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The following observations are based on the experience my wife and I had with Coco, our calico Persian female whom we treated for 2 1/2 years for CRF. We learned that in addition to developing new skills it was equally important to establish communication and a cooperative bond with our cat. We did this by following three basic principles: - Respecting her Intelligence, Being Sympathetic to her Needs, and Establishing a Routine. 1. RESPECT YOUR CAT'S INTELLIGENCE. This means two things: recognizing your cat's ability to understand and draw conclusions, and giving him the right to participate in decisions. For a long time I tried everything I could think of to make pill-taking easier for Coco. I coated pills with butter to make them go down easier, wrapped them with cheddar cheese to make them taste better, surprised her while she was sleeping and off guard, etc. The result was generally a frantic struggle which all too often Coco won. Though she loved and trusted me, Coco had come to the conclusion that when I had medicine in my hand I became a ruthless attacker who wanted only to subdue her and force things down her throat. She was reacting to what she saw as a fit of temporary insanity on my part. One day in desperation I had a talk with her. I held her in my lap on her favorite pillow and while petting her gently but firmly showed her a pill and explained that I needed to give it to her so she'd feel better. Instead of rushing to get it over with I gently grasped her head from behind, putting my thumb and fingers into the corners of her jaws to spread them, but not insistently. I allowed her to refuse the first time, petted her some more, and kept trying until she stopped resisting. Once she realized that I wasn't going to try to overpower her she cooperated and the pill went down much easier. From that time on I always showed her anything I was going to put in her mouth and she eventually accepted pill-taking as a normal thing to do. It wasn't the act of taking the pill that was so frightening as much as the feeling of being ambushed. This doesn't mean that everything always went smoothly. Sometimes the pill popped out after being put in and I thought that she was spitting it out on purpose. As it turned out, I just wasn't getting it far enough back in her throat. When she flicked her tongue she was actually trying to swallow, but the pill bounced and flew in the wrong direction. I had to overcome a fear that she would choke in order to make sure to place the pill as far back as possible, then hold her muzzle closed and stroke her throat to help swallow. When everything went smoothly and the pill went straight down she was proud of having done her job well! ... and of course she always received extensive praise and petting afterward. The positive reinforcement made her want to succeed in learning to do a difficult job. Part of the importance of patience deals with timing. Coco's real concern was a fear of choking if a pill went down wrong, and even at her best she had a nervous anticipation. When it was time to take the pill and everything was in position she'd open her mouth and make practice moves as if to swallow. Her job was to swallow immediately. My job was to time it so that the pill was in the right place at the right time, neither too early or late. Sometimes this meant I had to wait and gauge her rhythm, otherwise it might just bounce off of her tongue. Sub-Q fluids are much easier for cats to learn to accept because they can feel immediate relief from the treatment. By the time Coco got to the point of needing a daily treatment she might feel like you or I would after a long day's walk through Death Valley on a summer day without a canteen: headachy, tired, stiff, and generally worn out. After about 25 ml the headache would go away and she'd relax and start to purr for the remainder of the treatment. Knowing this, it's important to eliminate stress from treatment time and make it a bonding experience. If you go to start an infusion with hesitancy or the fear that you'll hurt your cat, it'll be sensed and the cat will also be nervous. In the beginning, I used to have to chase Coco around the room, pin her down, wrap her in towels, etc., and the whole thing was a tiring experience that took up to two hours. After we developed an understanding and a routine the whole affair could be done in less than 20 minutes, even at a slow drip. 2. BE SENSITIVE TO YOUR CAT'S NEEDS. After we'd progressed to the point where neither of us was afraid of the treatment it began to happen that after a little of the Ringer's had gone in Coco would just get up and walk away. The first few times it took me completely by surprise! I wasn't restraining her at all and she actually walked off the needle and left fluid streaming out! My response was to chide her, telling her she knew better than that. After that I always made sure to hold a hand in front of her chest to stop her if she tried to leave. My assumption was that, feeling better, she figured she didn't need anymore. However, even though I held her she would sometimes get to that point and struggle until I let her get up and leave. Eventually I noticed that she was always getting up for one of three things: the cat box, food, or water. Perking up after getting a little Ringer's she suddenly had an overwhelming urge to do something that she had neglected while she was feeling down. We found that if we followed the simple routine of offering her food and water and taking her to the cat box before giving her a treatment she would sit pleasantly for as long as needed. Since these are all basic rights of any animal, we called the procedure "reading Coco her rights". She got so good about sitting still that on more than one occasion I was able to leave her hooked up while I put her off of my lap and walked across the room to answer the phone. Once, after midnight, we both fell asleep and I woke up to find a very juicy kitty who had taken over 500 ml and was still sleeping happily! Cats love ritual. It helps them know what to expect so they can retain a feeling of being in control. It also gives a basis to establish communication as they develop ways to initiate the ritual/routine. This is how a cooperative bond may be formed. The first steps involve positive reinforcement, similar to training a dog. The difference is that instead of bribing a cat to do what you want you're giving him a reason to want what's good for him. The more minor rituals you have, the better the chance of communication developing. For example, Coco enjoyed drinking out of a water glass while Connie held it in her hand. Connie thought it was cute, so she always made a big fuss about it. When Coco wanted water, she'd climb up on her special pillow on the bed, facing Connie (who was bedridden), stand at attention, and wait. Connie then filled the glass from a bottle kept full by the bed and praised Coco as her tongue lapped against the opposite edge of the glass. Through this simple ritual a bond was formed and communication occurred. The same principle helped in giving all of the medications Coco had to take, especially when adding new ones. Coco's favorite treat was freeze-dried liver treats, which I broke up and fed her by hand. Whenever I had to give her a new medication I always followed with liver and lots of praise as reinforcement. After a few times the liver was no longer necessary and could be reserved as a pure treat. In later stages, when she had numerous medications to take at the same time, they always came in the order of least-liked first so that things got progressively better for her. Pills came first because they were her greatest anxiety. If she had more than one pill to take, the first would be the largest and most difficult to take. Next came liquid antibiotics or vitamins because she swallowed them much easier (tastiest last). Finally as her greatest reward she got her fluid treatment. Eventually since she wanted her sub-q she willingly put up with the steps that she knew led to it. At first, I initiated the ritual. I'd pick her up and take her to her food dish and wait. Next stop was the litter box. Finally, Connie would put the pillow on her lap and pour her some water. After she'd been "read her rights" we proceeded to the business at hand. After a while as soon as I started hanging her Ringer's bag and changing the needle Coco would visit her food dish and cat box and approach Connie for water if she wanted some, then settle down on her pillow with her back offered for her treatment. That was her signal that she was ready to start the whole medication sequence. Eventually she started omitting the visits to the litter box and food dish unless she actually needed them. On those occasions if I tried to give her her rights, she'd object, as if to say I was treating her like a child. At those times we said that she had "waived her rights". We learned to accept the fact that she knew the routine and her part in it, and that her part was to take care of her actual needs. She was able to do this without going through unnecessary steps in the ritual. |