Skip to main content

Tag: cats

Older posts

See These Cats “Meow!” Early Detection of Feline Diabetes

Natalie L. Marks, DVM, CVJ, CCFP, Elite FFCP-V

While our profession originated in preventive medicine, many veterinarians today spend most of their time on chronic disease detection and management. Some of this shift is due to cats living inside the home with longer lifespans. However, other significant factors include pet parents waiting longer to seek veterinary care due to myths about cat health and the rising costs of veterinary medicine.

As Fear Free Certified Professionals, we don’t just consider physical health but also the emotional health of the feline patient, pet parent, and our teams. When specifically thinking about how this applies to the diagnosis and management of our feline diabetic patients, there are two fundamental tenets for success: educating cat caregivers on signs of diabetes for earlier detection and offering alternative treatment options for qualifying patients to ensure complete health.

With a diagnosis of diabetes, some colleagues may question why we need another treatment besides insulin. For one, owner compliance with needles, insulin administration, and insulin overdosing are of concern. Also, we know that there is an increasing number of cats being diagnosed with diabetes. An estimated 600,000 cats in the U.S. are diagnosed with diabetes during their lifetime, with the prevalence of this devastating disease increasing over the past decade. However, the most crucial statistic from research shows that 125,000 cats go untreated1.

Early Detection

We must continue to educate pet parents about the more common signs of diabetes. Urban myths circulate with inaccurate information, such as the idea that indoor cats don’t need routine veterinary care and that these cats vocalize when they don’t feel well.

Instead of acquiescing, let’s provide simple early-detection guidelines. Here are the four most common signs of feline diabetics displayed through the mnemonic “MEOW:”

  • More eating and drinking
  • Excessive appetite
  • Overweight
  • Weight loss that occurs suddenly

This can be used in several social media posts—be sure to communicate this to pet parents where they can best receive information!

In addition to the most common signs, it’s also helpful to give pet parents an idea of other risks. Some of the increased risk factors for dogs hold for cats, like chronic pancreatitis, being middle age, and use of steroids, but there are definite differences

that your cat’s parents want to know! This is especially true with how much of a role obesity plays – cats with an obese body condition score are four times more likely to develop diabetes! Besides the other complications of obesity, this is a big reason to ALWAYS give our patients a body condition score and discuss appropriate weight management guidelines. Indoor cats, neutered males, chronic kidney cats, and hyperthyroid kitties are also at risk.

When pet parents call for an appointment based on the clinical signs observed at home, continuing the education process during the physical exam is essential. Cats are very similar in pathophysiology to overweight adults; 80% (or more)2 have Type 2 diabetes. This is due to either an insensitivity or resistance to insulin in tissues. Pancreatic beta cells don’t like a high glucose environment or being overtaxed. When that happens, we see the progressive loss of beta-cell insulin production and burnout.

Diagnosis of diabetes also requires diagnostics. Let’s recommend a foundational diagnostic workup instead of just a blood glucose spot check. This includes a full CBC (complete blood count), a chemistry panel with electrolytes, a concurrent urinalysis with culture (preferably low colony count), a UPC (urine protein: creatinine ratio), blood pressure, and a thyroid panel. While many of our patients develop their diabetic state secondary to adipocyte inflammation, we can see other associated disease states like chronic kidney disease, hypertension, hyperthyroidism, and acromegaly.

Fear Free Treatment Options

Insulin is a successful treatment option for many diabetic cats. However, a large population remains completely untreated, and for those yet to be diagnosed, insulin may not be a good fit for the family’s lifestyle. Veterinary teams must provide safe and effective treatment alternatives.

Bexacat™ (bexagliflozin tablets) is the first sodium-glucose cotransporter 2 (SGLT2) inhibitor approved by the FDA in any animal species. Bexacat™ introduces a mechanism of action for veterinarians and pet owners that offers a non-insulin, needle-free, once-daily oral medication specifically designed for cats with diabetes mellitus. This first-in-class therapeutic is indicated to improve glycemic control in otherwise healthy cats with diabetes mellitus NOT previously treated with insulin.

Let’s consider what’s different about the mechanism of Bexacat™ vs. traditional insulin. Insulin drives glucose into the cells, whereas Bexacat™ drops blood glucose levels by promoting urinary excretion or preventing renal glucose reabsorption.

Several differentiating features of Bexacat™ help promote physical and emotional health. First, unlike traditional insulin, Bexacat™ does not require dosing calculations or titration, measuring in syringes, or potential dosing errors. It’s one flavored tablet per cat daily and can be given in food. Not only does this streamline the process for clients, but it also helps them efficiently manage their schedules or travel demands by

having other caregivers participate. The tablet has been shown to have 96-97% palatability in studies3, which also encourages easing client compliance!

Another unique characteristic of Bexacat™ is that dosing is independent of our patient’s blood sugar or if the cat gains or loses weight. This is incredibly helpful in easing the minds of cat parents, especially as we start to talk about the possibility of remission monitoring. We need a minimum weight of 3kg for cats taking Bexacat™.

The essential piece of success is case selection. At this point, Type 1 Diabetics and feline patients who have been on traditional insulin are not candidates for Bexacat™ use. This is because when cats have been diabetics for a long time or are Type 1 (insulin-dependent), they don’t have enough healthy B-cells in their pancreas to produce insulin – an essential qualification to use Bexacat™. The longer a cat has diabetes mellitus, the higher the risk of amyloidosis and beta cell depletion. A newly diagnosed cat will likely have a larger beta cell mass and be more likely to be able to produce at least some insulin. Cats also need to be able to secrete endogenous insulin. However, no accurate test exists to determine this. Glucose toxicity from hyperglycemia is toxic to beta cells.

Finally, patients also need qualifying lab work. Any significant renal (Stage III IRIS or higher) or significant hepatic disease disqualifies the patient. We also need to rule out DKA (diabetic ketoacidosis). But, the final piece, and what may be very new to many of us, is a beta-hydroxbutyrate (BHBA) level of <37 mg/dL or 3.6 mmol/L and precaution of <25 mg.dl or 2.4 mmol/L if history of renal disease or metabolic acidosis. We can use a BHBA level of 2.4 mmol/L if using a handheld monitor. If ketones are in the urine, exclude the cat from being a good candidate.

References:

  1. https://www.businesswire.com/news/home/20221209005431/en/Elanco-Announces-FDA-Approval-of-Bexacat%E2%84%A2-bexagliflozin-tablets-%E2%80%93-the-First-of-its-Kind-Oral-Feline-Diabetes-Treatment-Option
  2. Chandler M, Cunningham S, Lund EM, Khanna C, Naramore R, Patel A, Day MJ. Obesity and Associated Comorbidities in People and Companion Animals: A One Health Perspective. J Comp Pathol. 2017 May;156(4):296-309.
  3. Elanco Animal Health. Data on File.

Important Safety Information:

Before using Bexacat, you must read the entire package insert, including the boxed warning. Cats treated with Bexacat may be at an increased risk for conditions called diabetic ketoacidosis or euglycemic diabetic ketoacidosis, both of which may result in death. It is critical that cats taking Bexacat be examined by a veterinarian promptly if sudden decreases in appetite or water consumption occur, or if weight loss, tiredness, vomiting, diarrhea, or weakness are seen. Discontinue Bexacat and call your veterinarian immediately if any of these occur as they could be signs of diabetic ketoacidosis or

euglycemic diabetic ketoacidosis. Before giving Bexacat, be sure to talk with your veterinarian about any past illnesses your cat has had including if your cat has ever been on insulin, as cats that have been treated with insulin should not receive Bexacat. Do not use Bexacat if your cat has experienced pancreatitis, liver disease or reduced kidney function as serious side effects may occur. Bexacat is available by veterinary prescription only. Not for human use. Keep out of reach of children. Contact a physician immediately if swallowed accidentally.

Bexacat, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates.

©2024 Elanco or its affiliates. PM-US-24-0954

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

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

How to Make Exam Rooms Fear Free and Friendly for Cats

Julie Liu, DVMSeveral years ago, when I was still a staff vet, I would routinely walk into the doctors’ office in the morning to see one of my associate-mates typing away at her computer with the overhead light turned off. The exterior wall to the office was a large window that faced east so there was always some early morning light coming through, but still, I didn’t get it. Wasn’t it always better to have more light? Why toil away in the dark like a cave creature?

After a few mornings, I started getting used to only having natural light in the office and noticed that I felt a lot calmer. If another doctor turned the light on, it felt way too bright and jarring. I realized that something as simple as decreasing the intensity of the light source in my environment could magically decrease my stress levels without me even noticing.

When it comes to our feline patients, many of the surroundings in a vet hospital can seem similarly disruptive, and may even lead to fear, anxiety, and stress (FAS). By reimagining the veterinary environment and catering to the feline senses, we can promote relaxation and a less stressful experience for both cats and humans. Here are some simple, budget-friendly tips for creating Fear Free feline exam rooms.

Provide a Safe Place

In 2022, the AAFP/ ISFM released an update of their guidelines for a Cat Friendly Veterinary Environment, in which they reference the 5 Pillars of a Healthy Feline Environment. While you may not be able to achieve all 5 Pillars in every exam room, being mindful of them will go a long way towards keeping your feline patients calm.

Pillar 1, “Provide a Safe Place”, is paramount. So what makes cats feel safe? When cats are experiencing FAS, hiding becomes a major way in which they cope. Think of all of those patients you’ve seen hiding under their bedding or overturned litterbox in the treatment area, or hiding under a chair in the exam room–they’re trying to cope with the stress of being in a scary place. Ensuring that every exam room is stocked with towels and a cat bed with high sides will facilitate hiding and comfort during the visit. You can even go next level and place a towel warmer outside the exam rooms. The thermoneutral zone for cats is 86-100.4℉ (30-38°C), so grabbing a warm towel as you’re heading in will allow your feline patient to feel even cozier.

Cats also feel safer when they can be elevated. If the cat chooses to explore the exam room, non-slip cat shelves, perches, and cat cubby holes mounted onto the wall will allow them to survey their surroundings from a height while also remaining hidden. Just ensure that any cubby can be opened easily to access the patient for their exam, as removing a cat from their “safe” place will increase FAS. Along the same lines, if budget allows, replace any exam room chairs with a bench that extends to the floor so cats don’t have to be pulled out from their hiding spot when it’s time for handling.

It can also take several minutes for cats to acclimate to a new area, so if you’re taking all feline appointments to “the back” where it’s noisy and full of dogs to collect samples, expect their FAS levels to escalate. Instead, treat each exam room like a private, “safe”  treatment area for that kitty and stock it appropriately with everything you might need for samples: tubes, syringes, smaller gauge needles, butterfly catheters, slides, and EMLA cream to reduce the pain of needle pokes. If your team members aren’t comfortable collecting samples in front of the cat parent, I’ve found that most clients are more than willing to hang out in the waiting area and drink a coffee or play on their phones until you’re done.

Considerate Approach

As Fear Free professionals, we should always use Considerate Approach with our patients, which means we want to consider how our felines are experiencing their environment during care.

  • Touch. Exam tables are slippery, cold, and uncomfortable. To provide stability and extra warmth, ensure all exam tables have a non-slip surface such as a yoga mat to act as a base under your warm towel. Every room should also have a non-tippable cat scale with a non-slip surface, which could be a Feliway-sprayed towel that you “tare” prior to weighing the cat.
  • Taste. Does your clinic have treats for dogs, but not cats? While many cats will be too fearful to eat treats, others can readily be distracted by catnip, Temptations, Churu, squeeze cheese, tuna, whipped cream, and other delicious snacks during interactions. Also be mindful of taste the next time you’re dousing your feline patients with alcohol to collect samples–unless you wipe the alcohol off of their fur with a damp washcloth, you’re contributing to their negative experience when they groom themselves after the visit. Consider using water instead of alcohol.
  • Visual. Photorealistic depictions of cats or other animals may cause cats to react, so abstract art often works best. If you’re lucky enough to have a quiet exam room with a window, consider making that a feline-only room. Many cats will explore the room and gaze outside during a visit, which works great as a distractor. Cats are also better able to see in lower light than people, so try installing a dimmer switch to decrease the light intensity.
  • Auditory. Vet clinics are loud. Dental scalers, cage doors slamming, and dogs barking can significantly increase FAS during a feline visit. Installing soft closers on cabinets and doors and hanging a “Shhh….feline appointment in progress!” sign on the treatment area side of the door will remind team members to use their inside voices and keep environmental noises low. You can also hook a speaker up to the exam room computer and play soft, cat-specific music. A 2019 study published by the Journal of Feline Medicine and Surgery found that cats listening to cat-specific music in a veterinary clinical setting had lower cat stress scores and lower mean handling scale scores than cats that were exposed to silence or classical music.
  • Olfactory. Pets leave behind lots of scents during visits, and smelling them may increase FAS, particularly if a dog was just in that room. Having a cat-specific exam room helps prevent olfactory stressors, and Rescue will allow you to disinfect and remove traces of the previous patient while minimizing harsh smells from scented cleaners.
  • Pheromonal. When your cat rubs their cheek against your leg or the furniture, they’re depositing the feline facial pheromone that marks an area as “safe”. Feliway Classic mimics this pheromone and comes in user-friendly diffusers that can be plugged into every exam room. You can also pre-spritz your scrubs at the beginning and middle of each shift and room towels with Feliway spray at least 15 minutes before your first appointment, then reload for afternoon kitties since it wears off in four to five hours. Don’t forget to label your diffuser with some client education so cat parents see the Fear Free value.

The exam room can be a scary place for many cats, causing them to experience FAS even before handling. Adding some Fear Free tools and considering the feline senses will help turn your exam rooms into kitty havens.

Resources 

https://fearfreepets.com/cat-friendly-exam-room/#:~:text=Avoid%20chairs%20cats%20can%20get,Choose%20light%20colors 

https://fearfreepets.com/top-10-treats/

https://fearfreepets.com/helping-our-feline-friends-feel-fear-free-with-dr-tony-buffington/

https://fearfreepets.com/providing-the-optimum-environment-for-cats/

https://fearfreepets.com/creating-a-comfortable-environment-in-the-clinic/

JFMS: https://journals.sagepub.com/doi/full/10.1177/1098612X221128763

JFMS: https://journals.sagepub.com/doi/10.1177/1098612X19828131

Cat music: https://www.youtube.com/watch?v=vGyElqvALbY

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.

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

 

Words Count: The Language of Fear Free

Julie Liu, DVMLast year, I watched a great webinar on Fear Free Pets by Dr. Tony Buffington called “Helping Our Feline Friends Feel Fear Free.” He shared a number of helpful tips on helping reduce stress for feline patients, but one of the points he made really resonated with me. He talked about going to an exhibit hall at a conference and seeing a booth selling signs that can be clipped onto the front of the cage, including a red sign that said, “Caution, fractious cat.” He asked if there were any signs that said “Caution, fearful cat,” because when he saw “fractious cat” his instinct would be to take care of himself to prevent injury, whereas if he saw “fearful cat” his instinct would be to take care of the cat.

Based on that conversation the company started making “fearful cat” signs, but it got me thinking about the language of Fear Free and the terms I routinely hear vet professionals use for pets exhibiting FAS (fear, anxiety, and stress): “fractious,” “angry,” “spicy,” “CAUTION!!!”, and of course, a variety of R-rated terms used only in the treatment area. And I totally get it. No one wants to get bitten, scratched, snapped at, or injured, and it seems like these terms will keep us safer when approaching stressed patients. So why could this language be problematic?

Well, I’ve noticed that when there’s a patient alert such as “fractious” for a cat, people tend to approach the pet in an adversarial way. They put on their cat gloves, take a deep breath, and go into the exam room ready to do battle with their patient, which usually includes scruffing the cat to immobilize them. Unfortunately, this approach often has the opposite desired effect. Cat gloves can cause fear in patients, and scruffing is painful and takes away the cat’s sense of control. The “fractious” cat’s FAS levels then escalate, which increases the chances of getting injured.

Changing our language so that it describes and advocates for the emotional health of the patient can keep us safer. Instead of “fractious,” what about, “Fearful, keep in carrier until doctor is ready, prefers hiding under towel for exam and vax”? It’s rare to see these types of patient alerts, yet they take only a few seconds to update in a medical record.

Terms like “fractious,” “angry,” and “&#%!@” also shut down the empathy we should strive to bring to our patients, both feline and canine, and joking that a pet is “spicy” trivializes their emotional experience. Instead, see how it feels when you use patient-focused language such as “fearful,” “anxious,” and “stressed.” Just as most of us felt at least one of these emotions during the pandemic (or even all three at the same time), most of your patients are feeling at least one of these emotions during their vet visit. In fact, many of these “spicy” patients are utterly terrified and completely justified in their emotions considering all of the scary things they experience at the vet. Using terms like “fearful” and “anxious” also contributes to a Fear Free culture and sets the tone for how we’d like fellow team members to approach their patients–with empathy, not as adversaries.

As Fear Free professionals, we have the tools to identify, prevent, and alleviate FAS. Modeling Fear Free language is another important step we can take to bring compassion to the patients in our care.

Resources

https://fearfreepets.com/helping-our-feline-friends-feel-fear-free-with-dr-tony-buffington/

FAS Spectrum Handouts

https://serona.vet/collections/cage-tags-signs?page=1

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.

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

 

5 Steps to Heartworm Disease Awareness

By Jennifer Merlo, DVM, CVBMC, Fear Free Director of Veterinary AffairsWe mention heartworm prevention to pet parents during almost every veterinary visit. So how is it that more than 1 million pets in the United States have heartworm disease1? American Heartworm Society (AHS) study data collected in 2022 shows that rates of heartworm disease continue to trend upward in both recognized “hot spots” and in locations where heartworm disease was once rare.2

Due to the increased incidence of travel and remote work career options, the United States is experiencing spread of heartworm prevalence throughout the country. Despite our best intentions, our pet parents are still unclear on the severity of the disease and the importance of maintaining proper heartworm prevention.

Here are five ways to help increase your client compliance and decrease the incidence of heartworm disease in your area:

  1. Discuss heartworm prevention at every visit for every pet.

Veterinarians and veterinary staff recognize the importance of discussing heartworm prevention at puppy appointments. However, often we forego discussing it during adult and senior canine patient visits. The AHS reports that only 37 percent of the U. S. canine population is on heartworm prevention!3 This is a staggering number, and it is our job to educate our clients on the importance of prevention for every pet, year-round. We must make it a point to have this discussion with them at every visit and reinforce the importance of prevention rather than treatment.

  1. Cats get heartworms, too!

Too often we neglect to have this important conversation with our feline pet parents. Fewer than 5 percent of cats are on heartworm prevention3. Most feline pet parents do not think about their cat being at risk, since most of them are indoor-only pets. It is important to have open discussions with cat owners about the spread of heartworms. Educating them that even “indoor” cats are still at risk for mosquito bites and heartworm disease can help reduce the incidence within our feline population. Pet owners may not be aware that there are multiple options for adequate heartworm prevention in cats that do not include giving an oral medication; something we know that causes lower compliance rates in cat owners.

  1. Heartworms travel and so do our pets.

The last few years have seen an increase in the number of remote workers, as well positions that require travel across state lines. Our pet owner population now looks at their dog companions as part of the family who often travel with them. As veterinary professionals, we can no longer rely on heartworm incidence maps as they relate to our direct location since our patients are traveling on a regular basis. Heartworm disease has now been diagnosed in all 50 states and without proper education our pet parents may not be aware that they are unintentionally putting their pets at risk. Be sure to ask questions about travel, including vacations as well as work travel, and be sure that pet owners understand that all pets, in all states, are at risk for contracting heartworms.

  1. Ensure that pet parents are regularly giving heartworm prevention.

When I was in practice, I was always in awe of the fact that most pet owners had an ample supply of heartworm prevention at home, yet our records indicated they should need to buy more. This is often because most pet owners only give their pet’s heartworm prevention one-third of the time. With the numerous options available on the market today, there is an option available for every pet parent to become compliant with their pet’s prevention routine. Discuss different prevention options and gauge what your client feels they can be most consistent with. By opening the conversation and talking through what works best for them, you increase your veterinary-client bond while simultaneously reinforcing the human-animal bond.

  1. Recommend heartworm testing annually.

 Despite everyone’s best intentions, sometimes doses of prevention get missed, and it’s our job to help our pet parents provide the best medical care for their pets. Recommend yearly heartworm testing to ensure that their pet is free of heartworm disease. Make obtaining the blood sample a Fear Free experience by using a Considerate Approach through positive rewards such as delicious treats or petting and using small-gauge needles to minimize discomfort. My staff was great at using insulin syringes to obtain the minimal amount of blood necessary to perform this annual test while the pet parent offered the patient treats. Most of our patients did not even realize venipuncture had occurred! Remind owners that unless we test, we won’t know, and that it’s just as important to monitor for heartworms as it is to prevent them.

It only takes one bite from an infected mosquito to transfer heartworms to a cat or dog. Let’s join with our pet parents to ensure that all our canine and feline patients are well protected.

Resources

  1. American Heartworm Society, 2023; https://www.heartwormsociety.org/
  2. American Heartworm Society Incidence Map, April 11, 2023
  3. The Truth About Cats and Dogs, American Heartworm Society

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

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

Can Trapping Cats Be Fear Free? Find Out Here

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.

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

How to Make Dentals Fear Free for Pets, Clients & Yourself

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.

Want to learn more about Fear Free? Sign up for our newsletter to stay in the loop on upcoming events, specials, courses, and more by clicking here.

How to Conduct a Fear Free Pain Exam for Cats

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.

Why FeLV and FIV Don’t Have to Be Death Sentences for Cats

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

Gabapentin Reduces Stress in Feline Patients, Study Shows

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.

  1. 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.
  2. https://fearfreepets.com/wp-content/uploads/2017/09/Preparing-for-the-visit-store.png
  3. 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.
 

Feline Pheromones: The Science Behind Them

Ramona MarekIf you have a veterinary practice or manage a shelter, you’re likely familiar with pheromone products available in the form of diffusers, sprays, wipes, or collars. These products claim to stop unwanted behaviors such as scratching, spraying, litter box mishaps, hiding, and fighting. Do they really have those properties, and should you recommend them to clients or adopters? Let’s dive into the science of pheromones: what they are, how they work, and whether they can help cats.

Pheromone History

Scientists have long been fascinated by the notion of chemical communication between members of the same species. The first pheromone, a female silk moth secretion, was chemically identified in 1959 by German chemist Adolf Butenandt and his team.

Pheromones are odorless, colorless chemical signals used as a form of intraspecies scent communication. When detected they cause physiological and behavioral changes.

What Pheromones Do

Pheromones have a broad range of purposes that include alarm signaling, mating, social interactions, territory marking, and maternal bonding. Cats of all species send and receive messages via the pheromone message board.

Pheromones are secreted by specialized sebaceous or mucous glands on the body. For cats, these include facial glands (on chin, cheeks, and forehead), anal glands, paw pads, and mammary area.

When cats rub their heads against people, furniture, or objects, comforting pheromones are released from the cheek glands, marking this place as a comforting one for future feline reference.

Anal glands release pheromones in urine and feces that deliver messages regarding mating viability, expression of fear or stress, or territorial response (think urine marking or spraying). Scratching, a natural cat behavior, releases pheromones from the paw pads. Scratching delivers scent and visual cues about territorial ownership to other cats.

Mammary pheromones are activated in nursing mothers when kittens suckle. Kittens detect the pheromones, which produce a calming response. It also helps kitten and mother cat recognize each other if they become separated.

Pheromones are detected through the complex olfactory system and received via the nasal cavity, lined with millions of olfactory receptor cells. Once detected, cats tongue-flick the molecules to the vomeronasal, or Jacobson’s, organ, located on the roof of the mouth. This stimulates the flehmen response, which causes the mouth to gape open. It may look like a sneer, but this active process enhances pheromone perception. The pathway continues to the brain, which produces a behavioral or physiological response.

Natural pheromones perform a variety of important functions, but what about synthetic pheromones?

Using Synthetic Pheromones

Synthetic pheromones are lab recreations that mimic natural pheromones to help promote a sense of calm and security in stressful situations. The idea is to build a sense of confidence and prevent or alleviate fear, anxiety, and stress (FAS) and related behaviors such as spraying, scratching, and intercat aggression. They are not sedatives, essential oils, or medication.

The first companion animal pheromone product, Feliway Classic by Ceva, debuted on the pet market in 1996. This product, available in spray and diffuser, is a copycat of the feline F3 facial-marking pheromone deposited when cats rub their cheeks on objects, marking the area as safe. Feliway MultiCat, based on the cat appeasing pheromone (CAP), premiered in 2016. CAP originates in the mammary region of nursing mothers and provides a sense of safety, security, and harmony. It helps to reduce conflict and social tension in multi-cat households. Feliway Optimum is the latest diffuser product. FELIWAY Optimum may help to reduce scratching, urine spraying, tension and conflicts between cats, fears, and reactions to changes.

Synthetic pheromone products can be layered and used together in the clinic, shelter, or home. For example, Feliway Classic and Feliway MultiCat diffusers can be used together in exam rooms, shelter cat rooms, and in homes. The diffusers can also be used in combination with the spray Feliway Classic on towels or mats in an exam room, shelter cat living area, or on a cat’s favorite blanket or carrier. In the home, Feliway Optimum can be used in preferred scratching areas.

Other companies have launched similar products, and there are dog versions too. Dog and cat products can be used together to promote peaceful compatibility in multi-pet homes. Because pheromones are species-specific, cat pheromones don’t work on dogs and vice versa.

Does this mean clients or adopters can plug in a diffuser, snap on a collar, or spritz a blanket and expect immediate and magical behavior changes? No. Some cats may be more receptive to pheromones and alter their behavior, but pheromone products aren’t magic elixirs. The underlying cause of the stress must also be identified and resolved.

Synthetic pheromones are an aid in a behavioral plan, not a one-size-fits-all cure. “Synthetic pheromones can be successful when a client follows the written-out behavior plan,” says Rachel Geller, Ed.D., Certified Cat Behaviorist. “Sometimes the addition of synthetic pheromones allows the cat to better access the behavior program. Alone, the products usually aren’t enough to resolve the problem but when used with behavior modification they can resolve some of the emotional part of the problem for the cat. I never put a timeline on resolving cat behavior problems. In these matters, it’s best to go at the cat’s pace!”

Whether used in veterinary clinics, shelters, or homes pheromone products are designed to bolster a sense of calm, comfort, and positive feelings in stressful environments. It’s important to assess the environment from the cat’s perspective.

  • Trips to the veterinarian usually induce high levels of FAS. Before the trip, advise clients to spray the carrier and a towel with the synthetic pheromone, and wait about 15 minutes for the alcohol to evaporate before putting the cat inside the carrier. Cover the carrier with the towel. The calming effect lasts four to five hours.
  • Scratching and spraying. “Synthetic pheromones can be used if you have a cat who is peeing to mark his territory. Cats don’t pee on territory where they facially mark, so these products trick the cat into thinking he has already marked the territory as his own,” says Dr. Geller.
  • Litter box avoidance. First, schedule a vet visit to rule out medical conditions. Recommend that clients set up the litter box arrangement to optimize cat-friendly preferences (size, location, number, preferred litter). Keep it clean! Owners should avoid punishing cats and add positive social interactions.

“Synthetic pheromones are especially helpful for those times where everything is completely new. Examples are moving to a new home, buying new furniture, or putting in new carpet. These products can be used on unfamiliar objects in the home to help a cat feel more safe and secure with them,” says Geller. Suggest that clients use the products in their home before bringing home a newly adopted cat to provide a sense of comfort and security upon arrival.

When a cat’s sense of wellbeing is disrupted, they can become stressed. Stressors can be environmental, physiologic, or social. Stress can be mild, moderate, or severe, temporary, or chronic.

Stress has a profound effect on emotional and physical health and behavior. Stressed cats may refuse to eat, become ill, or develop serious behavior problems. Minimizing stress is crucial to the health and wellbeing of cats. Synthetic pheromones can help to make cats feel safe and secure in their environment.

“Many times, cat behavior is 100-percent fixable and solvable through consistent behavioral interventions that are developed by looking at what is happening from the cat’s point of view. There is always a reason! If there is more going on, such as an emotional issue, stress, or anxiety, pheromones and even a pharmacological approach can be considered,” Geller says.

Pheromone products are versatile and easy to use, and they can be used in combination with a behavioral plan and medical treatments. While not magic, they may be the essential element your feline patients or shelter cats need to ensure a healthy, happy life.

Sources

Rachel Geller, Ed.D., Certified Cat Behaviorist

Gary Landsberg, DVM, DACVB, DECAWBM (CA). Fear Free webinar. The Science for Pheromone Therapy: Show Me the Evidence.

American Scientist. How Animals Communicate Via Pheromones. Tristam Wyatt.

https://www.americanscientist.org/article/how-animals-communicate-via-pheromones

Tristram D. Wyatt, Pheromones, Current Biology, Volume 27, Issue 15, 2017, Pages R739-R743,

ISSN 0960-9822, https://doi.org/10.1016/j.cub.2017.06.039.

https://www.sciencedirect.com/science/article/pii/S0960982217307765

Prior, Miriam Rebecca, Mills, Daniel Simon. Cats vs. Dogs: The Efficacy of Feliway FriendsTM and AdaptilTM Products in Multispecies Homes. Frontiers in Veterinary Science Volume 7, 2020, Pages 399. ISSN 2297-1769, DOI 10.3389/fvets.2020.00399.

https://www.frontiersin.org/articles/10.3389/fvets.2020.00399/full

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

Ramona D. Marek, MS Ed, is an award-winning writer and 2017 recipient of the prestigious Fear Free Pets Award. She writes about pet care, health and behavior, and cats in the arts. She’s also the author of “Cats for the GENIUS.” Her feline muses are Tsarevich Ivan, a joie de vivre silver tabby Siberian, and Natasha Fatale, a full-time diva dressed as an “anything but plain” brown tabby. You can read more about Ramona and her work at www.RamonaMarek.com.
 
Older posts