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There’s a patient profile most of us recognise immediately – Geriatric cat. Chronically losing weight. Owner reporting it’s been years since the last vet visit. When you ask why, the story is always the same: the carrier comes out, the cat disappears under the bed. Twenty minutes of struggle later — claws, hissing, the works — the cat is inside, has urinated and defecated in transit, and vocalises the entire car trip. Then the waiting room. Then the consult room, where it takes two or three staff to safely collect a blood sample, and everyone involved — cat, owner, and team — leaves the experience worse off than when they arrived.
These cats don’t come back. Their owners love them. They’re not neglectful. They’re just not willing to put their animal through that again.
The problem is that by the time a geriatric cat is losing weight, not coming back is a clinical problem, not just a compliance one.
It’s tempting to frame these patients as “difficult.” But the evidence increasingly suggests the difficulty isn’t inherent to the patient — it’s a predictable response to the environment.
A 2015 study by Nibblett, Ketzis and Grigg directly compared stress indicators in cats examined in a clinic versus a home setting. Blood glucose was lower in every single cat at home. Cortisol levels dropped 218% when the first exam was clinic-based and the second was at home — more than double the drop seen in the reverse order — suggesting the clinic experience itself primes a stress response that compounds on future visits (Nibblett, Ketzis & Grigg, 2015).
The white coat effect in small animal medicine is now well documented. Clinic-induced blood pressure elevation has been demonstrated across multiple studies, with statistically significant differences between home and hospital readings (P = 0.04), alongside elevated heart rate and rectal temperature (Brown et al., 2007). In the context of a cat already presenting with weight loss, stress-induced hyperglycaemia can complicate interpretation of blood glucose results — with struggling and acute stress directly linked to elevated lactate and norepinephrine concentrations, potentially mimicking pathological findings if the clinical environment isn’t accounted for (Rand et al., 2002).
The diagnostic picture you’re forming in clinic is, in some cases, a picture of a stressed cat — not necessarily a sick one, or not only a sick one.
I have a number of geriatric cats on my books who fit this profile exactly. Chronic weight loss, suspected or confirmed hyperthyroidism, owner at the end of their rope with clinic visits. These are cats that, in a clinic environment, require two or three staff members for venepuncture and are genuinely distressing for everyone involved.
At home, in their own space, at their own pace, the picture is completely different. I routinely collect blood from these cats single-handedly. No nursing assistance. The cat is settled in the corner of the couch, unrestrained. I’m sitting on the floor beside them. The owner is nearby if they’re comfortable. If they’re anxious — and they often are, and they’re usually very aware of it — I suggest they go about their day. It’s just the cat and me.
In the interest of transparency: one cat that comes to mind did require a second visit and a second attempt at collection. The owner didn’t hesitate. They were absolutely determined not to return to a clinic, and a revisit at home was no obstacle at all. More importantly: these clients follow through. They allow me to come back. They book the repeat blood tests. They titrate medication properly. They monitor the patient the way a chronic condition like hyperthyroidism actually requires. Compliance — real, sustained compliance — is not just a communication problem. It’s an access problem. And for a subset of patients, the clinic is the access barrier.
I’m not suggesting mobile vet care is appropriate for every patient or every scenario. There are obvious limitations — advanced imaging, surgery, intensive care — where the clinic is irreplaceable. But there’s a category of patient worth identifying: the anxious, elderly, or transport-intolerant animal with a chronic condition requiring monitoring. For these patients, the question worth asking isn’t “how do we get them to tolerate the clinic better?” It might simply be: “does the clinic need to be part of this at all?”
Fear Free literature suggests that 78.5% of dogs show fear on the examination table, and 38% of cat owners report feeling stressed at the thought of a clinic visit — with stress and transport aversion cited as primary drivers of veterinary avoidance (AAHA, 2015; Volk et al., 2011). That’s not a small number. And for every owner who voices it, there are several more who simply stop booking. The cats that never came back didn’t stop needing care. They just stopped being able to access it.
The owners of these patients are, almost universally, highly engaged and deeply concerned about their animals. They’re not the ones skipping appointments because they don’t care. They’re skipping them because the experience of getting there is — for their cat, and for them — genuinely traumatic.
When we frame that as a compliance problem, we put the failure on the client. When we look at the environment as a variable, we start to see the system differently.
There’s solid evidence that owner anxiety in novel environments directly influences canine stress responses — and the same dynamic applies in feline contexts (Byrne & Arnott, 2024). Removing the owner from the clinic waiting room, the car trip, the struggle with the carrier — these aren’t small things. They change the physiological and behavioural state of the animal before the consultation even begins.
For some patients, removing the clinic from the equation isn’t a compromise. It’s the clinical decision that actually gets them the care they need.
American Animal Hospital Association (AAHA) (2015) Canine and Feline Behavior Management Guidelines. Available at: www.aaha.org (Accessed: 13 May 2026).
Brown, S. et al. (2007) ‘Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats’, Journal of Veterinary Internal Medicine, 21(3), pp. 542–558.
Byrne, A. & Arnott, G. (2024) ‘Empathy or Apathy? Investigating the influence of owner stress on canine stress in a novel environment’, Applied Animal Behaviour Science, 279, 106403.
Nibblett, B.M., Ketzis, J.K. & Grigg, E.K. (2015) ‘Comparison of stress exhibited by cats examined in a clinic versus a home setting’, Applied Animal Behaviour Science, 175, pp. 68–75.
Rand, J.S., Kinnaird, E., Baglioni, A., Blackshaw, J. & Priest, J. (2002) ‘Acute stress hyperglycemia in cats is associated with struggling and increased concentrations of lactate and norepinephrine’, Journal of Veterinary Internal Medicine, 16(2), pp. 123–132.
Volk, J.O. et al. (2011) ‘Executive summary of the Bayer veterinary care usage study’, Journal of the American Veterinary Medical Association, 238(10), pp. 1275–1282.
Dr Stuart Cunningham BVSc is the owner and principal veterinarian of Personalised Mobile Vet (PMV), a solo mobile veterinary practice based in South East Queensland. A former clinic vet turned mobile-only practitioner, Stuart now brings patient-paced, fear-free veterinary services to cats and dogs across Brisbane, Ipswich, Logan, Moreton Bay, and the Lockyer Valley. His practice is built on one simple belief: "it just takes time."
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