Low-Stress, Low-Restraint Handling Techniques
AN INTRODUCTION TO LOW-STRESS, LOW-RESTRAINT HANDLING TECHNIQUES FOR PETS SCARED OF THE VET
If your pet is scared of the vet, the innovative low-stress, low-restraint handling techniques used by the staff at Mile High Animal Hospital of Aurora may be just what the vet ordered. It’s no secret that a visit to the veterinarian is a source of stress and fear for many dogs and cats. The team at Mile High Animal Hospital of Aurora consistently searches for new ways to help our patients feel less anxious when visiting our practice. In 2014, we committed ourselves to embrace a new approach for patient contact in the veterinary hospital. Low-stress handling has changed the way we interact with pets. Our patients are benefiting from the effort, and our clients are amazed at the change in their pets’ demeanor and comfort using these techniques.
Here are some additional ways Mile High Animal Hospital is contributing to a low-stress environment:
- Scales inset into the floor so dogs don't have to step up onto them.
- Dedicated cat room to avoid unsettling scents/stimuli for cats. Our cat room has a towel warmer, cat tree, "hiding" places, Feliway/pheromone diffuser.
- Fold-up exam tables to ease "exam table" anxiety, allows doctors to sit on the floor with pets, allow more room for bigger dogs, etc.
- Dedicated comfort room with private entrance/exit for euthanasias or contagious pets.
- Textured yet seamless floors to help pets gain traction when walking on it, keeps older dogs or dogs with mobility issues from splaying out on floors.
- Double door entrance to ensure nobody escapes.
- Waiting areas with dividers for less animal interaction/stress.
- Natural lighting inside (vs. fluorescent).
- Enclosed courtyard for pet "nature breaks".
WHAT IS LOW-STRESS HANDLING FOR PETS?
Low-stress handling is a set of techniques that depends on recognizing what each pet needs in order to feel most comfortable. Dr. Sophia Yin, a veterinarian with a special interest in animal behavior, played a definitive role in the development of low-stress handling techniques. Understanding a pet’s mindset is key to sympathizing with that pet, so that’s the first obstacle in reducing stress.
For cats, it’s important to remember that, while they are hunters, cats are a prey species, instinctually aware of the dangers of being hunted by larger animals. In Colorado, coyotes are prevalent and most families keep their cats inside. While indoor cats are safer, protected from predators, speeding cars, deadly viruses (feline leukemia, FIV, and FIP), and aggressive interactions with other cats, this sheltered life can make a trip in the car a shocking experience. When cats arrive at our office, some feel like their world has turned upside down and they don’t know what’s going to happen next. Most frightened cats want to hide and we’ve found that draping towels over their heads and bodies during an exam or a blood draw will help them feel safer. Another successful technique we employ is to examine a cat from the tail forward, completing the evaluation with a comprehensive eye exam. We’ve found that many cats are less anxious when their heads are examined last, so we do whatever is needed to help the exam go as smoothly as possible.
Communication also is key in low-stress handling. If we can understand what our patients may be thinking, we’re halfway to fostering an environment that isn’t so frightening. But we don’t need to wait for a pet to communicate fear in order for us to respond to that fear. Many pets who don’t know us will be fearful when coming to the veterinary clinic. They’ve gone to other facilities where they were held down, poked, prodded, and maybe even muzzled. If we can stop that fear before it starts, we’re even further along.
One way that we create comfort is by utilizing an animal’s sense of smell in a positive way. Our pets perceive the world through their sense of smell as much as or more than through any of their other four senses. Dogs and cats are able to release pheromones to indicate danger or safety, as well as other information.
Other dogs and cats detect those pheromones and can enter a situation with optimistic anticipation or with a sense of dread based on what they smell. Researchers have developed synthetic pheromones that we use to signal cats and dogs that the exam room they’re entering is a place of safety, not a place of danger. In addition, cats can detect the feline synthetic pheromone, but not the canine synthetic pheromone, and dogs can detect the canine synthetic pheromone, but the feline pheromone has no effect on them. By releasing the synthetic pheromone into the exam room before the pet arrives, our patients’ sense of smell tells them to anticipate a safe place, not a danger zone. The use of pheromones coupled with the low-stress techniques we utilize reinforces the pet’s perception of a safe zone, and each successive visit is progressively easier for them to handle.
Another way to help ease a pet’s fear of the vet is to have the pet parent bring a pet in hungry and bring a favorite food with them to the visit. Now the pet is food motivated and, while eating a meal in the exam room, it’s more able to ignore the veterinarian who is performing a gentle, respectful exam.
Common ways for animals to communicate is through body language. Are the ears upright or pinned back? Is a dog looking straight at us or is his head angled away and he’s looking at us from the side? Is he hiding under a bench or sprawling in the middle of the exam room floor? Most of our patients are fantastic communicators. It’s up to us to observe their behaviors and interpret them. Once we interpret those behaviors, we respond in an appropriate fashion.
A cat that pins its ears back when approached is sending a clear signal that it’s frightened. Instead of ignoring those signals and creating more fear and trauma, we simply cover the cat with a nice, warm towel sprayed with a synthetic calming pheromone, let the cat hide and feel safe.
For dogs, it’s a dead giveaway that the dog is frightened when it crawls under the exam room bench or hides behind its owner. At that point, it will only add more fear to drag the dog out into the middle of the exam room. To calm a fearful dog, we sit on the exam room floor, ignore the cowering pet, and speak calmly with the owner, and periodically toss tiny treats to the dog to encourage it to come out from its hiding place. The dog will “read” the behavior of its calm pet parent, and may come to associate our veterinary staff as a source of treats.
However, treats don’t always work. When a dog is still fearful after receiving some treats in a calm environment, our staff is trained to position themselves to the side of the room and invite the pet parent to sit in the middle of the exam room floor. The dog’s human is usually home base and the dog will come out from under the bench to get as close to “home” as possible. If the dog still won’t come out, the veterinary staff leaves the room altogether to give him a break. When we return to the room, the dog may be ready for us to be closer. But if it hides again and is still fearful, we speak with the pet parent and discuss postponing the appointment while we try some other desensitization techniques or find a medication that will help the frightened pet feel less anxious.
SUCCESSFUL LOW-STRESS HANDLING NEEDS PARTICIPATION FROM PET PARENTS
In order for low-stress handling to be effective, all human parties involved need to be on board. In the beginning, low-stress handling techniques take longer but are well worth the effort. Pets do not get over terrifying experiences with groomers, boarding kennels, or previous rough experience at a veterinary facility overnight or in one visit.
Essentially, animals need to be “rewired” to understand that they are at a place where they will not be treated roughly. Patience and time are needed to help them understand this. The boisterous, two-year-old lab who sits in my lap on the exam room floor and sees the world as sunshine and tennis balls doesn’t need extra attention in the exam room. But those pets who have had traumatic experiences need more time to adjust to the exam room, the technicians, and the veterinarians who are there to help.
Appointment planning for fearful dogs is helpful. For example, if a pet owner with a fearful pet makes a 2 pm appointment and has to pick up the kids from school at 2:45 pm, there simply isn’t time to work with the animal to help them feel comfortable. In addition, if the pet owner is stressed because of a very full schedule, the pet may “read” the stress as fear of the current place vs. the stress of a busy life. Pet parents of fearful dogs and cats need to schedule appointments when they can be there for an extended visit, and give the pet plenty of time to adjust and calm down.
THE FULL VETERINARY STAFF SHOULD BE TRAINED IN LOW-STRESS TECHNIQUES
A family with an anxious pet also needs to choose the right veterinary hospital or clinic to take care of that pet. Fearful pets will have a comfortable experience when all members of the veterinary team understand how to help reduce patient stress. It starts with the receptionist and client care coordinators. The veterinary team member who greets that family at the front desk needs to be prepared to get fearful pets into a quiet exam room ASAP, so there’s less risk of confrontation with other pets in the lobby.
The exam room assistant or veterinary technician should be able to see that some pets aren’t ready for their vitals being taken right away and to start applying low-stress techniques to calm the fearful pet. The veterinarian needs to understand that fearful pets need more time than others, how to interpret animal behavior, and how to respond rather than react. This is key to helping create a fear-free experience for scaredy cats & dogs. A dog who growls or barks when the vet comes in the room, but doesn’t lunge, is communicating. It’s not acting aggressively but it is warning the vet that he’s worried and to please stay away. The vet who ignores those signals and immediately puts a muzzle on that dog without trying to facilitate a more relaxed interaction is reacting to that dog, not responding.
Reacting by immediately muzzling a fearful dog just makes it worse. Instead, the vet needs to find a way to help that dog feel more comfortable, so an exam can be performed and treatment can be administered. If it’s a preventive well care visit and the dog is too frightened to tolerate an exam, the exam can be postponed until the dog is able to be more relaxed. If the pet is ill and needs evaluation and treatment, other techniques may be indicated.
Even sedating a pet to facilitate an exam, diagnostics, and treatment is better than holding it down or muzzling it, causing worse fear than before.
As a last resort, if sedation is not in the pet’s best interest and the treatment has to be performed immediately, then a basket muzzle can be used. Basket muzzles (like what Greyhounds wear on the racetrack) will keep pet parents and veterinary team members safe, but they’re not as confining and frightening as a typical muzzle. An added plus, treats can be offered through the sides of the muzzle, helping a pet to be distracted during treatments.
HOW TO FIND THE RIGHT VETERINARIAN FOR PETS SCARED OF THE VET
So how do you find a vet who’s willing to find a way to help your scaredy cat or dog without making it even more terrified? For starters, check with the American College of Veterinary Behaviorists for a referral to a veterinarian in your area that accommodates dogs and cats scared of the vet. Visit http://www.dacvb.org/about/member-directory/ and look for a veterinary behavior specialist in your area. These specialists exist to help pets with severe behavior problems. You don’t need them for routine veterinary care, but they should be able to refer you to a nearby veterinary team who has experience working with fearful pets in a gentle, constructive way. If they can’t refer you to a veterinarian knowledgeable in low-stress handling techniques, find a dog trainer in your area who endorses a purely positive reinforcement approach with no physical punishment. Those trainers are frequently great resources for referring you to like-minded veterinarians in the area.
After you’ve obtained some referrals, interview the veterinarians just like you would interview a pediatrician for your children. Explain your concerns to whoever answers the phone when you call and ask for a meet-and-greet or schedule a consultation (without your pet) with the vet who will be seeing your pet.
During your meeting, describe previous experiences and ask how the vet would handle the situation. Ask if you can you have an extended appointment slot instead of a regular appointment since working with frightened pets typically takes longer. Ask what the charge is for the additional time. If you find a veterinarian who understands and respects your concerns about your fearful pet, then schedule an appointment. If the vet’s responses don’t meet your expectations for what your pet needs, keep looking.
Keep in mind that, in the beginning, appointments for fearful pets will take longer. There is a light at the end of the tunnel, though. As your fearful pet learns that going to a veterinary hospital that practices low-stress handling is not frightening, but rather is a source for delicious treats and gentle care, subsequent visits will take less and less time because your pet will get over its fear and come to enjoy seeing the people at the veterinary clinic. By taking your pet to a veterinary hospital where low-stress techniques are practiced, your pet’s stress levels will go down, your stress levels will go down, and excellent veterinary care becomes much easier.
Low-stress handling techniques are the next level of veterinary care that help ease the stress and fear of vet visits for all pets, and particularly for fearful dogs and cats, and for dogs and cats that have had bad experiences with groomers, boarding kennels, or veterinary clinic. Your pets deserve vets who will find new ways to give them happier, healthier lives.
To schedule an appointment for a fearful pet that’s scared of the vet, and would benefit from our low stress, low-restraint handling techniques and philosophy of pet patient care, call Mile High Animal Hospital of Aurora at 303.693.6484 or request an appointment.