Friending the cat in your practice-what technicians can do (Proceedings)

Its no secret that cats don't like going to the veterinarian. They've never liked it. Unfortunately, cat owners are giving up the battle and fewer cats than ever before are visiting a veterinarian regularly. Information from the 2007 US Pet Ownership and Demographic Sourcebook showed a significant decline between 2001 and 2006 in the number of visits cats made to the veterinarian. Five years later, cats still aren't getting the care they need according to the recently released Bayer Veterinary Care Usage Study. Insights from this study, however, show us what we need to do to reverse this trend.

"Feline resistance" isn't the only factor driving the decline in veterinary visits. The study, a research initiative conducted by Bayer Animal Health, the National Commission on Veterinary Economic Issues and Brakke Consulting, identified five other key reasons that visits have been declining: "sticker shock," the recession, the fragmentation of veterinary services, the Internet, and a lack of understanding about the need for care.

Reach out to cats and their owners

Cats that need medical care are out there. About 30-40% of visits in a typical clinic involve cats and yet cats outnumber dogs as owned pets. Many of your clients own cats that you don't even know about. The first step is to identify these felines. Don't just say, "Do you have any other pets?" on your new client worksheet"; say "Do you have any cats?" "When did they last visit a veterinarian? Even if your practice owner/manager isn't interested in updating the form or training the receptionists to ask all clients these questions, YOU can do it. Then use that information—set these pets up in the reminder system and talk to the client about the needed care even if this isn't the pet they have brought to the practice today. Ask about the status of every pet during every visit: "How is Fluffy doing? We haven't seen her in over a year. Let's schedule an appointment."

Ideally the practice will also reach out to cat owners who don't currently visit your practice by forming alliances with cat clubs, boarding facilities and animal welfare organizations in order to educate cat owners about the need for care through seminars, mailings, first time visit promotions or other joint activities. Even if your practice doesn't want to do this, you can provide education to organizations you work with.

Give cat owners a reason to visit

Both dog and cat owners surveyed in the Bayer study demonstrated a real lack of understanding about the care their pets need. Cat owners, however, have much less of an understanding of the need for physical exams and other preventative care; about 40% said they would not take their cat to the veterinarian if vaccinations weren't needed compared to 24% of dog owners. Many cat owners said they would only take their cat to the veterinarian if it was sick, they were comfortable with longer intervals between visits compared to dog owners and believe that indoor cats and older cats don't need as much care as outdoor or younger felines.

And yet when cat owners were asked what it would take for them to visit the veterinarian more often, three of the top four items are easily addressed by better client education. 49% or more cat owners said they would take their cat to the vet more frequently if they knew they could prevent problems and expensive treatment later, they were convinced visits would help their pet live longer or if they really believed their cat needed exams more often.

Fill that gap between what cat owners do now and what they would do if they understood the need better. First of all, make sure you're up to date about the care cats need. An excellent resource for both doctors and team members is the AAFP-AAHA Feline Life Stage Guidelines released in 2010. This publication outlines optimal care for cats in each of six life stages from kitten to geriatric. If your practice doesn't have standards for care for cats, offer to help develop them. At a minimum, you can understand what care cats need and then transfer your cat-knowledge to cat owners.

Many cat owners in the Bayer study indicated they wanted an annual healthcare plan tailored to their cat; they want to know what kind and how many exams are needed during the year, what kinds of procedures and diagnostics you recommend, what they can do at home to keep their cat healthy and what symptoms to watch for that might indicate their cat is ill. Make this conversation a priority each time Fluffy and her owner visit; don't just talk about what you recommend today but go through the care needed over the next 6-12 months as well. Offer to help develop a personalized written annual plan that can be customized for each cat owner and sent home with them. Pet owners typically remember only a fraction of what they hear at the practice and need something to remind them. And, of course, make sure that your reminder system includes all of these recommendations as well.

Telling cat owners what care their pets need is just a start; what cat owners really want to know is why cats need this care. Without a strong sense of "why", the importance of the recommendations gets lost. Don't just say—"We recommend Fluffy come back in six months"; say "Before you leave, let's set up another appointment for Fluffy in six months so we can make sure she is still in great shape. Cats are excellent at hiding illness and early detection of disease often allows for better care, a better prognosis and a reduction in the long-term cost of Fluffy's care." What you want to communicate with every recommendation is that better wellness and preventative care results in a happier, healthier cat and a happier owner.

Help educate everyone at the practice

Every team member should have a role in communicating with cat owners; but just because someone works in a veterinary clinic doesn't mean they understand or are comfortable with cats. During a typical visit, cats and their owners spend as much time interacting with technicians and receptionists as they do with doctors so educate yourself and offer to help train other team members so everyone is comfortable dealing with felines and can communicate intelligently with cat owners.

Team members need to not only be able to talk about cat issues but they need to be able to handle cats in a gentle and soothing manner. The natural instinct when dealing with a fractious cat is to hold on to it tight or pin it to the exam table; but less is almost always more with cats. Visit the Catalyst Council website for excellent training videos about examining anxious cats, getting cats out of cages and handling them for lab sample collection. The AAFP/ISFM Feline Friendly Handling Guidelines (www.catvets.com) are also a valuable resource with sections on recognizing fear and anxiety in cats and interacting with cats while at the practice.

Outline the topics that need to be covered in kitten visits, adult cat visits and senior cat appointments; offer to develop a checklist for use by everyone in the practice. Even if your practice doesn't want a formal checklist, this will help you remember what topics to cover with cat owners. Use posters, models and handouts to further illustrate the points that need to be covered.

Send cat owners home with handouts and recommendations for further reading; a booklet called: CATegorical Care: An Owner's Guide to America's #1 Companion from the Catalyst Council (www.catalystcouncil.org) is an excellent resource. In addition to printed materials, provide your clients with a list of websites (yours included!) that have good quality cat information. Medical information is important but also point them in the direction of sites on cat behavior, training, and general care.

Don't wait for cat owners to visit before you start talking to them. Critical cat information should be included in your newsletter or direct mail/email blasts as well as in your social media efforts. Expand your website to include a wide variety of interesting and important feline information. Everything you talk to clients about when they visit should be included on your website for easy reference. Your clients are going to check out the Internet for information; do everything you can to make sure they are getting good quality information from you.

De-stress visits for cat owners

Cat owners interviewed during the Bayer study were eloquent about the difficulties they encountered in trying to take their cat to the vet; the cats hid when they saw the carrier, scratched and bit their owners, cried all the way to the clinic and went ballistic when some big dog nosed up to the carrier in the reception area. Results of the online survey reiterated the findings from these one on one interviews; 58.2% of cat owners said their pet hated going to the vet as opposed to 37.5% of dog owners. And 37.6% of cat owners said just thinking about taking their cat to the vet was stressful.

The practice should make it clear to cat owners that everyone in it cares about cats and understands their needs. Don't let the dog pictures outnumber the cat pictures in your reception area, post pictures of client or staff cats, provide books and magazines about cats, offer a range of cat products, post displays of cat breeds and have a notice board for cat information.

Ideally, the practice should offer seminars or handouts on topics specific to cats such as life stage needs (kitten, geriatric), dietary recommendations, how to administer medications, and cat friendly boarding facilities. Kitten kindergarten classes are also an excellent way to educate cat owners. If your practice doesn't do any of this now, offer to help develop these things.

A little socialization can often ease cats' veterinary visit anxiety but most cat owners don't know how to do this. This is where the veterinary team comes in. The first step is to teach owners how to get their cats comfortable with a cat carrier. Several tips include:

     • Leave the carrier out in areas the cat frequents

     • Place comfortable bedding and toys in it

     • Spray the bedding and carrier with synthetic pheromones

     • Place treats in the carrier

The point of these exercises is to make the carrier a routine part of the cat's life; not something that is associated with a dreaded experience.

Once the cat is used to the carrier, the owner should take him or her on short car rides. The carrier should be placed somewhere in the car where it won't slide around or be jostled; this frightens cats. Some cats like the carrier to be covered with a towel or blanket; others prefer to be able to see out. Just as with people, some cats get carsick; instruct cat owners to withhold food and water before the trip or consider anti-emetics in more severe cases.

Another way to reduce the cat's veterinary visit anxiety is to get it used to being touched as will happen during an examination. Veterinary team members should show cat owners how to gently touch the cat's paws, look into its ears, open its mouth, and run their hands over its legs and body similar to what the cat will encounter during its veterinary visit.1

Just telling clients what to do isn't enough, however. The benefits of these exercises should also be communicated. Instead of saying "Here are some socialization exercises you should do with Fluffy," say something like "Cats are usually more nervous about visiting strange places than dogs are; here are some easy things you can do at home to reduce Fluffy's anxiety about visiting the veterinary practice. This will make it easier for you to bring her in and easier for us to give her the care she needs."

Think about things the practice can do to de-stress the visit for cats and offer to help implement some of these ideas:

     • Separate entrances or waiting areas for cat owners and dog owners, even a small screened off corner of the reception area just for cats can make a difference

     • A designated cat exam room away from the noise of the practice

     • "Cat only" appointment times

     • Carriers for loan to clients

     • House-calls

Again, it's not enough to just do these things, however; you also need to communicate them to Fluffy's owner. Unless you explain it in words of one syllable, she may not understand or appreciate your efforts. When a team member immediately moves Fluffy and her owner into an exam room, say "We're going to put you in an exam room straight away so Fluffy won't be frightened by the other pets in the reception area. This room is nice and quiet and especially designed for our cat patients." If you designate certain days or times as "cat only" slots, tell the client what you are doing: "We are going to schedule Fluffy's next appointment on Tuesday afternoon at 3:30. We only see cats on Tuesdays so Fluffy's visit with us will be much calmer and easier on her."

Cats and their owners may never love visiting the veterinary practice but with a little effort, both the owner's and the cat's stress level can be vastly reduced. Once that happens, you can focus on giving cats the care they need and deserve.

1. AAFP and ISFM Feline-Friendly Handling Guidelines, Journal of Feline Medicine and Surgery (2011) 13, 364-375