterinary expenditures declined even while the companion cat population remained ahead of owned dogs.1 According to the AVMA, there was an 11% decline in feline veterinary visits between 2001 and 2006 and a 4.4% decline between 2006 and 2011.2 In 2011, only 55.1% of cats visited the veterinarian compared to 81.3% of dogs. In 2016, 25% of households owned a cat, with an estimated population of 58.4 million cats.3 This figure is lower than previously reported, due to more accurate methodology or possibly a trough in cat ownership. Similar to 2011, only 54.3% of cat-owning households visited a veterinarian. The most commonly reported reason for not visiting the veterinarian was because the cat was not sick or injured. A total of 6% of owners reported they did not take their cat to the veterinarian because it was too difficult to transport the cat or because the veterinary visit was too stressful. Finally, cats were three times as likely not to receive preventive health care (36%) than dogs (12%). Reasons for this disparity range from the difficulty of transporting cats (e.g., putting them in a carrier) to a lack of awareness regarding cats’ basic medical needs, a failure to recognize signs of illness, and the misperception that cats can take care of themselves.4 Similar concerns exist in other countries. For example, in Canada in 2011, only 46% of cat owners had taken their pet to the veterinarian within the last 12 months, compared to 77% of dog owners.5 In the same survey, 58% of cat owners claimed their cat had no health issues or seemed to be in perfect health. In response to the decline in veterinary care for cats, in February 2008, the AAFP and the CATalyst Council (https://catalystcouncil.org) hosted the CATalyst Summit, which featured representatives from more than 30 independent organizations across North America, including veterinary associations, shelter and welfare groups, foundations, cat fanciers, the media, and commercial industries. At this event, more than 50 people united in their concern for the health and well-being of cats vowed to change the negative ways in which cats are often perceived and portrayed. After the summit, leaders formed the CATalyst Council and set forth a vision of a future in which “all cats are valued and well cared for as pets.” Several collaborative and strategic initiatives were identified and implemented, including the development and publication of Feline Life Stage Guidelines by the AAFP and American Animal Hospital Association (AAHA) for veterinary health care teams. These guidelines have also been made available online (https://catvets.com/guidelines/practice-guidelines) and are referenced in other areas of this textbook. With preventive care medical protocols for cats in place, efforts turned to developing educational resources to promote cat-friendliness. Following the lead of UK-based International Cat Care (ICC) and their Cat Friendly Clinic program (https://icatcare.org/catfriendlyclinic), CATalyst Council (https://catalystcouncil.org/cat-friendly-practice/), and AAFP (https://www.catvets.com/cfp/cfp) developed and distributed information which is widely available online. Any veterinarian who treats even a single cat is a feline veterinarian and as such will benefit from a greater understanding of normal feline physiology and behavior, the ways in which cats respond to external stimuli, and the idiosyncrasies of domestic cats. The first chapter of this text, Understanding the Cat and Feline-Friendly Handling, provides critical knowledge and should be reviewed, understood, and embraced by the entire health care team as a prerequisite to becoming cat-friendly. From a scientific standpoint, this is important because investigations regarding stimulation of the hypothalamic–pituitary–adrenal axis show that stressors placed on any individual cat can have negative consequences and play a role in development of disease and sickness behaviors.6,7 This knowledge will help all veterinary health care team members to construct or modify physical and administrative features of their veterinary practices to enhance the comfort, care, and safety of cats, clients, and coworkers. By making the necessary modifications, incorporating proper handling techniques as described in the AAFP/International Society of Feline Medicine (ISFM) Feline-Friendly Handling Guidelines (https://catvets.com/guidelines/practice-guidelines), and implementing ongoing feline health education, virtually every veterinary facility can become a cat-friendly practice. The AAFP Cat Friendly Practice and the ICC Cat Friendly Clinic programs allow veterinary clinics to earn designation at different participation levels. Additionally, CATalyst Council (https://catalystcouncil.org/resources/) and AAFP provide open access to educational videos for veterinary teams (https://www.catvets.com/education/online/videos). It is necessary to begin by engaging the entire health care team in the development of a cat-friendly practice. A key understanding is that having a cat-friendly practice is first a mindset, then a commitment to cat-friendly human behaviors, and last, the physical features or environment. The framework for any new team and client communications, techniques, and physical or administrative changes can be provided in the following sequence: Cats are more sensitive to sights, smells, and sounds, as well as touch, and arousal occurs through these senses, particularly in an unfamiliar setting. Heightened arousal after a change in routine and then travel frequently results in fear, and the normal physiologic mechanisms of fear can lead to aggression if the cat is unable to escape to a perceived safe area. For example, if a cat is forced into an unfamiliar carrier and transported to the veterinary hospital, the stress generated by these activities has already initiated changes in heart rate, respiration, and other effects of epinephrine release by the time the cat arrives. In other words, the cat may be experiencing stress before it is even presented to the practice. With this understanding, the veterinary team can take the appropriate measures to prevent or mitigate this arousal, or at least respond appropriately. The cat-friendly veterinary visit begins when the first contact with the cat owner is made. The practice website should indicate the commitment to being cat-friendly and may include the AAFP Cat Friendly Practice or the ICC Cat Friendly Clinic logo if the practice has been so designated. An example of how one practice achieved Cat Friendly Practice designation and the outcome is found in the online materials for this chapter ( Links to resources can include carrier and transport tips such as CATalyst Council’s video “Cats and Carriers, Friends Not Foes” (https://catalystcouncil.org/resources). Team members who have been instructed will ask the prospective client open-ended questions such as “How well does your cat take to its carrier and travel?” and offer suggestions to minimize the stress and anxiety associated with travel to the veterinary office. Additionally, immediate pet owner access to remote health information and even veterinary consultations (telemedicine) and other services is becoming more common and may provide an opportunity to further promote cat-friendly interactions. Veterinary licensing bodies and other regulatory agencies should be contacted to ensure the local veterinary practice act allows the use of telemedicine. Cat owners notice certain signs that cats are welcome at veterinary hospitals. Exterior features such as signage and cat statuary create an inviting appearance. Some facilities offer a separate entrance for cats (Fig. 2.1). The reception area is usually the first place where an owner interacts with a veterinary clinic or hospital, and a warm and calming environment contributes to a comfortable atmosphere for the client and cat. Cat-specific décor portraying cats in a positive manner is far more likely to encourage the cat owner to think, “This place likes and respects cats,” than a design that focuses on dogs at the expense of cats (Fig. 2.2). Posters or illustrations of staring cats are not recommended insofar as cats perceive this behavior as confrontational. Elevated counters or platforms near the reception desk allow space for cat carriers to be kept away from dogs (Fig. 2.3). Segregated seating, which is less likely to result in visual and auditory arousal of the feline patient by dogs, other cats, or unfamiliar clients, is preferred (Fig. 2.4). Another way to reduce arousal is to have clean towels available to cover cat carriers (Fig. 2.5). Escorting the owner and cat into an examination room as soon as possible may help prevent further arousal. Some veterinary practices have adopted “cat-only” office hours on certain days to decrease the likelihood of interaction with canine patients. Providing cat-specific educational material in the reception area will also benefit both clients and cats.
The Cat-Friendly Practice
Abstract
Key words
INTRODUCTION
WHAT IS A FELINE VETERINARIAN?
FOUNDATIONS OF A CAT-FRIENDLY PRACTICE
PHYSICAL FEATURES OF A CAT-FRIENDLY PRACTICE
eCase Report 2.1).
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