Demographics,lifestyle and veterinary care of cats in Australia and New Zealand

Abstract

Objectives

The aim of this survey was to provide up-to-date information on the demographics, lifestyle and veterinary care of cats in Australia and New Zealand.

Methods

An online survey consisting of 19 questions was created using SurveyMonkey. Cat owners were invited to participate through advertisements in veterinary clinics and social media.

Results

The average number of cats in a household was two. The majority of cats lived in free-standing houses (78%) in the suburbs (66%). The majority of cats were desexed (94% [49% female neutered; 45% male neutered]). A total of 57% of cats had been strays or came from an animal shelter. A total of 40% of owners had intended not to let the cats outside when they first acquired them. A total of 63% of cats were described as indoor–outdoor cats. Although owners described 34% of cats as ‘indoor only’, 58% of those cats had access to the outdoors. The majority of respondents’ cats were vaccinated annually (63%) and visited a vet at least annually (79%). The most common reasons to take a cat to the vet were vaccinations or the cat being unwell. The most common reasons not to regularly take the cat to the vet were that the cat was never unwell, cost or stress for the cat.

Conclusions and relevance

Consideration of the lifestyle of cats is important to optimise veterinary care. Cats across Australia and New Zealand have a variety of different and changing lifestyles. Therefore, careful owner questioning is required at each visit to maximise healthcare outcomes for cats.

Introduction

In Australia and New Zealand, cats are a common pet, with the owned cat population estimated at 3.3 million ¹ and 1.13 million, ² respectively. Despite high levels of cat ownership in these countries and their increasing importance as pets, there is a relative paucity of published information regarding the lifestyle and demographics of cats, and the nature of their veterinary care. Available data on feline demographics and lifestyles in Australia has thus far been limited to specific and restricted geographical areas: Perth, ³ Australian Capital Territory (ACT), ⁴ Sydney^5,6 and a suburb of Townsville. ⁷ To the best of the authors’ knowledge, there are no similar published, peer-reviewed data available from New Zealand. Consideration of these factors is important for feline practitioners in optimising health care outcomes for their patients. Husbandry and lifestyle factors may influence the risk of exposure to certain infectious agents, including important zoonotic agents, the risk of physical trauma or the propensity to develop specific behavioural problems. An understanding of the lifestyle of cats can inform decisions relating to differential diagnoses and treatment and prophylaxis of microbial and parasitic diseases.

The benefits of regular wellness visits for cats are recognised by the veterinary community. ⁸ Despite acceptance and promotion of the importance of regular veterinary care by the profession, studies conducted elsewhere have highlighted a disparity between these recommendations and the reality of veterinary care provided to owned cats. A study of feline veterinary care has been conducted in the USA ⁹ but to the best of the authors’ knowledge little is known about the reasons that owners in Australia and New Zealand visit or do not visit veterinarians regularly with their cats. Filling this existing knowledge gap may allow for informed strategies to be developed to encourage owners to be more proactive with their veterinary visits, with a likely consequence of improved healthcare outcomes.

The aim of this survey therefore was to provide up-to-date information on the specific features of the demographics and lifestyle of cats under veterinary care across Australia and New Zealand. The survey also investigated cat owners’ awareness of feline infectious diseases, vaccination and visit rates and reasons why cats are not taken to the veterinarian regularly. The resulting snapshot of the owned cat population provides important baseline information for feline practitioners in these countries.

Materials and methods

An online survey was created using cloud-based software from SurveyMonkey. The survey opened on 18 August 2014 and was closed on the predetermined date of 28 January 2015. Cat owners in Australia and New Zealand were invited to participate through advertisements in veterinary clinics and social media.

The survey consisted of 19 questions (see supplementary material) reflecting potential cats’ demographics, source, lifestyle and veterinary care. Questions were designed by the authors with input from a number of practising feline veterinarians and feline specialists. Where possible the questions were constructed to require a single binary response (yes/no) by the participants. Most questions were presented in multiple choice format, with a series of fixed potential answers including an option for ‘other’, providing an opportunity for free text to be inserted. To enhance participant comprehension, colloquial or common terms were used in addition to scientific nomenclature. Six questions were mandatory (marked with an asterisk, see supplementary material); the survey would not progress if the owner did not type an answer to these questions. The other 13 questions could be skipped should the owner wish not to answer them. The final question (Q19) appeared in the survey only if the owner had ticked any of the boxes in the preceding question that showed they visited the vet with a frequency of less than once per year.

A sample size of 1067 owner responses was determined to be sufficient for a ± 3% margin of error at a significance level of 0.05. Multiple choice questions allowed only calculation of the percentage response for each answer option. The minimum, maximum, mean and median responses were calculated for each question with a numerical answer. The relationship between variables was calculated using χ₂ tests (SAS9.4; SAS Institute).

Results

Participants

There were 1803 respondents and Figure 1 shows the distribution of respondents across Australia and New Zealand. A total of 1603 respondents answered all of the mandatory questions.

Figure 1

Map of (a) Australia and (b) New Zealand showing distribution of respondents

Demographics

The majority of cats lived in free-standing houses (78.3%) in the suburbs (66.0%). The median number of cats in a household was 1 (range 1–28). The majority of the respondents (51.2%) were from single-cat households, 46.4% had 2–5 cats, 1.8% had 6–9 cats and 10 households (0.6%) owned more than 10 cats. The median age was 4 years old (range kitten to 22 years) with 14.6% of cats classed as 1 year old or younger. There was no significant difference in age by area, state or type of dwelling. The majority of cats (55.1%) were classed as domestic shorthair. Pedigree cats comprised 27.5% of the population and consisted of 35 different breeds. People in the Central Business District (CBD), ie, city centre, were significantly more likely to own a pedigree cat (36.4%) than people who were rural (22.7%), semi-rural (27.7%) or suburban (27.1%) (P <0.01 for all comparisons with CBD). The majority of the cats were desexed (94%) and males and females were almost equally balanced (48.9% female neutered; 44.6% male neutered). The distribution of age and gender are shown in Figure 2. Cats in New Zealand were less likely to live in the CBD than cats in Australia (1.9% vs 10.1%) and more likely to live rurally (16.3% vs 11.6%); both comparisons P <0.0001.

Figure 2

Age and sex distribution of client-owned cats included in the survey

Lifestyle

The majority of cats (56.6%) had an unknown background when acquired by their current owners, consisting of those which were classified as found or strays (20.6%) and those which had come from an animal shelter (36.0%). An additional 12.0% of cats had been acquired from a veterinary clinic and these are often kittens or cats from an unknown source. Only 18.7% of cats came from a registered breeder.

In classifying the lifestyle of their cat, owners classified 33.9% of cats as indoor only, 3.0% as outdoor only and 63.0% were described as indoor–outdoor. New Zealand had fewer cats classified by their owners as indoor only than Australia (5.2% vs 39.0%, P <0.0001). Only one classification was allowed per cat, and the survey provided a description for indoor–outdoor as meaning ‘any combination of inside and outside of the house’. Of the 1620 respondents who answered this question, 5.0% owned both indoor only and indoor–outdoor cats and 0.06% had both indoor only and outdoor only cats. Regardless of the owner classified indoor–outdoor status of their cat, a follow-up question asked for details about the type of access the cats had to the outdoors, and gave a choice of fixed answers only. Of the 33.9% of owners who described their cats as ‘indoor only’ in the previous question, 58.3% indicated their cats actually had some degree of current or previous access to the outdoors. The nature of the outdoor access of these owner-classified ‘indoor only’ cats included ‘they only go outside in an enclosed run’ (35.1%), ‘only go outside when I watch them’ (23.2%), ‘only go outside for a short time’ (defined as less than 30 mins per day; 21.6%) and ‘they used to be indoor–outdoor or outdoor cats but now I keep them inside all of the time’ (20.1%). A subsequent question asked whether those indicated as ‘indoor only’ cats had ever been outside at some point in their lives, not including in a cat carrier. A total of 60.4% of cats classified by the owners as ‘indoor only’ had access to the outdoors at some point in their lives.

Sub-analysis showed that cats described by their owners as indoor only were more likely to live in a flat/apartment vs a free-standing house (54.8% vs 30.6%, P <0.0001) and in a flat vs a townhouse (54.8% vs 44.4%, P <0.02). Indoor only cats were also more likely to reside in the CBD (46.1%) than in rural (22.6%), semi-rural (33.6%) or suburban areas (34.6%) (P <0.0001 for all comparisons with CBD). Pedigree cats were significantly more likely than non-pedigree cats to be described as indoor only (44.4% vs 30.8%, P <0.0001).

The results indicated that 39.7% of all owners had intended not to let the cats outside when they were first acquired. The most common reason for the owners to change their minds were ‘I felt bad keeping them inside’, ‘it was too hard to keep them inside’ or ‘we moved area’.

Veterinary care

The majority of respondents’ cats visited a vet annually or more often (79.2%), with only 6.2% of respondents having taken their cats to a vet just once in its life. Overall 62.6% of cats were vaccinated annually with flat dwelling (78.5%), CBD and suburbs (68.4%) and pedigree cats (67.5%) the most likely to be vaccinated annually. New Zealand owners were less likely to vaccinate their cat annually (52.4% vs 64.3%) and more likely to do so every 2–3 years (19.1% vs 12.4%) (P <0.0001 for all comparisons with Australian cats).

The most common reported reasons to take a cat to the vet were when the cat was unwell (77.5%), regular vaccinations (75.1%) or routine check-ups (55.8%). Less common reasons were cat fights (29.1%), blood tests (16.7%), skin problems (16.2%) or chronic illness (17.1%). Owner-reported indoor cats were more likely to visit the veterinarian once a year than outdoor cats (65.4% vs 59.8%, P <0.01), as did pedigree cats (66.4% vs 60.3%, P <0.01). CBD cats (68.1%) visited more frequently than rural (59.3%), semi-rural (52.5%) or suburban (63.2%) (P <0.0001 for all comparisons with CBD). Australian cats were more likely to visit the vet annually or more frequently than New Zealand cats (63.3% vs 51.9%, P <0.0001). The most common reported reasons for not regularly taking the cat to the vet were that the cat was never unwell (55.1%), financial cost associated with veterinary visits (39.9%) or stress for the cat (23.9%). A total of 12.3% of respondents did not believe that regular check-ups were necessary, 12% did not believe that regular vaccinations were necessary and 15.5% did not know that annual check-ups were recommended.

The majority of respondents’ cats were vaccinated annually (62.7%) or had vaccinations every 2–3 years (12.8%), with 12.1% reported to have been vaccinated only once as a kitten and never again since. General awareness of communicable diseases among the owners surveyed was high. The greatest awareness was for feline herpesvirus/feline calicivirus (85.4%), heartworm (80.9%) and feline immunodeficiency virus (74.7%) while the lowest level of awareness was demonstrated for feline infectious peritonitis (33.1%), Chlamydia species (51.2%) and feline leukaemia (56.4%). Only 3.4% of the owners were not aware of any of the diseases listed. A significant difference in the awareness of heartworm existed between respondents from Australia (84%) and New Zealand (57%) (P <0.0001). There was no significant difference in disease awareness between the owners of pedigree cats and those who owned non-pedigree cats.

Discussion

Information on the lifestyle and demographics of cats in Australia and New Zealand has heretofore been limited to a few geographically restricted areas. The distribution of respondents in the current study matches the distribution of people across Australia and New Zealand aside from a slight over-representation of responses from Victoria and under-representation from Queensland. The results presented therefore provide a useful snapshot of the demographics and lifestyle of cats under veterinary care in these countries. This survey also provides useful information on the nature and level of veterinary care provided to these animals.

Demographics

The median number of cats per household and median age of the cats in the current study was similar to previous reports in Australia^3,5–7 and New Zealand. ² The proportion of pedigree cats in the current survey (27.5%) was similar to the figure previously reported in Sydney (23.4%) ⁶ and Townsville (32.5%) ⁷ but higher than the figure reported in Perth (17.3%) ³ and New Zealand (4%). ² A total of 35 different pedigree breeds were represented and in common with previous data from Sydney, ⁶ the most common pedigree breed was the Burmese. Consistent with previous studies^2–4,6,7 the majority of cats were desexed. The percentage of cats desexed in more recent studies is higher than reported in the earlier Perth study, ³ which may be due to an increase over time in the percentage of cats being desexed, or may reflect differences in the study population between the different surveys (owners of cats under veterinary care vs randomly selected owners of cats).

Lifestyle

In common with a previous study conducted in a smaller geographical area of Australia and a large survey in New Zealand, ² the majority of cats in Australia and New Zealand are acquired from sources with little or no knowledge of medical history or potential prior exposure to infectious diseases. ⁷

It is perhaps not surprising given higher traffic flow and potentially lack of access to a garden, that cats that lived in urban areas in a flat or in a town house were statistically more likely to be kept indoors than cats that live in the suburbs or rural areas. Veterinarians working in such areas should consider this when educating clients upon the risk of feline predation of native wildlife species. Pedigree cats were also more likely to be kept indoors. Possible explanations for this may include a greater cat–owner bond, perhaps influenced by the financial investment involved in purchasing a pedigree cat, or perhaps the influence of advice given by breeders on the care of their cats. Lower cat–owner bonds have been previously reported overseas as being associated with owners who paid little/nothing for their cat. ¹⁰ Most cats in Australia and New Zealand have some access to the outdoors as 63.0% of cats were described by their owners as indoor–outdoor cats. This reflects the percentage of cats with indoor–outdoor lifestyles seen in previous studies: Townsville (67.7%), Sydney (72.9%)^6,7 and New Zealand (88%). ² Of the 34% of cats classified by their owners as indoor only, more than half of these (58%) actually had some form of outdoor access in their lives. Therefore, 83% (63% indoor–outdoor plus [0.58 × 34%] owner classified as indoor only = 83%) of cats in Australia and New Zealand have, or have had, access to the outdoors. Having some access to the outdoors enriches a cat’s environment but it also increases a cat’s exposure to accidents, cat fights and diseases transmitted by cat-to-cat contact.^11,12

Cats with outdoor access are at greater risk of exposure to infectious agents, either through direct contact with other cats (eg, feline immunodeficiency virus [FIV]/feline leukaemia virus [FeLV] ¹¹ ), infected wildlife (eg, Salmonella species, Toxoplasma gondii^13,14), disease carrying vectors or ectoparasites (eg, Dirofilaria immitis, Mycoplasma haemofelis^15,16) or indirectly though contact with contaminated environments (eg, Toxoplasma gondii ¹³ ). An understanding and appreciation of the increased risk faced by outdoor cats and an accurate assessment of the cat’s lifestyle may help direct a clinician’s investigations when faced with an unwell patient, and also enables an informed risk–benefit decision to be made regarding vaccination protocols and chemoprophylaxis for endoparasites and ectoparasites. It is also important in providing appropriate risk-based advice to owners regarding potential zoonoses such as toxoplasmosis and salmonellosis. The discordant results in this survey between the owner reported lifestyle of their cat, and the cat’s actual outdoor exposure highlights that additional and specific questioning should be employed to ensure a correct risk assessment can be performed so that cats receive the most appropriate prophylactic measures for their specific circumstances.

The current study also highlights that the lifestyle of a cat may change, with 39.7% of the respondents answering that they had initially intended to have an indoor only cat but had changed their minds and started to let the cats go outside based on changing beliefs, housing conditions, or changing behaviour or medical condition of the cats in the house. This is an important point to note given that when decisions were made about a kitten’s vaccinations and other prophylaxis they likely were completely indoor cats at that stage. Therefore, the veterinarian should closely question an owner at every visit about whether the circumstances of the cat have changed, as this may influence diagnostic or prophylactic decisions.

Veterinary care

Awareness of potential communicable feline diseases was high among the owner population surveyed. As most of the participants were made aware of the survey via the veterinary profession this population could be assumed to have higher disease awareness than the average population of cat owners. The fact that only 3.4% of the population surveyed were not aware of any of the diseases shows that the veterinary profession has educated their clients well. In general, the owner-reported awareness of these diseases paralleled the relative prevalence of the diseases in the population, with the highest awareness reported for feline herpesvirus and feline calicivirus, with a lower level of awareness for feline coronavirus and FeLV. A notable exception to this trend is the reported awareness of heartworm, a surprising finding given the low reported prevalence of heartworm in cats in Australia. ¹⁷ This high level of awareness of heartworm in cats in Australia may be a false association due to high general awareness of heartworm in dogs through mainstream media advertising of canine parasiticides in this country.

Almost two-thirds (62.7%) of cats were vaccinated annually, which is consistent with previous reports (72.2% and 62.5% vaccinated in the last 1–3 years^6,7). The number of owners reporting their cats receive triennial vaccination was low and may reflect the absence of registered triennial vaccines in Australia and New Zealand at the time of surveying. The proportion of cats vaccinated once as a kitten and never again was low (12.1%); however, as 14.6% of the cats in the survey were 1 year old or less, the true percentage of cats that are vaccinated as kittens and receive no further vaccines as adults is likely to be lower.

Only 6.2% of respondents had only taken their cats to a vet just once in its life. Again as 14.6% of cats in the survey were 1 year old or less it is likely that they make up a percentage of these respondents. Therefore, the percentage of owners that would only take a cat to a vet only once in its life is likely to be lower than reported. This is a similar percentage to previous studies ⁶ however it should be remembered that the respondents in the current survey were recruited via veterinary hospitals and may therefore represent a biased population that is more likely to seek veterinary care.

Annual (or more frequent) wellness visits are recommended by a number of professional bodies. Despite this, 20.8% of owners did not meet this minimum recommendation. As cats are good at hiding pain and illness, poor compliance may result in delayed diagnosis and treatment and therefore a corresponding poorer clinical outcome. Understanding and addressing the barriers, real or perceived, that prevent owners presenting their cats regularly will have positive effects on animal welfare. In this survey, the most common reasons not to visit a vet annually reflected anticipated stress for the cat, cost and a lack of perceived need. In a large survey conducted in New Zealand, the most common reasons for not taking a cat to visit the veterinarian in the past year were ‘not sick/not necessary’ (90%) and cost (14%). ² These results are similar to US-based study in which owners were asked to agree or disagree with statements regarding regular veterinary visitation. A total of 24% of those surveyed completely agreed/somewhat agreed with the statement that ‘routine check-ups are unnecessary’, 15% with the statement that ‘indoor pets don’t need check-ups’ and 34% somewhat disagreed/disagreed with the statement that ‘without check-ups pet is more likely to get sick’. ⁹ This US-based survey also showed that owners anticipated an unpleasant experience taking their cats to the vet: 58% of owners said they believed that their cat hated visiting the vet and 38% of the owners got stressed at the thought of visiting the vet. ⁹ That study also highlighted that cat owners are likely to perceive their pets as self-sufficient, low-maintenance creatures that rarely need medical attention. In addition, the same US survey showed that as 63% of cats in cat-only households never go outside; their owners assume the cats are not susceptible to disease. ¹⁸

These three surveys all show that veterinary clinics should take as many steps as possible to reduce stress for the cat and cat owner at each visit, as well as educate the owner on the need for regular check-ups and vaccination. Schemes such as the International Society of Feline Medicine Cat Friendly Clinic programme or the American Association of Feline Practitioners Cat Friendly Practice program give guidance on ways to minimise stress for feline patients and their owners and implementation of such guidelines may improve client compliance. A significant proportion of respondents highlighted cost as a factor preventing visits. Additional research in this area is needed to understand whether this is linked to the absolute ability to afford the veterinary care offered or whether it relates to a perceived lack of value in the services provided. In the latter case, increased education of clients as to the benefits of regular veterinary care, for example via client education evenings, email communications or newsletters is needed. Utilising real life examples where subclinical disease was identified early through routine check-ups leading to successful outcomes, or where lack of preventative veterinary care led to poorer outcomes, may help reinforce the benefits.

Limitations

Potential limitations for the survey include sample size and other survey errors such as respondent or survey bias. Sampling errors occur because a sample of the population is used, not the entire population. However, a large sample size does not ensure a representative sample and the design of a survey is as important as the sample size. Of the other types of survey error, it is possible that a response or non-response error occurred due to either the people who were interested and chose to take the survey or the people who chose not to take the survey biased the sample, or that the respondents gave inaccurate responses due to badly worded questions, prompted answers or reliance on memory. Non-sampling errors cannot be compensated for by increasing sample size.

Cat owners were invited to participate through access to the survey via their veterinary clinic therefore, although this may introduce some bias, the data can be used to inform clinical decision making as it represents the population of cats that the veterinarian treats. However, the results may not be generalisable to the cat population of Australia and New Zealand not under veterinary care.

Conclusions

Cat owners have a high level of disease awareness and, given a perceived need, will visit the veterinarian regularly with their pet. Cats across Australia and New Zealand often have unknown backgrounds and lead a variety of different lifestyles that can change over time. Therefore, careful owner questioning is required at each visit to maximise healthcare outcomes for cats.

Supplemental Material

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Owner questionnaire