Routine HealthCare Examination: Physical examination
Throughout the clinical examination, principles of good cat friendly handling should always be adhered to. Knowing what should be done in every physical examination is one thing, but whether the cat will allow it is another matter!
Assuming the cat has arrived in the consulting room table without too much anxiety, the way in which a physical examination is conducted will determine how much useful information you can gather – It may also determine whether the owner will bring the cat back in for its next routine health check or whether they choose to avoid the practice – at least until their cat is seriously ill.
- Be flexible – find out what makes the cat more relaxed, and adapt the place, position and way that you conduct the physical examination to suit the individual cat.
- Let the cat choose. Some cats will be happier being examined on their owner’s lap; others will be more relaxed on the floor. A window to the outside can provide a good distraction and some restless cats will more happily stay still on a window ledge than on the table. Others may prefer to stay sitting in their carrier while more nervous cats may prefer to hide under a blanket in their carrier for as much of the examination as possible.
- Don’t rush – this is vital when examining a cat. A little extra time is needed to keep the cat calm, and this is a classic example of ‘more haste less speed’. Split the examination into short sections and allow the cat to relax (change positions, have a look around, etc) in between. As soon as the cat begins to get restless give it a short break to relax – just a few seconds for a stroke or a walk around the table can make all the difference.
- Use gentle persuasion. Cats like to be in control and don’t like being placed in uncomfortable positions. The aim is to complete the majority of the examination without the cat realising you are doing anything more than just stroking it.
- Sitting, lying or standing – try to carry out as much of the examination as possible with the cat in its preferred position. This will help to maintain a calm cat.
- Use minimal restraint. As soon as you restrain a cat, it will anticipate something bad is going to happen. Try simply placing a hand in front to stop the cat jumping off the table when necessary.
- Avoid direct visual contact – this is threatening for the cat. Perform as much of the examination as possible with the cat facing away from you, avoiding direct eye contact. The cat will often feel more secure if it is sat against you, facing away. Avoid loud or sudden noises and don’t face the cat into a bright light. Talk to it in a calm, quiet tone also avoiding sudden movements.
- Pain and anxiety – be aware that osteoarthritis (common in older cats), or other sources of pain may make handling uncomfortable. Hypertensive or hyperthyroid cats may also feel more anxious and need extra care and patience.
- Last things last! Any direct eye contact and anything that might be uncomfortable (such as taking the rectal temperature and looking in its mouth) should be left to the end.
- End on a positive note – make sure the cat is given time to calm after the examination, with stroking, praise, treats etc.
A case for sedation?
Some cats are so fearful that the gentle approach is simply not achievable, even with the most patient of handling. These cats are a minority but need careful consideration. Anxiety or fear should never be heightened by scruffing the cat or forcibly restraining it. If appropriate, consider chemical restraint and if this is done, ensure you get as much information as possible while the cat is sedated! This may include an oral examination, cystocentesis, blood sampling and imaging, if appropriate.
Weight – every cat, every time!
Accurate weighing (and recording of the weight) is essential at each visit. This is needed for several reasons including accurate dosing of drugs, and for monitoring changes in weight.
A cat’s weight should never be guessed. Different cats vary substantially in size, and the average weight of a normal adult cat may range from less than 3 kg to greater than 6 kg. For nervous cats, recording the weight of the empty carrier may avoid the need to take the cat out of the carrier to weigh it at subsequent visits.
Recording the weight, change in weight and percentage change in weight at each examination is valuable. The absolute values may not look that remarkable, but the percentage change can be revealing, especially for the owner.
% weight change = (Previous weight – current weight / previous weight) x 100