The easiest and least stressful way to handle, treat, and care for feral cats is to wrap them in a blanket or large towel, making sure their head is covered completely (and that they can breathe). You can then very carefully expose whatever area you need to examine or treat and do what you need to do.

Gabapentin has been proven to reduce the fear response in cats during the TNR process. We now give it orally immediately upon intake. Depending on the cat and circumstances, we may give it every 12 hours for the first few/several days. Ask your veterinarian, because this can make a HUGE difference. After intake, many ferals will eat Gabapentin mixed with tuna juice offered to them in a small bowl prior to feeding (usually not until you leave the room for a bit).

• When you first bring the cat in, they will be in a trap or cage of some sort. I sit at the entrance to the trap (facing the trap) and put a large blanket in my lap and then fold it over the top and sides of the trap entrance. The idea is to give them a dark, enclosed place to go that will automatically wrap them completely in the blanket and in your lap where you can do an intake exam and any treatments that are necessary.
• When you are in position (make sure there are no gaps between the blanket and the trap for the cat to escape through), open the trap door and slowly uncover the trap starting with the opposite end. This should encourage the cat away from the light and towards your lap. If you have another person with you, they can move to the opposite end of the trap and quietly encourage the cat toward you.
• Sometimes it takes a few minutes, just be patient and wait. It is super important to keep everything as quiet as possible to not add to the cat's stress level unnecessarily.
• If the cat doesn't move into my lap on its own, I will insert a trap divider if the trap is longer than my arm so I can reach all the way to the back of the trap. I will then cover my hands with a thick towel and cover the cat with the towel. It is CRITICAL to know where the cat's snout is at all times. The key to success with this method is getting the towel looped completely over the head whilst preventing the cat from scooting backwards to escape.

  
  Some tips:

  • Keep your fingers parallel to the top and/or side of the trap as much as possible to reduce risk of sticking a finger into a bitey mouth.
  • Don't panic, stay calm, take your time and commit to your goal of getting the cat completely wrapped and calm in your lap.
  • If it gives you more confidence, wear safety gloves the first few times you try it, until you get a feel for doing it and then you can try without gloves.
  • If you get them into your lap and they are fighting to escape, apply gentle pressure and be still until they calm down. Same concept as using a thundershirt. You may need to skip the less critical steps in your intake exam if you have a cat that continues to fight you - for a cat that isn't obviously unhealthy, we do a minimum of Revolution, check/clean/treat ears and vaccinate, and will do the rest the next day (once the cat is enjoying the effects of their gabapentin).
  
  
• Once the cat is inside the blanket in your lap, quietly close the trap door and make sure the cat is completely and tightly enclosed by the blanket. This will make them feel less vulnerable.
• Most feral cats will shut down in a trapping scenario, which is a natural response to the stress and fear of trapping and interacting with a predator (you) they think is going to eat them. The stress of being trapped is unavoidable, but it can work in our favor because it makes it easier to do the intake exam.
• We clean ears, blacklight (for ringworm), check for injury, check teeth/mouth/gums, check hydration, and for adults we treat for fleas/ear mites/some worms (Revoultion), vaccinate, trim nails IF the cat will be staying with us for several weeks, and other things as needed. This is usually your best opportunity to fully examine the cat, so make sure you do as much as you can, starting with the highest priority tasks.
• To do an exam, start with the least invasive thing and work your way to the face area. Only expose the part of the cat you are examining, and make sure the head stays completely covered. If the face pops out, the cat may run away and you will have lost your opportunity to complete the exam and introduce them to the Bin of Safety.

• P.S. Ear mites can be your best friends.

  We have discovered why ear mites exist, and it is to help us give feral cats positive interactions with humans! Almost every feral who has come in with ear mites has responded positively to ear cleaning and ear rubs - not just tolerated it, but leaned into our hands for more. It has been an amazing way to connect with them, and you can tell a lot about a cat's personality from how quickly and enthusiastically they respond to ear mite cleaning.
• Once the exam is finished, I have the Nest set up nearby and ready to receive its new guest. This includes comfy bedding and Feliway. I carefully shift the cat out of my lap and in front of the entrance and then uncover the face with the entrance covered so the cat will go into the Nest instead of into the room, where they are more likely to panic. This establishes the Nest as their safe place, which will make your life 1000% easier when it comes to medicating and other interactions.
• Once they are in the Nest, we leave them alone and observe with a webcam. You could use a Nest (or similar) security cam, or baby monitor to keep an eye on your feral - you will learn SO much more when you can observe them without humans around.

We have been surprised by how many of our adult or injured ferals have responded to socialization. We are usually able to tell within the first week whether the cat is open to us or whether she would be happier returning to the wild once she is healthy, although this can be the opposite in cats that are very sick/injured when they come in.

Sometimes when cats are feeling terrible and are recovering from surgery, they are soft and will allow and even enjoy interaction and strategic petting. Then, once they start to feel better, they remember they are feral cats and no longer appreciate human interaction.

If a cat seems open to us, we will work with her as long as she continues to make progress and as long as she seems content in captivity.

We judge contentness via our cams, so we can observe whether she is doing normal happy-cat things - eating, drinking, using the litterbox, playing, exploring, interacting with the other cats - when the human predator isn't around.

We do not recommend keeping a cat that is not engaging in normal happy-cat behavior any longer than absolutely necessary. It isn't kind or fair to them to try to force socialization if they aren't receptive to it, especially if you have a managed colony to return them to.

• We have a team of volunteer snugglers who take snuggle shifts starting a few days after intake. They use various approaches, but the goal is to have positive, non-threatening interactions with the cats. Some sit quietly with the cats, some talk to them, some offer treats, some try to engage them in play, some will wrap in a blanket and rub itchy ears or do grooming. A variety of approaches seem to be effective, depending on the personality of the cat.
• I have found that humans usually have to make the first move to make contact, and cats are usually reassured by the human's touch as long as they don't have to look at us at first. My approach is to push their boundaries very gently to help them build confidence more quickly.
• I blanket-wrap the cats (usually because I have to do meds or check incisions/bandages) and the ones who are receptive will eventually relax in my lap if I pet them slowly while keeping their faces covered. If you give them plenty of time to relax the first few days and they remain tense the whole time, they are less likely to be receptive to socialization.
• You might make amazing progress in one session with a feral, but you will have to re-establish trust the next time you go in. Don't be discouraged, this is normal. It will take them less and less time each visit for them to remember you are not there to eat them.

• Pay attention to how they react when you clean their ears. (Also, MAKE SURE you know how to properly clean ears before you attempt it). Cleaning the ears will give them some relief from the itching of ear mites, and seems to feel REALLY good. The cats we've had success socializing have responded noticeably to the ear cleaning and subsequent ear/neck/cheek/head rubbing. It can take 20-60 minutes per session to get them relaxed enough to respond positively, but if you eventually feel them lean into your hand to ask for more, they are almost always going to be receptive to socializing. If the cat is very stressed or panicked and you don't notice that improving within the first 10 minutes or so, it's better to let the cat go and see if they are more settled the next day.
• Know the difference between a cat that is shut down and a cat that is relaxed. Most ferals will respond to the stress of trapping by shutting down. A cat that is shut down won't respond to tempting treats like tuna, she will tolerate petting but will not enjoy it, and you will see signs of stress - increased respiration rate, large pupils, sweaty paws. This is pretty common in the first few days to a week when the feral is adjusting to her new environment. At some point, you will notice a change - some will become more assertive/aggressive as they become more confident, some will become more accepting of human interaction, and some will become more intent on avoiding you. Just because a cat is shut down doesn't mean she won't relax and enjoy petting during a session.
• Confident cats and receptive cats are more likely to become adoptable than fearful cats. I am working on a model for evaluating feral cat behavior that may predict outcomes and identify the best approach. Stay tuned. :)
Things that might help:
• Gabapentin (see above).
• A short (24-36") pool noodle or feather wand - they often like to be petted as long as they don't have to acknowledge it is a human doing the petting. Often we can slowly slide our hand up the noodle/wand until we are petting with our hand.
• Housing them with a more socialized feral, if possible. We work on socializing our ferals at our feeding station and bring any in that seem ready for a home. They make great ambassadors for less confident ferals.
• Hand-feeding tuna, sardines or other scrumptious treats.
• Playing - iPad with cat games that make mouse/bird noises, catnip toys and wand toys have been pretty popular with ours.
• Brushing with a toothbrush, especially ears, cheeks and chins.

Some tricks we have learned from a medical perspective:

• We use extended release meds wherever possible - for example:
  • Extended-release (SR) buprenorphine injection to manage pain for 72 hours instead of having to give oral meds every 12 hours.
  • Convenia injectable antibiotics, which cover the cat for 14 days with one SQ injection, will save you a ton of time and the stress of having to give oral antibiotics every 12 hours. Please note that Convenia may not always be the most ideally-appropriate antibiotic for every situation (from a purely medical perspective), but it offers a significant benefit from a holistic/stress perspective, so it is our preferred go-to for the usual feral maladies. With that said, we also do a LOT of culture+sensitivity testing because we want to be as responsible as possible about our use of antibiotics. There's always a trade-off, you will just need to know what the pros and cons are for your particular situation and make the best decision you can based on the information you have at the time.
• We have to be creative about giving meds in general - some cats will eat oral meds mixed with canned food, tuna, sardines or something else tasty. When they won't, we ask if the meds come in other formulations - pill vs. oral liquid, injectable, etc. We try the least invasive approaches first and can usually (but not always) figure out an acceptable delivery method that doesn't involve toweling them or direct human interaction.
• For pills (and some liquids), we try putting them in #5 gel capsules, then wrap in pill paste, then roll in crushed temptations (think Ferraro Rocher) and leave in a small bowl close to where they're hanging out in the room. This has been pretty successful. It helps that we can leave the room and observe via our cameras to see when they eat it and make sure another cat isn't trying to steal it.
• When all else fails, having a nest in the room with a remotely operating guillotine door has been essential. We either wait til the cat is inside or help encourage them inside, lower the door, and then open the front cabinet doors and swiftly and decisively wrap them in a towel just like we do when they are in the trap. This allows us to do whatever we need to do without having to chase them around the room.
• For exams at our vet's clinic, we help hold them because we have more experience with ferals than most of the techs and it isn't always safe to sedate prior to an exam (for example, pregnant cats). We can safely do full exams, ultrasounds, and anything else that needs to be done.
• If your vet isn't experienced with feral cats, you may need to advocate for more feral-friendly medical practices such as those listed above. Our vet team has been AMAZING about evolving with us as we bring in new challenges.