Reducing Feline Stress

Before we can reduce the stress that cats typically endure when visiting the vet, we must first understand the causes for this stress. Consider a typical vet visit from your perspective, then consider the same visit from a cat's perspective. All is not lost, however, there are steps you can take to help make future experiences enjoyable or, at the very least, tolerable.
Your Kitty is due for a checkup. You know how important annual exams are for animals since they age so much more quickly than people, so you call and make an appointment at the vet for an that afternoon. Half an hour before the appointment, you retrieve the cat carrier from the basement. Of course, somehow your cat has become suspicious and is now hiding under the couch. You call sweetly to Kitty. She looks the other way, completely ignoring you. Next, you try to lure her out with treats, to no avail. Finally you move the couch, scoop her up, and try to gently stuff a reluctant cat into the carrier. If lucky, your arms and hands are free of bites or scratches. Take a deep breath, and out the door you go. Kitty yowls all the way to the vet. You feel awful hearing her misery. You arrive, check in at the front desk, and sit down in the lobby to wait your turn. Kitty is still yowling intermittently.  After a few minutes you are led to the exam room. The assistant weighs Kitty, takes her ear temperature and informs you the doctor will be in shortly. You wait a few minutes for the doctor while Kitty sits under your chair and refuses to come out. Soon a cheerful doctor in a crisp, white lab coat greets you and Kitty. You pick up your feline friend and place her on the exam table while talking to the doctor about how Kitty has been doing for the past year. The doctor takes out her stethoscope and listens to Kitty's heart and lungs. Next, she gently squeezes her belly. During the exam, you chat casually with the doctor. Finally, the doctor recommends performing an annual blood panel to make sure Kitty's internal organs are functioning properly. You agree because, after all, Kitty is part of the family and you want to see live a long, healthy life. The doctor picks up Kitty and takes her to the treatment area to have a technician draw her blood. After a few minutes, the doctor returns with Kitty: "You're all set!" She will call you with lab results later in the week. You and Kitty sit in the lobby chatting with another client about how cute their new puppy is until the receptionist alerts you it is time to check out. You return to the car and head home. Once again, Kitty yowls all the way. Thankful to be home, you open the carrier door to release Kitty and you return the carrier to the basement. Kitty is already stretched in her basket cleaning herself. She's obviously happy to be home too.
From a cat’s eyes:
“I am lying in my basket, soaking up the warm afternoon sun just like I do every day, when my person starts acting strangely. She takes a big deep breath and runs downstairs. I crane my head to listen. All of a sudden, I hear her touch the handle of that awful box! I’m outta here! I just barely make it under the couch in time. She is determined to get me to come out. But, I won’t come out for treats, for love or for anything in this world because I know what that box means. It doesn’t mean love and treats. She finally moves the couch to expose my safe spot. She scoops me up and shoves me in. Now I’m in the box and she carries me to the car that makes me want to throw up.  She is going to take me to that place that reeks of scared, sick, and strange animals. I protest, but my cries fall on deaf ears. Once we get there, she takes me inside. Yup. I’m barraged by scents of fear mixed with little bits of pain, over-excitement combined with hints of happy. I wait for an eternity in this horrible box, having soiled myself because the ride over here was excruciating. I cry to no avail. Once we get into a little room, my person opens the door of the box. Thank you!! But wait…what is this stranger trying to do to me? I do not approve and you did not ask! This person picks me up, puts me on top of a weird thing and sticks something in my ear. Once she leaves, I am free to hide out under my person’s chair to catch my breath. Next a lady comes in. She also smells like all sorts of animals. I am NOT coming out. She’s wearing that coat. That means she is about to poke and prod me. My person grabs me and sets me up on a table While I enjoy being high up, I do not enjoy being handled against my wishes. They tell me “I’m ok”, but I don’t believe it. (You people are so intrusive!) The white-coated lady speaks to my person like nothing is happening. I close my eyes and tense up till the touching is over while I listen to them talk. Hold on, the tones of their voices are changing. Wait. Where are you taking me?! Oh no!!!! The white-coat person takes me to a loud, smelly place where there is nowhere to hide. She sets me down on another table and speaks to the girl that stuck that thing in my ear. Now 5 people stand over me, gushing about how cute I am. This is all well and good and you are nice people, I’m glad you think I’m cute… but, please, leave me alone! Take me back to my person. Someone holds my head, while another person pokes me with a needle. They make me stay still. They try to give me treat. What kind of cat do you think I am?! Thankfully, they finally take me back to my person who puts me back in the box (at least it’s clean now)! We leave that little room, but we aren’t home yet. We sit in another loud room where I can hear and see dogs… ugh! Then, oh no! We get back into the thing that moves and makes me want to throw up. I give my person a piece of my mind. I cry desperately to get her to take me home. Finally we stop. She gets me out and I can already smell home!! When she opens the door I jump out and run straight for my basket. Now... let me get this horrid stench off of my fur….
It is so very easy for us humans to get caught up in seeing life from our own perspectives ("I have to pay the electric bill today, then make sure the trash goes out on the curb tonight, can't forget to call mom, etc"), we forget that life is all together different from the eyes of a cat. We know that we take our pets to the vet because we love and care for them. We very easily have the capability to look at life from the perspective of cat, but we cannot say the same for the cat. If we take the steps necessary to show our pets and help them understand they are safe, the process of going to the vet and traveling in general will be much simpler and more enjoyable for everyone.
So.. What's all Kitty's fuss about and what steps can I take to alleviate the stress?
First let's make sure to keep one thing in mind: Cats communicate primarily through action and body language. This is what we must do to help them understand. We cannot explain things to them and expect them to get it.
Certain things (carrier, car, vet) carry certain associations/expectations. We must break those negative associations and replace them with positive ones as much as possible (literally as much as possible, inundate them with positive experiences and they will eventually forget the negative ones.) Please know will take effort, consistency and patience to undo anxious behaviors/phobias. The amount of time and effort completely depends on your cat's personality and your consistency. Work on one thing at a time.
Let's start with the carrier. the dreaded carrier. First of all, be sure you have an appropriate size/shape carrier to suit your cat. They should be able to stand up and turn around in it. If your cat like to be up high and have a good view, make sure you provide that for them in the carrier. If they like to hide and tunnel, provide a carrier that has less "windows" or cover the carrier so they feel safer.
Once you have the right carrier, make sure you keep it in a place where they like to hang out, keep the door open and put some comfy bedding in it so they can choose it as a safe spot. Throw treats into it. You can actually feed them in it if you want. Encourage it to be their  go-to spot. If they associate it with being comfortable and safe, that's how they will feel when they are in it. If it only comes out when bad things happen, that's how they feel when they are in it. Make sense? Once the carrier is the happy home of your cat, move on to making the car a positive experience.

The car can be a frightening thing for a cat because it moves, makes them feel funny and the scenery is constantly changing, making it difficult for them to assess their surroundings. This one may take more effort and time, but is completely achievable for most cats.
To make the car a positive experience, take baby steps to help your cat feel safe. Don't move too fast, or the result will be more fear.
Make sure the carrier is completely secure in the car and cannot move. If your cat gets carsick, put the carrier on the floorboard in the front of the car, as there is less movement than anywhere else. Cover the carrier.
Start out by sitting in your car with Kitty for a few minutes. Talk sweetly to her and play quiet, soothing music. Remember, we're trying to set the mood. After a few minutes, try to give Kitty a treat. Not just any treat, but one she goes absolutely crazy over (for mine it's canned tuna). Tell her how amazing she is. The end. Take her back inside and put her carrier back in her spot. Do it again every day. By spending just 5 minutes a day on these things, it can make all the difference in the world to sweet Kitty. Once you feel she knows that when she goes to the car she gets amazing treats, start the car and do the same thing each day. Sit there with the car on. Read a book. Just make sure YOU are relaxed during this process.Then you can work your way up to going on joy rides. Once you are at the point where you can ride around and she is ok, take her with you to get cat food. Take her with you to the bank and ask for a treat at the drive through. Take her anywhere and everywhere you can think of where something positive can happen. Always, always always follow the experience with a really awesome treat and praise. Even if she doesn't eat it or seem to appreciate it.
Now, onto the vet...
Tell your veterinarian that you would like to work on improving her behavior and stress level at the vet. In fact, tell every person at the vet that comes in contact with your cat in case they need to change anything (not taking Kitty to the treatment. Hands down the best way to acclimate a pet to the vet is repeated "happy visits." Ask the support staff at your vet when the best time would be to go into an exam room and let Kitty walk around for about 5-10 minutes. When you get into the exam room, set the carrier on the floor and open the door. Do not interact with her or try to get her out at first. Let her come out on her own terms (always try to do this if you can). If you end up sitting there and she never comes out, that's fine. This is all about increasing her comfort level. With a cat, allowing them to feel as much control over their environment as possible will increase their comfort level at an exponential rate. Do this as many times as you absolutely can before taking her in for a real exam, then continue to do it after any exam visits. Of course life happens and sometimes we don't get to play out best case scenarios, but just do your best and try to be consistent. Make sure you keep your veterinarian in the loop because he or she may have sound advice if something goes awry or if you happen to backslide for any reason. Remember to be patient and ask for help if things aren't going the way you had hoped. Good luck and good day!

Got Worms?

Got worms?

Parasites: Friends We Can Do Without

Even with warm weather waning, veterinary staff are on the lookout for “wormy friends” hanging around the neighborhood. Roundworms, heartworms, whipworms, hookworms… and then there are other parasites that aren’t worms at all, but protozoa. Some parasites only affect our pets, but several species are also quite happy to take up residence in humans if they can. Especially with small children, it’s easy to imagine how this might happen (child sees shiny object on ground, child puts object in mouth, worm eggs on object are swallowed: voila!).

How common are these “friends?” It varies by region within the US, by parasite, and by pet. In some situations, 1 in 4 (!!) pets will be infected, in others only 1 in 21, or even fewer. If you’re curious for specifics, check this out: http://www.petsandparasites.org/parasite-prevalence-maps/ 

Veterinarians have excellent treatments for parasites. We also have excellent prevention for some, but not all parasites. For example, there is excellent heartworm preventative available, and some medications also cover hookworms and roundworms. However, there are not current preventatives for whipworms or protozoa, though there are effective treatments for them.

So, how do we know that our companion has parasites overstaying their welcome?

A common idea is that you can see worms if the animal has them. Unfortunately, adult worms prefer to live safe and warm deep inside of animals, where we can’t see them. (Gross, right?) With intestinal worms, it is the offspring in egg or larva form that go out by way of the fecal express. With tapeworms, a sharp eye can see the eggs – they look like small cream-colored grains of rice. http://avetsguidetolife.blogspot.com/2010/09/tapeworm-blues.html With most others, though, the eggs are microscopic. And in the case of heartworms, owners can have no way of knowing their animal is infected until they become clinically ill – at which point their pet’s life may already be in danger.

This leads us to testing: fecal tests for intestinal parasites and blood tests for heartworms. Sometimes, we find that we are testing without finding anything. Why might that happen? There are a few possibilities:

(1) Your pet doesn’t have worms. Hooray!

(2) In the beginning of an infection, the parasite may be to “young” to have shed any eggs. A test in those early days may be an incomplete negative.

(3) Many worms shed eggs intermittently, sometimes even months passing between shedding events. A test in between shedding events may show no eggs.

(4) The test may not be detecting the eggs. While only small bit is needed for a fecal test, a too small sample can hinder effective testing. Further, some parasites (like whipworm!) tend to show up poorly in tests.

The good news is these issues can be addressed by communicating clearly with your veterinarian and periodically double-checking. If you pet is healthy, annual testing may be sufficient. However, if your pet is ill, or has been diagnosed with parasites, more frequent testing will be necessary. Typically two negatives in a row are considered enough, but remember that other factors (such as the health of your other pets) should also be considered.

In general, it’s important to keep an eye on our pets eating and drinking, stools, and any weight changes. It’s also important to test periodically, just in case your pet is hiding the signs. By doing those things, we can help our veterinarian say “here’s your hat, where’s your hurry?” to our wormy friends. 

Jeanne Coffin

Masters of Conservation Medicine
Tufts University

Asheville, NC

Who does your dog’s rabies vaccine protect?

Who does your dog’s rabies vaccine protect?

Easy answer: your furbaby

Tricky answer: you AND your community

Extra tricky answer: your ecosystem

Yup, that’s right! We have arrived in the realm of ecology, by way of your local vet’s office. But let’s back up a second and ask our question again in context. Let’s play out a little scenario: your local friendly veterinary assistant called you, reminding you that your beloved companion is overdue for vaccines. They make a point of saying “And that includes the rabies vaccine, which is especially important!” You’re left wondering – why do they make such a big deal out of it? Rabies is supposed to be really rare, right? Well, as you see above, the answer is that the rabies vaccine protects a lot. It is our one and only “ace in the hole” against a nearly always fatal disease.

Most people are aware that rabies is an extremely dangerous infectious disease to which our beloved pets are susceptible. Most people also know that people can get rabies; fewer are aware that all mammals are susceptible. Every once in a very great while a true rabies infection survival story is reported. This lucky handful of humans usually underwent weeks or months of intensive and expensive care.  Most of the time, though, a rabies-infected animal (or human) dies a painful and terrifying death. This is the first answer to the question of why it is so important to prevent infection in the first place: the rabies vaccine protects your furbaby from a particularly unpleasant death.

To get to our second answer, a bit of history. Rabies was at one time a serious and relatively common problem in the USA, with dangerous outbreaks occurring since before the Declaration of Independence up to the early 1900s. Many people—and many more dogs—died. Happily this is no longer the case. In the 1940s a tremendous effort involving education and vaccination began to control the disease in dogs. By vaccinating dogs, people were protected. Over time, the use of vaccines became recommended for other pets as well. Massive vaccination and animal control campaigns have enabled several countries to eradicate rabies within their borders. In those countries rabies is no longer a concern – but the United States continues the battle against rabies. We still need the help of every pet owner to maintain our control over the disease.  That is why vaccinating your dog protects you and your community.

And, now, on to the ecosystem. Rabies is present among various wild animal populations. Skunks, foxes, bats, raccoons, and opossums—to name a few species—are all susceptible to infection. However, it is much more challenging to vaccinate wild animals than domestic ones. The good news is that scientists are working hard to find effective ways of inoculating these animals. Meanwhile, our best line of defense for those poor, unvaccinated wild critters is to reduce the “circulation” of the virus as much as possible, thereby minimizing the chances of infection among wild animals. We do this by making more and more animals resistant to infection, which takes them out of the circulation loop, so to speak. How do we do that? By vaccinating the easy ones: pets.

So there you have it. The rabies vaccine: protecting you, your pet, your community, and the ecosystem you live in—all with regular visits to the vet and the occasional little needle poke! (The recommended frequency of rabies vaccines varies among states.)

For more information on rabies in humans, see: http://www.cdc.gov/rabies/

For more information on the ecological dimension of disease  click here

This blog was authored by:

Jeanne Coffin

Masters of Conservation Medicine
Tufts University

Asheville, NC

We are proud to have her as an assistant at our hospital!

Post-op Pets

 Many fur-parents don't know just what to expect after they pick their fur-kid up after surgery. At Charlotte Street Animal Hospital, the day after surgery (or the day after going home) our technicians call to check in on all of our surgery patients to see how they are doing, and to help ensure that the recovery period is as successful as possible. Most pet owners (except those with a medical background) may not know what to expect after their pet’s surgery. Any surgery—whether it be human, canine, feline, or avian—is a big deal. Even routine dental cleanings require pets to undergo general anesthesia. Knowing what to expect, what is normal/abnormal, and what you should do at home for your pet will help make this important part of your pet’s care a little less stressful.  

What your pet needs from you after surgery:

• Supervision. If your pet has an incision, keep it clean and dry and check it every day until healed for swelling, discharge or redness. Limit activity as instructed. Call us for tips and/or sedatives if you are unable to restrict your pet’s movement.
• Less food. Anesthetic drugs can upset tummies and slow digestion time. Feed about 1/2 their normal amount. You know that being at the vet all day is stressful for your baby, so you may be tempted to try to compensate with treats and lots of yummy canned food. Resist this urge. The last thing your recovering pet needs is a bout of vomit or diarrhea or a tummy-ache after being at the vet all day. Attention and affection is the best thing to make you and your pet feel better.
• Peace and quiet
• Lots of snuggles and the most comfortable bed ever

What is "normal" 1-2 days after anesthesia:

• Wanting to rest, being tired or sluggish. Older pets may take a little longer to act like themselves again. 
• Pets receiving intravenous (IV) fluids while under anesthesia will urinate more frequently than usual for the first 24 hours. If you are unsure if IV fluids were administered, a shaved front leg likely indicates a catheter was placed in order to give IV fluids.
• Pets may also not be very thirsty if they have received IV fluids, since their bodies are well hydrated. 
• Pets may not have a bowel movement for 24-48 hours. Anesthetic drugs slow down the GI tract. Also, food intake is restricted before and after surgery, so there is less bulk to process. 
• Behavior will differ depending on your pet’s personality. S/he may want to come home and hide, or be more hyperactive than usual as a reaction to stress. But like the toddler who needs a nap but seems hyper-energetic, if your pet is asking you to go out to play, s/he really just needs to rest and recover.  
• Other pets in the home, may react negatively to a pet who has been at the vet all day. Remember, animals live their lives by smell. The patient will come home stressed and smelling unfamiliar. You may need to separate your pets for a time to maintain a stress-free recovery environment for the patient. For years I had heard such reports from clients and personally experienced an instance just last week. My cat had 5 teeth extracted. One of my other cats hissed and growled at him when he returned home. I had to separate them for a full 2 days while my poor kitty recovered.
• Coughing. The endotracheal tube (the tube that goes down the trachea to deliver oxygen and anesthetic gas throughout the procedure) may result in mild throat irritation for a day or two after the surgery. 

What is not normal and needs to be addressed by your veterinarian:

• If any of the above symptoms persists for more than 48 hours, please call your veterinarian.
• Diarrhea
• Vomiting  
• Respiratory congestion
• Third eyelid up
• Not eating for 24 hours
• Incision site appears red, inflamed, has an odor, or discharge  

Most pets benefit greatly from recommended surgical procedures.  Pre-anesthetic bloodwork and a regimen of annual wellness exams will help ensure that when your pet needs surgery s/he is strong, healthy, and will recover as quickly as possible.  Remember, we don’t just take care of your pets, we are pet parents too! We work hard to ensure that your pet is cared for with the compassion and expertise that we would want our own pets to receive. So, we encourage you to share any questions, concerns, or comments about your pet’s post-surgical recovery.  We are here to help.