Page 78 - WSAVA2018
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 25-28 September, 2018 | Singapore
plugged into treatment and hospitalization areas as well as reception and consultation rooms can help patients relax.
6. Elevated blood glucose and glucosuria may be a result of persistent stress. A diagnosis of diabetes, therefore, should be confirmed by finding an elevated serum fructosamine.
While the number of cats kept as companions in North American homes continues to increase, the number
of feline visits to clinics has been declining since
2001. Based on the AVMA’s 2007 pet ownership and demographics survey, there were 13% more cats than dogs, yet cats failed to receive the same degree of veterinary attention. In small-animal practices, dogs represented 59% of office visits, cats only 39%. The 2011 Bayer Brakke study further noted three client-driven factors that limited the number of feline visits.
1. Inadequate understanding of the need for regular preventive health visits other than for vaccination.
2. Resistance to bringing a cat to the clinic because of the distress caused by putting a cat into a carrier and making the trip to the clinic.
3. The cost of veterinary care, in particular the frequency and size of price increases. (The state of the economy was a separate, external factor.)
In November 2012, Bayer conducted an online survey
of 401 veterinary practice owners across the USA. The Bayer Veterinary Care Usage Study III: Feline Findings noted that 78% of veterinarians believed that better care for cats represented one of the most significant, missed opportunities for the profession. Yet, while 70% of those veterinarians were familiar with the earlier Bayer-Brakke studies, and while most recognized that cat owners consider a clinic visit to be stressful for themselves and their cats, nearly one-third of practices did not have staff trained on how to make visits less stressful for clients. Additionally, relatively few practices had adopted exam rooms used only for cats (35%), cat-only waiting areas that are physically and visually separated from dogs (18%), and cat-only days and appointment hours (11%). The study found that 46% of the surveyed clinics had recently started taking specific steps to increase visits among current feline patients, attract more cat-owning clients, and make their practices more “cat friendly”.
Clearly there is a need to grow compliance among cat owners. However, part of the lack of awareness (at best) or reluctance (at worst) for making simple, inexpensive changes in attitude and facility is that many veterinarians and veterinary staff members prefer, or feel more comfortable, working with dogs than cats. The survey also identified that veterinarians find it easier to diagnose dog cases.
The verb “comply” means to act in accordance with
a wish or command (Oxford), to conform, submit, or adapt (as to a regulation or to another’s wishes) as required or requested (Miriam-Webster). For clients
to comply with our recommendations, they have to fully understand, be willing and able to perform the actions that we are recommending. We need to enroll them so that they believe in the importance of these actions. But explanations aren’t enough: on-going caring communication are needed to enhance client compliance.
Many clients believe that cats are self-sufficient, have very few needs, and are low maintenance pets. They don’t understand that cats live as solitary hunters because their prey are too small to share. This means that they lack the resources of a supportive society.
To avoid showing vulnerability they hide illness well. Additionally, cats are prey to larger birds and other species. This is critical in understanding why cats so easily feel self-defensive and how to work with cats. Educating potential and existing clients what these subtle signs of sickness are is a huge opportunity for increasing compliance. All veterinary team members also have to recognize that any admission of illness by a cat may signal a problem that has been going on for longer than recognized. Following are descriptions of signs that clients can be taught to look via direct emails, newsletters, the clinic website, and social media.
Subtle Signs of Sickness (adapted from www. and www.
1. Inappropriate Elimination: Regardless of how “deliberate” it may seem to be, when a cat is avoiding
or not using the litter box, they are trying to tell you something. The message may be that they are in physical discomfort or psychological distress. Physical problems include inflammation of the bladder or
bowel, arthritis, hyperthyroidism, diabetes, dementia. Psychological distress may be due to social disturbance, anxiety due to other animals, children or adults, boredom, or a lack of opportunities to perform the full, natural repertoire of cat behaviours.
2. Changes in Interaction: Changes in how a cat interacts with people, other animals or his/her environment may indicate pain or distress.
3. Changes in Activity: A decrease in energy may be abrupt or gradual. The latter is often attributed to “just getting older”, however, a healthy individual does not inherently “slow down” due to increasing age. A cause for such changes should be investigated. Dehydration, pain - from anything, including arthritis-, and hypokalemia are some of the problems that should be evaluated. The reverse is also true: an increase in energy in a previously

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