Advice on cat behavior in German veterinary practices:Expectations of cat owners and influencing factors on compliance

ABSTRACT Veterinarians play an important role in establishing and sharing the welfare of companion animals by carrying out regular health checks and informing owners about the specific needs of the animal’s environment and conditions of good husbandry. A survey among German cat owners revealed which role advice about cat behavior plays in daily practice and its influence on the cat owner’s compliance. Some owners (29.6%, n = 263/889) reported behavioral problems in their cat. Not all owners considered their veterinarian as their contact of choice for behavioral advice, although veterinarians who met owners’ expectations for advice on cat behavior are significantly more often described as feline-friendly (P < 0.000). Owners who expected an empathetic treatment of their cat will show a better compliance (P = 0.003). Owner compliance can be improved by providing accurate and effective veterinary advice about cat behavior and behavioral problems (P = 0.003). Thus, a sound foundation in cat behavior and knowledge of current treatment recommendations for feline behavioral problems can be worthwhile to ensure good husbandry for cats.


Introduction
Veterinarians have an ethical commitment to ensure animal welfare (Neville, 2004).This also includes helping to create suitable environmental conditions for the animal.On the one hand, the veterinarian can make a contribution by carrying out regular health checks on the animals entrusted to him/her, but also by informing animal owners about the specific needs of animals and conditions required for good husbandry.The American Association of Feline Practitioners (AAFP) recommends general examination that takes place at least once a year for cats (Quimby et al., 2021).A large number of German veterinarians also adhere to this recommendation (Eschle, Hartmann, & Bergmann, 2020).To ensure that cats are regularly presented to a veterinarian, stress should be avoided as much as possible, as in a previous study 38% of cat owners reported that they perceive a veterinary visit as stressful and 28% stated that they would take their cat the veterinarian more often if the visit would not be that stressful for them and their cat (Volk, Felsted, Thomas, & Siren, 2011).In another study, we showed that 50.8% of German cat owners perceive a visit to the veterinarian as stressful (Karn-Buehler & Kuhne, 2021).Thus the provision of regular health care can be at risk when a visit to the veterinarian is perceived a stressful for both the cat owner and their cat.At the same time, reducing stress for cats during a visit to the veterinarian can increase the cat's welfare by adhering to feline-friendly handling and treatment methods, such as providing the opportunity for the cat to hide under a towel (Riemer et al., 2021) or the use of synthetic pheromones in the waiting area and the treatment room (Pereira et al., 2016;Riemer et al., 2021).
However, the routine examinations recommended annually should not only include a physical health check.The veterinarian should also take an extended history by asking about the environmental conditions in which the cat is housed (such as the number of litter boxes, feeding management, outdoor access, etc.), as well as the behavior and possible behavioral problems of the cat (Overall, 2014;Quimby et al., 2021).By expanding the history and including behavioral questions and questions about the domestic environment of the cat, veterinarians may help to ensure the cat's welfare in the home environment, as it could be determined whether the housing conditions are suitable for the cat.A survey of cat owners from Australia previously showed that there might be a need for advising cat owners about adequate housing conditions, since environmental needs of many pet cats were not being met, according to the authors (Lawson, Langford, & Harvey, 2020).For example 71.3% of the cat owners reported that they provided their cats with only one litter box or multiple litter boxes together in one place, while at the same time 19.8% of the cat owners stated that their cat showed inappropriate urination, and 79.5% respondents reported inappropriate scratching although they provided scratching posts (Lawson et al., 2020).Furthermore, a study from Italy showed that advising owners of kittens about feline behavior led to these owners reporting fewer behavioral problems in their cats months later compared to owners who were not advised at the first veterinary visit (Gazzano, Bianchi, Campa, & Mariti, 2015).To the best of the authors' knowledge, there are no comparable studies in Germany on advice on cat behavior and behavioral problems, such as the one carried out by Gazzano et al. (2015) in Italy.
In order to successfully monitor the physical and mental health of cats, it is necessary that they are presented to a veterinarian regularly for health checks.A good veterinarian-client relationship can be helpful, since advice with good information transfer (which includes good communication skills, providing required pet-care information and addressing the pet owners' worries and fears) is positively related to strong veterinarian-client loyalty (Küper & Merle, 2019;Lue, Pantenburg, & Crawford, 2008).As a result of a strong veterinarian-client bond, pet owners are more likely to return to the same veterinarian again, even if they have to travel further distances, are less likely to visit a different veterinarian to get less expensive health care, and are much more likely to adhere to their veterinarian's recommendations regardless of the cost (Lue et al., 2008).Also empathy and positive communication experience with which the pet owner is, according to his/her own statement, satisfied can lead to repeated visits to the veterinarian (Brown, 2018).However, it has not yet been examined whether this information transfer also applies specifically to advice on cat behavior.
The aim of the study was to survey cat owners to find out to what extent advice about ways to reduce stress during veterinary visits, as well as normal and problematic cat behavior, is provided by German veterinarians.In addition, the study aimed to find out whether the advice meets the expectations of the cat owners, and whether cat owners show better compliance if such advice was given by the veterinarian.We have hypothesized that there is little advice on behavior and optimal husbandry for domestic cats provided overall during many veterinary visits.Pet owners generally seem to consult internet sources regarding pet health information more often than the veterinarian (Kogan, Oxley, Hellyer, Schoenfeld, & Rishniw, 2018;Volk et al., 2011).We therefore hypothesized that the veterinarian may not be the contact of choice for cat owners when it comes to questions about cat behavior because the owners' expectations of veterinary advice are not met.Furthermore, we suspected that cat owners would like more advice from the veterinarians on how to implement a low-stress veterinary visit and cat behavior in general, and that good advice and education from the veterinarians on these issues leads to better compliance of the cat owners.
To test our hypotheses, cat owners from all over Germany were invited to participate in an online survey, as we were especially interested in their opinion and perception of advice given by their veterinarians.Even if this method leads to a convenience sample, the attitudes of a large number of respondents on a certain topic can be determined, which is why online surveys have been increasingly used in scientific practice to survey cat owners in recent times (Gehrig et al., 2019;Grigg & Kogan, 2019;Küper & Merle, 2019;Lawson et al., 2020).

Data collection
As the questionnaire was very extensive, the results of the survey on the subject of stress in cats and their owners when visiting the veterinarian, as well as the demographic data of the respondents, were published previously (Karn-Buehler & Kuhne, 2021).A questionnaire was created encompassing questions from typical categories of advice in the veterinary practice, cat behavior and problem behavior in cats and expectations for advice from the veterinarian (see the Supplementary Materials for the full questionnaire).Before publishing, a pilot study with four test persons was conducted in order to check the questionnaire for comprehensibility and completeness.Answering the questionnaire took about 20 minutes.The survey was available for participation via LimeSurvey® (LimeSurvey GmbH, Hamburg, Germany) from June 12, 2020 to December 31, 2020 and and aimed at all cat owners in Germany.The owners were motivated to take part in the completely anonymous survey through different online channels.The link to the online survey was published on Facebook, Instagram, in cat forums and a trade magazine, which resulted in a convenience sample of cat owners.Owners of multiple cats were initially instructed to select a cat from their household and to answer the questionnaire with regard to this selected animal.Data were collected and evaluated completely anonymously.The consent to the use of the data in accordance with the General Data Protection Regulation (GDPR, Regulation (EU) 2016/ 679) at the beginning of the questionnaire was mandatory for participation.An answer to all the other questions was optional.Given the opportunity to skip single questions and terminate the survey at any point, some incomplete records were collected.

Survey response
A total of 1075 cat owners participated in the survey, but 186 respondents canceled directly after agreeing to the GDPR without answering any questions.The questionnaires of the remaining 889 respondents were evaluated in the descriptive analysis.Of these, 731 participants completely answered the questionnaire.As answering particular questions was not obligatory to continue the survey, some respondents did not answer all the questions.However, regardless of this, all the answers given by a respondent were included in the analysis.

Data analysis
The data were statistically evaluated using IBM SPSS® Version 27 Statistics Software (SPSS Inc., Chicago, IL).A descriptive summary of all responses was created.The respondents could agree or disagree with various statements designed to detect if the veterinarian provides advice on how to reduce stress for cats during and after veterinary visits (as recommended in the AAFP and ISFM Feline-Friendly Handling Guidelines (FFHG) (Rodan et al., 2011)) e.g., "My veterinarian has already advised me on how I can make a veterinary visit less stressful for my cat" or "My veterinarian advised me to put a towel/blanket over the carrier when I have to wait in the waiting room with my cat"); and, on cat behavior in general (e.g., "There is a contact person in my veterinarian's practice who I can turn to, if I have a problem with my cat (e.g., the cat bites or pees in the apartment)").Subsequently, cat owners were asked if they have ever had noticed behavioral problems in their cat, and if so, who helped them address the problem behavior, and who they usually consult for advice on general cat behavior.
To detect cat owners' expectations for the veterinarian being able to provide appropriate advice on cat behavior and housing conditions, the respondents were asked to agree, partially agree, partially disagree or disagree to statements like "I expect my veterinarian to give me tips on what a cat-friendly home/facility looks like." or "My expectations of my veterinarian, when I have a question about my cat's behavior, have always been met."Finally cat owners were asked to provide information about the housing conditions of their cat by answering yes/no questions about access to food and water, toys and scratching opportunities.Linear regression was used to detect significant dependencies between the owner's perception of, and the veterinarian's advice on, low stress designs of veterinary visits, cat behavior and behavioral problems.Two statements at a time were selected and subjected to a linear regression to detect interdependencies.Owner compliance was determined using a principal component analysis (PCA) by analyzing three statements the respondents should agree, partially agree, partially disagree or disagree with on adhering to and implementing the veterinarian's advice.In order to be able to identify influencing factors on compliance, the factor resulting from the PCA was in turn subjected to a linear regression with individual statements on veterinarian's advice and owner expectations.The calculation of one main component ("The veterinarian is perceived as feline-friendly, patient and empathetic"), which was also used for statistical evaluation in this paper, has already been published in a previous paper (Karn-Buehler & Kuhne, 2021).In all statistical evaluations, P < 0.005 was considered statistically significant.

Advice on the low-stress design of a veterinary visit provided by veterinarians
Only 25.2% (n = 192/762) of the cat owners reported that their veterinarian had already advised them on how to organize a visit to the veterinarian in a low-stress manner.There were also few respondents who stated that their veterinarian had provided advice on transportation of a cat with minimal stress; 20.9% (n = 159/762) stated that they had been informed about what a good carrier for cats looks like or how carrier training can be performed at home (16.8%, n = 127/757).Only a minority (15.6%, n = 119/761) also reported receiving veterinarian's advice on the use of synthetic feline pheromone fractions to support low-stress transport to and from the veterinarian.In addition, 52.7% (n = 67/127) of the owners who had received advice from their veterinarian on carrier training stated that they nevertheless perceived putting or leading the cat into the carrier as stressful for themselves.According to the owners, only 27.0% (n = 141/523) of the veterinary practices provided advice on a particular problem behavior of cats (e.g., aggressive behavior in a multi-cat household, which can occur between the cats after the return home of a single cat visiting the veterinarian).Cat owners whose veterinarian had given advice on how to achieve a stress reduction in regard to a visit to the veterinarian and/or at home (for example, by providing advice on carrier training; or, information on how to avoid aggressive behavior toward the returning cat in a multicat household) described their veterinarian significantly more often as being feline-friendly (R 2 = 0.017, F (1,510) = 8.938, P = 0.003).

Advice on behavioral problems in cats provided by veterinarians
In addition to asking respondents about advice on specific behavior problems that arise in connection with the visit to the veterinarian, we also asked about advice received on cat behavior and problem behavior in general.Less than a third of the owners (29.6%, n = 263/889) reported that they have or have had a behavioral problem with their cat (e.g., the cat bit or peed in the apartment).Of those owners who report behavioral problems, 37.7% (n = 98/260) mentioned that the veterinarian they visit most often could also help them with problem-solving behavioral issues.If their veterinarian could not help solve the problem, most owners sought advice on the internet (Figure 1).A total of 55.9% (n = 425/760) of the owners stated that the veterinary practice they visit most often has a contact person whom they can initially address if they observe behavioral problems in their cat.

Advice on cat behavior provided by veterinarians
For general questions about cat behavior, most owners sought advice on the internet; followed by the veterinarian they visit most often (Figure 2).The owners' expectations for the veterinarian being able to provide advice on cat behavior were high.Most owners (86.7%, n = 657/758) expected their veterinarian to be able to provide appropriate behavioral advice.At the same time, however, veterinarians were the contact of choice for questions about cat behavior for just over half of the owners (58.9%, n = 446/757).Slightly more owners agreed that their veterinarian fulfills their expectations regarding advice and information about cat behavior (69.4%, n = 526/758).Cat owners, who stated that their subjective expectations of the veterinarian's advice on cat behavior had been other 1% Figure 1.Sources of help and advice on behavioral problems with cats consulted by German cat owners (n = 162) when their veterinarian was unable to help them successfully resolve the issue.
met, also perceived their veterinarian as feline-friendly, patient and empathetic more often (R 2 = 0.077, F (1,752) = 62.373,P < 0.000).Those cat owners were also more likely to agree that their veterinarian was their contact of choice in questions about cat behavior (R 2 = 0.181, F (1,755) = 167.224,P < 0.000).
At the same time, there seemed to be little demand for advice on the basic environmental needs of cats.A majority (64.9%, n = 492/758) of owners said that they expect a veterinarian to be able to advise on species-appropriate housing conditions.To assess the subjective knowledge of cat owners about cat behavior, respondents were asked to agree, partially agree, partially disagree or disagree to the statement "I can say about myself, that I know a lot about cat behavior."4.1% of the cat owners (n = 31/748) disagreed or partially disagreed and were therefore defined as having little knowledge of cat behavior based on their self-assessment.Those owners were more likely to desire more advice and information from the veterinarian about environmental needs (R 2 = 0.024, F (1,737) = 18.129,P < 0.000) than those who agreed or partially agreed to the statement and were therefore assigned as being familiar with normal cat behavior.Owners were also more likely to desire more advice and information from the veterinarian about environmental needs, if the veterinarian had previously informed them about cat needs (R 2 = 0.012, F (1,743) = 8.716, P = 0.003).
Only 17.3% of the owners (n = 129/747) were made aware by their veterinarian that cats require specific environmental conditions in order to ensure their well-being.At the same time, however, not all cat owners fully met the basic needs of cats in their home environment (Figure 3).A large majority of the owners (94.9%, n = 710/748) stated that they were familiar with normal cat behavior.It is noteworthy that fewer people (77.7%, n = 582/749) educated themselves about cat behavior before they obtained a cat.Overall, 10.7% (n = 80/747) of the owners stated that the veterinarian suggested that she/he should educate herself/himself about cat behavior before opting to adopt or obtain a cat.

Compliance
For our survey analyses, compliance was rated as high if the owners agreed to several statements about following the veterinarian's advice, the importance of their cat's health, and receiving detailed information from the veterinarian concerning the cat's state of health (Table 1).Most of the owners (97.0%, n = 726/748) stated that one reason to change veterinary practice they visit would be if they did not like the way the veterinarian treated their cat.On the other hand, only 41.7% (n = 312/749) regarded a lack of advice on cat behavior as a reason to visit a different veterinarian the next time one was needed.Almost all owners agreed that their cat's health is a valuable asset and that they were willing to spend a lot of money for it, depending on their circumstances (97.9%, n = 731/747).
A majority of the owners (93.7%, n = 703/750) were willing to invest more money in therapies if the veterinarian gave them detailed explanation and advice on the clinical picture of their cat's disease.
The vast majority of owners reported trying to implement the advice of their veterinarian in the best possible way (98.2%,n = 734/748).Owners for whom it was important that the veterinarian treats their cat sensitively showed higher compliance (R 2 = 0.127, F (1,711) = 108.458,P < 0.000).Compliance was also higher when the veterinarian was able to provide advice on cat behavior and behavioral problems (R 2 = 0.012, F (1,736) = 9.078, P = 0.003).A little more than half of the respondents (55.6%, n = 417/750) stated that they would appreciate if there were more cats-only practices and clinics available to them.Cat owner who welcomed more cats-only practices and clinics also showed higher willingness to invest money in their cat's health (R 2 = 0.014, F (1,745) = 10.913,P = 0.001).The health of my cat is important to me.For this I am also willing to spend as much money as it is possible for me.
If my veterinarian informs me in detail about the disease of my cat, I am also willing to invest more money in examinations and therapies than without detailed information from the veterinarian.

Discussion
The results show that only around 25% have ever taken up advice from their veterinarian about techniques to ensure a low-stress veterinary visit.It is known that owner perception of stress in cats during a visit to the veterinarian can lead to a decrease in regular consultations (Volk et al., 2011) and thus the recommended, at least annual, preventive health care may be at risk (Quimby et al., 2021).An important step to retain clients and thus to ensure regular health checks of their cats could be appropriate advice on how to effectively reduce the stress of veterinary visits for the cat.It should be noted that a visit to the veterinarian starts at home; owners can already perceive signs of stress in their cat before going to the veterinarian in the home environment (Mariti et al., 2016) and, above all, the transport of the cat can be perceived a stressful situation for the animal and its owner (Mariti et al., 2017).Raising the owner's awareness of how to counteract transport stress by using carrier training may help, as it has already been shown that this training can have a positive effect on signs of stress in the cat (Pratsch et al., 2018).It might also be useful to proactively educate the owners about the body language and behaviors associated with feline stress, as owners themselves may not recognize signs of stress in their cat (Mariti et al., 2017) and thus may not see the need for a carrier training.What we cannot determine with our survey is whether an advisory service was offered by the veterinarians but not accepted by the owners.However, the study from Volk, Thomas, Colleran, and Siren (2014) showed deficits in the provision of behavioral advice by veterinarians; in a survey among veterinarians, only a few provided instructions on how to make transportation and visits to the veterinarian less stressful for the cat (Volk et al., 2014).
Even if the owners' expectations of the veterinarian regarding information about cat behavior are largely met and appropriate advice is thus expected from their veterinarians, veterinarians are still not the contact of choice for most owners when they have questions about their cat's behavior.Here, advice is sought more frequently on the internet (Figure 2).This finding is in line with results from previous research that the internet is playing an increasingly important role as a source of information for owners regarding the care of their animal (Volk et al., 2011).It is essential that behavioral advice is given by behavior professionals, in order to avoid diseases that can arise in connection with psychological problems, the failure to meet essential needs and development of associated stress, such as a feline lower urinary tract disease (FLUTD) (Amat, Camps, & Manteca, 2016;Buffington, 2002;Sparkes et al., 2016).This may be particularly important for indoor cats, as these cats may be more at risk of developing behavioral problems than cats with outdoor access (Bradshaw, 2018;Heidenberger, 1997;Sandøe et al., 2017); indoor cats in our survey make up the largest proportion among the different housing styles (52.5% (n = 384/731) indoor cats with limited and secured outdoor access and 18.2% (n = 133/731) cats living exclusively indoors).If owners have more knowledge about cats, they also report comparatively fewer behavioral problems in their animals (Grigg & Kogan, 2019).At the same time, more detailed training of veterinarians and veterinary staff in this area may be required to impart this expertise, as there seems to be a lack of confidence among veterinarians about their own knowledge about cat (problem) behavior (Goins, Nicholson, & Hanlon, 2019).In a survey conducted among Irish veterinary personnel only about 60% of the surveyed persons were convinced that they are able to recognize and identify behavioral problems in cats correctly (Goins et al., 2019).This may also be reflected in the small number of cat owners in our survey who say their veterinarian was able to help them resolve problematic behavior in their cat.
In this study, a large majority (94.9%, n = 710/748) of owners said they were well-versed in cat behavior, which is in line with the results of a survey of cat owners in Australia (Lawson et al., 2020).However, owners' claims of knowledge about cat behavior and needs should be questioned, as these claims were not supported by responses to other survey items.One result from this study can illustrate this discrepancy as an example: Although 94.9% of the respondents stated that they were well-versed in cat behavior, only 76.1% (n = 566/744) said that their cat had more than one litter box available, despite the common recommendation that a cat should be provided with more than one elimination space (DePorter, 2016;Ellis et al., 2013;Neilson, 2004).A proactive instruction by the veterinarian on this topic could therefore not only improve the environmental conditions for cats in this example; correct toilet management can also help prevent FLUTD in cats (Sparkes et al., 2016).Thus, owners claiming to be familiar with cat needs and behavior, as well as those who do not, could both benefit from advice on this issue.In order to create a healthy environment for cats, several housing conditions, in addition to a correct toilet management, should be addressed by veterinarians when advising cat owners about specific needs of cats (Ellis et al., 2013).Veterinarians should at least recommend: • unlimited access to key resources like food and water • appropriate opportunities to scratch and play • sufficient individual hiding and sleeping spaces • opportunity for the cat to experience stable and predictable social interactions with their human • cats should be allowed to deposit its scent Providing housing conditions that meet all of these points allows the cat to display its natural behavior.Advising cat owners on this behavior can prevent the cat from experiencing stress and ensures well-being for the cat.For example, by advising on the importance of scent marks, a veterinarian can prevent the owner from removing those marks and thus the cat's sense of security.Due to the design of the study, we cannot say whether cat owners expect advice from their veterinarian on these explicit aspects of cat husbandry.But what we can say is that nearly 64.9% of cat owners expect their veterinarian to advise on species-appropriate housing conditions and over 86.7% of cat owners expect their veterinarian to be able to provide appropriate advice on cats' general behavior.The veterinarian must therefore be able to advise on the environmental needs mentioned here and associated natural cat behavior, so that owners, in turn, perceive them as feline-friendly and as a contact of choice; instead of first asking the internet for advice, which 31% of respondents do.Behavioral problems in cats often require professional advice from a referring behaviorist, which is supported in the present study by the fact that only 37.7% of cat owners who reported behavioral problems in their cats stated that the veterinarian they visit most often, could help them solve behavioral problems.Veterinarians who have not completed a postgraduate behavior specific training program, for example such as those approved by the American College of Veterinary Behaviorists (ACVB) or the European College of Animal Welfare and Behavioral Medicine (ECAWBM), should therefore refer cat owners to specialist behaviorists when behavioral issues are present.
The proportion of cats not being neutered or spayed has to be taken into account from an animal welfare point of view.Even if the percentage of intact cats roaming outdoors is lower than in previous surveys among German cat owners (Kuhne, 2019), it is nevertheless noteworthy that this hardly differs from the proportion of non-neutered cats kept exclusively indoors.The reasons why indoor cats might not been spayed could be that they are too young and have not been spayed yet or the cats are used for breeding purpose.Cats having unlimited outdoor access should be spayed, in order to prevent uncontrolled reproduction of cats (Wallace & Levy, 2006).Behavioral problems and unwanted behaviors such as urine marking or inappropriate urination may also be eliminated or at least decreased by early neutering in both sexes (Quimby et al., 2021) and thereby reduce the risk of abandonment of cats by enhancing the human-cat bond (AAFP Position Statement, 2012).
Although reported compliance values were very high even without the veterinarian providing advice about general and problematic cat behavior, we were able to show that provision of such information still affects the owner's compliance.This confirms that compliance is not only determined by the willingness of the owner to adhere to the veterinarian's recommendation (Wayner & Heinke, 2006), it is a sum of the veterinary advice, the acceptance of the owner and the care provided by the veterinarian and practice staff (Eschle et al., 2020).Conversely, one could come to the conclusion that without appropriate advice, good compliance cannot be expected on the part of the owner.Good communication on the part of the veterinarian is essential, as is shown in our results, as well as in other published studies.Most of the owners (93.8%, n = 703/750) in the present study agreed with the statement that, if the veterinarian provided detailed information, they would be willing to invest more money in examinations and therapies than without this detailed consultation.It has been shown previously that a good exchange of information leads to an increase in satisfaction and loyalty of the owner (Küper & Merle, 2019), whereas a lack of information can be the reason that a veterinary practice is avoided by the owner in the future (Brown, 2018).Lue et al. (2008) were already able to identify the communication skills of veterinarians as a good indicator of strong customer-veterinarian loyalty.By developing a strong relationship between both parties, trust could be established to the extent that the veterinarians are seen as contact of choice with regard to cat behavior.Thus, a comprehensive, evidence-based treatment of both the cat's physical and mental health might be guaranteed from a single source.The interaction of the veterinarian with the pet also influences the customer-veterinarian bond (Lue et al., 2008) and we, too, were able to identify the owners' expectation of the veterinarian treating the cat sensitively as a further factor influencing owner compliance.A direct impact of particular feline-friendly handling and treatment methods, which are recommended in the FFHG, on owner compliance could not be determined as significant.Nevertheless, it could be both helpful (from a compliance perspective) and economically rewarding for a veterinarian to be perceived as feline-friendly by the owner and to implement the recommendations of the FFHG in practice, since the desire for more cats-only practices correlates positively with the willingness to invest financially in the cat's health.In such cats-only practices, for example, due to the fact that only cats are treated, one can assume that no dogs and associated smells will be found in the waiting room or, in the case of hospitalization, in the ward and that cat cage equipment is especially designed for cats (Horwitz & Little, 2016;Rodan et al., 2011).

Limitations
Due to the distribution of access to the survey and the fact that no remuneration was made for participation, it can be assumed that only committed cat owners took part and the study population cannot be regarded as representative, as we used a convenience sampling method.This method is increasingly used in veterinary science due to the wide spread use of the Internet and the possibility of surveying many pet owners (Gehrig et al., 2019;Grigg & Kogan, 2019;Küper & Merle, 2019;Lawson et al., 2020).The cat owners were approached to take part in the survey via social media, cat forums and a trade magazine, which means that primarily those who are explicitly interested in cat content were made aware of this study.Proactive advice and information about cat behavior seems to be all the more important in order to alert less interested owners to this topic, since major problems in cat husbandry could arise in the absence of sufficient owner knowledge and interest.Cats' mental and physical health could thus be more at risk in those cases.

Conclusions
The key findings of the present study are: -If veterinarians provide advice on low-stress designs of a veterinary visit and meet owners' expectations of advice on general cat behavior, veterinarians are perceived more often as felinefriendly and cat owners will show higher compliance.
-Veterinarians should aim for being feline-friendly as cat owners reported that they would change the veterinary practice or clinic they visit, if they don't like the way their cat is treated by the veterinarian.
-Cat owners who appear to have little knowledge of general cat behavior or where history shows that housing conditions do not meet the cat's environmental needs should be advised proactively, as these owners also increasingly requested veterinary advice.
We were able to show that, despite there being minimal provision of advice on cat behavior and minimal implementation of low-stress handling practices in German veterinary practices, these variables represent an influencing factor on good owner compliance.Veterinarians should also be invested in

Figure 3 .
Figure 3. Owner information on environmental conditions and resources available to the cat in the household.

Table 1 .
Statements used for describing the owner's compliance determined by principal component analysis (PCA).