Handling cats for any procedure can be difficult because they are seldom happy about being restrained and can become very fearful if they feel they are not in control of their own safety. This can be especially true for cats that are feeling pain. In this article, Senior Feline Nurse, Suzanne Rudd from the Feline Centre (Langford Veterinary Services, University of Bristol), looks at respectful and gentle handling techniques – particularly when pain is suspected – which are not only relevant in the clinic but which can also be adopted in the home.
Our cats are living longer, and as we know, are masters of disguise when it comes to hiding signs of pain; thus it can be difficult to recognise when our cats are displaying signs of discomfort. However, recent research indicated that 90% of cats over 12 years of age showed some signs of degenerative joint disease (DJD) (also known as osteoarthritis), a painful condition. With this in mind, it is sensible for vets and nurses, as well as owners, to assume some degree of osteoarthritis and its associated pain
in cats over 12 and employ gentle and respectful handling.
Because older cats may need to go the vet more often, and indeed should go regularly for check-ups, they will need to be put into and taken out of their carriers. First of all, it may be useful to look at the type of carrier you have – if the entrance is only at the front and quite small, is it going to be difficult to fit the cat through, especially if the cat plants its feet either side of the door and won’t budge. International Cat Care recommends owners use carriers which open at the front but that also have a top half which can be removed totally, or has a wide opening at the top, so that there are different options for getting the cat in and out.
Once at the veterinary clinic, Suzanne advises not to grasp the cat by the shoulders or front legs and pull the cat out as this will make the cat resist and may also cause discomfort in arthritic joints. The clinic should have consulting rooms which are cat friendly, meaning that there are no gaps or areas where a cat can hide and where retrieving it would be difficult. Then the owner can place the basket on the floor, open the front door of the basket and allow the cat to walk out of its carrier while the veterinary personnel are talking to the owner.
If the cat does not want to leave the basket voluntarily, then a top opening basket can have the top removed and the cat can be lifted carefully out giving it support under its chest and hindquarters (see picture). This not only applies to cats with arthritic pain but also to cats with abdominal pain (as lifting under the abdomen could be very uncomfortable). The method is of course beneficial for all cats, whether they are in pain or not because it is comfortable and the cat feels secure.
Sometimes when the top of the basket is removed, the vet or veterinary nurse can examine the cat while it is still in the basket. Suzanne suggests that it is better and safer to lift the cat out of the carrier when is on the ground than when it is at table height, as from the ground the cat can be fitted into the handler’s body which can provide extra cushioning and security. Lifting a cat from a top opening carrier at table height often means that the cat is being lifted into the air at arms’ length and provides no security for the cat, which may cause it to struggle (especially if the cat does not like being picked up anyway) – this leads to greater chances of being scratched and the cat will then already be unsettled before the examination begins. Again, there are lessons here we can learn for our cats at home.
In clinics which ‘think cat’, the vet and vet nurse can work around the cat for as much as practicable rather than forcing the cat to sit a certain way or in a certain place. An examination can be performed on the floor, in a basket, on the table, on a work surface or even on a window ledge. Allowing the cat to look out of a window can also provide an excellent distraction while the examination is being performed. It is also sensible to examine the painful part of the cat last as tolerance may be limited after this.
Cats will often seek height for security, therefore a consulting room can also be made more cat friendly for a painful cat by having platforms to allow it to access the work surface if it desires. This can be achieved by simply providing a footstool, chair or ramp for the cat to use. A towel on weighing scales can encourage the cat to sit on them, and comfortable bedding placed on the table can allow the cat to settle and sit in its most comfortable position. These are all veterinary considerations, but again we can use them in our own homes when we consider the comfort of our cats.
Restraint for procedures
There may be times where your cat needs to be restrained for certain procedures. At the clinic and at home, cats with chronic pain need careful consideration when restraining. Whether the cat is conscious, sedated or anaesthetised the veterinary surgeon and nurse should be careful when handling the cat, not putting excessive strain or force on the joints. This is easily overlooked when cats are sedated or anaesthetised but the cat may be in much more discomfort on recovery if their joints have been over-manipulated.
At the clinic and back at home, two handlers can be better than one when needing to restrain a cat. With two people holding the cat, less force is often required and for painful older cats, less distress may be caused – something we may have to consider when administering medication at home.
Cats that are painful will feel more vulnerable at the veterinary clinic and often seem hyper-sensitised to further induced pain such as the pain from a needle or catheter. Vets and nurses should perform such procedures using good cat friendly principles, such as ensuring a quiet environment and performing the procedure in stages. For example, clipping and applying a local anaesthetic cream first then allowing 40 mins for that to take effect while the cat settles, can make a huge difference in the successful outcome of blood sampling or placing an IV catheter into a cat. Finally, where a cat is suspected to be painful, analgesia should be given, even if only a single dose to see if the cat improves in demeanour and anxiety.
While the information in this article was originally written for veterinary nurses considering how best to handle cats at the veterinary clinic, it reminds us how important it is to choose a clinic which is cat friendly and considers the comfort of our cats in every procedure they do. It also helps us to think about how we handle our cats at home, especially as they get older.