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What the direct study found
The case series, “A cat-friendly underwater treadmill: Case series and practical implications in reducing stress,” by Uccheddu, Sinigoi, and Furlanello, appeared in Applied Animal Behaviour Science in November 2025 (DOI 10.1016/j.applanim.2025.106803). It describes 12 cats referred for neurological or musculoskeletal rehabilitation at the San Marco Veterinary Clinic in Padua, Italy. The cats were introduced progressively to the underwater treadmill, and stress-related behaviors were recorded across sessions.
The published abstract reports the following results. Each value applies only to this small clinical group and this clinic.
| Measure | Reported result | What it does and does not show |
|---|---|---|
| Completion of the program | All 12 cats completed the program; no cat was excluded from the underwater-treadmill portion after initial evaluation | Shows feasibility in this referral setting. There was no control group, so it cannot show that the staged approach caused the completion. |
| Odds of stress expression across three treadmill sessions | OR 0.58, p = 0.050, a downward trend | Borderline statistically and based on 12 cats. It is a trend, not a confirmed reduction. |
| Number of stress counts across sessions | RR 0.91, p = 0.37, no significant change | Stress counts did not change significantly, so the sessions did not clearly reduce overall stress signs. |
| Reward preference and stress signs | Cats preferring play reinforcement showed fewer stress signs than cats preferring food (RR approximately 0.19, p = 0.01) | A subgroup association in a small sample. It does not justify choosing play over food for all cats. |
Taken together, the case series supports the idea that a carefully staged approach can make treadmill work possible for some cats. It does not establish long-term benefit, the best acclimation schedule, or a validated universal stress score for feline underwater-treadmill sessions.
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How habituation is staged
An AAHA account published February 10, 2026, by Colette Kase describes the feline-specific approach used by the clinicians behind the case series, based on their interviews. It presents this sequence as part of one clinical protocol rather than a timetable that works for every cat. The stages are:
- Explore the dry setting first. Let the cat investigate the quiet treatment room and the dry treadmill before any water is introduced.
- Introduce moisture gently. For example, touch the paws with a damp towel before anything else happens.
- Start with shallow warm water. The cat stands in shallow water while it gets used to the equipment’s sounds and movement.
- Increase water exposure gradually. Progress only while the cat stays within its behavioral welfare limits.
- Use the caregiver and a preferred reward. The cat’s own caregiver can be present, and the reward may be food, touch, or play.
- Pause or adjust when distress rises. Distress is a reason to stop or step back, not a reason to push on.
- Finish with a low-stress drying routine. The account describes towel drying rather than blow dryers.
Owners should not try to recreate this sequence at home. Water exposure in a home bath or pool carries the same aspiration and drowning risks described below, and the sequence is only meaningful when a trained team is watching the cat.
Choosing rewards for the individual cat
Reward preference is individual, and the case-series data point toward choosing a reward for the particular cat rather than applying one rule. Food, touch, and play were all described as options in the AAHA account. The account also describes a licking mat spread with food as a positive-association aid for one cat. A licking mat is not therapeutic equipment and should not be assumed to suit every cat.
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Behavior sets the pace
The central idea in this approach is that behavior, not the calendar, decides whether a session moves forward. The reported protocol uses stress-related behavior to decide whether to progress, pause, or regress. The study’s authors framed this in direct terms in the AAHA account:
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- Stefania Uccheddu, DVM, PhD, Dipl ECAWBM, veterinarian in behavioral medicine and welfare and co-author of the study: “Stress monitoring should be considered a primary clinical parameter. Early identification of stress signals enables cooperative participation and protects welfare throughout the rehabilitation process.”
- Laura Sinigoi, DVM, MSc, CVA, CTPEP, rehabilitation clinician and co-author of the study: “Progression should be guided not only by pathology, but also by welfare thresholds. Therapy should proceed only when stress remains below predefined limits.”
These are practitioner statements about their own protocol, not independent trial conclusions. Stress monitoring is meant to complement diagnosis, pain assessment, and veterinary judgment, not replace them.
Medical and safety limits
Hydrotherapy is a clinical rehabilitation modality, not a general bathing exercise. A veterinary rehabilitation review by Goldberg (Journal of Feline Medicine and Surgery, 2025) makes several points that matter for any cat:
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- A cat should never be left unattended in water, because aspiration and drowning are real risks.
- Open wounds and infection are discussed as contraindications to water-based therapy.
- Strenuous swimming or treadmill work may be unsuitable for cats with cardiac disease.
- Any treatment plan should be prescribed and medically overseen by a veterinarian trained in rehabilitation.
Medical suitability is therefore decided by veterinary assessment of the individual cat and its diagnosis, not by a cat’s willingness to enter the water on a given day.
Reducing clinic stress before any water work
Most cats find veterinary visits stressful, and the 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines (Taylor et al., Journal of Feline Medicine and Surgery, November 2022; DOI 10.1177/1098612X221128763) explain why. Unfamiliar surroundings and accumulated stressors can make clinic visits difficult, and the guidelines recommend reducing exposure to other species and tailoring the clinic environment to feline sensory and behavioral needs. These are expert guidelines drawn from the literature and, where evidence is lacking, from expert experience. They are not hydrotherapy trial data, but they set the baseline for handling a cat in a rehabilitation setting.
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Questions to ask a rehabilitation provider
If a clinic offers feline hydrotherapy, the AAHA account emphasizes individualized plans, stress monitoring, trained staff, and a calm environment. Useful questions include:
- Is the plan prescribed and overseen by a veterinarian trained in rehabilitation?
- How do staff assess fear, stress, pain, and fatigue during a session?
- Can the cat pause or stop, and what happens when it does?
- How is familiarization with the dry equipment handled before water is introduced?
- What water depth, water temperature, and session length are planned for this cat?
- Can the caregiver be present?
- What supervision and emergency procedures are in place for the whole session?
- Which objective functional outcomes will be tracked over time?
There are no two established feline hydrotherapy protocols that can be fairly ranked from the available evidence, so these questions are more useful than comparing clinics by name or price.
What is not yet established
The feline evidence is a single small case series. It has no control group, does not establish long-term benefit, does not show that the approach works in every clinic, and does not set an acclimation schedule for individual cats. The sources do not give a population-level figure for how many cats are candidates for hydrotherapy, so no such estimate should be assumed. Hydrotherapy should not be presented as proven effective for all feline rehabilitation needs.
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Cats are sometimes excluded from hydrotherapy because of assumptions about water aversion. The case series suggests that some cats can be included when the approach is staged and monitored, but it does not show that cats are universally able to tolerate water, and an individual cat’s refusal or distress is always a valid signal to pause.
The AAHA account also mentions professional training in feline hydrotherapy. Course availability and details were not confirmed in the source material, so check directly with a provider or training body before enrolling.
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