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Figure 4.5 Tender hold during physical examination.
Source: Courtesy of Kara M. Burns, LVT, VTS (Nutrition).
Using recumbent restraint is necessary for many procedures. Procedures such as drawing blood from a cephalic or jugular vein, administering an IV injection, oral and ophthalmic examination, and administering medications are a few of the procedures that warrant restraint in sternal recumbency. In this kind of restraint, the health‐care team member places one hand under the neck or muzzle region of the dog and the other around the hindquarters and pulls the dog in close to their body. If the dog is trying to scratch with its front paws, the team member can remove the arm from around the hindquarters and wrap it around the abdominal area with the hand coming from the underside of the dog to the front legs. The front legs should be grasped slightly above the carpal area.
Placing a dog on its side will allow for restraint in lateral recumbency. With the dog on its side, the front legs are held while the team member places one arm across its neck. The other hand is used to hold the back legs. This is a useful restraint for urinary catheterization, radiographs, suture removal, and for access to the lateral saphenous vein.
Restraint in dorsal recumbency calls for two team members. The dog is placed in lateral recumbency and is carefully rolled onto its back. The front paws are extended cranially with the back paws extended caudally. This exposes the thorax and abdomen of the dog. A V‐trough or foam wedges may be necessary to prevent the dog from rolling. This technique is often used for radiographs or cystocentesis.
Feline
Prior to their domestication, cats were known to be solitary animals that follow an organized social structure. Cats are also known to be very territorial. In today’s society, cats often live indoors and with other cats. Cats can and do get along with other cats, but they have a vast array of communication behaviors of which the health‐care team should be well aware. Some of these behaviors are listed below.
Body posture of a feline
Relaxed – the cat walks with its tail down, but its tail will rise when it greets other cats and humans it knows.
Fear aggression – the tail will be held close to the body and oftentimes will be fluffed (to give the appearance of being bigger). The pupils are often dilated.
Aggression – the ears are swiveled, displaying the inner pinnae sideways, and the pupils are oblong.
Frightened – the dorsal area will be arched and the tail raised. Again, the fur along the back and covering the tail will be fluffed to give the appearance of being larger and more intimidating.
Facial expressions of a feline
Relaxed – ears are upright, whiskers are on the side of the face, pupils of eyes are moderately dilated (Figure 4.6).
Aggressive – ears are erect and facing back; pupils are constricted.
Frightened – ears are flat against the head, whiskers are held stiffly out to the side, and the pupils are dilated.
Conflicted – ears will alternate between the flattened and turned‐back position.
Alert – pupils are dilated, and whiskers are tensed.
Figure 4.6 Relaxed cat facial expression.
Source: Courtesy of Kara M. Burns, LVT, VTS (Nutrition).
For cats, scratching is a visual sign of territory ownership. The cat marks the area with the glands present around the paw pads. Scratching leaves a visual sign of territory ownership and maintains the claws.
Vocalization
Meows – expression of needs to owners (often associated with feeding).
Loud yowls – typically heard from queen in heat.
Growling – range in volume; often in conjunction with aggression or fright.
Purring – humans generally believe this is a sign of contentment, but it can also be a sign of low‐grade pain.
Other feline body language
Glands on facial area – the cat deposits secretions when it rubs itself on an object to be marked.
Urine – sprayed by male cats at the height of the cat’s nose, to mark territory for the next cat coming to the area.
Feces – the cat may bury or leave feces to alert other cats to its territory.
When the veterinary health‐care team is working with a feline patient, it is advisable to perform procedures quickly and efficiently. It is in the best interest of the patient and the team to avoid repeating procedures. If restraint is needed when working with felines, the team should start with the lowest amount of restraint necessary to finish the procedure quickly and efficiently. Should the cat begin to resist the restraint, the grip should be tightened only until control can be maintained. If the cat continues to resist, it should be released and other restraint options (i.e., chemical) should be discussed. Prior to releasing the cat, it is imperative that all team members know that the restraint is being slackened. One should attempt to relax the cat prior to restraining it through the use of touch (petting the cat) and voice (speaking to the cat). The cat is in an unfamiliar place surrounded by people it does not know. Kindness goes a long way! Rough handling and extreme restraint should never be used in the handling of cats, and cats should never feel as though they are fighting for life.
When cats become aggressive, the potential is high for them to use their claws and teeth. The teeth can leave deep puncture wounds that have a high risk of becoming infected. Also, cats are able to move in any direction. When the health‐care team members think they have control, the cat may contort itself into an unexpected position. When cats are restrained, all doors and windows in the hospital should be closed to insure the cat will not escape from the building.
Restraint
When restraint of a cat is indicated, one of the best tools for the health‐care team to have readily available is a large towel, which can be used to wrap the cat’s body securely (Figure 4.7). It also allows for wrapping, and thus controlling, the cat’s body, feet, and claws. For femoral or cephalic vein exposure, or if an IM injection is warranted, a front or back leg can be held outside the towel wrap. Also, the towel wrap restraint allows for oral or ophthalmic medications to be given without risk of the cat scratching a health‐care team member. Some health‐care teams have found that simply covering the head of the cat (paying careful attention to insure the cat can breathe) calms the cat down and enables them to perform procedures. Whichever method is used, insure that all team members involved are in agreement with the restraint plan.
Another tool that is very beneficial when cat restraint is needed is the cat bag or feline restraint bag (