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Rachel Lees RVT, KPA CTP, VTS (Behavior)As a veterinary behavior team member, I strive to strengthen and improve the human-animal bond in every patient and client I encounter. In behavior medicine, though, we are often fighting a losing battle. By the time clients find us, they have exhausted funds trying different training techniques. The relationship between person and pet is hanging by a thread.

These battered bonds are often related to behavior problems such as destruction to the home, inappropriate elimination, and aggression. In a 2013 study by Jennifer Y. Kwan and Melissa Bain, 65 percent of owners relinquished pets for behavior reasons. This study also supported the use of positive reinforcement, finding that use of punishment-based methods resulted in less satisfaction with a pet’s behavior, which can be damaging to the bond.1

The word “repair” means to restore by replacing a part or putting together what is torn or broken or to restore to a sound or healthy state. How can we repair a nearly broken human-animal bond?  The role of a veterinary technician or assistant can be crucial in mending and strengthening this bond.

A skilled veterinary behavior professional should be able to demonstrate the prescribed behavioral therapy plans, coach the client through them, and be flexible with both pet and owner learning styles.2 In my practice, I describe my role as “case manager”:  the person with whom each client is in contact with most frequently. It is my job to relay information clearly and effectively to the veterinarian and be sure that the entire behavior team (veterinarian, trainer, and owner) are working toward the common goal of restoring the bond.

Counseling aspects of behavioral medicine and marriage/family therapy have many commonalities.3 One of the most profound similarities is how change occurs in the context of treatment. In behavior medicine, our clients may come in with negative thoughts, anger, and fears associated with their pet. The veterinary technician or assistant’s role in the behavior team is to change the emotional experience of the pet along with that of the pet owner. When a family walks into our practice and their pet has been displaying owner-related aggression, my first questions are the following:

  • How are you feeling about your pet?
  • Do you feel safe in your home?
  • What is your current relationship with the pet?

The client needs to express their concerns if treatment is going to be attempted. Behavioral therapy is essential, but the context and triggers of the problem are less important until people can form a more positive association with the pet. After the veterinarian discusses the behavioral diagnosis, I typically break down the information in a more down to earth fashion so the entire family can understand the mental concerns their pet has developed. In this way, the family can begin to relate to the pet and see things through their eyes, and this can jump-start the process of rebuilding the bond.

A second similarity to human-based therapy is the difficulties and barriers associated with clients.4 Most of our clients walk into the consultation room and expect to be told they did something wrong. They may be defensive, anxious, and closed off, reluctant to give a detailed behavioral history, which can impact treatment.

Sometimes clients are fearful about sharing a pet’s aggressive behaviors because they do not want to euthanize their pet. They feel as if they will be judged and forced to make an unwanted decision. One of my strongest skills as a behavior team member is gaining the trust of clients and building a strong rapport early on. I want each client and pet to have a wonderful experience with our clinic, but I also want to have a strong connection with that client, share empathy, and understand each issue from their perspective.

Clients may be at the end of their rope, but usually there is an inch of that rope left to work with. I think of the rope as the bond between owner and pet. Hang on to that tiny piece as it is still technically intact! Each client walks into the practice for a reason even if there is only a tiny strand of the bond remaining. If you can open them up, connect, and gain their trust, you can begin to reshape the negativity they feel toward their pet and repair the relationship.

One of the most important terms when repairing the human-animal bond is “empathy,” the ability to have a deep emotional understanding of another’s feelings and experiences.5 For veterinary behavior team members, this ability is crucial for success with any client or patient.  They should be able to identify and empathize with the fear and anxiety the pet and client may be experiencing. This is the first step in modifying the behavior of both. Psychologist Marshall Rosenberg stated it best: “When we understand the needs that motivate ourselves and others’ behaviors, we have no enemies.” 6

I think this is important to recognize when working to rebuild or strengthen a human-animal bond. It is important for the client and veterinary behavior team to see things from the pet’s perspective. The client can then learn that the pet is not their enemy. The pet is not performing these behaviors to spite them. The pet is fearful, stressed, or anxious and may be trying to keep themselves safe.  Being able to take a walk in someone else’s shoes, or paws, is a vital step in deepening the human-animal bond.

Mending the human-animal bond is not an easy task. It takes the expertise of a strong, educated, and skilled veterinary behavior team to even begin to reunite and mend the connection between client and pet. When working in a general practice, any sign that the human-animal bond is deteriorating between a client and patient should be brought to the team’s attention so the veterinarian can make a referral to a veterinary behavior practice.

As veterinary team members, we all want to save the lives of pets. This begins with keeping a strong bond between client and pet. Giving appropriate, science-based recommendations on training and behavioral therapy can be the first step in this process, starting with puppy and kitten visits. If we all work toward a common goal, we can make a difference.

References: 

  1. Kwan Y. Jennifer, Bain J. Melissa. Owner Attachment and Problem Behaviors Related to Relinquishment and Training Techniques of Dogs. Journal of Applied Animal Welfare Science. 2013; 168-183. https://doi.org/10.1080/10888705.2013.768923

2-6.  Shaw K. Julie, Martin Debbie.  Canine and Feline Behavior for Veterinary Technicians and Nurses. 1st edition.  John Wiley; 2015.

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, an Elite 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.
 
 
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Caring for Caregivers: The Three Areas Crucial to Mental Wellbeing

In this webinar presented by Natalie Marks, DVM, CVJ, you will learn about the variables that place veterinarians at high risk for mental health challenges and how to assess your own wellbeing. Dr. Marks will identify concerning signs in our own health and others as well as the three areas crucial to mental wellbeing: compassion satisfaction, compassion stress, and compassion fatigue. She will also provide realistic strategies to help veterinarians take care of themselves physically and mentally.

Brought to you by Virox Animal Health, Makers of Rescue

The Paw Project and Fear Free Together At Last!

The Paw Project’s beginning was rooted in helping relieve big cats from complications from being declawed. Thankfully, founder and director Dr. Jennifer Conrad saw the same need in domesticated felines. Don’t miss this opportunity to hear about her journey and her rebuttals against the common arguments in favor of elective feline onychectomy.

Fear Free Certified Practice Town Hall: Discontinuing Declaw Procedures

Following the announcement that Fear Free Certified Practices would be required to phase out elective feline onychectomies, we hosted a town hall with Fear Free founder Dr. Marty Becker, founder and director of The Paw Project Dr. Jennifer Conrad, pain management guru Dr. Michael Petty, and board-certified veterinary behaviorist Dr. Valarie Tynes. The “whys” behind this decision were shared and we wrapped up the hour with Q&A from the audience.

You must be a Fear Free Certified Practice member and logged in to view this webinar

Experiences That Matter: Providing Veterinary Care During The Pandemic

Pet owners have many options when choosing their veterinary healthcare provider. Why should they choose you? Differentiating yourself is a challenge at the best of times, made even more problematic during a pandemic where curbside care has limited our ability to created strong, long-lasting bonds with our clients.

In this webinar, Jonathan Bloom, DVM, presents new, easy-to-use strategies that result in “experiences that matter” and that very quickly define you as the veterinarian of choice.

Brought to you by Elanco.

Yes, You CAN Perform a Fear Free Canine Orthopedic Exam

In this webinar, Kristin Kirkby Shaw, DVM, MS, PhD, DACVS-SA, reviews the importance of diagnosing osteoarthritis (OA), how to perform canine exams, and pain management. Dr. Shaw also provides resources from the New Science of OA Pain website, which has canine and feline OA checklists, feline exam videos, and chronic pain teaching tools that can be provided for pet owners.

Brought to you by Zoetis Petcare.

Fear Free

Specific signals of fear, anxiety, and stress (FAS) differ slightly by species, but what remains constant for delivering Fear Free care is to attend to what animals communicate through their body language.

For exotic animal veterinarian Alicia McLaughlin, who practices at the Center for Bird and Exotic Animal Medicine in Bothell, Washington, paying close, constant attention to body language signals throughout interactions and care is vital for protecting the emotional experience and safety of her animal patients and the veterinary team.

In the case of Dr. McLaughlin’s exotic animal patients, signs of FAS may be slightly different and adjusted to depending upon the species. Avians in particular can be challenging for most people to read. But with practice, reading their signs of FAS becomes second nature.

Some signs of increasing fear, anxiety, and stress McLaughlin watches for in avian patients include eyes appearing more round as opposed to soft and almond-shaped. Stressed birds also do not preen themselves and are unwilling to eat even favorite treats. Birds may stand taller on their perch and lean away from a scary object or person, with feathers slicked and held close to the body. If these body language cues are ignored, birds may attempt to fly away or vocalize, or FAS may progress to defensive gesturing, with the bird opening the mouth, lunging, and threatening to bite.

Another aspect of body language to watch for is overexcitement.

“Overexcitement can lead to aggression quickly,” McLaughlin says.

Signs of overexcitement include feathers ruffling on the nape of the neck. A parrot may fan out tail feathers. Parrots have voluntary control over their pupils and can dilate and constrict them rapidly in what is referred to as eye pinning, another sign of overexcitement and a red flag for potential aggression.

Carefully and continually monitoring for signs of FAS throughout preparatory visits and actual veterinary care is protective both for the ability to handle patients in the immediate situation and for building their long-term comfort with care.

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

Julie Liu, DVMPet parents will remember their animal’s euthanasia for the rest of their lives, and if their pet is agitated or anxious, they’ll remember that, too. Helping them to plan ahead can make the experience easier for your patients and their families.

When people make the difficult decision to euthanize a pet, there are many other smaller decisions they’ll have to make, such as when to schedule and whether they or their children should be present. Among the details that should be considered on your end is how you can reduce the animal’s fear, anxiety, and stress during their final moments.

When pets have a fear of the veterinarian and are brought in for euthanasia, their stress levels can escalate. The procedures that may take place before euthanasia can be scary or painful, such as being restrained by a veterinary staff member while their front leg is shaved and an IV catheter is placed. While this usually occurs away from the owner, the experience is often stressful enough that the difference is noticeable when the pet is returned to the exam room.

Even if a particular patient doesn’t routinely require anti-anxiety medications, consider them when clients are bringing pets in for euthanasia. Many pet parents have concerns about their sedating effects, but this is one instance where it truly doesn’t matter–sedation will only help the euthanasia go more smoothly. Dispense them at least a few days ahead of time to ensure that the client is able to give a test dose before the day of the pet’s euthanasia. Some anti-anxiety medications such as gabapentin also help reduce pain, so they can decrease discomfort to procedures such as IV catheter placement prior to euthanasia. If your patient is agitated or is still fearful despite oral pre-visit pharmaceuticals, consider injectable sedation prior to euthanasia. The last thing a pet parent wants to see in their time of grief is their pet flailing, vocalizing, or trying to escape. Sedation will decrease stress for the pet and their family.

If your practice routinely uses IV catheters for euthanasias, have clients rub a lidocaine numbing cream such as Supernumb on the tops of their pet’s forelegs several hours prior to euthanasia. IV catheter placement is painful, and numbing the area will make for a more compassionate experience, especially since multiple catheter attempts are sometimes needed in debilitated pets .

In your Fear Free practice, you use treats with patients during routine visits, and you can use them with euthanasia, too. Providing a smorgasbord of vanilla ice cream, lunch meat, cheese chunks, Churu, peanut butter, or whipped cream will allow clients to continue bonding with their pets while lowering their stress. Take care to avoid giving greasy foods such as burgers–while tempting to offer as a last meal, they can cause nausea and gastrointestinal upset.

If you don’t offer housecalls for patient euthanasia, I urge you to consider it. Even pets who don’t have a strong fear of veterinary visits will never be as relaxed at the vet as they will in their home, with their familiar bed and environment. You can even have classical music playing quietly in the background to help create a calming environment. I’ve euthanized several pets in their homes, and in every instance I felt that the experiences of the pet and the owner were better than they would have been in the clinic environment.

Pets deserve to have a Fear Free death as much as they deserve to have a Fear Free life. By considering a patient’s emotional health during their final days, you’ll help make their passing as compassionate as possible.

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

Julie Liu, DVM, CVA (Certified Veterinary Acupuncturist) is a small-animal veterinarian who practices in Austin, Texas. In addition to advocating for Fear Free handling of pets, she is passionate about feline medicine and senior pet care.
 
Linda LombardiSome aspects of the experience of visiting the veterinarian are generally recognized as stressful to pets, such as strange noises, unfamiliar people and animals, and being handled in uncomfortable ways. Less clear – and now even more relevant in the wake of the pandemic – is a question asked by a recent study: how are pets affected by whether or not their owner is present during the exam?

In research published in Journal of the American Veterinary Medical Association in November, 32 dogs underwent a standardized exam consisting of examination of the head, palpation of lymph nodes and body, axillary temperature measurement, heart rate assessment, and respiratory rate assessment. The exams were recorded on video under two conditions, with owners present or absent. Behaviors indicating fear were assessed, including reduced posture, avoidance, escape, lip licking, body shaking, yawning, and vocalizing; physiological measures were also taken.

Based on their findings, researchers concluded dogs were less stressed when the owner was present during the exam.

“When the owners were allowed to be present with their dogs, they did have more reduced fear levels: reduced vocalizations and reduced temperature, and we also saw some female dogs had lower heart rates when they were with their owners,” says coauthor Anastasia C. Stellato. “So our results show that, if possible and if it’s appropriate for that client, to allow owners to be in the exam room could have a beneficial impact.”

Owner presence didn’t eliminate fear: more extreme responses, such as attempting to escape, were the same in both groups, despite the superficial nature of the exam. “It’s important to keep in mind that the exam we conducted was very passive,” says Stellato. “It was on the ground, they had a traction mat, we didn’t even use rectal temperature, and yet we still saw those fearful responses.”

So while those reactions indicated that the dogs would have preferred to avoid the exam, owner presence apparently allowed them to tolerate it somewhat better.

The study found an age difference in that older dogs lip-licked less than younger dogs when their owner was present. It’s possible that this was the result of a stronger bond developed over the years, but since length of ownership was not recorded, this remains a hypothesis for further investigation.

One finding that was surprising to the researchers was that owner-present dogs yawned more. Yawning is a complex behavior in dogs, so this result is difficult to interpret. “It was contrary to our expectation, so it requires further investigation,” says Stellato.

On the whole, the results suggest that when possible, allowing the owner to be present can be a simple way to reduce stress.

Veterinary behaviorist Karen van Haaften, senior manager of behaviour and welfare at British Columbia SPCA, says: “I think it’s a nicely designed study. It’s randomized and controlled, which is nice to see in a clinical study. I personally am not surprised by the results of this paper, but I think it’s really useful information for both veterinarians and pet owners to know, and I think it’s a timely one to consider, because during COVID, most vets are not allowing pet owners into the hospital.”

Even after the pandemic is over, pets will still need to be separated from their owners sometimes, so ways to mitigate the stress of this experience need to be considered. Van Haaften says: “When I read this, I’m asking myself, why are we seeing this response? Is it the social support — the bond that the pet has with the owner — that is reassuring to them? Or is the lack of familiarity? They don’t see anything in this clinic environment that feels familiar to them. Probably it’s both, but if the second, we can work on that.”

When pets do need to be separated from their owner, she says, consider how to include things familiar to the pet in the experience.

“We can interact with them in the way that we see that the owner does – use cues the owner uses, use training that they already know, walk them in on equipment that’s familiar, maybe bring something familiar from the owner into the room with them.”

Post-pandemic, we can return to the idea that familiarizing pets with the clinic in advance; for instance, dropping in simply to get some treats and meet friendly people. “If you do that a couple times a week they’re going to love going into the clinic — now it’s a familiar place where good things happen to them.”

And in some cases, a very little bit of familiarization right before an exam can make a big difference. “For some dogs, it doesn’t take that long to bond with a person,” van Haaften says. “If a technician or someone spends five minutes feeding cookies, performing trained cues with a dog, suddenly, now they’re good friends, and the dog has a familiar person they can go into the clinic with.”

Some clinics are doing exams outdoors for pets who are stressed inside the clinic, which can allow the owner to be nearby and this might be worth continuing for some pets as well. In general, van Haaften recommends flexibility and attention to individual differences.

“Behavior during vet exams is really complicated, and different techniques are going to work with different animals,” she says. “Be creative, be willing to be flexible about how you do exams to give your patients the best experience.”

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, coauthored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.
Linda LombardiThe veterinary clinic or hospital can be a stressful place for cats, full of strangers and strange noises and sights. A recent study suggests a simple and inexpensive way to reduce this stress by use of plexiglass sheets hung over the front of the cage.

In the study, thirty pet cats were placed in one side of two connected cages (the starting side, left or right, varied randomly) for 70 minutes. There were three conditions: open cage vs a cage-front covered by clear plexiglass; open cage vs opaque plexiglass; and clear vs opaque plexiglass. Observers calculated stress scores from the cat’s behavior during the first and last 15 minutes and recorded how much time was spent in each cage.

The cats who were most stressed in the first 15 minutes spent significantly more time in the cage that blocked the most incoming stimuli: they preferred either type of plexiglass to the open cage, and preferred opaque plexiglass to clear.

Coauthor Kyle G. Mathews, DVM, MS, DACVS of North Carolina State University says the idea behind the study was to find an affordable way to make clinics less stressful, while still allowing a full view of the patient. The opaque plexiglass is “like looking at the cat through a pair of sunglassses,” he says, which is much better than other inexpensive possibilities. “When you put a towel over the cage, or you give them a hiding box, you can’t see the animals.” When staff need to open the door to look at the hidden cats, that adds stress; if there’s a problem, staff might not notice in a timely fashion.  “They may have IV lines, and that makes giving them a hide box difficult, because they could get their lines tangled up,” he adds.

Other possibilities are more expensive. For example, louvered windows, such as those used for privacy in conference rooms, would probably work. “You’re looking down at an angle and can see the cat, but the cat looking straight out can’t see the room,” he says. “But these are very expensive and have to be custom made.” In comparison, inexpensive plexiglass cut to order can be bought fairly cheaply and all that’s needed is to attach hook and loop fastener strips to hang it from cages.

If you’re wondering why not a one-way mirror, they ruled that out immediately for good reasons. “A one-way mirror only works if there’s light on one side, and dark on the other. So the person in the dark room can see the person in the light room, but the person in the light room can’t see the person in the dark room,” he says. “So we’d need the light in the cage with the cat and the room would need to be dark.”

While they may be a start, barriers won’t solve all the problems that stress cats. In particular, while plexiglass sheets block light (a 74.4 percent reduction for opaque and 13.9 percent for clear), they do little to block noise (only a 4.5 percent reduction). Although no one has specifically studied the effect of noise on cats, it’s almost surely a problem, especially in an echoing stainless steel cage.

“Eventually, if people don’t want to rebuild a room for cats, we may need to design a cage that has insulation around the outside of it, but still stainless inside that you can clean,” he says. “But noise reduction is going to be a more expensive alteration. So this was our first attempt at looking at, is there something relatively cheap that a practitioner could use to retrofit their clinic that would make it feline friendly.”

Further research also needs to be done in a real hospital setting: this study was done in a special room, with video of the sights and sounds of a veterinary inpatient ward projected onto a screen. But in the meantime, the results suggest that it’s worth trying and doesn’t appear to have any downsides. “The indication is that it probably is helpful, especially in the most stressed-out cats,” he says. “It’s not going to hurt them – they’re not going to move away from it, there was no indication that was the case.”

Board-certified veterinary behaviorist Margaret E. Gruen, Assistant Professor of Behavioral Medicine at North Carolina State University and a Fear Free Certified Professional, agrees that this is worth trying, noting that odors, separation from owners, lack of hiding places, and sounds of people talking and monitors beeping are all stressors for cats, making hospitalization and recovery more difficult for them as well as increasing morbidity. They may refuse to eat or be hesitant to use the litter box. And anxiety is often difficult to differentiate from pain in cats. Looking at ways to mitigate these stressors while still being able to easily observe feline patients, especially when they are ill or recovering from procedures, benefits both veterinary teams and the cats themselves.

“The cats, and their people, will appreciate it,” she says. “And having happier cats in the hospital is a win for everyone.”

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.