Pet-Specific Care for the Veterinary Team. Группа авторов

Demographics Sourcebook [1] which showed a decline in the number of veterinary visits and expenditures for pet cats. Furthermore, compared to dogs, cats were twice as likely not to visit a veterinarian at all. At that time, it was also noted that households considering their cats as family members had a higher average number of veterinary visits (2.0) compared to households that viewed their cats as pets/companions (1.4) or as property (0.7). This insight is one of the reasons that supporting the human–animal bond is critical for cats (see 2.14 Benefits of the Human–Animal Bond). Unfortunately, the declining trends have continued and the 2017–2018 edition of the AVMA Pet Owner and Demographics Sourcebook [2] reported that 45.7% – nearly half of all cats – did not visit a veterinarian in the year the study was conducted. Of those, 41% cited the reason as their “cats did not get sick or injured.” Only 16% cited “did not have the money…” to pay for a veterinary visit as the reason their cats didn't receive veterinary care.

      While this and other data seem daunting, it creates a tremendous opportunity for the veterinary profession. To make this happen, hospital teams need to commit to creating, implementing, and sustaining a knowledgeable, feline‐friendly mindset and environment. This will allow cat owners to feel comfortable and committed to getting their cats veterinary care, irrespective of their age or perceived health status.

      Fortunately, as the realization of this opportunity occurred, several organizations began or increased their efforts to improve cat health. The CATalyst Summit brought together more than 50 people and organizations representing all stakeholders in cat care, including animal welfare organizations. Subsequent to the summit, the CATalyst Council was created, representing a unique coalition of cat health and welfare organizations, companies, foundations, and the media. The American Association of Feline Practitioners (AAFP) and American Animal Hospital Association (AAHA) developed Feline Life Stage Guidelines [3]. The AAFP and International Cat Care (ICC, known as Feline Advisory Bureau at the time) both began their efforts for their Cat‐Friendly Practice and Cat Friendly Clinic initiatives. These organizations have robust online resources that practices should visit and take the needed steps to acquire the related designations and certifications. The tools provided by the AAFP and ICC as well as those from the Canadian initiative Cat Healthy and the Ohio State University's Indoor Pet Initiative for Cats [4] offer resources for veterinary teams, animal shelters, and pet owners.

      As a profession, we must understand consumers' desires, for without them, companion cats will not benefit from evidence‐based, feline‐friendly, health and welfare knowledge that we have, must implement and share. Consumers become clients when the 45.7% of cat owners not currently obtaining veterinary care do so.

      1.5.4 Cat Concepts in the Veterinary Clinic

      Cats are unique pets because they are both predators and prey, hunters and hunted. When pet parents and healthcare providers understand that concept, everything else becomes obvious. Cats prefer familiar places, people, and patterns, and when faced with anything unfamiliar, they become fearful and may exhibit heightened arousal. To avoid (potential) conflict, their instinct is to flee (flight) and when they have no means of escape, as in a closed exam room, this heightened arousal may manifest as fear aggression. Unfortunately, this normal behavior has caused many cats to be labeled as “AGGRESSIVE” – which is frequently captured on the medical record in upper case letters and even numbers of exclamation points. Approaching cats with quiet observation, nonthreatening postures, and expressions (get low, turn and look sideways) and slow movements is less likely to cause additional arousal. Largely due to the lack of habituation to travel and carriers, most cats are far less accepting of transport and travel than dogs. As such, they are frequently aroused before they come in our doors. What would it look like if we could have a warm, quiet and calm exam room ready for a cat so they could bypass the reception area that has the sounds, sights, and scents of their most common and feared predators – unfamiliar dogs and people?

      Preventive care for all ages includes health and lifestyle‐appropriate vaccines, nutrition, parasiticides, and especially regularly scheduled wellness visits, annually at a minimum and semi annual or quarterly examinations are in the “well” cat's best interest, including juveniles and young adults with weight gain or red gums. Addressing changes early in the process to prevent future problems like obesity, diabetes mellitus, and oral disease is paramount to pet‐specific and client‐centered care (see 4.7 Embracing Early Detection). If verbiage used in veterinary practices includes some version of “She only has a tiny bit of tartar so she might need a dental next year,” there is an immediate opportunity to ask your co‐workers why, and as a team explore how that cat, their owners and even the veterinary practice could be better helped with earlier care (see 4.9 Periodontal Disease). A single, simple circumstance such as that could provide the pivot point for all team members including owners and managers, veterinarians and veterinary nurses, assistants and caregivers to be aligned and on board with pet‐specific care.

      1.5.5 Feline Friendliness Starts at Home

      The educated and engaged veterinary team is knowledgeable about helping owners understand cats' needs and environment enrichment by engaging in conversations using open‐ended questions such as “How many litterboxes do you have… where are they…how often are you able to clean them…?” and “Tell me about mealtimes in your home…” Note: the most important part of asking open‐ended questions is listening to the answers (see 9.2 Asking Good Questions). Therein are the clues for true patient status.

      Regarding mealtimes, we know that cats are solitary hunters and as such, their normal feeding preference is without oversight or interruption by other animals, including cat housemates. If a client describes feeding their cats within eyesight of each other, during the nutritional assessment and recommendation, information on how to feed (location, frequency, puzzle/foraging feeders) is as important as what to feed.

      It is also important to know that simple changes in a cat's routine have been shown to induce stress‐related illnesses. Sickness behaviors have been documented and include gastrointestinal (vomiting, diarrhea) and lower urinary tract signs (feline interstitial cystitis) [5]. All are common presentations to veterinary clinics and environmental stress should be carefully explored in these cases.

      Many cats will benefit from anxiety abatement in advance of collecting the cat for travel. Having carriers out in advance of transport, using synthetic facial pheromones in and around the carrier and bedding, nutritional supplements and diets to promote calmness, and even antianxiety therapeutics are examples of tactics and treatments used widely (see 6.6 Fear Free Concepts). Gabapentin can help prevent and diminish arousal and is routinely used in advance of travel for this purpose. It is important to recognize that tranquilizers merely diminish the cat’s ability to respond to fear and arousal, and do not help the cat feel less stressed or fearful.

      1.5.6 It's All About the Cat, and Their Person

      As knowledgeable advocates for cats, veterinary teams that have made the sustained commitment to understanding cat behavior and handling cats appropriately represent the ethos of feline‐friendly, client‐centered, and pet‐specific care. That, along with celebrating the bond between people and their cats, will help ensure lifelong care for cats with your practice.

EXAMPLES

      Sunshine, a 12‐year‐old spayed female brown tabby DSH, presented for the first time to a feline‐exclusive veterinary practice. She had received no veterinary care after her kitten vaccines and sterilization. She was reported to have a “good appetite and thirst,” and the owner brought her in because she noticed she was losing weight. On subjective observation, she was emaciated, agitated, and vocalizing. On