Making the clinic ‘cat friendly’ – structure and equipment

Author:

Andrea Harvey

Published:

November 4, 2020

The veterinary team has become increasingly aware of what is required to make their clinics more "cat friendly". There are certain areas like the waiting room and consulting room that requires a different structure or equipment that can reduce stress of these feline patients. The manner in which veterinarians handle the cats in the consult room during the physical exam can help reduce fear or fear-associated aggression that is escalated by stress. Tactics to make human behaviour less threatening to cats can be used to further decrease anxiety.

Waiting room/reception area

The overall aims should be to create:

A calm and unthreatening environment for the cat to wait in so that it is not frightened by the time it reaches the consultation room.

An atmosphere that reassures feline owners that this is an organisation staffed by people who care about both them and their cats.

When the cat initially enters the clinic it will attempt to assess the safety of this new environment. The waiting room should be designed and used in a way that minimises the threats cats may feel (visual, auditory, olfactory, etc.).

Simple things can help:

Space may allow for the creation of a completely separate and dedicated cat-only waiting room. This is ideal, but even with this, additional design considerations are important.

If a separate waiting room is not possible, consider physically separating the waiting room into two different areas for dogs and cats. Appropriate walls or barriers should be used to ensure visual contact is avoided between dogs and cats, and measures should be taken to avoid having barking or noisy dogs in the waiting room (e.g. getting noisy dogs to wait outside).

In addition to separating dogs and cats by some means, thought also needs to go into the location and size of this area, as well as the route that cats are taken into and out of it. The cats should encounter minimal human and animal traffic while in the waiting area. The value of a feline-only area is greatly compromised if cats have to pass through a noisy area or right past dogs to get to the consulting room. Some clinics create a separate doorway into the consulting room from the cat waiting area so cats can enter the consulting room without having to risk an encounter with a dog.

An alternative measure, if partitioning the waiting room is not possible, is to have routine set cat consultations times scheduled separately from dog consulting times. Thus at any one time, the waiting room will only be used by either dogs or cats. However, thought should be given to any dogs that may need to be discharged from the clinic while cats are in the waiting room or should a dog need to come in, and direct contact avoided.

Other important considerations for the feline waiting area include:

Avoid locating the reception desk in a narrow area as this encourages contact between dogs and cats when clients are at the desk. Having a wide desk and a large space in front minimises this risk. Additionally, having a low reception desk, or a wide shelf in front of the reception desk where clients can place cat baskets (above the head height of most dogs will help, and will avoid clients having to put the basket on the floor where cats may feel more vulnerable).

Prevent or reduce any noises from the consultation rooms reaching the waiting area.

Display clear notices asking clients with dogs to keep them away from cat carriers, and reinforce this by asking dog clients to be considerate of cats in the waiting area.

Try to ensure clients and cats are not left to wait for excessive periods in the waiting room, but are able to move to the consulting room as quickly as possible.

Some clinics have enough space to allow cat owners to take their cats directly into a consulting room without having to sit in the waiting room at all. Additionally, if a cat is known to be very stressed in the waiting room, or becomes obviously stressed put a blanket over the basket and see it as soon as possible.

Direct visual contact with other cats can also be very threatening and stressful, and a small cat waiting area can force cats to be close to each other at busy times. Measures to help overcome this include:
Erecting small partitions between seats to separate cats in the waiting area.
Providing clean blankets or towels to cover the cat’s cage, and encouraging owners to bring their own blankets/towels for this purpose.
Cats feel insecure if they are placed at floor level. Having shelves, perches or chairs to place cat baskets and carriers on is very useful. These should ideally be about 1.2 m from the ground and have partitions (or use covers) so that cats are not confronted with each other.
An alternative is to have a bank of compartments within the waiting area in which carriers can be placed while owners are waiting (or when they are paying etc.).

Each clinic will need to work out what measures are practical and usable in their situation, but the key to creating a truly cat friendly waiting area is to consider the needs of cats, and then carefully plan the best way to meet these.

Exam/Consulting Room

The aim should be to provide a safe nonthreatening consulting area where cats can be examined calmly and effectively.

Handling the cat in the consult room

Getting the cat out of the carrier

Open the door of the carrier while taking the history to allow the cat to choose whether it wants to venture out on its own. Some cats may walk out of the carrier more readily if it is on the floor.

If the cat is out of the carrier, put the closed carrier out of sight during the exam but allow the cat to return to it immediately after the procedures are completed. Calm cats that enjoy the experience may be left to explore the exam room, if appropriate. If the cat is still in the carrier when you finish history-taking, quietly remove the top and door, if possible. Most cats are very comfortable remaining in the bottom half of the carrier, and will allow a large portion of the examination while being there. If the cat is fearful, place a towel between the two halves of the carrier as you remove the carrier top; this covers the cat in a ‘tent’ but the cat remains accessible.

Some carriers cannot be disassembled; in these cases reach in and support the caudal abdomen and back legs to encourage the cat to move forward or if the cat acts in a fearful manner, gently slide a towel around the cat to remove it.

Physical examination

Patience, gentleness, and empathy are vital characteristics in the consultation room. Even with the best environment and best approach, some cats will remain very anxious and a full physical examination may not always be possible at the first attempt. Be prepared to take additional time if needed, schedule another appointment if needed, or hospitalise the cat if necessary. Again, remember that the attitude and approach taken by staff in the consult room may determine whether or not the client will ever bring the cat back to the clinic.

Useful tips for the physical examination include:

Don’t ever rush when examining a cat. A little extra time taken will reap huge rewards and this is a classic example of ‘more haste, less speed’.

Be flexible and let the cat choose – the key is to find out what makes the cat more relaxed and adapt the place/position/way that you do the physical examination to suit the individual cat. Some will be happier on their owner’s lap, others on the floor. Some may enjoy looking out of a window, while others prefer to stay sitting in their carriers or even hiding under a blanket. Try to adapt to whatever the individual cat prefers, be gentle and take your time. Give the cat plenty of fuss and attention if that is what it likes, talk gently and aim to complete the majority of the physical examination without the cat realising you are doing anything more than just stroking it.

Sitting with the cat on the floor often helps, and can make handling much easier. This is also true for things like neurological examinations.

Some cats prefer to lie down, while others prefer to stand - try to do as much as possible with the cat in its preferred position.

Apply ‘cat friendly’ principles, and always adopt the minimal restraint necessary. Any form of overt restraint will signal danger to the cat.

If helpful, split the examination into short sections, and in between allow the cat to change position, have a look around etc. As soon as the cat gets restless, give it a break – even for a short period, for a stroke or a walk around the room or table.

Avoid direct eye contact where possible. To help with this, perform as much of the examination as possible with the cat facing away from you. Avoiding sustained eye contact will be much less intimidating. Where direct eye contact is needed, a relaxed gaze with slow blinking will help.

Avoid loud or sudden noises (including ringing sounds and sharp shoe heel noises) and bright lights. Also, be aware of the sounds you use – for example a ‘Shhh’ sounds like a hiss to a cat and should be avoided. Talk to the cat calmly, slowly and with a quiet reassuring tone. Avoid sudden movements.

Be aware that older cats often suffer from osteoarthritis, which may make handling uncomfortable or painful.

The hypertensive or hyperthyroid cat may feel anxious and require a more cautious approach.

Perform more invasive examinations last. Leave taking the cat’s temperature (where needed) and opening its mouth to the end of the examination if these things are likely to stress it.

Pay attention to owners if they warn that a cat is likely to bite or scratch. Don’t expect owners to hold cats safely, and remember the safety of the owner is your responsibility while they are in the clinic.

In exceptional cases, some cats are so fearful that a full examination is not achievable even with the most patient of handling. This is rare, but rough handling with heavy restraint (scruffing the cat and pinning it to the table) is likely to only make things much worse and cause huge stress to the cat. In such rare cases, consider if chemical restraint is appropriate, and if so, ensure you get as much information as possible (and collect samples if appropriate) while it is sedated.

Always make sure that owners know and understand what you are doing when you are examining the cat, and what you have found – normal or otherwise, so that they can understand and enter into the healthcare process.

Making human behaviours less threatening for the cat

Avoid direct eye contact

Move slowly and deliberately; minimize hand gestures

Put yourself on the same level as the cat; approach from the side and do not loom above or over the cat

Use a calm quiet voice. Animated discussions may engage the client but scare the cat

If the cat is anxious, return it to the carrier before going over instructions with the client, unless you need to demonstrate a technique

Be aware of your own emotions and their potential effect on the cat’s behaviour

In summary, patience, gentleness, and empathy can go a long way to help reduce stress in cats. If these principles are properly implemented and your practice structure supports minimizing stress from the moment the owner and cat enter the practice until they leave, your staff, the owners and feline patients will have a better experience overall.