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Fear Free Shelters: Lower Stress for Dogs Via Play

Heather E. LewisHealthy play is necessary for the wellbeing of all animals, including humans! For sheltered dogs, play has become increasingly important for many reasons:

We are more aware of the need to provide quality enrichment to sheltered animals.
Shelters are providing more behavioral care for dogs.
Play reduces fear, anxiety, and stress.
Play helps dogs feel more comfortable in the shelter environment.

We love designing for play. There are many small design nuances but here are some basic highlights:

Play Group Space. Play groups must be set up with the support of staff and volunteers, with proper training, as well as within the proper environment. Ideally, play groups will have the following:
- A series of interconnected yards (rather than one large yard) to customize play groups based on dogs’ sizes and size needs.
- Visual barriers between yards and kennels.
- Double-gated entrances for safety.
- Access to water via kiddie pools for the dogs to cool off and to provide a large water source that is less likely to be guarded.
- Shading and reasonable surfaces are important as well. K9Grass (a brand of faux grass) is our favorite, but only if it is installed correctly so that it drains and does not collect water. It also needs to be shaded or it can get too hot for paws.
- Safe fencing that keeps dogs contained without risk of escape.

Water Play. Water play works well for dogs who enjoy play groups and for those who do not. We have started incorporating splash parks for sheltered dogs (see photo). It is spectacular to witness a formerly fearful sheltered dog interacting playfully with water. Splash park plans must be created by people who know how to design for dogs, as they have different types of plumbing, surfacing, and play structures than those designed for children. When we design a splash park, we consider the following:
- Incorporate additional space around the water feature so the dogs can go in and out of the water. This enhances choice.
- Safe surfacing is critical. Our favorite is a soft, grip-textured surface designed for dogs.
- The water itself should be safe. It is not recirculated, so it is best to have the water provide watering to landscaping once it has been used in park fountains.

Individual Play Spaces. We know that some dogs do better with one-on-one time than they do in groups, and we know that water features cannot be used during cold winters. Therefore, do not forget to provide these spaces for your sheltered dogs:
- Walking Paths. These should be loop type with multiple forks along the loop, so that dogs do not have to pass each other side to side. Good walks provide exercise, connection, and some Fear Free training opportunities.
- Ball Throwing Areas. We like to provide a larger yard (60’ long minimum) for flying disc or ball throwing.
- Small (20×20, for example), more fully enclosed yards. These are great for gentle socializing with fearful dogs who may retreat in large yards, or for adoption meet and greet.

As we continue to improve the Fear Free shelter, dedicated play areas are a critical part of the design. It is best to designate outdoor areas for play so everyone gets fresh air, but if your shelter is land constrained, or in an urban location, playrooms can be indoor if necessary.

Regardless of your resources, find ways to incorporate play. For a dog, and especially one who is fearful, play is an important and often shorter path to happiness and comfort, as well as to finding the right forever home.

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

Heather E. Lewis, AIA, NCARB, is a principal of Animal Arts, an architectural firm that has exclusively designed animal care facilities, including veterinary hospitals and animal shelters, for more than three decades. She has worked on dozens of projects across the country, both large and small in her 19 years with the firm. Heather is a member of the Fear Free℠ Advisory Board and assisted in creating the Fear Free facility standards for veterinary hospitals. Heather is a regular contributor to various veterinary industry magazines. She has spoken on the design of facilities for the care of animals at dozens of national and regional conferences including Fetch Hospital Design Conferences, the UC Davis Low Stress Animal Handling Conference, and the Humane Society of the United States Animal Care Expo.

Photo courtesy Humane Society of Southwest Missouri

A Close Look at Canine Enrichment: What, Why, and How?

Course Overview

True enrichment goes way beyond simply providing dogs with food puzzles each day. For instance, a comprehensive enrichment strategy incorporates all types of enrichment: social, occupational, physical, nutritional, and sensory. This course will show you how to engage all the senses, as well as how to thoughtfully determine which enrichment activities are most appropriate for individual dogs, how to enrich the lives of dogs in a veterinary clinic, and those who are recovering from an injury and on restricted exercise.

This course, approved for 1 RACE-approved CE hour, was written by Laura Ryder, CPDT-KA, KPA CTP, IMDT.

This course consists of four lessons:

Lesson 1: Exploring enrichment using all the senses
Lesson 2: Identifying the right balance
Lesson 3: Enrichment for dogs in the vet clinic
Lesson 4: Enrichment for dogs on restricted exercise or cage rest

Success Story: How I Used Fear Free Handling for a Frightened Puppy

Susan Claire, CPDT-KA, FFCATA young man called me because he could not get a harness or even a collar on Oakley, his 6-month-old Pomsky-Klee Kai mix. He explained that this had recently become a problem after an unfortunate incident with a Velcro-closure harness, which accidentally stuck to Oakley’s thick coat. It was frightening and painful for him when the owner pulled it off.

The situation was urgent because Oakley now snarled and snapped at the owner whenever he tried to put a collar or harness on him so he was unable to attach a leash to the dog to take him out for walks. I advised him to try to slip on a martingale collar and leave it on Oakley temporarily until we could get him to accept the harness. I don’t normally use a martingale but in this case it was a logical option.

When I arrived for the first session, Oakley—one of those dogs who never stop moving—showed interest in interactions and did not give distance-increasing behaviors, but he also didn’t ask to be touched. I began by using a clicker to mark and reward every time he stopped moving or made eye contact. Then I laid down a super-soft non-skid consent mat, sat in front of it, and used the clicker to shape Oakley into lying down facing me on the mat.

Then I showed the owner how to desensitize Oakley to first tolerating a stethoscope, then having his feet and ears touched, and finally to a fake injection with an empty syringe. We showed Oakley each item, marking and reinforcing him for sniffing it. We moved each item slowly toward him, always stopping if we observed stiff or avoidance body language. I name each item and procedure so the dog knows what to expect during these sessions, and I advise clients to use the same words while the veterinarian is performing an exam or procedure: “heart” for stethoscope, “feet,” “ears,” and “pinch-poke” for syringe/injection.

After this, we tried to use similar techniques to put a Sensation Harness and then a collar on Oakley. I saw the problem the owner described, so we switched gears. I wanted to know if Oakley was generally fearful, so I set up boxes for nosework, a Snuffle Mat, a Wobbler, and a Spin-it. Oakley engaged with these items enthusiastically, demonstrating no fear. We did a few behaviors on the consent mat (sit, watch me, touch, and down), allowing Oakley to disengage and go to the boxes or Snuffle Mat if he needed to de-stress and return to the consent mat when he was ready to re-engage. I instructed the owner to practice all of the above between our sessions.

During the second session, we repeated the above and added one behavior to the consent mat training: holding the harness for Oakley to see, clicking if he sniffed it or moved his head toward it, and eventually trying to lure his head through it while saying “Put it on” but not restraining him in any way. We were successful with this but not in clipping the harness. We then did some obedience/safety exercises, such as come and loose-leash walking and finished with a game of fetch.

At the third session, Oakley greeted me with distance-decreasing behaviors and physical requests to be touched. He was happy to interact and be touched. When I put the consent mat on the floor, he ran to it and lay down, eagerly awaiting our interactions. The owner and I slowly went through the desensitization-to-handling process and he was able to get the mini Sensation Harness (with its tiny little clip) onto Oakley and clip it, with no snarling, biting, freezing, or avoidance behaviors of any kind from the dog. I was pleasantly surprised and the owner was thrilled.

I advised him to continue to use food while putting the harness on or taking it off to keep the positive association going, to always use the phrase “Put it on” to alert Oakley to what was coming, and to continue the consent mat handling exercises so that Oakley would be comfortable during veterinary exams. I advised as well to always end with a short play session or walk.

The icing was the nice Yelp review from the owner, who described the problem and wrote, “Susan was amazing! She was great to work with and I am so happy with the results!”

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

Pheromones to Help Pets Cope with Holiday Stress

Pheromones to Help Pets Cope with Holiday Stress

The holidays are often overlooked as a major time for stress in our patients’ lives. In this webinar, Valarie V. Tynes, DVM, DACVB, DACAW, will review the common triggers occurring from October through the end of December and how to equip your clients with the best information to make it a happy holiday season for everyone.

Brought to you by our friends at Ceva Animal Health

Bad Breath Is a Really Big Deal!

Bad Breath Is a Really Big Deal!

One of the first things veterinarians learn is that the whole body is connected—even poor oral health can have lasting impacts on a dog’s longevity and quality of life. Fighting smelly breath before it starts by implementing (easy!) at-home dental routines can ensure your patients have more wags and fewer worries. Join Jan Bellows, DVM, DAVDC, as he discusses the importance of canine dental care.

Brought to you by BARK.

Design Solutions to Tackle Stress in Treatment Areas

Heather E. LewisMany veterinary practices have developed effective solutions for Fear Free exams and for low-stress patient housing. The next important area to tackle, the treatment room, is an inherently stressful space. Why are treatment rooms so stressful and what can we do to reimagine them?

Treatment rooms are stressful because they are generally designed to be a wide-open space, with many different functions occurring simultaneously. Treatment rooms are this way to ensure efficiency of staffing and safety for patients. For example, animals may be housed in treatment because this is the location where they can be monitored most easily. What if it were possible to maintain safety and efficiency, while de-stressing the treatment and other medical areas of your hospital? I know that it is! Below are a few of our favorite solutions for incorporating Fear Free design concepts throughout the medical areas of the hospital.

Separated Cat Treatment. One of the easiest ideas to implement is a separate cat treatment area located near cat exam rooms and ward. With this design, the cat areas of the hospital can function as a “mini clinic” space. This does not take a lot of room and removes cats from the chaos of the primary treatment space. Designs that include windows into the main treatment room allow for better communication between the cat area and other medical spaces.

Minor Treatment. This treatment space is located behind exam rooms and functions as a quiet area for simple procedures that might need more space or equipment than an exam room might offer. The client can step into this space as well. This minor treatment space is intentionally placed away from potentially frightening and unfamiliar sounds, smells, and activity associated with procedures and surgery. It can remain calmer and quieter because of its placement.

Treatment Curtains. Treatment curtains are borrowed from cubicle curtains used in human medical triage and emergency care. They allow for flexible visual privacy, and they also cut down on noise and visual stimuli, as we have learned anecdotally from using them. A curtain track can be placed in the ceiling around any treatment table to convert it into a semiprivate space.

Separate ICU and Recovery. Separating more critical patients behind glass in the treatment space does wonders. Even if you have few critical or recovering patients, separating them will help create a quieter treatment space and quieter patient space. If you like the idea of glassed wards for more critical patients, ensure that the glass goes to the floor so you can quickly glance in and monitor patients, to continue to keep them safe.

Better Materials and Systems. Once the design is reworked to make treatment areas more specialized, focus on the next layer of design: selecting better materials and systems. Here are a few of our favorite ideas:

Dimmable lighting. Lighting that dims allows you to de-stress the space when things are quiet, such as overnight for hospitalized pets.
Windows and daylight into treatment. Placing some outside daylight in the treatment room can make it feel more connected to the natural environment, helping to de-stress the space and make your staff feel a lot better.
Indoor/Outdoor options. As the Covid-19 crisis has taught us, having some flexible outdoor space can be very helpful for a veterinary practice. What about having a treatment porch, or if that is too ambitious, what about at least having a few operable windows, or a beautiful garden for walking post-surgical patients?
Noise control. Noise control is critical. Use good ceiling materials that cut down on noise. Use quiet casters on your chairs, and quiet latches on cages. Every bit of unnecessary noise is an opportunity to rethink design elements.

We have a long way to go with veterinary treatment spaces, but with Fear Free, we’re on our way to reimagining medical care that is far better for the emotional wellbeing of pets than it has been in the past. We are excited to see your ideas implemented in the treatment room of tomorrow, and we know that we will never look back.

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

Heather E. Lewis, AIA, NCARB, is a principal of Animal Arts, an architectural firm that has exclusively designed animal care facilities, including veterinary hospitals and animal shelters, for more than three decades. She has worked on dozens of projects across the country, both large and small in her 19 years with the firm. Heather is a member of the Fear Free℠ Advisory Board and assisted in creating the Fear Free facility standards for veterinary hospitals. Heather is a regular contributor to various veterinary industry magazines. She has spoken on the design of facilities for the care of animals at dozens of national and regional conferences including Fetch Hospital Design Conferences, the UC Davis Low Stress Animal Handling Conference, and the Humane Society of the United States Animal Care Expo.

Navigating Your Practice’s Preventative Care Yellow Brick Road During a Pandemic

Vaccines, Clients & Curbside… Oh My! Navigating Your Practice’s Preventative Care Yellow Brick Road During a Pandemic

Join Dr. Julie Reck, owner and founder of Fear Free Certified Practice Veterinary Medical Center of Fort Mill, for a discussion on vaccines, how to administer vaccines in a Fear Free manner, and how to improve communication throughout your practice to navigate preventative care in a curbside environment.

Brought to you by Elanco.

Know Your Breeds: An Expert Shares Tips on Getting Along With Different Dogs

Deb M. Eldredge, DVM
It can be helpful to “know your breeds” for many reasons as a veterinarian but especially for two big ones. The first is health.

Some problems may be breed-specific or at least have a genetic predisposition in some breeds. This can help with your diagnostic planning and, in some cases, could save a life – think of a Border Collie who ingested a tube of equine ivermectin and happens to have the MDR 1 defect.

You might even have a diagnosis simply by noting the breed! A colleague walked through our treatment area one day carrying a West Highland White Terrier pup. She said the pup was not eating well and seemed to have a painful mouth. I looked up from whoever I was working on and said, “CMO – craniomandibular osteopathy. Treat with steroids – most fully recover.” Boy, did I look like a brilliant superhero!

I am very involved with purebred dogs, plus I enjoy genetics, so any articles on problems in purebred dogs catch my eye. Sometimes these articles are in peer-reviewed journals and sometimes they are in AKC or breed club publications. There are also some excellent books out there on genetic problems in purebred dogs and cats. It is well worth the expense to have at least one in your clinic library.

If you work with any breeders at your clinic, keep up to date on those breeds at least. Most reputable breeders can provide you with some excellent information on genetic problems in their breed. Also, put the Canine Health Information Center website on your toolbar.

CHIC is run through the Orthopedic Foundation for Animals in conjunction with breed parent clubs. Not all breeds participate but most do. The clubs determine what are the most common inherited health problems seen in their breed. Then they provide a list of required health testing for a dog to be CHIC-certified. For example, in my main breed, the Belgian Tervuren, a dog must be tested for thyroid, hips, elbows, and eyes to be awarded a CHIC certificate. It is important to note that the dog does not have to be normal for all the testing, but the breeder or owner must have it done and must make the information publicly available on the CHIC website. That helps everyone involved in that breed.

Encourage any breeders you work with to participate in the CHIC program. It is better for the breed and knowing about the CHIC program makes you aware of what problems might be noted in that breed.

Beyond health, there are behavior considerations with many breeds. Working and herding breeds often have a guarding aspect to their instincts. Think about walking into an exam room with a large German Shepherd Dog inside. Appointments go better if you are in the room before these dogs. That way the space is claimed by you and the dogs are less likely to growl or react to you. This is especially true with large male dogs of these breeds who come in with women. Chivalry is not dead in the canine world. (And this may be a reason why curbside appointments in this “time of COVID” actually go fairly smoothly since you are in the room ahead of the patient and the dog has no one to guard!)

These dogs can also react negatively to any kind of direct stare. Remember that Border Collies actually control livestock using their eyes in many cases. They won’t hesitate to stare you down.

On the other hand, most hound breeds, especially scenthounds, are pretty happy-go-lucky and don’t care whose room it is or if you look them in the eye. But check carefully for any pee marking after these dogs leave the room. Sporting dogs are generally outgoing too, although Chesapeake Bay Retrievers should be treated the same way you would working or guardian dogs.

Terriers tend to be physically tough. Knowing that, if an owner says their Schnauzer is acting painful, that dog may be in a great deal of pain. This is not a case to put on hold.

Some breeds have behaviors that border on medical conditions – think flank sucking in Doberman Pinschers, tail chasing in Bull Terriers, or fly snapping (at imaginary flies) in Cavalier King Charles Spaniels. The better an understanding you have of breeds, the better you will be able to serve your patients.

A caveat to these comments – each dog is an individual. There are Mastiffs who would help you carry out their owner’s belongings if you came to rob the house. There are Golden Retrievers who will guard an exam room with intensity. Still, general knowledge of a breed can be helpful in your day-to-day life at the hospital.

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

Deb M. Eldredge, DVM, is a Cornell graduate and the first recipient of the Gentle Doctor Award. She is an award-winning veterinarian and writer.

Alone in the Wilderness

Course Overview

Are you the only person in your clinic who has a passion for Fear Free? It’s easy to get discouraged and frustrated when we are surrounded by obstacles. This course provides tools to achieve your Fear Free goals even when you feel like you are all alone in your work. Learn how to get buy-in, implement strategies from the ground up, and encourage your colleagues to join your heart’s work of protecting the emotional welfare of our treasured animal patients.

This course, approved for 1 RACE CE hour, was written by Monique Feyrecilde BA, LVT, VTS (Behavior).

This course consists of five lessons:

Lesson 1: The essence and importance of Fear Free Practice
Lesson 2: Understanding the dynamics of change
Lesson 3: Implementing change within your practice
Lesson 4: Addressing common push-back topics
Lesson 5: Thrive where you’re planted, or transplant to a new garden

5 Fear Free Experts Celebrate Their Wins

Kim Campbell Thornton
Blood draws, chemo, happy vet visits, even training veterinary students: Fear Free makes things work. Here are this month’s success stories.

Chemo for Indy

Indy was a middle-aged mixed-breed dog who developed Stage 3a lymphoma requiring weekly treatment under a CHOP chemo protocol. Only one problem: he was an FAS 4-5 patient who did not like to be touched, let alone restrained. How were we going to treat weekly with IV catheter-administered chemotherapy? Spent a lot of time in the early days fine-tuning a PVP protocol that allowed us to work on touch gradient approach so we could eventually hold his paw and use a regular or butterfly catheter to administer therapy. We always had myself and one specific technician available to work on desensitization with gentle restraint and forelimb holding. Lots of treats. For longer IV treatments, we preemptively sedated Indy. By the end of his treatment cycles, he would walk into the chemo room, sit or lie on a padded mat, and let us treat without incidents. Amazing! It works!

Jeffrey D. Palmer, DVM, Elite Fear Free Certified Professional, Burr Ridge Veterinary Clinic, Darien, Illinois

PVP, Tuna Lead to Successful Cat Exam

A new feline patient with a high level of fear, anxiety, and stress went home with gabapentin as a pre-visit pharmaceutical. The exam we performed two days later was great. He was readily eating tuna and happy to be petted. He did well for a complete exam, including radiographs and blood draw. The Feliway-infused towel was also a great help.

Matthew Hudson, DVM, Elite Fear Free Certified Professional, VCA Blum Animal Hospital, Chicago, Illinois

Cat Can Do

We have seen so many success stories with numerous patients, but the best for me is my personal cat. He is an uncontrolled diabetic, and the first year I owned him he had a lot of blood draws and vet visits. He was a wonderful-tempered cat at home, but at the clinic, while he never bit or scratched, he hissed and struggled every time he came out of the cage and became a difficult patient to handle. He is very food-motivated and after we started Fear Free practices and he got squirt cheese and baby food every time he was handled, he now purrs and rubs on everyone when he comes for treatments and is so much happier and easier to handle. I am overall so much more aware of a patient’s anxiety level the moment they walk in the door now, and it gives us a chance to start finding ways to alleviate their stress before it escalates.

Cheri Crane, Elite Fear Free Certified Professional, Customer Service Representative, Healing Paws Veterinary Clinic, Springfield, Missouri

Culture Change

For most of my practice career, I have been involved in student training. Some students embraced the things I taught them about the importance of minimizing fear, anxiety, and stress in patients, while others felt I was “too soft,” “only cared about giving the animals treats,” or “was crazy or misguided in my efforts.” Fellow faculty members sometimes shared these sentiments and even accused me of not being able to “get the job done” when I would elect to postpone or re-plan a procedure for an animal. The revolution of awareness that Fear Free has helped to create in our profession has changed the way I am viewed by students and colleagues. No longer the “crazy Dr. Griffin,” I am the one they ask to teach them about low-stress handling and Fear Free techniques. The art and science of Fear Free have become valued: this is truly a gift for all of us, our patients, and their owners. I look forward to the day when Fear Free is taught in all veterinary colleges and is fully embraced as an indispensable standard of care in veterinary practice.

Brenda Griffin, DVM, DACVIM, Elite Fear Free Certified Professional, Adjunct Clinical Associate Professor of Shelter Medicine, Maddie’s Shelter Medicine Program, University of Florida College of Veterinary Medicine, Gainesville, Florida

Happy Puppy, Happy Vet Visit

I took a client’s puppy to our veterinary office for a happy visit after the previous appointment did not go well for them. We played on the floor, showed off some of their tricks, ate some really yummy food. I was able to ask for a nose target to get up on the scale all on his own! We were able to leave with a calm, happy puppy and his next vet visit went much better.

Jenn Hauta, Elite Fear Free Certified Professional, Fairy Dogmother Training & Pet Care, Nanaimo, British Columbia, 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.

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