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Bernadette Kazmarski
We think of Fear Free techniques for handling pets in shelters, at veterinary visits, and in our homes. But some cats need to be brought to those places in a most stressful way—being caught in a humane trap. Fear Free techniques can help relieve stress even in these situations.

Most cats are trapped for TNR—neutering, vaccination, and return to a colony. Young kittens and somewhat friendly cats will often be kept for socialization and adoption. Lost cats often need to be trapped, as well as cats in hoarding and humane cases. All of those circumstances are already very stressful.

Being Trapped Violates a Cat’s Instincts

So if cats find boxes irresistible, why would walking into a wire box be frightening to them? Cats will seek and tuck themselves into small spaces for safety and as part of their predatory behavior to both inspect to find prey and hide to ambush prey. But a cat doesn’t want to be ambushed herself, and she needs to feel a sense of security about the space and see a safe exit in order to explore it.

Knowing that, we set up a wire tunnel with one way in and no way out and we expect a cat to walk into it? Yes, we do. They need to be handled, held overnight or longer, and sometimes treated while in a trap too. It’s an immense amount of anxiety and stress for any cat.

Fear Free for Community Cats

This is one area of cat handling where, knowingly or unknowingly, Fear Free techniques have long been used because following a cat’s cues and overcoming her anxiety is the only way to trap successfully.

“Working in TNR/community cat care, I think Fear Free is extremely important,” said Sterling “TrapKing” Davis, founder of TrapKing Humane. “The purpose is to prevent and alleviate fear/stress/anxiety in pets and for our community pets.”

No trapping happens without a plan and preparation for each step of the process, so the cat is treated humanely and experiences the least amount of stress: set the trap in a safe location, use high-value food as a bait, monitor the trap, and when the trap closes behind the cat cover the trap immediately to calm her and eliminate visual stimulation. Then, at each move minding the cat’s comfort and security, carry the trap and transport to wherever the cat needs to go for the necessary services and care.

“It’s things like making sure you have newspapers/pee pads in the trap beforehand. Making sure to cover the traps to calm the kitty and during transports, having a decent temperature and keeping vehicle windows rolled up as wind noise can be really scary, especially with everything going on,” Davis says. “TNR kitties will be a little confused/stressed until you return them back to their colony so Fear Free and understanding it can be extremely helpful.”

Familiarity in the Midst of Chaos

Though there are protocols for trapping, a cat rarely walks into the trap on the first attempt. All cats react to a change in routine with some amount of distrust, and you’re about to put a big change in their routine. Plan the process around familiar elements and adjust as necessary. Here are two examples from my own experiences.

Adding something new to any cat’s environment can create stress. If a cat seems particularly fearful, I’ll often start by conditioning her to the trap: set up the trap, sanitized and sprayed with pheromones, secured open so it can’t accidentally shut, and the cat can walk in and out, rubbing her scent on it. Feed her in the open trap until she seems comfortable, and when ready set the trap so it shuts when she confidently walks in for breakfast.

If the cat has a regular caretaker, they can participate to keep the cat’s routine as familiar as possible. In trapping a colony of 10, I made the plans, set the traps, then left to remove my scent and activity while advising the caretaker in messages. He opened the garage door, greeted them, then sat down with his coffee as he always did. We trapped them all in two days with very little stress because they were confident enough of their circumstances and caretaker to walk into the traps for their food.

Stacy LeBaron, host of the weekly Community Cats Podcast, agrees. “Incorporating some Fear Free techniques into a good trapping plan could benefit both the cat and the trapper during the trapping, surgery, recovery and release stages. Being calm, quiet, and relaxed are bedrocks to successful trapping and colony management,” she says.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Bernadette E. Kazmarski is a self-employed commercial artist, writer, graphic designer, illustrator, and fine artist whose portfolio includes hundreds of commissioned pet portraits as well as landscape and wildlife artwork. She is author of the award-winning daily blog The Creative Cat featuring feline and pet health, welfare, adoption, and rescue, plus humor, poetry, and lots of cat photos. Bernadette has been rescuing and fostering cats since 1980 and works with her local TNR organization to TNR or foster/socialize. Her current feline family includes a mom and litter of five incredible house panthers and five former feral rescues in training, plus two rescue fosters from her neighborhood.

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Sandra Toney

When she was 12 years old, Karina Salvo, DVM, CTPEP, CVFT, CVMMP, volunteered to work for a one-doctor practice. Cleaning cages, doing laundry, and walking dogs led to watching her first surgeries. From that point, she knew that her career path would lead to veterinary school.

But one thing she and the veterinarians she grew up working for—and later, with—didn’t learn was how to make exams easier on pets. When she became aware of Fear Free®, though, it made sense to her that veterinary visits should be less frightening and more fun for patients.—not to mention for veterinarians and technicians themselves.

“The one thing that I noticed in each and every practice was the frequency in using force to hold a patient,” says Salvo, now an Elite Fear Free Certified® DVM who also has certifications as a palliative and end-of-life practitioner (CTPEP) and in branches of Traditional Chinese Medicine (CVFT and CVMMP). “Some of the staff wrestled what I thought were highly aggressive dogs down to the ground in order to give a single vaccine or draw blood. The end result was someone got hurt, scratched, urine and feces everywhere, and a dog that was left splayed out and panting on the floor in exhaustion or cowering in the corner. This was the ambience of the veterinary field I grew up in.”

As she learned more from Fear Free, she found that in-clinic exams became easier.

Now she owns her own practice, AcuVetDoc Veterinary Reproduction & Animal Care Wellness Clinic, in Royal Palm Beach, Florida, where she treats not only pets but also wildlife. That allows her to see only one patient at a time.

“I can practice 100 percent the way I choose to. I intentionally do not have a receptionist or a technician,” Salvo says. “Patients are scheduled on the hour instead of every 15 minutes. This allows me to work one on one with the patient and the owner. My ‘team’ in my practice is the owner, myself, and the patient. By working together, all of us can better understand the patient and the medicine. Practicing this way has allowed me to build trust in my patients as well as owners because both are comfortable.”

Salvo greets clients and patients at the door so she can watch how the animal walks into the building. If owners have given permission beforehand, treats are on the carpeted floor as they enter.

Animals who have previously had poor experiences at veterinary clinics may be directed into an exam room that resembles a living room—with carpet, a bookcase, leather sofa, chair, and hidden treats. While Salvo sits on the floor, pockets filled with treats, and talks to the owner, patients can explore, approaching when they’re comfortable. If they need more time, Salvo may simply hand out treats during the visit, holding off on an exam. She discusses this possibility with clients beforehand so that they’re aware the first interaction may be a “meet-and-greet,” with the exam portion on a subsequent visit.

Many of her patients enjoy “playtime,” a rewarding exam in which Salvo uses tasty treats to get patients to move on their own but in a fashion that allows her to examine them. For instance, she might get them to sit or turn their head so she can look inside ears or examine the mouth.

One patient who stands out in her memory was a 12-week-old Cockapoo puppy whose first experience at a veterinary clinic had involved being held on an exam table while he screamed, attempted to bite, and urinated and defecated. The veterinarian told the owners that their puppy had mental health issues and should be returned to the breeder. This time they were hoping for a better experience.

Salvo met the owners outdoors, where she had set up chairs and some treats. They sat down, talked about how the puppy was doing at home, and handed out treats to the puppy. Salvo assigned homework: to find tasty, high-value treats that could be dropped on the floor any time visitors came to the home and to be used as rewards during training. She suggested walking the puppy in areas far enough away from people that strangers wouldn’t want to pet the dog but close enough that he could see people, other dogs, and vehicles such as carts. Offering high-value treats during these walks would contribute to forming a positive association with the experience and a connection with the owners.

At the second visit a few days later, Salvo again met the owners outside and had tasty treats already on the ground for her new friend to gobble up. Eventually, the puppy approached her and she was able to perform an exam and give an oral vaccine as the puppy sat next to the clients and received treats.

“On subsequent visits, we sat next to each other outside, and he came and laid on my lap and became more interactive with me and less afraid of the environment,” says Salvo. “With a cheese and Cheerio trail to lead him inside, we made it to the scale and an exam room!”

Three months after that first visit, the puppy frequents farm fairs, Home Depot, and PetSmart, and comes running into the clinic to greet Salvo.

“This is an amazing story with very patient owners who were willing to take their time to understand and provide their dog with what he specifically needed when he needed it, redirection to something positive, protection from being thrown into the middle of a chaotic situation, and to slow introduction to the world around him,” she says.

Fear Free continues to make a difference in her practice. “The best feeling is when the owners are ready to leave and the patient stays behind and makes eye contact with me waiting for another fun treat,” Salvo says, “or when they return and they are pulling their owner into the building.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Sandra Toney has been writing about cats for over 25 years and is an award-winning member of Cat Writers Association and Dog Writers Association of America. She has written for many print and online magazines about cat health and behavior as well as authoring eight books. She lives in northern Indiana with her cat, Angel.

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Kristin Shaw, DVM
Are you diagnosing and managing canine osteoarthritis the same way you were taught in vet school? Depending on when you graduated, chances are the techniques and treatments you learned may be due for a refresh. This article will offer tips for ensuring you are practicing the best medicine you can for your canine patients while following the principles of Fear Free practice.

Diagnosing OA: You don’t have to cause pain to find pain

If you were ever taught that you had to “push harder” to find the pain—forget that! Instead, there is a very good chance you can diagnose OA pain without even putting your hands on a dog (though that is still important!). Dogs show chronic, OA pain through changes in their mobility, posture, function, mood and behavior.1 Additionally, joint pain leads to compensatory pain in other parts of the body, including muscles. There are a number of ways we can identify OA pain without trying to make the dog cry out with our palpation.

  • Use a screening checklist: A recent study found that using an owner checklist that asks questions about a dog’s mobility at home can increase the rate of identifying dogs with OA.2 See here for the checklist that was used in this study and is available for you to implement in practice.
  • Observation is key: Dogs with OA may hide an obvious lameness during a traditional gait evaluation. While it is still recommended to watch how dogs walk on a leash, more rewarding information is often gleaned observing a dog’s posture and from watching how a dog moves through transitions (rising from a down position, moving into a seated or down position).3 When standing, if the spine is not neutral, and/or if limbs are held in abnormal or asymmetric positions, and/ or if weight is shifted off of a limb or body segment, these are all indications of likely joint pain. If any slowness or asymmetry to movement through transitions is seen, there is a good chance the dog has musculoskeletal pain.
  • Sedate for radiographs! Imagine being pinned to a cold table in a dark room and having your painful limbs manipulated. You would at the very least squirm too! Sedation and analgesia are musts for obtaining high quality, diagnostic radiographs while minimizing stress and discomfort. Also remember to take orthogonal views, centered on the joint of interest, and take both sides for comparison.

Treating OA: Unmanaged OA pain is a life-threatening condition

We care about OA because it causes pain. And not just pain in the arthritic joint, but over time, whole-body pain develops. Additionally, chronic/maladaptive pain is progressive and usually worsens, often drastically, without treatment.4 Multimodal, proactive, and continuous pain management is essential to reduce the devastating consequences of unmanaged OA.3

  • Multimodal is built on effective analgesia: According to the 2022 AAHA guidelines, the first line of analgesia for canine OA should be either NSAIDs or the anti-NGF monoclonal antibodies (mAbs).3 Both of these classes of drugs have proven efficacy and safety in dogs with OA. There are additional benefits of anti-NGF mAbs that may make it a better option for many dogs. Anti-NGF mAbs are administered by a veterinary professional, in the clinic, so take away the caregiver burden of an oral medication, improving owner compliance. Additionally, anti-NGF mAbs directly target a key player of chronic pain, sensitization, and neurogenic inflammation and have an encouraging safety profile. Maintenance of a lean body condition and regular exercise are also required as part of an effective OA plan. Other supplemental therapies may be considered as needed.
  • Proactive pain relief is standard of care: Canine OA is predictable- it typically develops secondary to developmental orthopedic disease (dysplasia, OCD) or joint trauma. Therefore, as soon as a dog is diagnosed with a joint disorder, which in the case of developmental disease generally occurs in the first few years of life, a proactive OA plan should be put in place. Clients should be educated on OA, the consequences of unmanaged pain, and how to monitor for pain at home. Analgesics should be started when pain is mild rather than waiting until it becomes severe.
  • Don’t let the pain break through: It is tempting to suggest to pet owners that they give analgesics on an as-needed basis. However, this can become problematic if they don’t recognize the early signs of pain. Chronic pain signaling leads to physical changes in the spinal cord that ultimately result in severe, neuropathic pain.4 A study that evaluated maintaining dogs at the NSAID label dosage vs. gradually reducing the dosage of the NSAID overtime, found that the dogs maintained at the label dosage, had the best outcome.5  Furthermore, continuous pain management through daily NSAIDs has been shown to improve signs of OA in dogs.6 Once a month anti-NGF mAb is given as a monthly SQ injection and controls pain for up to 4 weeks, which may be an optimal alternative to asking pet owners to give a daily medication. Remember to ensure a pleasant and enjoyable visit utilizing Fear Free techniques whenever dogs are coming in for any type of appointment, including monthly injections.

References

  1. Roberts C, Armson B, Bartram D, et al. Construction of a conceptual framework for assessment of health-related quality of life in dogs with osteoarthritis. Frontiers in Vet Sci. 2021.
  2. Wright A, Amodie DM, Cernicchiaro N, et al. Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. JSAP 1-10, 2022.
  3. Gruen ME, Lascelles BDX, Colleran E, et al. 2022 AAHA Pain management guidelines for dogs and cats. JAAHA 58:55-76, 2022.
  4. Malfait AM, Miller RE, Miller RJ. Basic Mechanisms of Pain in OA: Experimental observations and new perspectives. Rheum Dis Clin N Am 47:165-180 (2021).
  5. Wernham BGJ, Trumpatori B, Hash J, et al. Dose Reduction of Meloxicam in Dogs with Osteoarthritis-Associated Pain and Impaired Mobility. ,J Vet Intern Med 25:1298–1305, 2011.
  6. Innes JF, Clayton J, Lascelles BDX. Review of the safety and efficacy of long-term NSAID use in the treatment of canine osteoarthritis. Vet Record 166:226-230, 2010.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

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Jan Bellows, DVM, DAVDC
Wouldn’t it be wonderful if you could approach dentistry without fear, anxiety, or stress?  It can be done and it’s not all that difficult.  Let’s dissect the touchpoints of dental fear and how to replace dread with confidence. 

Client Fear

1. Fear of Anesthesia

This is generally your client’s number-one trepidation. Fortunately, modern, safe anesthesia procedures include (1) evaluating the patient with physical and laboratory exam beforehand, (2) tailoring medication protocols to the patient, and (3) constant monitoring while anesthetized and during post-anesthesia recovery. Sharing these safety measures with your clients goes a long way to alleviate their fear.

2. Fear of Tooth Loss

Often clients will ask “How will my dog eat if you extract so many teeth?” The reply should be “Better than ever before because by removing the diseased teeth, the mouth will now be pain-free.”

3. Fear of Expense

This concern is often shared by both the client and veterinarian. To mitigate this fear, concentrate on what needs to be done to provide the pet with a pain-free, healthy, “happy” mouth. When asked “What is this going to cost?” early in the exam, answer that you will discuss fees “before we leave this room” and “cost is going to be part of the good news.” This can help set the client’s mind at ease and allow them to focus on their pet, the exam you’re performing, and the expertise you’re sharing. Once you’ve established an optimum treatment plan, you can work together to find the best way to make it happen, including payment.

Keep in mind that clients are used to going to their own dentist and are familiar with dental costs. Fortunately, most veterinary practices offer financing, such as the CareCredit healthcare credit card,
 as a payment option. This allows clients to pay for their pet’s dental care over time in budget-friendly monthly payments rather than the entire cost upfront.

Functional vs. Optimal Care

There are bound to be challenges on the path from the basic dental care to optimum care. Most clients want to do the very best for their pet, but cost and time commitment with after care can be barriers. Our job is to provide them with solutions that make the best care possible—budget-wise, time-wise, and health-wise.

Root planing, local antimicrobial administration (LAA), 
and laser periodontal surgery are often recommended for optimum care, but these simply may not be in the financial comfort range of some clients. This is where payment options can help to pay for the care they want for their pet or they can choose functional care.

Some pet owners may be unable or unwilling to provide needed follow-up care. In these cases, multiple extractions are usually necessary to create a pain-free, functional mouth. It may not be gold standard, but the pet will receive great basic care that supports quality of life.

Perhaps the most important thing to remember is that moving clients from fear to acceptance for their pet’s dental care is possible when we take the time to communicate the value and not just the cost. 

Veterinary Fears

1. Oral Surgery

While the goal in veterinary dentistry is to save teeth, it often becomes necessary to remove some or all of the teeth. Indications for extractions include fractured teeth, advanced periodontal disease, non-functional orthodontic disease, and chronic ulcerative conditions. Oral surgery fears include excessive bleeding, inability to remove the entire tooth, jaw separation, and dehiscence. Fortunately, these worries are easy to change into happy opportunities.

  • Excessive bleeding can be mitigated through avoidance, realizing that in the maxilla the most troublesome area surrounds the infraorbital artery, which exits the infraorbital canal just above the maxillary third premolar. In the mandibles the area to avoid is the mandibular canal. When either of these are breached, bleeding occurs, which can be minimized by elevating the head with towels, applying a hemostatic agent (Vetigel®), and gauze pressure.
  • Inability to remove the entire tooth through root separation can usually be prevented by examining intraoral radiographs before the procedure, large exposure, and gentle luxation with a sharpened luxating elevator.
  • Jaw separation, occurring usually secondary to advanced periodontal disease, is rare.  Consultation with a veterinary dentist is recommended.
  • Dehiscence is also rare and, in most cases, should be left alone to self-heal.

2. Not enough time

This proven workflow can eliminate time fears.

A client calls to schedule a teeth-cleaning visit due to oral malodor. The client care coordinator shares that your practice provides more than teeth cleaning. The client will be scheduling an appointment for oral prevention, assessment, and treatment (Oral PAT). This is the time to be sure clients understand the value of complete oral care:

  • There is a dental cause for their pet’s halitosis.
  • This will be diagnosed during the initial oral examination, pre-anesthesia testing, as well as a tooth-by-tooth examination under general anesthesia.
  • Recommended treatment for the cause will be discussed, and it can be performed during the same anesthesia, time permitting, or at a later time.
  • The doctor will make plaque and tartar control suggestions the client can perform at home to support overall oral health.

Here’s a timeline example…

9 a.m. The owner brings their dog or cat into the exam room. Review the history and previous laboratory results, examine the pet, and focus on the oral cavity. Discuss owner willingness and ability to provide daily plaque control. Share the value of the services, then discuss fees for  initial diagnostics and dental scaling and radiograph imaging before the client leaves the exam room. The client agrees in writing that they understand:

  1. Anesthesia will be performed, and they have been informed of the associated risks.
  2. There will be additional fees if extra care is needed to treat the cause of the malodor.
  3. Payment options are discussed openly.

Next, inform the client what to expect from the day and arranges a time (1 p.m.) to speak to the owner while the pet is still anesthetized after the cause of halitosis has been determined.

9:30 – 11 a.m. The staff acquire pre-anesthetic test results to share with the veterinarian and prepare the patient for anesthesia.

11:30 a.m. – 12:45 p.m. The patient is anesthetized, teeth are cleaned, intraoral radiographs are exposed and placed in
 a template for the veterinarian to examine chairside. The veterinarian is handed a dental probe to conduct the tooth-by-tooth examination and treatment plan, dictating results to an assistant who creates the dental chart. The assistant tabulates additional fees and creates a report or takes cell phone images, which are emailed to the client.

1 p.m. Talk to the pet owner to review what was found and describe optimum treatment and why it is important for their pet. Fees for the additional care are discussed, along with payment options.

3 p.m. Therapy (e.g., extraction of multiple teeth and application of a locally applied antimicrobial to stop bleeding on probing points) is completed.

5:30 p.m. The client meets with the doctor to review the diagnostics and therapy. A follow-up appointment is set to evaluate healing and create a daily plaque prevention program tailored for the pet.

3. Proper Assistance, Equipment & Instruments

An assistant goes far to lessen the load on the veterinarian during dental treatment.

Proper instruments and equipment are also important:

Elevators: Because there are a variety of sizes of teeth, one needs a variety of sizes of dental elevators. Generally, select the elevator that best fits the contour of the tooth to be extracted. The Heidbrink and Miltex 76 are root tip picks useful in elevation and for extracting retained root tips. They also can be used to cut the gingival attachment off the tooth prior to displacement with dental elevators.

Extraction Forceps: Smaller extraction forceps have been designed for dog and cat teeth. They have more parallel jaws, increasing the surface contact and are much more effective than the human incisor forceps formerly used in veterinary dentistry.

Magnification & Lighting: One frustrating aspect of oral surgery is the limited access and poor visibility. These problems may be decreased using magnification (2.5-3 power) and head lamps.

Sterilization of Equipment: Since extraction is a surgical procedure and the instrument penetrates tissue sterile instruments should be used. While it is true that the tissue surrounding the tooth is already infected, it is inappropriate to add different species of bacteria to the infection. Chemical disinfectants may be effective, but they take time to work, and must be thoroughly washed off prior to use.

Hemostatic Agent: Vetigel® is used to syringe over a bleeding area. Within a minute the bleeding generally stops.

Flaps: Surgical extractions are performed by making releasing incisions on the mesiobuccal and distobuccal line angles between adjacent teeth. These releasing incisions are joined by an intrasulcular incision that follows the gingival margin. The periosteum and gingiva are elevated off the bone with a periosteal elevator, to create a full-thickness gingival flap. The buccal plate of bone over the tooth is removed with a water-cooled high-speed bur.  The root is removed, and the flap is closed without tension over the alveolar socket.

Postop

Radiographs taken postoperatively allow the practitioner to verify that the entire tooth has been extracted. Radiographs create a permanent record of the procedure. The possible pain to the patient caused by the disease condition or the procedure creates the need for consideration of pain medication administered by injection of a local anesthetic, parenteral injection, and oral pain relief medication.

Complications

  • Tooth roots may become separated during the extraction procedure, creating non-extracted root fragments. The preferred treatment in this situation is to create a buccal flap over the fragment for removal.
  • Collateral damage to other oral or extra oral structures including perforation and orbital contusion of the eye with sharp dental instruments.

Using proper instrumentation and extraction technique makes the extraction simpler, safer, and easier on the patient and practitioner. Multirooted teeth should always be sectioned prior to extraction to prevent the likely hood of fractured root segments. Difficult extractions can be accomplished by gingival flap surgery to facilitate atraumatic elevation of the root in a buccal direction. Pre- and postoperative radiographs and pain control help document what has been done and provide the patient with a relatively painless procedure.

Pet Fears

Let’s not leave out the patient, who is our most important consideration. Fear Free practices such as use of nonslip surfaces and techniques such as considerate approach and touch gradient contribute to the success of dental procedures.

Creating a Fear Free dental practice is achievable. I am always happy to help. Please email any questions (dentalvet@aol.com) or call on my cell 954-465-4200.

References

  1. DeBowes LJ. Simple and surgical exodontia.Vet Clin Small Anim 2005; 35:963–984.
  2. Gunew M, Marshall R, Lui M, Astley C. Fatal venous air embolism in a cat undergoing dental extractions.J Small Anim Pract2008; 49, 601–604.
  3. Holmstrom SE, Frost, P, Eisner ER. Exodontics. In:Veterinary Dental Techniques for the Small Animal Practitioner. 3rd ed. Philadelphia: Saunders, 2004, pp. 291–338.
  4. Kapatkin AS, Manfra Marretta S, Schloss AJ. Problems associated with basic oral surgical techniques. In:Problems in Veterinary Medicine. Dentistry. Manfra Marretta S ed., 1990; 2: 85–109.
  5. Reiter AM, Brady CA, Harvey CE. Local and systemic complications in a cat after poorly performed dental extractions.J Vet Dent 2004;21: 215–221.
  6. Reiter AM. Dental surgical procedures. In:BSAVA Manual of Canine and Feline Dentistry. Eds. C. Tutt, J. Deeprose, D. Crossley. BSAVA, Gloucester (UK), 2007, pp. 178– 195.
  7. Scheels JL, Howard PE. Principles of dental extraction.Sem Vet Med Surg 1993; 8:146–154.
  8. Smith MM, Smith EM, La Croix N,et al. Orbital penetration associated with tooth extraction. J Vet Dent 2003;20:8–17.
  9. Van Foreest A: Exodontia (tooth extraction in dogs).EJCAP 1993; 3:35–42.
  10. Verstraete FJM. Exodontics. In:Textbook of Small Animal Surgery. Philadelphia: WB Saunders, 2003; 2696–2709.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Dr. Jan Bellows received his undergraduate training at the University of Florida and Doctorate in Veterinary Medicine from Auburn University in 1975.  After completing a small animal internship at The Animal Medical Center in New York City, he returned to south Florida where he still practices companion animal medicine surgery and dentistry at ALL PETS DENTAL, in Weston Florida. He is certified by the Board of Veterinary Practitioners (canine and feline) since 1986 and American Veterinary Dental College (AVDC) since 1990  He was president of the AVDC from 2012-2014 and is currently president of the Foundation for Veterinary Dentistry. Dr. Bellows’ veterinary dentistry accomplishments include authoring five dental texts – The Practice of Veterinary Dentistry …. A team effort (1999), Small Animal Dental Equipment, Materials, and Techniques (2005, second edition 2019) and Feline Dentistry (2010, second edition 2022).  He is a frequent contributor to DVM Newsmagazine and a charter consultant of Veterinary Information Network’s (VIN) dental board since 1993.  He was also chosen as one of the dental experts to formulate AAHA’s Small Animal Dental Guidelines published in 2005 and updated in 2013 and 2019.

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Michael Petty, DVM, CVPP, CVMA, CCRT, CAAPM/strong>The approach to a pain exam in a cat barely resembles what you might do with a dog, who you can take outside on a leash and trot around, and who are usually more accepting of a physical exam for pain. Instead, I am going to describe the team approach to diagnosing pain in cats.

Owners often report that their cat has become grouchy or will even growl and strike out while being petted or picked up. The underlying cause could be that the cat is in pain and doesn’t want to be touched out of fear of causing more pain. It’s much the same as a person with a painful wrist or shoulder; they understand how to move that arm without causing undue pain, but a well-meaning handshake from another person can cause excruciating pain as the person with the painful arm loses control of the movement.

This leads us to the beginning of the pain exam: discussing with the owner behavioral changes they have either observed but dismissed (often as “old age” or some new quirk) or behavioral changes such as elimination outside the litter box. Indeed, a 2020 study published by Daniel Mills et al. in the journal Animals called Pain and Problem Behavior in Cats and Dogs found that it is estimated that almost 80 percent of behavioral issues can be related to various painful conditions; not only musculoskeletal, which is the focus of this discussion, but also other sources such as gastrointestinal pain. Hence it is crucial that every member of the veterinary staff plus the owner be involved in order to properly diagnose, treat, and evaluate the progress of any therapy. Otherwise, the mental snapshot of the animal in pain might be as jumbled as a jigsaw puzzle dumped out of its box.

The pain exam starts with your customer service representative, maybe the most important person in the diagnostic team. They are going to hear the owner say things that an educated customer service representative might recognize as a sign of pain, such as not using the litter box, suddenly fighting with other animals in the house, or hiding in another room. The receptionist then has the ability to ask the owner to video the cat walking across the floor, using a step, or jumping to a favorite spot. The receptionist can also ask them to visit websites, for example www.catredflags.com, to set the stage for a pain discussion once in the clinic.

The pain exam continues with the technician who, clued in by the receptionist that there might be a pain problem, can ask about videos. If the client did not visit any of the suggested websites, the technician can have them do so on a clinic tablet or laptop.

At this point, it is important to ask about behavioral changes: has the cat’s world become less vertical and more horizontal? Does the cat hesitate to jump or jump up in stages using a chair, for example, to reach a windowsill? Does the cat socialize less with humans or other animals in the household? There are more examples on the website mentioned in the previous paragraph. All of these inquiries help to “soften up” the client for the message that their pet may be living in a constant state of pain and has been telling them all along through their actions.

The pain exam concludes with the veterinarian, whose success in diagnosing pain depends heavily on the events and education preceding the examination. Without them, the owner might not see the cat through the eyes of someone trained to recognize pain in cats.

I always start my pain exam by letting the cat wander the room, keeping an eye on how they move and jump. Cats should move like a tiger gracefully moving through the jungle, with a fluidity of movement. Of course, some cats do nothing but hide under a chair during the visit, so this is the importance of asking the owner to take videos: This is my number-one diagnostic tool to know that “somethin’ ain’t right” with the cat’s musculoskeletal system. Pointing out what we see to the owner brings them a new sense of enlightenment regarding the cat’s condition.

Once I know something is wrong, I finally put my hands on the cat to locate the problem. The physical starts with stroking the cat from head to tail, in a gentle pattern. For many cats in pain, this will relax them and build a trust that will allow you to do slightly more potentially painful manipulations. You can also look for areas of sensitivity at this gentler touching. When these painful spots are found, there is no longer any need to revisit them; what more can you ascertain or achieve, besides increased stress in the cat?

The next step is to focus the exam on suspect areas. By this time, you may have an idea as to the general body area where the pain is located. If so, depending on the cat’s FAS score, I may examine only those joints, as the exam is over when the cat says it is over, and further manipulation may result in a heightening of their FAS score, indistinguishable from a response to pain. I find it easier to manipulate the cat’s joints when they are in lateral recumbency.

Manipulation of the elbow in a recumbent position. Please note, this is my daughter’s cat Alvin who is very compliant. This cat is not being scruffed; his head is only being held in place.

However, some cats will not allow that to happen. The exam can also be done with the cat in a standing position.

Examination of the lumbosacral joint in a standing position.

Each joint needs to be gently extended and flexed to look for resistance, but not to the point of causing undue pain. Again, if you are trying to persuade yourself or the owner that there is an issue, this is not the way to do it. For videos on how to do a complete pain exam on a cat, visit https://www.zoetisus.com/oa-pain/feline-exam-videos.aspx to see Dr. Duncan Lascelles demonstrate.

This brings us to radiographs. Some cats have either a demeanor or pain level so high that a physical exam should not be performed. If we are convinced that the issue is pain, it is now become less important to know the exact location, thanks to the approval of frunevetmab, an anti-NGF monoclonal antibody that is distributed to all of the OA joints in the body.

However, if we are not convinced, or we hope to do directed therapy such as acupuncture or rehabilitation therapy, then radiographs are a must. These should always be performed with something to reduce the cat’s anxiety and pain during the radiographic study. I prefer butorphanol as it gives 15 minutes of mild to moderate pain control as well as an additional few hours of somnolence, which can help ease the cat’s anxiety while waiting to go home. Just remember, the pain control lasts only about 15 minutes or so after injection; don’t confuse any sleepiness on the cat’s part past 15 minutes as pain control. And a final word on radiographs. Many cats with OA actually form areas of calcification distant from the joint. If you haven’t brushed up on diagnosing OA on radiographs in cats, you may want to explore that further.

Notice the distribution of calcification in this cat with knee OA. There is a typical lesion on the left knee but both knees have areas of calcification proximal to the joint. Sometimes they will even be seen floating in an adjacent muscle. Another reason to consider that cats might actually be aliens.

Utilizing the team approach and minimal hands-on interaction can greatly diminish the FAS in our painful feline patients who are going to be resistant to touch. Now that we have examined that cat with input from the entire veterinary staff, along with the owner and the cat itself, we no longer have a jigsaw puzzle, and can move forward with the therapeutic phase of their OA treatment.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Michael Petty, DVM, a certified veterinary pain management expert and veterinary acupuncturist, is author of Dr. Petty’s Pain Relief for Dogs: The Complete Medical and Integrative Guide to Treating Pain (Countryman Press, February 2016). He owns Arbor Pointe Veterinary Hospital and the Animal Pain Center in Canton, Michigan, and is past president of the International Veterinary Academy of Pain Management.

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Alyson Evans, RVT, CVT, Elite FFCP, CCFPAs many of you have read previously, I have been suffering from burnout. It took me a full year to accept that I needed to seek professional help to address my emotional ailments. Some days were better than others and some were darker.

From the day I went onto the Sondermind website and filled out the questionnaire about what I needed to address, I knew I was done holding onto so much darkness, hurt, and feelings of failure and worthlessness. A therapist contacted me within the day, and I scheduled my first appointment.

During my first session I burst into tears and felt relief. More, I felt the start of freedom from everything weighing me down. My weekly sessions dove into dark places that I didn’t realize were affecting me in an unhealthy way.

I have learned so much: That the emotional baggage of a recent trauma I had witnessed was called secondary trauma. And that when burnout and secondary trauma come together, the result is compassion fatigue.

I know many people are terrified of seeking professional help, believing it is a sign of weakness. It isn’t. Seeking professional help is a sign of strength and self-worth, recognition that it’s okay to put ourselves first. It’s difficult to do that, especially if we are veterinary professionals, but humans are not meant to fix everything on their own. We aren’t meant to be all-knowing and all-healing, let alone self-healing, at least not without a little help and guidance.

At a recent therapy session, I didn’t have much to talk about other than two vivid dreams, unusual because typically my dreams fade away rather than sticking in my memory. In the first, I was bitten on my right wrist and left ankle by a snake. After some research, I learned that this dream signifies overcoming a mental obstacle or issue as well as dealing with criticism. Both were accurate. I felt like I had been healing but hadn’t fully realized it. In the next dream, our neighbor, with whom I’ve had issues in the past, was drawing beautiful chalk murals on our sidewalk. She told me she wanted to start over and admitted that she had not been very nice to me for the past two years.

When I told my therapist about these dreams, I explained that I thought they were signaling that I was free to move on and move forward from the darkness I had been harboring. My therapist, smiling, nodded her head in agreement and for the first time I felt pride in myself and how far I have come.

My therapist once asked how I would know that I had achieved healing. “Pride,” I said. I would feel proud of myself for learning and practicing the tools I had gained from therapy to self-heal to the best of my ability, for putting aside my self-pride to seek professional help. Now that has happened.

My hope in sharing this journey is that some or all of you will find the strength to advocate for yourself. Take a chance on yourself and seek professional help. Speak up and ask for help or let someone know you are not okay. You can learn how to set boundaries, love yourself, and know that it is okay to not always be okay.

Here are some things that help me daily:

I play calming music in the car to and from work: It’s not just great for a Fear Free visit to and from the vet office for our pets, it is great for our own mental wellbeing going to and from a place that can cause us fear, anxiety, and stress.

When I start to feel stress or anxiety, I ask myself, “Is this helpful or hurtful?” and then move on.

I no longer work through lunch: I need that time to recharge, whether by meditating, listening to music or a podcast, or watching a Ted Talk or Netflix show.

I make plans for the weekend or holidays: Making plans with my family helps us not to stagnate at home but to get out of the house and do things together.

I set a bedtime for the kids: Adults need their own time. Keeping kids on a set schedule for bedtime helps parents stay connected and have time to check in on one another.

I don’t try and solve every problem: We are in an industry where people come to us with problems that we do our best to solve. It is okay to guide family and friends toward solving their own problems and making their own mistakes.

I treat myself: A hair appointment, a new outfit, or a mani-pedi are all ways to relax and feel special now and then.

I explore new options: The best time to explore other opportunities is to do it when we don’t have to. If you are happily employed but want to see what other hospitals are like or what opportunities are out there, investigate them. When we are not in a position where we might have to settle, we can explore our own values in a career and determine what is important to us. Many times, this exercise can help us realize what we value in ourselves or desire in a career path or future hospital.

I accept my feelings: It’s okay to express my feelings, whether someone else agrees with them or not.

I’m open and honest with loved ones: When I allow myself to be vulnerable and talk about how I am feeling or anxieties or fears I have, I allow my family to be part of that, which in turn has helped them feel more involved with my life rather than just being spectators.

Check out our Fear Free on the House page for resources on wellness, quick tips, and more!

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Alyson Evans  RVT, CVT, Elite FFCP, CVBL, is hospital manager at Briargate Boulevard Animal Hospital in Colorado Springs, Colorado.
 
Barbara HeidenreichYour practice may not specialize in birds, but if there is not a board-certified avian practitioner in your area, you may find yourself seeing pet birds occasionally. Learning how to interact comfortably with them can help you add new clients and keep them and your feathered patients happy.

Unlike a dog or cat that may respond to a new person right away, birds can sometimes require a little extra effort on our part, especially if this is their first visit to your facility.

Birds can often show escape and avoidance behaviors when meeting a stranger. Here are some things you can do to help them to be more comfortable when you are getting to know them in a clinic setting.

  1. Give the bird space: Although it is tempting, try not to go right up to a bird. Give him some time to get used to you being in the same room. Once he is looking relaxed and comfortable you can move a bit closer.
  2. Speak softly: Many parrots respond to our loud voices by getting louder. Parrots can go from calm to highly aroused when we get animated, which can create conditions in which aggressive behavior is more likely to occur.
  3. Move slowly: Birds tend to show fear responses when people move too quickly. You don’t want to scare your soon-to-be new friend.
  4. Approach from the front: Be sure to approach the parrot so that he can easily see you coming. Many birds don’t like it when someone is moving behind them.
  5. Show him something special: Before walking closer to a parrot, it is a good idea to have some preferred food items, small parrot toys, or other desired item with you. Ask the client what the bird likes best. Show the bird what you have to give him before you get too close.
  6. Watch his body language: When you show the parrot the special treat or item you have for him, watch how he responds. If he leans toward you, he is saying he would very much like to accept your gift. If he leans away, he might be saying he is not sure he is ready to make friends right now. If he is not ready, you can always try again later.
  7. Offer the special item: If the parrot leans forward and reaches his beak toward what you have to offer, you can move closer and give him what you have. Whenever you offer a preferred food item or toy to a parrot for the first time, try to present it so the bird has to lean forward to take it with his beak. This way you don’t have to get too close to the bird’s beak, and you can be extra-sure the bird is ready for the item. Sometimes when we get too close or offer the item too fast, a bird might respond by biting.
  8. Offer more items: If the parrot takes the first food item or toy and is receptive, he might look or lean toward you for another one. If he does, that is an invitation to really start getting to know each other. Continue to offer him the desired items. This will cause your new parrot friend to look forward to seeing you.

Once a parrot understands that desired interactions occur in your presence, you will begin to notice more affiliative responses. He might be eager to step onto your hand. He might even talk or sing to see if he can encourage you to come closer to gain desired outcomes. As the bird’s comfort increases, he might even let you stroke the feathers on his head. This can be a good sign that you were very careful not to evoke fear responses and have done a good job building desired engagement.

Making friends with a parrot sometimes takes a little extra effort. But it is a very special compliment when a parrot accepts you as a friend. Pay close attention to your actions when you are meeting a parrot for the first time, and offer him preferred food items and fun toys. To learn more about interacting with, caring for, and managing parrots, seek out the Fear Free Veterinary Certification Program-Avian, which includes how to recognize stress in birds, how to handle and examine them safely, and how to teach cooperative care behaviors.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Barbara Heidenreich is an animal training consultant specializing in exotic animals. She consults worldwide working with zoos, universities, veterinary professionals, and conservation projects. She has worked onsite with over 80 facilities in 27 countries. She is an adjunct instructor at Texas A & M University. She has authored two books and contributed to four veterinary textbooks. She is a coauthor of two Fear Free® Avian Certification Courses. Much of her work focuses on training exotic species to cooperate in medical care. Barbara is an advisor for the Animal Training Working Group and the Parrot Taxon Advisory Group for the European Association of Zoos and Aquariums. She has provided her expertise to conservation projects The Kakapo Recovery Program and The Borneo Orangutan Survival Foundation. Her goal is to leave behind a legacy of kindness to animals by sharing her expertise.
 
Audrey Pavia
For many young people who love animals, becoming a veterinarian is a life-long aspiration that starts in high school and culminates in acceptance to a veterinary college. Reaching that goal takes an incredible amount of work and dedication and can take a toll on a student’s mental health.

Veterinary schools around the country have come to recognize the emotional challenges veterinary students face as they work to complete their degrees and have stepped forward to provide them with help. Right now, every Association of American College of Veterinary Medicine (AACVA) member school offers some kind of program design to help students maintain mental health.

How It Started

Kathleen Ruby, PhD, a psychologist based in Neskowin, Oregon, helped create the first mental health program for vet students, at Washington State University College of Veterinary Medicine.

“I was hired as one of the first counselors/mental health practitioners in the country for a college of veterinary medicine in 1998,” she says. “At the time, the position was quite ill-defined. It had been set up at the request of several faculty who found themselves counseling struggling students not just academically, but regarding personal issues and mental health problems.”

Dr. Ruby had been informed of two suicides of students in the college within a decade, and between these tragedies, and some faculty feeling uneasy about the one-on-one care many students seemed to require, the administration was persuaded to hire a professional to aid and support students.

“As a PhD mental health therapist with 12 years of experience running a private practice, as well as having helped a medical social worker work with students in my husband’s medical residency, I was seen as a good candidate,” she says.

At first, Ruby’s position was viewed as similar to an in-house university counseling center, where students made counseling appointments when they felt they were needed, and the counselor served as an in-house therapist.

“The program continued this way for a couple of years, and I found myself inundated with anxious, depressed, and overwhelmed students,” Ruby says. “The levels of anxiety, anxiety disorders, and mild to moderate depression were much higher than I was used to seeing in my private practice.”

Ruby notes that most vet students are young adults, which is the prime age for some mental illnesses to appear.

“I found myself dealing with several bipolar breaks,” she says. “Acutely, there were students who were victims of sexual assault, rape, and domestic violence, as well as divorce.  More chronically, we had several students who had a great deal of childhood trauma, which they’d been able to cope with until put within the pressure cooker of an extremely difficult curriculum challenge.”

Ruby found–and other counselors in CVMs agreed–that the academic intensity; the closed nature of programs in which classes are small, with approximately 100 students who remain together all four years; the financial challenge of paying for medical school; the young-adult life stage; relationship challenges; and personal challenges inherent in medical training all contributed to making veterinary medical training a challenge to student mental health and well-being.

“Once this was ‘diagnosed,’ we began to craft programs to address some of the major stress points in the environment of training itself,” she says.

Helping Students

Fast forward to 2022, and students at vet schools in the U.S., as well as some in Australia and New Zealand, have access to mental health programs designed specifically for them. In addition, the AAVMC now offers an Accepted Student Wellbeing course for new vet school students, and is partnering with several organizations, including the Veterinary Mental Health Initiative, to create tailored resources on specific topics for students, staff, and faculty.

At University of California at Davis, the school of veterinary medicine student mental health program is designed to be multifaceted to meet student needs through the entirety of their professional school experience, according to A. Zachary Ward, Ph.D., coordinator of mental health and wellness programs.

“We start by interfacing with our first-year students in their first weeks of the program,” he says. “We work to overtly promote the focus on mental health and wellness at our school, and reduce the perceived stigma associated with reaching out for help when needed. We provide multiple presentations on mental health topics over the years and serve as mentors to the Health and Wellness Club, a student-run organization on our campus.”

The program also provides consultation to students, faculty, and staff on mental health-related topics, with particular focus on consultation around how someone can help a student when concerned about their mental wellbeing.

“We also explore methods for promoting mental wellbeing within the systems of our campus,” says Ward. “However, the bulk of what we do is provide direct clinical services to our students through individual psychotherapy, crisis intervention, group counseling, and couples therapy.”

It Works

These efforts to help vet students navigate life is paying off at UC Davis, according to Ward.

“Results can be measured in several ways, using metrics that we use to show psychotherapy works, via students’ responses to mental health symptom surveys and client satisfaction surveys,” he says. “However, to me, it’s the qualitative feedback that we receive from students that really tells me that our program is making a significant impact in their lives.”

Ruby believes the best gauge of success is how far and wide the understanding of mental health issues and the importance of personal well-being has spread throughout all echelons of the veterinary profession in the past two decades.

“Leadership at veterinary colleges and throughout the profession have gone from being somewhat apprehensive about the need for such care and training to becoming enthusiastic supporters and advocates,” she says. “Almost all the colleges now have at least one mental health professional, and some more than one. Most have well-integrated and sustainable wellbeing programs that are woven throughout the curriculum.”

Veterinary mental health and its challenges have been recognized, studied, and reported on throughout academic journals and popular media, Ruby says. She finds that this proliferation of knowledge, resources, training, and awareness-building has been a positive and helpful force within the profession.

“Perhaps the most exciting trend for me is that many of the speakers at educational conferences, and some of the current counselors, authors, and researchers are now DVMs who have recognized the need within their profession and have gone on to get additional certification in mental health and well-being fields to work within and improve the health of their own profession,” she says. “I can think of no greater validation than that!”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Audrey Pavia is a freelance writer and author of Horses For Dummies and Horseback Riding for Dummies. She lives in Norco, California, with her two Spanish Mustangs, Milagro and Rio.
 
By Kim Campbell ThorntonTwo infectious retroviral diseases are often thought of as a death sentence for cats, but they don’t have to be. One is feline leukemia virus, and the other is feline immunodeficiency virus.

Apprehension about transmission and preconceptions about how they can affect a cat’s quality of life or adoption potential often leads to routine euthanasia for shelter cats who test positive for either disease. And some veterinarians may recommend against adopting a cat with FeLV or FIV particularly if clients have other cats in the household.

Life-saving protocols and good guidelines for adopters make those concerns outmoded, however. Cats with FeLV or FIV can live normal lives without being a hazard to other cats. With preventive healthcare strategies and prompt identification and treatment of illness, both diseases can be managed effectively and their spread limited. Moreover, the Association of Shelter Veterinarians and the American Association of Feline Practitioners do not support euthanasia based solely on a cat’s infection status.

FeLV

Approximately three to four percent of cats in the United States test positive each year for feline leukemia virus, according to the 2020 AAFP Feline Retrovirus Testing and Management Guidelines. The diagnosis affects an estimated 60,000 cats in animal shelters annually.

It’s important to know that the disease, which suppresses a cat’s immune system, does not run a straight course, says Julie Levy, DVM, PhD, DACVIM, DABVP (Shelter Medicine). It affects different cats in different ways and at different times. Levels may change over time depending on a cat’s immune status. Some cats live with the disease with little problem. It may flare up if the cat is stressed or has a comorbidity such as an upper respiratory infection and then subside. It’s not possible to run a test once and then expect the cat to remain the same throughout life.

More important, people are willing to adopt cats with FeLV and give them the care they need.

There is a high national demand for a lifesaving option for cats diagnosed with FeLV, and more and more shelters are working to place FeLV-positive cats in homes. Programs include Chicago’s Tree House Humane Society, Philadelphia Animal Welfare Society, Operation Kindness in Carrollton, Texas, and Austin Pets Alive!

A cat with FeLV can live for many years without illness and without spreading the disease to other cats if they are adopted into single-cat homes or with other FeLV+ cats. This has made a difference for cats in several ways. One is that recommended options for testing have been pared down to a small menu of the most accurate and cost-effective tests. A long-running study has allowed researchers to determine the most reliable tests as well as to evaluate how the status of cats with the disease changes over time. Using a new quantitative PCR test, shelters can now identify whether a tested cat is likely to be a long-term survivor or develop disease and mortality early.

Preventing FeLV

The advisory panel of the AAFP recommends that kittens be vaccinated for FeLV starting as early as 8 weeks of age with two vaccines given three to four weeks apart and then boosted when they are a year old. Vaccination of cats for FeLV during kittenhood, followed by a single booster vaccination at one year of age, is the best way to prevent spread of the disease and reduce its incidence.

While it does not consider FeLV a core vaccine for adult cats, the AAFP recommends that adult cats should be vaccinated annually for FeLV if they are at risk. Risk factors include spending time outdoors, living with cats known to be infected with FeLV, or interacting with cats of unknown disease status.

Ask clients or adopters about the lifestyle and vaccination status of other cats in the home. While vaccination doesn’t help cats already infected with FeLV, it is important for uninfected cats who may have access to the outdoors or potential contact with infected cats. It’s not uncommon for indoor cats to accidentally get out of the house or to experience a change in lifestyle leading to time spent outdoors on a regular or full-time basis.

Elanco’s range of vaccines against FeLV are designed to give feline patients a more comfortable vaccine experience. The ½ mL vaccine—containing half the volume of traditional 1 mL vaccines decreases administration time, increasing the comfort of the vaccination. It is also highly purified, using PureFil technology, designed to reduce adverse reactions associated with extraneous proteins and cellular debris. The vaccine line is available in a variety of combinations, including the only 1/2mL FVRCP+FeLV vaccine, to reduce the number of injections that may be needed.

FIV

Along with FeLV, feline immunodeficiency virus is one of the most common causes of infectious disease in cats worldwide. Cats typically acquire FIV through bite wounds when they fight with FIV-infected cats. A cat’s FIV status should be determined at the time of adoption or if the cat later becomes ill or has any risk of exposure.

But an FIV-positive test does not make a cat unadoptable. While the possibility of transmission is there, exposure to an infected cat is not as risky to uninfected cats as previously thought. FIV-positive cats living amicably with disease-free cats do not appear to pass on the disease. Nor do FIV-positive queens pass on the disease to their kittens. Casual contact, such as allogrooming or sharing water bowls, has not been found to be a common or efficient route of transmission. And while FIV is contagious among cats, it’s not transmissible to humans.

FIV infection can have three phases: acute, asymptomatic, and progressive. In the acute phase, occurring one to three months after infection, cats may have mild signs or no signs. It is followed by an asymptomatic, or latent, phase, which can continue for months or years. They may or may not progress to symptomatic disease.

With good care, some infected cats can live for many years with good quality of life. Some cats show no signs at all, although they remain infectious. However, because FIV affects the immune system, cats with the disease can be more prone to respiratory, dental, eye, or skin infections. Other signs associated with FIV include fever, lethargy, chronic diarrhea, and weight loss.

Clients or adopters caring for cats with FIV should protect them from injuries or wounds that could lead to secondary bacterial infections, as well as from other viruses and parasites that could cause illness. Best management practice is for these cats to live indoors, where they are protected from exposure to potential injuries and infections and prevented from spreading the disease to other cats.

A vaccination for FIV is not commercially available in the U. S., nor is it recommended by any veterinary organizations or schools of veterinary medicine. Its use can complicate diagnosis of FIV infections. Vaccinated cats produce antibodies indistinguishable from antibodies induced by natural infection, making test results unclear if a cat’s vaccination history is unknown. Cats vaccinated for FIV should have a microchip or tag indicating their vaccination status.

The bottom line is that cats with FeLV or FIV are often young, healthy in the moment, enjoying life, and can make great companions. With good care protocols, they can live happy lives with people and other cats.

Click-thru URLS

Fear Free         https://fearfreepets.com/

Blog                 https://fearfreepets.com/blog/

Elanco Animal Health https://www.elanco.us/

American Association of Feline Practitioners 2020 AAFP Feline Retrovirus Testing and Management Guidelines (sagepub.com)

This post is brought to you by our sponsor, Elanco, the maker of TruFel Ultra Vaccines.

TruFel, Ultra, Purefil, Elanco, and the diagonal bar logo are trademarks of Elanco or its affiliates.

©2022 Elanco or its affiliates. PM-US-22-1068

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Alyson Evans, RVT, CVT, Elite FFCP, CCFPSix months ago, I wrote about my experience with burnout. I thought then that I had reached my lowest low, but I was wrong. Here’s what has been happening since then.

I have been doing nail trims and anal sac expressions in my neighborhood for the last three years.  Recently, one of my neighbors had asked on our community Facebook page if someone in the veterinary field could answer a question. Her dog was limping, and she didn’t know what to do.  One of the neighbors offered her some doggy aspirin she had bought at the pet store. I quickly advised against giving unprescribed medications to her pet.

The conversation turned into a bullying session. One of my neighbors told me I shouldn’t try to act like a veterinarian. I have never felt so disrespected in the 15 years I have been in this career.

I shut down.

The next thing I knew, I was in my closet, crying, repeating to myself, “I don’t care, I don’t care anymore. Why should I care about others’ pets if I am going to be treated like crap? I’m done.”

I may have been improving with burnout, but I had just hit a whole new level of compassion fatigue.

I had a full weekend’s worth of nail trims to do and was going to make a little more than $200 in five hours. I didn’t care about the extra money anymore and canceled all appointments for the foreseeable future.

In tears, I explained to my husband why I had given up making extra money on the side. It was clear he wanted to help but didn’t know what to say or do. I knew I needed professional help.

Now I’m in the process of finding a therapist I can connect with. Until then, my family and I have adopted the following tools to help reduce stress:

–Simple Habit, a meditation app. My son uses it to fall asleep and settle down. He will ask to meditate to go to sleep now.

–A “coming home” routine: The spouse who is home first allows the second spouse to “finish coming home.” This gives them some quiet transition time to put their bags down, change clothes, and relax. When they’re ready to engage with the other spouse to prepare for the evening, they come out of the bedroom or wherever they choose to decompress.

–Boundaries with kids: I explain to my son that I need time to talk with his dad and ask him to sit quietly and watch a short show or play ABCmouse, a reading app. I also set timers in the house called, “Time to get ready for bed,” “Time for bed,” and “Quiet time is over.”

–Communication: When I start to feel like I’m getting anxious, I communicate how I am feeling and what I need to be able to come back down to earth.

Most of all, we continue to remind each other to slow down, be present, engage, and take time to listen to one another. My husband and I are working to improve our communication with our 3-year-old son so we can help him become an emotionally intelligent person, something his dad and I still work on ourselves.

We make time to have difficult conversations, and when we get into arguments, we try to make it a conversation, being mindful of raised voices, body language, and facial expressions. When necessary, we call each other out in a respectful way, in the moment, to help the other become aware of what they are doing.

The Fear Free way of thinking has helped me in so many aspects of my life. I use the techniques with my own son when he has doctor appointments as well as in everyday life. I communicate with him, making sure he knows what is coming up next, where we are going, what the doctor will do next. He is better behaved and calmer when things are explained to him, in most settings. I think that most children would respond to situations in a calmer manner when a Fear Free or Considerate Approach is taken.

In a work setting, my current team is emotionally intelligent, and all know the battle that I am fighting, which helps. Openly discussing things with your team can not only help you to become stronger but also to be seen with more respect and empathy than if you suffer in silence to spare everyone else’s feelings. Maybe someone on your team is suffering as well and doesn’t have the courage to speak up. Sharing your battles may give them strength to seek help for theirs. I wish more practice managers and owners would spend a day, at least, in a Fear Free certified hospital.

The most important message I want to send is that the battle of burnout is ongoing, and it’s not one you can win on your own. It doesn’t fix itself overnight or with a couple of therapy sessions.

Here is a quote I read frequently from Rachel Ashwell’s book “Painted Stories”:

“There is a time for taking action and creating work, and there is also a time for rest and seeking new ideas. Learning when you need space will help you to build a more sustainable creative practice.”

Check out our Fear Free on the House page for resources on wellness, quick tips, and more!

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.