In veterinary school I frequently heard the following refrain: “Cats are not little dogs.” The goal of the statement was to point out that it is not safe to extrapolate medical knowledge from dogs to cats. Cats have unique metabolisms and physiology. They react in their own way to medicines, treatments, handling techniques, and diets. You should never assume that what works for a dog will work for a cat, or that what’s safe for a dog will be safe for a cat. To repeat: Cats are not little dogs.
To which I say: No kidding. The surprise and scandal here is not that cats aren’t dogs. The real issue, one that has irked me since time immemorial, is that it’s in any way necessary to say that cats aren’t dogs — to veterinary students (and later, as I would discover at conferences, to veterinarians) no less.
I have long referred to cats, with apologies to Simone de Beauvoir, as the second species of veterinary medicine. It seems that dogs get all of the action. From the first day of veterinary school until the day of retirement, dogs are No. 1 for many vets. It starts with the bane of first-year vet students’ existence: anatomy. We spend months on the dog, with a couple of days at the end dedicated to cats. As school progresses, we study dog diseases first, while cat problems seem an afterthought. Pharmacology focuses on dogs, with many caveats offered about more research being necessary to determine the effects of the medications on cats. Caseloads in teaching hospitals is tilted heavily toward dogs (more on that in a moment).
That continues in practice, where most veterinary research is focused on dogs. Most new therapies, treatments, and ideas are developed with dogs in mind. Most veterinary clinics are hospitable places for dogs — my pal Buster tries to enter every veterinary clinic he sees — but hell on earth for cats.
Cats face prejudice and aren’t valued by some practicing vets. When my childhood cat developed a hernia, the vet — THE VET — tried to talk my family out of surgery because he thought the cat wasn’t worth the money. (She underwent surgery anyway and provided many additional years of loving companionship.)
How did it come to this? Why is the most popular pet in America a second-class citizen?
I have gradually and reluctantly come to an understanding of how this travesty came to pass. The answer, with apologies to Deep Throat, is: Follow the money.
It turns out that cat owners are less likely than dog owners to seek routine veterinary care for their pets. In fact, a recent poll found that 52 percent of cat owners avoid regular vet visits, and they have a reputation in veterinary medicine for not being willing to spend as much as dog owners. This leads to a feedback cycle: Big, Evil Pharma invests in research that it believes will pay out. Therefore drugs are developed for dogs, with cats as an afterthought. Vet-school teaching hospitals see more dogs because more dog owners are willing to accept referral to an expensive specialty practice. Vets see more canine cases and dogs become their priority. This goes all the way up to academic researchers, and a pattern of dogs coming first develops even in the highest echelons of the ivory tower.
This should not be taken as a blanket condemnation of cat owners, nor as an attempt to shift blame away from the veterinary community. The same poll mentioned above found that 58 percent of cat owners mentioned that they believe — rightly, in many cases — that their cat hates going to the vet. There is no doubt that veterinarians could do more to make themselves cat-friendly.
I am happy to say that a sea change appears to be under way. The status of cats in society seems to be increasing towards a more appropriate level, and cat owners appear more likely to accept treatment at the vet’s office.
When I treat cats (or dogs) I always recommend the course of treatment that I feel will be best for my patient — and in my experience, cat owners are as likely as their dog-owning counterparts to move forward with the recommended plan. According to another recent poll, cat owners are now willing to spend slightly more than dog owners at the vet. This attitude will ultimately trickle to the top, inspiring more research and innovation that will benefit cats (because it will be profitable for the big corporations that develop many new veterinary therapies and fund a great deal of veterinary research).
Many vets acknowledge and are working to eliminate their complicity in the matter. Veterinary offices can now be certified as cat-friendly, and cat-only veterinary offices are thriving in many places. Organizations such as the CATalyst Council and the American Association of Feline Practitioners are advocating for cats to all stakeholders. Some advanced therapies, such as kidney transplants, have been pioneered in cats. Provider-centered care is giving way, slowly but inevitably, to patient-centered care.
There is still progress to be made, but I am hoping that by the time I retire cats will have achieved full first class citizen status in veterinary medicine.
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