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Cat Advice

  • Vaccinations
  • Worming
  • Ageing Cats
  • Hyperthyroidism
  • Diabetes
  • Feline cystitis
  • Kidney disease
  • Hypertension
  • Feline dementia
  • Environmental Enrichment


How do vaccines work?

A vaccine is a liquid containing bacteria or viruses that is used to stimulate an immune reaction. Because the immune system has memory, it will produce a quicker and stronger response to subsequent contact with the infection being vaccinated against.

The bacteria or virus in the vaccine is killed or altered so that it stimulates an immune reaction, but does not cause disease. Killed vaccines are less likely to cause disease, but also produce a weaker immune response.

What can I vaccinate my cat against?

Core vaccines

Feline herpesvirus - Infection causes flu like symptoms. Although the clinical signs resolve, the infection persists in the body, and recurrent episodes of disease occur, especially at times of stress. Also causes severe eye disease especially in kittens

Feline calicivirus - The second “cat flu” virus, causing sneezing and tongue ulcers. Cats may clear the infection, or become chronically infected. Several strains exist so vaccines may not provide full protection

Feline Enteritis - Related to parvo in dogs - causes severe diarrhoea, also brain disease in kittens before birth

Non-core vaccines

Rabies - Not given routinely, however is required as part of the pet passport scheme. Vaccination every 3 years in the UK

Chlamydophilia - Causes conjunctivitis and cold symptoms, especially in younger cats

Bordetella - The bacteria responsible for kennel cough in dogs - not routinely given as uncommon in cats

Feline leukaemia - virus Infection of blood cells, causing anaemia, immune disease and blood cell tumours. Spread by direct cat to cat contact

What are core and non-core vaccines?

“Core” or essential vaccines are those vaccines that are advisable for any cat, no matter what the circumstances, due to the ease of spread and the seriousness of the diseases they protect against. Non-core vaccines are considered individually, based on age, life style, and contact with other cats. Non-core vaccines will be discussed during your vaccine consultation.

Do house cats need vaccinations?

Even if a cat never leaves the house, the core vaccines are recommended, as the diseases they protect against do not need direct cat-to-cat contact for spread. Feline enteritis can be carried on clothing or shoes, and the cat flu viruses can be spread through the air - for example at veterinary practices. They are also required for cats going into catteries.

The feline leukaemia virus vaccine is usually not necessary for a house cat living on its own. 

When can I get my cat vaccinated?

All cats will require an initial vaccination course of two injections, given three weeks apart. Kittens can start the vaccinations from eight weeks, with the second vaccination at twelve weeks.

Current recommendations are for annual boosters. The booster consultations also provide an opportunity to discuss any healthcare issues you may have and to provide an annual health and weight check.

Immunity may last for more than twelve months, and vaccinations may be given less frequently, however this increases the risk of infection. Cats going into catteries will require annual vaccinations.

What are the risks of vaccination?

Side effects from vaccination are very rare, and are usually mild. The most common side effects are slight swelling or tenderness at the injection site, lethargy, and loss of appetite. These usually subside within twenty four hours.

The most significant and well publicised side effect is fibrosarcoma - a tumour at the vaccination site. Some vaccines are more likely to cause tumours. The incidence of fibrosarcoma in the UK has been estimated at 1 in 250,000 vaccines.

However, vaccines are for the most part safe, and provide important protection against several diseases which can be expensive to treat, and potentially life threatening.

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Most puppies and kittens are born with worms, and people are familiar with the importance of treating for these internal parasites. Symptoms can be vague and mild, especially with minor infestations. However the range of worms seen across the UK is increasing, due to climate change, increased overseas travel, and changing life styles. These newer worms can cause more severe disease, and many can also affect people, so regular worm treatment is more important than ever.


Roundworms are the most common internal parasite, and almost all kittens and puppies are born with them, as they are passed on by their mothers before birth, or in the milk. The worms live in the intestine, and pass eggs in the faeces which can survive in the soil for several years. These eggs then re-infest cats and dogs. Mild infestations may cause no signs, but heavy infestations will cause diarrhoea, weight loss, and a pot belly. These worms also occasionally infest people, when they can cause damage to other organs such as the eye and brain - especially in young people. Regular worming of dogs and cats especially when young, and standard hygiene proportions, will help to reduce the risk to children.


Tapeworms are the other common worms seen in cats and dogs. They rely on an intermediate host for their life cycle. Eggs passed in faeces of the dog or cat are eaten by the intermediate host. The dog or cat then eats the intermediate host containing the immature stages of the worm. The most common tapeworm is Dipylidium - the flea tapeworm. The other common tapeworm is Teania - for which the intermediate hosts are farm animals, rabbits and rodents. Hence flea infestations and hunting increase the exposure to these worms. These worms cause mild signs (diarrhoea, weight loss) in cats and dogs, but significant problems in the intermediate host, and so control is important to protect the agricultural economy.

Although these tapeworms do not affect people, a third tapeworm, called Echinococcus, will infest people causing potentially fatal damage to internal organs, especially the liver. Echinococcus is rare in the UK but more common in Europe.


Hookworm is uncommon in the UK. Eggs passed in the faeces are eaten, or can pass through the skin of the paws. The adult worms attach to the lining of the gut, and feed on blood, so heavy infestations can cause anaemia.

Lungworm and Heartworm

Lung worm affects dogs and cats, and can cause coughing and breathing problems. It is spread when pets eat infested faeces.

Heartworm (Dirofilaria) is found on the continent, and is spread by mosquitoes. Infestations cause heart failure, and regular treatment of animals going abroad is advisable.


There is no treatment that covers all these worms. Treatment should therefore be based on the relative risk and seriousness of the different worms. For example, treatment against tapeworms is important for hunting cats, while pets going to France regularly should have routine treatment against Dirofilaria.

Frequency of worming also depends on risk of exposure, but we recommend treatment every three months on average.

For further information on the treatment of worms in cats please telephone the practice.

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Ageing Cats

Advances in veterinary medicine, nutrition and general care mean that cats now often live much longer, healthier lives than they used to. However as they age, their bodies and their requirements change. There is a huge amount we can do to make the twilight years of our feline friends more healthy and comfortable. An understanding of this period of a cat’s life will help you and them enjoy it to the fullest.

As with people, the effects of wear and tear can take their toll as cats get older, and several of the body’s organs can become less efficient.

Ageing changes in cats

  • Reduced absorption of food from the gut can lead to weight loss and diarrhoea.
  • Dental disease, and a reduced sense of smell, may result in a reduced appetite.
  • Older cats tend to sleep more, and to be less active. Arthritis is common in older cats.
  • Diseases such as hypertension, hyperthyroidism, diabetes, and kidney disease are common in older cats.
  • A reduced immune system results in an increased risk of some infections, such as cat flu.

How old is your cat?

The feline advisory bureau (FAB) has devised a life stage system to help consider the health risks to cats at different ages. According to this scale, cats reach adulthood at 2 years of age (equivalent to 24 human years), but after this every year in a cat’s life is equivalent to four human years.

Life stage Age Human equivalent

Ktten 0-6 months - 0-10 years

Adolescent 7 months to 2 years - 12-24 years

Prime 3-6 years - 28-40 years

Mature 7-10 years - 44-56 years

Senior 11-14 years - 60-72 years

Geriatric 15+years - 76+ years

Health tips for older cats

A change to a senior diet - is sensible as the dietary requirements of older cats are different. Because older cats also need more fluids, it may be better to feed them them a wet food.

Monitor weight and appetite - as weight loss and appetite changes are common in older cats and may be the first signs of disease.

Consider the creature comforts of older cats - provide warm, quiet comfortable spots where they can have a “cat-nap” away from everyday bustle.

Regular health checks - are important to pick up old age diseases early when they are easier to treat. We recommend health checks every six months for cats over ten years of age. 

Keep their nails short - as older cats can’t retract their claws so well and tend to get them snagged in carpets and jumpers. Overgrown claws may also cut into their paws.

Keep vaccinations up to date - as reduced immunity in older cats means they are more prone to diseases such as cat flu.

Regular grooming - especially of long haired cats, is important as older cats are less able to look after themselves. Use the opportunity to give them a good check over.

Gentle play - with older cats will help to keep their minds and bodies active and healthy.

A collar with a name tag, or microchip - is a good idea, as older cats are more likely to get lost.

As your cat gets older, look out for subtle changes that might be the first signs of disease. Several conditions seen in older cats, such as hypertension and kidney disease, can be treated effectively if diagnosed early; however if left too long, they may be harder to treat, and may cause permanent damage such as blindness. Older cats often seek more affection - providing the ideal opportunity to give them the “once over”.

Things to look out for

  • Increase or decrease in appetite
  • Change in weight
  • Changes in behaviour
  • Increased vocalisation
  • Increased drinking

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Hyperthyroidism is a common problem in older cats, caused by an increase of the thyroid hormones (T3 and T4). The disease usually causes weight loss and an increased appetite as the most obvious symptoms Diagnosed early, it can be usually be treated effectively, leading to significant improvement in weight and condition. Untreated, it leads to other problems including heart disease and diabetes.

What is thyroid hormone?

Thyroid hormone is produced by the paired thyroid glands, situated in the neck. Thyroid hormone controls the metabolic rate and activity levels of the body. Increased levels of thyroid hormones cause the body to work faster. This causes increased activity levels, increased heart rate, and increased energy requirements.

Signs of hyperthyroidism

  • Increased appetite
  • Increased drinking
  • Weight loss
  • Poor coat condition
  • Restlessness or hyperactivity
  • Diarrhoea or vomiting
  • Rapid heart rate

How is hyperthyroidism diagnosed?

The symptoms, combined with an obviously enlarged thyroid gland in the neck, are usually suggestive of hyperthyroidism. The diagnosis is confirmed using blood tests to check the levels of thyroid hormone.

Because the condition can lead to heart disease and high blood pressure, we will often investigate these problems in cats suspected of having hyperthyroidism.

We usually also run blood tests to look for other conditions such as diabetes and kidney disease, which are also common in older cats, and may occur at the same time. Presence of these conditions may affect the success of treatment, and the choice of treatment.

Treatment of hyperthyroidism

The aim of treatment is to reduce the level of thyroid hormone in the blood to normal. This can be achieved by surgical removal of the abnormal thyroid gland, by medication, by radioactive iodine therapy, or by a specific diet. Each treatment option has advantages and disadvantages, but all are usually successful.

1. Medical therapy - Medical therapy involves giving tablets daily that block the production of thyroid hormone by the thyroid glands. The treatment is safe, although side effects including vomiting and skin irritation are occasionally seen. The main disadvantages of medical treatment are that it requires the administration of tablets for the rest of the cat’s life, and that regular checks and blood tests are necessary to ensure the appropriate dose of medication.

2. Surgery Surgical removal of the enlarged thyroid is possible. Medical therapy is usually given for three weeks prior to surgery to stabilise the condition and reduce anaesthetic risk. Surgery avoids the need for long term treatment - however does carry the usual risks associated with anaesthesia and surgery. There is also a risk of recurrence of hyperthyroidism after surgery, as the second thyroid may become affected at a later date.

3. Radioactive iodine Radioactive iodine is used to destroy the thyroid glands, so reducing thyroid hormone production. This treatment avoids the need for long term medication, and also avoids the need for anaesthesia and surgery. However, due to the risk of radioactive contamination with treatment, it requires isolation of affected cats at specialist practices for up to six weeks.

4. Diet A commercial diet with restricted iodine is available. This limits the cat’s ability to produce thyroid hormone; however the diet needs to be fed exclusively, and many cats find it unpalatable.

Which treatment is best for each cat will depend on several factors such as ease of giving tablets, other conditions affecting anaesthetic risk, and ability to travel to a specialist centre. These issues will be discussed in each individual case to help you make the best decision for your cat.

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Diabetes is a common problem in middle aged and older cats, and it appears to be on the increase. Although many people are daunted by the prospect of having to treat a diabetic cat, with time and commitment, it can be very rewarding. Although most cats will need insulin injections initially, in the long term many cats can be managed by dietary control alone.

What is diabetes?

Diabetes is caused by a lack of insulin. Insulin enables sugar to pass from the blood stream into the body’s tissues, where it is used as an energy source. Insufficient insulin causes sugar to get “trapped” in the blood stream, where the body can’t use it. Instead the body uses fat as an energy source. The breakdown of fat causes a build up of toxins called ketones.

How is diabetes diagnosed?

The presence of high blood sugar, or sugar in the urine, are both suggestive of diabetes. The diagnosis can be confirmed by determining the amount of “fructosamine” in the blood, which gives an estimate of the average blood sugar level over the last two weeks.

Because of the high incidence of multiple diseases in older cats, we routinely run a blood screen looking for conditions such as kidney disease and thyroid disease - as these will affect the success of diabetic treatment. We also check the blood pressure and weight of diabetic cats for monitoring purposes.

Signs of diabetes

  • Weight loss
  • Increased drinking
  • Increase or decrease in appetite
  • Inappropriate urination
  • Vomiting Lack of energy

These symptoms can be seen in several conditions in older cats, so although the signs may be suggestive of diabetes, further tests will always be necessary to confirm the diagnosis.

Diabetic stabilisation

Treatment of diabetes usually requires twice daily insulin injections. The amount of insulin required is different for each cat.

An initial insulin dose is normally calculated based on your cat’s weight, and blood sugar level. We then need to assess your cat’s response to this dose, and adjust it up or down accordingly. Regular blood tests are used to make these adjustments, and it is usually necessary to keep your cat in the practice for some of these tests. The blood tests are carried out approximately once a week, until we have found the correct dose of insulin. This process of repeated blood tests and dose adjustment is called stabilisation, and may take a few weeks or several months. Some cats prove difficult to stabilise, and we may need to try different types of insulin in these cases.

Long term treatment

You will be shown how to give insulin injections at home. It is important to maintain a regular routine, with insulin injections and food being given at the same time each day, in order to keep insulin requirements constant.

Monitoring your cat’s weight, drinking and eating will help you assess how well the diabetes is under control. Regular health checks by the vet, with blood tests, are also important. Changes in insulin dose may be recommended following these checks.

Low carbohydrate diets have been shown to make stabilisation of diabetes in cats, and in some cases may avoid the need for long term insulin. Various commercial low carbohydrate diets are available for diabetic treatment.

Treatment of diabetes in cats takes a lot of time and effort, and can be expensive. It requires a daily routine, regular injections, and frequent veterinary visits. It isn’t for everyone, but it can be a very rewarding experience. 

Regular check-ups are important for all animals on long term medication, to assess the progress of disease, and to monitor for other conditions that might affect treatment. This is particularly true in older patients, where multiple concurrent diseases are not uncommon.

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Feline cystitis

What causes cystitis?

Cystitis is inflammation of the bladder. There are several possible causes of cystitis in cats, so some investigation of the condition is usually necessary. Initial investigation involves urine analysis, but further tests, including blood tests, X-rays, and scans, may also be suggested, particularly in older or very young cats, in cases that fail to respond to treatment, or in cases that recur.

The most common cause of cystitis in cats is “idiopathic cystitis”, in which no specific causes can be identified.

Signs of cystitis

  • Straining to pass urine
  • Frequent urination
  • Discomfort or crying on urination
  • Blood in the urine
  • Urinating in unusual places

How serious is it?

Cystitis is distressing for cats and their owners. In male cats, there is also a risk of bladder blockage, which is potentially life threatening, and so male cats with symptoms of cystitis should always be seen urgently.

Fortunately, most cats “grow out of cystitis”, with bouts getting less severe and less frequent as they get older.

*Due to the risk of obstruction, cystitis in male cats should be treated as an emergency*

How is cystitis treated?

Pain killers - can be used to make your cat more comfortable during individual bouts of cystitis

Increasing fluid intake - by feeding wet food, providing several water bowls throughout the house, and even offering flavoured water, will produce more dilute urine, which will reduce the bladder irritation.

Reduce stress - by providing hiding places both inside and outside the house, as stress is thought to play a part in the condition

Pheromones - can be used to make cats feel more relaxed

Increasing activity levels - by playing with your cat, and providing environmental enrichment has been shown to reduce the incidence of cystitis in affected cats

Reduce competition - between cats by providing multiple litter trays, feeding and drinking stations

Special diets - may help by changing the composition of the urine

Long term medication may also be used in some cases to reduce the frequency and severity of episodes

Regular check-ups are important with all animals on continuous treatment to monitor for progression of disease, and to look for concurrent problems that may affect the choice of treatment.

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Kidney disease

Kidney disease affects around a fifth of cats over fifteen years of age, but can also occur in younger cats. Traditionally it is a disease with a poor prognosis, and there is still no cure for kidney failure, however a greater understanding of the disease means that with early diagnosis and treatment, many affected cats can now live a happy life for several years.

The role of the kidneys

The main role of the kidney is to remove waste products (called “uraemic toxins”) from the blood, which are produced in the liver by the processing and breakdown of protein. In high concentrations these toxins cause damage to blood cells, stomach ulceration, and irritation to the brain and nervous system. Eventually, they will lead to coma and death.

The kidney also has a role in stimulating blood cell production, and in controlling body fluids, minerals and blood pressure.

Signs of kidney disease

The early signs of kidney disease are vague, and may be put down to old age. Common signs include:

  • Loss of appetite
  • Increased thirst
  • Lethargy
  • Anaemia
  • Blindness
  • Muscle weakness
  • Smelly breath
  • Weight loss
  • Poor coat
  • Odd behaviour

What causes kidney disease?

There are several causes of kidney disease, including infection, tumours, immune diseases and toxins. In many cases the exact cause is unknown. However, once the kidneys become affected, the normal repair mechanisms usually cause further damage. The result is progressive disease producing “end stage kidneys”.

How is kidney disease diagnosed

Kidney disease is confirmed using a combination of blood tests and urine tests. We also advise checking the blood pressure as high blood pressure (“hypertension”) can be a cause of ongoing kidney damage. Regular checks are important to monitor the effects of kidney disease, and adjust treatment accordingly.

How can we treat kidney disease?

Feeding a specific “renal” diet has been shown to be the single most significant factor in determining survival of cats with kidney disease.

Measurement of blood pressure is important, both to control progression of kidney disease, and to prevent other effects of hypertension.

Monitoring and controlling mineral levels (especially potassium and phosphorus) will make affected cats feel better.

Control of urinary tract infections (“cystitis”) prevents further damage to the kidneys from bacterial infection.

Maintaining fluid intake by having drinking water freely available, and using flavoured water, will prevent dehydration. This can be supplemented by subcutaneous and / or intravenous fluid administration.

Nausea and vomiting are common in moderate to severe kidney disease, and a reduced appetite can be seen even in fairly mild cases. These symptoms can be controlled with a variety of drugs.

“ACE inhibitors” are used if there is significant protein loss through the kidneys.

Regular check-ups are important for all animals on long term medication, to assess the progress of the condition, and to look for other conditions that might affect treatment choices. This is particularly true in older patients, where multiple, concurrent diseases are not uncommon.

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Hypertension, or high blood pressure, is a common problem in older cats. It is usually seen as a result of another underlying disease - particularly kidney disease and hyperthyroidism. Left untreated, it can cause damage to the eyes, brain, heart and kidneys. Treatment is usually fairly straightforward, although investigation and treatment of the underlying disease is also important.

What are the symptoms?


The most common and obvious symptoms are damage to the eyes - causing blindness and internal bleeding.


Damage to the brain can cause behavioural changes, and a wobbly gait. These are often put down to old age by owners.


Damage to the heart can cause breathing difficulty due to congestive heart failure.


Damage to the kidneys may cause weight loss, reduced appetite and increased thirst.

How is it diagnosed?

Blood pressure is measured using a cuff around the leg or tail, in a similar way to blood pressure measurement in people. Because of the association with other diseases, blood tests and urine test are usually used to look for an underlying cause for hypertension.


Hypertension is treated with tablets given daily. Regular monitoring of blood pressure, together with any underlying disease, is important, and doses of medication may need to be adjusted based on the response to treatment.

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Feline dementia

With improved nutrition and healthcare, cats are now living to a greater age than they use to. Sadly, this means we are seeing an increasing number of “senile” cats - indeed it has been estimated that half of all cats over the age of fifteen suffer from some degree of dementia.

Signs of dementia 

  • Reduced interaction with people
  • Reduced activity
  • Reduced grooming
  • Inappropriate toileting
  • Changed sleep patterns
  • Aimless wandering
  • Getting lost
  • Confusion or disorientation
  • Inappropriate vocalisation

What causes dementia?

Dementia, or “cognitive dysfunction syndrome” is thought to be caused by reduced blood flow to the brain, protein deposits within the brain, and damage to the brain from free radicals. It results in a reduced mental faculty. Several other diseases seen in elderly cats can also affect brain function, while conditions such as arthritis may mimic some of the symptoms of dementia.

What can we do about it?

Encouraging activity in elderly cats (for example by playing with them) helps to keep the brain active and healthy. Increase the number of litter trays around the house to encourage appropriate training. Specific diets high in antioxidants may reduce ongoing brain damage - suppplements such as vitamin E and evening primrose oil may also help.

Affected cats are easily upset by change, so try to keep a consistent routine.

Regular health checks in elderly cats will enable an early diagnosis of conditions such as hyperthyroidism and high blood pressure, that can cause brain damage.

There is no medication licensed for the treatment of this condition in cats, however several treatments, including drugs aimed at reducing anxiety, and increasing blood flow to the brain, have been used.

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Environmental Enrichment

While we think of cats as independent and self-sufficient pets, it is easy to underestimate how reliant on us they are for their well-being. We are usually good at satisfying their physical needs with feeding, warmth, and medical care, but may not appreciate that their behavioural needs are very different from our own. Providing a rich behavioural environment not only ensures a happy cat, but can reduce behavioural problems such as urine marking. There is also growing evidence that some medical problems, such as cystitis can be triggered by a stressful environment.

What is environmental enrichment?

Environmental enrichment is the adaptation of a cat's surroundings to enable them to behave as naturally as possible. It can be considered under the following headings:

  • Eating, drinking and toileting
  • Playing and hunting
  • Physical space
  • Interactions with animals and people

Eating, drinking and toileting

Cats are naturally solitary animals, and so find competition for basic resources such as food and water stressful. Distributing several food and water bowls and litter trays around the house (ideally one for each cat, and one extra) will help to reduce competition.

Unlike humans, cats do not normally eat and drink at the same time - they prefer not to get their water contaminated by the feathers and guts of their natural food! So keep food and water bowls separate. They are also fussy about their water - try bowls of different shapes and materials to encourage drinking, - or “pet fountains” so they can drink running water. Some cats find rain water or boiled water more palatable than chlorinated tap water.

Make sure litter trays are placed in a private place - cats will feel vulnerable when toileting and like to do it in secret. Some cats may prefer covered litter trays, others open litter trays - so provide both. Again ensure that sufficient litter trays are provided (“one per cat and one extra”).

Playing and hunting

In the wild cats will catch and eat up to twenty small meals a day. Providing two large meals in a bowl isn’t natural for their digestive system - and doesn’t present much of a challenge either!

Ad lib feeding of dry food will help to replicate this “little and often” feeding pattern, although dry food may not be ideal with some medical conditions such as kidney disease.

While actual hunting probably shouldn’t be encouraged, cats can be made to work for their food using feeding toys - either commercial, or home made (such as the “catmosphere”) - in which food can be hidden. Hunting behaviour can also be simulated using something as simple as rolled up paper - or more sophisticated toys like laser pointers, These not only keep cats entertained, but provide good exercise as well.

Physical space

Cats are natural climbers, and will use high places both to hide, and to survey their surroundings. It is important to provide “vertical space” for cats, using cat towers, shelving, or “cat trees”. Cats will also often take advantage of an upstairs window to look out over the street below.

Cats like “time out”, and should be allowed spaces where they can hide away, particularly in a new environment or following the addition of new pets or family. Boxes, airing cupboards, cat baskets may all suffice - offer several options and let the cats decide what and where they prefer!

Interactions with other animals and people

Although naturally solitary animals, cats will benefit from the company of both people and other pets. Playing with cats will help to keep them active and mentally stimulated. They enjoy being stroked and fussed, but only on their own terms - it is important to respect their privacy.

Cats will also enjoy interactions with each other, especially when young - however introducing adult cats to each other can be challenging, and as with people, not all cats get on. Cats and dogs can also make good companions - but only if socialised with each other at an early age.

Environmental enrichment can benefit all cats, but is particularly important for indoor cats, which have limited opportunities to demonstrate their full range of natural behaviour. Further information on the subject can be found on the web-site of International Cat Care.

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