Cat behaviour and physiology differs to that of dogs, they are great pretenders and often don't reveal what is wrong with them until they are near critical. When they present to the vets they often present with non textbook clinical signs making them particularly tricky to manage in an emergency. The aim of this lecture, through a case-based discussion between a critical care vet and nurses is to highlight challenges encountered when faced with unstable cat in the emergency room and provide tips to tricks to help manage them.