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Lisa Radosta, DVM, DACVB, shows how to examine a feline patient who is exhibiting mild to moderate FAS in a safe and controlled manner.
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Debbie Martin, RVT, CPDT-KA, KPA CTP, VTS (Behavior), demonstrates how you can help coach your clients to get their dogs on the scale easily and without stress.
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Kristin Kirkby Shaw, DVM, MS, PhD, DACVS-SA, shows you how to perform a one-minute orthopedic exam on a dog utilizing Fear Free principles. For a more detailed exam, you can view an extended video here.
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Feline blood draws are often stressful for the professional, and even more so for the patient. Veterinary technician/trainer Tabitha Kucera, CCBC, RVT, KPA-CTP, shows how you can get a blood draw done on a feline patient quickly, easily, and, most importantly, Fear Free.
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
Join Mikkel Becker, Lead Animal Trainer for Fear Free, to discuss her newest course, Next Level Nail Trims. Mikkel shares stories from the trenches on dealing with difficult nail trims and gives her top tips for creating a Fear Free nail trim experience.
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.
Julie Liu, DVMNo sooner do you read the alert, “Caution, will bite!” on your next patient’s chart when you hear him enter the building: loud yowls in the waiting area, followed by hissing, growling, striking, and screaming when you dare to peek at him through the carrier in the exam room. Is it a scene from a veterinary horror movie? Nope, just a senior cat who’s been losing weight for a couple of months, is overdue for rabies, and oh by the way, can you also trim his nails?
Fear of the veterinarian is a common finding among our feline patients and unfortunately, left unaddressed, can often escalate to aggression and worse veterinary care. Cat parents may put off bringing their cat to the vet due to the stress involved, and veterinarians are often unable to perform an exam, diagnostics, or treatments due to risk of injury. If you’ve ever attempted to “examine” one of your feline patients by observing them solely from the carrier, a recent JAVMA study1 may bring hope.
In the double-blinded, randomized, placebo-controlled study, two groups of healthy cats at least 6 months of age were given either gabapentin or a placebo capsule two hours before the first of two veterinary visits. One group had a history of fear-based aggressive behaviors (FAB), and the other did not.
During the vet visits, the cat parent was present but did not interact with the cat, and the vet attempted to go through the following steps with a standardized clinical exam, corresponding to a compliance score of 0 through 9: no handling; removing the cat from the carrier; cardiopulmonary auscultation; abdominal palpation; intraoral exam; ocular exam; otic exam; rectal temperature; and finally, return of the cat to the carrier. The exam was stopped if the cat tried to bite or scratch the vet, but the exam continued if the cat hissed or growled. On the second of the two visits, performed a mean of about 15 days after the first visit, the cat received the opposite treatment of either placebo or gabapentin and the steps to attempted clinical exam were repeated.
The results suggested that the compliance scores of cats in the FAB group that received gabapentin were significantly higher (median, 9) than the same cats with FAB that received a placebo (median, 0.5). Forty-two percent of the cats receiving gabapentin did experience some side effects, most commonly drowsiness and myorelaxation. However, all adverse effects had resolved after approximately 10 hours, which is a reassuring point to make with concerned cat parents. In addition, most cat parents in the study rated the gabapentin and the placebo as being fairly easy to administer with regular food.
If you’re not using gabapentin routinely for your feline patients to reduce stress, now is a great time to start. An easy way to get cat parents on board is to send home a “Fear Free goody bag” that includes two free doses of 100 mg gabapentin (a trial dose and a day-of dose), an individually packaged Feliway wipe, and the Fear Free handout “How to Prepare Your Pet for a Veterinary Visit.”2 Cat parents who balk at having to pay a dispensing fee for a gabapentin prescription may welcome a sample, and gabapentin is so inexpensive that the cost vs. benefits of actually being able to handle and treat your feline patients will pay off a thousandfold. Just make sure you discuss potential side effects and recommend that they give the gabapentin in a tasty treat such as Churu to avoid causing a food aversion with their regular canned food.
If the cat parent does their part by administering the gabapentin to their fearful cat, we as Fear Free Certified Professionals must do ours and use feline-friendly handling. A perfectly mellow cat floating away on a cloud of gabapentin is going to come crashing to earth if they’re scruffed or dumped out of their carrier. While removal from the carrier was the second step in this study’s standardized physical exam, if a cat doesn’t want to come out of the carrier on their own, they’ll often become much more stressed when they’re removed from the familiar environment of their carrier. Try removing the top of the carrier and allowing your feline patient the option of hiding in the towel–you’ll find that you can often do an entire exam, vaccines, and sample collection this way without the cat escalating to FAB.
For more info on feline-friendly handling, check out the updated, amazing, and free AAFP webinar by Dr. Ilona Rodan.3 Even experienced cat people will learn some great tips on ways to keep their feline patients as relaxed as possible.
- Kruszka, M., Graff, E., Medam, T., & Masson, S. (2021). Clinical evaluation of the effects of a single oral dose of gabapentin on fear-based aggressive behaviors in cats during veterinary examinations, Journal of the American Veterinary Medical Association, 259(11), 1285-1291.
- https://fearfreepets.com/wp-content/uploads/2017/09/Preparing-for-the-visit-store.png
- https://catvets.com/education/online/webinars/feline-friendly-handling-interactions
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Julie Liu is a veterinarian and freelance writer based in Austin, Texas. In addition to advocating for Fear Free handling, she is passionate about felines and senior pet care. Learn more about Dr. Liu and her work at www.drjulieliu.com.
Course Overview
This one-hour course is for Fear Free Certified veterinarians considering relief work and relief vets considering Fear Free certification—both of which have an opportunity to positively impact the profession but also face unique challenges. Throughout this course, you will learn how to practice Fear Free as a relief vet and address different types of communication unique to this role. In addition to bringing Fear Free to general relief practice, we’ll also cover some of the situations you may encounter in emergency or shelter relief practice. You’ll also learn tips for identifying compassionate clinics who share your Fear Free philosophy.
This course contains nine short lessons:
This course was written by Julie Liu, DVM, and Cindy Trice, DVM and is approved for 1 hour of RACE CE.
Course Overview
This short course will cover a novel technique for minimizing stress to birds while also comparing this technique to past concepts covered in the original Fear Free Veterinary Certification Program – Avian. We will teach you an alternative, advanced approach to reinforcing desired behavior in avian patients displaying fear or aggression that are not responding to other Fear Free training techniques. We’ll also provide several examples of using a Constructional Approach to teach useful behaviors and recommendations associated with the client and team communication surrounding the use of Fierce/Fearful to Friendly (F2F).
This course includes three lessons:
- Lesson 1: Using the Constructional Approach to change responses from Fierce or Fearful to Friendly (F2F)
- Lesson 2: Case Studies
- Lesson 3: Practical Implementation
This course was written by Barbara Heidenreich and Alicia McLaughlin, DVM, CertAqVet and is approved for 1 hour of RACE CE.