Letter to dvm360: Photo raises concerns about patient fear, team safety

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Reader, dvm360 contributor agree: Veterinary patients that bite need a different technique.

How the photo and article were presented in the October print issue of dvm360 magazine.The photo accompanying the article “The four Fs of stress in pets” in the October issue of dvm360 shows one of the worst ways to examine a fearful dog (especially a dog the size of the one pictured, or larger). By kneeling, the examiner will have little chance of quickly moving away from a dog if it should lunge at her.

The dog is also semi-trapped against the wall. For some dogs this may help keep them in the general vicinity. For others, it may increase their fearfulness and their likelihood to lash out. Other than the very good, balanced leg positioning of the holder of the dog, she will be of limited help in preventing a dog bite, other than pulling the dog backward.

Ideally, if an examiner is going to get down to the dog's level, she should stay on her feet. It is important not to stare at a fearful dog. This means that the eye examination may be the last thing you do, if it can be accomplished at all. And remember, “muzzle” is not a dirty word. If it is used judiciously and in a positive manner, everyone will be safe.

Sue Geske, DVM, PhD

Double Diamond Veterinary Hospital

Bozeman, Montana

Editor's note: The photo in question was submitted by dvm360.com contributor Dr. Michael Nappier for a different article and not originally intended to accompany the “Four Fs” article citing Dr. Gary Landsberg. The decision to include the photo with Dr. Landsberg's article was made by the editors of dvm360 magazine. Here's Dr. Nappier's response to the above letter:

The inclusion of the photo in this article on stress in pets could certainly generate these concerns. This is not a technique I would use in a dog I was concerned of having a level of fear that could lead to biting because you are less able to move out of the way.

That said, the forced perspective of the photo doesn't highlight the fact that the dog has 180 degrees of forward space to move away from the examiner if it wants. That is also the reason the person holding the leash isn't restraining in a forceful manner; the dog can voluntarily move away from the examiner if it wishes.

The idea is to lower the stress level so that the dog will voluntarily stay and allow the exam without being cornered or forced into a position it doesn't want to be in. For a dog with a higher level of fear I would absolutely use a muzzle if it could be accomplished in a positive manner or give the dog some sedation.

Michael Nappier, DVM, DABVP

Assistant professor of community practice

Virginia-Maryland College of Veterinary Medicine

Blacksburg, Virginia

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