Meeting Basic Needs, Triage, and Management


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Meeting Basic Needs, Triage, and Management


Cats and dogs, as domesticated species, have developed distinct behavioral patterns influenced by their evolutionary history. Understanding these behaviors is essential for providing appropriate care. Often a change in behavior is the first indicator of a medical issue. Recognizing these species‐specific signs is key for more accurate diagnoses and timely medical interventions. Gaining a comprehensive understanding of the specific needs of each animal is important for meeting their basic needs, playing a significant role in reducing behavioral problems and promoting optimal welfare.


Measuring Welfare


The Five Freedoms, Five Domains, and Five Provisions are central to the understanding and evaluation of animal welfare, each highlighting key aspects of an animal’s wellbeing. These frameworks aid in developing criteria and scales for assessing the welfare state of animals. Watters (2021) emphasizes that inaccurately assessing an animal’s welfare can result in significant negative consequences, including behavior problems.


The Five Freedoms


Originating in the 1960s in the United Kingdom, the Five Freedoms have significantly influenced animal welfare, enhancing the quality of life (QOL) for animals. Initially conceptualized as ideal states rather than standards for acceptable welfare, as noted by the UK’s Farm Animal Welfare Council in 2012, these freedoms are valuable guidelines but may not fully address all aspects necessary for a comprehensive welfare assessment (Farm Animal Welfare Council 2012; Mellor 2016a,b).


The Five Domains


Building on the Five Freedoms, the Five Domains model, introduced in 1994, offers a more comprehensive framework for assessing animal welfare (Mellor et al. 2020). This model represents a significant advancement through acknowledgment of the complexity of animal welfare, which encompasses both the physical and emotional states of an animal. These are integral parts of their welfare (Mellor et al. 2020). Even if their physical needs are met, animals still may experience poor welfare if they are in a negative emotional state (Mellor 2016a,b; Mellor et al. 2020). With this recognition, the Five Domains model broadens the understanding of welfare, emphasizing the need to address both physical and emotional aspects for overall animal welfare (Mellor et al. 2020).


Limitations and the Introduction of the Five Provisions


Recognizing the limitations in the concept of “freedoms,” Mellor (2016a) identified two key shortcomings. First, the focus on “freedom” from negative experiences was often misinterpreted as implying their complete elimination, whereas the realistic goal is their minimization. Second, the original framework’s emphasis on avoiding negative experiences was considered insufficient given the evolving understanding that animal welfare management should not only minimize negative experiences and emotional states but also promote positive experiences and emotional states.


The Five Provisions


The Five Provisions were developed (Mellor 2016a,b) to overcome the shortcomings of the Five Freedoms. Initially aligned with the Five Freedoms, these provisions were later updated to outline welfare goals for each provision. These updates helped guide welfare management toward both minimizing negative experiences and promoting positive ones. Incorporating aspects of the European Welfare Quality assessment system and integrating elements from all domains of the Five Domains model, this updated framework provided more accessible and clear guidance for animal welfare management, applicable to a variety of species (Mellor 2016a,b).


Incorporating Positive States in Animal Welfare Frameworks


In the context of animal welfare, which encompasses the Five Freedoms, Five Domains, and Five Provisions (Table 4.1), a fundamental principle across all frameworks is that the absence of negative welfare states does not necessarily indicate the presence of positive welfare states. The Five Freedoms and Five Provisions emphasize that true animal welfare extends beyond the avoidance of harm (Mellor 2016a). These provisions provide guidance not just for reducing negative experiences but also for actively encouraging positive ones (Mellor 2016a). This approach aligns with a broader perspective of welfare that advocates the cultivation of positive states. Similarly, the Five Domains model focuses on both physical and mental wellbeing, emphasizing the importance of promoting positive emotional experiences in addition to alleviating pain or fear (Littlewood et al. 2023).


Table 4.1 The Five Freedoms, Five Domains, and Five Provisions models.


Source: Adapted from Mellor (2016a).



























Five Freedoms Five Domains Five Provisions
Freedom from hunger and thirst Nutrition By providing ready access to fresh water and a diet to maintain full health and vigour
Freedom from discomfort Environment By providing an appropriate environment including shelter and a comfortable resting area
Freedom from pain, injury, and disease Health By prevention or rapid diagnosis and treatment
Freedom from fear and distress Mental state By ensuring conditions and treatment which avoid mental suffering
Freedom to express normal behavior Behavior By providing sufficient space, proper facilities, and company of the animal’s own kind

Within any animal welfare framework, genuine welfare is characterized by not only the absence of discomfort but also the presence of positive wellbeing (Littlewood et al. 2023; Mellor 2016a,b, 2017). A comprehensive and humane approach to animal welfare involves addressing both the physical and emotional needs of animals. Focusing on these aspects enables early intervention and helps prevent behavioral problems, particularly those that arise from poor welfare conditions.


The Five Pillars of a Healthy Feline Environment


Organizations like the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) have adapted the Five Freedoms specifically for domestic cats, creating the Five Pillars (Table 4.2) (Ellis et al. 2013). These pillars move away from the concept of enrichment, traditionally seen as adding extra features to a cat’s environment, to concentrate on the fundamental aspects of a healthy feline environment. If any of these pillars are not adequately addressed, it can lead to deficiencies, potentially causing negative behavioral outcomes in cats driven by emotions such as fear, anxiety, and frustration (Ellis et al. 2013).


Table 4.2 The Five Pillars of a healthy feline environment.


Source: Adapted from Ellis et al. (2013).





















Pillar Questions to ask
Provide a safe place

  • Can you describe the environment from your cat’s perspective to make sure they feel safe in their home territory?
  • Have you taken into account any external factors or threats, such as outdoor cats, that might impact your cat’s sense of safety at home?
  • Are there any specific external sights, sounds, or smells that might make your indoor cat feel unsafe or threatened?
  • Have you noticed any unfamiliar smells, noises, or the presence of other animals or humans inside your home that could be causing stress for your cat?
  • What do you do to make sure your cat feels safe and comfortable at home?
  • Do you have spaces in your home where your cat can retreat to feel safe? Can you describe these areas?
Provide multiple and separate key environmental resources

  • Are there separate food and water sources provided for the cats in the household?
  • Are the litter boxes well maintained and accessible to all the cats in the home?
  • Do you have resting places at various heights, including some that accommodate only one cat?
  • How many scratching areas are available for the cats to use?
  • Are the cats fed in separate rooms away from other animals or with visual barriers, and are they at least six feet apart to prevent stress during mealtime?
  • Are water bowls placed away from the food areas to accommodate a cat’s natural preference to keep food separate from water?
  • Are environmental resources available in multiple locations throughout the home, allowing cats to choose based on their sense of safety and accessibility?
  • Have you considered adding extra litter boxes in different locations to prevent house‐soiling, especially when multiple cats are present?
Opportunities for play and predatory behaviors

  • Do you provide opportunities for your cat to express their natural hunting instincts indoors?
  • Have you considered using food‐dispensing and puzzle toys to encourage predatory behaviors and mental stimulation for your cat?
  • How often do you engage in interactive play sessions with your cat, and for how long each session?
  • Have you experimented with various puzzle feeders and toy styles to discover what your cat enjoys the most, and are you open to adapting these as your cat’s preferences change?
  • Are you aware that incorporating play and predatory behaviors into your cat’s routine can improve their physical fitness and provide essential mental engagement?
Provide positive, consistent, and predictable human–cat social interactions

  • Do you provide positive, consistent, and predictable human–cat social interactions for your cat?
  • Are you aware that cats often form social bonds with humans but prefer to interact on their own terms?
  • Do you respect your cat’s preferences when it comes to physical interactions, understanding that they may not always welcome such engagement?
  • Are you knowledgeable about the proper ways to interact with cats in a respectful and gentle manner?
  • Do you avoid inappropriate physical interactions with your cat, such as vigorous petting, touching unwanted body parts, holding your cat against their will, or using hands for play?
  • Have you considered that inappropriate interactions can lead to anxiety and defensive behaviors in cats, such as biting or scratching?
Provide an environment that respects a cat’s sense of smell

  • Do you provide an environment that respects your cat’s sense of smell?
  • Are you aware that cats have a far more acute sense of smell than humans?
  • Have you considered that fragrances commonly found in households, such as perfumes, scented candles, cleaning agents, air fresheners, and even scented cat litter, can potentially compromise your cat’s sense of safety?
  • Do you understand that these strong scents can be irritating to your cat’s delicate olfactory senses?

The Interplay of Physical Health and Behavior in Animal Welfare


Assessing animal welfare requires a multifaceted approach that includes behavioral observations, health assessments, and evaluation of the living environment. Often changes in behavior are the initial indicators of underlying medical conditions; therefore any recent or sudden changes in behavior need to be investigated and addressed. Routine veterinary care should include comprehensive physical examinations and diagnostics such as a complete blood count, serum biochemistry, and urinalysis. Being proactive and intervening early for medical conditions can significantly improve the success rates of treatment and intervention.


Choice, Control, and Agency in Animal Welfare


Agency in animal welfare means granting animals the ability to make choices about their environment and have control over those choices (Littlewood et al. 2023), involving cognitive and physical engagement. When animals have options, their stress is reduced and their overall wellbeing improves. Recognizing and understanding an animal’s choice can sometimes be challenging. However, animals often make decisions that lead to positive outcomes; therefore, relying on observations of their choices provides insight into their preferences (Littlewood et al. 2023). Not all animals will choose to participate or “opt in” every time. Therefore, choosing to “opt out” provides just as much valuable information as when they choose to opt in (Littlewood et al. 2023).


One example of this is cooperative care training, which involves teaching animals how to participate in their own veterinary care and husbandry procedures. When animals are given the opportunity to consent, defensive behaviors and protective emotions are less likely to occur (Jones 2023). For instance, in dogs, a chin‐rest behavior can signal consent for an examination or venipuncture. Just as placing their chin on an object or lap is a clear “green light” to continue, lifting their chin is a clear signal to say “stop.” However, some may argue that this could be coercion for food. Therefore, to ensure true consent and not coercion, animals should have alternative choices in their environment that are equally enticing, such as a mat in a different area or free access to a special food‐dispensing or puzzle toy (Horowitz 2021). This way, it becomes easier to determine when an animal is providing genuine consent rather than merely offering a highly reinforced, trained behavior in anticipation of food.


Quality of Life Assessments


The concept of QOL in animals is primarily determined by their mental state and influenced by the frequency of pleasant emotional states. It is another way to measure the welfare status of an animal, with more frequent positive states indicating a better QOL. QOL can be affected by factors such as illness and physical health. For example, discomfort or distress caused by a disease has a negative impact on QOL. However, if there is no impact on comfort or pleasure, then QOL remains unaffected (McMillan 2000).


Accurately measuring QOL can be challenging in animals, as they hide pain well and cannot directly communicate their thoughts and feelings. Therefore, their QOL is evaluated through subjective and objective measures, such as validated scales and behavior observation (Taylor and Mills 2007). The goal of these measurements is to improve QOL (Yeates and Main 2009), evaluate the effectiveness of treatment plans, assist pet caregivers in making decisions such as euthanasia (Belshaw et al. 2015), determine appropriate pain management, and identify the need for more intensive treatment and intervention.


The general steps involved in a QOL assessment are as follows:



  1. Important factors: Start by recognizing factors influencing the animal’s overall physical and emotional health, such as general well‐being, movement, weight, pain management, and behavior. Since every animal is unique, consider the caregiver’s viewpoint and the animal’s specific circumstances and underlying health conditions when assessing QOL.
  2. Emotional state: Watch how the animal behaves and responds to their surroundings. These states are assessed on a spectrum from comfort to discomfort (McMillan 2000). Comfort means a calm and relaxed mental state with minimal unpleasant sensations (Kolcaba and Kolcaba 1991), while discomfort can come from things like hunger, pain, fear, or frustration. However, discomfort does not always mean the animal is suffering; suffering implies a more severe or prolonged state of discomfort (DeGrazia 1996).
  3. Basic needs: Unmet needs significantly affect an animal’s health and safety. Therefore, meeting an animal’s basic physiologic needs, such as adequate nutrition, free access to water, shelter, and a safe environment, is essential for their QOL. Assessments should verify if these needs are met and address any deficiencies impacting the animal’s health and comfort (Dresser 1988; Hunt 1997; Hurnik 1988; Littlewood et al. 2023; Mellor 2016b, 2017; Mellor and Beausoleil 2015; Odendaal 1994).
  4. Physical health: Health problems, whether ongoing or sudden, can make an animal uncomfortable and restrict their ability to engage in usual activities (McMillan 2000; Morse et al. 1994), significantly impacting their QOL. Therefore, it is important to thoroughly assess an animal’s health to identify and address any underlying conditions that may be affecting their daily life.
  5. Agency and choices: When an animal feels they lack control or choices, they may experience learned helplessness or emotional shutdown due to the inability to change their current situation. This lack of choices and control can lead to protective emotions and a lower QOL (Friedman et al. 2021; Littlewood et al. 2023; McMillan 2000; Seligman 1975). Assessing the living environment and daily routine helps identify opportunities for the animal to make their own choices, such as hiding, interacting with others, or engaging in normal behaviors (Littlewood et al. 2023).
  6. Social relationships: Dogs are a social species, while cats are selectively social. Opportunities for social interaction with other animals or humans can enhance wellbeing, while isolation or inadequate opportunities for social relationships can lead to stress and protective emotions, thereby decreasing QOL (Baqueiro‐Espinosa et al. 2023; Corsetti et al. 2023; Lamon et al. 2021; McMillan 2000; Mellor et al. 2020; Voith and Borchelt 1985).
  7. Health parameters: Use validated tools and measurements to evaluate an animal’s physical wellbeing, including mobility, pain levels, behavior, weight, and eating habits (Belshaw and Yeates 2018; Belshaw et al. 2015; Cobb et al. 2021; Fulmer et al. 2022; Reid et al. 2013; Roberts et al. 2021). This assessment helps understand how these factors affect the animal’s QOL, which can differ depending on individual needs. For instance, a diabetic dog requires specific monitoring such as blood sugar levels and insulin dosages, while for a healthy dog the focus is more on preventative care and weight management.
  8. Comprehensive assessment: After identifying relevant factors, conduct a thorough evaluation. This involves observing and documenting the animal’s behavior and physical condition. For example, veterinarians may track an animal’s movements, sleep patterns, appetite, and reactions to their surroundings, people, or other animals.
  9. Prioritize: Evaluate each factor based on its significance and its effect on the animal’s overall wellbeing and comfort. This may involve a balancing act, as what might be minor in one case could be critical in another. It might mean addressing urgent issues like severe pain before less urgent concerns.
  10. Decisions and recommendations: Improving an animal’s QOL entails addressing both their immediate and long‐term needs. Depending on the assessment and the significance of each factor, treatment plans may need adjustments. This could involve implementing new pain management strategies or making difficult decisions such as euthanasia. Other options might include changing the environment, diet, or behavior. Collaboration among veterinarians, pet caregivers, and other animal care professionals ensures decisions are made in the animal’s best interest (Yeates et al. 2011).

There is an example of a QOL assessment in Table 4.3. Tiger is an indoor‐only, male, neutered cat who was adopted from the shelter and is approximately seven years of age, with a body condition score (BCS) of 7/9. He is the only cat in the home and loves to spend his day sleeping in the big picture window in the sun.


Table 4.3 Example of a quality‐of‐life assessment.





































Assessment category Details for Tiger
Important factors Life satisfaction: comfortable, limited outdoor access
Mobility: reduced, overweight
Weight management: critical, due to obesity
Pain control: potential future issue
Behavioral health: good, monitor for changes
Emotional state Comfort: content in sunny spots, relaxed
Discomfort: difficulty grooming due to weight
Basic needs Nutrition: needs controlled diet plan
Hydration: adequate
Shelter: safe, comfortable, indoor environment
Safety: protected but limited exercise options
Physical health Chronic health issues: obesity, potential for diabetes, potential for osteoarthritis
Activity limitation: struggles with agility due to weight
Agency and choices Environmental control: limited due to indoor living
Routine: stable but lacks variety
Social relationships Interaction with humans: affectionate, enjoys company
Interaction with other animals: limited, potential enrichment
Health parameters Mobility: limited due to weight
Pain levels: not an issue currently
Behavioral signs: content but less active
Physiologic measurements: overweight
Comprehensive assessment Movement: reduced agility and stamina
Appetite: overeating, needs diet regulation
Responsiveness: good to humans, less overall activity
Behavioral observations: more sleep, less playfulness
Prioritize Immediate plan: weight management
Less urgent concerns: social interactions, environmental changes
Decisions/recommendations Immediate plan: weight management program
Pain management: monitor for future needs
Environmental modifications: indoor enrichment
Dietary changes: reduced‐caloric diet
Social enrichment: increase play and interaction
Monitor health: regular vet exams, consult nutritionist

Overall, Tiger appears to have a good QOL. However improvements are needed such as weight loss to reduce the potential for endocrine and orthopedic conditions, as well as to facilitate grooming and good hygiene. He may also benefit from increased social interactions. Next let us explore how introducing a new kitten into the household to increase these social interactions and physical activity could change his assessment and plan (Table 4.4).


Table 4.4 Impact of kitten introduction.





































Assessment category Details for Tiger with kitten addition
Important factors Life satisfaction: may increase with feline companionship
Mobility: encouragement to move and play more
Weight management: more physical activity anticipated
Pain control: monitor if increased activity affects any pain points
Behavioral health: monitor for adjustment period and signs of stress or engagement
Emotional state Comfort: observe Tiger’s reaction to the kitten, ensure a low stress introduction
Discomfort: watch for any signs of anxiety or agitation due to the new companion
Basic needs Nutrition: separate feeding areas to prevent food competition
Hydration: additional water sources
Shelter: ensure both have comfortable, private resting areas
Safety: supervise interactions initially to ensure safety
Physical health Chronic health issues: monitor if increased activity with the kitten affects his health
Activity limitation: observe if Tiger becomes more active with kitten’s presence
Agency and choice Environmental control: introduce kitten gradually to Tiger’s environment
Routine: establish a new routine including individual playtime for each
Social relationships Interaction with humans: continue current level of human interaction
Interaction with other animals: facilitate positive interactions between Tiger and kitten, monitor closely
Health parameters Mobility: expect increase in mobility due to play
Pain levels: monitor for changes
Behavioral signs: look for changes indicating stress or happiness
Physiologic measurements: monitor weight with increased activity
Comprehensive assessment Movement: assess improvement in mobility with play
Appetite: ensure both cats have adequate nutrition, monitor food intake
Responsiveness: observe Tiger’s reaction to the kitten
Behavioral observations: note changes in sleep, play, and grooming habits
Prioritize Immediate attention: monitor introduction phase and Tiger’s reaction to kitten
Less urgent concerns: gradual adjustment of routines and environment for both cats
Decisions/recommendations Immediate actions: careful, supervised introduction of kitten
Environmental modifications: create spaces for both cats, including hiding spots and perches
Dietary changes: maintain Tiger’s diet, adjust as needed for activity
Behavioral therapies: encourage joint play sessions
Collaboration: monitor interactions and body language between the cats, consult veterinarian or board‐certified veterinary behaviorist if needed

In summary, the addition of a kitten could help to improve Tiger’s QOL assessment through increased activity and weight loss. However, it will be important to make sure both the kitten’s and Tiger’s individual needs are met and to monitor body language and interactions between the cats to ensure the emotional health of both cats remains protected.


Pain and Grimace Scales


Another welfare assessment is to monitor pain and overall discomfort. Various QOL scales are available, with the best choice often being a validated scale, such as those proposed by Schneider (2010) or Niessen (2010) (Belshaw et al. 2015). A scale that is representative of the individual animal’s challenges should be used since generic scales may not account for significant individual differences that impact QOL (Belshaw et al. 2015).


Pain plays a significant role in behavioral changes; therefore, regardless of the scale chosen, pain assessments are often paired with QOL assessments to provide important information about an animal’s comfort level and overall welfare state. Pain assessments can also be performed independently from QOL assessments.


Assessing Pain


Assessing pain in animals is complex. Unlike humans, animals cannot verbalize their pain, and many species instinctively conceal their pain. Additionally, the manifestations of pain can vary significantly between species and even among individuals within a species, often presenting as subtle signs that are challenging to recognize (Belshaw and Yeates 2018; Bloor 2017; Caddiell et al. 2023; Gruen et al. 2014, 2020, 2022; Lush and Ijichi 2018

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Mar 1, 2026 | Posted by in NURSING & ANIMAL CARE | Comments Off on Meeting Basic Needs, Triage, and Management

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