AAFP and ISFM feline-friendly nursing care guidelines

Abstract

NURSING CARE: The term nursing care means different things to different people. The authors of these AAFP and ISFM Feline-Friendly Nursing Care Guidelines define nursing care as any interaction between the cat and the veterinary team (veterinarian, technician or nurse, receptionist or other support staff) in the clinic, or between the cat and its owner at home, that promotes wellness or recovery from illness or injury and addresses the patient's physical and emotional wellbeing. Nursing care also helps the sick or convalescing cat engage in activities that it would be unable to perform without help. GUIDELINES RATIONALE: The purpose of the Guidelines is to help all members of the veterinary team understand the basic concepts of nursing care, both in the clinic and at home. This includes methods for keeping the patient warm, comfortable, well nourished, clean and groomed. The Guidelines provide numerous practical tips gleaned from the authors' many years of clinical experience and encourage veterinary team members to look at feline nursing care in ways they previously may not have considered. OVERARCHING GOAL: The primary goal of feline-friendly nursing care is to make the cat feel safe and secure throughout its medical experience.

Figure 1

Ensuring a sense of safety and security is the ultimate goal for managing feline patients in the veterinary clinic. When cats do not feel safe and secure, they display behaviors associated with fear or aggression. Both fear-induced withdrawal (left-hand arrow) and aggression (right-hand arrow) make treatment difficult or impossible. In addition, the physiologic effects of stress impair recovery from illness or injury. ‘Frozen fear’ and ‘Content patient’ images courtesy of Hazel Carney. ‘Aggressive “bad cat”’ ©iStockphoto.com/Anna Sematkina

Figure 2

(a) Reception personnel are readily accessible to the cat owner in order to respond to questions or concerns. (b) The waiting room includes a separate area for owners who want additional privacy or to isolate their cats from other pets or clients. (c) Bench seating allows for elevation of the cat carrier and placement next to the owner. (d) A towel draped over the cat carrier provides an impromptu hiding place in the reception area. Images courtesy of FAB/ISFM

Figure 3

The cat owner’s presence during the examination can help minimize the cat’s anxiety in response to environmental or procedural stress. Courtesy of FAB/ISFM

Figure 4

Medial saphenous vein catheter placement is a good option for short procedures and blood draws. Courtesy of Sheilah Robertson

Figure 5

(a) Familiar objects create a less threatening presurgical environment. (b) A cat bag provides warmth and gentle restraint. (c) Placement of an IV catheter provides venous access for multiple injection procedures or repeated blood draws, minimizing discomfort in a feline surgical patient. Images courtesy of Sheilah Robertson

Figure 6

A hospitalized cat can readily access a litter box with low sides (a), whereas a high-sided litter box (b) would be much more difficult to access. Images courtesy of Susan Little

Figure 7

Three examples of inside-the-cage hiding places that provide security for the hospitalized cat. Images courtesy of FAB/ISFM

Figure 8

Examples of cat-friendly equipment. (a) Cat scale with elevated sides. (b) Small blood collection tubes. Images courtesy of Dawn Brownlee-Tomasso

Figure 9

A thick towel or fleece provides warmth and security for the hospitalized cat. Courtesy of FAB/ISFM

Figure 10

Hand feeding of small amounts of food, short-term use of appetite stimulants, and petting may encourage convalescent cats to resume eating. Courtesy of FAB/ISFM

Figure 11

Many cats benefit from a feeding tube when other strategies to encourage eating have failed. Note that a soft Elizabethan collar is preferable where available. Courtesy of FAB/ISFM

Figure 12

(a) Brief periods of exercise out of the cage in a quiet room with a litter box and food may improve appetite and elimination in hospitalized cats. Cats should be kept out of direct line of sight of each other; in this instance, there were no other cats in the ward.(b) A technician or nurse can encourage out-of-cage activity during the cat’s hospitalization and ensure its safety. Images courtesy of Susan Little

Figure 13

For receptive cats, non-medical interaction such as grooming, petting, hand feeding or playing may improve mental and physical wellbeing and speed recovery. Courtesy of (a) Heather O’Steen and (b) FAB/ISFM

Figure 14

(a) The individual cage arrangement pictured contributes to a low-stress hospital environment by preventing direct line of sight among patients. (b) A convalescing cat has soft bedding and a cardboard box in which to hide; a soft neck wrap comfortably secures the jugular catheter. (c) A cat bed provides warmth and security. (d) Providing the postsurgical patient with food from home helps re-establish a familiar routine. (e) Positive staff interaction with receptive cats contributes to the patient’s sense of security Courtesy of FAB/ISFM Courtesy of FAB/ISFM Courtesy of Sheilah Robertson Courtesy of Susan Little Courtesy of FAB/ISFM

Figure 15

A soft Elizabethan collar (a) is more comfortable than a rigid collar (b). A flexible self-adhesive bandage (c) is preferable to a stiff, restrictive bandage (d). Images courtesy of Sheilah Robertson