Cat Restraint Methods

General
Every cat is different. Cats do not respond to voice commands very well. There is no dominant-submissive behaviour in the cat world. Cats are not pack animals. The point of cat restraint is to come to a place of compromise. Push the cat just far enough to do what you need to do. Adjust your technique to meet the cat's temperament. Most cats are not particularly comforted by human touch. But if cat seems friendly can start with extending a hand to it. Then petting all the way down the back firmly, or rubbing its cheeks. Can turn a bad cat friendlier.

The Minimum Person Rule
One person should be in charge of the cat. This person is in charge of deciding whether the cat wants to be petted or just kept on the table. No one else should interfere unless first person's safety is at risk or they are uncomfortable with the situation. Often when working with a cat we may reach a point where the cat is struggling and we are unable to get anything done. Give the cat a break. Stop the procedure. Hands off except to keep the cat on the table. (Possibly return to kennel, but see the 'cat and kennel' rule.) During time out do not touch the cat except for the one person as above. Back off. Cats do not like to be ganged up on. Never restrain a cat until the other person is completely ready. Allow the cat a break when nothing is going on. Cats do not like to be cornered or feel fully restrained.

Distraction
- Pen in front of face (gives something to bite besides your fingers)
- Pen tapping
- Funny noises - clicking, kitty-kitty
- Lightly blowing on face (usually works well so cat doesn't realize what's happening. Drives some cats crazy so note how cat is responding)
- During vaccines - a scratch somewhere else
- Head tapping

Scruffing
A common cat restraint method is to hold it by its scruff. It is not painful for the cat and it triggers a reflex to pull its hind legs up (like carried by its mother). However, it will likely upset the cat, so should not be the first technique used. It is also not very good when someone has to deal with the front of the cat ie. blood collection. Hold the head instead. It can be useful in transporting an unhappy cat. Remember to keep a hand under its hind end especially if fat. Not to be used in front of owners without warning. Use this when it seems to be the most appropriate method.

Leather Gloves (Gauntlets)
Useful for cats in some situations. Cat can still bite through gloves so be careful. May make cat more aggressive but offers you some protection. Might be able to pin a cat using gloves. Don't have any fine motor control of your fingers through heavy gloves. If using gloves and towel to remove a cat, may remove the gloves when doing the actual procedure.

Minimalistic
The key to cat restraint is the minimalist technique. If you are in danger from the cat more forceful methods are applied as needed. But always start minimal to avoid a quick progression to the dangerous cat stage. Never start with the level of firmness that you would with a dog.

Different Cat Personalities

'Do Anything to Me' Cat
Is a rare cat in the vet clinic. A cat may be like this at home but rarely do cats remain so easy-going in the vet clinic. Always use minimal restraint to avoid it turning into a bad cat.

Friendly-Unfriendly Cat
Many cats. May appear friendly, want to be petted but turn bad quickly when procedures are started. Pet this kind of cat - nails to rump or face in order to keep the situation as peaceful as possible. Minimal restraint.

Too Scared to Move Cat
Also common - acts good, but does not respond to petting. Appreciate this cat's cooperation by keeping procedures as short as possible. Minimal restraint - don't scare it more than it already is.

Bad Cat
Many - May need to apply a firmer technique - scruffing, blanket, two people, cat bag, etc. Still, just to keep everyone safe - no more restraint than necessary. Always carry this cat with its face and claws pointed away from you. Can scruff, and hold hind legs to prevent raking.

Extremely Bad Cat
Feral, trying to escape, almost impossible to deal with - various techniques - cat gloves, 'Lil Bugger Bag', sedation. Only someone experienced with fractious cats should be restraining this cat.

Dealing with the Cat in the Reception Room
Keep in carriers. Don't let out around other animals. Weigh in examination room. Horizontal blinds - don't have down for cat appointments. What other pets in the reception area - dogs or male Tom cats?, what type is the clinic front door? Does one door open right to the outside? Worry about degree of fear the cat may already have. What are your plans to recapture a cat should it escape from its owner?

Cat Harnesses
Cat collars - if go outside should be 'breakaway' or a little loose. Shouldn't be alone outside with a harness.

Removing Cat from Carrier
Once cats are in the practice, it's best to allow them to come out of their carriers on their own terms. In many cases, cats may remain couched inside, a common sign of fear. To reduce stress, it's best to remove the top portion of the carrier in order to have access to the cat rather than reaching in and pulling the cat out. In some cases, the cat can be 'dumped' out of the carrier onto the table, but again, this can be stressful for the patient and alarming for the owner to see. Use a calm voice at all times. Remember that any time you reach into a carrier to pull a cat out, you risk a scratch or a bite.

Returning Cat to Carrier
These last photos show how a cat can be returned to its carrier. In most cases, a frightened cat will gladly return to the safe confines of hits carrier. Simply open up the door to the carrier and allow the patient to walk (or run) in.

Putting Cats into Cages/Kennels
CARRYING CATS
Cats feel secure when they are in small quarters.
Best way to carry a cat is in its carry-kennel/box. When carrying the hind quarters are placed under the elbow area and pressed securely to your body with your forearm. (like a football) The cat will be in sternal against your forearm while the front legs are held in one hand (with you finger between the legs)
 - Always be ready to scruff the cat - 

Good Cat
Set up cage with blanket, litter first. If in carrier - dump cat in cage. May need to reach in and pull cat out by the scruff. Do in kennel room if possible, or close to cage. Or in exam room. This is when cat is likely to bolt. Once have good control of cat put into cage. Partner cat dump. One person holds carrier and the other pulls the cat out. Be very careful not to catch nails or feet in the carrier. Reach in and feel for the feet.

All Other Cats
Similar to above but use thick towel or blanket or gloves. If cat removal not necessary can use a larger cage and just place whole carrier inside - open carrier door so cat can go out or eat as necessary. If drop-off and will be looked at soon, may not need to be removed from carrier until time of appointment.

Cat in the Kennel Rule
Whenever you put a cat into a cage (vet kennel) it will become more aggressive. Avoid placing cat into kennel repeatedly or unnecessarily. Easier to watch cat on the table for 5-10 minutes, rather than being unable to retrieve cat from cage afterwards. Group procedures together when possible.

Removing Cats from Cages/Kennels

Good Cat
Do not pick up as you would at home - even if it is your own cat. Try to turn head away from you. Cat is less likely to rake with hind claws. Control head - various methods, and support body. Depends on cat. A few are really good, but it is rare. Scruff and hold back legs is safest, least stressful way.

Medium Cat
Blankets work well. What does not work well is jerky start and stop movements. If the cat knows you're scared it won't work. Just reach in and pick up cat. Some cats are just 'talkers'. Don't let a hiss or growl dissuade you. Can use cat gloves but may have less control. Have as many doors closed as possible. Scruff cat.

Really Unfriendly
Back-up and have doors closed. These cats will run right by you. Make sure your friend is good at grabbing running cats. Practice reflex skills. May use a net-bag ( Easy-Nabber ). Bag on sticks can allow you to nab a cat. Can give injections through the net. Can give a cat an injection in a kennel. One person will pin the cat in the corner, and the other will give injection in hind area of cat.

Cat Bags
Cat bags are good depending on how fat cat is, and how easy to get it into the bag in the first place. Prefer the 'place cat on top of bag' method. Make sure other opening zippers are closed before cat goes into bag. Restraint bags can be used to restrain cats as well as small dogs. The bags are made of canvas or nylon, with a hook or other type of fastener at the neck opening and one or more zippers (or strips of Velcro) to allow selective exposure of a body part. Instead of a restraint bag, a heavy towel or a pillow case can be used to wrap the cats body, leaving the head exposed but are not nearly as effective as a bag. The open bag is draped over the cats back and the neck closure is fastened. The neck fastener should be tight enough that the cat cannot insert a front foot through the neck opening. The cat is turned on its back or held off the table so the longest zipper can be zipped. As you close the zipper, take care not to catch the cat's fur in the zipper. The cats feet are now restrained so that you can work with his/her eyes, ears or give medication. Zippers are strategically placed around the bag to allow selective exposure of a body part. This is useful when trimming toenails. A second method is to get the cat to lay on the bag, then pull the sides of the bag around the cat and zip over the back. This method is less effective as the cat often tries to stand as you zip the zipper. The cat is placed in a laying position on the bag. The sides of the bag are pulled up over the cat's back. The zipper is pulled closed, taking care not to catch the cat's fur in the zipper.

Wrapping or Toweling a Cat
Easier than cat bag if done well. Wrapping your cat with a towel is a good way to restrain it for ear cleaning. In essence you will be wrapping it like a burrito. For cats in general the less restraint the better- let the towel do the work. Put a large towel on a table and put your cat towards the front end of this towel. Bring each side of the towel over the cat and leave only the head and tail to stick out. Bring the back, unfolded section of the towel over the front just up to the back of your cat's head. Finish the 'burrito' by wrapping the towel under each side of your cat. The only thing sticking out of the towel at this point is the head. Hug the cat gently to you with one hand and you will have your other hand free. Besides cleaning ears this restraint technique enables you to administer oral or topical medication. A heavy bath towel can substitute for a restraint bag. The cat is snuggly wrapped in the towel covering all 4 feet. The bag can be held closed or pins or clips can be used to keep the towel in place. The head is free to allow you to work with the cat's eyes, ears or to give medications.
One foot at a time can be pulled out from the towel restraint for toenail clipping.

Stretching a Cat
Works well for not so good cats. Stretch between scruff and hind legs. Don't do in front of an owner. Good for injections and cat shaving. Let person know if your hands are cramping up or you need to re-grip. Good for X-rays alone. Cats can be restrained in lateral recumbency using the 'stretch' method, holding the scruff of the neck and the hind legs. It is more difficult for the cat to get a hind limb loose from the grasp of the holder if the legs are held between different fingers of the same hand rather than both legs grasped together.

Cat Muzzles
Muzzles used for cats are called hoods and cover the end of the face and the eyes. The end of the muzzle is open for easy breathing. The cat is often less apprehensive about having its ears or feet handled if they cannot see. The top of the hood that is placed over the top of the cat's face is wider than the bottom.

A cat hood can be made using a paper cup and a ribbon or string. Cut off the bottom of the cup. Punch 2 holes on opposite sides of the lip of the cup. Tie 2 pieces of string or ribbon through the holes. Place the cup over the cat's nose and eyes and tie the strings together behind the cat's ears. You can tie the strings in a bow or in a knot and have a scissors handy to cut the string to remove the hood. The bottom of the cup should extend 1/2 to 1 inch beyond the cat's nose. The cat can easily open his/her mouth.

Routine Cat Procedures
 

For PE
Usually we start with just keeping the cat on the table. Hold front legs (pilling technique) while the vet is looking at head so they don't get scratched. (Your job is to protect the vet and/or client). May hold head a little while vet is listening to heart, feeling abdomen. Sometimes the vet will hold cat themselves while doing this. Taking rectal temperature - good hold - be prepared for squirming. Scruff cat or hold head. Hand on back end to avoid squirming. May also pin cat in sternal. Start by putting the cat on a table while talking in a soothing voice and petting it. Hug the cat to you with one hand while simultaneously holding its head and neck gently with your other hand. This method works well with many cats. If the cat uses its front legs to push your hands away you can solve this problem by holding the front legs, always with one of your fingers between the legs.

For Blood Collection
Minimize the time cat is actually restrained. Use minimal technique. Not a little dog. Usually stay stiller with less restraint whereas dogs stay stiller with moderate restraint.

Venipuncture of the Cat
The same techniques for placing cephalic and jugular catheters as described for the dog, are applicable to the cat. In addition, there exist some procedures that are more commonly used to venipuncture the cat.

Cephalic Vein (Front leg)
Vein is in same place as dog vein. Vein holding technique is the same. Reach over top of cat and roll vein and push elbow forward. Sometimes it works to release pressure slightly and then hold off again. Only if vet or tech tells you to. Otherwise maintain the pressure on the vein. Ways to hold head: Don't scruff as cat may be able to bite person collecting blood as they are close to cat's head. Hold head from underneath on either side of neck (don't obstruct neck). Or with one finger over nose. Hold off vein afterwards. Release cat's head when holding off vein unless cat really upset. Sometimes can pick up whole cat and hold it and thus able to keep pressure on front leg.

Jugular - 3 Methods
In sternal: hold front legs over the edge of a table. Cats are small so basically front of cat needs to be in one straight line to allow collector room to maneuver. Use hand closest to edge of table to hold feet. (Have a finger between the feet.) Hold cat's body pressed between your other arm and your body. (Can do hands either way depending on comfort and vein to be collected from.) Hold head as for cephalic, but must be stretched up a little. May need to adjust head until collector can see/feel vein. Hold head on right side for left vein and vice versa. Hand will always be sort of the in the way. Minimize this by finger placement.

Sideways: preferred method for some cats and some collectors. Cat feels more secure. Must have cat with side up that vein is to be used. Usually you just hold the head and front legs. Possibility of getting raked with back legs, but a second person holding on to the back legs might aggravate cat further. Must think about which method is more risky for your comfort level.
(If cat rakes you, and sticks claws into you, try not to move. Gives cat something to grip and you may get scratched more if you move.)
Once blood is collected allow cat to sit up normally while you hold off vein (collection area).

Similar hold - usually head and feet, in dorsal recumbency. Depends. Maybe hold body while collector holds head. Not used that often depending on clinic. A canvas or nylon, zippered bag can be used to restrain a cat for jugular venipuncture or catheter placement. Some bags have multiple zippers to allow access to limbs. The cat is held in dorsal recumbancy. The holder places a finger in the thoracic inlet to impair venous return from the head and cause the vein to distend with blood. The venipuncturist holds the head with one hand and makes the puncture with the other hand.It is possible to sample the jugular vein of a cat without a holder, using a cat bag and a tourniquet. A piece of soft rubber tubing can be used as a tourniquet to occlude venous return, resulting in venous engorgement. A hemostat is used to pull the tubing tight on the neck. The amount of pressure applied is similar to the amount of pressure applied when digitally occluding the vein. If you are right handed, use your left hand to position the head. If the cat's head is at the edge of the table, you have the most flexibility in manipulating the position of the head. Put approximately a 20 degree bend on the needle, bending it with the sterile needle cap before making the puncture. After completing the venipuncture, open the jaws of the hemostat to relieve pressure on the vein before the needle is removed from the vein. Failure to do so results in hematoma formation.

Femoral (Medial Saphenous) Vein (Back Leg)
The back leg vein used on cats is the femoral vein ( = medial saphenous). On inside of leg. Usually collect blood around area of tibia. Very small, easily damaged, but very visible.
Not moving is very important - usually this works best with minimal restraint.
Good cat -- one person method - may feel very insecure to you but if cat is allowed to move its head it is less likely to realize its legs are being restrained. Hard restraint usually results in more wiggling. Not likely to bite or scratch.

Method A - Take the scruff of the cat's neck in one hand, grasping as much of the loose skin as possible along the neck. Grasp high up between the ears, or the cat may be able to turn her head and bite.
Wrap the fingers of the other hand around and through the cat's hind legs. Gently stretch the cat out by separating your hands. Brace the cat's back and neck firmly against your forearm.
The hand holding the hind legs can then be used to hold the top leg and tail out of the way, while the person performing the venipuncture pulls out on the leg closer to the table.
Pressure placed vertically on the inner thigh will occlude and raise the femoral vein.

Method B -- With one hand, place arm over the cat's neck and hold both front legs
(especially the bottom one - same as a dog in lateral). With other hand tuck top leg behind wrist and hold off vein by placing fingers under the leg and thumb across top of leg as close to body as possible to allow maximum room for blood collection.
Cat is allowed to look around. And back leg usually stays in place.
Afterwards, hold off collection area for long period of time - bleeds a lot. Usually scoop up the cat while keeping pressure on leg.
Always check for bleeding and cleanliness before cat goes back to owner.

Arm 'over top' of neck method

Restraint Position: Lateral recumbency on table. One hand (one with watch) is used to occlude the vessel at its most proximal location (femoral triangle). The opposite arm/hand of person providing restraint is used to control the head and front legs. Distal line is at the level of the stifle joint.

Bad cat -- two person method - If cat is not good, recommend going directly to two person method instead of holding cat like a dog.
Two person - One person holds the head and front legs, and the other holds the top hind leg and occludes the vein as well. Good for people, not so good for cat.
This is a good technique for bad cats as you can cover the head with a blanket, or wrap the cat up and be far away from dangerous parts during blood collections and injections.

IV Catheter
Similar to dog. Must be very still. So whatever works. May wrap cat or have someone hold back end and legs to avoid raking. Same as for dog when to release pressure on vein, though may not have a lot of blood pressure so make sure they know if you have released pressure so they don't think it's not in the vein. Less likely to bleed all over.

Removing IV - hold head or scruff and push elbow forward - keeps other person as far from teeth as possible. Very difficult if cat is bunching it's leg up.

Nail Trim
Hold cat whatever way allows access to paws - like dog, or just in arms, or if bad, wrap in blanket and extent one foot at a time. Hold the cat's paw in your hand with your fingers on the underside & your thumb on the top. Gently apply a forward pressure to one toe. This causes the claw to come out of the sheath, which makes it more visible. Notice how in the middle of the claw is pink, this is the quick & it contains blood & nerves. This must NOT be cut as it will cause pain & bleeding. If you do accidentally cut this, apply a styptic pencil to the claw to stop the bleeding. If you don't have a styptic pencil ordinary household flour will do. The claw should stop bleeding in about 5 minutes. Don't forget the dewclaws on the side of the paw. They don't touch the ground and may need more frequent trimming.

Anesthetic Induction
If masking down - best to wrap cat. Cats are good fakers - careful when unwrapping - usually just pull out a back leg first to see how stiff it is. IV injection similar to dog. If really bad get two people and use back leg. If they want help intubating is same as for a dog. Feral cats or really bad cats are often placed in induction chambers. Make sure room door is closed when dumping into chamber.

Restraint for Euthanasia
IV injections similar to dog. Whatever vein is used, just release pressure once there is flash of blood, but continue to push leg forward (whether front or back leg) during injection. Hopefully will tranquilize cat if it is really bad so in front of owners won't be too bad. Either front or back leg for euthanasia.

Restraint for Pilling
Hold body and front legs, with a finger between legs.

How to Give a Cat a Pill
These directions are for a right handed person. The cat will want to back away from the pill so hold him in the crook of your right elbow so that he has nowhere to go. The pill is held in your left hand. With your right hand, take the cat by the cheeks and lift his nose to the ceiling. His mouth will automatically drop slightly open. You are grasping his zygomatic arches (bones) for a firm grip. Use a finger of your left hand to open his lower jaw wider. He has no strength in the lower jaw in this position and cannot bite. Place the pill as far back as possible into the mouth. Let the cat's face go and watch for lip licking motions which usually indicates that the pill has been swallowed. Some cats are good at deception so it is a good idea to open the mouth after a moment to see if the pill has been swallowed.

Mistakes to Avoid
- Do not try to approach the cat from the front. He will back away from you and escape. Your body should be behind the cat, with you and the cat facing the same direction.

- Do not try to give the pill with the cat's head in a natural position. You will be bitten. You must hold the cat's head vertically at about 450 in order to be successful.

Don't forget to check the cat's mouth before releasing him. Many cats know you are waiting to see the licking motions and will try to fool you. If the pill is still present in the mouth when you check, just reach a finger in and tip the pill further back on the tongue or allow the cat to spit the pill out and begin again.

Giving Oral Medications to a Cat
Medications for oral administration may be in pill, capsule or liquid form. Hold the cat's head from the top using your left hand if you are right-handed. The cat's check-bones (called zygomatic arches) provide a convenient handle by which to hold the head firmly without causing the cat any discomfort. Tilt the head back and the cat will often drop their lower jaw open. Hold the pill or capsule in your right hand between your thumb and index finger. You can place one of the remaining fingers on your right hand on the lower incisors to keep the lower jaw open. Keep your finger over the small incisor teeth NOT over the sharp fangs (canine teeth). Drop the pill or capsule as far back over the tongue as possible, then immediately close the mouth and blow on the cat's nose which will encourage them to swallow. If the cat does not open their mouth when you tilt back the head, holding the pill as before between the thumb and index finger... use the middle finger of the same hand holding the pill or capsule, to pry open the lower jaw. Place your middle over the small incisor teeth NOT over the sharp fangs (canine teeth)... ...and pull open the lower jaw.
Keep the middle finger in place to hold the lower jaw open (3), then either drop the pill or capsule as far back on the tongue as possible or the index finger (1) and thumb (2) can be used to push the pill over the back of the tongue. .

IMPORTANT: If you use your thumb and index finger to push the pill over the base of the tongue, your fingers will be inside the cat's mouth and you must work rapidly to avoid getting bit. Close the mouth and stroke the cat's neck or blow sharply on his/her nose to encourage the cat to swallow.

Using a Pilling Device or 'Pilling Gun'
There are several styles of pilling devices that can used to place a pill or capsule over the base of the tongue so that you do not have to place your fingers in the cat's mouth. There are several ways to hold the pilling device. You can hold the device between your thumb and middle finger, either with the index finger positioned to 'push' the trigger or to prevent premature release of the pill, you may move the index finger to push the trigger just before dislodging the pill in the back of the throat. You can hold the device between curled fingers and palm either with the thumb positioned to 'push' the trigger or to prevent premature release of the pill, you may move the thumb to push the trigger just before dislodging the pill in the back of the throat. Or you can hold the device between the index and middle fingers with the thumb positioned to 'push' the trigger. Tilt the head back and the cat will often drop their lower jaw open. Insert the pill at the end of the pilling device over the base of the tongue. If the cat doesn't open its mouth, use the middle finger of the hand holding the pilling device to open the lower jaw. Insert the pill at the end of the pilling device over the base of the tongue. Push the plunger on the pilling device with your thumb or index finger to deposit the pill far back in the cat's mouth.

Liquid Medications
Liquid medications are given in a pouch between the teeth and cheek (the cheek pouch). The medication is quickly squirted into this pouch, the mouth is held closed and the neck stroked or the nose sharply blown on to encourage the cat to swallow. Liquids are more likely to accidentally enter the windpipe compared to pills or capsules. To avoid the cat inhaling liquid into the windpipe, DO NOT tilt the cat's head backward.