Exploring end-of-life management of old and chronically ill cats

My second study towards my PhD is well under way. The recruitment phase started on social media (Facebook and Twitter) with a call for cat owners to participate. Interested cat owners who have put down their cat in the last 6 months are redirected to an online survey which takes them through a few quick questions. These are to help us interview the right people.

We want to make sure we are interviewing cat owners who recently euthanased their pet. If it was too long ago then the vet involved may not remember enough details for their (separate) interview. The cat owners, and their vet, must also be in New Zealand. The interviews are done in person so I need to be able to visit them. We are also asking owners to tell us why the cat was put down. If it was due to a disease that lasted a long time, or because the cat was older, then we might get more information about tricky decisions that were made. On the other hand, a cat that was put down because it was involved in an accident would probably provide much less information. The owners also need to give us permission to contact their vet for interview and leave us enough information to contact them.

We have also had a write-up about the study in VetScript – the magazine for The New Zealand Veterinary Association (NZVA). An email has also gone out to all NZVA members. Massey University has got on board with an article on their website and the study has been shared through their social media channels. These various initiatives are helping get the word out about the importance of the study and how to participate.

Why am I doing the study?

The research seeks to uncover how the owners of older cats or cats with chronic disease perceive the role their vets have played in the euthanasia process, before comparing this to the vet’s own understanding of their involvement. We are also looking at the decision-making process and how cat owners, and their vets, are making euthanasia decisions. This improved understanding of what drives owner behaviour would safeguard older cat welfare and further inform vets of their role in end-of-life management.

How can you get involved?

If you are a cat owner who meets our criteria, or you know someone that might, please take the time to visit our online recruitment page and answer a few questions. This should only take 5-10 minutes of your time.

If you are a veterinarian and you think you might have a client that would be happy to chat to me then please direct them to our online recruitment page.

If anyone has questions about the study they can get in touch with me at: K.Littlewood@massey.ac.nz

Cat Friendly Veterinarians

Following on from my previous post on environmental enrichment for New Zealand cats, this post will focus on some things veterinarians can do to improve the lives of their feline patients.

There are many ways we can increase the number of positive experiences pet cats have. Not least is helping to ensure their experiences when visiting a veterinary clinic are less negative, and more positive [1, 2]. This is where individual veterinarians and clinics come in. If a cat is not ‘happy’ about going to the clinic, then an owner is less likely to bring their pet to the veterinarian as often as they may otherwise [3, 4]. Feline environmental enrichment is not just good for the cat; it is good business.

How can we treat our cat patients with kindness? (and differently to dogs)

Cat are not just mini dogs. They respond very differently towards veterinary consultations. From the cat that refuses to leave its carrier, to the one who refuses to go back in; the cat who stiffens up and tries to draw blood, to the one who just wants to rub its face all over you. We know there are many differences even between cats. However, there are a few things we can do to make life a little easier for those that are struggling with going to see a veterinarian.

cat-friendly-vets

Cat carrier training

For starters, training cats to not completely hate the idea of going in their cat carrier can make life much easier for everyone. This is something that owners will need to work on at home, but as veterinary professionals we can help pick up on these problems and guide owners in the right direction. If a cat is not apparently ‘happy’ about going in a carrier, then an owner is probably going to think twice about bringing ‘Fluffy’ in to get that cough looked at. This can be bad for the cat, and bad for business.

Dr Sarah Ellis (@sarahlhellis) has written an excellent blog post on Katzenworld about how to train cats to like their carrier. The post starts off with some tips about what makes a good cat carrier and then goes through how to counter-condition cats to their own carrier. It would be a great post for veterinary professionals to be familiar with and then make owners aware of. A veterinarian could quite easily have a chat to an owner about carrier training if they mention having troubles, or if the cat is clearly not happy about going back in at the end of a consultation. It could even just be something we casually ask, for example ‘How does fluffy like her carrier?’.

I was in a pet store recently (acquiring more toys for my spoilt felines) and happened to be walking past a couple who were looking at cat carriers. They were complaining about their cat not liking the one they already own. They saw the cat toys I had and (guessing I had a menagerie) asked me which one I used for my cats. As a busy-body (and cat enthusiast) I could not help but ask them if they had ever heard of cat carrier training. They had not and were very interested to hear about it. I gave them the link and they (happily) trotted off to have a read.

Cat friendly veterinary practices

Veterinarians and clinics with cat friendly approaches can also get involved in feline environmental enrichment. Once cats arrive at the clinic, in the carrier they have now learnt to like, it is up to us to make that experience as positive as possible. Not only do we want them to come back, but we also want to tip the balance of their possible experiences towards the positive side as much as possible [1, 2] – if we are aiming to be the animal welfare advocates that the New Zealand Veterinary Council would like us to be.

Low stress handling techniques and clinic design can have a massive impact on the experiences of our feline patients. Many clinics could be re-designed with feline patients in mind (e.g. separate dog and cat waiting areas, separate consulting rooms, and separate hospitalisation areas with each species comfort in mind), but there are also simple cost-effective ways of providing for our feline patients. Cats do not respond well to aggressive handling techniques. How many veterinarians or veterinary nurses have ‘lost’ a cat after pushing it too far? It makes it very difficult to work with them in the future – and the owners are never very impressed. The International Society of Feline Medicine (ISFM) recognise this and have written an excellent article [5] in The Journal of Feline Medicine and Surgery about feline-friendly handling guidelines.

The ISFM are also responsible for the worldwide Cat Friendly Clinic programme, designed to increase the number of cat friendly veterinary clinics by providing free information – to enable clinics to work towards a voluntary accreditation scheme. The importance of handling cats in clinics is emphasised by this scheme. Once accredited, veterinary clinics can advertise this accreditation to cat owners and are then eligible to be listed on the ISFM website. Veterinarians and clinics can register their interest for free to receive more information about this accreditation scheme.

In addition to all these differences in the ways we treat our feline patients, there are some things we can do for them that we are already doing for dogs. Providing yummy cat friendly treats in consult rooms can be used to reinforce any positive experiences and counter-condition pets to the veterinary clinic [6]. If it makes it easier to examine an overweight cat after a few treats are given, then this is probably going to do more good than potential harm – so long as we are clear with the owner why we are doing it in this instance. Giving cats a little more time, once out of their carrier, to acclimatise themselves to the room (as we so often allow for in dogs) is also likely to help the consult go smoothly.

These are just a few of the ways that, as veterinarians, we can improve the lives of our feline patients – at least during the time that we have some control over their experiences. Enriching the lives of cats is not just good for them; it is also good for us.

References

  1. Green, T.C. and D.J. Mellor, Extending ideas about animal welfare assessment to include ‘quality of life’ and related concepts. New Zealand Veterinary Journal, 2011. 59(6): p. 263-71.
  2. Yeates, J.W. and D.C.J. Main, Assessment of positive welfare: A review. Veterinary Journal, 2008. 175(3): p. 293-300.
  3. McMillan, F.D., Maximizing quality of life in ill animals. Journal of the American Animal Hospital Association, 2003. 39(3): p. 227-235.
  4. Vogt, A.H., et al., AAFP-AAHA feline life stage guidelines. Journal of feline medicine and surgery, 2010. 12(1): p. 43-54.
  5. Rodan, I., et al., AAFP and ISFM Feline-Friendly Handling Guidelines. Journal of Feline Medicine and Surgery, 2011. 13(5): p. 364-375.
  6. Westlund, K., To feed or not to feed: Counterconditioning in the veterinary clinic. Journal of Veterinary Behavior: Clinical Applications and Research, 2015. 10(15): p. 433-437.

Environmental enrichment for New Zealand cats

Lately there has been an exciting boom in posts, blogs, popular articles, tweets, and even a journal article [1], illuminating the benefits of environmental enrichment for pet cats. There are entire websites (e.g. food puzzles for cats) dedicated to helping cat owners find ways to positively enrich the lives of their pet(s).

The concept of environmental enrichment is not new; zoological parks and laboratory animal facilities have been using enrichment programmes as a means of alleviating boredom and negative mental states in captive populations for some time [2-4]. The 2015 World Associations of Zoos and Aquariums (WAZA) Animal Welfare Strategy has an entire chapter dedicated to environmental enrichment [5].

Interactive ‘food puzzles’ used for zoo animals are easily translated to our pet felines [1]. The authors of this journal article are based in North America, where the fact that a large proportion of pet cats are kept indoors means their feline populations could also be regarded as ‘captive’ animals. However, even for our largely ‘free-ranging’ New Zealand cats, there are benefits to providing them with more opportunities for positive affective engagement.

‘Positive affective engagement’ happens when animals are able to respond to motivations they have to behave in ways they find rewarding [6]. The animal is engaged and experiencing positive ‘affects’ or mental states (e.g. happiness, playfulness). Therefore, environmental enrichment involves providing these opportunities for animals to respond behaviourally to their environment and/or other animals.

In addition to food puzzles, there is another enrichment activity that cat owners could take from zoos (and dog owners!); reward-based training. Yes, cats can be trained. Drs John Bradshaw (@petsandus) and Sarah Ellis (@sarahlhellis) have written a book (The Trainable Cat) to show us how to do this. I am excited to read (and use) it! There is also an excellent ‘train your cat’ series of videos, which demonstrates how you can train your cat to like its cat carrier, be good at the vet, and even come back to you. Julie Hecht (@DogSpies) would also like you to know cats are open to training and takes us through the steps she took with her cat and a new sofa. Training could be another opportunity to provide cats with opportunities for positive affective engagement. Zazie Todd (@CompAnimalPsych) summarises reward-based training in an excellent blog post ‘Reward-based training is for all our pets’. It’s not just for dogs or animals in captivity.

The life of a domesticated cat is essentially a ‘dumbed down’ version of their wild cousins. In place of long hours spent hunting for food, they are instead provided with energy-dense cat biscuits and meat from a can. They need to expend this unused energy somehow and this can often result in negative behavioural consequences, including (but not limited to); bullying of other cats in the household (a problem in my house) or stalking and torturing wildlife. This last issue is particularly problematic given the conservation status of much of New Zealand’s native birdlife. Environmental enrichment for our cats; using toys, food puzzles, and training, could be the answer.

My Experiences

My husband and I are currently owned by two ‘free-range’ (during the day) cats. Our male ginger can be a bit of a bully towards our female tabby. This is much worse when he is bored. On days when we have not made efforts to entertain him, and/or the rain stops him frolicking outdoors, he is relentless with his attacks on his fluffy sister. However, when one (or both) of us has the energy to play with him his sister is free to roam without fear of sudden ginger attack. With the recent addition of a slow feeder bowl, he now has to expend more energy eating than he had to previously. The ginger attacks have again reduced.

We long ago taught him to ‘sit’ on command – he is very amenable to food-based rewards. This was as far as we went with him. However, with all this excitement surrounding cat training I am keen to try some more tricks! My husband rolls his eyes and calls me crazy when I ask the ginger for his paw in exchange for a treat. I think the cat will have the last laugh though – he is getting more and more compliant…

Version 2
The ginger lies in wait

Environmental enrichment strategies, such as food puzzles and reward-based training, can (and should) be used for outdoor cats too.

References

  1. Dantas, L.M., et al., Food puzzles for cats: Feeding for physical and emotional wellbeing. Journal of Feline Medicine and Surgery, 2016. 18(9): p. 723-732.
  2. Mellor, D.J., Affective states and the assessment of laboratory-induced animal welfare impacts, in ALTEX. 2011.
  3. Fraser, D., Understanding animal welfare: the science in its cultural context. UFAW Animal Welfare Series, ed. J.K. Kirkwood and R.C. Hubrecht. 2008, Chichester, United Kingdom: Wiley-Blackwell.
  4. Young, R.J., Environmental enrichment for captive animals. 2003, Oxford, UK: Blackwell Science.
  5. WAZA, Chapter 3: Environmental Enrichment, in Caring for Wildlife: The World Zoo and Aquarium Animal Welfare Strategy, D.J. Mellor, Hunt, S. & Gusset, M., Editor. 2015, World Association of Zoos and Aquariums (WAZA) Executive Office: Gland, Switzerland p. 34.
  6. Mellor, D.J., Enhancing animal welfare by creating opportunities for positive affective engagement. New Zealand Veterinary Journal, 2015. 63(1): p. 3-8.