Reducing Stress During Veterinary Visits

Question 1

Understand the use and meaning of cooperative care in veterinary patients

Question 2

Know the potential consequences of stress during veterinary visits and how to reduce stress for both dogs and cats

Answer 2

consequences:
1. avoidance of cat carrier or car travel (cat never makes it to clinic)
2. difficulty handling
3. distortion of physiological values (bloodwork and diagnostics)
4. reactivity in waiting area
5. anxiety during boarding or hospital stay (may not eat while in hospital)
6. aggression
7. injury risk to team members

Question 3

describe stress signs in dogs

Answer 3

1. lip licking
2. yawning
3. shifting body weight away from trigger: crouching, flexing forelimbs
4. avoidance of direct eye contact: sideways stare
5. panting, trembling
6. increased facial tension (submissive grin)
7. ears to side or back
8. refusal of treats
9. activity level change: freezing, pacing, agitation
10. defensive aggression

Question 4

describe stress signs in cats

Answer 4

1. crouching
2. lateral body position
3. ears directed back or flattened
4. tail close to body
5. standing with forelimbs close to hindlimbs
6. back arched
7. defensive aggression

Question 5

describe creating a protocol for reactive patients

Answer 5

1. schedule reactive patients during quieter times
2. call or text client when they can walk directly into exam room
3. enter through side door
4. be prepared: pre-med protocols, basket muzzle training

Question 6

describe creating low stress reception environments

Answer 6

1. allow maximum distance between pets
2. barriers to reduce visual contact between patients
3. sound absorbing tiles or panels
4. solid wood doors, textured flooring
5. elevated surface for cat carriers or separate areas for dogs and cats

Question 7

describe the relationship between wait time and stress

Answer 7

1. increased wait time in stressful lobby areas increases stress
2. fewer stress signs occur when waiting in empty examination room as compared to lobby area

Question 8

describe the effect of taking the pet to the back or away from the owner

Answer 8

1. separation from pet parent during minor procedures should be avoided
2. owners presence is a calming influence for both dogs and cats
3. if owner prefers not to be present for minor procedures, ask them to step out of the room instead of taking the pet to a common area
4. the “pet is better” when owner is not there is actually
   -freezing (a passive coping response) or learned helplessness (was active defense with owner present
   -only do this if you need to!

Question 9

describe strategies to reduce general stress during vet visits

Answer 9

1. encourage benign visits to the hospital
2. use food rewards in interactions with patients
3. threat reduction during appointment: turn to side, squat, shift body weight away from pet, use pet’s name frequently, use treats, toss treats on flow, break eye contact, move slowly, speak softly
4. examine pet where pet is most comfortable
5. cats should never be taken out of carrier: allow them to leave on own or lure with treats, take carrier apart, use towels to create security
   -only scruff cats if absolutely necessary
6. avoid: scruffing, verbal reprimands, pinning, alpha rolls, muzzle grips, gauze muzzles, gauntlets, squeeze cages

Question 10

describe reduction of pain

Answer 10

1. distraction:
   -tactile stimulation preceding and during injections
   -trained behavior: chin rest
   -administration of food
2. EMLA cream: lidocaine/prilocaine
   -dogs: 60 minutes before
   -cats: 20 minutes before
3. small bore needle
4. new needle after drawing up medication

Question 11

Know the proper timing for administration of pre-veterinary visit medications and criteria for selecting appropriate medication protocols

Answer 11

1. trazodone and/or clonidine and/or dexmedetomidine PLUS
   -do not use alpa 2 agonist as pre-med if you plan to use injectable in clinic (can lose selectivity and actually increase agitation
2. gabapentin or pegabalin

2-3 hours before appointment

3. once get to clinic if need more:
   -acepromazine 20 minutes prior to procedure