tbe_admin, Author at Fear Free

How Fear Free Helps Pets Get Better Care

Kim Campbell Thornton
Managing pain and completing procedures and exams in a way that keeps patients not only calm but actually eager—or at least willing—to participate is at the heart of Fear Free. We love hearing how Fear Free techniques help your patients and your own pets make it through needle sticks, diagnostic tests, and more to receive the care they need in a kind, respectful, and stress-less way both in the clinic and at home.

Fluid Dynamics

My cat Cleo is nearly 17 and receives sub-q fluids regularly at home. She used to grumble and try to get away but once I started Fear Free, I began giving her favorite crunchy treats before, during, and after administering fluids. Now she purrs through the whole procedure, and any time I approach the spot in the house where we do fluids, she walks up for “crunchie time.” I’ve been able to switch back to a larger needle because she doesn’t notice the poke while snacking, which makes administration faster, too.

Kate Regehr, Douglas College, New Westminster, British Columbia, Canada

PVPs for Moose

Last year, Moose came into our clinic with lots of anxiety and fear, so much that we were unable to properly perform a physical exam or collect blood from him. This year, Moose had trazodone on board and his visit went fantastic. Our team was able to get him on the scale, perform a full exam, and collect blood. Moose’s mom was so happy and relieved to know that Moose could have a Fear Free veterinary visit where Moose can feel safe.

Jessica Decock, Georgian Bay Veterinary Hospital and Mobile Services, Perkinsfield, Ontario, Canada

Pain Relief, Pet Relief

Chewy had a lot of fear and anxiety at the veterinary clinic, causing her to behave aggressively and making it difficult to give her the care she needed. While training her, I observed various signs of pain, which were most likely adding to her anxiety. I alerted her caregiver to my observations so she could better assess and monitor her dog and update her veterinarian. Chewy and her caregiver had previously had negative and traumatic experiences at a veterinary clinic so I referred them to Keystone Veterinary Clinic, which has Fear Free Certified Professionals who created a handling plan to enable Chewy to have a thorough exam, radiographs, and other diagnostics in a safe and low-stress manner. I also worked with the owner to begin muzzle training. The combination of appropriate scheduling, handling, and sedation, Chewy was able to receive the diagnostics and treatment she needed.

Tabitha Kucera, RVT, CCBC, KPA-CTP, Positively Pawsitive, Cleveland, Ohio

Meeting Goals for Gus

Gus had developed severe resource guarding of his food and water bowls, as well as fear and anxiety regarding being touched and having his gear put on and taken off. As a result, he snapped at and bit a walker. We worked closely with his owners and utilized Fear Free strategies and positive reinforcement training to get Gus comfortable with having strangers in the home. We were eventually able to find a solution that allowed Gus to be comfortable having walkers touch and refill his water bowl and approach his food bowl without any signs of resource guarding or fear, anxiety, and stress. Now Gus happily greets his walker at the door, demands affection, and has no issues on his walk or in his home.

Katie Pape, Windy City Paws, Chicago, Illinois

Turning Around First-Visit Blues

Yesterday, we had a new client come in for a vaccine appointment for her new blue merle Corgi puppy, which she had picked up the previous day. In the lobby, the pup was quiet and at first glance appeared to be coping well, but once in the exam room, I noticed she was scared and only wanted to stay between mom’s legs. We needed to vaccinate her so she could attend the puppy kindergarten class our behaviorist runs. We were able to get an oral bordetella vaccine in her, luring with baby food. When we attempted to poke with the needle for the other vaccination, though, she cried. We tried to warm her up to us so we would be able to get the vaccination in her. She escalated in the room and turned and growled. We then decided to abort mission. We did not want to ruin her experience at the veterinarian, especially since this was her first time here and she was a baby. We prescribed gabapentin and planned to have her come in the next day, early in the morning, to give her a better experience. Luckily, mom and dad were 100 percent on board with this. They came in the next morning and our front desk staff directed them to a room right away. When we walked in with the vaccine, she was asleep on the table. Dad said she was very sleepy. I grabbed a cup of Braunschweiger and fed her a small piece of it. She eagerly ate it but didn’t move her body. We desensitized and performed gradient of touch and she was fully distracted by the yummy treats. We gave her the vaccine and she never stopped eating and did not even notice the poke. We were thrilled!! Yay for pre-visit medications!

Maria Marano, The Ohio State University Veterinary Medical Center Community Practice, Columbus, Ohio

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Kim Campbell Thornton is content manager for Fear Free Pets and is a Level 3 Fear Free Certified Professional. She has been writing about dogs, cats, wildlife, and marine life since 1985.

Time, Training Help Pet Pig Overcome Fears

Mikkel Becker

The fear of visiting the veterinarian and the anxiety of riding in the car isn’t limited to dogs or cats. Other animals experience these anxieties as well, including pigs. I know, because I was part of a major effort to help one adorably sweet and sizably grand pet pig, Dee Dee, to overcome her fear of car trips and veterinary visits.

Dee Dee’s fears were anything but mild when I met her. At one time she enjoyed riding in the car and veterinary care was a non-issue. But that changed after a spay surgery with a previous veterinarian when she was received third-degree burns from a heating pad during the procedure. The extreme pain and distress of the experience changed her behavior any time she rode in the car or was taken to the veterinary clinic. Any indication that she was going to be placed in the car sent all 250 pounds of Dee Dee into a flailing, fighting fury to flee to safety. She seemingly paired the car ride and traveling to new places with the distress and pain of the one experience.

From Chaos to Calm

Just getting Dee Dee into the car involved recruiting neighbors and the strength of many large men to push, pull, and pick her up into the car while other people blocked her movements and view using cardboard boxes. Dee Dee squealed in panic the entire trip and in her distress peeing and pooping all over the inside of the SUV in which she rode.

By the time I met Dee Dee, not only was she in distress, so was her owner, Olive. She was overwhelmed by the impossibility of getting her pig the care she needed, including hoof trims, a long overdue necessity. Olive was trapped between the duty of caring for her pig’s health and the guilt of not wanting to put Dee Dee through any more terror to get the care she needed. Thankfully, with the right Fear Free partnerships and training, Dee Dee was able to get the physical care she needed without losing her emotional wellbeing in the process.

As a trainer who is Fear Free certified, I was able to incorporate aspects of reward-based training that I commonly use with dogs into my training with Dee Dee. In addition to training, an essential step was to find a Fear Free-certified exotic animal veterinarian. We came across Dr. Alicia McLaughlin from the Center for Bird and Exotic Animal Medicine near Seattle, Washington, who was equally committed to reducing Dee Dee’s fear, anxiety, and stress.

We taught Dee Dee to touch and follow a target, in her case a plastic serving spoon. This became her go-to way to say hi to new people. Targeting was also an excellent way to encourage her to willingly follow toward, away, onto, or off certain spaces to better guide her movements. This was useful both for getting her to willingly approach the car and walk up the ramp, as well as to move onto spaces such as the scale or into the exam room.

Dee Dee also had an impressive array of other fun tricks we capitalized on as relationship builders for her care, including sit, down, and Zen down, during which she would lie on her side. Such behaviors were vital to earn her participation during care, for keeping her in a stationary position, and for getting a better view of her hooves and belly.

Training for Travel

To get Dee Dee ready, an essential step was to replace her car ramp with a far sturdier version. Dee Dee was petrified of her previous ramp and avoided it at all costs. This time we took ramp training slowly by introducing it on a flat surface and teaching her to walk across it following a treat trail and her target spoon.

After successful ramp crossings on the flat surface, she graduated to higher spaces, including the curb and couch. Dee Dee liked this training so much she often opted to walk across the ramp and lie down atop it in her free time.

Separately, we desensitized Dee Dee to being around the car, including opening car doors or turning on the car while she did tricks, without actually getting in or going anywhere. We incorporated “go to your space” by training her to move to her blanket, which was useful as a portable safe space during trips in the car and at the vet.

In preparation for the visit to the hospital, Dr. McLaughlin prescribed pre-visit medications to help keep Dee Dee calm and reduce her panic.

Edible and Physical Treats

For training treats, we chose small, healthy snacks, including measured portions of her regular food, a cut-up apple or banana, and Cheerios. Our go-to treats were veggies cut into bite-size bits, including red, green, and yellow peppers, and her favorite, cherry tomatoes (reserved for the most challenging behaviors). Dee Dee’s previously expanding waistline began to shrink.

Dee Dee also liked back scratches and “getting forked”: a massage-like action with gentle poking of a fork that sent her into a euphoric trance. We used this to encourage her to relax as well as a reinforcer for performing certain behaviors. In getting Dee Dee up the ramp and into the car on the actual day of her veterinary trip, a human to scratch her back helped to keep her settled.

Challenging Setback

Unfortunately, our gradual acclimation timeline was thrown off because of a hoof injury that required veterinary care sooner than we had planned in our training timeline. We had to adapt the foundation we did have to help Dee Dee into the car, despite not having the full timeframe to practice with the ramp. This big jump was undeniably going to be too much for Dee Dee, so we coupled our training efforts with Dr. McLaughlin to provide pre-visit sedation that would keep her calm while still alert and mobile.

The first attempt at sedation wasn’t enough to take off the edge. Rather than forcing the issue, we settled on stopping with her moving partway up the ramp for treats and then taking a break when we noticed that past that point she was showing increased signs of FAS. The dose was adjusted, as was the angle of the ramp, so that it had a more gradual incline. Dee Dee then loaded calmly and was on her way, this time with less distress and visibly less mess.

Dee Dee’s list of known tricks was used when she arrived at the vet to increase her familiarity and cooperation with the staff and to pair the positives of trick training alongside care. The team also created a relaxed ambiance by dimming the lights and playing calming classical music. Then, by giving her pre-sedation medication of oral Valium hidden within food treats, she became sleepy and calm to the point that a sedation mask was easily placed over her nose. The care for Dee Dee’s hooves was then able to be performed without fear, anxiety, and stress being associated with the experience.

Continuing Education

After her visit, Dee Dee’s instruction continued, along with desensitization to hoof care at home. She has also learned to give in to pressure rather than to fight against it to help both with her walks and with tolerating minor restraint or guidance. Dee Dee has also been working on informational cues that teach her to turn when asked, even learning to differentiate left from right turns when asked; yet another sign of the brilliance of pigs.

The future for Dee Dee is full of hope with the help she was provided through Fear Free care. Despite a less than ideal start, she’s on track to become the healthiest and happiest pig she can be.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Mikkel Becker, CBCC-KA, CPDT-KA, KPA CTP, CDBC, CTC, is lead animal trainer for Fear Free Pets. She is a certified behavior consultant and trainer who specializes in reward-based training that’s partnered closely with the pet’s veterinary team. Mikkel is coauthor of six books, including From Fearful to Fear Free.

4 Reasons to Start a Puppy Socialization Class in Your Clinic

Valarie V. Tynes, DVM, DACVB, DACAW

Do you still believe that a puppy should have all her vaccinations before ever meeting another dog? Do you think the safest place for every new puppy is within his own home until after the last set of vaccinations? If so, you may be running the risk of the puppy’s early death due to behavior problems.

Studies have demonstrated that behavior problems likely result in more pet deaths than any other single cause.^{1, 2,3}A properly run puppy socialization class should not put your patients at any increased risk of communicable disease.⁴

If you do not have a reliable, safe place to refer your clients to for puppy classes, then consider offering them at your own clinic. Puppy classes are fun and, when held at your clinic, allow you and your staff to reap the benefits. Here are four reasons to consider adding puppy classes to your practice’s programs:

1. Proper socialization is critical to the puppy’s proper development and the window for this period of development is only open until about 14-16 weeks. After that time, puppies are not as able to learn to cope with novelty and develop new relationships with other individuals.

Your clinic is a safe place for this experience to happen because:

You can sanitize the surfaces puppies will contact.
You can be certain that all puppies who attend have had at least one vaccination several days prior to their visit.
You can give each puppy a brief exam and send puppies home if they appear to be sick.

2. Puppy classes help create more cooperative patients. When puppies come to your clinic once a week for a few weeks, and the only thing that happens there is they get to play with other puppies, meet some new people, see some strange things and get lots of treats, they learn that there is nothing scary about the vet clinic.

Part of at least one puppy class session should involve demonstrating to pet owners how to handle their new puppy’s ears, toes, tail, and other body parts in a way that mimic handling for veterinary and grooming procedures. When this is done while giving treats, puppies learn that this type of handling is routine and “no big deal.”

You can help set the puppy up for success in advance by recommending the owner use an Adaptil Junior collar. This is a collar impregnated with dog appeasing pheromone, the same pheromone that mother dogs release during the period of time when they are nursing puppies. Numerous placebo-controlled studies have demonstrated its ability to help decrease signs of fear and anxiety in many situations.^5,6,7 When placed on puppies during their critical period for socialization, the collar has been proven to help with the socialization process.⁸ Puppies between 8 and 16 weeks of age who wore an Adaptil collar for just 30 days while attending a puppy class showed signs of being better socialized 1, 3, and 6 months later than puppies who wore a placebo collar.⁹

3. Puppy classes will bond clients to your practice. When clients see how much you care about their puppy’s healthy development and good behavior, they will appreciate your commitment to their puppy’s overall health.

When they see how happy their puppy is to return to your clinic time and time again because he only has good memories associated with the visit, they will have no reason to ever consider going to another practice.

4. Puppy classes provide an added revenue stream. They do not have to be managed by the veterinarian. It is very possible that you have a staff member who is interested in learning more about how to do this and would love the opportunity to take on such a valuable and rewarding project. There are several excellent resources available for learning how to teach a puppy class and with some training and practice most anyone can add puppy classes to their clinic’s list of services. One of the best is the Puppy Start Right for Instructors Course, which offers a discount to Fear Free Certified Professionals using code FEARFREEPSRI.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

References

This article was brought to you in collaboration with our friends at Ceva.

Dolan ED, Scotto J, Slater M, et al. Risk factors for dog relinquishment to a Los Angeles municipal animal shelter. Animals (Basel) 2015; 5: 1311-1328.
Dreschel NA. The effects of fear and anxiety on health and lifespan in pet dogs. Appl Anim Behav Sci 2010;125: 157- 162.
Houpt KA, Honig SU, Reisner IR, Breaking the human-companion animal bond. J Am Vet Med Assoc 1996; 208: 1653-1659.
Stepita ME, Bain MJ, Kass PH. Frequency of CPV Infection in Vaccinated Puppies that Attended Puppy Socialization Classes. J Am Anim Hosp Assoc 2013; 49:95-100.
Pageat P, Gaultier E. Current research in canine and feline pheromones. Vet Clin North Am Small Anim Pract 2003: 33;187-211.
Mills DS, Ramos D, Esteller MG, et al. A triple blind placebo controlled AABS investigation into the assessment of the effect of Dof Appeasing Pheromone (DAP) on anxiety related behaviour of problem dogs in the veterinary clinic. 2006;98:114-126.
Gaultier E, Bonnafous L, Vienet-Lague, et al. Efficacy of dog-appeasing pheromones in reducing stress associated with social isolation in newly adopted puppies. Vet Rec 2008;163:73-80.
Gaultier E, Bonnafous L, Vienet-Lague, et al. Efficacy of dog appeasing pheromones in reducing behavours associated with fear of unfamiliar people and new surroundings in newly adopted puppies. Vet Rec 2009;164:708-714.
Effects of dog appeasing pheromone on anxiety and fear in puppies during training and on long term socialization: Denenberg S. & Landsberg G.M. JAVMA, (2008) 233;12

Can You Spare 15 Minutes? Study Shows Value of Brief Petting Sessions for Shelter Dogs

Linda LombardiWhen asked why they don’t volunteer at a shelter, people often say they don’t have time. What if they knew that just 15 minutes of quiet petting could have a measurable effect on a dog’s wellbeing? That’s the result of a recent study.

Research has shown the benefit of repeated sessions of human interaction for shelter dogs. “We wanted to see, if you only had time to stop after work for fifteen minutes and go in and pet a dog, would it have a positive impact on that dog?” says lead author Ragen T. S. McGowan, research scientist at Nestlé Purina.

To answer this question, researchers chose 55 shelter dogs who could safely interact with strangers. The dogs were fitted with cardiac monitors, and saliva samples were taken before and after the session. Volunteers were asked to sit in a small room with the dog and pet them calmly, speaking in a soothing tone of voice. The session was recorded for behavior analysis.

Petting Benefits

Measurements showed that the dogs had lower heart rates at the end of the session, as well as increased heart rate variability. Heart rate variability — whether the distance between heartbeats is regular or irregular — is an indicator of emotional state. Under stress, heartbeats are more regular. The increase in heart rate variability showed that the dogs had become more relaxed.

Cortisol measures did not show a difference, which McGowan says is not surprising in such a short time. She also notes that cortisol can be tricky to interpret because it’s really a measure of arousal, which can be negative or positive. However, the fact that cortisol did not increase suggested that the dogs were not stressed by the experience.

The dogs’ behavior also showed increased signs of relaxation, although the study did note individual differences, with the dogs falling into three general groups. “We had a good portion of the dogs that enjoyed this so much that they just melted into a puddle in the person’s lap,” she says. “We had other dogs that enjoyed it but also enjoyed walking around checking out the room, then going back to the person.” The third group seemed to not quite get it. “They stood at the door, like they were saying, ‘Are we going for a walk now? What are we doing in this room?’ ” she says. “But regardless, in all the dogs we saw a positive impact in their behavior.”

Volunteers Benefit Too

Erica Feuerbacher of Virginia Tech, who studies shelter dog welfare, calls this study “fascinating and very important.” She says, “The idea that you can just pop in and spend 15 or 20 minutes with a shelter dog and improve its welfare opens the door for more people to interact meaningfully with shelter dogs and know that they’re making a difference.”

Since the study shows the value of just sitting quietly with a dog, it also opens up opportunities for volunteers who don’t have the physical ability or inclination for more strenuous types of interaction, she says.

Volunteer training is important, since first meeting a stranger is exciting, and most people aren’t naturally inclined to greet dogs in a calm way. Volunteers for the study were given specific instructions on how to pet and interact with the dogs. “I don’t think it would take too long to train people to interact appropriately and let the dog have some say in whether they want to approach and interact,” Feuerbacher says.

The study also highlights the importance of providing shelter dogs opportunities to relax. McGowan says the interaction in the study was different from what dogs usually had with volunteers at this shelter. “In most cases the volunteers walk dogs, so dogs see a volunteer and think, ‘Oh, I’m going on a walk,’ which is exciting,” she says. “We wanted to try to trigger the opposite positive emotion, that state of relaxation, because that’s something shelter dogs often don’t get much opportunity for.”

Relaxation Nation

Dogs in shelters are already in a stimulating environment, with lots of noise and activity, but often the only enrichment they get provides even more stimulation. “You go into a shelter and often the dogs are bouncing off the walls, and there is the idea that they have this pent-up energy and what they need is to get out and run,” says Feuerbacher. “We’re now starting to challenge that notion a little bit. Do we know, is that really what they need?”

A lot of what we do with our dogs at home — cuddling on the couch watching TV, say — is like the calm interaction in this study. While it seems as if we’re doing nothing, it’s an important bonding experience. And while shelter dogs may appear to already spend a lot of time doing nothing, it’s a different kind of nothing. “They may be doing nothing active, but are on high alert the whole time, rather than getting to relax,” she says.

Shelters can give dogs breaks from that stimulation in several ways. One that Feuerbacher suggests is an office foster program, where a dog gets to hang out in someone’s office at the shelter for a few hours.

McGowan also notes that relaxed dogs are easier to work with. Sitting quietly with a dog for 15 minutes ahead of a veterinary exam or grooming is worthwhile for everyone involved, she says. “Spending that time to get that dog into a more positive relaxed state ahead of that handling makes the whole interaction go a lot easier.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Linda Lombardi writes about the animals who share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.

Building Bonds the Fear Free Way

By Kim Campbell Thornton
Nail trims are the bane of numerous pets and people. Owners don’t like doing them, and assistants and technicians don’t enjoy being “the bad guys” who have to do the dirty deed. Blood draws and even simple exams can bring bad feelings to the forefront, too. Fear Free to the rescue! Get inspired by fellow Fear Free Certified Professionals as they help pets stay cool, calm, and collected during care.

All About Eva

Eva, a spunky and energetic German Shorthaired Pointer, is a staff favorite for more than just her adorable, tongue-hanging-out smile, but there’s one thing Eva never liked: nail trims! Prior to the hospital’s transition to Fear Free in early 2017, it was a challenge to trim Eva’s nails, requiring three or four technicians to assist with restraint, plus a muzzle and calming cap. We started implementing Fear Free teachings right away with all of our patients, but one staff member has really gone above and beyond her commitment to Fear Free training to help Eva overcome her fear. Kayla McNeely volunteered to assist with Eva’s nail trims, and she can now perform Eva’s nail trims solo, standing, with minimal assistance from Eva’s mom, Sheila, who says, “Kayla’s patience and kindness have worked wonders with my girl.” Our hospital requires all staff members to go through Fear Free training to help ensure that all of our clients, patients, and staff have a pleasant experience during their exams. We have seen a tremendous difference in many patients at our hospital since our transition to Fear Free, but Kayla and Eva’s journey together is by far our most successful Fear Free adventure to date.

Beth Chinnick, CVT and practice manager, Compassion Animal Hospital, East Berlin, Pennsylvania

Ruba Loves Laps

One-year-old Ruba disliked having her feet touched and her nails trimmed. We trialed trazodone for six months for all nail trim visits. It started to work well, and we discovered she preferred sitting in Dr. DaCosta’s lap. Ruba now comes in for frequent nail trims with minimal restraint and no trazodone needed. We are so proud of her progress and the team’s dedication to using Fear Free techniques.

Brianna King, Clinic Manager, Watzin Veterinary Clinic, Waterdown, Ontario, Canada

Practice Makes Perfect

Mikey Bear used to require sedation before blood draws, but I showed his amazing humans how to hold his back leg for a blood draw and wet the vein while giving him treats to get him used to the feeling. They worked on this for a month, and when they came back, the blood draw was a snap. I discovered they had added another step to the homework and were poking the vein with a toothpick at home.

Jessica Jaffe, CVT, VCA Wakefield Animal Hospital, Wakefield, Massachusetts

Thinking Outside the Office

I was on primary care rotations at University of Wisconsin Teaching Hospital, and my first case of the day was a 150-pound Great Dane who had a history of being nervous during veterinary visits and in the presence of strangers. When I was notified that he and the owner had arrived, she went to the waiting room but was told that they were outside in the car. Even with sedation prior to the visit, he was too afraid to come out of the car. After speaking with the owner and assessing the situation, I decided that additional sedation and performing the exam in the car would spare him an immense amount of stress. We moved slowly, made intentional actions, and kept him comfortable. The smooth experience left the owner grateful. I firmly believe we took the pet out of petrified.

Bianca Ferlisi, veterinary student, University of Wisconsin School of Veterinary Medicine

From Terror to Trust

When I worked at a veterinary emergency clinic, one of the dogs in the hospital was so fearful that he would begin to thrash and hit his head in the ground if anyone touched his leash. I sat in front of his cage with my back to him so he could become accustomed to my scent. Then I started placing treats in his cage and turning my back again. Eventually, I opened the door and put a leash on him and sat next to the door. When he came out of the cage on his own, I was able to walk him with no tension on the leash. Gaining an animal’s trust is a beautiful thing.

Shelby L. Dan, veterinary assistant, Downtown Animal Hospital, Toronto, Ontario, Canada

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Kim Campbell Thornton is content manager for Fear Free Pets and is a Level 3 Fear Free Certified Professional. She has been writing about dogs, cats, wildlife, and marine life since 1985.

Crisis Communication: Tips for Calming Pet Owners

Maggie MartonA 2018 article published in Veterinary Sciences synopsized a dissertation examining the connection between owner loyalty to their pets’ veterinarians and their perception of the communication from the veterinarian and staff. The study found that good communication delivered all kinds of benefits, from customer loyalty to trust in the veterinarian to likelihood of following treatment instructions to perception of a greater value for services rendered.

But good communication can be difficult, and it can feel nearly impossible in times of crisis–when a pet is ill or injured, when an animal is dying, or when a client doesn’t understand or can’t afford care options, for instance. While many communication tools are available, one promising model for veterinarians to help calm pet owners is Nonviolent Communication (NVC).

What is NVC?

The goal of NVC is to communicate and express yourself clearly, then receive what you hear back without judgment. The communication model avoids language that promotes disconnection, such as blaming, comparing, judging, or doling out advice.

Leslie Ritter-Jenkins, a certified trainer with the Center for Nonviolent Communication, says NVC is being practiced in the human medical field and fits veterinary medicine well. “Because veterinarians, like many people in the medical world, are people of authority, we tend to give them a lot of power,” she says.

Being mindful of language used matters because people tend to either rebel or submit to perceived authority. This is critical in times of crisis because when a client is triggered–by fear, anger, grief, and so on–that lack of control makes communication more difficult. As the “authority” in the room, using NVC tools can establish trust and confidence between the veterinarian and client while avoiding or mitigating conflict.

It’s just one framework for clear communication, but its principles fit veterinary medicine because the foundation is built on one thing: compassion. In times of crisis, especially when life and death decisions must be made, a compassionate response can shift the tone of the conversation.

The NVC Process

According to the Center for Nonviolent Communication, the model consists of two sides: empathetically listening and honestly expressing. You can’t control what your client says–or hears–especially while facing stress or fear, but you can control your listening skills and your response. Here are the four steps to the NVC process to employ:

Observations: without judgment
Feelings: underlying emotions
Needs: universal and what makes us human (e.g. mutuality, respect, freedom, choice, partnership)
Requests: a clear, doable ask

Ritter-Jenkins points out that what a client poses as a feeling is more often a need, so the NVC skill involves drilling down to identify what’s really going on. She says, “If someone says, ‘I feel disrespected,’ their feeling isn’t disrespect. The feeling is probably hurt or scared. Their need is respect.”

Listen closely to the data your client provides either overtly or through your observations and consider whether there’s an emotion or need masked by the language. It’s a skill that takes time to hone. Practice sessions during staff meetings may be helpful.

How Can NVC Help in the Exam Room?

“All humans share the same feelings and needs. When we get out of right and wrong thinking, better or worse, appropriate or inappropriate, and we speak this language of feelings and needs, we have a language that connects us universally. When a vet can hear behind what the customer, the human customer, is saying and then use a sentence or two of empathy, it’s very efficient connecting with feelings and needs. You can get to the heart of things, what’s really happening with the customer, fast,” Ritter-Jenkins says.

She shares an example from her own life when she faced an end-of-life decision with one of her cats. Her cat suffered from an undiagnosed GI disorder. They tried various approaches, and she ultimately went to the vet for help because her cat wasn’t eating, he was losing weight, yet he was acting completely normal.

“She could hear in that data and say, ‘It sounds like you’re feeling torn because you know that there’s something physiologically wrong and the cat is likely in pain and suffering, and you’re torn because you’re seeing some normal behavior and you’re needing clarity about what’s going on.’ That would’ve been exactly right–an empathic guess,” she says. “Or she could have said, ‘It sounds like you’re feeling exasperated and want some clarity or want some support in this decision.’”

When faced with a potentially costly procedure, a devastating diagnosis, or an end-of-life decision, client reactions run the gamut, but people often shift swiftly into panic or crisis mode. Listen, then present the data, the science, while being clear that you’re not telling the client what to do. Jumping in with unsolicited advice, especially when a client is in crisis, creates a barrier to empathy, as does judging, storytelling, one-upping, and philosophizing.

One of the easiest ways to achieve this? A quick question.

Take some time during or toward the end of an appointment to ask, “Have your questions been answered? Do you have anything else that you’re concerned about that we haven’t covered?”

Practice NVC

The science supports this model of communication. “What happens is the vagus nerve that goes from our brain and feeds our heart, our lungs, and our digestive system, empathy calms that. When someone empathizes with us, our whole body relaxes. We have the beauty of this connection, and it’s not just emotional. It’s physiological,” Ritter-Jenkins says.

Earlier this year, VIN offered a course on empathy and reflective listening, which included the Nonviolent Communication text as recommended reading. The concept is gaining traction in veterinary medicine. On its website, the Center for Nonviolent Communication posts practice group meetups open to anyone wanting to learn and practice the skills. Or pick up a copy of the book, Nonviolent Communication, and practice with your staff.

Bottom line: It’s a worthwhile endeavor to communicate well with your clients, especially during times of crisis, and it might even help build your business by increasing customer loyalty. The NVC model provides a framework to achieve those goals.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Maggie Marton is an award-winning pet writer based in the Indianapolis area. She covers dogs, cats, kids, and often the intersection of all three for print and online publications. Maggie is the author of Clicker Dog Training: The Better Path to a Well-Behaved Pup and the blogger behind OhMyDogBlog.com and TheZeroWastePet.com.

Why Behavior Evaluations in Shelters Can Be Misleading

Linda Lombardi

There was a time when formal shelter behavior evaluations for dogs seemed like an important breakthrough. But while an objective way to assess behavior seems like a great idea, it’s increasingly clear that these batteries of tests aren’t doing the job it was hoped they’d do.

In 2016, Gary Patronek, DVM, and Janis Bradley published a paper analyzing the literature on canine behavior evaluations, concluding that they were “no better than flipping a coin.”

This did not prompt immediate abandonment of these tests and there were some understandable questions about their conclusion. How was it possible for their review of the literature to conclude that these tests were not valid and predictive, when individual papers said that they were?

In a new paper they address those questions, delving into statistical issues, the difference between colloquial and technical uses of words like “valid,” “predictive,” and “reliable,” and the kind of evidence needed to justify using a test for real life–and sometimes life and death–decisions.

Testing the Tests

Standards exist for judging whether a test has real-world applicability. “This is not something we need to reinvent,” Bradley says. “There is robust human diagnostic test literature that tells us how to do this and what acceptable standards are, and behavior evaluations in dogs–at least the ones that we looked at, that were intended to have application to dogs in shelters–simply don’t meet any reasonable standard.”

One problem with research on predictive ability of behavior evaluations is that most of it has been done on owned dogs, not dogs in shelters.

“Epidemiologists will tell you there’s no such thing as saying a test is valid,” Bradley says. “All you can ever say is that we’ve demonstrated validity with this population, in this context, with this exact instrument. If you change any of those things–and likely all of those things are going to change in any application in a shelter–any claims you make for validity go completely out the window.”

Many shelters modify protocols, and it’s impossible to perform a test as consistently in the shelter environment as in a lab. Tiny details can change results. One study showed that factors like the evaluator’s height and how much they leaned over changed the outcome. “Try to imagine the world where you’d have the kind of consistency that would eliminate confounds like that in a shelter environment,” Bradley says. “It could never happen.”

The context is also different, and in an important way. The ability to identify aggression is of greatest concern in these evaluations, and results can vary by environment.

“The most common underlying motivations for aggression are fear and anxiety because aggression is distance-increasing behavior,” says veterinary behaviorist Wailani Sung, DVM, of the San Francisco SPCA. “Dogs in the shelter are already lower in tolerance because their overall stress level is so high. So they could test more negatively in a shelter environment versus in a home where they have more stable relationships and a more consistent environment.”

Another problem is that serious aggression is rare in dogs, and those dogs probably don’t get evaluated at shelters. “Most shelters eliminate the tail end of the bell curve without ever subjecting them to a behavior evaluation,” says Bradley. “If everyone’s afraid to go into the kennel with the dog, they’re not going to take it out and do a behavior evaluation.” For statistical reasons, it’s more difficult to design a reliable test for a rare behavior if there’s a concern about false positives. In this instance, false positives–a result that claims to show a dog is aggressive when he isn’t really–can result in unnecessary euthanasia.

“This entire enterprise to a certain extent appears to be based on an idea that there’s some elevated risk with regard to shelter dogs,” Bradley says. “There’s no evidence that this is the case.” Shelter dogs are no more or less likely to someday show aggression.

What’s the Alternative?

Although there’s a considerable body of research questioning the validity of behavior assessments, it takes time for that to trickle down to the real world. “There’s a huge discrepancy between the academic world that has been studying these things versus the practical world that’s out there on a day-to-day basis that still has the pressure of putting safe animals out into the world,” says Jeannine Berger, DVM, vice president of rescue and welfare at the San Francisco SPCA.

Change is hard, and this is a hard kind of change. “Sometimes you don’t want to be shown that what you’re doing is not helpful and may be harmful. That’s a bitter pill to swallow,” says Dr. Sung.

Dr. Berger says discussion about behavior assessments has increased since the ASPCA came out with a position statement last year referring to this literature. “People actually in the field are now starting to question if this is the right approach to making those decisions,” she says.

Amy Marder, VMD, who spent much of her career working on these types of assessments, now believes the best approach is for staff to observe dogs in day-to-day interactions and keep good records. This doesn’t have to involve more work or resources, since it happens during physical exams and walks, which need to be done anyway. “You can get a lot of information from doing routine procedures rather than a formal evaluation,” she says.

This is what San Francisco SPCA does. “We use the five freedoms model to assess welfare, and everyone is trained on that,” Berger says. “We are looking at, are they eating, are they drinking, are they comfortable in their environment, are they fear free and distress free, are they performing normal behaviors, are they free of illness and disease,” she says. “We use that to assess each animal every day, and anything out of the norm is reported and is addressed.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Linda Lombardi writes about the animals who share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.

Kitten Socialization: Creating the Purrfect Feline Patient and Pet

Rachel Lees RVT, KPA CTP, VTS (Behavior)

As veterinary professionals, wouldn’t we all love ways to keep our clients and feline patients happy, healthy, and even make our jobs safer? Let’s scratch the surface of the basics of kitten socialization, the benefits of kitten socialization classes, and how we can start these courses in our own practices.

Who doesn’t love a sweet, fluffy, and cuddly kitten? But they don’t become that way on their own. Veterinary team members and owners have long recognized the importance of puppy socialization and training classes, and these same tactics can be used for kittens as well. That’s right! Socialization is just as important for kittens as it is for puppies. It’s important for humans, too. Here’s why.

Educating Owners and Staff

As veterinary professionals, we have only a certain amount of time to discuss these things with new kitten owners during appointments. An educated veterinary team is key to starting kittens off on the right track to enjoy handling, being placed in their carriers, and be more comfortable with husbandry care at home.

These things are beneficial for the veterinary team as well. Revenue increases because cats are more compliant about being brought to the veterinary hospital, and everyone is safer because fewer patients display fear, anxiety, or stress. Implementing and recommending these classes in a practice can also increase revenue as a new service and be a way to bond kittens and owners to the practice.

Socialization Timeline

Knowing and acknowledging the kitten socialization period is critical in setting up new owners and kittens for success. For kittens, the socialization period starts at 2 weeks and ends at 7 to 10 weeks. This is the time when kittens begin to become less reliant on the queen for survival and have increased interaction with social and environmental stimuli. It’s the most important sensitive period in feline development and can help to prime felines to live safely and comfortably in human households. Positive social experiences in kittenhood with other species and stimuli are hugely beneficial in creating behaviorally healthy adult cats.

You may be thinking that kittens do not come into the practice until after this developmental period has passed and you are correct! Kittens may not come into our practices until they are 8 to 10 weeks old. Kitten classes can still be beneficial because the socialization window does not slam shut. It closes slowly, so these classes can be beneficial for kittens up to 14 weeks of age.

Kitten Classes

Kitten Kindergarten or Kitten Kindy was brought to the forefront by veterinary behaviorist Kersti Seksel, VBSc (Hons), MRCVS, MA (Hons), FACVSc, DACVB, DECAWBM of Australia. The classes have the following goals:

Socialize kittens
Educate owners about normal feline behavior
Teach owners how to interact and play with their kittens
Train kittens to accept handling procedures
Identify any problem behaviors and provide up-to-date, humane, and scientific advice
Educate owners on all aspects of kitten development, pet care, and living with a cat in the family

I structure and run kitten classes as follows:

Interaction with other pet owners and felines of the same age range (with appropriate health and vaccination requirements)
Provide different surfaces, textures, objects, and sounds for the kittens to experience during exploratory time
Discuss and demonstrate carrier training using marker training
Review the following focus points to set the new kitten owners up for success:
- Litter Box Basics
- Socialization Period
  - Fear Free has a fantastic Kitten Socialization Bingo Worksheet in the Toolbox. I have used something similar in the past and given prizes for owners who get the “Bingo” or successfully socialize their kittens to many positive things from week to week.
- Scratching and playing
- Handling and administering medications

Courses can be offered weekly in a rotational style to get as many kittens into the class as possible, monthly as a kitten party, or in a weekly 3-week course. The possibilities are endless!

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Rachel Lees, a Level 3 Fear Free Certified Professional, is a veterinary technician specialist in behavior, a KPA certified training partner, and lead veterinary behavior technician at The Behavior Clinic in Olmsted Falls, Ohio. She loves helping people create and maintain a strong human-animal bond and has a special interest in kitten and puppy socialization and development.

Can Special Music for Cats Reduce Their Stress at the Clinic?

Linda Lombardi

We know that music can affect human mood, but we don’t usually think about whether cats or dogs care if we play Mozart or Metallica. We probably should: Studies have shown that classical music reduces stress in dogs, and a study of cats under anesthesia showed differences in respiratory rate and pupillary diameter in response to classical, pop, and heavy metal music, with the lowest values for classical music and the highest for heavy metal.

Can we use these effects to our advantage? A recent study in the Journal of Feline Medicine and Surgery shows that music specially designed for cats has small but significant effects on cats undergoing a veterinary exam. It’s worth considering other aspects of the sound environment of your clinic as well.

Sounds Cats Like

Music for Cats by composer David Teie incorporates sounds intended to be familiar and comforting to cats, reminiscent of purring and suckling sounds, with frequencies similar to cat vocalization ranges. “However, he also layers in a melody of music that is pleasing to people as well,” says researcher Amanda Hampton of the School of Veterinary Medicine, Louisiana State University. “That part of the music, it seems that cats don’t really respond to, but that way we don’t get tired of it.”

Previous research in homes testing this music against silence and regular human classical music showed that cats seemed to prefer it. “They found that cats would approach the speakers playing cat music more, or go into postures that were more relaxed,” says Hampton.

Effects of Music

Building on this, Hampton and colleagues tested the effect of cat music during a veterinary exam. Twenty cats took part under all three conditions: cat music, classical music, and silence, with two weeks between tests. Cats were placed in an exam room for 10 minutes and then given a physical exam that included a blood draw. They were evaluated at three points with a standardized Cat Stress Score (CSS) based on body language and behavior–before the music began, during the exam, and after the exam–and with a Handling Score (HS) during the exam. Cats showed lower CSS and HS when listening to cat music compared to classical music and silence.

The blood drawn was also tested for neutrophil:lymphocyte ratio (NLR) as a measure of stress, but no differences were found. All cats had slightly elevated NLRs, which the authors suspect was an effect of the stress of travel to the clinic which had not had enough time to subside. “NLR goes up quickly but takes a little while to come back down, so what we could be seeing is the response they had to being put in the carrier or the car ride,” says Hampton.

How and When to Use Sound

Mikel Delgado, PhD, researcher at the School of Veterinary Medicine at UC Davis, thinks that this study shows that cat music might be a useful additional tool, but cautions against making too much of it.

“They found that the cats who were listening to cat music were easier to handle and had lower stress scores, but my caveat is that the differences between the groups were fairly small,” she says. “It wasn’t like this is a game changer, like if you play cat music everything else is going to be easy.”

Delgado says music is no substitute for making sure you’re doing everything else you can to reduce the stress of the veterinary experience for cats.

“If you’re not already using Fear Free or low-stress handling techniques, music is not going to fix your handling methods for cats,” she says. “If you don’t have your hospital set up for other aspects of reducing stress, like minimizing the time cats have to sit in the lobby, providing towels to cover carriers if owners don’t bring their own, making sure they have a non-slip surface to lay on while they’re being examined, music is not going to overcome those things.”

If you’re already doing all of that right, adding music might help, but also take the opportunity to think more broadly.

“The implications really have to do with what humans do when they are working with cats,” Delgado says. “People might not realize that what they’re doing and the kinds of noises they’re making might have implications for their patients.”

Consider the whole sound environment before you consider adding any kind of music. “Here’s an experiment to do in your treatment room: they make all kinds of apps for your phone that tell you how loud your background noise is,” she says. “I think situational awareness could help a lot of practices improve their environment, because I think most of us are louder than we realize we are. People should consider, can they lower their voices? Can they do less banging and slamming?”

Shelters should think about these considerations as well. “Maybe people should use headphones if they want to listen to heavy metal music when they’re cleaning cages,” she says. If you have a loud PA system, think about whether you could use walkie-talkies or text messaging with phones on vibrate. “If you need Jim to come to the front desk, does everyone in the shelter need to hear that?” she says. “Try to refine your communication techniques to modify that ambient noise that animals that are already in a stressful environment are experiencing.”

If you’ve got all that under control and want to try cat music, some additional considerations are when and where to use it. The study had cats listen to the music for ten minutes before the exam, but further research is needed to know whether a shorter period will have the same effect. Be aware that there is as of yet no published research about how dogs react to it. And while the piece of cat music used in the study was specifically designed to be less repetitive and easier on human ears, like any music, not everyone will love it. “I actually find the music relaxing,” says Hampton. “But maybe you have it playing in a cat ward, or in the exam room while the cats are in there, but perhaps not throughout the whole hospital, so if you have a staff member who doesn’t like the music, they don’t have to listen to it all day.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Linda Lombardi writes about the animals that share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.

A Kitten or Cat Care Clinic Provides Client Education Outside Office Hours

Deb Eldredge, DVM

A wonderful way to educate clients and potentially help out local pet adoption groups is to hold a kitten or cat care clinic. June is an ideal time for a kitten-themed clinic but any time of year will work. You might choose to do a couple of cat care clinics each year; consider one with a focus on senior cats, for instance.

A Job for a Cat Lover

Have a clinic employee who is considered one of your “cat people” in charge of this. If your clinic has a room big enough for a seminar, use that. I have used our local cooperative extension meeting room, usually available free of charge. As an alternative, a community college might have a free room available.

Most communities have local radio talk shows that are always looking for interesting people and events. Between that and posters at local shelters, pet stores, and your own clinic you should have plenty of free PR.

Gather Info and Freebies

Once you have a site, start collecting freebies to hand out. Our local pet store offered up bags and some treat samples. Go directly to companies; for example, Arm and Hammer donated small boxes of litter box deodorant. I have had samples of joint supplements, treats, food, catnip, and toys to put into the bags. You might be able to get starter kits to include as well, especially for kittens. The Pet Poison Helpline will donate magnets. If you got some donations of larger items you can make up baskets for a free door prize raffle for attendees.

Next, look for educational literature. Between AVMA, AAFP, Winn Feline Foundation, Cornell Feline Health Center, and AAHA, there is plenty of wonderful information for cat owners. You can also make copies of any handouts your own clinic has customized.

Involve Some Felines!

With June not only being Adopt a Cat Month/Adopt a Shelter Cat Month but also prime kitten time, I also recruited a couple of kittens from a local shelter. We bathed them, did FeLV and FIV testing, performed fecal checks, and provided their first vaccines. The kittens attended as demo animals for things like nail trims but also with the hope that they would charm their way into new homes. You could also have an adult cat or two present. If you aren’t comfortable using “unknown cats,” bring a clinic cat or employee cat who is good with crowds. I have used my own cats who were certified therapy cats as well as shelter cats and kittens.

Educate and Expand

Have a set list of topics to cover. Basic wellness care is a good starting point. If our clinic was concentrating on kittens I would bring up carrier training and behavior modification to prevent scratching or biting problems. Emphasize techniques to get kittens started on the Fear Free path. For senior cats you might want to discuss one or two of the most common senior cat problems such as kidney disease and arthritis.

Once you start doing “care clinics” you may find you have other topics to cover. Basic first aid is a good one or a nutrition basics seminar. These clinics can draw in new clients and also help your staff in the long run by educating people and answering their questions outside a busy work environment.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

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