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Meeting environmental needs improves health
Recently, it has been recognized that emotional well- being is highly dependent on meeting the environmental needs of cats. These include those relating to the indoor and outdoor physical environment, as well as a cat’s social interactions, human and otherwise. In the AAFP and ISFM Feline Environmental Needs Guidelines, five pillars are described that form the basis of a healthy feline environment (Ellis, 2013). These pillars are:
1. A safe space
2. Multiple and separated resource stations (food, water, toileting areas, scratching areas, play areas, perches, resting and sleeping areas)
3. Opportunity for play and expression of predatory behaviors
4. Positive, consistent and predictable interactions with humans
5. An environment that respects the importance of a cat’s sense of smell
When these are not met, cats become stressed to varying degrees. Some may express illness (such
as inflammatory bowel disease, lower urinary tract inflammation), while others will manifest their distress through inappropriate elimination.
Other considerations
As cats age, they tolerate less time in the clinic. Siamese cats are especially prone to becoming depressed.
Three days may be as long as a cat can stand the anxieties and indignities of hospitalization, even with daily visits from the owner. Consider capping intravenous catheters and send patients home, having them return for outpatient care. Even for in-hospital care, capping catheters off overnight (administering the overnight
dose via the subcutaneous route) allows greater ease of movement, avoids alarms, which keeps patients awake. In either case, administer the overnight fluid volume subcutaneously.
Because cats “see” the world in overlapping clouds of smells, we should strive to provide familiar smells and reduce foreign, medicinal smells. Client-worn shirts
or toys from home are helpful in cages. Feline facial pheromone may help to reduce stress. Because cats’ sense of hearing is tuned more finely than ours, a quiet and reassuring environment is desirable. Cats should not be exposed to the sounds of predators, namely barking dog, but strange machines (faxes, printers, phones, dishwashers, centrifuges, etc.) should also be addressed. Reducing noises should be addressed when using certain induction agents as some enhance hearing (e.g., ketamine).
Avoid changing a cat’s diet during hospitalization as is likely to result in inappetence and possibly the development of an aversion. If a change in diet is
required for therapeutic reasons, try to make that change gradually in the safety of the home territory.
Taking a thorough history is especially important given cats’ tendency to hide illness. Listening carefully to clients and their concerns is extremely important. Often clients detect changes that represent real problems. This is probably more common than the client who is blissfully unaware of significant health problems. By asking open- ended questions, we elicit a more detailed history than using only specific questions. For example, asking, “Have you noticed any changes in the contents of the litter box?” will probably evoke a yes or no answer. Whereas: “What does his stool look like?” followed by: “Would you describe it as hard pellets, moist logs, cowpie, or colored water? What colour is it? When did you first notice this?” will probably provide more useful answers. “Is there anything else?” is a very effective question.
Schedule a recheck appointment to evaluate the effect of any medical or nutritional therapy. Reassessing important variables (e.g., body weight, body condition score, previously abnormal laboratory results) and updating the patient history allows us to provide better care for our feline patients. Care of the client is essential to providing complete patient care. It is only through listening to, educating, and working with the client that we are able to offer the very best veterinary care.
Examples of practical applications
1. If a cat is uncooperative, a comprehensive physical examination can usually be done using only a towel as a protective barrier. Facing the cat away from you is less threatening for her. Confining the cat between your legs as you sit on the floor provides adequate persistent firm restraint that is reassuring rather than frightening.
2. Swaddling a cat’s forelimbs and torso may help with blood and urine collection, placing the cat in lateral recumbency for cystocentesis and using the medial saphenous vein. This vein is also a superb choice for catheter placement and administration of intravenous medications. If the cat is allowed to have her front end in a sternal position while the back end is in lateral recumbency, she may struggle less.
3. Allow the client to be with the kitty as much as, and whenever, possible.
4. Recognize that a persistently elevated systolic value above 160 or 170 mm Hg probably represents true hypertension rather than the stress response. If in doubt, repeat the value later during the visit.
5. FeliwayTM (Ceva Animal Health), a synthetic analog of a feline facial pheromone, may have a calming effect
on cats. Spray (or wipe) it into kennels and carriers and even on your clothing before handling an anxious cat. Let the substance evaporate for a few minutes before placing the cat into the sprayed space. Feliway diffusers
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