Around 80 percent of all shelter cats develop some degree of anorexia, feline specialist Dr. Susan Little told veterinarians at the North American Veterinary Conference in February. What can be done to help them?

The key is reduction of stress, which is associated with a number of feline health and behavior problems. The top three problems are not eating at all, not eating enough, and vomiting, which can delay adoption, causes suffering in the cat and even can lead to life-threatening illness.

While improved housing is key to reducing stress, particularly by providing sufficient space and places to hide, the “what, where, when and how” of feeding needs to be addressed as well. Dr. Little’s tips included:

Dietary history. If possible, get a dietary history on the cat at intake, and try to feed her a diet as close to what she’s used to as possible. If using donated food, try mixing it with the regular diet to minimize change.

What to feed. Food should be fresh, unspoiled, and life stage-appropriate. Feed the same type of food consistently. If your organization relies on donated food, try to combine the familiar and donated foods to minimize stress. Smell is very important to cats, so enhancing the smell by warming or moistening the food, or adding high-value flavorings, will increase the chances they’ll eat.

How to feed. Always give food and water in wide, shallow bowls, not small curved bowls. Food can be given on a paper plate or paper towel. Feed small, frequent meals and always pick up the food bowl between feedings.

Where to feed. Many cats will not eat if other people or animals are around, so give the cat a peaceful, quiet and private place to eat as possible.

When to feed. Always feed, clean and interact with the cats on a set routine to minimize stress.

When nothing else works. If the cat is still not eating, try hand-feeding. If that doesn’t work, warned Dr. Little, do not resort to tube feeding for adult cats; the process is dangerously stressful. Syringe feeding is also too stressful. Instead, she said, consider placing a nasogastric tube for a few days in extreme cases.