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PEER REVIEWED 28 JULY/AUGUST 2018 emotional welfare of the patient. 24 Fear or anxiety can exacerbate pain and further impairs the animal's ability to cope. 25 In addition to analgesia, it is important to minimize stressors both at home and in the practice. 26 Chronic pain is common in cats, and signs vary depending on the location and severity of the pain. Up to 92% of cats have degenerative joint disease (DJD), a disease of the joints in limbs and/ or spine. 27 Although more common in older cats, DJD can occur in cats of all ages. 27 Analgesia should be given to painful and potentially painful cats prior to examination and potentially painful procedures (e.g., radiographs or venipuncture). 28 The facial expressions most important to recognize with acute feline pain are widening of the muzzle and between the ears. 29,30 The AAHA/AAFP Pain Management 2007 Guidelines are useful for unrecognized painful feline conditions and procedures and the updated 2015 guidelines provide further information about feline degenerative joint disease ( ). MAKING THE APPOINTMENT WORK Understanding the cat can aid in developing a practice environment that respects the species, while facilitating the work of veterinary professionals. Although humans cannot detect the cat's chemical communication, we can learn to recognize the meaning of behaviors, vocalizations, body posturing, and facial expressions. Body postures are more readily detected from a distance, but it is the facial expressions that provide immediate indications of the cat's emotions. 22,30 Educating all team members to recognize calm versus distressed behaviors can help formulate the best plan for handling individual patients and one that works for the practice. Understanding Feline Senses Cats have keen senses to both hunt successfully and protect against predators. Understanding the cat's senses reduces stressors, alleviating anxiety and other negative emotions. Olfactory and chemical messages: The cat's sense of smell is superior to ours and their nasal cavity also detects pheromones, chemical messages used to communicate within the species. 31 Scents that humans may not notice can significantly impact feline welfare, so avoid perfumes and scented cleaning supplies in the practice. 2 Instead of isopropyl alcohol for venipuncture and catheter placement, use diluted chlorhexidine when possible. The scent of unfamiliar people and non-feline patients, as well as the scent and pheromones of other cats, also causes negative emotions. Provide separate cat waiting areas, cat wards, and cat-only exam rooms when possible. If a cat rubs its facial glands or rest of the body on a part of an exam room, wipe away its pheromones or scent before another cat enters. Also, unless the cage is soiled, spot-clean cages instead of fully cleaning to retain the cat's own scent until discharge. 32 Scents and pheromones can also help cats feel more relaxed. Familiar items brought from home, such as the cat's favored treats and bedding, or an item of clothing with the owner's scent, are helpful during veterinary visits, hospitalization, and boarding. Synthetic feline facial pheromone analog may provide a calming effect throughout the practice and increase appetite in hospitalized patients. 33,34-35 Feline synthetic facial pheromone is available in diffusers and sprays; wipes are available only in the United States. Offering treats or cat food to cats that are not fasting, nauseous, or vomiting provides a more positive experience. Cats frequently enjoy treats during veterinary visits; some will eat even during minor procedures ( FIGURE 4 ). Hearing: Cats hear a broad range of frequencies, which makes their hearing superior to that of most mammals, including people and dogs. 36 This broad range includes ultrasound and detection of ultrasonic chatter of rodent prey. 37 The cat's pinnae are movable to help locate sounds of prey and predators. With such a keen sense of hearing, auditory stressors such as noise, loud voices, and the sounds of other animals negatively affect welfare in the FIGURE 4. Venipuncture is performed on a young adult cat that continues to eat through the procedure.

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