In Home Visits For Cats - Revised
Taking cats to the veterinary office can be a frustrating and traumatic ordeal, as many owners have experienced. Because of the perceived emotional “trauma,” it seems like a much better alternative to have a veterinarian come into the home for the examination. In fact, this may not be the best approach after all.
It is important to realize that cats are unique in their attachment to their environment. They are territorial and the home, or where ever they inhabit, is their comfort zone. Any change to their habitat upsets the stability they have to this attachment. As much as we would like to think differently, we people are just litter mates in our kitty’s minds. New litter mates (people) coming into the comfort zone are perceived as “threats” in many cases. Although some cats are quite accepting of a new human interloper, most cats are not until they can feel there is no threat. In most instances, it takes time for this to occur. A few minutes is usually not an adequate enough time for them to become comfortable.
An examination requires several steps that are not very acceptable from the cat’s standpoint. Opening the mouth to look at the teeth and tongue is not pleasant for them. Neither are palpation of the abdomen or taking the temperature. Even listening to the heart can be upsetting. Add to these, vaccinations and/or nail trimming or other procedures, and you have significant reasons for the cat to react negatively.
If we look at the entire process from the cat’s perspective (as best as we can understand that), they will identify the next “new” litter mate as being a similar threat as the veterinarian was. This reaction can make the kitty more anxious whenever someone they do not recognize comes into their comfort zone. This can certainly lead to more anxiety and even behavioral problems.
A valid question is, “Doesn’t a trip to the veterinarian also cause anxiety?” The answer is, “Certainly.” However, by taking the cat to the veterinary office, we are not affecting their comfort zone because we are taking them out of the comfort, but bringing them back to the comfort without changing it when they return. Most cats are quite passive in the veterinary hospital and the examination can proceed much easier. There are also trained assistants to help with the process.
If you have a compliant feline, then the entire process in the home is relatively straightforward and easy. However, if you have a sensitive cat, one that hides when a stranger comes into the home, then the process is not easy and may even be futile. Over the years, I found I was only able to examine about fifty percent of the kitties I was called for. I have learned over many visits, it is much easier to discuss the above information during the appointment making process. It then becomes the owner’s decision to have me visit.
Calming medications can sometimes be helpful. Pheromones like Feliway and pheromone collars may be beneficial when used periodically for the home or veterinary visit. Sedatives can cause the opposite reaction in cats and unless they are “tested” prior to the visit, are not recommended. They may often have a prolonged effect that is not desirable. See below for new “chill” protocols.
Cats are wonderful, but baffling personalities. Determining the best approach to the examination process is not an exact science. For a compliant kitty, the home versus clinic visit seems to make no difference. For the sensitive kitty, it may be best to take them to the hospital for the examination. It is also important to realize that only minor procedures can be accomplished in the home. Anesthesia, radiographs (X-rays) and complicated procedures are always best done in the clinic environment.
In-home versus a hospital visit is always a judgement call on the owner’s part. If there is a concern at all, it is better to error on the side of hospital visit so the comfort zone is not affected.
In_Home Transitions (Euthanasias)
In-Home Transitions (Compassionate Euthanasias) require a completely different outlook. With this situation, it is much better to perform the procedure in the home environment. In most cases, the cat is ill or has a terminal condition and they are more accepting of visitors. Initially, a sedative is administered by injection subcutaneously (under the skin) and the kitty goes into a blissful sleep before the final medication is given intravenously.
Because cats can be so stressed out getting them into the carrier, the trip in the car and the actual visit, several different protocols have been developed to manage the entire process and help the cat handle the stress involved.
Here are several different protocols using a singular medication or combination of medications. You should discuss with your veterinarian if one should be used for your cat prior to a visit to the veterinary hospital:
Tuft Protocol: A combination of 3 orally administered medications that reduce anxiety and/or aggression: Gabapentin, Melatonin, and Oral Transmucosal (OTM) Acepromazine
Gabapentin: usually given the night before and 2-3 hours prior to traveling to the office.
Trazodone: usually given 2 hours before the appointment.
Gabapentin plus Trazodone: The Gabapentin is usually given the night before and again 2-3 hours before the appointment. The Trazodone is given along with the Gabapentin 2-3 hours prior to the visit.
Gabapentin as discussed above plus Feliway (a pheromone) sprayed in the carrier and a probiotic given in the meal prior to the visit (not used if an anesthetic procedure is planned)
Dramamine may be helpful as a replacement for Gabapentin.
Feliway helps in about 50% of cats to calm them. May be helpful when sprayed in the interior of the carrier.
Cat Friendly Hospitals
Many veterinary hospitals are now certified as “feline friendly” and it may be worthwhile to determine if your hospital has that certification. It makes a significant difference for subsequent visits.