Becoming a cat friendly clinic - Veterinary Practice
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Becoming a cat friendly clinic

From feeding bowls and the substrate in litter trays, to smells and noises, there are numerous changes that can be made in the veterinary surgery to support feline patients

How many of you have heard the old saying “cats are small dogs”?

This is so wrong and far from the truth it’s unbelievable, and in practice there are lots of different actions we can implement to make our feline friends’ visits to us more tolerable. Many of you will have heard of the “Cat Friendly Clinic” initiative run by the International Society of Feline Medicine (ISFM) – this is an accreditation which can be awarded to your practice if you meet a list of criteria including kennel type and size, client education, feline protocols and much more. I work in a Silver Cat Friendly Clinic and it is definitely something which is appreciated by our clients, while also allowing us to educate people on best cat care and behaviour. If your practice is not an ISFM Cat Friendly Clinic, there are lots of little changes that you can make to the care of your feline patients to make their stay with you as relaxing and stress free as possible.

Food and water

While advice should be available to owners of new kittens on the best type of feeding utensils for their cats, it is also important to consider such advice for feline patients in the surgery. Ceramic or glass feeding bowls are best for cats as plastic ones can give off and hold odours, and while stainless steel bowls are hygienic, they can be off-putting for two reasons:

  1. Seeing a blurred reflection of themselves can cause cats to feel threatened
  2. A collar and bell may clink against the bowl, causing the cat distress

You should also consider bowl size as some cats don’t like bowls which push on their whiskers when eating or drinking.

Another thing to consider are feeding balls, puzzles and toys, to encourage movement and foraging. This can be especially good for cats who are on cage rest, as using a feed puzzle in their cage can provide some added mental stimulation, and they are good for cats who maybe need to lose a little weight as they encourage movement.

Many cats do not like to drink when in close proximity to their food bowls, so locating the water bowl on the opposite side of the kennel/room as the food bowl may help

Within the kennel and home environment the position of the water bowl is important. Many cats do not like to drink when in close proximity to their food bowls, so locating the water bowl on the opposite side of the kennel/room as the food bowl may help. Some conditions require increased water intake and it is important to advise owners on how to do this, as some cats refuse to drink from a water bowl and prefer a dripping tap or puddle outside. For such cats, you could suggest that the owners leave a saucer of water outside and potentially use a water fountain indoors.

Resting places

Cats love to relax and sleep – my cat would happily sleep for 23 hours a day given the chance! It is important that we make them feel as relaxed as possible to allow for these rest periods. As natural climbers, resting and observing in high places is important to our feline friends. Where possible, avoid floor-level kennels where people spend periods of time hovering above the kennels, as this can make cats feel like people are towering over them.

Hideaways are also really important, and the cat should never be disturbed in the hide, unless you are concerned for their health or a medication is due. You can purchase special cat hideaways which are easy to wash and allow the cat not only to hide inside, but also to climb on top of the hide to allow them to feel high up. If these aren’t available think outside the box – literally – using old cardboard boxes upturned with a hole cut in one end, which allows hiding and also allows climbing on top. Igloo beds allow hiding holes for cats, but it is important to remember with both these options the potential for contamination with bodily fluids.

If a hideaway is not available or appropriate (you may need to regularly view the animal’s respiration and can’t do this in a hideaway), then consider using a blanket or towel to cover part or all of the kennel door allowing the cat to feel hidden, while you are still able to gently lift a corner or quietly peek over the top. Warm places are also usually favourite places for our feline friends, so allow plenty of bedding to “snuggle” in and consider the use of temperature-controlled heat pads. Cats are also territorial animals and like their own scents, so do not wash bedding too often; only wash if contaminated with bodily fluids, and where possible place a blanket from home in their kennel to help with the scent acquisition.


Do any of you ask owners what substrate their cat has in their litter trays?

This is something which is often overlooked but is actually really important as cats can be so fussy that a change in substrate (litter) can stop them using the litter tray. The position and type of litter tray is also crucial. Covered trays are popular as they are perceived as cleaner and people think cats like to hide; however, some cats may feel uneasy using one of these, as they only have one entrance/exit point. Self-cleaning trays are great for owners, but poor for cats because the trays can make sudden movements and noises which cats can find disturbing.

We have all had cats in our surgeries who are not using the litter tray and maybe toilet on their bed or elsewhere in the kennel, or hold themselves for days until desperate. There are lots of reasons why cats don’t use their tray, including:

  1. The litter is not deep enough – be generous, cats like to dig around and bury bits
  2. Wrong substrate – if they are used to wood litter at home but you have clumping clay, they may not use it. Also bear in mind those owners whose cats only toilet outside, as these cats may benefit from having some soil put in a litter tray
  3. The litter tray may be too small – 1.5 times the length of cat from nose to tail tip is ideal
  4. Position of tray – a litter tray located in a discreet corner, away from food and water bowls is best
  5. Not emptied frequently enough
  6. Disinfectant smell – when cleaning out litter trays, try not to wash the whole thing in strong-smelling disinfectant

For the education of our clients, it is also very important to be able to recognise the difference between urinating and scent marking – urine for scent marking is very different to depositing urine to empty a bladder. During urination the cat squats and passes urine on horizontal surfaces. If the cat is urinating on sofas, duvets, baths and sinks, there may be a bladder issue or a behavioural issue, such as incorrect litter.

It is also very important to be able to recognise the difference between urinating and scent marking – urine for scent marking is very different to depositing urine to empty a bladder

Scent marking, or spraying, is normally performed standing with a treading motion of the back feet; the tail will quiver and a small amount of urine is deposited on a vertical surface. These surfaces often include curtains, door frames and electrical equipment. This type of behaviour is more commonly territorial and behavioural, rather than medical.

Patient restraint

“Less is more” is often true with our feline patients, and minimal restraint will often facilitate better results. It is important to consider all options when restraining a patient for a procedure, including:

  • Where is the best place to perform the procedure? Moving the cat around the building to strange-smelling areas will heighten their anxiety
  • Who is needed to perform the procedure safely? Often two people for “handling” is useful for procedures as one person can provide distraction with treats, food or stroking
  • How are we restraining them – do you need a towel to wrap the cat in securely or allow them to hide their heads in? If the patient is stressed and angry, and potentially a danger to themselves and the handlers, consider using some form of behaviour modification drug or sedation
  • Do we have everything prepared? Make sure everything you do and might need is prepared and ready

The ISFM have a statement against this as it has been proven that scruffing a cat can actually exacerbate their feelings of stress and anxiety

“Scruffing” of cats is the act of holding or restraining them via the spare skin on the back of their neck. It was traditionally used for “angry” cats as it was deemed safer for handlers; however, now scruffing is recognised as a negative restraint method. The ISFM have a statement against this as it has been proven that scruffing a cat can actually exacerbate their feelings of stress and anxiety.


Cats have very sensitive hearing and are able to hear high-pitched noises much more clearly than dogs and definitely above the human ability. So, it is important to consider noise pollution in the cat kennels, which should ideally be located away from noisy thoroughfares or barking dogs. Music can be used to provide background noise, but this should be soft classical, not rock or pop music. It is also important to be aware of noises such as the kennel doors banging closed, so it may be worth considering placing some rubber grips over the kennel door closers to minimise loud noises.


When I think about cats and their sense of smell, I always think about those snotty cat-flu cats who are inappetant as they cannot smell their food, so aren’t enticed by it. It is important to think about odours when we have feline patients in the surgery. The use of pheromone or calming sprays or diffusers can be used in the cat ward and in areas where cats spend time, such as the preparation room before a procedure starts.

Another aspect to consider is the cleaning of the patient’s kennel and belongings. Shake blankets out daily, but don’t wash them unless they are contaminated with bodily fluids, so they remain smelling of the cat. Avoid using strong-smelling washing powders as blankets which have a strong smell of cleaning products may be nice to us, but not so nice for our feline friends. If the patient’s kennel needs a freshen up, avoid using disinfectants where possible, as if you are placing the cat back in the same kennel afterwards the disinfectant smell can be quite disturbing. Obviously bodily fluids need cleaning and the kennels need a thorough clean between patients, but if the kennel is not grossly contaminated I would avoid disinfectants during the patient’s stay. Instead, a shake down and hot water wipe off will allow the scents of the cat to remain.

Client education

I am a massive advocate of client education, making advice as user-friendly and as easily accessible as possible. Information handouts are a great way of educating clients: remember sometimes people are too embarrassed to ask or are just genuinely unaware of something. However, these need to be accessible and we need to let people know they are there, so whether you choose to have a file behind the desk, all handouts saved on the practice management system or an area on your website with information handouts, you need to let people know.

Information handouts are a great way of educating clients: remember sometimes people are too embarrassed to ask or are just genuinely unaware of something

How do you let people know what resources you have available?

  • Have some copies printed out and placed on the cat side of the waiting room
  • Ensure all staff know what handouts are available and encourage them to give them out to clients with cats with certain conditions
  • Make a “new kitten” booklet to provide all basic information and then the routes to find out more (such as website address)
  • Run a social media promotion about a feline condition or behaviour with a link to your website
  • Consider pulling a list from your practice management system of all cat owners and emailing them a brief summary of what information you have available and a link to your website


As you can see, there are lots of actions to consider when nursing our feline patients and this really is just touching the surface. So, embrace your feline nursing skills and let’s up the nursing care of our feline patients.

Shelly Jefferies

Shelly Jefferies, RVN, NCertPT, has been a veterinary nurse for over 20 years, and has worked in a variety of veterinary settings. Her main nursing interests are wound management and canine rehabilitation. Having been a clinical coach for most of her qualified life, Shelly enjoys training student nurses and regularly presents CPD events on her favoured topics.

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