Stress recognition

Fear and anxiety in cats may first manifest as changes in ear position, eyes and facial expression, body position, sweating from the paw pads, and tail movement (Figure 7-1).¹ Fearful cats may attempt escape, and vocalization such as hissing can indicate an escalation in stress. Overt aggressive behavior can include scratching and biting. Some fearful cats will freeze. It can sometimes be difficult to distinguish between stressed and fearful cats with those in pain. The cat-friendly practice publications and feline-friendly handling guidelines contain more information about recognition of fear and anxiety in cats.^2–4

Management of stress

Fear aggression is commonly seen in all veterinary practices and yet it is still widely unrecognized and often misinterpreted as dominance behavior, or it is casually disregarded as a negative character trait. How a cat’s behavior is interpreted will have a significant influence on how it is approached, handled, treated, and understood. Negative feelings, attitudes and poor handling techniques of a cat with fear and fear aggression will only heighten the problem. Conversely, empathy, a calm approach and careful consideration as to how to make the environment less stressful for cats will have an extremely positive impact, possibly leading to all cats receiving better treatment and more accurate and thorough monitoring. There is also the added benefit that there will be a reduction in stress for the staff as well as the cat. Stress can have a significant impact on a cat’s appetite and immune system and so a reduction in stress will aid a better and more rapid recovery, which may then allow earlier discharge home.

Ideally, stress reduction should start at home and so providing accurate and concise advice to clients about getting their cat to the veterinarian is important from the very first time they contact the practice (Box 7-1).⁵

Putting measures in place to help reduce stress for cats within the practice does not mean a complete renovation of the premises. Many things can be improved, even within a small practice, to make it more cat friendly. To do this, it is necessary to ‘think cat’ and imagine how a cat would feel entering the clinic in its current set up. Cats have incredibly strong senses and they are very instinctive animals, so it is important to think about what a cat may see, hear, smell or experience at the practice.

The consulting room

Within the consulting room, the first sources of stress that need to be considered will come from the general environment and in particularly the smell, sounds and lighting. Many of the ideas suggested in Table 7-1 can also be incorporated into the consulting room and again it is essential to try and ‘see’ the consulting room from a cat’s point of view. The other source of stress will be the structure of the consultation and the approach of the attending clinician or nurse to the cat.

The consulting room should be suitable and secure so that the cat carrier can be placed on the ground and the door opened. It will be much less stressful for the cat if it is allowed to come out of the carrier on its own accord rather than have a pair of unfamiliar hands dragging it out. Cats that will not leave the carrier should be lifted out by removing the top of the carrier, if this is possible; it is much less confrontational to lift the cat from above than to pull the cat out from the front opening (Fig. 7-3). Top opening baskets are therefore recommended for cats.

Once out of their basket, cats frequently want to wander around the consulting room to assess their environment; and therefore they should be given this opportunity while the history is being taken. It is important to ensure that there are no small corners or gaps between or under the consulting room furniture that a cat may decide to hide in, which could cause a confrontational struggle to get the cat out of. Confronting a stressed cat in this way will only cause fear, which may well result in fear aggression. A cat that is stressed before the clinical examination has been conducted will inevitably be a less than ideal patient and the resulting difficulty in handling will only lead to further stress and possibly aggression.

Having a litter tray in the consulting room may be welcomed by some cats who have been kept indoors leading up to the trip to the veterinary surgery and then have had a stressful journey to the practice. Examining a cat with a full bladder may be stressful for the cat and they may be reluctant to sit still, and become agitated. Litter trays must be completely changed after every use as the smell of another cat’s waste could be very threatening to the cat, as well as a potential source of infection. A set of weighing scales in the consulting room will not only be a reminder to weigh the cat at each visit but also make it a less stressful experience by not needing to take the cat back into the waiting room or ward to be weighed.

Offering guidance to owners as to how they should behave around their cat and how to interact positively with their cat to help reduce its stress levels can also help (Box 7-2), but care should be taken to present this in an empathetic manner.