Feline BEHAVIOR + RESTRAINT + PE

Common Behavior concerns

• Inappropriate elimination

• Urine marking

• Scratching

• Increased aggression (toward people and other animals)

• Fear and Anxiety at the vets office

Defense cascade

To help make feline vet visits better

• Get the owner involved! Desensitization training starts at home

  • destigmatize the carrier

• Create a cat friendly environment at the clinic

• Usage of medication

Relaxed Feline

• Ears: up and forward

• Eyes: normal pupils, eyes may be closed

• Mouth: closed mouth

• Whiskers: forward

• Body position: back flat, sitting/standing/laying loosely, looking around

• Tail: up or relaxed, gentle back and forth movements

Stressed Feline

Ears: back and/or flattened

Eyes: Dilated pupils

Mouth: open mouth - may be panting, hissing, spitting, vocalizing or lip licking

Whiskers: back

Body Position: Back arched, fur standing up, crouched or tense, may be fixated on you or refuse to look at you

Tail: tucked, fur bristled, rapid and intense movements

Relaxed/content/happy

Curious/interested/engaged

Fearful/Anxious/stressed

Towel restraint

tuck front limbs up first, then wrap one side, then the back, and then finish the burrito by wrapping the other side

Cat Bag

Muzzles

Velcro secured, nylon material

Tie or buckle secured. Leather or plastic material

• long part goes over the head

Cat gloves

Snake hold

From behind, place the first and middle finger on top of the cats head, with the thumb and ring finger on either side of the head under the jaw. You can then use that arm to keep light pressure along the back of the cat

Ring grip

From the front, cup under the cat’s jaw with the first finger and thumb on either side (making a “c”)

Triangle Hold

From behind, place thumbs behind head on either side and first fingers under the chin. Keep other fingers curled into hand

Standing Restraint

Commonly used for examination

• standing beside or behind the cat, use one hand to maintain loose control of the head by using a relaxed ring grip. The other hand can be used to provide more restraint if needed by reaching over the back and under the abdomen. Keeping the cat tucked in close to your body will help prevent excessive squirming

Sitting Restraint

Commonly used for Exams, jugular or cephalic venipuncture, cephalic IV catheter placement, SQ injections/fluids, ear cleaning

• Use one hand to maintain control of the head, and the other hand can be placed along the back/tail base, applying light pressure to encourage the cat to remain sitting. Keeping the cat tucked in close to your body will help prevent squirming

Sternal Restraint

Commonly used for cephalic or jugular venipuncture, SQ injection/fluids, ear cleaning

• The “cat press” Standing beside the cat, make a “c” with on hand and use it to cup over the back of the neck near the shoulders. Use the other hand to apply light to medium pressure along the low back/tail base to encourage the cat to remain laying

Lateral Restraint

Commonly used for saphenous venipuncture, IM injections, cystocentesis

• The “cat stretch”

• The “pretzel”

• Some cats may better tolerate this restraint if their front half is allowed to remain sternal

Cat stretch

Dorsal Recumbency Restraint

Commonly used for cystocentesis, FAST scan

• One or Two person

• Can use a trough to help the cat feel more secure and balanced

Ear Cleaning

Need: Otoscope, Cotton balls/cotton tip applicator, Ear cleaning solution

Technique: Use the otoscope to visualize the overall and confirm the tympanic membrane is intact. Take swab for cytology before cleaning. Saturate a cotton ball with ear cleaning solution and squeeze that into the ear. Massage bass of ear. Clean

Nail Trim

Need: Trimmers, Clotting agent like Kwik Stop, Moistened cotton tip and a paper towel

Technique: Comfortably restrained, grasp the paw and gently squeeze to extend out the nail, Identify the quick and cut at least 2mm below it. 

Body Condition Scoring

Small changes in a cats weight can indicate underlying illness

Weigh EVERY patient

PE - Integument

Evaluate the skin, nails, paw pads, nailbed.

Any matted or unkempt fur?

• obesity

• Pain, especially if localized

• Compulsive behavior/anxiety

Ectoparasite

• Fleas, flea dirt, ticks, mites

Masses

Skin disease

Lymph Nodes

Peripheral

• submandibular

• prescapular

• popliteal

Not easily palpable

• if you feel them readily, they are probably enlarged

Symmetry

pain

PE - Head

Look for symmetry

Vibrissae are sensitive structures

Evaluate cranial nerves

Evaluate Nasal Planum

• thickening, discharge

Mucous Membranes

Color: Pink, pale, white, icteric, cyanotic

• Cats are usually a lighter pink than dogs

• best evaluated on hard plate

Capillary Refill time (CRT)

Moisture?

Look under tongue (masses, foreign bodies?)

Look at tonsils

PE - Teeth

Commonly get periodontal disease

• Stomatitis or gingivitis

• Dental tartar or calculus

• Tumors

PE - Eyes

External: Symmetry of globes, pupils, etc. PLR and Menace Response

• Pupils are elliptical not round

• Siamese type cats may have nystagmus normally

• Sclera is less visible than in dogs

Internal:  Retinal Examination

PE - Pinna/Auricle

Preauricular alopecia is normal

Evaluate for ear mites

Evaluate for Discharge

PE - Ear Canal

Tympanum easily visualized

Evaluate for masses, mites, polyps

PE - Neck

Palpate for enlarged lymph nodes

Auscultate the trachea for increased upper airway sounds

Palpate for thyroid gland enlargement

Range of motion (any pain?)

PE - Lungs

Cat thorax is slightly compressible

• If not, may indicate disease

Auscult lungs first

• Bronchovesicular sounds are quiet in cats

• 10-30 bpm in unstressed cat

• Listen in all 4 lung field (crackles, wheezes?)

PE - Heart

Listen to the heart

• Sternal then rock the diaphragm to the left and right

• Murmurs are best heard parasternal

• Heart valve sounds are similar to the dog..

  • left = pulmonic, mitral, and aortic

  • Right = tricuspid

• Any arrhythmia is significant in cats

PE - abdomen

Liver, stomach, and pancreas generally not palpable in normal cat

Both kidneys are readily palpable

• Right - high under the ribcage

• Left - caudal to ribs, loose in the abdomen

Palpate small intestines for thickening “ropey”, pain, gas, or masses

Colon - dorsal, tubular structure, usually can palpate feces

Urinary Bladder - Soft and compressible, HARD = BLOCKED

PE - Musculoskeletal

Evaluate for muscle mass - senior cats or debilitated cats often have generalized muscle atrophy

Evaluate joints - Symmetry, Range of motion, pain (osteoarthritis in geriatric cats), Laxity (Patellar luxation)

Evaluate Posture: changes may indicate disease or pain

PE - Genitourinary Female

Vulva is ventral to anus

Mammary tissue on ventral abdomen

• palpate for masses

PE - Genitourinary Male

Penis is ventral to the anus not the abdomen

Penile spines are seen in intact males

Testicles may not be fully descended into the scrotum until 5-7 months old

PE - Genitourinary BOTH

Anal sacs, Perineum - look for masses

Relaxed

Stressed

Anxious

Fearful/annoyed

stressed/angry

A cat is approaching you with its tail held high and slightly curved at the tip. This body language indicates:

Confidence and friendliness

A cat that is slow blinking at you is likely:

Expressing affection and trust

A cat’s tail puffed up and fir standing on end generally indicates:

The cat is scared or trying to appear larger to a perceived threat

If a cat’s whickers are pulled back against its face, it likely indicates:

the cat is nervous, scared, or feeling threatened

A cat that is “kneading” with its paws is:

Displaying a sign of affection or comfort

A cat that is vocalizing loudly with a low, guttural sound is likely

Signaling that it feels threatened or is in pain

What is the normal capillary refill time for a cat

less than 2 seconds

True/False

You should avoid palpating the abdomen if the cat shows any signs of discomfort

False

What would you do if you notice a cat has a heart murmur during the exam

Record the finding and recommend further diagnostics

When assessing a cat’s breathing, which of the following is considered abnormal?

Rapid breathing rate

TPR

100-103 degrees

HR - 160-220

RR - 20-30

Fearful cat typically displays what

aggression

What does a cat’s tail flicking back and forth typically indicate?

Annoyance or agitation

Ears are rotating or twitching indicates what

The cat is trying to listen to sounds around it

What does it mean if a cat suddenly starts to groom itself during an interaction?

The cat is trying to calm itself or diffuse tension