Fear Free for Cats

By Tammy Hunter, DVM; Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CRPP

My veterinarian recently posted information in her office that she and her staff are qualified as Fear Free Certified® professionals. What does this mean?

The veterinary profession now understands that many cats do not receive the veterinary care they need and deserve. Many pet owners decline to take their cats for regular veterinary visits because they perceive that their cats resent and fear the visits. The veterinary behavior community has clarified that many cats experience fear, anxiety, and stress (FAS) when faced with a visit to the veterinary clinic. FAS can be a problem at many points leading up to and during the veterinary visit. Cats can experience FAS during travel from home to the veterinary practice. Some cats have learned that they only get in the car to travel to the veterinarian’s office, and that means that FAS begins to exert its negative influence before the cat even gets to the clinic.

I’d like to know more about FAS and what it might mean for my cat.

Fear, anxiety, and stress are rooted in responses to stressful events and results in both physiologic and behavioral changes. FAS inhibits healing, can contribute to chronic health issues, and can make any required treatment difficult. The stressors that contribute to FAS in the context of veterinary visits include humidity, odors, extraneous noise, pheromones, pain, hunger, thirst, disease, being surrounded and handled by strangers, and being separated from human family members. The stress response is the body’s attempt to return itself to a more normal state of functioning. It is important to remember that the threat causing the stress response may be either real or perceived.

What are the signs of a cat’s stress response?

A cat experiencing FAS will exhibit a stress response in two phases: immediate signs that develop acutely, and delayed signs that appear later. The signs of an immediate stress response include:

  • decreased rational thinking
  • decreased ability to perceive pain
  • fear-based aggression
  • increased heart rate
  • panting
  • blood shunting away from the core/organs and to the muscles (preparing the body for “fight or flight”)
  • memory consolidation that will result in “flashback” experiences in the future

The signs of a delayed stress response are influenced by chronically elevated cortisol levels. Several body systems may be affected including:

  • Gastrointestinal system
    -inflammatory bowel disease

  • Musculoskeletal system
    -muscle wasting
    -chronic fatigue
  • Immune system
    -delayed healing
  • Skin
    -poor hair growth
    -hair thinning
  • Urinary tract
    -feline lower urinary tract disease (FLUTD)


Are there other effects or negative results from stress on cats?

When experiencing FAS in the context of veterinary visits, it creates issues around the visit itself. Cats with FAS are more difficult to examine, which may compromise the veterinary healthcare team’s ability to make a complete and accurate diagnosis. FAS may cause a cat to react aggressively to members of the veterinary healthcare team, resulting in injury to them. Because of some of the immediate effects of FAS, a cat needing sedation or anesthesia will require larger doses of medication, which may create an increased risk to them. In addition, cats experiencing FAS who must have surgery will have slower post-operative healing, and cats who are hospitalized due to illness will experience a longer recovery time.

There are long-term future consequences for cats experiencing FAS. Fear impacts learned behavior, undermining training in even the best-behaved, good-natured cats. This means that a cat experiencing FAS may lose complete connection with his usual comfort being handled. Fear happens in the emotional center of the brain, and these cats cannot “think” their way out of their FAS experience. Fear also evokes vivid sensory memories linking the environment and people associated with veterinary visits. Think of this as the PTSD of the cat world. Fear-based memories are very easily retrieved when the cat is in that situation again.


Is there anything to be done for a cat who experiences fear, anxiety, and stress when he must go to the veterinary clinic?

Fortunately, there are many things that can be done for cats who experience FAS around their visits to the veterinarian. Creating a Fear FreeSM veterinary visit starts before your cat even leaves your home. Your veterinarian can guide you in conditioning your cat to better enjoy time in your car and by helping your cat not to associate car rides with “bad” things. Once you arrive at your veterinary clinic, the practice team will help to create a Fear FreeSM experience for her (and for you). Every cat is different, so your veterinarian will provide insight and guidance as to how the examination and visit will go. There may be treats involved. There may be a need for medication, and your veterinarian may recommend the use of Feliway® pheromone for calming. The best strategy for an individual cat will be determined by your veterinary healthcare team in dialogue with you and your family.

Rest assured, it is possible to help your cat reduce/eliminate FAS from her veterinary visits.

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