Tips for reducing patient fear in the veterinary clinic
- Reduce stress by having separate waiting areas for dogs and cats with separate air-handling systems, if possible.
- Ensure that all dogs can have at least 1–1.5 body lengths between themselves and other dogs. Barriers can help keep animals separated.
- Invest in nonslip floors that are back friendly and provide secure footing for dogs and cats.
- Create a protocol for reactive patients. That may include either calling or texting clients when they can walk directly to the exam room, having the veterinarian already in the exam room, using a blind or bringing a reactive dog into the hospital through either a side or back door. Reactive dogs may do best as the first or last patient of the day. They generally do worse in a busy practice in which appointment delays are common. Giving preanesthetic medication with the client present may facilitate care.
- Move at the animal’s pace. Rushing may cause delays or intractability at a later visit.
- Teach staff to use standardized questionnaires to evaluate stress at the hospital and invest in ensuring that everyone can accurately read canine and feline normal and stress-related behaviors and body language (Tables 1, 4).
TABLE 1
Most commonly recognized signs of nonspecific anxiety/distress in dogs and cats11–22
- Urination
- Defecation
- Anal sac expression
- Panting
- Increased respiration and heart rate
- Trembling, shaking
- Muscle rigidity (usually with tremors)
- Lip licking
- Nose licking
- Grimace (retraction of lips)
- Head shaking
- Smacking/popping lips or jaws together
- Salivation/hypersalivation
- Vocalization (excessive and/or out of context)
- Frequently repetitive sounds, including high-pitched whines, like those associated with isolation
- Yawning
- Immobility, ‘‘freezing,’’ profoundly decreased activity
- Pacing, profoundly increased activity
- Hiding or attempted hiding
- Escaping or attempted escaping
- Body language of social disengagement (i.e., turning head or body away from signaler)
- Lowering of head or neck
- Inability to meet a direct gaze
- Staring at some middle distance
- Body posture lower than normal (in fear, the body is extremely lowered or tail tucked)
- Ears lowered/possibly droopy because of changes in facial muscle tone
- Mydriasis
- Scanning (i.e., moving eyes and/or head across the environment to
continually monitor all activity) - Hypervigilance/hyperalertness (may only be noticed when touched or interrupted, but pet may hyperreact to stimuli that otherwise would not elicit this reaction)
- Shifting legs
- Lifting paw in an intentional movement
- Increased closeness to preferred associates
- Decreased closeness to preferred associates
- Profound alterations in eating/drinking (acute stress is usually associated with a decrease in appetite and thirst, whereas chronic stress is often associated with an increase)
- Increased grooming, possibly with self-mutilation
- Decreased grooming
- Possible appearance of ritualized/repetitive activities
- Changes in other behaviors, including increased reactivity or increased aggressiveness (may be nonspecific)
TABLE 4
Key Behaviors Used in Clinical Settings to Identify Fearful Dogs and Cats
Behavior patterns associated with normal development |
Behavior patterns associated with problematic development |
|---|---|
| Approaches unfamiliar people | Will not approach/actively avoids unfamiliar people |
| Approaches and/or plays with other friendly and/or solicitous animals | Doesn’t interact or play with other solicitous animals, avoids them or responds aggressively to their solicitations for play |
| Not fearful of most noises and recovers quickly from exposure to loud noises | Fearful of many noises and does not immediately recover from exposure to loud noises |
| Takes treats and explores exam room | Doesn’t take treats, hides, freezes, or panics in the exam room |
| Uses litter box/eliminates outside when taken out and does not soil the house if otherwise given reasonable access | House/litter box training is either not progressing or regressing |