Examination of kittens is an essential part of clinical practice for both general veterinarians and specialist ones. In order to be able to measure an animal’s temperature accurately, palpate it or withdraw blood or other organic material, it should be possible to handle the patient easily and, if necessary, for long periods of time. Some critical steps associated with the clinical examination can be optimised in order that the kitten associates this examination with a positive feeling and, therefore, has a “good memory” of this experience:
- the journey (cat carry box, journey by car);
- the waiting room;
- the examination room (table, exploration);
- the veterinarian (tone of voice, movements, hands and gowns);
- the clinical examination (manipulation, food treats).
THE JOURNEY
The journey starts when the owner puts the kitten into the carry box. This operation should not be transformed into a chase, otherwise the patient will associate this event with a negative experience which may then lead to aggressive behaviour when handled during the examination. The cat has a double status (being both a predator and a prey) and it can rapidly modify the dimensions of its field of aggression. This animal does, in fact, have a territorial field which is centred on its own body and any intrusion can almost instantaneously cause aggressive behaviour. The size of this territory varies depending on the emotional and physiological state of the animal: when the cat is “fearful” the area is extremely broad, while when it is “calm” the area is much smaller.
The journey in the car is another critical period. Vocalisations, emotional micturition and defecation, polypnoea, sialorrhoea and vomiting are all signs of an extreme sense of unease and may contribute to the development of a phobia. In fact, as a result of a biofeedback mechanism, neurovegetative manifestations may become progressively more intense and in the future may appear just on seeing the car. Transportation phobia and “car sickness” compromise the emotional state of the animal which leads not only to memorisation of a negative experience but also to the expansion of the field of aggression of the cat.
In order to make the journey in the proper way, both the kitten’s entry into the carry box and its journey in the car should be optimised.
Entry into the carry box:
- use a plastic carry box (avoid metal mesh boxes);
- spray synthetic pheromones into the carry box (2-3 puffs, done outdoors to favour the evaporation of the solvent present in the product);
- wait a few minutes and then leave the box open in the room of the house which is most frequently used by the kitten;
- put some food treats in the carry box in order to encourage exploration of the box;
- these operations must be repeated daily until the cat readily enters the box and stays in it for long periods;
- the carry box should remain accessible for the entire life of the animal (Fig. 1);
- it is worth repeating the application of synthetic pheromones before every journey;
- once back home the carry box should be carefully cleaned with tepid water and a neutral soap in order to eliminate the alarm pheromones deposited by the kitten during the journey and the examination;
- it is advisable to repeat the application of the synthetic pheromones after each journey.
The journey by car:
- spray synthetic pheromones in the area of the car where the box is going to be put (2-3 puffs, done leaving the doors open so as to facilitate evaporation of the solvent present in the product);
- wait for a few minutes and then put the patient into the car;
- avoid braking suddenly or accelerating repeatedly because the sense of unease resulting from the journey could trigger neurovegetative manifestations (sialorrhoea, vomiting);
- a journey by car should be repeated on a weekly basis (for example, going around the block), at least during the first year of life of the kitten, so as to allow the animal to get used to the car;
- it is advisable to repeat the application of synthetic pheromones before each journey.
THE WAITING ROOM
The presence of other animals (conspecific or not) and of unknown human beings may contribute to the expansion of the cat’s field of aggression. Furthermore, sudden noises and movements may frighten a kitten, an animal with the dual status of prey and predator. Alarm pheromones deposited in the waiting room by other dogs and cats in the preceding hours may contribute to modify the patient’s emotional state.
In order to associate the clinical examination with a “positive recollection”, the stay in the waiting room should be optimised:
• the floor should be cleaned several times a day with tepid water and a neutral soap in order to eliminate the alarm pheromones;
• noises, such as those from doors which close violently, and abrupt movements of staff (for exa
mple, running or gesticulating) should be limited;
• reserve some seats (indicating them with a sign) for cat owners, in order to avoid pheromones belonging to different species in that area;
• provide some places (for example stools) on which to put a carry box (Fig. 2);
• it is advisable, when possible, to have a room (also within the clinic) reserved only for cat owners, in which a *Feliway diffuser can be used;
• the owner should be informed about the possibility of booking an appointment for the kitten beforehand, so as to limit the time spent in the waiting room as much as possible.
THE EXAMINATION ROOM
The examination room must be hospitable from the point of view of the kitten. Rooms with natural lighting are to be preferred, as are those in which the patient can be left free to roam during the conversation with the owner. Kittens are curious and explore unknown places with pleasure (Fig. 3).It is worth remembering that sudden noises and movements frighten cats, which are animals with the dual status of prey and predator. The surface of the examination table must be comfortable, soft and slip-proof. The presence of alarm pheromones deposited by other animals during previous visits may have an impact on the emotional state of the patient inducing avoidance and flight.
Fig. 3. Rooms with natural lighting are to be preferred, as are those in which the patient can be left free to roam during the conversation with the owner.
In order to receive the patient correctly, the entry into the examination room should be optimised:
• clean the table with tepid water and a neutral soap in order to eliminate alarm pheromones;
• after this, detergents and disinfectants can be used, although the table should then be cleaned again with water and a neutral soap just before receiving the patient (otherwise the chemical composition of pheromones could be altered);
• spray synthetic pheromones (2–3 puffs);
• wait a few minutes and then put the carry box on the table;
• the cat must have the necessary time available to study its surroundings, without being forced out of the box;
• the cat should be allowed to explore the room (having first blocked any opening which could be used as a hiding place) before the physical examination is started;
• the patient should have access to a fresh water dispenser (or drinking fountain).
THE VETERINARIAN
The factors that can contribute to altering the emotional state of the kitten are the veterinarian’s tone of voice and movements. Talking with a loud voice, moving abruptly and gesticulating frightens the patient and favours the expansion of its field of aggression. In addition, alarm pheromones on the hands and gown of the veterinarian may cause a flight reaction in kittens and puppies, jeopardising the physical examination (Fig. 4).The manipulation of the patient should start only when the kitten has finished exploring the examination room (the kitten cuddles next to the carry box which has been left open, on the floor or - more frequently - on the table).
The following points are important in order to optimise the approach to the patient:
• use of a low tone of voice tone and a continuous singsong rhythm tranquillises the patient;
• movements must be slow, with as little gesticulating as possible. Remaining still at the desk favours exploration of the room, especially by kittens;
• just before starting manipulation of the patient, the veterinarian should wash his or her hands and forearms with water and a neutral soap, so as to remove any alarm pheromones;
• after the examination of a particularly fearful patient (dog or cat) it is advisable to use a clean gown as the fabric could be impregnated with alarm pheromones.
THE CLINICAL EXAMINATION
A structured clinical examination obliges the veterinarian to carry out the clinical manoeuvres in a well-defined order: inspection, palpation, percussion, auscultation and temperature measurement. It is worth remembering that measuring the temperature is undoubtedly the “most annoying” of these interventions. In order to minimise the kitten’s discomfort during the examination it is advisable to start with the inspection and auscultation, then measure the animal’s temperature and conclude with palpation. By doing this, the examination can be completed while leaving the kitten a “positive” memory of the experience. In order to carry out a proper clinical examination it is also essential to understand “how” the patient communicates. Dilatation of the pupils, tremors, exudation of the footpads, nose licking, polypnoea, yawning, emotional micturition/defecation are all signs of stress indicating to the clinician that the patient’s “collaboration” has come to an end (Fig. 5).
In order to manipulate the patient in a proper way the clinical examination must be optimised:
• before starting to manipulate the patient it is necessary to wait for the kitten to take the initiative and establish the first contact, as the cat must observe and explore the clinician before accepting any physical contact;
• the manipulation must be done with soft, short movements (limited to the head and neck) and, especially in kittens, repeated over time (almost rhythmically, like a massage);
• avoid grasping the kitten by the nape of its neck! This manoeuvre could be useful later as part of a behavioural assessment;
• it is worth remembering that once physical contact has been established, it should then be maintained until the end of the examination because otherwise the field of aggression of the cat could expand, hindering any subsequent manipulation:
• at the end of the examination the patient should be invited to enter into its carry box rewarding it with a tasty treat (on sale in pet shops);
• it is advisable to close the carry box just a few seconds before accompanying the owner to the exit, so as to prevent the cat from becoming agitated, vocalising and trying to get out of the box;
• each manoeuvre should be preceded by a verbal explanation: “Now I will…”.
CONCLUSIONS
Optimising the clinical examination by paying attention to the above mentioned five steps will allow the veterinarian to examine the patient whenever necessary. The kitten will in fact associate the experience with a “positive memory” and will accept repeat the examination again in the future. It should be highlighted that the time necessary to complete the examination following the five steps will be longer than the time usually reserved for such a task. To keep up to date, the clinician must increasingly set the wellbeing of the patient as the goal and give priority to the quality of the examination rather than to the quantity of such examinations.
Suggested readings
- Caney SMA. Cos’è e come impostare una “cat friendly practice”. Proceedings of the 55th Congresso di Medina Felina, March 2007;14-24.
- Colangeli R, Giussani S. Medicina Comportamentale del Cane e del Gatto. Poletto Editore, Gaggiano. 2004.
- Giussani S, Colangeli R, Fassola F. L’uso dei feromoni nella terapia comportamentale del gatto. Esperienze cliniche. Zootecnia e Veterinaria 2003;31:13-34.
- Giussani S, Colangeli R, Fassola F. Approccio clinico all’utilizzo della feromonoterapia nel gatto. Zootecnia e Veterinaria 2003;31:35-45.
- Giussani S. La visita clinica del gatto: 5 consigli per perfezionarla. Proceedings of the 56th Congresso Internazione Multisala SCIVAC; Rimini 2007;255-7.
- Giussani S, Colangeli R, Fassola F. L’uso dei feromoni nella terapia comportamentale del cane. Esperienze cliniche. Zootecnia e Veterinaria 2002;30:13-34.
- Giussani S, Colangeli R, Fassola F. Approccio clinico all’utilizzo della feromonoterapia nel cane. Zootecnia