Fear Free Visits for Cats

Fear Free Veterinary Visits For Cats

The veterinary hospital can be a scary place for a pet. Strange people, unfamiliar smells and noises, poking, prodding, and sometimes pain from procedures, all add up to a very frightening experience. Some cats are fearful of their transport carrier and some pets are afraid of car rides or become car sick. This means that many pets are fearful before their visit even starts!

Simple things we don’t think would be frightening to our pets can be perceived as such.

Dogs barking can be very intimidating to cats. White coats or strange objects such as laser or anesthetic machines can be frightening. Noises we don’t notice, like beeping timers or a whirling centrifuge, may startle a pet. Animals emit fear pheromones that other pets can smell. Altogether, the veterinary hospital can be not only scary, but overwhelming.

Anxiety has Consequences

• Anxiety is the anticipation of danger – it’s being worried about what will happen next. When anxiety occurs, the body has what is termed a stress response, triggered by the release of stress hormones such as adrenaline and cortisol.
• Fear is the next step above anxiety, and occurs when pets perceive the danger they were anticipating is now upon them. It is the normal reaction of an animal faced with a situation that it perceives as dangerous. Signs of fear are usually more apparent than those of anxiety.
• Terror is the most extreme sign of stress, when a pet is in full “fight or flight” mode.

An example of anxiety for a human is heading off to a checkup at the doctor or dentist office, which is not painful but not any fun either. Fear might happen if you were going in for surgery. You know it will be both scary and probably painful. Terror is how you would react if someone was coming at you with a gun or a large knife to kill you. It’s a much higher level of fear than we commonly experience.

It’s easy to underestimate or discount a pet’s fear. It’s often our response to think that the pet should just “suck it up” because “it’s not that bad,” but we don’t have the pet’s perspective. The point is, we are not trying to kill our patients, but they may think we are. Most of our patients are nervous or fearful, and a few probably believe they are going to die when they come here; they are that frightened. This is an unfair amount of fear to put a pet through, even if it’s only once a year, plus it often gets worse over time. Eventually, it’s dangerous for both the pet and the veterinary staff.

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The stress response is a normal and adaptive mechanism that prepares an animal for activity or defense, but it also has adverse consequences such as increasing heart rate, blood pressure and blood sugar. These are all things we like to measure during a veterinary visit. The more stress, the less accurate our measurements are going to be. Long term stress, which can happen when a pet is hospitalized or boarding, has even more adverse consequences – inability to sleep, poor appetite, decreased immune function, risk for diarrhea, etc.

Our goal is to minimize the stress response and to reduce it whenever possible, preferably avoiding the Fear and Terror stages altogether. This means we have to address anxiety early so it doesn’t progress to a more severe response. Anxiety itself can often be reduced so veterinary visits are more pleasant. We tend to take it for granted that our pets are frightened at the vet but it doesn’t have to be that way.

So How Do I Know if My Pet Is Anxious or Stressed?

Your pet may be more frightened than you realize. Most people are familiar with at least some of the behaviors that indicate a dog or cat may be stressed or frightened; shivering, cowering, hiding – we all understand those. But many times people miss more subtle cues of anxiety, like tucking the front paws underneath themselves. Looking or moving away, dilated pupils and refusal to take treats are other signs.

There are four basic ways in which animals behave when stressed or afraid. These are Fight, Flight, Freeze and Fidget.

Fighting includes growling, hissing, biting and other aggressive behaviors. Cats are more likely than dogs to try to defend themselves from unwanted handling by becoming aggressive.

Fleeing is when the cat tries to get away from us. Cats can do a lot of damage with their claws trying to escape. Since they instinctively climb when frightened, they may end up on the shelves or on top of the cabinets, having further frightened themselves sending the items in their way crashing to the counter. Digging or chewing in a carrier or at cage bars or the floor of an enclosure are also attempts at fleeing.

Dogs are more likely to fidget when anxious, including yawning, lip licking, pacing, panting, getting up and down, or nudging their owners.

Cats are more likely to freeze, where they hold rigidly still or stiff with their pupils dilated. Cats may lie in what’s called the “meatloaf position” with their front paws curled protectively underneath them.

About 75% of dogs and cats show at least a couple of these signs when they visit the veterinarian. Sometimes this is situational – for example, a cat is fine until taken out of the carrier or lifted on to the exam table and then he gets scared. Be alert to the signs so we can address the fear.

Each fearful event that does not have a positive outcome is likely to lead to a worsening of the problem. Over time, if the event is not as bad as the animal feared, anxiety can lessen. If the experience is as bad or worse, the anxiety can progress to fear and then to phobia, which is no fun for anybody, least of all your pet. No human or pet should have to be that traumatized if there is a way we can prevent it.

What can be done to reduce stress?

We use lots of treat rewards, praise and petting. We would much rather bribe a cat with chicken baby food to trim the nails than to need 3 people hanging onto the frightened, struggling animal to hold it down.

Many cats feel safer when hiding, so putting a blanket or towel over them can be helpful, especially if it’s been sprayed with Feliway™.

We use pheromones a lot nowadays. Feliway provides a calming a comforting, reassuring smell. Having a blanket sprayed with Feliway over the cage during a veterinary visit, or wiping it in the carrier ahead of time, can keep a cat much more calm and relaxed. The doctors and techs spray Feliway on our lab coats so we smell calming to our patients. We also have diffusers in the exam rooms and kennel areas that release Feliway into the air.

Not only do we use it here in the hospital but there are two different formulations for use at home, one that helps with litter box avoidance and the other with intercat aggression. Pheromones also come in collars, so the anxious pet can wear the smell all the time if needed. This is especially useful for timid, newly-adopted cats.

Another product that we recommend is the Thundershirt™. Thundershirts, and similar products, squeeze pets like a hug, which relaxes them. Similar wraps are used for autistic children to help calm and settle them. The pressure of a wrap like this stimulates the release of endorphins. Not only are Thundershirts good for thunderstorms, they work here in the hospital as well. Some cats do well with Thundershirts but the effect isn’t as predictable in cats as it is in dogs. We have Thundershirts available to use here but they work better if you put them on at home beforehand.

Most cats benefit from a dose or two of antianxiety medication before veterinary visits. Clients are often hesitant to give their pets prescription antianxiety medication, but the risk of problems from these drugs is very low. We want to give your cat the medication he or she needs in order to have a reasonably calm and quiet visit, with less stress for everyone involved.

Fear and stress affect the immune system, blood pressure, blood sugar and the mental health of your pet. The danger is not in giving your pet the medication but rather from fear behavior, which can injure the pet, our staff or you. To us, it also seems cruel to let pets be so scared when we could do something about it.

For cats, we usually use gabapentin as our anxiety medication. Most cats will take it mixed in canned cat food, especially when something else tasty, like FortiFlora™, is mixed with it. We have you pick up the medication ahead of time so you can administer prior to your appointment. FortiFlora is a probiotic that not only tastes good but helps to prevent the GI upset that can accompany fear.

Can anxiety be prevented?

When puppies and kittens come in to see us, we work especially hard to make their first visits fun and not scary. What they learn as youngsters will stay with them for the rest of their lives and we want to get off to a good start. We snuggle them, give them baby food, carry them around, and try not to have them feel the poke of the needle when we vaccinate them. It’s amazing how they won’t notice an injection as long as they are eating a tasty treat!

Socializing your kitten to people, other pets and different situations is very important.  The more people a young kitten meets, the more relaxed he will be around humans all his life. Youngsters should get lots and lots of socialization to other people.