Tag Archives: restraint

If you’ve ever worked in a shelter or veterinary setting, there’s a pretty good chance that you’ve spent some time scruffing cats. Maybe you’ve taken your cat to the vet and the veterinary staff placed your cat in a “scruff-hold.” For those of you who have no idea what I’m talking about, scruffing is a way of restraining cats, by holding them firmly by the loose skin at the back of the neck. For some cats, this type of handling restricts their movement, which can facilitate handling and various procedures like getting a blood sample. Although scruffing is still a common way to handle cats in veterinary clinics, there is increasing resistance to using this type of handling.

Mother cat carrying kitten. Photo by Margo Akermark via Wikimedia Commons.

Scruffing likely came into fashion because it resembles the way that mother cats handle their kittens – carrying them by the back of their neck. When the momcat does this, kittens are immobilized and likely easier for mom to relocate. Immobility in other species (such as rabbits and rodents) when scruffed is attributed to anti-predator behavior. Scruffing adult cats can have similar effects (induced immobility), although not in all cats. Because the lack of movement experienced by cats during scruffing may be due to fear, rather than a relaxed state, many individuals and organizations are calling for veterinary staff to embrace other handling techniques for cats.

International Cat Care and the American Association of Feline Practitioners have released statements that scruffing should either not be performed, or should not be the routine, “default” method of handling cats who visit a vet clinic. Other organizations, such as the ASPCA, emphasize other methods of cat restraint. Various certifications are now available for training in low-stress handling, fear-free veterinary practice, and cat-friendly practices.

Now this is all well and good, but as can happen, sometimes people endorse a practice without a strong evidence base. Until the past few months, there have been few published studies related to cat restraint, and whether or not certain handling methods are truly stressful to cats. Dr. Carly Moody devoted her dissertation research to the exploration of various aspects of cat restraint. I blogged about two of her other studies recently, and now she’s got a new paper, hot off the presses, looking at three types of cat restraint.  In “Getting a grip: cats respond negatively to scruffing and clips” published in Veterinary Record, scruffing, clipping, and full-body restraint were compared with passive restraint to see whether they led to stress responses in cats.

Fifty-two shelter cats were tested; all cats experienced passive restraint as a control and ONE of the other forms of restraint. Some cats were held with passive restraint first, and others received the experimental condition first, to control for any order effects of being handled. Cats were first assessed as either friendly or unfriendly (I’d prefer a term like avoidant!) by measuring their approach and response to a stranger and being petted, before the restraint methods were tested.

Photo by Moody et al, from the published manuscript.

In passive restraint (a), cats were handled with minimal pressure and were allowed to stay in the position they preferred. Full-body restraint (b) involved holding the cat on its side, while holding the legs and not allowing much movement. In the scruff condition (c), cats were held by the skin at the back of the neck and was allowed only minimal movement. Finally, in the clip conditionm(d), two Clipnosis clips were applied to the back of the cat’s neck. Clipnosis clips resemble binder clips, and are a way to scruff “hands-free.” All cats were restrained by the same person in the animal shelter’s clinic facility.

The stress measures included ear movement, respiration rate, pupil dilation, lip licking and vocalizations. The results showed that cats undergoing full-body restraint had a higher respiration rate and more vocalizations. Full-body restraint and clips led to more pupil dilation, and all three tested restraint methods led to more ear movements when compared with passive restraint. To summarize, full-body restraint and clips were the most stressful, and scruffing also led to more stress responses when compared to passive restraint. Three indicators of stress (respiration rate, pupil dilation, and ear movements) were consistent with the previous work from this lab. Based on this study, the authors recommend that people do not use full-body or clip restraint, and that scruffing should not be a default method of handling cats.

A few potential weaknesses of the study include the fact that they did not do any medical procedures on the cats to see if there was any relationship between the type of restraint and cat’s behavior during an exam. The full-body restraint involved laying the cats on their side, which was different from the other three conditions, where the cat was typically upright. It is difficult to say whether it was the restraint or the body position that might have led to the stress response.

An example of scruffing plus full-body restraint.

Finally, MY personal experience, is that most handlers who scruff cats, simultaneously place them on their sides in some type of full-body restraint. So it is possible that some people will think that because scruffing was not as stressful as the other tested modes of restraint, that it’s perfectly fine to utilize this form of handling with nary a second thought. It would be great to include this type of handling (scruff + restraining the body) in a future study – it is possible that combining the two techniques is even more stressful than just using one alone.

Scruffing doesn’t prevent biting; many veterinarians have been bitten by cats in practice, and since most clinics (perhaps until recently) likely use scruffing to restrain cats, it is obviously therefore not a guarantee of safety. However, it is a habit that many may find hard to break, especially if they are used to and comfortable scruffing, and not as experienced or comfortable using other methods, such as towel-wrapping or chemical restraint (drugs). Many years ago, when I worked in an animal shelter and handling a lot of cats, I was doing a lot of scruffing! That was the norm. In my current work situation, I’m not routinely restraining cats anymore. But if I were back in that position, I’d be ready to try something different.

At the School of Veterinary Medicine at UC Davis, we teach a cat handling lab to first year students, and the mantra is “EBY – Even Better Yet” – what can we do better to handle animals safely, and in a manner that is likely to reduce stressful responses in the present and during future veterinary visits. These students have typically been trained to scruff cats by default. Sometimes they express resistance to trying something new; but hopefully with practice and increasing evidence that scruffing increases stress, they will get more comfortable with other, less-stressful techniques.

Kitty in a towel wrap. Photo by Kerri Lee Smith via Flickr/Creative Commons License https://www.flickr.com/photos/77654185@N07/26719456934

I was recently inspired when my friend Ellen Carozza, LVT told me that her veterinary practice has been “scruff-free” for almost 20 years. And she still has all of her fingers! She has been a strong advocate for providing cats with a safe and low-stress experience at the vet clinic, and has excellent videos of how the staff at her clinic handle “difficult” or “aggressive” cats, including several types of towel wraps. It’s hard to argue with 20 years of proof that it’s not necessary for effective treatment of cats (when we tell the first year vet students that there are scruff-free cat clinics, it blows their minds!). But think of it this way – if aversive restraint techniques were just not allowed or available to you – what would you do instead? And now it’s hard to argue with the mounting scientific evidence that when it comes to handling cats, “less is more.”

 

Reference

Moody, CM.Mason, GJ.Dewey, CE.Niel, L.
(2019) Getting a grip: cats respond negatively to scruffing and clips

Did you know that cats should see their veterinarian at least once a year? That’s right, even if they are indoors only and seem healthy, it’s good to have a check-up. A big reason that people do not take their cat in for regular care (aside from money) is the stress they perceive that their cat experiences. A survey found that 38% of cat owners reported that they get stressed out just thinking about taking their cat to the vet, and 58% say their cat hates going to the vet. I’ve previously written about how training your cat to love a carrier can make this whole process a LOT easier. But what about what happens AT the vet?

Passive versus full-body restraint. Image from Moody et al., 2019

Researchers at the Ontario Veterinary College have published two studies exploring how the way cats are handled at the vet might effect their behavior.  The premise of both studies was comparing responses to what the authors call “passive restraint” (defined as handling the cat lightly in a position of the cat’s choosing) and “full-body restraint” (holding the cat on their side, while grabbing the cat’s legs, preventing movement of the head, body and limbs).

 

 

Both studies included (I think the same) 51 healthy adult shelter cats. All cats were first categorized as either friendly or unfriendly according to an “Unfamiliar Person” test. Each cat was individually placed in a room in a carrier. The carrier door was opened and the cat was given two minutes to choose to exit the carrier, explore the room, and approach the experimenter (an unfamiliar person). If at the end of two minutes, the cat was still in the carrier, the experimenter removed the top of the carrier and left the room, and the cat was given another minute to explore. At that point, the experimenter approached and attempted to pet the cat. Friendly cats had to leave the carrier, approach the experimenter within about a foot and a half, and allow petting. Twenty-four cats were categorized as friendly, and 23 as unfriendly.

Next, all cats were given a two-minute “mock” physical exam using either passive or full-body restraint. The experimenters measured how long it took to restrain the cat, as well as the presence of ear movements, tail lashing, lip licking, respiratory rate, and amount of pupil dilation to assess stress responses to both types of handling. Two cats in each condition were not able to be examined due to aggressive behavior.

Lip licking can be a sign of stress. Photo via Public Domain Pictures.

Now for the results of the first study “Can you handle it? Validating negative responses to restraint in cats”: it took longer to get cats into full-body restraint than passive restraint. Full-body restraint also resulted in a higher respiratory rate and more lip licking. Cats who had been subjected to full-body restraint were quicker to jump off the examination table. The authors concluded that the full-body restraint increases the activation of a cat’s stress system, and the attempts to escape the exam table suggest that those cats found the experience more aversive than the cats in the passive restraint condition.

Image from Moody et al., 2019

Fast-forward to 2019. The second study that was just published earlier this year in Applied Animal Behaviour Science, titled “Testing two behavioural paradigms for measuring post-handling cat aversion behavior,” looked at whether cats found the handler threatening AFTER being placed in either full-body or passive restraint. After the two-minute exam, cats were given two tests to assess how they felt about the person who did the exam. For the first, cats had previously been trained to walk down a runway for treats. Only 38 of the shelter cats were able to be trained to complete this task. The cat was placed on the runway, with the handler at the other end, and the experimenters recorded whether the cat approached or moved away from the handler.

There were no differences in the time it took cats to approach the handler, regardless of whether they had been subjected to passive or full-body restraint. Because no differences were found, and because a sizeable number of cats could not be trained to use the walkway, it appears that this is not a good measure of aversion responses in cats.

The apparatus used to test location preference. From Moody et al., 2019.

But wait, there’s more! The researchers next tested whether cats would form negative associations with a LOCATION after full-body restraint compared to passive. This study included 45 shelter cats and 10 adult laboratory cats who were group housed. All cats were subjected to BOTH restraint methods for one full minute, but in two different, visually distinct compartments of an enclosure. After the cat had been restrained, they were allowed to choose which side of the compartment they wanted to stay in – the one they had been passively restrained in, or the one in which they received full-body restraint. All laboratory cats, and the “friendly” shelter cats spent more time in the passive compartment; the “unfriendly” shelter cats were equally torn between compartments, perhaps finding both types of handling aversive.

From these studies, we can conclude that overall, cats have fewer stress-responses to passive restraint. For some cats, particularly the friendly ones, those stress-responses carried over to preferring the location that they had received passive restraint in compared to full-body restraint. However, the cats subjected to full-body restraint were no more or less likely to approach the person who had restrained her compared to the passively restrained cats, so to answer my original question, it doesn’t appear that cats hold much of a grudge if any.

Cat handling is a hot topic for a lot of reasons, and the trend of “less is more” can be found in several movements to help make the veterinary experience better for cats (e.g., Cat Friendly Practice, Fear Free and Low-Stress Handling programs). I feel like I should mention that “scruffing” or the restraint of cats by holding the skin of their neck is NOT what was tested in this study. I bring this up because scruffing is a commonly used method of restraint that is considered outdated and a bit  controversial, and unfortunately I know of no research to condemn or condone its use. Two studies (here and here) did not find strong evidence for aversive responses to a handling technique called “clipnosis” or pinch-induced behavioral inhibition in cats, which is sort of similar to scruffing. Regardless, the consensus is that cats should never be LIFTED by their scruff.

And, when we teach cat handling at the veterinary school, the messages that we try to leave in the student’s minds are, “do you automatically default to heavy handed techniques, and if so – why?"  and “EBYs (Even Better Yets)” – what can we do better next time?

References

Moody, C. M., Picketts, V. A., Mason, G. J., Dewey, C. E., & Niel, L. (2018). Can you handle it? Validating negative responses to restraint in cats. Applied Animal Behaviour Science204, 94-100.

Moody, C. M., Mason, G. J., Dewey, C. E., Landsberg, G. M., & Niel, L. (2019). Testing two behavioural paradigms for measuring post-handling cat aversion behaviour. Applied Animal Behaviour Science210, 73-80.

Nuti, V., Cantile, C., Gazzano, A., Sighieri, C., & Mariti, C. (2016). Pinch-induced behavioural inhibition (clipthesia) as a restraint method for cats during veterinary examinations: preliminary results on cat susceptibility and welfare. Animal Welfare25(1), 115-123.

Pozza, M. E., Stella, J. L., Chappuis-Gagnon, A. C., Wagner, S. O., & Buffington, C. T. (2008). Pinch-induced behavioral inhibition (‘clipnosis’) in domestic cats. Journal of Feline Medicine and Surgery10(1), 82-87.