Dr. Angie Krause (00:02)
Welcome back to  of Truth, where we tell the truth about veterinary medicine. I'm Dr. Angie, and this is my co-host and veterinary nurse extraordinaire Jojo. And today we are going to talk about spicy kitties, also known as fractious kitties.

JoJo (00:20)
Spicy is so much more fun. Yeah.

Dr. Angie Krause (00:22)
That's so much more fun.

Do you think if you were a cat, you would be a fractious cat? No. Okay. You go catatonic. totally. Don't you think I'm like a

JoJo (00:28)
No. Sadly, I'd be the loaf. ⁓ Would you be a spicy cat? I have

such envy. I wish I were like had orange blood in me. Just.

Dr. Angie Krause (00:41)
Well, I don't know if I have

the orange blood, but I probably have like some Calico or tortie something. You'd be an amazing patient.

JoJo (00:45)
No, I'm so passive. I'd probably be ragdoll all the way.

yeah, for sure. I am as a human, so I think that would translate to a cat.

Dr. Angie Krause (00:57)
Yes, you know what? I'm a good human patient too. I've never bitten anybody. ⁓

JoJo (01:02)
Like the bar is so low. I have scratched. I scratched. Yeah. Okay. Well anyhow. Yes.

Dr. Angie Krause (01:05)
The Mars, so.

You've scratched? Okay. Well, maybe you're more fractious than we think. So

fractious kitties are kitties that could be nice at home or otherwise friendly, but when they get to the veterinarian or when they're restrained or we're trying to give them injections or get their blood become violent. Let's say violent.

JoJo (01:33)
climbing the wall eat your face off kind of violent

Dr. Angie Krause (01:38)
Yeah, well, I there's such a spectrum

of violence. You have some cats that are just going to give you a swat. You have some cats that are going to bite you. You have some cats that are going to just absolutely attack your face. I think that is so rare. Like I so rarely interact with a cat that's going to retaliate. That's going to come at me. Like usually if you go hands off, they're going to, you know, they want to retreat, but sometimes they'll have cats that just come at you.

JoJo (02:03)
Yeah. Do you remember that cat that would just attack under the table? Like if you're even if you're sitting there, they would get the back of your leg.

Dr. Angie Krause (02:13)
⁓ no, did they attack my 

JoJo (02:15)
Anybody anybody that came

in they're like just watch your legs

Dr. Angie Krause (02:21)
know

Jojo and I have been in some kind of terrifying house call situations together. I don't even remember that.

JoJo (02:25)
with cats. ⁓

In the kitty bag, this one I remember, this was the one that we had to get into this kitty bag, which was an amazing tool. And amazing that the guardian was like, Hey, let's use this tool. But it was a bag in which the cat was very restrained, but we could access parts of the cat.

Dr. Angie Krause (02:30)
yes.

Yes.

Yes. Yes.

Yes. So you get blood and vaccinate this kitty. So they, eventually they started putting her in a bag and I don't even think I needed you at that point because once she was in a bag, I could unzip a leg and vaccinate her or get blood because she was in a bag. And I've seen all kinds of great rolls that are similar to that, that make the cats feel nice and safe. And so.

JoJo (02:47)
Who?

Bye.

Dr. Angie Krause (03:10)
I am a cat person and I usually feel like I can handle these kitties. You have to know when less is more. There are all these different flavors of fractious kitties and some kitties just need to not see what you're doing. So you just put a towel over their head. Some kitties need to just not be handled that much so we can talk about the controversy of scruffing kitties. ⁓ And some cats just need a lot of chemicals sedation ahead of time.

JoJo (03:39)
That is a spectrum. And I think people don't always know until they see their kitty in the situation. Because while your kitty may behave one way at home, and that's the benefit of when we were doing house calls, is we often saw what the person was seeing. Or we saw the kitty that just wouldn't survive in the clinic, like where they were terrified for their life, including on the car ride there. So sometimes people are learning that in the car ride.

Dr. Angie Krause (03:40)
Yeah.

Yes.

yeah.

Yes.

JoJo (04:05)
And then other times they're just like, is happening? think it's, I think it'd be scary to see your cat have that switch flipped.

Dr. Angie Krause (04:13)
Yes, yes. I imagine a lot of people feel apologetic and we never blame. We never blame you if your kitty is, is violent or aggressive with us. And we actually don't really blame your kitty.

JoJo (04:25)
Not really, no. I have admiration for those kitties. mean, their boundaries are so clear.

Dr. Angie Krause (04:33)
Their boundaries are so clear. think, well, I don't know about Fiona. I can vaccinate her at home. But I think that this one has maybe the propensity to be a fractious cat at the vet. I don't know. What do you think, Fiona? Would you do it? Would you do it? Doesn't she just kind of seem like she'd be fractious? Yes.

JoJo (04:50)
You ⁓

Like she could turn without warning.

She's like, I'm so cool and sweet and I am no longer cool and sweet.

Dr. Angie Krause (05:00)
Bye.

Well, and there are certain colors of cats that are more prone to being fractious. Like it's hardly ever a black cat. Hardly ever a black male cat. If it's gonna be a black cat, it's gonna be a black female cat, but usually not. And usually they're orange or calico.

JoJo (05:18)
Hmm.

That's where I was going next, Calico's.

Dr. Angie Krause (05:25)
or tabby, not tabby, tortie, like the tortoise shell or the bengels The bengels will eat your lunch. really? Yeah, they're kind of intense.

JoJo (05:28)
Mm-hmm.

I haven't seen very many of them in practice. Yeah, but,

the orange kitties have a reputation.

Dr. Angie Krause (05:42)
yeah, there's two types of orange kitties, just the orange kitties that are sweet and they're going to do whatever. And then the orange cat that's like, I'm not taking any of what you're serving.

JoJo (05:51)
Do you think there's a difference in the male-female category with orange cats?

Dr. Angie Krause (05:55)
Well, I feel like since most orange cats are male, yeah, I don't know.

JoJo (05:57)
Yeah, do we get it?

Dr. Angie Krause (06:01)
No, don't. Yeah, I don't think I have enough data.

JoJo (06:03)
And no,

I don't either. I'm like, wait, what orange female cats do I remember?

Dr. Angie Krause (06:08)
Yeah. There's only, yeah, don't see him that often.

JoJo (06:09)
So I don't know.

Okay, so how do we really launch this conversation in a way that's helpful for our listeners?

Dr. Angie Krause (06:19)
Well, I

think the most important thing if you have a fractious cat or if your veterinarian has told you that your kitty maybe was difficult or violent or whatever, that chemical restraint is really the nicest thing for everybody involved, including your kitty. And so I like to use Gabapentin. And some people are worried about sedating their cat before they bring them in, but it's actually really, really helpful.

But I've started, there's a lot of cats that gabapentin, if you give that a couple hours before the visit, it's just not going to do anything. They're so mad and so worked up. They're just going to eat through it. And I started adding trazodone on with gabapentin and it's amazing. Gabapentin and trazodone together are rarely used out in the wild and they really should be. It really should be more veterinarian should be doing it. So tell your veterinarian.

JoJo (07:09)
Hmm.

Are you doing the

gabapin trazodone the night before and the morning of?

Dr. Angie Krause (07:18)
sometimes. So it's like, call that the hangover sedation protocol. And that can be really helpful depending on what time your appointment is so that they're hung over from the night before. And so, yeah, I think that's helpful. But usually when I add on trazodone, I don't know that you need to hang it over. It's just so effective. Those kitties are high.

JoJo (07:40)
Right,

most kitties that we've used this with, their people have been so pleased because they've gotten all the care they've needed. It's been a lot less stressful. Everybody's happier, their cat sleeps it off. Yeah, it's... Right. But people are really resistant to using chemical restraint.

Dr. Angie Krause (07:47)
Yes.

Yeah.

Yeah. And they're just high. They're just feeling good. ⁓

Yeah, they really are. they're like, I feel guilty. Or, mean, for some cats, you actually can't because maybe the people, the guardians can't. Medicate their cat. And so it's like, you can get them in pills or in liquid form. And, ⁓ sometimes it's not even possible at home. And that's just, then that's a whole different type of.

JoJo (08:17)
Mm-hmm.

Hmm.

Dr. Angie Krause (08:30)
And those cats, usually what we need to do is we do injectable sedation when they get to the clinic so that they are having some twilight sleep while we're doing whatever we're doing. But that's so rare.

JoJo (08:42)
Well, are you still, it's been a minute since I've seen patients in a clinic. Are they still boxing down cats? So they put them in a, I mean, do you want to describe it or?

Dr. Angie Krause (08:51)
You're not,

yeah, like where they put them in a box and put basically gas anesthetic in the box. No, I mean, it's a bit of a red flag. yeah, like 20 years ago. It's highly frowned upon. One, I think it's too stressful for the cat. Like, can you imagine? No, thank you. Yeah. Yeah.

JoJo (09:03)
Okay, because that used to be standard of care.

Mm-hmm. it looked terrible. It looks so uncomfortable. Like the cat

is just spinning in this little box trying to, you know, until they fall asleep.

Dr. Angie Krause (09:25)
Yeah, no,

I don't think most people are doing that because the thing is if you can get your cat in a box, now we have all these devices where we can just make the box smaller and smaller and then they could get an injection, you know, on the end of a pole. No, I'm just kidding. Like usually there's some way to get an injection in them. I know we have to like dart the cat.

JoJo (09:34)
Mm-hmm.

Sometimes

that feels the safest.

Dr. Angie Krause (09:52)
I know, I know some cats,

but I find that if we can catch cats early in their kind of stress, because at the end of the day, like we can laugh about these cats being violent and wanting to kill us, but at end of the day, like their fight or flight is just activated. Like they're literally fighting for their lives at this point. That's their perception of what's happening. And so if we can reduce their stress with some Gabapentin, some Trazodone, or like we should talk about some better handling techniques.

then usually they don't escalate from visit to visit. Like you can tell the cats that have had way too much veterinary care because every visit is just a little bit worse and they become less tolerant.

JoJo (10:36)
Well, I think that's when we start to see a lot of cats too. Somebody might bring their cat in for an annual vaccine, have this terrible experience, which ends up being a terrible experience for the cat, the person, the staff, for everybody, less the staff typically. mean, it's part of daily practice, but then that cat stops getting care. I feel like that's where it goes. Like people are just like, I'm not doing that again. And so what I hear you saying is we have

Dr. Angie Krause (10:57)
Totally.

Yeah.

JoJo (11:04)
real good options.

Dr. Angie Krause (11:06)
We do. And we have better handling techniques. Which brings us, we should talk about scruffing kitties.

JoJo (11:09)
Mm-hmm.

Right, I bet

it's interesting. Okay, you go.

Dr. Angie Krause (11:17)
Okay. Well, Texas A ⁓ 20 years ago, over 20 years ago, they taught us to not scruff. So like that was really frowned upon and in our feline internal medicine rotations, it was, you know, we were taught how to single-handedly get blood on cats in their cages in the corner. And

That, like once you get out into practice, that is such an unrealistic, you know, they're like, ⁓ gosh, can you imagine being a fourth year veterinary student trying to learn medicine? Also learning how to do venue, like jugular venu puncture on a cat by yourself. No, it was awful. And what I loved is about that is that at least it got me thinking about what, what was good restraint, what was fair to the cat, you know,

JoJo (11:50)
I'm trying to picture that. like, how is that done?

by yourself.

Dr. Angie Krause (12:15)
They were all about keeping the room dark and we had the feliway away. We're spraying the pheromones everywhere and we're doing all these things and towels. so I think it was great. Was it realistic? No, no it wasn't. And, but it did teach me, hold on, Fiona's gonna try to get into a bag of chips. I feel like my cats are just always hungry. Man, we cannot have these, let's see.

JoJo (12:20)
Mm-hmm.

Dr. Angie Krause (12:42)
say bye to everybody. It gave me a kind of a different view and goal on how to work with my feline patients. And I really tried to do less. And so I actually still scruff cats, but I don't start with a scruff. And some cats do do well with a scruff. I mean, the idea is that

JoJo (12:58)
Mm-hmm.

Dr. Angie Krause (13:03)
Once they're not kittens anymore, there's not like some reflex that when you hold their scruff that they're going to relax. Like, you know, that's gone and now it's just kind of insulting, but it can really be helpful because some cats will literally try to turn around in their own skin to bite you or to scratch you. And for some cats, once you scruff them, they're just like, okay, I give up. Yeah.

JoJo (13:22)
Mm-hmm.

Right? They do. So

yeah, I'm trying to think of trying to understand that logic fully because in one practice that I worked for, we actually use the bag clip method where you have a little clip and you use the clip as the scruff mechanism. the clip is scruffing the kitty, which then allows for the cat. A lot of cats would just lie down and then you only needed one tech to do what it was.

Dr. Angie Krause (13:49)
Yeah.

⁓

JoJo (13:55)
going to

Dr. Angie Krause (13:56)
yeah.

JoJo (13:56)
do. So it was less hands involved and by all perception the cat seems relaxed.

Dr. Angie Krause (14:03)
Yeah, I think that's probably not really what was happening, I, you know, based off of what I was taught, but I wonder if that there was like so much sensory input that they were just like, okay, yeah. I mean, can you imagine that kind of hurts just thinking about it.

JoJo (14:14)
Mm-hmm.

those claw clips, yeah. I'm sure.

Dr. Angie Krause (14:22)
Yeah, was it like

the straight ones or were they claws? Like what's in my hair?

JoJo (14:26)
No, that would have been nicer. I think what's in your hair would be nicer than like the little manila envelope clips, like the paper clips. Yeah, the black clips with the look. They probably scrub pretty tight.

Dr. Angie Krause (14:34)
Yes, I think that must have hurt. But I don't know.

I've never been a cat, but I don't know. Like that seems, yeah.

JoJo (14:43)
Yeah, I

assume that we've moved past that. mean, how we scruff in practice is not scruffing. It's really a light hold on their head, you know, just behind their head. It's more of a support. And so many cats relax into that.

Dr. Angie Krause (14:55)
Yeah.

definitely. And some cats, like if you're trying to lay them on their side, they just, they maybe want to have their, their head up and their kind of elbows down and then you can do whatever you need. I mean, some cats that you do have to put in full like lateral recumbency, like all the way on their side. But I think it's so important to just tune into each cat. And for those of you listening, like know how your cat does with restraint.

JoJo (15:04)
Yeah.

Hmm.

Dr. Angie Krause (15:31)
Usually in clinics we'll say, know, cat does best with a jugular or cat does best with a medial saphenous or which is the place, the location of vein that we use. But also ask your veterinary team. So if you ever went somewhere else, you can just be like, Hey, he does best for this type of restraint so that they don't have to figure it out. So it's better for your kitty too.

JoJo (15:56)
Okay, so restraint and some of that is a fear free techniques like I don't know what they are teaching for cat restraint, but I would imagine that it's less is more.

Dr. Angie Krause (16:07)
I think less is more and more chemical restraint and more, you know, there are a lot of fancy things that we can do with towels and these new fun wraps. Like as I have been doing more relief, especially the bigger corporate hospitals, they have like some pretty fun toys. And so there's ways that we can restrain cats that aren't just like smushing them on the table or having to do much. Yeah.

JoJo (16:16)
Hmm

Right.

should we talk about what a guardian can do prior to coming to the clinic to help their fractious kitty feel a little safer? And it can be drugs and.

Dr. Angie Krause (16:46)
Yeah, totally.

mean mostly drugs. But yeah, I guess, you know, getting them used to the carrier. But like honestly, Jojo, I tell people to do that. I don't ever do it.

JoJo (16:54)
Mm-hmm.

I mean, that can work if you have an appointment that is planned. Like if I had an appointment that was, you know, two weeks out, I might pull the carrier and put it into the house and start putting sweet treats in it.

Dr. Angie Krause (17:16)
I would never do that, but you should. You should.

JoJo (17:18)
and getting the easiest

carrier to get that kitty out of. I think that can take down the stress once they get to the vet because some of these carriers, I mean, we're having to turn it upside down, shake the cat out. You know, it's a whole ordeal rather than just take off the top or remove a side. There are such nice carriers to be had.

Dr. Angie Krause (17:31)
Yes.

So my favorite carrier. Well, first of all, this is just a side note, but the backpack carriers. my gosh. And then the little like astronaut bubble looking thing. The little astronaut bubble. I love those, but okay, those aren't functional. ⁓ My favorite carriers are the ones that can open from the top or the side and that you can open, like you can take the top off. Now.

JoJo (17:47)
They're cute.

Yeah.

Dr. Angie Krause (18:04)
You can take the top off either with screws or with, I don't know, what are they? Just kind of like latching. ⁓ God, I hate those. But I'd rather have those than nothing, but it is, you're like, okay, this is, we have to do this quickly. But the ones that just have the latches, you can take it on and off of the latch. Like that is ideal. So get those carriers if you don't have one. But yeah, I mean,

JoJo (18:09)
The wing nuts. they have the wing nut ones and then the... Yeah.

Dr. Angie Krause (18:29)
Making it so that your cat is okay in the car is that takes some work and some cats are going to be okay and some some cats are going to be okay. So.

JoJo (18:39)
Right?

Or a house call vet

Dr. Angie Krause (18:41)
That was our solution. We saw so many kitties and we saw so many fractious kitties that were just amazing for us. One, because we're amazing too, but because we were so sweet to those kitties and ⁓ we were definitely the dream team when it came to low stress handling and.

JoJo (18:49)
Mm-hmm. Yeah.

Well, they were never rushed. So we just had at the time for that cat to appreciate who we were and that we were gonna mostly respect their boundaries, right? Like where they wanted to be is where we were gonna be. So if that meant behind a toilet, we were going to be behind a toilet. If that meant on a top shelf of a closet, we were gonna be on the top shelf of a closet. We just do it.

Dr. Angie Krause (19:03)
Yeah.

Yes, exactly.

you

my gosh. I have stemmed

and scaled closets. have like climbed up, done an exam on the top shelf. yeah.

JoJo (19:27)
Yep. ⁓

Yeah, so I mean

those are ideal, but I know it's not accessible for everybody. But what's important is that your kitty is getting care.

Dr. Angie Krause (19:40)
No.

Yes, I know your fractious kitty might have dental disease. Your fractious kitty needs blood work. Like it's so important.

JoJo (19:54)
Yeah, and I feel like it's not one of those things we're going to train out of a cat like we can with many dogs. So drugs. Drugs.

Dr. Angie Krause (20:01)
No.

Drugs, use the drugs. It's okay, even if you're

like everything's holistic and natural, it's better because honestly all that cortisol is not good for your kitty. And so, but it's also not good for your kitty to not get veterinary care.

JoJo (20:14)
Yep.

Exactly, I think that's where it comes down to with holistic sometimes is if we're looking at the whole being drugs

Dr. Angie Krause (20:23)
Yes. Yeah.

gabapentin and trazadone. Yes.

JoJo (20:31)
Yes, can really

help with all the other mechanisms that are going to suffer.

Dr. Angie Krause (20:37)
And they're super safe. Super safe.

JoJo (20:38)
Yeah. And if they were

going to start with one, what if what if they're like, I'm not comfortable starting with two? Yeah.

Dr. Angie Krause (20:44)
gabapentin.

Yeah, I mean, it works. Don't don't go low on the dose. Do 100 milligrams or I mean, you don't have to. But if my cat's really fractious, then I'm going to go ahead and do the full 100 milligrams. And then if that doesn't work, then add on the trazodome and then you can reduce the gabapentin

JoJo (20:50)
Mm-hmm.

Okay.

And they can just call the veterinarian and say, I want to pre-visit sedation protocol.

Dr. Angie Krause (21:05)
Yeah.

Yes. They

love you.

JoJo (21:10)
they want that.

Dr. Angie Krause (21:12)
my gosh. We love that so much. Our worst nightmare is when we see, okay, you know, fluffy needs or muffin or whoever Fiona needs a hundred milligrams of Gabapentin before a visit. And we walk into the room and they're like, yeah, we didn't give the Gabapentin. And we're like, ⁓ no.

JoJo (21:28)
I

just want to call it then like hey let's just try again tomorrow.

Dr. Angie Krause (21:33)
Yeah, we

often do say like, no, I mean, we'll try but it's hard.

JoJo (21:42)
Yeah, and then I think we scar that kitty a little bit. Every time that we try to provide care that that cat is resistant to, I feel like we're creating a negative memory, like a negative pathway to that. I feel gabapentin trazodone that can just remove that pathway.

Dr. Angie Krause (21:46)
We do.

Totally.

She is trouble. Okay. Well, that's what we have to say about fractious kitties. We'd love to hear what you have to say about fractious kitties. You can leave a comment. Leave us a review too. Tell us how...

JoJo (22:06)
Trouble. Okay.

I want to see pictures. I want to see pictures

of your spicy kitty. ⁓

Dr. Angie Krause (22:24)
I know. Everyone's like,

my cat's so sweet at home. And we believe you.

JoJo (22:28)
Oh, 100%.

Yeah. No.

Dr. Angie Krause (22:32)
but if you want to learn about other things like vomiting cats, or if you have a dog and want to learn about itchy dogs or anything else, because you've listened to this podcast, we are going to give you a course for free on our website. can go to boulder holistic vet.com and I think it's learn with us, go to learn with us and then go to our course selection and you can use the code truth tales.

spelled anyway you want t-a-i-l-s or t-a-l-e-s and you can get that course for free.

JoJo (23:10)
Happy vet care.

Dr. Angie Krause (23:13)
Drug your cats. See you later. Bye.

JoJo (23:14)
drugs.