From fearful to Fear Free veterinary visits
Forget the old ideas of scaredy cats and fraidy dogs. You can make veterinary visits more comfortable for every patient with these simple steps.
Noise. Keep noise to a minimum. Dogs and cats can be extremely sensitive to noises. Close kennels quietly while holding up on latches to minimize the noise. Also keep voices lowered and even phones on a lower setting to prevent the animal from startling from loud, sudden noise.
Use background music, like Through A Dog's Ear or Through a Cat's Ear, or classical music with the addition of a white noise machine, to keep pets calm and make sudden noise less startling.
Treating. Treat more frequently than you think. One of the main mistakes team members make is treating too little. The treating during a procedure needs to be frequent, nearly throughout. This means that rather than the standard one or two treats after an exam, treat throughout with a minimum of 10 to 20 treats per minute during physical handling or procedures. This keeps stress levels low and rewards calm behavior while building a positive association.
Handling. Look into gentle handling techniques using Low Stress Handling and Behavior Modification of Dogs and Cats by Dr. Sophia Yin.
The desire to care for animals probably drove you to a career in veterinary medicine. But it's disheartening to realize that when you're caring for the physical health of a dog or cat, the animal's emotional and behavioral health may inadvertently suffer. If you can keep pets calm during visits, they're easier to handle during the exam and other procedures. It may also lead to a more accurate diagnosis when stress doesn't mask or change baseline conditions like temperature, pulse, respiration and blood pressure. Blood work is more accurate and the pet is much less likely to mask sensitivity, pain or sickness.
There is also less risk of creating or elevating associated fear and anxiety after a visit if the pet remains calm and relaxed. Fear Free tactics can also reduce the risk of struggles with a panicked and aggressing animal that may lead to injuries to the animal, owner and veterinary team.
When clients feel you've handled their pet with care both medically and behaviorally, they may feel greater loyalty to the clinic and less hesitation to bring in their pet for a visit-increasing the chance of recurring, regular veterinary visits. Best of all, creating Fear Free visits plain and simple just feels good because you're doing good.
Going Fear Free and reducing anxiety at visits doesn't even require a massive financial or time investment. And incorporating easy changes makes a dramatic difference in reducing fear levels for animals.
Here are 16 easy-to-implement steps-including a veterinary visit protocol from my father, Dr. Marty Becker-for converting the veterinary visit into a lower stress, Fear Free experience that takes the pet comfortably from their living room to the exam room and back home again with ease.
1. Set the stage for puppies and kittens
Care about the type of training people are using with their dog. Dogs trained with aversive methods-including jerks on prong or choke chains, yelling, electric or spray collars, electronic fences or physical punishment with hitting or being sprayed with water-have 2.2 times the risk of being aggressive to people outside of the home. Reward-based training decreases the chances of aggression and makes for a more confident, calm dog with a more positive association with people. Take the time to get to know trainers in the area you can recommend or partner with who use positive, non-force based training for behavior cases.
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2. Puppy socialization class is imperative for reducing aggression in dogs, particularly with strangers. Puppies that have been socialized have a 1.6 times reduced risk of showing aggression to people outside of the home. Puppy class benefits extend into various areas of the dog's life, including their comfort level with people. And those dogs who have had puppy class will be more easily approached and handled without the same level of risk. Consider planning a puppy class in your hospital where young pups can create a positive play and training experience within the walls of the veterinary hospital. They also get practice with the environment, like going on a scale for treats or associating the smell of alcohol with training and play.
3. Cats need socialization as well. Many cats are neglected when it comes to having their socialization needs met. But they, too, need to meet various people and animals and have life experiences like car rides to feel comfortable and confident as adults. Encourage kitten owners to give their young cat various experiences in a safe environment, like their home. For example, you might suggest they invite friends to their home to pet, play with and handle their new kitten.
Waiting for the exam
4. Keep dog and cat areas separated in the waiting area. Create elevated areas for pet owners to safely set cat carriers out of the way. And build visual blockers, like extra towels or temporary gates with blankets draped over to create a visual block for animals that are overly upset at the sight of other people and animals.
5. Nix the slip. Slippery floors are frightening to dogs. So consider using a series of mats or grips that go underneath mats to provide a steady trail for the dog to walk on through the waiting room. Some dogs tolerate wearing gripped booties or disposable pad covers that give grip and prevent slipping.
6. Add medication if needed. If a dog or cat seems anxious or extremely fearful when first visiting the office, or if they refuse to take treats, STOP! You now have two choices. Reschedule the pet visit for another time when you can use different medications or procedures-like a Thundershirt-or go straight to chemical restraint to make the animal relaxed for examination.
7. Eliminate the wait. If possible, for cat owners especially, bring the animal into the exam immediately, rather than waiting in the reception area. Cats need about 10 to 15 minutes ideally and dogs need five minutes to settle down and relax. Open the door or remove the top of a carrier for cats to allow them to venture out on their own volition. Have coaxers, like treats, feather toys, catnip-for cats that relax, rather than become aroused-and toys that are easily sanitized, like food puzzles. This way the owner can coax their pet to come out of a carrier or move on the floor.
8. Use Trick training and play. Animals almost always have a positive association with their tricks. Instruct waiting dog owners to run through their dog's gamut of tricks while waiting. Just by running through tricks, many a dog has been kept calm and happy while waiting. And you'll enjoy an easier exam with better baseline stats during the exam simply by interacting with dogs using their tricks. You can make notes of the types of tricks and cues the owners use in the pet's profile for future visits. For instance, asking the dog for a shake or roll over and getting a treat for doing so is a simple way of relaying to a canine that the team member is a friend, rather than a threat, when they first greet.
During the exam
9. Ignore. Keeping your body turned to the side and seemingly ignoring the pets while watching them out of the corner of your eye when you take the pet's history relays to pets that you mean them no harm. Let the pet approach you first. Toss treats on the floor in a Hansel and Gretel trail to get the animal moving around. Sit or kneel with sideways body posture while tossing treats, or use a toy for cats or extremely playful dogs if play works best. Once pets approach you-the “treat lady” or “candy man”-they are less likely to hide, aggress or panic when you touch them in the exam.
10. Stabilize the scale. Being weighed on a slippery scale can be scary. Use a yoga mat, towel or blanket to place on the scale for greater paw grip. Coax a pet into these areas with a food lure in a hand, a toy or even petting, and continue to reward while the pet remains there until the weight is taken. Built-in scales are usually the least fear-evoking, while elevated scales that require stepping up are the most frightening.
11. Address fear of instruments. If animals are fearful of a particular instrument, like a stethoscope or otoscope, teach them to target the area. Reward sniffs or a nose moving toward the object with a verbal “yes” and reward with a treat, toy or pet. Or move the instrument closer to the pet in gradual steps, while marking verbally and using rewards for the animal remaining in place. Continue to offer treats while you use the instrument.
12. Distract to take a temperature. This is uncomfortable, frightening and invasive. Use a latex glove or Q-tip and dab lidocaine on the rectal area three minutes before taking the temperature to decrease the sensation when you take a temperature. Also use distractors, like spreading Cheese Whiz on the exam table for the pet to lick up. Or have the animal face the owners while they give attention and pets and reward a calm focus with treats.
13. Know when to stop. If a pet is fearful during routine care, break and come back with calming medication or training. Nail trims can cause intense fear in many dogs and cats, and when they're forcibly restrained and muzzled, they become more fearful and difficult to handle. Instead, use desensitization and counter-conditioning techniques. Add in medication if needed to keep them from panicking and destroying their association with the entire visit.
Back at home
14. Give pet owners an empty syringe case for practice. Give a cue like “syringe” and touch the animal, then follow through with a treat. Combine this with grabbing a small piece of skin and fur and treating, then gradually poking lightly with the syringe. This helps the pet associate this type of handling as no big deal.
15. For pilling, teach the three-pill trick. Use an empty food pill casing-the promise-or a piece of hot dog, peanut butter or cream cheese without a pill. Give the second with the pill inside-the deed-and follow with an empty pill casing-the chaser-that's just the treat. Or train the pet to do the pilling motion with treats or a syringe with flavored broth inside to associate the motion with good things. Or for cats, use a semi-solid, like spray cheese, and do a line of treat, plus a few dabs-with pill hidden in one of the larger dabs-followed by another line, to get the pet to eat the pill without realizing it.
16. Ease ear Treatment. When medicating for ear infections, train the pet to have ears touched while getting treats. Train a word to the behavior, like “ears,” before touching so the pet knows what's going to happen and that a treat follows. As they grow comfortable, handle the inside of the ear. Then use the word and touch the ear with the bottle without medication or treats. As the pet shows a positive association, use the medication and follow with a reward.
Mikkel Becker, CPDT, KA, CTC, is the animal trainer for Vetstreet.com and is an honors graduate of the rigorous and prestigious Academy for Dog Trainers at the San Francisco SPCA.