Improving the feline veterinary consultation: the usefulness of Feliway spray in reducing cats' stress

Safety and efficacy assessment of a synthetic porcine recombinant corticotrophin for the ACTH stimulation test in healthy cats

Porcine adrenocorticotrophic hormone (ACTH) has been considered valid for the ACTH stimulation test (ACTHST) in humans and dogs; however, its safety and efficacy for use in cats are unknown. Also, the equivalence between 5 µg/kg and 125 µg/cat dose of synthetic corticotropin (1-24 ACTH - cosyntropin/tetracosactide) is assumed for ACTHST in cats. This study evaluated the safety and effectiveness of different porcine recombinant ACTH doses for the ACTHST in healthy cats and its equivalence with tetracosactide. The study was divided into two arms. The first evaluated safety and equivalence of intravenous 1 µg/kg, 5 µg/kg, or 125 µg/cat porcine ACTH in seven healthy cats for the ACTHST evaluating basal and post-ACTH androstenedione, aldosterone, cortisol, and progesterone concentrations. In the second arm, the equivalence of the 125 µg/cat porcine ACTH dose was evaluated compared to results obtained using 125 µg/cat of tetracosactide in ten healthy cats regarding cortisol responses. In all tests, several cat-friendly strategies were adopted, and the ACTHST protocol involved basal and 60-minute post-ACTH blood sampling and intravenous ACTH injection. No adverse reactions were documented, and no tested cat showed any complications during the study. No porcine ACTH tested dose significantly increased androstenedione secretion. In contrast, all tested doses were able to increase progesterone concentration significantly (P < 0.05), and Δ-progesterone in response to 5 µg/kg or 125 µg/cat was considered equivalent (P > 0.99). The 125 µg/cat dose promoted greater responses for both cortisol and aldosterone, characterized by Δ-cortisol (P = 0.009) and Δ-aldosterone (P = 0.004). Despite equivalent Δ-cortisol results in response to 5 µg/kg or 125 µg/cat (P = 0.18); post-ACTH results of cortisol in response to 5 µg/kg only approximate statistical significance when compared with basal (P = 0.07). Porcine ACTH and tetracosactide significantly increased post-ACTH cortisol concentration (P < 0.0001) while the Δ-cortisol was slightly greater in response to the porcine ACTH (P = 0.006). These results suggest porcine ACTH could be an alternative source of corticotropin for the ACTHST in cats; however, maximum corticoadrenal stimulation seemed more reliable in response to a 125 µg/cat regarding cortisol and aldosterone.

Evaluation of Stress Scores of Healthy Adult Cats during Barometric Whole-Body Plethysmography and Its Correlation with Measurement Parameters

Barometric whole-body plethysmography (BWBP) is considered to be a particularly gentle method of assessing lung function in cats. However, there have been no studies to date investigating the stress experienced by cats during measurements. The prospective study included 48 healthy adult cats. Each cat was measured in the plethysmographic chamber for a total of 30 min and stress levels were determined every 10 min using a stress ethogram. At the beginning of measurements, 75% of cats were assessed as tense. Over the three time periods, a significant (p < 0.001) reduction in the total stress score was observed. In addition, all measurement parameters correlated significantly with the stress score, with the exception of enhanced pause and tidal volume. It can therefore be assumed that cats will initially experience stress during examination in the plethysmographic chamber, but stress will decrease significantly over time. As the stress level correlates with many measurement parameters, this should be taken into account when interpreting the results.

Use of Gabapentin or Alprazolam in Cats during Postoperative, Short-Term Hospitalization

This prospective, randomized study aimed to assess the anxiolytic efficacy of gabapentin or alprazolam in cats during short-term postoperative hospitalization. Sixty cats were randomly assigned to three groups (gabapentin-treated [100 mg per cat], alprazolam-treated [0.125 mg per cat], or placebo-treated), with treatments administered twice daily for two days. Stress levels were evaluated using Cat Stress Scores, serum cortisol, and glucose concentrations. Pain scores, food consumption, and adverse effects such as sedation were also monitored. Fifty-five cats completed the study. Both medications demonstrated similar reductions in stress levels. Cats receiving gabapentin had lower pain scores, while those receiving alprazolam exhibited significantly increased food intake on the first postoperative day. However, both medications resulted in comparable levels of sedation. In the context of postoperative hospitalization, pharmacological intervention with anxiolytics could be effective in reducing stress levels. Despite potential side effects, gabapentin and alprazolam may contribute to an improved quality of short-term hospitalization for cats.

The Influence of Noise Level on the Stress Response of Hospitalized Cats

The study aimed to investigate the impact of noise levels in the hospital environment on the stress experienced by hospitalized cats undergoing elective ovariohysterectomy surgery. A total of 33 domestic female cats were included in the study, divided into four groups: a control group (CG) and three experimental groups based on ward noise levels: G1 (Quiet, <60 dB), G2 (Medium, between 60 and 85 dB), and G3 (Noisy, >85 dB). Behavioral assessments, respiratory rate (RR), and plasma cortisol levels ([Cort]p) were measured as indicators of stress. A composite measure of stress, termed the final stress value (FSV), was calculated by summing scores across various behavioral categories. Data collection occurred at three time points: immediately following surgery (T1), and at 2 h (T2) and 3 h (T3) post-surgery. FSV and RR were assessed at all three time points (T1, T2, and T3), while [Cort]p levels were measured at T1 and T3. The study observed that the median values of FSV, RR, and [Cort]p tended to increase with both higher noise levels and longer exposure durations to noise. Significant differences in RR were found between group pairs G1G2 at T1 (|D| = 0.63 < cut-off = 0.98), and G2G3 at T2 (|D| = 0.69 < cut-off = 0.97). Regarding [Cort]p, significant differences were noted between the CGG1 group pair at T0 (p < 0.01), and T3 (p = 0.03). Furthermore, an excellent Spearman correlation coefficient (rho = 0.91) was found between FSV and RR, indicating that RR can serve as an effective tool for assessing stress levels in cats. The findings of this study provide valuable insights into the welfare of cats in a hospital environment and support the scientific validity of existing recommendations aimed at improving their well-being. Specifically, the study underscores the importance of minimizing noise levels in hospitals as a means to reduce stress in cats. This conclusion aligns with existing guidelines and recommendations for enhancing the welfare of hospitalized cats.

Advice on cat behavior in German veterinary practices:Expectations of cat owners and influencing factors on compliance

Veterinarians play an important role in establishing and sharing the welfare of companion animals by carrying out regular health checks and informing owners about the specific needs of the animal's environment and conditions of good husbandry. A survey among German cat owners revealed which role advice about cat behavior plays in daily practice and its influence on the cat owner's compliance. Some owners (29.6%, n = 263/889) reported behavioral problems in their cat.  Not all owners considered their veterinarian as their contact of choice for behavioral advice, although veterinarians who met owners' expectations for advice on cat behavior are significantly more often described as feline-friendly (P < 0.000). Owners who expected an empathetic treatment of their cat will show a better compliance (P = 0.003). Owner compliance can be improved by providing accurate and effective veterinary advice about cat behavior and behavioral problems (P = 0.003). Thus, a sound foundation in cat behavior and knowledge of current treatment recommendations for feline behavioral problems can be worthwhile to ensure good husbandry for cats.

The Effect of a Synthetic Scent on Cheetah Behaviour

In cheetahs, age at first parturition correlates negatively with reproductive lifespan (asymmetric reproductive aging); therefore, breeding cheetahs at a young age is essential to maximize reproductive performance in this species. However, younger females display a significantly reduced frequency of copulatory behaviour, which negatively affects breeding. Volatile organic compounds (VOCs) are known to regulate appropriate behavioural responses in various species, including reproductive behaviour; moreover, they have proven to play a role in captive breeding methods in cheetahs, as well as mate choice. Therefore, the objective of this study was to evaluate the effect of a synthetic scent (SS) on the frequency of the five oestrous behaviour(s) (sniff, rub, roll, spray, and meow-chirp) known to be indicative of oestrus in female cheetahs. Based on the results of a previous study from our research group, five VOCs, identified in the marking fluid of male cheetahs, and known to be pheromones involved in reproductive behaviour, were used to create the SS. This was accomplished by mixing benzaldehyde, acetophenone, indole, dimethyl disulphide and phenol with (99.9%) ethanol. Seven female cheetahs were then observed for one oestrus cycle without stimulation (control) and then once again while exposed to the SS (treatment), which was sprayed on foil trays placed around the outside of each enclosure. The occurrence of the five oestrous behaviours was recorded and tallied per day of observations. Although the SS did not have a significant effect on the frequency of oestrous behaviours displayed by the females used in this study, five of the seven (71%) did show an increase in their behaviour with the SS when oestrogen concentrations were at their highest (peak oestrus), including three of the four younger females. The SS also significantly increased the sniffing behaviour in general. Although the results of this study do indicate that VOCs influence cheetahs and their behaviour, firm conclusions cannot be drawn due to the low number of animals used, as well as the significant effect the observation methods had on the results. Nonetheless, this study represents the first of this kind in cheetahs, therefore representing an important step in determining the role of VOCs in aiding breeding in captivity.

Feline Stress Management During air Travel: A Multimodal Approach

PRACTICAL RELEVANCE

More cats are travelling by air every year; however, air travel involves several common causes of stress for cats, such as environmental changes and a lack of control and predictability. The use of a multimodal stress management protocol for all stages of the relocation process, including appropriate and effective anxiolytic medication where necessary, is therefore important in order to safeguard the cat's welfare while travelling.

CLINICAL CHALLENGES

Cats may be presented to veterinarians for the purpose of preparing them and/or their documentation for air travel. Maintaining and protecting a cat's physical, mental and emotional health in a stressful environment, while subjected to likely unfamiliar sights, noises, smells and the movement of the aircraft, and additionally dealing with international legislation, regulations and documents, can pose a complex challenge to veterinarians.

AIMS

This review describes the importance of stress management during air travel for cats, aims to raise awareness about the often poorly understood challenges involved, and outlines effective and airline-compliant stress management modalities. While the discussion is focused on air travel specifically, the stress management methods described can be applied to all types of longer distance travel, such as a long road trip or a ferry crossing, as well as a stay in a holiday home.

EVIDENCE BASE

There are currently no studies specifically on air travel in cats and, similarly, there are also limited data on air travel in other species. Many of the recommendations made in this review are therefore based on the authors' extensive experience of preparing pets for travel, supported by published data when available.

2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines

PRACTICAL RELEVANCE

The '2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines' (hereafter the 'Cat Friendly Veterinary Environment Guidelines') describe how the veterinary clinic environment can be manipulated to minimise feline patient distress. Many components of a veterinary clinic visit or stay may result in negative experiences for cats. However, much can be done to improve a cat's experience by making the veterinary clinic more cat friendly. Exposure to other cats and other species can be reduced, and adjustments made with consideration of the feline senses and species-specific behaviour. Caregivers can prepare cats for a clinic visit with appropriate advice. Waiting rooms, examination rooms, hospital wards and other clinic areas can be designed and altered to reduce stress and hence encourage positive emotions. Changes need not be structural or expensive in order to be effective and make a difference to the cats and, in turn, to cat caregivers and the veterinary team. Moreover, by improving the all-round experience at the veterinary clinic, there are positive effects on preventive healthcare, identification of and recovery from illness, and compliance with treatment.

CLINICAL CHALLENGES

Good feline healthcare necessitates visiting the veterinary clinic, which, simply by being outside of a cat's territory and familiar surroundings, may lead to negative experiences. Such experiences can trigger negative (protective) emotions and associated physiological stress, which can result in misleading clinical findings, patient distress, prolonged recovery from illness, further difficulties with handling at subsequent visits and potential veterinary personnel injury. There may be a mistaken belief that veterinary clinics must undergo significant renovation or building work to become cat friendly, and that, if species cannot be separated, then clinics cannot improve their care of cats. These Guidelines aim to dispel any such misconceptions and provide detailed practical advice.

EVIDENCE BASE

These Guidelines have been created by a Task Force of experts convened by the International Society of Feline Medicine and American Association of Feline Practitioners, based on an extensive literature review and, where evidence is lacking, the authors' experience. Endorsements: These Guidelines have been endorsed by a number of groups and organisations, as detailed on page 1161 and at icatcare.org/cat-friendly-guidelines and catvets.com/environment.

Perception of stress in cats by German cat owners and influencing factors regarding veterinary care

OBJECTIVES

Visiting the veterinarian is generally perceived as a stressful situation for cats. Previous studies have shown that the perception of stress may influence cats' healthcare. In order to minimise stress in cats during the veterinary consultation, feline-friendly handling has gained importance and is increasingly being used. The aim of this study was to find out whether cats experience stress during a visit to the veterinarian (and, if so, to what extent), and which factors influence the perception of stress and whether feline-friendly handling techniques have an impact.

METHODS

An online survey was conducted among German cat owners. In total, 889 questionnaires were evaluated. The results were analysed with binary logistic regression and a χ² test. A principal component analysis was used to detect the main influencing factors on the perception of stress.

RESULTS

Most of the cats (88.7%, n = 732/825) were perceived as stressed during a veterinary consultation, while only about half of the owners (50.8%, n = 419/824) stated that they felt stressed themselves. The cat owners (n = 819) who perceived visiting the veterinarian as a stressful situation also described their cat as stressed significantly more often compared with owners who did not feel stressed (χ² = 101.113, P <0.001). The probability that owners experienced stress themselves was significantly increased if they perceived their cat to be stressed too (odds ratio 0.073, 95% confidence interval 0.016-0.328). One factor that influenced whether an owner was stressed was the stress behaviour of their cat (P <0.001). Furthermore a feline-friendly demeanour by the veterinarian led to less stress in the owners (P <0.001).

CONCLUSIONS AND RELEVANCE

The owner's stress influences the perception of their cat's stress. By adhering to feline-friendly handling guidelines, veterinarians can reduce owner stress associated with veterinary visits, thereby promoting optimal veterinary care and health for their feline patients.

Effect of a synthetic feline facial pheromone product on stress during transport in domestic cats: a randomised controlled pilot study

OBJECTIVES

Transport can be a stressful experience for domestic cats. The objective of this study was to evaluate the effect of a new synthetic feline facial pheromone product on relieving stress in domestic cats during short-distance transport.

METHODS

A randomised, blinded, placebo-controlled pilot study was conducted. Prior to baseline screening, cat owners were trained via online meetings in the assessment of stress-related behaviours and overall stress visual analogue scoring. All assessments were completed 30 mins after the start of transport. A total of 150 domestic cats exhibiting stress-related behaviours during baseline screening were recruited and randomly assigned to either the treatment group (n = 75) or the placebo group (n = 75). For the placebo-controlled intervention, the product and placebo, which were identical in appearance, were provided to the treatment and placebo groups, respectively. Fifteen minutes after spraying the carriers with the product or placebo, cat owners were required to take their cat out and complete the same assessments (baseline screening).

RESULTS

After the intervention, the performance of the stress-related behaviours curling, lack of motion and meowing during transport outside the home was significantly reduced in the treatment group compared with the placebo group (P <0.05). When the baseline stress visual analogue scale (VAS) score was >2.94 cm, cats in the treatment group had significantly lower post-intervention stress VAS scores compared with those in the placebo group (P <0.05).

CONCLUSIONS AND RELEVANCE

A synthetic feline facial pheromone product can alleviate short-distance transport-related stress in domestic cats with higher stress scores. This finding will benefit domestic cats during transport outside of the home.

Dealing With Stress in Cats: What Is New About the Olfactory Strategy?

Domestic cats are descended from solitary wild species and rely heavily on the olfaction system and chemical signals for daily activities. Cats kept as companion animals may experience stress due to a lack of predictability in their physical or social environment. The olfactory system is intimately connected to the brain regions controlling stress response, thus providing unique opportunities for olfactory strategies to modify stress and related behavioral problems in cats. However, the olfactory intervention of stress in cats has been mainly focused on several analog chemical signals and studies often provide inconsistent and non-replicable results. Supportive evidence in the literature for the potentially effective olfactory stimuli (e.g., cheek and mammary gland secretions, and plant attractants) in treating stress in cats was reviewed. Limitations with some of the work and critical considerations from studies with natural or negative results were discussed as well. Current findings sometimes constitute weak evidence of a reproducible effect of cat odor therapy for stress. The welfare application of an olfactory stimulus in stress alleviation requires a better understanding of its biological function in cats and the mechanisms at play, which may be achieved in future studies through methodological improvement (e.g., experiment pre-registration and appropriate control setting) and in-depth investigation with modern techniques that integrate multisource data. Contributions from individual and environmental differences should be considered for the stress response of a single cat and its sensitivity to olfactory manipulation. Olfactory strategies customized for specific contexts and individual cats can be more effective in improving the welfare of cats in various stressful conditions.

Double-blind, placebo-controlled trial of venlafaxine to treat behavioural disorders in cats: a pilot study

OBJECTIVES

Venlafaxine, a specific inhibitor of both noradrenaline and serotonin, is commonly used in human medicine to treat depression, anxiety and social phobia. Its formulation in small granules renders it interesting to test on cats, which are usually reluctant to take medication. Venlafaxine was administered at 1 mg/kg for 60 days, using a double-blind, placebo-controlled protocol, to cats aged ⩾6 months exhibiting aggressiveness, fear or house-soiling.

METHODS

After one cat's withdrawal, 21 cats were included in the study: 11 in the venlafaxine group and 10 in the placebo group. Three consultations were conducted, on day 0, day 30 and day 60. Each visit consisted of (1) veterinarian- and owner-based scoring of the cat's behavioural improvement; (2) scoring of the cat's compliance with removal from its carrier and compliance with manipulation; and (3) owner scoring of the ease of administration and recording of the potential adverse effects of the treatment.

RESULTS

Improvement was significantly higher in the venlafaxine group; as early as day 30, according to the veterinarian scoring, and at day 60, according to both the veterinarian and owner scoring. In contrast, neither the removal nor the manipulation scores were significantly different between the two treatment groups. Venlafaxine seemed to improve all three studied signs, as early as day 30 for fear and aggressiveness, and at day 60 for house-soiling. The adverse effects of venlafaxine were limited to drowsiness in one cat. All cats tolerated the treatment well during the 60-day period.

CONCLUSIONS AND RELEVANCE

These results suggest that venlafaxine is efficient in treating several behavioural problems and is easy to administer. More studies should be conducted to explore its effects at different dosages on specific diagnoses.

Clinical evaluation of the effects of a single oral dose of gabapentin on fear-based aggressive behaviors in cats during veterinary examinations

OBJECTIVE

To investigate the effects of a single oral dose of gabapentin on fear-based aggressive behaviors (FABs) in cats during veterinary examinations.

ANIMALS

55 healthy pet cats (26 with and 29 without a history of FAB during veterinary visits [FAB and untreated control groups, respectively]).

PROCEDURES

A standardized 9-step clinical examination protocol (with patient compliance scored from 0 to 9 according to the highest completed step) was tested on untreated control group cats. The protocol was then used in a double-blind, randomized, placebo-controlled, crossover-design trial in which FAB-group cats received owner-administered gabapentin (100 or 200 mg/cat) or placebo capsules 2 hours before the first of 2 veterinary visits and received the alternate treatment before the second visit ≥ 1 day later. Ease of administration (scored from 1 [very difficult] to 4 [very easy]) and adverse effects were recorded. Compliance scores were compared between treatments for the FAB group and between FAB and untreated control groups. Changes in scores between treatments for the FAB group were used to investigate associations between selected variables and the outcome of interest.

RESULTS

FAB group compliance scores after gabapentin administration (median, 9; range, 0 to 9) were significantly higher than scores after placebo administration (median 0.5; range, 0 to 7) and did not differ from scores for the untreated control group. Owner scores indicated capsule administration was easy. Adverse effects (most commonly drowsiness, myorelaxation, and ataxia) resolved ≤ 10 hours after detection.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested oral administration of gabapentin to cats 2 hours before a veterinary visit can reduce FAB during physical examination, enabling more complete evaluation.

Feline comorbidities: The intermingled relationship between chronic kidney disease and hypertension

PRACTICAL RELEVANCE

Chronic kidney disease (CKD) is a highly prevalent disorder of senior cats. CKD is frequently diagnosed in association with hypertension, and the two conditions have an intermingled cause-and-effect relationship. Hypertensive target organ damage (TOD) to the eye, brain, heart and kidney significantly impacts the welfare of cats suffering from this comorbidity. Hypertension also drives proteinuria, which is an independent risk factor for progression and mortality in cats with CKD. Blood pressure monitoring and institution of effective antihypertensive treatment, where indicated, is therefore crucial in effective management of the feline CKD patient. Current guidelines recommend a target systolic blood pressure of <160 mmHg to minimise risk of TOD. Both amlodipine besylate and telmisartan are effective antihypertensive agents for use in these patients.

CLINICAL CHALLENGES

Clinical signs of hypertension may not be apparent to owners of affected cats until severe hypertensive TOD is present. Despite this, blood pressure monitoring in cats with CKD is still infrequently performed, and hypertension likely remains underdiagnosed in this population.

EVIDENCE BASE

This review is based upon evaluation of the currently available published literature, including relevant consensus statements. There is a large body of evidence supporting the association between hypertension and CKD in cats. However, significant aspects, such as the mechanisms behind this association, and effect of hypertension and antihypertensive treatment on mortality and progression of CKD, remain unclear. Further research is therefore required in order to improve understanding of these conditions.

Assessment of the cutaneous trunci reflex in neurologically healthy cats

OBJECTIVES

The aim of this study was to perform the cutaneous trunci reflex (CTR) in neurologically normal cats using two different instruments and determine how body condition score (BCS), body circumference, age, sex and instrument type may affect this reflex.

METHODS

Sixty-five cats without evidence of neurologic disease were prospectively enrolled. Cats were randomly assigned to have the reflex tested first using a pair of hemostatic forceps or the integrated Babinski tip of an MDF Babinski Buck Reflex Hammer. After 30 mins, the reflex was retested using the other instrument. Data collected included the reflex presence, reflex caudal border, reflex intensity (weak, moderate, strong) and reflex symmetry (unilateral or bilateral). The influence of BCS, body circumference, age and sex on these variables was statistically evaluated along with effect of the instrument used.

RESULTS

The CTR was elicited bilaterally in 52 (80%) cats and unilaterally in 64 (98%) cats. In two cats, the CTR was only able to be elicited using the Buck Reflex Hammer, while in four cats, the CTR was only able to be elicited using hemostatic forceps. Body circumference, BCS, age and sex had no effect on the presence, caudal border, intensity or symmetry of the CTR, regardless of the instrument used. No difference in the bilateral presence of the CTR was noted based on the instrument used first (P = 0.53). When assessing the influence of the instrument on reflex presence, caudal border, intensity and symmetry, the hemostatic forceps elicited the reflex further caudally (P = 0.02) and usually bilaterally (P = 0.02).

CONCLUSIONS AND RELEVANCE

The CTR could be elicited in the majority of cats with both instruments. However, hemostatic forceps elicited a reflex more caudally and bilaterally symmetrical than the Buck Reflex Hammer.

Effects of Waiting Room and Feline Facial Pheromone Experience on Blood Pressure in Cats

Obtaining accurate blood pressure measurements in cats is challenging due to the stressful nature of clinic visits. The objective of this study was to evaluate the effects of veterinary clinic waiting experiences and a feline pheromone spray on blood pressure in the cat. We hypothesized that reduced stress associated with bypassing the waiting room and use of synthetic feline facial pheromone (FFP) spray would result in lower blood pressure. A 2 × 2 factorial design involved two rooms and two FFP treatments. Thirty-nine healthy adult cats were recruited and were systematically assigned to four treatment combinations administered over four visits in 2016 and 2017. Cats were kept in the hospital waiting room or were taken directly to the exam room, with or without FFP treatment. All cats were then acclimated to the exam room for an additional 10 min, where vocalizations were recorded manually, before blood pressure measurements were collected using Doppler ultrasonography. Data were analyzed using generalized linear mixed models, with room × FFP interaction, visit, sex, and trial year in the model. There was no significant effect of waiting room by FFP interaction on blood pressure (n = 0.95). Mean blood pressure was significantly higher at visit 1 than visits 2 and 4 (P < 0.01), but higher at visit 3 than visit 2 (n = 0.02). Mean blood pressure was higher in males (n = 0.01), and males were more likely to be categorized as borderline hypertensive/hypertensive or severely hypertensive (n = 0.01). Number of vocalizations was significantly associated with waiting room by FFP interactions (P < 0.01), with fewer vocalizations associated with bypassing the waiting room and when FFP was provided. In conclusion, although we found some behavioral evidence supporting stress reduction when feline patients bypass the waiting room and are provided with FFP, these interventions did not result in lower blood pressure in a clinical setting.

A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting

Simple Summary

The majority of dogs and cats are fearful during veterinary visits, and some individuals may show aggression as a result. We review ways to avoid negative experiences and promote positive emotions in animals visiting the veterinarian. Whenever an animal is in the practice, the veterinary team should endeavour to make the visit as pleasant as possible, by using non-threatening body language and by creating positive associations. High-value food (unless an animal needs to be fasted) or toys should be used generously throughout the visit. In the interaction with the animals, low-stress handling methods, brief pauses and adjusting the procedure based on the animal’s body language help them to feel secure. Distractions can be used to minimise perceived pain such as from injections. If a known painful area needs to be treated, pain killers are advised. For animals that are very fearful, several medication options are available that can be given prior to the veterinary visit to help them with their fears. With reward-based training, animals can learn to accept veterinary procedures. A stress-free veterinary visit benefits all involved parties—the animals, their owners, as well as the veterinary team.

Abstract

A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. We briefly summarise the available evidence for the interventions discussed. The set-up of the waiting area (e.g., spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended, both to prevent and address existing negative emotions. Short-term pain from injections can be minimised by using tactile and cognitive distractions and topical analgesics, which are also indicated for painful procedures such as ear cleanings. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease fear and stress in patients and consequently their owners, thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

Assessment of the cutaneous trunci muscle reflex in neurologically abnormal cats

OBJECTIVES

The aim of this study was to evaluate the presence of the cutaneous trunci reflex (CTR) in a population of neurologically abnormal cats in regard to age, body condition score (BCS), sex, breed, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification.

METHODS

A retrospective medical record review was performed to identify cats with a history of neurologic disease undergoing a complete neurologic assessment between 24 September 2012 and 20 March 2019. CTR outcome (present, absent), signalment, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification were recorded.

RESULTS

A total of 182 cats were identified. The CTR was present in 118 cats (64.8%) and absent in 64 cats (35.2%). Statistical analysis revealed no association between CTR outcome and age, BCS, sex, breed, evidence of traumatic injury, non-spinal pain, known metabolic disease, mentation, neurolocalization or diagnostic classification. A significant association was found between spinal pain and CTR outcome (P = 0.037).

CONCLUSIONS AND RELEVANCE

These findings suggest that elicitation of the CTR in the cat can be unreliable. Further prospective controlled studies are warranted to determine whether continued inclusion of the CTR in feline neurologic examinations is justified. Consideration of the reliability of the CTR is indicated, particularly in the context of fractious or anxious patients for which only a limited window for examination may be present.

Cats at the Vet: The Effect of Alpha-s1 Casozepin

Simple Summary

Cat owners try to avoid necessary health checks at the vet, because they are related to stress for both the cat and them. In this study, we examined the influence of the dietary supplement, α-s1 casozepin, on fecal cortisol metabolites and the autonomic nervous system in cats. We found evidence for a positive effect on the autonomic nervous system. Our findings, although preliminary, suggest that α-s1 casozepin may improve the coping of cats with stressful events.

Abstract

The aim of this study was to evaluate the impact of α-s1 casozepin on cat stress responses at a veterinary practice. Cats feel confident in their familiar surroundings and daily routine. A visit, and transport, to the veterinarian is a stressful experience for cats and their owners. Stress can mask clinical signs and has physiological impacts. Alpha-s1 casozepin (Zylkène; Vétoquinol) could potentially minimize stress in cats with its calming and anxiolytic characteristics. A randomized, partial double-blind and placebo-controlled study was carried out with 60 adult cats. The trial was designed for three groups: low dose (15 mg/kg q24 h α-s1 casozepin for six days), high dose (75 mg/kg q24 h α-s1 casozepin for three days), and a placebo (one fructose capsule per day for three days). For the study, cats had a checkup at their trusted veterinarian without the dietary supplement, followed by a second one four weeks later. Alpha-s1 casozepin or a placebo was administered three to six days before the checkup. Fecal cortisol metabolites (FCMs) were measured to non-invasively evaluate the impact of α-s1 casozepin on adrenocortical activity. The cat owners and veterinarians also assessed the physiological reactions (respiratory rate, sweaty paws, pupils, panting, and vocalization) of the cats at home, in the waiting area, and in the examination room. The only significant effect (kappa coefficient κ = 0.007 and κ = 0.003) found in this study was the absence of sweaty paws in cats who were treated with the high dose of α-s1 casozepin over three days, observed in the waiting area and examination room of the veterinarian’s practice, respectively. Alpha-s1 casozepin also showed a small but insignificant reduction in FCM levels. Alpha-s1 casozepin influences the autonomic nervous system, and can inhibit sweaty paws during stressful situations for cats.

Environment and Feline Health: At Home and in the Clinic

Environmental optimization of both the home and the veterinary clinic not only is important for promoting good emotional and cognitive health for domestic cats but also contributes to the promotion of good physical health. All 3 aspects of the feline health triad are interconnected. Inappropriate learning can occur resulting in perpetuation of behavioral responses and confirmation of emotional associations. In addition, the physiologic responses to compromised emotions and sustained negative emotional motivation can be involved in the triggering, maintenance, and increased significance of a range of physical health issues, including urinary tract, gastrointestinal, and dermatologic disease and chronic pain.

Subhypnotic dose of intravenous propofol stimulates appetite in cats with stress-induced anorexia

BACKGROUND

Stress-induced anorexia is common in cats. While medications are available to stimulate appetite, many require oral administration, have delayed onset-of-action or cause adverse side effects. The aim of this study was to determine whether cats diagnosed with stress-induced anorexia given a subhypnotic dose of intravenous propofol would have increased short-term appetite as compared to those given placebo.

METHODS

Anorexic shelter cats received either 1 mg/kg propofol or 1 mL saline placebo and then presented with various commercial cat foods. Grams of food consumed was measured at 15 and 30 min, and total grams compared between treatment and control groups using the Wilcoxon rank-sum test. 12 cats were enrolled, with six cats randomly assigned to each group.

RESULTS

The median amount consumed by the treatment group was 31 g (range: 0-72), with the median for the four cats (67 per cent) who consumed food being 45 g (range: 26-72), or 49 per cent of their daily maintenance calorie requirement. The median amount consumed by control cats was 0 g (range: 0-5), with one cat consuming food. Total grams consumed was different between treatment and control groups (P=0.05).

CONCLUSION

A subhypnotic dose of intravenous propofol increased appetite in cats with stress-induced anorexia for a 30 min period.

The Major Cat Allergen Fel d 1 Binds Steroid and Fatty Acid Semiochemicals: A Combined In Silico and In Vitro Study

The major cat allergen Fel d 1 is a tetrameric glycoprotein of the secretoglobin superfamily. Structural aspects and allergenic properties of this protein have been investigated, but its physiological function remains unclear. Fel d 1 is assumed to bind lipids and steroids like the mouse androgen-binding protein, which is involved in chemical communication, either as a semiochemical carrier or a semiochemical itself. This study focused on the binding activity of a recombinant model of Fel d 1 (rFel d 1) towards semiochemical analogs, i.e., fatty acids and steroids, using both in silico calculations and fluorescence measurements. In silico analyses were first adopted to model the interactions of potential ligands, which were then tested in binding assays using the fluorescent reporter N-phenyl-1-naphthylamine. Good ligands were fatty acids, such as the lauric, oleic, linoleic, and myristic fatty acids, as well as steroids like androstenone, pregnenolone, and progesterone, that were predicted by in silico molecular models to bind into the central and surface cavities of rFel d 1, respectively. The lowest dissociation constants were shown by lauric acid (2.6 µM) and androstenone (2.4 µM). The specific affinity of rFel d 1 to semiochemicals supports a function of the protein in cat's chemical communication, and highlights a putative role of secretoglobins in protein semiochemistry.

The Major Cat Allergen Fel d 1 Binds Steroid and Fatty Acid Semiochemicals: A Combined In Silico and In Vitro Study

The major cat allergen Fel d 1 is a tetrameric glycoprotein of the secretoglobin superfamily. Structural aspects and allergenic properties of this protein have been investigated, but its physiological function remains unclear. Fel d 1 is assumed to bind lipids and steroids like the mouse androgen-binding protein, which is involved in chemical communication, either as a semiochemical carrier or a semiochemical itself. This study focused on the binding activity of a recombinant model of Fel d 1 (rFel d 1) towards semiochemical analogs, i.e., fatty acids and steroids, using both in silico calculations and fluorescence measurements. In silico analyses were first adopted to model the interactions of potential ligands, which were then tested in binding assays using the fluorescent reporter N-phenyl-1-naphthylamine. Good ligands were fatty acids, such as the lauric, oleic, linoleic, and myristic fatty acids, as well as steroids like androstenone, pregnenolone, and progesterone, that were predicted by in silico molecular models to bind into the central and surface cavities of rFel d 1, respectively. The lowest dissociation constants were shown by lauric acid (2.6 µM) and androstenone (2.4 µM). The specific affinity of rFel d 1 to semiochemicals supports a function of the protein in cat’s chemical communication, and highlights a putative role of secretoglobins in protein semiochemistry.

2019 AAFP Feline Zoonoses Guidelines

AIM

The overarching purpose of the 2019 AAFP Feline Zoonoses Guidelines (hereafter referred to as the 'Guidelines') is to provide accurate information about feline zoonotic diseases to owners, physicians and veterinarians to allow logical decisions to be made concerning cat ownership.

SCOPE AND ACCESSIBILITY

The Panelists are physicians and veterinarians who worked closely together in an attempt to make these Guidelines a document that can be used to support the International One Health movement. This version of the Guidelines builds upon the first feline zoonosis panel report, published in 2003 ( catvets.com/guidelines ), and provides an updated reference list and recommendations. Each of the recommendations received full support from every Panelist. Primary recommendations are highlighted in a series of 'Panelists' advice' boxes.

Cardiovascular reactivity to emotional stress: The hidden challenge for pets in the urbanized environment

Emotional stress is currently considered an important risk factor for cardiovascular diseases. Experimental evidence clearly shows robust autonomic cardiovascular effects in animals exposed to stress stimuli. Considering the remarkable variability of stressors, the urban environment can pose a severe challenge to cardiovascular control. Interestingly, pet ownership is indicated as an efficient non-pharmacological therapy to attenuate stress effects that can reduce the risk of cardiovascular disease. However, the risk of cardiovascular diseases in pets themselves living in urban environment has not received attention it deserves. Here, we review the central mechanisms involved in the autonomic cardiovascular response to emotional stress. Next, we discuss experimental evidence showing the cardiovascular effects produced by emotional stressors in animals, aiming to establish a parallel with common urban stressors. Association of additional risk factors such as sedentarism, obesity and ambient temperature are also considered. Our aim is to identify and raise awareness of the risk of cardiovascular disease in pets exposed to quotidian emotional stressors present in the urban environment.

Use of infrared thermography to evaluate the inflammatory reaction in cat testis after intratesticular injection of 0.9% NaCl or 20% CaCl2 with 1% lidocaine

ABSTRACT Due to the doubts and questions about the inflammatory reaction caused by chemical castration, this study aimed to use infrared thermography to detect, evaluate and monitor the inflammatory reaction caused by the intratesticular injection of calcium chloride (CaCl2) 20% with lidocaine 1%. For this, thermographic measurements were taken before (M0), 10 minutes (M1), 1 and 6 hours (M2 and M3), for 7 consecutive days (M4 to M10), at 15 (M11), 30 (M12) and 60 (M13) days after intratesticular injection. Additionally, changes to testicular tissue and effects over spermatogenesis were evaluated by andrological exam before (M0) and 60 days (M13) after intratesticular injection. All cats were orchiectomized at M13, and testicles were submitted to histological analysis. CaCl2 (20%) with lidocaine (1%) administration produced testicular tissue damage and interfered with the spermatogenesis in 70% of treated cats without exacerbating the inflammatory reaction or impairing the cat’s welfare. It was concluded that thermographic evaluation is a useful, efficient, easy and quick method to diagnose and monitor cat testicular inflammatory reactions.

Dog appeasing pheromone prevents the androgen surge and may reduce contact dominance and active submission after stressful interventions in African wild dogs (Lycaon pictus)

The endangered African wild dog (AWD; Lycaon pictus) is a highly social canid living in packs with a separate male and female hierarchy. Immobilisation, handling and translocations are acute stressors for AWDs, however such interventions are often needed for species management. In addition, new pack formation or temporary pack separation can lead to an increase in intra-pack aggression. The goal of this double-blinded placebo-controlled study conducted in captive zoo populations was to evaluate whether dog appeasing pheromone (DAP) reduces behavioural stress and faecal glucocorticoid metabolite levels (fGCM) normally associated with pack separation, immobilisation and reintroduction (SIR), and to assess whether this reduces aggressive behaviours and faecal androgen metabolite levels (fAM). Four packs (n = 11 males) were treated with DAP and 4 packs (n = 12 males) were treated with a placebo solution, applied at the end of anaesthesia. Behavioural interactions as well as fGCM and fAM were determined from 3 days before until 4-6 days after SIR. No effect of DAP on fGCM was observed, however, fAM increased after SIR in placebo but not DAP treated animals. Moreover, on the day of reintroduction, DAP treated packs tended to have lower rates of contact-dominance and active-submission behaviour, but higher rates of non-contact dominance behaviour. As these effects could decrease the risk of agonistic interactions, DAP may be a useful tool to help manage new pack formations and temporary pack separation.

Psychogenic stress in hospitalized veterinary patients: Causation, implications, and therapies

OBJECTIVE

To review the sources, adverse effects, diagnosis, treatment, and prevention of psychogenic stress in hospitalized human and veterinary patients.

DATA SOURCES

Data were collected by searching PubMed for veterinary and human literature from the past 10 years.

HUMAN DATA SYNTHESIS

Psychogenic stress has been linked to immune suppression; gastrointestinal, cardiovascular, and cutaneous diseases; delayed wound healing; alterations in pain perception; and neurologic impairment. Sources of psychogenic stress include environmental alterations such as excessive noise and light, social and physical factors, sleep disruption, drugs, and underlying disease. Nonpharmacologic options for stress reduction include environmental and treatment modifications, music therapy, and early mobilization. Pharmacologic options include sedation with benzodiazepines and dexmedetomidine. Trazodone and melatonin have been examined for use in sleep promotion but are not currently recommended as standard treatments in ICU.

VETERINARY DATA SYNTHESIS

Activation of the stress response in veterinary patients is largely the same as in people, as are the affected body systems. Possible sources of stress can include social, physical, and environmental factors. No gold standard currently exists for the identification and quantification of stress. A combination of physical examination findings and the results of serum biochemistry, CBC, and biomarker testing can be used to support the diagnosis. Stress scales can be implemented to identify stressed patients and assess severity. Nonpharmacologic treatment options include low-stress handling, pheromones, environmental modifications, and sleep promotion. Pharmacologic options include trazodone, benzodiazepines, dexmedetomidine, and melatonin.

CONCLUSION

The prevalence and clinical significance of psychogenic stress in hospitalized veterinary patients is unknown. Future studies are needed to specifically examine the causative factors of psychogenic stress and the effects of various therapies on stress reduction. The recognition and reduction of psychogenic stress in veterinary patients can lead to improvements in patient care and welfare.

Tools for Managing Feline Problem Behaviors: Pheromone therapy

PRACTICAL RELEVANCE

Cats are one of the most common companion animals in the world. However, relatively little scientific research has been conducted on cat behavior. With problem behaviors a leading reason for relinquishment of cats to shelters, or abandonment outdoors, solutions to address feline behavioral problems can have important welfare benefits. Because naturally occurring pheromones produce measurable species-specific responses in cats, the use of synthetic pheromone products consisting of the same compounds may activate a specific behavioral response in the receiving individual, allowing humans to better communicate with cats and manage feline problem behavior.

AIMS

In this article the scientific background for naturally occurring feline pheromones and semiochemicals and their impact on cat behavior is reviewed. This is used as a foundation to explore the three feline synthetic pheromones currently available and the empirical evidence that exists for their effectiveness. From this information, several recommendations for veterinarians and behavior professionals on the application of feline pheromone therapy in the home and veterinary clinic setting are presented.

EVIDENCE BASE

The efficacy of synthetic pheromones as a tool for the management of problem behaviors is a relatively new area of research and only fairly recently has the need to implement more rigorous research methodology been recognized.

Enrichment Preferences of FIV-Infected and Uninfected Laboratory-Housed Cats

Environmental enrichment is critical for alleviating stress in laboratory felines. However, there is a paucity of information about suitable enrichment for cats. This study aimed to determine preferred enrichment options of individually-housed, castrated male domestic short hair cats (Felis catus) used in a longitudinal study of the effects of chronic feline immunodeficiency virus (FIV) infection, and to determine if the FIV status of the cats affected enrichment preferences. Preference testing was performed with two types of grooming brushes, three different interactive play options, including a laser, ball, and petting interaction with a familiar investigator, and two types of toenail conditioning objects. We found that cats elected to be brushed, preferred social interaction and play with the laser to the ball, and preferred to scratch on an inclined-box toenail conditioning object compared to a horizontal, circular toenail conditioning object. There were individual preferences for enrichment opportunities. There were no differences in preferences between FIV-infected and sham-infected cats. These enrichment preferences may be used to advise laboratory animal facilities and researchers about how to best accommodate the behavioral needs of laboratory cats.

Effect of a Pheromone on Stress-Associated Reactivation of Feline Herpesvirus-1 in Experimentally Inoculated Kittens

Background

Stress contributes to reactivation of feline herpesvirus‐1 (FHV‐1). The usage of pheromones to decrease stress in FHV‐1 experimentally inoculated kittens has not previously been investigated.

Hypothesis/Objectives

To determine whether a feline pheromone would lessen stress, resulting in decreased recurrence of FHV‐1‐associated illness in kittens.

Animals

Twelve 5‐month‐old, purpose‐bred kittens.

Methods

Randomized, double‐blind, placebo‐controlled clinical trial. Kittens previously infected with the same dose of FHV‐1 were randomized into 2 separate but identical group rooms. After a 2‐week equilibration period, a diffuser containing either the pheromone or placebo was placed in each of the rooms, and the kittens acclimated for an additional 2 weeks. Every 2 weeks thereafter, for the 8‐week study period, housing was alternated between kennel‐ and group housing. Blinded observers applied a standardized clinical and behavioral scoring rubric daily. After each 2‐week period, serum cortisol concentrations and quantitative PCR for FHV‐1 and glyceraldehyde 3‐phosphate dehydrogenase (GAPDH) ratios were evaluated. Clinical, behavioral, and laboratory test results were compared between groups within individual and combined study periods.

Results

Sneezing occurred more frequently in the placebo group during individual (P = 0.006) and combined study periods (P = 0.001). Sleep at the end of observation periods occurred more frequently in the pheromone group during individual (P = 0.006) and combined study periods (P < 0.001).

Conclusions and Clinical Importance

The findings suggest that the pheromone decreased stress, and the decrease in stress response may have resulted in decreased sneezing associated with FHV‐1.

Clinical Evaluation of the Feline Neurologic Patient

Efficient, gentle, and safe handling of cats can result in complete neurologic evaluations and accurate neuroanatomic localizations. The clinic environment should facilitate the examination by providing a quiet and secure environment for the cat. When direct examination of a cat is not possible, the practitioner should fully use indirect methods of examination and video recordings of cat behavior or clinical signs. Direct examination of a cat should proceed in a logical order, where the most useful tests are performed early on in the examination.

ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats

Practical relevance: Feline hypertension is a common disease in older cats that is frequently diagnosed in association with other diseases such as chronic kidney disease and hyperthyroidism (so-called secondary hypertension), although some cases of apparent primary hypertension are also reported. The clinical consequences of hypertension can be severe, related to 'target organ damage' (eye, heart and vasculature, brain and kidneys), and early diagnosis followed by appropriate therapeutic management should help reduce the morbidity associated with this condition. Clinical challenges: Despite being a common disease, routine blood pressure (BP) monitoring is generally performed infrequently, probably leading to underdiagnosis of feline hypertension in clinical practice. There is a need to: (i) ensure BP is measured as accurately as possible with a reproducible technique; (ii) identify and monitor patients at risk of developing hypertension; (iii) establish appropriate criteria for therapeutic intervention; and (iv) establish appropriate therapeutic targets. Based on current data, amlodipine besylate is the treatment of choice to manage feline hypertension and is effective in the majority of cats, but the dose needed to successfully manage hypertension varies between individuals. Some cats require long-term adjuvant therapy and, occasionally, additional therapy is necessary for emergency management of hypertensive crises. Evidence base: These Guidelines from the International Society of Feline Medicine (ISFM) are based on a comprehensive review of the currently available literature, and are aimed at providing practical recommendations to address the challenges of feline hypertension for veterinarians. There are many areas where more data is required which, in the future, will serve to confirm or modify some of the recommendations in these Guidelines.