Veterinary Nursing Journal

ISSN: 1741-5349 (Print) 2045-0648 (Online) Journal homepage: http://www.tandfonline.com/loi/tvnj20

Handling the ‘challenging’ cat

Alice Allbrook BSc (Hons), RVN

To cite this article: Alice Allbrook BSc (Hons), RVN (2013) Handling the ‘challenging’ cat,
Veterinary Nursing Journal, 28:9, 288-291, DOI: 10.1111/vnj.12064

To link to this article: http://dx.doi.org/10.1111/vnj.12064

Published online: 21 Nov 2014.

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 CLINICAl

Handling the
'challenging' cat
Alice All brook asc IHonsJ, RVN
Langford Veterinary Services, Langford House, Langford, Bristol, 8540 SOU UK

ABSTRACT In order to work cooperatively with cats with1n the vetennary

environment, it is important to have a correct understandmg of the1r nature and
innate behaviours. The soc1al structure of the cat IS very different to that of people
and dogs and, therefore, at t1mes can prov1de challeng1ng s1tuatlons for vetennary
staff. Th1s article explores the pract1cal implication of these facts.

Alice Allbrook BSc IHonsl, RVN

The cat functions efficiently as a solitary when these are not respected and the
Alice graduated from Hartpury
animal. However, it has the ability to individual is unable to hide or flee, will it
College achieving a BSc (Hons) in form social interactions with others resort to fighting in order to defend itself.
Veterinary Nursing Science. She
which are far more complex than that of a
initially spent time working in a mixed
herd or pack animal. By understanding these communicative
Veterinary Nursing Journal 2013.28:288-291.

first-opinion practice in Bristol. In April cues, veterinary staff can recognise the
20 I I , Alice moved to join the nursing Cats are predatory and as obligate signs associated with fear and, therefore,
team at Langford Veterinary Services, carnivores have evolved physically to be respond appropriately, leading to a vastly
where she discovered her real passion specialist hunters - but they also have the improved interactive experience.
lay in feline medicine. She now works potential to be preyed upon. It is because
as a core feline nurse at the Feline of this that in times of fear the cat will Tactile communication is displayed as
Centre and has recently attained a react defensively in order to try and rubbing, grooming or kneading and
'distinction' in the 'ISFM Advanced escape or protect itself, in line with the indicates an affiliate friendly relationship.
Award in Feline Friendly Nursing'. 'fight or flight' response. The neck bite/scruffing is a signal that
is used only in three contexts - for
Such reactions may be misinterpreted as transporting young, sexual mounting or
aggression, when in fact they are indicative as a means to dominate during a fight.
of fear. This is very important to consider
within the veterinary environment. Scruffing the feline patient in the
veterinary environment will resemble a
Cats are solitary and self-reliant and display of dominance and is, therefore,
have no biological requirement for not appropriate for use when trying to
companionship like dogs or people do; convey a safe, feline-friendly environment.
so for some cats, casual low-intensity
encounters with owners may be sufficient. Body postures and facial signals can tell
It is because of this solitary existence that us a lot about a eat's mood - if it's fearful,
their need for survival is so strong. anxious, relaxed and so on. Ear position
plays a vital role in the interpretation of
Cats are small mammals and because these moods and can enable us, and other
they choose to live independently they cats, to understand calm behaviour and
cannot afford to get hurt. Therefore, they prevent fearful behaviour from escalating.
try to avoid physical confrontation at
all costs and will generally attempt to Erect ears show that a cat is alert and
intimidate using vocalisation and posture focusing on a stimulus, ears flat to the
as much as possible. head show intimidation, especially if
combined with a low body position, and
Body Language and ears folded back and flat indicate fear.

communication Visual signals are often used to diffuse

Cats use a variety of methods to a potential fight or to signal defensive/
communicate - including tactile, visual, offensive aggression and may be used as
olfactory and postural cues. Such displays a form of passive aggression. Dominant
To c1te th1s art1cle use either of elaborate body and tail posture, facial individuals will often stare at others for
DOl 10.1111/vnJ 12064 or Vetennary Nursmg expressions and vocalisations are all used prolonged periods to elicit a threatening
Journal Vol 28 pp288-291
in an attempt to avoid conflict. Only demeanour.

Page 288 • VOL 28 • September 2013 • Veterinary Nursing Journal © 2013 John Wiley & Sons Ltd
 CLINICAL
Tail position is another important method of communication for ~ Figure 1. The feline patient is displaying early signs of fear/anxiety as
the cat. Some feline tail postures have developed specifically to approached by veterinary staff. Mydriasis and mild rotation/flattening
communicate with humans - for example the 'vertical tail' seen of the ears can be noted as well as a low body stance.
when greeting owners. The tail is held upright, sometimes with a
slight kink to the tip, often quivering and is used in combination
with vocalisation and rubbing.

Such behaviour signals a relaxed, friendly intention and displays

clear familiarity and social bonding. In contrast to this, a
'straight' downward facing tail can suggest an offensive posture,
and if combined with a strong wag may suggest agitation or an
aroused state.

Body height and posture play a specific role in feline

communication and are intended as either antagonistic displays
or to inhibit aggression. Cats will alter their body 'size' to convey
either confidence or fear (Figure 1).

An intimidated cat will try to make itself appear larger in front

of an aggressor by fluffing up its coat - in particular the tail
- and adopting an arched back. Whereas a cat on the attack
will adopt an aggressive stance, lying low ready to pounce, or Cats use this communicative behaviour alongside specific body
extending its back legs to stand at full height and displaying language to express their displeasure and to avoid physical
piloerection along its back. conflict that may risk injury. It is only when such behaviour is
ignored that a cat will engage in a physical encounter.
Veterinary Nursing Journal 2013.28:288-291.

The submissive/fearful cat tends to crouch low to the ground in an

attempt to appear as small as possible, and in some cases may roll It is essential that veterinary staff are able to recognise in
over and expose the stomach area in submission to the aggressor. advance the signs of fear aggression to ensure appropriate and
careful handling during examination and hospitalisation.
Finally, vocalisation may become more dramatised during times
of emotional stress. Defensive aggression towards people or Improving the clinical experience
other cats may elicit hissing, growling and spitting and tends to
increase in volume as the cat becomes more aroused. In order to reduce the perceived threat of the clinic experience
for the feline patient, veterinary staff should promote an
empathetic feline-friendly attitude and ensure appropriate
environmental adaptations are put in place.

Not only is it essential to understand how to handle the

'challenging' cat, but to also consider why it may be challenging
and the ways in which improvements can be made to reduce
the perceived threat. In many cases, the feline patient will be
exhibiting fear aggression which is only natural when it is placed
in an unfamiliar environment.

In many cases, the journey to the veterinary practice can cause

a marked stress response as the cat is placed in carrier (which
in many situations can be stressful from the outset if a chase
is involved!), driven in the noisy car and then brought into
the veterinary waiting room which is full of unfamiliar noises,
smells and, in some cases, potential predators. The cat may then
need to wait sometime before it is taken into an unfamiliar
consulting room and examined.

All of these things can cause a marked arousal and anxiety

levels are likely to be extremely high by the time the clinical
examination is commenced. At this point the cat may now
present as 'difficult to handle'; however, rather than assuming it
is because the individual is 'always difficult; consider carefully
the journey and unfamiliar stimuli it has just experienced and
appreciate just how anxious it is likely to be.

Adapting the physical environment of the veterinary practice to

promote feline friendliness will help reduce feline anxiety as well
as improving the clinic experience for the veterinary staff. The
following is a list of a few simple modifications:

© 2013 John Wiley & Sons Ltd Veterinary Nursing Journal• VOL 28 • September 2013 • Page 289
 CliNICAL
• where a separate waiting room for to avoid direct facial staring which is a
dogs and cats is not possible, split the form of passive aggression between cats.
existing waiting room into two areas
and provide elevated shelves to keep It is important that these principles are
the cat baskets off floor level followed to reduce anxiety before physical
contact is made.
• provide clients with towels or blankets
to place over the cat carriers to
minimise anxiety Handling techniques
• provide warm, quiet consulting Correct handling techniques are vital to
rooms with comfortable non-slip ensure the safety of both patient and staff
examination surfaces and, where member, particularly when dealing with
possible, encourage veterinary staff the challenging individual. Restraining
to change scrub tops when switching cats is usually best achieved with a
between dog and cat consultations - 'less-is-more' approach; and even the
which latter point is often overlooked, challenging cat can be managed with this
together with the option of creating a principle.
dedicated feline consultation room
The use of a towel is usually all that is
• minimise traffic into the consulting needed to securely restrain the patient
room and be flexible with how and and provides protection and security for
where examinations take place - if both cat and handler via a minimal and
the cat is happiest in its carrier, then [!Figure 3. Where necessary. use a towel to
comfortable restraint. Using bags, masks
remove the lid and examine it within gently cover the head
and gloves is generally far more difficult
the 'security' of its box and often causes unnecessary stress for all
Veterinary Nursing Journal 2013.28:288-291.

• where hospitalisation is required, Approaching the involved (Figure 2).

consider how to provide a stress- challenging cat
reducing environment - the provision Accessing or transferring the patient
In some cases, despite the best efforts from the cage to a carrier, or vice versa,
of boxes or igloo beds in which they
can hide, can provide fearful cats with of veterinary staff to promote feline- may often prove difficult; but in many
friendliness, fear aggression can still cases a clinical examination - and even
much-needed security and may also
occur and, therefore, it is essential blood sampling - can be achieved within
aid staff when trying to take patients
that such patients are handled in an the base of the patient's carrier, where
in and out of their cages
appropriate manner. The goal is to handle necessary using a towel to gently cover
• the use of feline facial pheromones the patient respectfully, reducing threats the head (Figure 3).
in cages, tables and blankets helps and thus lowering the eat's need to react
produce a calming effect defensively. A towel is again very useful when
• where patients are particularly fearful, the patient needs to be moved in and
As mentioned previously, scruffing is an
stagger procedures to allow the patient
unnecessary act of dominance and will not n Figures 4 &5. Lifting the patient up past the
'time out' between being handled
provide a positive experience for the cat. It face should always be avoided.
• carry out procedures away from the is important to consider how you will be
ward area to prevent unnecessary perceived from the eat's point of view and
upset for all hospitalised individuals to be careful not to mimic the behaviour
of a predator or an aggressive cat.
• consider each patient's history on
an individual basis - some owners
When approaching the feline patient
may explain their cat is particularly
consider your body language and tone of
upset by the sight and sound of other
voice, watch how these are perceived by
cats. In these cases, it may be worth
the patient and be prepared to modify
considering the most suitable place to
your behaviour accordingly.
hospitalise an individual.
Using a calm tone of voice and slow
n Figure 2. The towel provides a secure, yet movements, that are not indicative of fear
comfortable restraint
or anxiety, will help reassure the patient.
Using light upper register tones mimic
that of chirruping, which eat's do when
they are relaxed. The use of low tones or
'shush'/'psst' are not recommended as
these are the equivalent to a hiss or an
aggressive growl. Try to present yourself
in a non-threatening manner that is
not representative of an aggressor - for
instance, sitting down or crouching near
the floor with a relaxed stance - and try

Page 290 • VOL 28 • September 2013 • Veterinary Nursing Journal © 2013 John Wiley & Sons ltd
 CLINICAL
Useful References
Camon, M. & Farner-van Hi)fte. M. (2006) feline Medicre:
A Pmcocol GUide For Vetemary Nt.rSeS ood Tec:hnK:ms. Elsellier
Butterworth Henemam. China.

Carney. H. C. Little. S. Brownlee-Tomasso, D. Harvey. A M.

Mattox. E. Robertson. S.. RuOOsky. R & Manley. D. (20 12)
AAFP and ISFM feline Friendy NLI>ing Guidelines. jourd of
Felne Medooe ood Sugety 14: 337-349.

Case. L P. (2003) The Cat Irs BehcMotr. NUfiiD«< ood Hed!h.

lowa State Press. lowa

Cutts. P. ( 1997) The Ccmplete Cat llOO<. /'.mess F\bli5hing

l.mited. London.
~Figures 6 &7. Clinical examinations. blood sampling and intravenous catheter placements
Harvey. A & Tasker. S. (20 I3) BSAVA !vtrvcJ of Felrle Pmcoce.
are generally achievable using towel restraint. BSAVA Goucester.

out of its kennel, and can be carefully It is, however, vital that procedures are Hewson, C (n.d) Wrrt are(n't) you lJSII1& pheromones n yoo.r
hospital wan:f1 There's more to redxing patJent stress. Vetemory
placed over the cat before lifting it up. only performed if the patient is coping,
lreknd Jourd 2(2): 84-90.
Care should be taken to ensure a hand because undo perseverance is not
is placed lightly over the patient neck beneficial. Rodan. I. (20 I0) Under>tanding feline Behaviou- and Application
for Appropriate Hancling and Management Top.cs 11 Compmon
ensuring the head is always facing away Anrrd Medone. 25(4): 178-188.
from the handler. Lifting the patient up
past the face should always be avoided. Summary Rodan. I. Sl.ndahl. E. Carney. H. Gagnon A C. Heat!\ S.
Landsberg. G. Seksel. K & Yil\ S. (20 I I ) AAFP and ISFM feline
In some cases where igloo beds or boxes Managing the challenging cat is more
Friencly Handling Guidelll'leS. jourd of Feline Medooe ood
have been provided, it may be possible to involved than just handling techniques Sugety 13: 364-375.
move the entire item into the cat carrier and requires an in-depth knowledge of
Veterinary Nursing Journal 2013.28:288-291.

(Figure 4 & 5). cats as a species. Providing the correct

Acknowledgement
attitude and environment from the onset
may, in fact, lead to a vastly improved The author WIShes to !hark Teresa l..ablak and Tom London for
Clinical examinations, blood sampling
the phot~ used in this artKie.
and intravenous catheter placements are experience for all involved. It is vital to
generally achievable using towel restraint consider the bigger picture when dealing
and providing the patient is not unduly with the fearful patient, because it may
stressed can typically be managed this just require the simplest modifications to
way (Figure 6 & 7). alter everyone's attitude. II

© 2013 John Wiley & Sons ltd Veterinary Nursing Journal• VOL 28 • September 2013 • Page 291