During visits, it is typical to examine the vital signs: heart rate, respiratory rate, temperature, and pain. However, a fifth vital sign, nutrition, is also a key component of overall health. Photo courtesy Hill's Pet Nutrition How do you provide essential care for a senior cat with chronic kidney disease, with fear-based behavior at veterinary visits that escalated to the point of expulsion from her previous clinic? This 16-year-old feline, potentially suffering from arthritis and exhibiting extreme sensitivity to having its feet touched, presented a challenge: the need for monthly claw trimmings while also protecting its physical and mental well-being. This scenario, familiar to many veterinary professionals, highlights the critical need for innovative and compassionate approaches to feline healthcare. State of feline care Although an estimated 74 million domesticated cats are in the U.S.,1 only 40 percent receive annual veterinary care, compared to 82 percent of dogs,2 according to the Hill’s Pet Nutrition 2025 World of the Cat Report. The stress associated with veterinary visits can significantly hinder cats from receiving necessary healthcare. Despite this challenge, feline medicine is experiencing a period of rapid growth, driven by increased research into cat-specific diseases and the dedication of feline-focused programs, such as International Society of Feline Medicine (ISFM)’s Global Cat Friendly Clinic program and Feline Veterinary Medical Association (FelineVMA), formerly the American Association of Feline Practitioners [AAFP])’s Cat Friendly Practices, which aim to create environments more sympathetic to feline patients and their owners.3 Staying current with these advancements in feline-specific practices, resources, treatments, and nutrition requires a thoughtful commitment to continuous education and training. However, the resulting improvements in patient care, potential for increased client satisfaction, and anticipated positive business outcomes make the investment worthwhile. Struggles of cat visits Many aspects of veterinary visits can be inherently stressful for cats. Their natural survival instincts, including a heightened awareness of danger and a tendency to conceal illness, are often amplified in the unfamiliar environment of veterinary practice, triggering fear, frustration, and even pain.4 Veterinary-related stress can induce a range of physiological responses, from changes in leukogram and biochemistry results, to elevated cortisol levels and altered behavior, potentially skewing test results and complicating accurate diagnosis.4 This stress extends to owners, who may experience anxiety related to transporting their cats, witnessing their distress, and managing the financial burden of treatment. To overcome these challenges, improve client retention, increase the frequency of annual visits, and enhance the quality of care and client education, veterinary practices should consider adopting cat-friendly strategies. The stress of veterinary visits can keep patients from receiving the care they need. Photo courtesy Hill's Pet Nutrition Rise of cat-friendly practices While the exact number of feline-exclusive veterinary practices and specialists remains unknown, their numbers gradually increase. In the U.S., there are currently 46 American Animal Hospital Association (AAHA)-accredited cat-only practices.5 Feline specialists are even less common, with only 84 active American Board of Veterinary Practitioners (ABVP)-certified feline practitioners nationwide as of 2023.5 Practices do not have to be “cat-only” to be “cat-friendly.” The Cat Friendly Practice (CFP) program, licensed by the FelineVMA, provides a framework for veterinary practices to create a less stressful environment for cats and their caregivers.3 The CFP program is designed to improve the quality of care for feline patients by enhancing the clinic environment and overall experience. It offers four certification levels: practices, veterinarians, veterinary professionals, and veterinary advocates. By the end of 2023, 880 practices achieved CFP certification, with an additional 355 actively pursuing the credential.4 The CFP program utilizes a 130-point online self-assessment checklist covering 10 key areas, including staff training and continuing education, feline handling and client interactions, boarding and hospitalization, surgical equipment, dentistry, diagnostic imaging and individualized preventative healthcare.6 A significant advantage of the CFP program is the accessibility of its techniques and criteria, which emphasize practical, low-cost adjustments such as refining handling techniques, optimizing room layout, adapting to the cat’s comfort level (e.g. examining on the floor or in their owner’s arms), adjusting room preparation to reduce traffic in and out of the clinic space, and individualizing treatment plans. The CFP website also offers a database of case studies and online resources to support implementation. Practices or individuals considering CFP certification should evaluate the training time and the potential benefits of increased client loyalty and revenue. Business and standard of care outcomes Studies have demonstrated CFP clinics’ positive impact on patient care and business performance. The Journal of Feline Medicine and Surgery reported that CFPs experienced higher mean visits per year per patient, performed diagnostic testing at 12 percent more clinical visits, generated higher annual revenue per feline patient (both for all visits and visits including diagnostic testing), had higher instances of patients undergoing bloodwork or urinalysis and identified a greater number of cats with clinical findings.4 Data from existing CFP clinics indicate that clinics following the guidelines experience improved client preparedness and satisfaction, reduced stress during visits, increased client retention, and more frequent feline patient visits, with clinics reporting an average revenue increase of 81 percent.2 While the primary motivation for adopting CFPs should be to enhance the standard of care, this data demonstrates the potential for mutually beneficial outcomes regarding business performance and client experience. Importance of feline-focused nutrition The rapid evolution of feline medicine is transforming clinical practice, leading to improved management of conditions.2 During visits, it is typical to examine the vital signs: heart rate, respiratory rate, temperature, and pain. However, a fifth vital sign, nutrition, is also a key component of overall health. For example, feeding certain therapeutic diets can dissolve bladder stones, reducing the risk of life-threatening emergencies. Ultimately, effective feline care requires a feline-focused approach. From managing diabetes to addressing kidney disease, feline-specific research and solutions differ significantly from their canine counterparts. By prioritizing nutrition and understanding the unique needs of feline patients, veterinary professionals can provide more comprehensive and effective care. Lisa Restine, DVM, DABVP (Feline), began practicing feline medicine upon graduation at a cat-only practice in San Antonio, Tex., and achieved board certification with the American Board of Veterinary Practitioners in feline medicine in 2020. Dr. Restine has been part of the Hill’s Pet Nutrition team since October 2023 as the Feline Professional Veterinary Affairs Manager. She continues to work with veterinary healthcare teams and pet parents on a global scale to educate and improve the health and well-being of cats. References “U.S. Pet Ownership Statistics.” American Veterinary Medical Association, 2024. https://www.avma.org/resources-tools/reports-statistics/us-pet-ownership-statistics. Little, Susan, Alexandre G.T. Daniel, Elaine Wexler Mitchell, Debra F. Horowitz, Ashlie Saffire, Julie A. Churchill, Erin Dresner, Petra Černá, Angelika Drensler, Lisa Restine. “World of the Cat Report 2025.” Hill’s Pet Nutrition, 2025. https://na.hillsvna.com/en_US/resources-2/view/244. “Cat Friendly Practice® Program.” Feline VMA, March 10, 2025. https://catvets.com/cat-friendly/cfp/. (30) St Denis, Kelly, Ashlie Saffire, Helen Michael, Corie Drake, and Wade Burton. “Cat Friendly Practice Improves Feline Visits, Resulting in Increased Laboratory Testing and Increased Diagnosis of Certain Common Feline Conditions.” Journal of Feline Medicine and Surgery 25, no. 11 (December 2023). https://doi.org/10.1177/1098612x231204199. Singler, Emily. “The Cat-Only Practice.” AAHA Trends, August 1, 2023. https://www.aaha.org/trends-magazine/august-2023/f2-the-cat-only-practice/. “How to Get Started.” Feline VMA, February 13, 2025. https://catvets.com/cat-friendly/cfp/getting-started/.
