Feb 28 2013

Hospital Visits & Low Stress Handling

A common refrain I hear in the examination room is “my dog/cat hates the vet so don’t be surprised if he/she acts up…..last time at my old vet’s office, they had to wrestle him down to give a shot”.

My retort?  “I hate going to my dentist/doctor so your pet’s displeasure is not a surprise…..despite this we won’t ever wrestle with your pet…….that isn’t good for them or us.”

In the old days (not that long ago), the prevailing attitudes amongst veterinary health care providers was, “if the patient acts badly, this is not our problem to deal with, it is the owners.”  This attitude resulted in a “get it done” attitude where strong arm tactics would be employed in order to facilitate treatment and care.  This almost always resulted in 1) an embarrassed/angry owner, 2) an even more terrified pet, and 3) a frustrated veterinarian and veterinary staff.

Now many veterinarians are beginning to employ “low stress handling” (LSH) in their practices.  We have employed these techniques for several years and continue to add to our arsenal of techniques all the time.

The basic concepts of LSH are rooted in the understanding of classical conditioning responses in dogs and cats (the proverbial “Pavlov’s Dog”).  Pavlov noted that behaviours could be reinforced by linking them to positive or negative stimuli.  For example, ringing a bell and giving food will cause the dog to anticipate food when they hear a bell ring in the future.  This positive (pleasant) adaptation the heart of LSH.

So how does this apply in practice??   Unfamiliar smells, sounds, and sights, and potentially threatening pets and people assault our patients the moment they enter our care. We perform unpleasant, sometimes painful procedures, often by force. A single such experience can condition a negative emotional response where the animal learns to fear us. This learned fear can result in fidgeting, attempts to flee, and/or aggression at subsequent visits.   So, what is it that we do to counter this?  We work to condition a POSITIVE emotional response. This approach can prevent fear from developing, as well as counter-act a fear that has already been established by previous encounters elsewhere. To create a positive emotional response, we pair the experience with something that naturally elicits a positive emotional response in the animal – food. Food is the easiest and most powerful means of providing this response because we are all programmed with an innate positive response to food (otherwise we would not survive for long).  We offer food/treats just before and during the experience particularly aversive procedures that may cause some discomfort (i.e.  Injection, Toenail trim, Otoscopic exam,  Restraint, Rectal temperature/palpation, Vaccination).  We usually offer very palatable treats (almost all dogs love cat treats so that’s what we employ…..after all, kids aren’t offer carrots or broccoli but a lolly-pop by the pediatrician).  Offering food keeps our patients from feeling stressed or fearful and displaying undesirable defensive behaviors and builds a positive emotional response for subsequent visits.  This is critically important particularly in puppies and kittens. The positive vibe is good for everyone, doctor, patient and owner!

In addition to this we maintain an examination room that is cat-specific so they never get even so much as a “whiff of dog”.  We enhance this olfactory experience by having several catnip toys spread around the room and a Feliway (pheromone) dispenser in this room to enhance the overall sense of well-being.  For dogs we completely avoid the use of force or any kind.  We never employ “alpha rolls”, “dominance downs” “leash corrections” or any other training technique that is not in our realm of responsibility.  We direct the handler to use quiet voice tones and encourage the dog with treats and a non-aggressive stance.  Often this includes several minutes of talk between me and the owner where I employ a very monotone, low volume “voice” and persist with this often until the dog changes its countenance from anger/fear/aggression to boredom.  Once bored, the dog’s guard is down and they become much more open to accepting treats and gentle handling.

We recognize that there is only so much that we can achieve in any one visit, particularly if very negatively reactive behaviours have been entrenched.  Despite this, we persist and accept the limitations of this and trust that this is the best way to hopefully work towards as positive an experience as is possible given the limitations we are presented with.

Posted by:  Dr. Mark Steinebach

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