Preventive Healthcare Guidelines: Part I

Photo Credit: Susie Schlesinger

The American Animal Hospital Association (AAHA) and the American Veterinary Medical Association (AVMA) have just jointly published Canine and Feline Preventive Healthcare Guidelines .  These guidelines are being distributed to veterinarians throughout the United States. The goal of the guidelines is to coach veterinarians on thoroughly counseling their clients on disease prevention.

To begin with, the new guidelines emphasize the importance of an annual examination as an opportunity to discuss nutrition, exercise, body weight, training, and parasite control, as well as provide early disease detection and treatment. This recommendation is vital because, for years, veterinarians have inadvertently trained their clients to bring their dogs and cats in for vaccinations rather than for a thorough physical examination and discussion of several important issues. The vaccine emphasis has backfired- now that adult core vaccinations are administered once every three years, clients are tending to show up with their pets only every three years rather than annually.

I will now walk you through the AAHA/AVMA preventive healthcare guidelines for cats. (My next blog post will include those pertaining to dogs.) As you read the following, please bear in mind that these guidelines were written for veterinarians. I will interpret as I type.

Preventive Health Care Guidelines for Cats

History: Discussion with the client should include lifestyle and life stage (age related issues), behavior, and diet. Note to reader- history taking includes so much more than this. I believe the authors of these guidelines wanted to ensure that discussion of life stage, behavior, and diet are always included along with discussion of particular symptoms or diseases.

Comprehensive annual physical examination: The exam should include dental assessment, pain assessment, body and muscle condition score (this is where you will learn if your kitty’s size is too large, too little, or just right). Note to reader- these components hardly represent a thorough or comprehensive physical examination. My sense is that veterinarians are being reminded to be sure to include these items.

Assessments: On the basis of history and physical examination findings the veterinarian should assess the following: medical conditions, parasite prevention and control, dental care, genetic issues, breed-related issues, age considerations, behavior, nutrition, infectious and zoonotic diseases.  Note to reader- zoonotic diseases are those that can be transmitted from animals to humans. Feline examples of this are toxoplasmosis and ringworm.

Client communication and education plan: According to these guidelines every cat should receive:

-Heartworm testing in accordance with existing guidelines. Note to reader- this will vary based on location and prevalence of disease.

-Testing for retroviruses (feline leukemia virus and feline AIDS virus) in accordance with existing guidelines. Note to reader- this will be based more on your kitty’s lifestyle than anything else.

-Annual testing for internal (intestinal) parasites

-Year-round broad-spectrum parasite control with efficacy against heartworms, intestinal parasites, and fleas; discussion about tick control

-Immunization with core vaccines (rabies, panleukopenia, feline herpesvirus-1, calicivirus) in accordance with existing guidelines. For kittens, feline leukemia virus vaccination is recommended.

-Appropriate identification including microchipping.

-Reproductive and genetic counseling and spaying or neutering unless specifically intended for reproductive purposes.

Lastly, the Preventive Health Guidelines recommend formulation and discussion of a plan for every individual patient. This plan is based on the history provided by the client in conjunction with physical examination findings. Topics that may be appropriate to discuss include:

-Diagnostic tests.

-Early disease screening tests. Note to reader- for example, if your kitty is a senior citizen, blood and urine testing may be recommended annually.

-Genetic screening tests. Note to reader- for example, if your kitty is a Maine Coon Cat, early testing for hypertrophic cardiomyopathy (a heart muscle disease) should be recommended.

-Tick control.

-Therapeutic recommendations.

-Dental recommendations.

-Behavioral recommendations.

-Environmental enrichment recommendations. Note to reader- this refers to ways to provide psychological stimulation (cat toys, scratching posts, climbing structures, other cats).

-Dietary and feeding recommendations.

-Immunization with non-core vaccines in accordance with existing guidelines.

-Other preventive recommendations and counseling regarding zoonotic diseases. Note to reader- as mentioned above, zoonoses are diseases that can be transmitted from animal to humans.

Whew! After reading all of this I’m tired! Are you? Believe it or not, all of this really can (and in my opinion, should) happen during the course of an annual examination.

Please bear in mind, these are guidelines for veterinarians, not rules. Your vet gets to choose whether or not to comply with these suggestions. And you get to choose who earns the privilege of caring for your precious kitty.

Please let me know if you have any questions about the particulars of these guidelines. Does your cat receive an annual health examination?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at,, local bookstores, and your favorite online book seller.

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7 Comments on “Preventive Healthcare Guidelines: Part I

  1. I have very happy, healthy dogs fed a raw diet and never have an illness.

    It is so sad to see people who care about their pets reject the simple prevention of heartworm disease.

  2. Wow! This is a lot to digest (and I need a while before we get to part 2!)

    I always question vets giving advice on behavior and nutrition since most have no training in this.

    These guidelines do seem much healthier than an empahsis on overvaccination. Though I agree with another poster that there certainly was some consideration of revenue raising along with the welfare of a pet.

    Overall though I like them. I am very holistic, my pets get no vaccines, or toxins like heartworm drugs etc. They do go to the vet for well check up every 3 to 4 months though. I always advise a minimum of 2 vet visits a year.

  3. Great information, Dr. Kay! I’m glad to see that you’re speaking for Spot – and talking for Tiger! And pet owners need to be reminded to schedule regular checkups for ALL species of companion animals. Thanks for all you do!

  4. The pet medical community has definitely caused problems relying on the excess vaccination of cats and dogs.

    Our pet adoption group requires a relationship with a veterinarian, and even some people who fancy themselves pet rescuers equate cat veterinary care with vaccines. It is a hurdle to overcome.

    At some point, the industry might further clean itself up by ending the promotion of overpriced, relatively low quality pet food.

  5. No disrespect taken and I’m glad you felt comfortable to voice your opinion on this. I think that the economic downturn has had many veterinarians stewing about how to keep their doors open. No doubt, many have been looking for ways to generate business. One very obvious way that is truly in the best interest of the patient is to try to convince people that their pets benefit from an annual examination. So, perhaps what began with financial motivation that just so happened to coincide with changing information about vaccinations has resulted in recommendations that benefit the patients. And isn’t that the common ground that everyone shares?

    Dr. Nancy

  6. Hi there,

    No disrespect taken. Thanks for your comment. Your concerns pack an element of truth- let me explain. This significant downturn in the economy has caused many veterinarians to think about how to keep their doors open. They didn’t have to look very far to find something that could enhance business along with the health of their patients. Veterinarians everywhere began to clearly recognize that many of their patients were “missing in action” when in came to their annual exams (thought to be a result of changing vaccination recommendations). So while it is very likely that recognition of the MIA problem was a result of idle veterinarians trying to enhance business, this recognition and the guidelines it has prompted truly serve the best interest of their patients. Does this help?

    Dr. Nancy

  7. No disrespect intended (and none toward my veterinarian, either), but this creeps me out.

    I didn’t click all of the links, but it is clear that this baby was put together to address a very serious concern: declining veterinary revenue. The partners read like a Who’s Who of We Need To Sell You More Stuff. Disturbing…