Feline behaviour – tailoring care for cats’ unique needs

Image © hedgehog94 / Adobe Stock

Abstract

A vet visit is stressful for most cats and clearly their owners, too. In fact, many cat owners report that their cats did not only show signs of distress while travelling and during the vet visit, but continued to demonstrate abnormal behaviour at home once they returned. Some cat owners, therefore, may defer routine veterinary examinations.

Norbert Mencke covers medicine to treat parasites, creating suitable environments and owner compliance.

Pet ownership has been growing around the world. It is estimated that around 91 million households in the EU owned at least one pet in 2022, with cats being the most popular pet (127 million), followed by dogs (104 million), birds (53 million) and other small mammals, aquatic animals and reptiles¹.

Germany and France have the highest number of cats (approximately 15 million) in the EU², closely followed by the UK with 11 million owned cats³. According to a 2023-24 pet owner survey in the US, an estimated 65.1 million households owned dogs and 46.5 million households owned cats². In Asia, approximately 59% of the population are pet owners, and 26% of them have cats⁴.

Developments in cat-friendly medicine

The pharmaceutical industry has been working on various solutions to provide cat-friendly medicines by:

Cats are not small dogs – a general misperception

The number of pet cat households is steadily increasing, but certain feline health care needs have received surprisingly little attention in the past.

Historically, many veterinary care principles of dogs have often been applied to cats, which is probably related to the fact that a lot of practitioners treat more dogs than cats⁵. However, although both animal species belong to the order of Carnivora, significant differences are present in the evolutionary biology between cats and dogs.

“Cats are not small dogs”, said Sam Taylor, head of veterinary specialists from the International Society of Feline Medicine (ISFM) at Vetoquinol’s first Scientific Roundtable (Paris, 2022).

She added: “Due to their unique evolution, their physiology and behaviour is very different from their canine counterparts.”

Self-protective behaviours of ancestors

Unlike dogs, which derived from the highly social wolf, domestic cats are descended from a solitary territorial ancestor⁵. Many of the self-protective behaviours can still be found in today’s domestic cat personalities, such as predatory behaviour, territoriality and avoidance of threats⁶.

Most cats have a strong need for familiarity and control, meaning that they do not easily adapt to changes. When confronted with an unfamiliar situation, running away, hiding or perching are typical cat behaviours. It is the cat’s coping mechanism to reduce stress and increase perceived safety.

Stress factors can be found in the physical environment (home setting), as well as in the social environment (owners and family members, other cats or pets). Being in a familiar physical and social environment provides a sense of control that makes the cat feel comfortable and reduces stress^7,8.

Cats have amazing senses. They have excellent vision and their hearing is better than that of dogs – all perfectly suited for the detection and location of small prey animals in low light conditions. Moreover, cats have a superb sense of olfaction, which is often overlooked. Their noses are approximately 1,000 times more sensitive than that of humans. Sensory stimuli perceived as negative or threatening will trigger self-protective behaviour in cats^5,6.

Cats have distinct dietary preferences where smell, taste and texture (“mouth feel”) play an important role⁹. It is one of the reasons why cats are so difficult to medicate. Oral administration of tablets or capsules is often only achieved by using restraint and forcing the cat to swallow (the “poke down method”)¹⁰. This is stressful, often painful (for cat and owner), and does not do anything to benefit the cat-owner relationship.

The alternative “crushing and hiding” of tablets in highly palatable food or liquids tends to work only rarely in cats.

Predatory behaviour – when cats play, meet untamed hunters

What pet owners generally perceive as play behaviour is very different between dogs and cats. When adult dogs play (with other dogs or humans), they often engage in a form of social play or social interaction. It may resemble natural predatory tactics (wrestling or chasing), but is usually expressed in a playful, non-aggressive way¹¹.

Social play is also frequently seen in kittens, but decreases as they grow older. When adult cats play, it is rather a form of hunting with typical “stalk-chase-attack-kill” patterns, during which cats may become quite unaware of their owner’s existence⁵.

No hands or feet

Owners should not encourage cats to play with their owner’s hands or feet. Playful clawing, biting or scratching behaviour of young kittens may not necessarily cause considerable damage to their owners, but this situation will inevitably change as they grow older and stronger¹². Moreover, cats that are used to hand play may show this behaviour during a veterinary exam, where it is a rather unwanted response. Owners should be advised to redirect their kitten’s/cat’s play behaviour to object play by using appropriate toys⁸.

Ideally, the training should start when cats are still young. Many cats like small mouse-sized toys with feathers or fur, as they tend to encourage the natural hunting and biting behaviour⁵.

It is important to choose toys that are of appropriate size so they cannot be swallowed. Toys with strings should be put away after play to avoid potential injuries when the cat is unsupervised⁷.

Feline parasites – similar, but different

Dogs and cats can be infected/infested by many endoparasites and ectoparasites, which, on first glance, seem to cause similar clinical pictures in both animal species. However, distinct differences exist, and while many parasites can equally infect/infest dogs and cats, a considerable number of parasites in cats are very different from that in dogs. These evolutionary-based differences are related to characteristics of the cat’s anatomy, physiology, immune system and behaviour, which are responsible for a different parasite-host relationship¹³.

Many parasites of dogs and cats have a public health significance, as they may also infect/infest humans (see VT53.46). It seems, though, that some dog parasites are more studied and more present in the heads of veterinarians and owners, compared to their equivalents in cats.

Ascarid infections, for example, are commonly seen in both dogs and cats worldwide. Studies in Europe across the past 25 years have shown that the average prevalence was 14.6% for Toxocara canis in dogs and 24.5% for Toxocara cati in cats, and numbers do not seem to have decreased¹⁴.

Obviously, worm control should be a routine topic in veterinary practice and equally discussed with dog and cat owners. However, several studies have shown that cats are less frequently dewormed than dogs^15,16. Moreover, many cats (and many dogs) are dewormed less frequently than recommended^15,17,18.

The European Scientific Counsel Companion Animal Parasites (ESCCAP) categorises owned cats into two risk groups:

In the guideline’s current version, ESCCAP advises faecal exams or anthelmintic treatment one to two times per year for group A cats, and at least four times per year for group B cats¹⁹. Individual recommendations can be made based on lifestyle and risk assessment.

Several reasons exist for low deworming frequencies in practice. One is seen in the lack of knowledge of the zoonotic potential of T cati. Several authors have stated that cat owners do not seem to be aware of the zoonotic risk¹⁷.

Scientists agree that human toxocariasis caused by T canis is much better understood than that caused by T cati. However, the zoonotic potential of T cati should not be underestimated^20,21.

Host-specific worms

Most flea (such as Ctenocephalides felis) and tick (such as Ixodes ricinus) species are not very choosy about their hosts, and equally infest dogs, cats, other animals and even humans.

Many roundworms and hookworms, however, are highly host-specific, meaning the worm species that are commonly found in dogs (such as Toxocara canis or Ancylostoma caninum) do not develop in cats, whereas worm species that infect cats (such as Toxocara cati or Ancylostoma tubaeforme) do not develop in dogs.

No rule without exception: the less prevalent worm species Toxascaris leonina and Uncinaria stenocephala can infect both dogs and cats.

All cats are at risk

Another reason may be the fact that cat-keeping habits differ between countries, and that cat owners’ perception of an “indoor cat” versus an “outdoor cat” seems to vary greatly.

Undoubtedly, free-roaming, unsupervised cats spending considerable time outdoors have the highest risk for worm infections. However, this should not imply that cats with restricted, supervised outdoor access (such as the owner’s private garden) are not at risk, nor that the infection risk for indoor cats is zero.

The participants of Vetoquinol’s second Scientific Roundtable in Athens in March 2023 agreed that it is advisable to undertake an individual infection risk assessment of a cat patient, broadening the simple “indoor cat” and “outdoor cat” categories. In fact, more subgroups exist within the domestic cat category that are defined by the cat’s lifestyle and the level of owner care (see VT54.05).

The cat’s age, its lifestyle and the geographic region are well-known risk factors for worm infections, but it was also shown that cats were more often infected with worms when fed with non-commercial diets (home-made food or raw meat) or originated from a multi-pet household¹⁸.

A key message for veterinary practitioners

Domestic pet cats of today still display many of their ancestors’ self-protective behaviours (predatory behaviour, territoriality, avoidance of threats).
Cats extremely depend on their senses. Sensory stimuli are major sources of stress and fear, making manipulation of cats much more challenging compared to dogs.
A cat-friendly environment (cat-only waiting rooms, cat-specific examination rooms) and cat-friendly handling techniques in veterinary practice are key to avoiding, or at least reducing, feline stress. The use of cat-specific medicines further adds to the cat’s emotional well-being, positively influencing not only the cat-owner relationship, but also the vet-client relationship, too.
Advising owners to train their cats at home (carrier and car ride trainings, not to play with hands or feet) are important preparatory measures for vet visits.
Regular parasite control is an integral part of feline veterinary care and can be tailored to a cat’s lifestyle.

Taking cats to a vet

Some cat owners, therefore, may defer routine veterinary examinations. Results from a veterinary care usage study showed that approximately 40% of the cats had not been seen by a veterinarian within the past year, compared to 15% of the dogs²³.

Many cats are already displaying signs of distress at home before they are placed into a carrier. Most cats do not like being forced into a carrier, and many of them show signs of anxiety or fear during car rides.

In the waiting room, the cat is exposed to a variety of new stimuli, such as new people, new animals (dogs, other cats, other pets), unfamiliar and loud noises (dogs barking, doors opening and closing, phones ringing, noises from machines or technical equipment) and unfamiliar scents (disinfectant odour, scent of dogs and other pets). Considering that cats extremely depend on their senses, these sensory stimuli are major sources of stress and fear⁶.

Carrier training

The American Association of Feline Practitioners recommends cat owners to prepare their cats for a vet visit by introducing regular carrier training to their cats at home, so that the carrier becomes a positive experience and a familiar and safe place for them²⁴. Carrier training and also car ride training may be important preparatory measures for vet visits, as they can help to reduce stress and fear responses during the examination procedure^22,25,26.

How to create a feline-friendly environment in a veterinary practice

A new set of guidelines was recently published by the ISFM and American Association of Feline Practitioners (AAFP), providing detailed recommendations for a “Cat Friendly Veterinary Environment”⁶. The guidelines are aimed at veterinarians, clinic staff and cat caregivers. They present ways to organise cat-specific or cat-only areas in the clinic, or if space and facility do not allow it, how to create calm and unhurried cat zones within a multi-pet clinic. This includes waiting and examination rooms, but also other clinic areas, such as operating rooms and hospitalisation wards.

Ideally, cat patients should be moved from a cat-only waiting room directly into a cat-only examination room, bypassing any of the stress factors mentioned previously, such as barking dogs, other pets and busy reception areas. Where this is not possible, appointments can be organised in such a way that certain mornings or afternoons during the week are reserved for cat patients only⁶.

Cat-friendly environments

A cat-friendly/cat-only waiting room area will be the first step in creating a positive clinic experience for cat patients in a veterinary practice. A cat-friendly examination room should be stocked with cat-friendly equipment, such as non-slippery mats, warm towels and a variety of treats. All technical equipment (such as stethoscopes, otoscopes, weighing scales and nail trimmers) should be of appropriate size for cats.

A high-sided cat basket or the bottom of a cat carrier accommodated with towels has been shown to be helpful during an exam. The cat can be placed in the basket or carrier with an opportunity to hide and reduce stress during any kind of examination or physical manipulation. In fact, the towel in the basket serves two purposes – providing a sense of safety for the cat, as well as protection against the cat’s teeth or claws^6,8,27.

Feline-friendly interaction includes both physical and the social environments

Apart from the physical environment, it is equally important to understand the importance of the cat’s social environment. The emotional well-being of a cat greatly depends on social interactions, which can be cat to cat, cat to human, as well as cat to other pets.

The ISFM and AAFP have recently updated the “AAFP and ISFM Feline-Friendly Handling Guidelines” from 2011²⁸. In the new version⁸, recommendations not only include the physical interactions (physical contact), but also describe the importance of non-physical interactions (such as visual, auditory, olfactory interactions) for the cat’s emotional health.

A variety of cat-friendly handling techniques are included, which veterinarians and staff members can use during a veterinary examination.

Manipulation of cats is much more challenging than that of dogs. Generally, minimal restraint should be used wherever possible, as restraint increases negative emotions in most cats, which may lead to unwanted responses. Other procedures – such as blood pressure measurements, ultrasound and x-ray examinations, general sampling procedures (blood, urine), ear cleaning, as well as routine procedures such as nail clipping or grooming – are discussed as well.

Felpreva contains tigolaner, emodepside and praziquantel (POM-V). Visit www.noahcompendium.co.uk to view the datasheet. The summary of product characteristics and further information is available from Vetoquinol UK. Advice should be sought from the medicine prescriber.

Vetoquinol

Vetoquinol is committed to advancing veterinary parasitology, demonstrated through our ground-breaking launch of Felpreva, the first endectocide spot-on for cats to treat both internal and external parasites, including tapeworms, in addition to providing three months’ ongoing protection against fleas and ticks.

Vetoquinol works with leading parasitology organisations – the European Scientific Counsel Companion Animal Parasites, the Companion Animal Parasite Council and the World Association for the Advancement of Veterinary Parasitology – and we support key parasitology conferences across the globe to encourage progress.

The Vetoquinol Scientific Roundtable Parasitology is just one example of Vetoquinol’s commitment to sharing knowledge and stimulating discussion across the animal health industry to aid innovation.

References

European Pet Food Industry Federation (2022). FEDIAF EuropeanPetFood releases its annual Facts & Figures confirming 340 million pets in Europe, tinyurl.com/58pj8dpv
Statista (2023). Estimated number of households owning at least one pet animal in Europe from 2010 to 2022, tinyurl.com/muf8bnbh
Cats Protection (2023). CATS report 2023, tinyurl.com/2f445srt
Rakuten Insight (2021). Pet ownership in Asia, tinyurl.com/4es77uhx
Bradshaw JWS (2018). Normal feline behaviour: …and why problem behaviours develop, J Feline Med Surg 20(5): 411-421. 6.
Taylor S et al (2022). 2022 ISFM/AAFP cat friendly veterinary environment guidelines, J Feline Med Surg 24(11): 1,133-1,163.
Ellis SLH et al (2013). AAFP and ISFM feline environmental needs guidelines, J Feline Med Surg 15(3): 219-230.
Rodan I et al (2022). 2022 AAFP/ISFM cat friendly veterinary interaction guidelines: approach and handling techniques, J Feline Med Surg 24(11): 1,093-1,132.
Hamper BA (2016). The unique metabolic adaptations and nutrient requirements of the cat. In Little SE (ed), August’s Consultations in Feline Internal Medicine, Volume 7, Elsevier, St Louis: 600-606.
Thombre AG (2004). Oral delivery of medications to companion animals: palatability considerations, Adv Drug Deliv Rev 56(10): 1,399-1,413.
Bradshaw JWS et al (2015). Why do adult dogs ‘play’?, Behav Processes 110: 82-87.
International Cat Care (2018). Playing with your cat, tinyurl.com/bdhcest3
Morelli S et al (2021). Canine and feline parasitology: analogies, differences, and relevance for human health, Clin Microbiol Rev 34(4): e0026620.
Overgaauw P and Nijsse R (2020). Prevalence of patent Toxocara spp. infections in dogs and cats in Europe from 1994 to 2019, Adv Parasitol 109: 779-800.
Strube C et al (2019). Survey of German pet owners quantifying endoparasitic infection risk and implications for deworming recommendations, Parasit Vectors 12(1): 203.
Miró G et al (2020). Survey of Spanish pet owners about endoparasite infection risk and deworming frequencies, Parasit Vectors 13(1): 101.
Nijsse R et al (2016). Prevalence and risk factors for patent Toxocara infections in cats and cat owners’ attitude towards deworming, Parasitol Res 115(12): 4,519-4,525.
Bourgoin G et al (2022). Prevalence of major digestive and respiratory helminths in dogs and cats in France: results of a multicenter study, Parasit Vectors 15(1): 314.
ESCCAP (2021). Worm control in dogs and cats (6th edn), tinyurl.com/4c77f8k8
Fisher M (2003). Toxocara cati: an underestimated zoonotic agent, Trends Parasitol 19(4): 167-170.
Ursache AL et al (2021). Toxocara cati and other parasitic enteropathogens: more commonly found in owned cats with gastrointestinal signs than in clinically healthy ones, Pathogens 10(2): 198.
Tateo A et al (2021). Factors influencing stress and fear-related behaviour of cats during veterinary examinations, Ital J Anim Sci 20(1): 46-58.
Volk JO et al (2011). Executive summary of the Bayer veterinary care usage study, J Am Vet Med Assoc 238(10): 1,275-1,282.
AAFP (2022). Visiting your veterinarian: getting your cat to the veterinary practice, tinyurl.com/nt6fzy9c
Pratsch L et al (2018). Carrier training cats reduces stress on transport to a veterinary practice, Appl Anim Behav Sci 206: 64-74.
Tateo A et al (2022). The welfare of dogs and cats during transport in Europe: a literature review, Ital J Anim Sci 21(1): 1,539-1,550.
Riemer S et al (2021). A review on mitigating fear and aggression in dogs and cats in a veterinary setting, Animals 11(1): 158.
Rodan I et al (2011). AAFP and ISFM feline-friendly handling guidelines, J Feline Med Surg 13(5): 364-375.