The Veterinary Journal 234 (2018) 96–101

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The Veterinary Journal

journal homepage: www.elsevier.com/locate/tvjl

Original Article

Respiratory rate of clinically healthy cats measured in veterinary

consultation rooms
E. Dijkstra, E. Teske, V. Szatmári*
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM, Utrecht, The Netherlands

A R T I C L E I N F O A B S T R A C T

Article history:
Accepted 21 February 2018 Respiratory rate is commonly recorded during physical examinations. However, reference intervals are
only available for resting and sleeping respiratory rates in cats at home. This observational study aimed to
Keywords: establish reference intervals for the respiratory rate in clinically healthy adult cats at primary-care
Breathing veterinary clinics. Respiratory rates were recorded from 131 cats, in 6 primary-care veterinary clinics, by
Feline observation under four circumstances: by the investigator in the consultation room prior to and during a
Physiologic physical examination, by the owner at home when the cat was resting or sleeping, and by the investigator
Reference when watching a video-film of the cat recorded by the owner at home.
Video
The respiratory rate of the 88 clinically healthy adult (12 months) cats in the consultation room
ranged 28–176 breaths/min (median 64) with a calculated reference interval of 32–135 breaths/min.
Based on video-recordings, the resting (n = 32) and sleeping (n = 38) respiratory rates of the same cats
were determined: median 27 (range 16–60) breaths/min and median 20 (range 9–28) breaths/min,
respectively, which were lower than the respiratory rates recorded in the consultation room (both
P < 0.0001). We conclude that the reference intervals proposed for cats in textbooks reflect the resting
respiratory rate at home. These values are inappropriate for using in the veterinary consultation room,
because based on such reference intervals, many cats would erroneously be categorized as having
tachypnea. Since the resting and sleeping respiratory rates at home show less variation, owners should be
encouraged to film their pets before they visit their veterinarian.
© 2018 Elsevier Ltd. All rights reserved.

Introduction recommended in textbooks (20–40 breaths/min) is inappropriate

for use in outside home environments (Rijnberk and Stokhof,
Respiratory rate is one of the most commonly assessed 2008).
physiologic parameters taken by veterinarians on a daily basis, Therefore, we sought to establish reference intervals for the
in each species, including cats. Increased respiratory rate can be respiratory rate in cats outside the home environment. We counted
caused by numerous physiologic and pathologic disorders, such as the respiratory rates of apparently clinically healthy, client-owned
stress, hyperthermia, pain and diseases of several organ systems cats brought to primary-care veterinary clinics in the consultation
(Sigrist et al., 2011). Identifying a respiratory rate as increased (i.e. room and had owners count and video-record respiratory rates at
tachypnea) requires a reference interval, derived from a large home. We hypothesized that respiratory rates of clinically healthy
cohort of healthy cats. Two studies have reported the respiratory cats at home would be lower than in the consultation room during
rates of cats with subclinical and clinical heart disease in the home a veterinary examination.
environment (Ljungvall et al., 2014; Porciello et al., 2016).
Additionally, one study describes the effect of hospital visits on Materials and methods
the respiratory rate and other physiologic variables in 30
Animals and inclusion criteria
apparently healthy cats (Quimby et al., 2011). However, a reference
interval for respiratory rates of cats in veterinary consultation Healthy client-owned cats were enrolled in this prospective descriptive field
rooms is lacking. Our impression is that the reference intervals study. Cats were considered to be clinically healthy based on their medical files,
medical history, general appearance and physical examination. If cats did not have a
physical examination at the time of respiratory rate evaluation, we considered them
as assumed healthy based on their medical files, general appearance and their
* Corresponding author. owners’ opinion. Physical examination consisted of evaluation of the respiratory
E-mail address: [email protected] (V. Szatmári). rate, respiratory type and respiratory effort, assessment of the femoral pulse

https://doi.org/10.1016/j.tvjl.2018.02.014
1090-0233/© 2018 Elsevier Ltd. All rights reserved.
 E. Dijkstra et al. / The Veterinary Journal 234 (2018) 96–101 97

(quality, rhythm and frequency), the hair-coat, the skin, the mucous membranes Ambulatory respiratory rates were recorded only if counted for at least 15 s. If
and the lymph nodes. In addition, abdominal palpation and thoracic auscultation the investigator could repeat the respiratory rate counting under the same
were carried out in each animal. Rectal temperature was measured only in some circumstances, the two measurements were averaged.
cats. The respiratory rate was measured by inspection only (hands-off), without Immediately after completing the veterinary visit, the investigator asked each
restraint or manipulation, prior to the onset of physical examination, when the cat pet owner to record a video-film of at least 15 s of their cat using their mobile phone
was still in its carrier in the consultation room. Examination of the hair-coat and the at home when the cat was sleeping (or resting) in sternal or lateral recumbency (3rd
skin included screening for flea infestation using a flea comb in each cat. measurement), and to count the respiratory rate for 30 s immediately after filming
Exclusion criteria were the presence of a known disease, pregnancy, lactation, while the cats were still sleeping or resting (4th measurement). Owners were asked
abnormalities found during the physical examination, and purring while taking the to count the respiratory rate without touching their cats (i.e. the same way as it was
respiratory rate. The respiratory rate of cats that underwent surgery (e.g. neutering) done at the veterinary clinics), preferably when the cats were sleeping. Owners who
and/or anesthesia were taken at home at least 2.5 weeks after the event to minimize had difficulties observing their cats sleeping were allowed to record resting
the effect of any factors on the respiratory rate, such as pain and discomfort. respiratory rates. Owners were asked to avoid collecting data when the cat was
Age, gender, breed and the reason for visiting the veterinarian were recorded. obviously purring. Additionally, each owner received a one-page printed letter with
The gender at the time of the first respiratory rate collection was used. Cats were instructions about how and when to record and count the respiratory rate of her/his
classified either as adult (12 months of age) or as young (<12 months). cat, and where to send the video-recording (electronically) and the data. The
owners were specifically asked to note whether the measurement was of a sleeping
Data collection or a resting cat.
This study was purely observational and required no extra handling of the cats
Data collection took place in 6 primary-care veterinary clinics, in the cities and than already planned for the original consult, therefore no institutional approval
outskirts of Amsterdam and Utrecht in the Netherlands over a period of 3 months was acquired. All owners signed an informed consent.
between May and August 2016. All clinics had one waiting room and 1–2
consultation rooms with ongoing consultations. Patients included dogs, cats and Statistical methods
small exotic animals. None of the veterinary clinics took special measures to
comfort their feline patients (e.g. by using feline facial pheromones, a separate All statistical analyses in this study were performed with commercially
waiting room or feline consultation hours). available statistical software (SPSS v23.0; IBM Statistics, IBM and MedCalc
Data collection on each individual cat occurred in two locations (in the Statistical Software version 18, MedCalc Software bvba). P values < 0.05 were
veterinary clinic and at home) and in both locations under two circumstances. In the considered statistically significant.
veterinary clinic, the respiratory rate was obtained by a single investigator (ED) D’Agostino-Pearson tests were used to investigate whether the data were
before any handling (such as physical examination) of the cat took place (1st normally distributed. If the data showed no normal distribution, logarithmic
measurement, referred to hereafter as ‘ambulatory’ rate). During this measurement transformation was done, and the same test was run again to evaluate normal
the cat was still in its carrier or transporter and had not been handled. Thereafter, distribution of the transformed data. Data are presented as median and range.
each cat was examined by the attending veterinarian. If the circumstances allowed Comparisons between measurements was performed using a Wilcoxon signed rank
(e.g. no sniffing by the cat or no handling by the veterinarian/technician blocking test.
the investigator’s view), counting the respiratory rate was repeated during this Effects of age and gender on the respiratory rate were analyzed with regression
examination (2nd measurement). This second measurement took place always analysis (general linear regression) on the log-transformed data. MedCalc statistical
before measuring rectal temperature or performing additional investigations (such software was used to investigate if reference intervals could be modelled for
as blood pressure measurement or blood sampling). different age groups, based on the method described by Altman (Altman, 1993).

Table 1
Characteristics of the study population.

Adult cats Adult cats Young cats Young cats

clinically healthy assumed healthy clinically healthy assumed healthy
(n = 88) (n = 18) (n = 24) (n = 1)
Age Median (range) Median (range) Median (range)
5.1 (1.0–17.0) years 3.2 (1.1–17.1) years 4.0 (3.0–11.4) months 10.6 months
Sex
Female neutered 41 10 4
Male neutered 41 7 2
Female intact 5 9
Male intact 1 1 9 1
Breed
Domestic shorthair 71 12 7 1
British shorthair 2 2 3
Siamese 2
Bengal 1 4
Maine coon 1 1
Ragdoll 1 1
Persian shorthair 1
Norwegian forest 1
Birman 1
Oriental shorthair 1 1
Savannah 1
Mixed breed 8 3 6
Reason for consultation
Vaccination 75 14
Dental examination 14 1
General health check 4
Neutering 1 4
Dental cleaning 3
Removal of sutures 1 1
Deworming 1
Tick removal 1
Nail clipping 1
Grooming 1
Microchip placement 1
Recheck appointments 3 1 4
98 E. Dijkstra et al. / The Veterinary Journal 234 (2018) 96–101

Reference intervals were estimated by using the following methods: (1) for Repeated measurement of the ambulatory respiratory rate
normally distributed parameters by calculating the mean  1.96 standard deviation
during handling (physical examination) was completed in 22
of the original data, or of the logarithmically transformed data if they were normally
distributed after transformation, and thereafter back-transformed to the original clinically healthy adult cats. The median age of these cats was 6.4
units; or (2) using a non-parametrical percentile method for all other data that were years, with a range of 1.7–16.1 years. After handling, ambulatory
not normally distributed (even after logarithmic transformation; Bland, 2015; CLSI, respiratory rates (median 32 breaths/min, range 32–141 breaths/
2008). min) did not differ from those before handling (P = 0.651).
However, we noted individual differences: three cats (14%) showed
Results no change, eleven cats (50%) showed an increase and eight cats
(36%) showed a decrease in respiratory rate during handling
We screened 142 cats and excluded 11, based on the predefined
exclusion criteria: one because of lactation, six because of a cardiac
murmur and four because of evidence of disease (diabetes
mellitus, n = 1; hyperthyroidism, n = 1; chronic renal failure,
n = 1; upper airway infection, n = 1). Therefore, the study popula-
tion consisted of 131 cats, of which 106 were adult (12 months)
and 25 were young (<12 months). Of the adult population 88 cats
were classified as clinically healthy and 18 assumed healthy. The
population characteristics and the reasons for the veterinary
consultations are shown in Table 1.
All cats in the current study showed costo-abdominal or
shallow breathing, without respiratory noise (i.e. stridor or
stertor). One cat showed intermittent open mouth breathing at
the beginning of the consultation, but had no other clinical
abnormalities detected on physical examination.
Ambulatory, sleeping and resting respiratory rates did not differ
between healthy and the assumed healthy cats (P = 0.088, P = 0.287,
P = 0.480, respectively); however, we used only the data from
healthy cats for calculating reference intervals. Data from the
assumed healthy and the young cats were included only in the
comparisons between the two observers (i.e. owner versus
investigator). Fig. 2. Conjoined dot plot of respiratory rates of 22 clinically healthy adult cats
before (ambulatory respiratory rates, ARR) and during physical examination
The ambulatory respiratory rate in the 88 clinically healthy
(examination respiratory rates, ERR) at the veterinarian’s consultation room.
adult cats ranged between 28 and 176 breaths/min, with a median Examination resulted in increased (n = 11), decreased (n = 8) or unchanged (n = 3)
of 64 breaths/min (Fig. 1). Reference intervals for ambulatory respiratory rates. Respiratory rates changed from 28 to 176 breaths/min (median
respiratory rate in adult cats were 32–135 breaths/min (90% 28 breaths/min) before handling to 32 to 141 breaths/min (median 32 breaths/min)
confidence intervals [CI] 29–36 and 120–150, respectively). during physical examination (P = 0.651). The greatest increase was 53 breaths/min
and the greatest decrease was 68 breaths/min.

Fig. 1. Box and whisker plots showing (left to right) the ambulatory respiratory rates (ARR) of 88 clinically healthy adult cats (median 64 breaths/min; range 28–176 breaths/
min); resting respiratory rate (RRR) of 32 clinically healthy adult cats at home, based on video-films recorded by the owners (median respiratory rate 27 breaths/min; range
16–60 breaths/min); sleeping respiratory rate (SRR) of 38 clinically healthy adult cats at home, based on video-films recorded by the owners (median respiratory rate
20 breaths/min; range 9–28 breaths/min). The central box represents the values from the lower to upper quartile (25–75 percentile); the middle line represents the median;
and the vertical line extends from the minimum to the maximum value, excluding ‘outlier’ values which are displayed as separate points. An outlier was defined as a value that
is smaller than the lower quartile minus 1.5 times the interquartile range, or larger than the upper quartile plus 1.5 times the interquartile range (inner fences). A distant
outlier (red square) is defined as a value that is smaller than the lower quartile minus 3 times the interquartile range, or larger than the upper quartile plus 3 times the
interquartile range (outer fences).
 E. Dijkstra et al. / The Veterinary Journal 234 (2018) 96–101 99

(Fig. 2). The greatest increase was 53 breaths/min and the greatest Ambulatory and resting respiratory rates, and ambulatory and
decrease was 68 breaths/min. sleeping respiratory rates of clinically healthy adult cats differed
Of the 131 owners, 113 (86%) obtained a video-recording at significantly (P < 0.0001 for both comparisons; Fig. 3).
home and sent it to the investigator. Of these, only five (4%) were Neither ambulatory nor resting respiratory rates of clinically
unusable for evaluation at first submission. Data from assumed healthy adult cats correlated with age (P = 0.717 and P = 0.420,
healthy and young (<12 months) cats were excluded from the respectively). Consequently, we could not model different refer-
following analysis. Therefore, we evaluated 70 video-recordings of ence intervals for cats of different age categories. Ambulatory,
88 clinically healthy adult cats: 38 documented sleeping and 32 resting and sleeping respiratory rate of clinically healthy adult cats
documented resting respiratory rates at home. Resting respiratory showed no gender-related associations (P = 0.244, P = 0.022 and
rate at home ranged from 16 to 60 breaths/min with a median of P = 0.962, respectively).
27 breaths/min (Fig. 1). Resting respiratory rate exceeded The owners of 28 of the 131 cats (21%) provided resting or
40 breaths/min in only one cat. Reference intervals for resting sleeping respiratory rate counts of their cats at home by direct
respiratory rate were 14–48 breaths/min (with a 90% CI of 12–17 hands-off observation. These measurements did not differ from
and 41–56 breaths/min, respectively). Sleeping respiratory rates at measurements obtained by the investigator from corresponding
home ranged from 9 to 28 breaths/min with a median of video-recordings on group level (P = 0.362), but in some instances,
20 breaths/min (Fig. 1). Reference intervals for sleeping respiratory we noted marked inter-observer variability (Fig. 4). Differences
rate were 11–29 breaths/min (90% CI 9.6–13.7 and 26.8–30.9). between the two observers (owner and clinician) in the resting
respiratory rate ranged from 21 to +10 breaths/min (median
difference: 0 breaths/min); differences in the sleeping respiratory
rate ranged from 4 to +11 breaths/min (median difference:
1.8 breaths/min).

Discussion

Our study shows that healthy cats have higher respiratory rates
in the consultation room prior to any handling, compared to the
resting or sleeping respiratory rates in the same cats at home.
Furthermore, the reference intervals based on these data for
respiratory rates in clinically healthy adult cats in the consultation
room extend from 32 to 135 breaths/min. This suggests that using
commonly proposed reference intervals is inappropriate when
measuring respiratory rate during a physical examination.
A high respiratory rate at the veterinarian’s consultation room
can be explained with a higher excitement level when awake
(compared to sleeping) and when stressed by being taken to a
veterinary clinic (as opposed to being at home). Differences in
excitement levels in cats between home and hospital environ-
ments have been demonstrated in several studies, and showed not
only a considerable individual variation, but also remarkable

Fig. 3. A. Conjoined dot plot showing the difference in the respiratory rates of 32
clinically healthy adult cats in the consultation room (ambulatory respiratory rates,
ARR) and at home when the cats were resting (resting respiratory rate, RRR). The Fig. 4. Conjoined dot plot showing the difference between the recorded respiratory
ambulatory respiratory rates are higher (P < 0.0001) and show less variation rate (video respiratory rate, VRR; filmed by owner, counted by the investigator) and
compared to the resting rates. B. Conjoined dot plot showing the difference in the the observed respiratory rate (ORR; direct observation by the owner). The data
respiratory rates of 38 clinically healthy adult cats in the consultation room (ARR) points indicate resting or sleeping respiratory rates of cats at home. Though no
and at home when the cat was sleeping (sleeping respiratory rate, SRR). The statistically significant difference between the two groups was found (P = 0.362), in
ambulatory respiratory rates (ARR) were higher (P < 0.0001) and showed less many cases there is a clinically relevant difference between the findings of the two
variation than the sleeping rates. observers ranging from 21 to +11 breaths/min.
100 E. Dijkstra et al. / The Veterinary Journal 234 (2018) 96–101

differences within the same cat among various visits (Belew et al., We did not educate owners about how to measure respiratory
1999; Abbott 2005; Quimby et al., 2011). In a recent study, a mean rates and many owners found it hard to identify the breathing
increase in respiratory rate of 12 breaths/min, with a range of 30 movements at home. The low number of responses to our request
to +108 breaths/min, was observed at the veterinary hospital to count respiratory rates at home reflects this problem, as only 28
compared to respiratory rates counted at home (Quimby et al., of the 131 cat owners (21%) managed to count the respiratory rate
2011). The same study reported a median respiratory rate of of their cats at home. Additionally, the counts provided by the
58 breaths/min (range 18–192) in the consultation room and an at- owners often differed from the counts that the investigator found
home respiratory rate of 50 breaths/min (range 24–84) of the 28 on the video-films that were recorded contemporaneously. In
observed cats (Quimby et al., 2011). These findings are similar to contrast, owners found filming their cat breathing easy to do: 113
those we observed. Though the respiratory rates in the previous of 131 owners (86%) made a video-recording. Although we found
study were measured with visual observation both in the home no difference between the respiratory rates counted by the owners
environment and at the veterinary clinic, all cats had undergone a and the rates that were counted by the investigator from the video-
blood pressure measurement and a cardiac auscultation immedi- recordings, there were quite some clinically relevant individual
ately before recording of the respiratory rates (Quimby et al., 2011). differences. The differences in the resting or sleeping respiratory
Conversely, we performed the base line observation prior to rates counted by the owner at home and counted from the video-
removing the cat from the carrier. Nevertheless, the respiratory recording by the investigator are unlikely to be linked to the
rates we measured after performing a physical examination did not within-cat variability since the variation in these parameters is
differ from those measured at baseline, suggesting that in most very limited (Orem et al., 1977; Ljungvall et al., 2014). Therefore,
cats, the timing of the in-clinic measurements might not be relying on cat owners to reliably monitor respiratory rates in cats at
important. home might result in erroneous measurements and could
The high and wide range of respiratory rates of healthy cats complicate disease management decisions. Whether training
recorded in veterinary clinics can be explained with the difficulty owners to measure respiratory rates would improve the accuracy
of recognizing panting in cats, which, unlike dogs, often keep their remains undetermined. However, having owners record the cats
mouth closed. Once the respiratory rate exceeds 50–60 breaths/ for counting by clinicians or technicians might provide a valid
min in cats, the duration of inspiration and expiration becomes alternative in cats where owners are unable to measure respiratory
equal (Jennings and Szlyk, 1985). Compared to dogs, cats have a rates reliably and accurately.
smaller range and an earlier transition from the resting situation We measured ambulatory respiratory rates over a minimum of
(i.e. when the duration of expiration exceeds that of the 15 s instead of the widely used 30–60 s. This was necessary because
inspiration) to the stage when expiration and inspiration are of the animals were moving, sniffing or vocalizing. Since rates were
equal duration (Iscoe et al., 1983; Jennings and Szlyk, 1985). After high, a possible multiplied measurement error was less likely to
this transition point, dogs start panting (Iscoe et al., 1983). happen. To reduce this error, we used the mean of two counts of
The respiratory rate of a cat in a consultation room might also 15 s for calculating the respiratory rate whenever possible (in most
be influenced by factors such as travel time from home to the clinic, cases).
whether the cat had an indoor or outdoor lifestyle and the The presence of subclinical disease, which could have resulted
demeanor of the cat during veterinary examination and in the in an increased respiratory rate (such as anemia, cardiac or
home environment. Because of the large number of possible respiratory disease), cannot be completely excluded because no
combinations of these factors in any cat, we chose not to thoracic imaging (e.g. radiographs), plethysmography, fecal
investigate these aspects. (parasitologic) or blood tests were performed. This is especially
The reported respiratory rates of 30 healthy cats (18–192/min) true for the assumed healthy cats, where not even a routine
at a veterinary hospital (Quimby et al., 2011) are similar to the physical examination was performed. This was the reason that the
respiratory rates of 103 cats (20–180 breaths/min) in a different respiratory rates of assumed healthy cats were excluded from the
study, referred for emergency consultations because of respiratory data set that was used for establishing the reference interval.
distress (Sigrist et al., 2011), and similar to the respiratory rates of However, we did not observe differences in the respiratory rates
the present study in clinically healthy adult cats (28–176 breaths/ recorded from these ‘assumed healthy’ cats and cats that
min). These findings suggest that a single respiratory rate underwent physical examination.
measurement in a consultation room is of limited clinical value. Several studies have shown that purring cats have elevated
After a physical examination most cats experienced a change in respiratory rates (Remmers 1972; Jennings and Szlyk, 1985). A
the ambulatory respiratory rate. However, the direction (decreas- recent study on 341 cats reported that 18% of cats were purring
ing or increasing) and the magnitude of change was unpredictable. (determined by auscultation) in the veterinarian’s consultation
Adult cats in our study had a median sleeping respiratory rate of room, irrespective of health, age or gender (Little et al., 2014). It is
20 breaths/min and it never exceeded 30 breaths/min, consistent likely that in the current study purring in some cats remained
with previous observations which showed that most healthy cats unrecognized, influencing the (ambulatory and resting) respirato-
have a mean sleeping respiratory rate of <30 breaths/min (median ry rates. Particularly from the video-recordings it was impossible
19 breaths/min, range 9–37 breaths/min; Ljungvall et al., 2014). As to determine with certainty whether a cat was purring.
the previous study demonstrated, we also found that the sleeping
respiratory rates were lower than the resting respiratory rates. This Conclusions
can be explained by the fact that awake cats can respond to
external stimuli (e.g. noise), which in turn can lead to an increased Respiratory rates can be very variable and high in clinically
respiratory rate. healthy adult cats examined in veterinary clinics. The reference
One of the limitations of the present study is that in most cats intervals commonly reported in veterinary textbooks propose
the respiratory rates at the two different locations (i.e. at home and most likely represent the resting respiratory rate in the home
at the veterinary clinic) were not measured on the same day. environment. Because the same cats have a low respiratory rate
Taking measurements on the same day might reduce the with a much smaller variability at home, veterinarians can
alterations in respiratory rate caused by environmental factors consider relying on repeated video-recordings made prior to each
(such as ambient temperature) or day-to-day variability of the cats’ scheduled office visit, for comparison, while avoiding comparisons
demeanor. made between these videotaped data and respiratory rate data
 E. Dijkstra et al. / The Veterinary Journal 234 (2018) 96–101 101

collected by in-clinic, hands-off inspection. This would not only Bland, M., 2015. An Introduction to Medical Statistics, 4th Ed. Oxford University
spare time for the veterinarian, but would also supply more Press, pp. 329–331.
Clinical and Laboratory Standards Institute (CLSI), 2008. Defining, Establishing, and
reliable information about this physiologic parameter of the Verifying Reference Intervals in the Clinical Laboratory: Approved Guideline,
animal. 3rd Ed. Clinical and Laboratory Standards Institute, Wayne, PA, pp. 15–27 CLSI
Document C28-A3.
Iscoe, S., Young, R.B., Jennings, D.B., 1983. Control of respiratory pattern in conscious
Conflict of interest statement dog: effects of heat and CO2. Journal of Applied Physiology: Respiratory,
Environmental and Exercise Physiology 53, 623–631.
None of the authors has any financial or personal relationships Jennings, D.B., Szlyk, P.C., 1985. Ventilation and respiratory pattern and timing in
resting awake cats. Canadian Journal of Physiology and Pharmacology 63, 148–
that could inappropriately influence or bias the content of the 154.
paper. Little, C.J.L., Ferasin, L., Ferasin, H., Holmes, M.A., 2014. Purring in cats during
auscultation: how common is it, and can we stop it? Journal of Small Animal
Practice 55, 33–38.
Acknowledgements
Ljungvall, I., Rishniw, M., Porciello, F., Haggstrom, J., Ohad, D., 2014. Sleeping and
resting respiratory rates in healthy adult cats and cats with subclinical heart
The authors are grateful to the participating veterinary disease. Journal of Feline Medicine and Surgery 16, 281–290.
practices and owners. For advice in statistical analysis the authors Orem, J., Netick, A., Dement, W.C., 1977. Breathing during sleep and wakefulness in
the cat. Respiratory Physiology 30, 265–289.
thank Dr. Jan van den Broek, Department of Farm Animal Health, Quimby, J.M., Smith, M.L., Lunn, K.F., 2011. Evaluation of the effects of hospital visit
Faculty of Veterinary Medicine, Utrecht University. stress on physiologic parameters in the cat. Journal of Feline Medicine and
A part of this study was presented as an oral research abstract at Surgery 13, 733–737.
Porciello, F., Rishniw, M., Ljungvall, I., Ferasin, L., Haggstrom, J., Ohad, D.G., 2016.
the European College of Veterinary Internal Medicine — Compan- Sleeping and resting respiratory rates in dogs and cats with medically-
ion Animals (ECVIM-CA) Congress, in Malta on 15 September 2017. controlled left-sided congestive heart failure. Veterinary Journal 207, 164–168.
Remmers, J.E., 1972. Neural and mechanical mechanisms of feline purring.
Respiratory Physiology 16, 351–361.
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