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Lessons from the Cat: Litter Box Basics for the Veterinary Team

Rachel Lees, RVT, KPA CTP, VTS (Behavior)Cats are often considered a more independent, self-sufficient species compared to dogs, largely because they do not need humans to take them outside to eliminate. Most cats successfully learn to eliminate in the home by going to a litter box.

Nonetheless, feline elimination issues are one of the biggest behavioral problems clients bring to veterinarians. Often, the problem develops because human preferences regarding litter box location and type don’t match up with the desires of their feline companions.

As veterinary professionals, we must feel comfortable teaching clients what their cat wants from an elimination station. This article will review cat preferences regarding desirable locations, litter box styles, litter types, and more. This information can not only help the cat who is eliminating outside the box but can also help new kitten owners be successful from the start in setting up their new cat’s environment.

Litter Box Design and Location

Place litter boxes in safe, low-traffic areas but right off a high traffic area, so it is easily accessible. Keep them away from loud appliances such as washers and dryers, furnaces, dishwashers, air conditioners, or toilets. All these items have the potential to frighten the cat with unexpected sounds, interrupting the normal elimination pattern. An example of a safe, quiet location is a spare bedroom or bathroom that is rarely entered.

Many commercial products also offer “hidden” locations where cats can eliminate, disguised as planters or side tables, for instance. Although this hides the litter box from the human, it may also place it in a higher traffic location. Keep this in mind when giving recommendations on litter box placement. Everyone prefers privacy for elimination, even cats.

Litter box design preferences differ from cat to cat and human to human. Most cats prefer an open litter box. Most cat owners prefer a covered litter box. Covered litter boxes may trap odors and make the human environment smell better but for those reasons they may not be as desirable for the cat. If boxes are not cleaned regularly, the odor may be aversive to them.

Most commercial open litter boxes are too small for the average cat. The size of the litter box should be one and a half times the length of the cat’s body. Most veterinary behavior teams recommend using storage containers, Tupperware bins, dog litter boxes, or cement mixing pans. It is also important to find out if litter box sides are low enough for the cat to jump in without injury or pain. Using a litter box that cleans itself is typically not recommended as the sounds and machinery can scare the cat.

Litter Preferences

Many different types of litters are on the market: scented, unscented, clumping, non-clumping, wheat, newspaper, sawdust, pine, and more. A study by veterinary behaviorist Jacqueline C. Neilson DVM, DACVB, found that cats generally prefer unscented clumping litter beneath their paws. And although scented litters may be more desirable to humans, cats often disdain them. Cats are far more sensitive to odors than humans. Keep in mind as well that crystal-like litter can feel unpleasant to sensitive paws. When the cat eliminates the crystals can “pop,” causing a startling sound. Recommend giving cats the most preferable substrate—a plain, unscented litter—to set them up for success.

Since Flushing Isn’t an Option: Cleaning Tips

Litter boxes should be scooped once or twice daily. Cats prefer a clean location to eliminate. When boxes are not cleaned at least once daily, this can cause an aversion as the cat may not want to step and eliminate in a litter box filled with yesterday’s urine clumps and stool piles. Most humans would not desire this either.

To make boxes as attractive as possible, they should be emptied, cleaned with a mild, unscented detergent, and refilled with fresh litter at least once a month. Avoid cleaning the box with strongly scented cleanser.

Recommendations for Multi-Cat Homes

Design, location, cleaning, and substrate preferences are identical, but in homes with more than one cat, owners should provide one box for each cat, plus one extra. Place boxes on separate floors and rooms of the home to prevent one cat from blocking access to a box.

Keep in mind as well that using covered boxes in multi-cat homes can create increased anxiety if one cat is a stalker. If victim cats venture into the box to eliminate, they cannot see if the stalker cat is creeping up on them. If there is low-level aggression between the cats, and the victim cat is attacked when coming out of the box, the experience can create litter box aversion. For this reason, open litter boxes should be recommended in multi-cat homes.

Remember: It’s a cat’s world. We just live in it!

Author’s Note: Elimination out of the box is not always a behavioral concern and can very well be a medical cry for help. It is always important to rule out a medical condition before blaming behavior. Every patient who eliminates out of the box should be examined by a veterinarian and medically worked up (CBC/Chem/UA) before specific recommendations are made.

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.

Fear Free Success Stories: Patience for the Win

Kim Campbell Thornton
Whether they are going through training or learning to overcome previous fears, dogs do best when people give them time and space, in tandem with management and—if needed—medication, to develop confidence.

Body Language Messages

I’ve been a volunteer puppy raiser for Summit Assistance Dogs for about seven years. Each year I’ve raised a pup following Summit’s training guidelines based on positive reinforcement and what puppies can handle at each developmental stage. Each pup explores the world in tiny increments based on what they tell me through body language about how the new environment feels to them. Sometimes we don’t even get out of the car if the pup seems to be hesitant. If they’re not ready for a new place, we go somewhere they have already been to build confidence. Each pup is born with unique strengths and levels of confidence. The big and bold ones move through environments more quickly than timid pups. My current pup, Jazz, came to me at 11 months of age. She was timid about change, so we moved slowly and calmly. We joined a scent work class, which allows the dogs to move freely at their own pace. This built her confidence quickly and now she rocks in almost any setting. Watching what your pet tells you through body language (relaxed, happy, withdrawn, cowering) is key to a truly Fear Free companion.

Anne Campbell, Greenbank, Washington

Muzzle, Medication, Management, Magic

Alaska is a three-and-a-half-year-old white German Shepherd, who was adopted from a pet store when she was three months old. Early veterinary visits had caused her to become fearful. Medication didn’t help and she required heavy restraint. Her pet parents called our clinic about taking her on as it had been suggested that she might prefer a female veterinarian.

We requested that they start to get Alaska comfortable with a muzzle at home and to do drop-in visits when our clinic wasn’t busy. They did all this over the course of a month. For the first visit, we asked Alaska’s previous vet to write her a prescription for Trazodone and advised her owner to give it on an empty stomach 12 hours and two hours before the exam, because of the hepatic first pass effect of the drug.

We booked out extra time for the visit. We took down preliminary info like diet, likes and dislikes, activity, allergies, etc., from mom while dad waited outside with Alaska. Her mom told us that at the previous vet, the exam room was small and that Alaska didn’t like being confined, so we pushed our rolling exam table against the counter, leaving an open space in the exam room. We had already started the lavender diffuser and Baby Einstein classical music.

To mask any hospital odor, the tech, assistant, and I washed our hands and exposed arms, dried them thoroughly, and applied Bath and Body Works Stress Relief Eucalyptus and Spearmint body lotion. The pet parents walked a muzzled Alaska into the room and we gave her space to walk and investigate. The assistant crouched to her level, and I sat on the lowered rolling table. We stretched out our arms for her to sniff….no growls! However, her ears were flat back. I called that to everyone’s attention and explained to her parents that she was wary, stressed, and afraid, and that we needed to move cautiously and slowly. As she made her rounds to us and looked us in the face, we closed our eyes or turned away, so we weren’t staring at her, while we talked to her gently and started to stroke her.

We started feeding her peanut butter, and I was able to look at her eyes from an angle, and slowly went to her ears, but she raised her lip at the otoscope, so I stopped and let her regroup. Mom then said she didn’t like ears, feet, or back touched. Eventually, Alaska’ s ears came from flat to sideways elevated to straight up. She nudged the assistant for attention, and I was able to palpate her abdomen, examine her haircoat, and auscultate her heart and lungs. The assistant continued with the peanut butter, mom with bits of chicken, and lots of neck rubs and sweet talk, and I was able to give her four vaccinations. We paused at that point, as she needed to have blood drawn for a heartworm test.

I wish I had grabbed my cell phone; Alaska was lying in the middle of the floor, back legs curled around, front feet outstretched, ears straight up, and if it weren’t for the panting, looking completely relaxed as if she were at home. The parents were amazed and happy; this had never happened before.

While they wanted to get everything done in one visit, I persuaded them that we should stop at this point so she would have a positive visit to build on. (I had squirted some alcohol on a lateral saphenous vein to see how she would take it, and while she didn’t growl, she didn’t like it, so more peanut butter to the rescue.) The owners concurred, and I had them take some Solliquin to start her on, and advised them to come back in a month. In all likelihood we will have to give some IM dexdormitor to draw the blood, but I think we can build on today’s visit. The pet parents couldn’t stop thanking us for taking the time and making the extra effort to understand their beloved dog. I love Fear Free!

Cathy Grey, DVM, Oakdale Animal Hospital, Oakdale, New York

Caring for Canasta

Canasta is fearful of strangers and handling, which makes veterinary visits difficult for both Canasta and her caregiver. I recently started working with Canasta on basket muzzle training and being more comfortable with strangers, but she was in need of bloodwork immediately. Her veterinarian prescribed pre-visit pharmaceuticals, and I worked with the technician to create a handling plan and came to the visit to assist. When Canasta walked in wearing her basket muzzle, I used gentle control to restrain her while the technician drew blood. Canasta even took a treat from the technician when we were done, which is a huge win! Her mother was crying, knowing her dog did so well, and I will continue to work on cooperative care with the caregiver and Canasta.

Tabitha Kucera RVT, CCBC, KPA-CTP, Chirrups and Chatter Cat and Dog Behavior Consulting and Training, and Lyndhurst Animal Clinic, Lyndhurst, Ohio

Want to be featured? Submit your success story here!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.

Stationing Behaviors: How to Teach Consent Skills (Part Two)

Rachel Lees, RVT, KPA CTP, VTS (Behavior)Consent skills, voluntary behaviors, cooperative care. Using these techniques would be a veterinary professional’s dream come true. Wouldn’t it be great if you had some hints to begin teaching these behaviors with your own patients and pets?

We want to get you started with this brief summary of how to begin to teach stationary behaviors as well as the beginning steps of teaching consent to animals. (See Part One for a full introduction to Stationary and Consent Behaviors) It’s a good idea to practice these behaviors at home with your own pets until you are comfortable and confident with the skills and techniques.

Shaping a Stationary Behavior

In part one of this blog post, it was stated that marker training and shaping techniques are the best methods to create a strong and fluent stationary behavior. When using marker training, we are allowing patients to make their own choices and learn through shaping.

Shaping is the process of “building” a behavior by successively reinforcing bits or “criteria” of the behavior that are approximations of the final behavior. The behavior is molded into the end goal by the communication the trainer gives the pet. In this situation, the communication is the marker. When the marker (tongue click, clicker, or word “click”) is audible, treats should follow. The pet learns that the last behavior performed during the marker signal earns reinforcement.

When using this technique, we must break down the behavior into achievable steps for the patient. That means having a complete picture of what the end goal behavior will look like. An example is teaching an animal to place all four feet on a mat. The moment the mat is placed on the ground, the trainer must be aware of what behaviors need to be reinforced. Listed below are steps and criteria to teach three different behaviors. Videos will accompany the criteria to demonstrate the breakdown of each step and how the learner will achieve the final goal.

Be sure you have a good understanding of the shaping plan so you can increase or decrease criteria as needed. For instance, you may need to vary criteria based on the rate at which clicking and treating occurs. Varying criteria while adding duration to behaviors is also a good idea. It gives the learner smaller points of achievement and can be gradually increased for a greater challenge. Making duration variable is more helpful than making duration progressively more difficult.

Shaping Four Paws to a Mat

The training session begins the moment the mat is placed on the ground. The trainer should observe and begin to reinforce for the following behaviors:

Click and Treat for head turning toward the mat
Click and Treat for looking in the direction of the mat
Click and Treat for looking directly at the mat
Click and Treat for weight shifting toward the mat
Click and Treat for moving in the direction of the mat
Click and Treat for placing one paw on the mat
Click and Treat for placing two paws on the mat
Click and Treat for placing three or four paws on the mat
Click and Treat for keeping all four feet on the mat for 1 to 2 seconds
Click and Treat for duration on the mat for up to 10 seconds
Click and Treat for duration on the mat for 20 to 30 seconds

Shaping Nose to Target Stick

Present the nose target a few inches from the animal’s nose and observe for any nose touching or interacting with the target stick. Reinforce the following pieces of behavior:

Click and Treat for head turning in the direction of the target stick
Click and Treat for looking in the direction of the target stick
Click and Treat for looking directly at the target stick
Click and Treat for weight shifting in the direction of the target stick
Click and Treat for moving in the direction of the target stick
Click and Treat for sniffing or interacting with the target stick
Click and Treat for consistently nose touching to the target stick
Click and Treat for holding the nose at the target stick for 1 second
Click and Treat for holding the nose at the target stick for 2-3 seconds in duration
Click and Treat for holding the nose at the target stick for 5-10 seconds in duration
Click and Treat for holding the nose at the target for 10-25 seconds in duration

Shaping Chin Rest

Begin the training session by placing a towel on the area where the animal will be resting the chin (owner’s lap, chair, stool). The trainer then observes and begins to reinforce for the following behaviors:

Click and Treat for head turning toward the towel location
Click and Treat for looking in the direction of the towel location
Click and Treat for looking directly at the towel location
Click and Treat for weight shifting toward the towel location
Click and Treat for moving and walking in the direction of the towel location
Click and Treat for sniffing or interacting with the towel location
Click and Treat for head movement over the towel location
Click and Treat for head movement down (moving head down toward the towel location)
Click and Treat for chin touching the towel location
Click and Treat for consistently chin touching to the towel location
Click and treat for holding duration of the chin touching behavior for 1 to 2 seconds (at the towel location)
Click and Treat for duration of the chin rest behavior at the towel location for 2 to 5 seconds
Click and Treat for duration of the chin rest behavior at the towel location for 5 to 10 seconds
Click and Treat for duration of the chin rest behavior at the towel location for 10 to 30 seconds

Teaching and Understanding Consent

Consent is taught by giving the patient specific criteria when they are in their stationed behavior. When the animal steps into the stationary behavior, the veterinary team member will begin the training session using forms of desensitization and classical counterconditioning for touching parts of the patient’s body. If the patient moves out of the stationary behavior in any way, shape, or form, the training session will be discontinued. When the patient makes the choice to move back into the stationary behavior, the training session can begin.

**Video Demonstration: Connor and Consent Mat**

Author’s Note: A veterinary team member should be well educated in canine and feline body language before working on these procedures. The best resource for fully training these behaviors is the text “Cooperative Veterinary Care” by Alicea Howell and Monique Feyrecilde that is published by Wiley Blackwell.

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.

Stationing and Consent Behaviors: Useful Skills for Every Veterinary Team (Part One)

Rachel Lees, RVT, KPA CTP, VTS (Behavior)Most of us became veterinary professionals because of our fondness for animals. Our goal is to assist them in times of need and to be their voice when they are unable to articulate their desires.

Unfortunately, our patients don’t always understand that. Most of our patients are not overjoyed about their trip to the veterinary practice. Even though we are here to help them live long, healthy, happy lives, they see our clinic as the place where they may be poked, touched inappropriately, and sometimes scared, even if this is not our intention.

Wouldn’t it be fantastic if we could communicate with our patients the way we can with humans? If they had the opportunity to say “Yes” or “No” to being injected or touched before resorting to a growl, bite, or air snap? Teaching strong stationary behaviors and using them as a consent cue can be useful and can take your veterinary team to the next level.

Stationary Behaviors

These behaviors cue the animal to stand, lie down, or touch a body part to a specific location for a duration of time. They are typically taught outside the veterinary setting using marker training and shaping techniques*. Once the patient is comfortable performing the stationary behavior in a non-stressful setting, training sessions can begin to take place at the veterinary practice. The patient should enjoy training and interacting with the stationary behavior as this is the place where most veterinary husbandry behaviors will be performed in the future. The patient should associate this location with reinforcements such as high-value food and fun. Stationing behaviors include but are not limited to the following:

Body Target to Mat
- Four paws on the Mat
- Lying in Sternal Recumbency on the Mat
- Lying in Lateral Recumbency on the Mat
Nose Target to a Hand or Object
Chin Rest
Paw Target to an Object

What Is Consent?

Once the above behaviors have been taught and the patient is 100 percent responsive in the veterinary practice, the concept of consent can begin. Consent allows the patient to choose to engage in training with the owner and veterinary team members by responding to the cued behavior and allowing the procedure to be performed. If the patient does not want to interact, they will send a clear signal that they are uncomfortable and are unable to perform the stationary behavior at the given time.

The goal with consent is to give patients some control by allowing them to make choices to reduce fear, anxiety, and stress, increase comfort, and increase the animal’s ability to cooperate. It is important to fully understand the patient’s body language and to understand that not responding to the cued behavior is not the patient being “stubborn.” If the patient is reluctant to stay in the cued stationary behavior, assess the patient and yourself, and then end the training session or veterinary visit. Remember that animals use avoidance behaviors such as displacement or conflict when a situation becomes stressful. Our goal is to give the animal a choice and to respect that choice.

Examples of avoidance behaviors:

Sniffing the ground
Not responding to a well-known station behavior
Yawning
Lip licking
Slow response to a station behavior
Head turning away
Weight shifting away

Final Note

If taught correctly, stationary behaviors can be an asset to any veterinary team. Any veterinary team member who is interested in teaching these protocols should consider training the patient ahead of time to wear a basket muzzle as we are teaching voluntary veterinary care. The patient can and will still say that they are uncomfortable if they are pushed too far above their comfort level. A veterinary team member should be well educated in canine and feline body language before working on these procedures. The best resource for fully teaching these behaviors is the text “Cooperative Veterinary Care” by Alicea Howell and Monique Feyrecilde, published by Wiley Blackwell.

*Shaping will be discussed in Part Two

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.

Success Stories: How Humans and Pets Benefit From Fear Free

Kim Campbell Thornton
It’s not just dogs and cats who benefit from Fear Free techniques at the veterinary clinic. Humans often find that they are calmer and happier as well.

Fear Freed

My sister has a beautiful kitty named Sushi whom she adopted about eight years ago. Her veterinarian, Dianicia Kirton, DVM, whose Hopkinton, Massachusetts, practice is Fear Free certified, has been recommending that Sushi get her teeth cleaned but my sister was hesitant. The veterinarian addressed each of her concerns until eventually she was ready to move forward. A few weeks later, Sushi’s mom brought her in for the teeth cleaning, although she was still nervous and reluctant. The veterinarian and staff were very calming and worked on Sushi quickly. Everything went well, and Sushi was her normal, happy self afterward. My sister told the vet that she felt like she had been “Fear Freed,” and Dr. Kirton responded, “Yes, it’s as much for the people as it is for the animals.” My sister was happy with the whole experience and thankful to have found a practice that uses these methods!

Kay Henze

Penny-Wise Visits

Pennie, a 7-year-old 78-pound Chesapeake Bay Retriever, had never had a full veterinary exam after her puppy vaccines because she bared her teeth and growled at veterinary team members at every clinic she was taken to. When she was brought to us, we implemented several Fear Free strategies, spending 45 minutes building her trust both outside the clinic and in the exam room. We were able to get her to stand on the lift table and receive vaccinations without being muzzled. On her third visit, we were able to lift her lips and examine her teeth. Now she boards with us routinely and is a big part of our veterinary practice family. Implementing these Fear Free tools has changed Pennie’s life and her owner is now able to better understand and relate to her dog, making it much safer to take her for walks and be groomed.

Dr. Sarah Lavelle, Ark Veterinary Practice, Belgrade, Montana

Happy Cats and People

We love our Fear Free veterinary hospital. At TLC, there are separate areas for cats and dogs. We took our two cats in last week, and the exam room was comfortable, with shelves for the cats to explore. A board listed the names of the technician and veterinarian who would be seeing the cats, so we knew who would be treating them. The technician who went over the intake information was sweet and tender with Lucy and Lilu. An email ahead of time alerted us that a new veterinarian would be seeing the cats. She was calm and handled the cats gently. Both cats were calm throughout the visit—although Lucy didn’t much like having her teeth examined—and when they got home they came out of their carriers calmly and went about their day. Lilu was her regular self and didn’t hide away as she has on some prior visits to other clinics. The clinic called the next day to see how the cats reacted to their vaccines and visit. We feel we have found our new clinic!
Katherine and Brent Williams, Albuquerque, New Mexico

Zola’s Optimism

Zola has been to a number of veterinary clinics before and has always been nervous and reactive. During her first appointment she was quite nervous, but with the help of some peanut butter as a distraction she allowed us to pet her. We decided that that was a win and that Zola would benefit from coming back another time after having gabapentin to help calm her. At her next visit, Zola was visibly more relaxed, and we had a Kong full of peanut butter ready for her. Knowing that Zola did better with minimal restraint we kept her focused on the Kong and were able to do a full exam, vaccinations and a blood draw. Zola’s owners had never seen her so relaxed at the vet and she has since come back willing and happy to see us.
Anne McClanahan, DVM, Four Lakes Veterinary Clinic, Madison, Wisconsin

Want to be featured? Submit your success story here!

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.

Even Mild Fear of Noise in Dogs Has Broad Effects

Linda Lombardi
Mild cases of noise reactivity in dogs are often not considered problematic enough to treat. However, in a recently published study, even mild noise sensitivity was associated with lower performance on a puzzle test. This suggests that these dogs have impaired functioning even when noise is not present and that more screening and treatment is called for.

Researchers analyzed three types of data collected as part of a larger study of pet dogs. Dogs were evaluated for noise sensitivity via a questionnaire and a score was calculated based on the number of categories of noise that caused a reaction, the behaviors indicative of fear and anxiety that were exhibited, and the intensity of the reaction. Dogs were also tested for noise sensitivity using a custom noise recording that was played starting at a low volume and gradually turned up.

Learning Affected

Dogs were then evaluated for their performance on a puzzle-box test. The clear plastic puzzle box had nine holes on top and one at the end. A tennis ball was rolled into the box and dogs were given five minutes to try to get it out. If they succeeded in under two minutes, they repeated the test, up to three times in total. While attempting the puzzle, the dogs were wearing a device that recorded their movements.

Comparing data from 17 noise-reactive dogs and 11 non-noise-reactive dogs, those who were sensitive to noise performed worse on the puzzle box. Movement recordings also showed a difference, says lead author Karen Overall. “The ones who did the best moved very efficiently and very quickly. Their movements counted. The dogs who reacted to noise and who did more poorly, or could not solve the test, had very jagged and inconsistent movements.”

These dogs did not seem to be able to move in a deliberate, coordinated manner in response to how the ball acted when they tried to manipulate it. “They have to correct their behavior according to the movement of the object that they see,” she says. “These dogs couldn’t do that.”

Some of the noise-reactive dogs did not perform well enough to repeat the test, but when they did, they also differed. “Unlike the dogs who didn’t react to noise, the dogs who did react to noise couldn’t learn from their previous tests and didn’t improve their scores,” she says.

Sound Effects

While it’s understood that being in a state of anxiety interferes with functioning, the results show that being noise-sensitive has more wide-reaching effects. Even in a relatively low-stress situation where noise was not an issue, these dogs showed impaired performance: “The room is quiet, they’re getting food treats, their people are there, but they still can’t learn.”

Overall says it’s important to understand that this was not a clinical population of noise-fearful dogs. “Largely they were fairly mild, and yet they still couldn’t do this,” she says.

They also were not generally fearful, which was screened for. “The dog who was the worst in the test, the only dog for whom we had to turn off the recording, she was the meet-and-greet queen of the universe,” she says. “She was charming and social and lovely until you played noise, and then she was broken.”

“Moderate to severe noise sensitivity in dogs is a well-known behavior problem. A connection between separation anxiety and noise sensitivity has also been recognized before. What has not been appreciated until Dr. Overall and her colleagues published this research is the impact that noise sensitivity has on the general anxiety levels and learning ability of affected dogs,” says Bonnie Beaver, DVM, DACVB, of Texas A&M University. “These changes exist even in mildly affected dogs, impacting their daily lives with ever-present stress.”

Screening and Treatment

Overall concludes that even mild fear of noises needs to be aggressively screened for and treated.

“I think we don’t realize how much these dogs are suffering,” she says. “This shows that you’ve got dogs who are afraid of noises and it’s impairing other parts of their life that people haven’t looked at. It’s impairing their ability to get information from the environment and their ability to problem solve.” This has a broad impact on their social functioning and their fundamental ability to enjoy life.

Overall now believes dogs should be screened for noise reactivity on every vet visit and that it’s particularly critical to screen young dogs. “I want vets to see dogs three or four times a year in the first two years of life, when their brains are developing, and subject them to standard screening tests,” she says.

This is important because early diagnosis and treatment can make a huge difference. “The rodent literature has shown that if you’re anxious and fearful and from a genetically fearful line, and they treat you as a baby, your brain develops normally,” she says. “And what wouldn’t we give for that? There’s too much suffering; I want these dogs to have joy.”

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.

Party Hats! Teaching Muzzle Training to Canine Patients

Rachel Lees RVT, KPA CTP, VTS (Behavior)Muzzle training is an important skill for every dog to have. Not only can muzzle training help keep veterinary teams safe during examinations and procedures, it can also provide opportunities for person and pet long term.

As humans, we may get stressed, fearful, anxious, or concerned about a situation and lash out aggressively. For us, that situation, if not escalated, may lead to an apology or resolution. But if a dog makes this choice, it can mean a bite, lawsuits, and potentially euthanasia. As veterinary professionals, our job is to enhance the human-animal bond and keep our patients safe, happy, and healthy. Using and recommending muzzle training can help prevent a bite on your patient’s record and potentially save a dog’s life.

The bad news is that dogs wearing muzzles are viewed as scary. This stigma needs to go because we never know when a pet will be in a situation where a muzzle may be beneficial. Those situations include emergencies such as being hit by a car as well as introductions to new challenges. Muzzles keep dogs safe when in public or around unfamiliar people, animals, and situations.

Using Marker Training and Positive Reinforcement

The best way to teach a patient to enjoy wearing a muzzle is through positive reinforcement: adding something to the situation to strengthen the likelihood of a behavior. Using this technique, we can teach dogs that muzzles are treat dispensers that make fantastic things happen.

For instance, muzzle training can be taught by using a luring technique in which treats are placed into the back of the muzzle to create a positive experience. This can be helpful, but moving from one step to the other too quickly risks pushing the pet too far and putting on the muzzle before training is complete. This can create fear, stress, and anxiety. Dogs may choose to place their head inside the muzzle for the peanut butter but may not truly understand the behavior they are being reinforced for. The result is that when we begin to place the strap over their head, they may display stress, fear, and panic.

Using marker training allows dogs to make their own choices and learn through shaping. Shaping is the process of “building” a behavior by successively reinforcing bits or “criteria’ of the behavior that are approximations of the final behavior. The behavior is molded by the communication the trainer gives the pet. In this situation, the communication is the marker. When the marker (tongue click, clicker, or word “click”) is audible, treats should follow. The pet learns that the last behavior performed during the marker signal earns reinforcement.

This video demonstrates the beginning steps of muzzle training using the shaping technique as described above. This patient does not have any learning history with a muzzle.

Breaking Down the Criteria of the Muzzle

When using the shaping technique, we must be able to break down the behavior into achievable steps for the patient. In the demonstration above, if the technician had expected the pet to place his nose inside the basket on the first try, it would have set the dog up for failure and frustration as he might not have received enough communication to learn the end-goal behavior. I typically break muzzle training into three different stages with initial goals to achieve and then break down those steps further. Here are the broken-down stages and criteria for each:

**The abbreviation C/T = Click then Treat**

Stage One: Nose into the Basket with Consistency
- C/T for pet looking at the muzzle
- C/T for weight shifting toward the muzzle
- C/T for nose touching the muzzle
- C/T for nose touching the opening of the basket of the muzzle
- C/T for nose touching the inside of the basket
- C/T for nose placement ½ way into the basket of the muzzle
- C/T for nose placement into the basket of the muzzle

Video Demonstration: FF Stage One Muzzle

Stage Two: Duration and Strap Introduction
- C/T for pet holding their nose in the basket for 1 second
- C/T for pet holding their nose in the basket for 2-3 seconds
- C/T for pet holding their nose in the basket for 5 seconds
- Raise strap and C/T for any attempt at nose into the basket (with the strap raised)
- Raise strap and C/T for holding nose inside of the basket with 3-5 seconds duration (with the strap raised)

Video Demonstration

Stage Three: Strap Behavioral Therapy and Wearing the Muzzle
- C/T for moving the strap ¼ of the way behind the pet’s head (without movement or shying away)
- C/T for moving the strap 1/2 of the way behind the pet’s head (without movement or shying away)
- C/T for moving the strap 3/4 of the way behind the pet’s head (without movement or shying away)
- C/T for moving the strap all the way behind the pet’s head (without movement or shying away)

**Depending on the pet, the strap may need to be tightened to make the fit tight. Once the pet is comfortable with the strap movement at the largest setting, begin to make the strap hole smaller and smaller over time**

C/T for wearing and responding to cued behaviors

Video Demonstration: FF Stage Three Muzzle & FF FINAL Muzzle Outcome

Utilizing Technicians

It takes time, coaching, and guidance to appropriately teach muzzle training. It’s best to utilize a veterinary technician who has an interest in training. Not only can this create a connection between client, pet, and practice, it can also increase revenue through technician muzzle-training appointments and product sales. The technician can teach this behavior to pets in private appointments or coach and demonstrate the behavior so owners can work with the dog at home. Regardless, scheduling appointments to check progress is crucial to making the end goal a reality.

Final Thoughts

Muzzle training using a marker gives the patient a choice to engage at their own comfort level. This also allows us to reinforce behavior at smaller criteria increases and change the way the pet feels about each step along the way. Muzzle training can be a life-saving behavioral investment for your client. They just need to have the right support and recommendations from staff like you!

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.

Fear Free Success Stories: Veterinary Visits for the Win

Kim Campbell Thornton
It’s not unusual for dogs to be fearful of veterinary visits, but it doesn’t have to be that way. Many dogs have benefited from Fear Free techniques to help them get through what was once a frightening event and even learn to love it. Here are some of their stories.

Kindness Worth Traveling For

I’m a Fear Free trainer, but there are no veterinarians I trust in my town, so I travel an hour to TLC Pet Hospital in Albuquerque and have had the most amazing experiences, thanks to the patience, kindness, and knowledge of the staff there. My dogs are fearful, and one is especially vet-phobic after traumatic experiences elsewhere. Some of his past vet visits have been so anxiety-inducing for him that I also end up in tears. But with gabapentin on board and the Fear Free approach from Dr. Long and Sam the veterinary assistant, my dog was wagging, approaching them, licking their faces, asking for pets, and acting like the brave and social dog he is at home. All of us in the room were floored by the change! At the next checkup he took food from them, did some chin-rest stationing with them, targeted their hands, and showed off his tricks. My own fear, anxiety, and stress levels have been drastically reduced thanks to their dedication to Fear Free vet visits. I’ll continue to do the two-hour round trip because I love having a veterinarian who listens to me and treats me like an adult, and because my dogs’ mental and emotional health is taken as seriously as their physical health at TLC. I am so thankful for their care and commitment to Fear Free vet visits and their overall friendly clinic.

Erica Beckwith, CTC, CBCC-KA, Fear Free Certified Professional, A Matter of Manners Dog Training, Santa Fe, New Mexico

Blood Draw Pugcess

Tater Tot is a Pug who needed a dental cleaning. Since he would be undergoing anesthesia, we required blood work beforehand. Tater Tot was generally friendly, soliciting attention and being food motivated, but when we attempted to occlude his lateral saphenous vein, he stopped eating and attempted to bite the technician holding him. He became distressed and tried to back up, so the technician placed him on the floor, where he again tried to bite her. The owner agreed to bring him in later on some anxiety medication.

Tater Tot came in a second time on gabapentin as well as clonidine. He appeared less excited and fidgety, but still sought attention. We offered him baby food on a disc toy and did his blood draw on the floor instead of the table. He ate throughout as we attempted to collect blood from his lateral saphenous veins. After poking both legs without success, we held him in position for jugular venipuncture, performed some brief desensitization and counterconditioning for that positioning, and successfully drew blood from his jugular vein. He went straight back to the baby food after the blood draw.

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

Toby Turns Around

I work closely with the veterinary hospitals in my town. The team at Appalachian New River Veterinary Associates (ANRVA) referred Toby to me. Toby was terrified at the veterinary hospital and could not take food, even as a young puppy. I established a rapport with Toby away from the veterinary hospital. I did this using special food and something else Toby loved – play! Toby learned foundation behaviors that gave some predictability to our sessions and helped him feel safe.
The team at ANRVA invited me to work with Toby in the exam rooms during their lunch break. Since Toby already had negative associations at the veterinary hospital, we started those sessions with just Toby’s owners and me. Toby and his owners entered the exam room the first time and surprise – I was there with some extra-special food for Toby (hamburger) and his favorite toy. Toby readily ate the memorable food and played with a toy. He even performed some simple behaviors. We repeated this a couple of times, and by the third time, Toby was excited to get to the exam room. Then we incorporated Dr. Suan Koh into our play and training sessions and, later, Dr. Cathy Kreis. Some of the support staff also got in on the fun.
Toby was successful for many reasons. He had committed owners who took the time to help Toby feel better about his veterinary care. The team at ANRVA is as committed to Toby’s behavioral health as they are to his physical health. They encourage and welcome clients to come in for happy visits with their pets. And, finally, both the owners and veterinary team are committed to positive reinforcement training.

Marge Rogers, CBCC-KA, CPDT-KA, Certified Fear Free Professional, Rewarded Behavior Continues, West Jefferson, North Carolina

A Win for Maxwell

Maxwell is a 7-year-old retriever/hound mix who was rescued from a hoarding situation with more than 100 dogs. Maxwell was the most fearful of them. We don’t know a lot about Maxwell’s day-to-day life while on the hoarder’s property, but volunteers reported that he was kept in a small shed without much social interaction.
Not surprisingly, he was fearful of people and of being touched or handled. The veterinary facility that provided Maxwell’s initial care was unable to examine him or perform any medical or handling procedures unless Maxwell was placed under anesthesia or heavy sedation. Maxwell would shake uncontrollably and withdraw if any person approached him. Unfortunately, during his initial care, some handling interactions were forced on Maxwell to which he responded by “gator-rolling,” snapping, and inflicting a severe bite to one of the vet techs.
After moving to a foster home, Maxwell was taken to see the wonderful Dr. Lynn Honeckman, owner of Veterinary Behavior Solutions and a Level 3 Fear-Free Certified Professional. She diagnosed Maxwell with severe global fear of people and new environments and started him on a course of daily behavior medication in an effort to reduce his anxiety.
Maxwell did not do well in his initial foster homes, so in December 2018 he moved into a new foster home, where he has remained and is doing very well. During his initial visit as well as his behavior rechecks, Dr. Honeckman recommended introducing Maxwell to cooperative care behaviors and made specific recommendations of pre-visit pharmaceuticals to help alleviate Maxwell’s fear during veterinary visits.
Since December 2018, Maxwell has been a client at Loch Haven Veterinary Hospital (one of the lead veterinarians, Dr. Jim Martin, is Fear Free certified and the entire hospital including all technicians follow the Fear Free approach). Since then, every veterinary visit has consecutively been more positive and more stress-free for Maxwell. Prior to his visits, Maxwell receives a combination of gapabentin and Sileo. His appointments are scheduled during times when the hospital is less busy, and the staff ensures we get put into a treatment room right away, where Maxwell is given ample time to acclimate before any staff enter the room. Physical handling is kept to a minimum and all procedures follow the Fear Free approach. One of Maxwell’s many cooperative care behaviors was to comfortably wear a basket muzzle. Although he has shown zero signs of aggression since switching to Loch Haven Veterinary Hospital, Maxwell now happily wears the muzzle for any physical handling in the exam room, which allows everyone to feel comfortable and at ease. Now – almost a year later – Maxwell no longer (or only rarely) shakes when entering the veterinary hospital. He willingly accepts treats while waiting in the exam room and is eager to perform his chin rest behavior while waiting to be seen. As his foster mom, I am overjoyed by Maxwell’s progress, none of which would have been possible without his dedicated veterinarians. Their care, patience, and understanding in using a Fear Free approach has made a world of difference for Maxwell and we could not be more grateful to them.
In his foster home, Maxwell has blossomed into a happy and playful dog who is particularly fond of his canine housemates. New environments will likely always pose challenges for Maxwell, but at home he has found his happy place.

Daniela Ackerman, Orlando, Florida

Want to be featured? Submit your success story here!

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.

Pig Out With Treats to Earn Porcine Trust

Mikkel Becker
One of the best ways to earn a pig’s trust and friendship is by appealing to the pig’s big appetite. The saying “eat like a pig” holds true for many pigs who are highly focused on food. At The Center for Bird and Exotic Animal Medicine near Seattle, Washington, Dr. Alicia McLaughlin and her team have found that food talks when it comes to swaying swine to seeing veterinary team members as friends rather than foes, and in doing so, obtaining their calm cooperation.

Creative strategies have also shown big benefits for some of Dr. McLaughlin’s patients. One strategy that works for some pigs is to “fork” the pig using gentle presses of a fork on the pig’s back. Pigs who are calmed by such touch will often lie down on their side to soak up the soothing massage, exposing their underside and allowing belly and foot exams to be completed with the pig’s willing cooperation.

Dr. McLaughlin also incorporates the owner’s participation into the care experience. With one pig, the trick for getting a willing hoof trim was as simple as the owner bringing in a favorite treat: cucumbers! On one end of the pig, a person held on to a whole cucumber for the pig to chomp on, while at the undercarriage another team member performed hoof care. By the time the entire cucumber was finished, so was the hoof care, making it a win-win for pig and people.

One technician during the exam or care is often charged with the task of giving tasty treats with the pig’s owner nearby to keep the swine distracted during the exam. The trick of treats is finding what works best for each patient. Pig owners are encouraged to bring in their pig’s favorites in addition to the ones already on hand in the hospital.

Three delectable delights for pigs to pig out on during Fear Free exams and procedures are peanut butter, cream cheese, and Cheerios. For instance, peanut butter placed on a tongue depressor or smeared inside a small bowl may be used to distract the pig during the exam.

One of the greatest challenges of pig exams is getting a weight. Pigs don’t like to be lifted or restrained, and with the size of many pigs, doing so to get the swine onto the scale would be upsetting, causing avoidance in the future.

A solid approach is to get the pig to move onto the scale on his own. This is best achieved with a combination of teamwork, time, and treats.

“Make your job as easy as possible by creating a chute-type scenario leading up to the scale using human bodies or other items to funnel the pig onto the scale,” says Dr. McLaughlin.

A line of Cheerios or other tasty treats can be placed for the pig to follow through the chute and onto the scale. In the center of the scale, place a pile of treats to keep the pig in place momentarily while being weighed.

Most important, avoiding force is critical for earning trust.

“Don’t push it. I’m a firm believer in giving a pig a little more time, and it will end up taking less time in the long run,” says Dr. McLaughlin.

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.

How Trap-Neuter-Vaccinate-Release Works in One Florida Community

Arden Moore
His official title is Community Outreach TNVR Coordinator, but most of the time, Paul Bates feels like a mediator, problem solver, and teacher. That suits him just fine.

Bates leads the team at Peggy Adams Rescue League in West Palm Beach, Florida. The organization works closely with shelter volunteers, cat rescue groups, and cat-caring neighbors to ensure free-roaming cats in Palm Beach County are properly vaccinated, sterilized, and fed.

It is estimated that more than 200,000 cats live on the streets in Palm Beach County. Once called feral cats, they are now identified as community cats.

“These are cats who live outside, who do not belong to anybody, and who are not adoptable because they are not socialized with people,” says Bates. “They certainly do not belong in animal shelters where they are often euthanized. Our job is to work with community cat advocates to make sure these community cats are neutered/spayed, vaccinated, and returned to their outdoor homes.”

On the Case

It’s a tall order, but Bates is up for the challenge. He is a Fear Free Pets Shelter Course graduate who works to educate people about the mindset of community cats and safe ways to trap, vaccinate, spay/neuter, and return these cats back to their colonies without stressing them or getting injured.

His shelter also helped get a county-wide law adopted that requires these cats to be sterilized, vaccinated, implanted with a microchip, have left ears clipped to identify these actions and then released to the same area where found.

Bates makes daytime and night-time visits to community cat sites in neighborhoods, car dealership parking lots, and alleys behind restaurants. He gives talks to volunteers and shares tips and resources on two key Facebook pages: Project CatSnip and Community Cats of the Palm Beaches. Project CatSnip is a program of the Peggy Adams Rescue League that provides free TNVR through grant funding and conducts free humane trapping classes.

Safety 101

Even though many of these cats appear friendly and may even allow a trusted person who feeds them to pet them, they are still capable of lashing out if they feel threatened.

“If you see a stray, friendly cat, do not attempt to pick up the cat and put him in a carrier because chances are that you will be bit or scratched,” he cautions. “Scooping up a cat in your arms can make them go into panic mode. The nails come out, and the teeth are ready to bite. It is far safer to set up humane traps to get them in so we can give them vaccinations and spay/neuter them and return them to their cat colony.”

To reduce fear or anxiety in the cat during transport, Bates recommends placing bed linens made of breathable fabric over the trap to help the cat settle down.

“A cat in an uncovered trap is apt to freak out and bounce off the sides of the cage,” he says. “Covered humane traps look like safe spots to a cat. Avoid using heavy blankets, thick towels or quilts because a cat inside could overheat due to the lack of air flow. And, he could also have to inhale the strong ammonia smell if he urinated or defecated during transport.”

To reduce fleas and ticks among these community cats, Bates recommends mixing food-grade diatomaceous earth powder with catnip and allowing the free-roaming cats to roll in it. This powder is safe for pets and people, but destroys exoskeletons in these parasites.

Tips for Success

Other insights shared by Bates:

Community cats should not be relocated. Many risk injury or death from vehicles or predators in their determination to travel miles to return to their colonies.
Attempts to completely remove a cat colony will only result in another cat colony moving in and producing kittens, a phenomenon known as the vacuum effect.
The best way to lure intact community cats into humane traps is to place traps where cats gather to eat and allow a few days for the cats to get used to them. Then create a trail of food leading into the traps and placing the highest-quality smelly food (to these cats, that is usually sardines or tuna or even Kentucky Fried Chicken) in the middle of the traps.
If you find a homeless cat whose left ear is notched, do not bring him to a shelter unless he is injured or ill. This is the universal sign that he is a community cat who has been neutered.
Do not leave bowls of food out; they attract raccoons and other wildlife. Set up specific feeding times and remove bowls within an hour.

Numbers indicate that this multi-approach effort is working. Before the TNVR program began in 2009, Palm Beach County shelters took in 19,000 homeless cats with more than 14,000 cats euthanized in 2008. That number has been cut to fewer than 2,000 cats euthanized this year in county shelters.

“It really takes a village to help these cats,” says Bates. “We have a passionate group of board members, staff, volunteers, and people in neighborhoods all doing their part to help feed and keep these cats healthy.”

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

Arden Moore is The Pet Health and Safety Coach. She is a best-selling author, radio show host, in-demand speaker and master certified pet first aid/CPR instructor who travels the country teaching with Pet Safety Dog Kona and Pet Safety Cat Casey. Learn more at www.ardenmoore.com and www.facebook.com/ardenmoore.

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