SPECIAL ARTICLE / AAFP/ISFM guidelines on feline-friendly handling
Minimizing the stress of medical procedures ✜ When performing multiple procedures, begin with those less stressful or invasive.40 ✜ Offer different routes of administering medi - cations, when available. Show the client how to give pills. Consider pilling aid devices, food or tasty treats in which pills can be hidden.41 ✜ Consider warming injections to room temperature, if this does not affect product efficacy. ✜ Use one needle to aspirate vaccine or drug, and a different, small-gauge needle to administer injections.42 ✜ Holding the head and body in natural positions may allow procedures such as jugular/cephalic venepuncture and cysto - centesis (Fig 7) with minimal restraint. ✜ For cats that react strongly when touched with a needle, and/or when multiple injections are anticipated, apply a topical anesthetic or use a transmucosal opioid.
FIG 7 Many procedures require minimal restraint if the cat is in a natural position, such as in this standing cystocentesis. Courtesy of Professor Danièlle Gunn-Moore
About scruffing techniques
‘Scruffing’* is a general term for a variety of holds on the skin of the cat’s neck. Grasping the scruff of the neck varies from a gentle squeeze of skin, to grasping a larger fold of skin with varying amounts of pressure. Consideration of natural feline behavior can help put this technique into perspective. Cats grasp the scruff of the neck of other cats in only limited circumstances.43,44 During the first few weeks of life the mother cat may lift kittens by the scruff of the neck using her mouth.45 This is a method of transport and immobilization, and not a form of discipline. During mating, the tomcat grasps the scruff of the queen.46,47
Some veterinarians and veterinary behaviorists do not use scruffing and do not condone its use. They find that using other gentle handling techniques is less stressful, more time efficient, provides greater safety for personnel, and allows the cat to have a sense of control. They prefer other methods to manage situations where feline welfare or personnel safety are at stake. Other veterinarians handle cats gently and use scruffing only if it is neces- sary to protect the welfare of the cat or for the physical protection of person- nel. Still others think that scruffing a cat is acceptable for short procedures, in an emergency, and to prevent the cat from escaping or injuring some- one.
The panel does If you think this technique is the
only alternative, carefully evaluate the cat for any signs of fear or anxiety. The cat may become immobile but may not be comfortable, or may become aggressive. Handle the cat as gently as possible and guard against using aggressive handling techniques out of anger or frustration. The panel does not condone lifting the cat or suspending its body weight with a scruffing technique because it is unnecessary and potentially painful. ‘Clipping’ or ‘pinch-induced behavioral inhibition’ is a term that pertains to using clips to apply pressure to the dorsal neck skin or other areas along the dorsal midline.44 Some veterinarians and behaviorists do not use clipping and do not condone its use. Some have reservations about the clipping procedure and have concerns about the ethics of controlling behavior through inhibition of behavioral responses. Others think it has a place when done appropriate- ly, in certain cats and under the conditions described above for scruffing.48–50
not condone lifting the cat or suspending its body weight with a scruffing technique.
*Footnote: On review of these guidelines, the ISFM/FAB feline expert panel strongly support the view that scruffing should never be used as a routine method of restraint, and should only be used where there is no alternative.
Techniques for working with fearful or aggressive cats
Veterinarians may need to work with feral cats or fractious cats that could injure clients or the team. Cats may show anxiety, aggres- sion and fear via a variety of behaviors. Fear is the most common cause of aggression in cats at the veterinary practice. Learn to recognize early signs and take steps to reduce or prevent escalation of fear. Carefully evaluate the situa- tion to select the most appropriate action.
Pre-visit techniques ✜ When making appointments, ask about and then record the client’s comments about the cat’s behavior (at home and during previous visits). Record in the client file in-clinic experiences about what works and what does not. ✜ Make attempts to decrease fear associated with the carrier using the techniques described earlier. ✜ Provide oral medication to manage the cat’s fear prior to a visit if the history or owner comments suggest this might be helpful. Use an oral benzodiazepine (eg, alprazolam) as an anxiolytic and possible amnesiac (note that benzodiazepines may cause disinhibition of aggression). Use anti-nausea medication (eg, maropitant) for cats with travel-induced nausea or emesis.51Avoid using acepromazine because it is a sedative, not an anxiolytic; it limits motor responses without modifying sensory perception; it increases sensitivity to noises; and it may increase aggression, making the cat more combative. Specific treatment protocols vary by country and among veterinarians. Consult with an anesthesiologist for further information.
JFMS CLINICAL PRACTICE 371
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