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Taking the Stress Out of Veterinary Care for Clients & Patients Through Technology

Fear, anxiety, and stress should not be barriers for any pet or pet parent when they need care from their veterinary team or other care providers like groomers, walkers, trainers, or pet sitters. Technology is bringing the world as we know it closer and making our day to day lives easier and more convenient. BabelBark has new technology tools that make caring for our beloved pets easier and better. Tanya Cooper, the Director of Veterinary Sales at BabelBark and a Fear Free Certified Professional, explains how the veterinary care team can be unified with the care providers in a pet’s life for better sharing of information between visits and how BabelBark’s tools of remote patient monitoring and enhanced communications can allow you to provide high-quality care that considers the wellbeing of the pet’s body and mind.

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Linda Lombardi

Even the best animal shelter can be a stressful place for dogs. Erica Feuerbacher studies how to improve their welfare and was intrigued by a program she learned about at Best Friends Animal Society in Utah. Volunteers could take dogs with them for an overnight sleepover, even volunteers on working vacations, who could bring them to their hotel. Feuerbacher and colleague Lisa Gunter thought they could answer some questions that were in the air about the program.

“Some people thought this was really useful,” she says. “The dogs got a break from the shelter, and they learned more about the dog when it was out and about.” Others were concerned that the program was stressful for dogs. Here’s what they found.

Test Tactics

They collected urine for analysis from a sample of dogs before, during, and after a sleepover. “We found that their urinary cortisol levels, a measure of stress, significantly dropped while they were on the sleepover,” Feuerbacher says. “They came back up when they returned to the shelter, but not above baseline levels, so they weren’t more stressed when they came back.”

This suggested that the sleepovers were good for the dogs, but would they have the same effect elsewhere? Best Friends is not a typical shelter; most of the dogs are long-term residents and many had been on sleepovers before. They repeated the study at four other shelters, from small limited-intake facilities to large municipal shelters. Urinary cortisol measurements for dogs getting two-night sleepovers revealed the same stress reduction effects.

Good Stress

Repeated sleepovers appear to have a positive effect. At BFAS, the number of sleepovers a dog had previously experienced was correlated with lower cortisol, suggesting that the experience at first involves a small amount of stress.

“Likely the results we saw were the decrease from stress in the shelter overlaid with some new stress from the new situation, but the decrease overrode the small increase,” she says. “With repeated exposure to this new experience—‘I go home with new people and hang out for a night’—the dogs show an even greater reduction.”

Dogs at the four shelters in the second study also wore activity monitors as a way to follow up on something the volunteers at Best Friends reported: that the dogs would check out the new place for 20 or 30 minutes and then sleep the rest of the time. The monitors showed that the dogs not only spent much of the time resting in the foster home, they seemed to be able to get more rest when they came back to the shelter.

“The longest bout of uninterrupted rest occurred at the foster home, which made sense, but we did see some carryover effects,” she says. Dogs got significantly more rest in the shelter after the sleepover. “We had lots of reports from staff saying ‘When the dogs came back from sleepover, they’re a different dog, they’re calm in the kennel, they’re showing better’ and our data supported those anecdotal observations.”

So while the cortisol measurements did come back up when the dogs returned to the shelter, the break appeared to improve their ability to be calm in the shelter environment. “I always compare it to a weekend,” says Feuerbacher. “I’m stressed on Friday at work, I relax on Saturday and Sunday, and yes on Monday I’m stressed again, but I’ve had rest and I’m probably better able to cope with it.”

Canine R&R

The fact that dogs spent most of their time away from the shelter resting might be a bit of a surprise, but a pleasant one, as it potentially makes a program easier to implement.

“Oftentimes we think about shelter dogs that they need to go out and do things, go on hikes, and get all this environmental enrichment, but it’s possible that the shelter environment is so stimulating already that what they really need is just some quiet time,” she says. “This opens up new opportunities for fosters who might say, ‘I don’t feel comfortable taking a new dog to Starbucks, but I can take this dog home and let him sleep at my house for a few hours.”

Success Story

One shelter that participated that was so pleased with the results of the sleepover that they continued the program after the experiment was over was the Humane Society of Western Montana in Missoula. Director of Programs Mariah Scheskie says staff sees a difference in the dogs that come back from a sleepover. “When they come back, not only are they calmer, the potential adopters looking through the kennels are more drawn to them because mostly they don’t pick the dog that’s jumping up and lunging at the glass.”

Now that the program is established, it’s easy to run. Volunteers know the procedures, what to take home with which dog and what the schedule is, so it doesn’t add work for shelter staff.

The finding that dogs mostly want to rest makes participation less intimidating. “Before having this information, people did think, ‘I have to take this dog and run them for 10 miles and do all these things, and that’s a lot of pressure,” she says. “But we’re saying no, just rent a movie and open a bottle of wine and stay home.”

One unexpected finding was large differences in baseline stress at different shelters that didn’t correlate with any obvious factors. This is something Feuerbacher thinks needs further study. “Yes, sleepovers help, but we really need to understand these differences between the shelters and how housing, handling, and husbandry practices are impacting those dogs,” she says.

In the meantime, short sleepover programs can offer benefits to dogs and a new way to volunteers to get involved. Scheskie has found that it makes shelter staff feel good as well. “The volunteer is going out, everyone’s yelling goodbye, the door closes, and everyone has this huge sigh of relief together,” she says. “I looked at my coworker the other day and said, ‘It’s amazing how good that feels. You just know they’re snuggling in the bed, they’re with a human, they’re having a great time.”

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

Consider the Senses of the Fear Free Exam

Dr. Julie Reck explores the details involved in creating a Fear Free experience. She also discusses pre-appointment opportunities, easy-to-implement facility alterations, and exam room cleaning tips to make sure your patients have the best experience possible. Sponsored by Virox.

Akita nose|Akita nose
Until recently, disinfection was considered to be a necessary evil, killing infectious microbes at the cost of exposing pets and people to harsh chemical odors. Disinfectants with unpronounceable names, such as sodium hypochlorite (bleach), quaternary ammonium compounds (QUATs), and potassium peroxymonosulfate, may have been the industry standard for a long time, but just like any other aspect of animal health, we always strive to do better for our pets and create a more positive experience for them in and out of the vet clinic.Accelerated Hydrogen Peroxide® (AHP®) technology had been used extensively in human healthcare to kill some of the toughest pathogens while putting patient safety at the forefront. When Virox Animal Health saw the same need for veterinary care, they knew that AHP would be a perfect fit to help protect people and animals while reducing fear, stress, and anxiety in a veterinary hospital. That led to the creating of Rescue, a disinfectant specifically tailored to protect companion animals and the people who care for them.

While traditional disinfectants have been a trade-off between safety and efficacy, Rescue eliminates the need to make this choice. Rescue’s safety profile, coupled with the lack of harsh chemical odor, realistic contact times, and superior cleaning powers, can help your facility along its journey in becoming Fear Free.

Reducing FAS in the disinfection process doesn’t, however, mean a loss of efficacy. AHP disinfection covers all the bases in a Fear Free approach to animal health. These include:

1. Other chemicals like bleach and QUATs can be harsh. We all know that from experience, but we might not realize that bleach can cause serious skin and eye irritation and respiratory illness1. QUATs, although safer than bleach, have been associated with asthma and can also be irritating to the eyes and skin2. Rescue kills those tough-to-kill pathogens, but its gentle formulation is non-toxic and non-irritating for the safety of your patients, staff, and clients.

2. Bleach and QUATs can often take up to 10 minutes of contact time to kill pathogens, which can really slow down your practice. When was the last time you waited 10 minutes for a disinfectant to do its job before wiping it off? Not to mention the fact that these chemicals may not stay wet on the surface for long enough to meet this contact time. Rescue has realistic contact times, ranging from 30 seconds to 5 minutes. Furthermore, its wetting agents help make sure that it stays wet long enough to disinfect. This means less product used, less waiting between patients, and a more efficient practice overall.

3. Rescue has broad-spectrum bactericidal and viricidal claims against the vast majority of pathogens we encounter in the veterinary setting, so you can be confident that even the toughest pathogens don’t stand a chance. AHP also has none of the odors associated with chemical disinfection, preventing additional stress to our patients during their visit.

4. Cleaning power. Many older disinfectant chemistries have been poor cleaners and were only able to kill pathogens on surfaces that had been pre-cleaned with soap and water. AHP contains powerful detergents, which break down soil and allow it to work in the presence of organic material. This brings cleaning and disinfection into one easy step, saving valuable time and resources along the way. Rescue is also a natural odor eliminator, which may help get rid of some of the smells that can contribute to fear, stress, and anxiety within your clinic.

References

      1. 1. Acute Antimicrobial Pesticide-Related Illnesses Among Workers in Health Care Facilities – California, Louisiana, Michigan, and Texas, 2002-2007. CDC Morbidity and Mortality Weekly Report. May 14, 2010.
        2. Omidbakhsh N, Sattar SA. (2006). Broad-spectrum microbicidal activity, toxicologic assessment, and materials compatibility of a new generation of accelerated hydrogen peroxide-based environmental surface disinfectant. AJIC 34(5), 251-257.

This article is brought to you in collaboration with our friends at Virox.This article is brought to you in collaboration with our friends at Virox/Rescue Disinfectants.

Kim Campbell Thornton

We’ve all heard nay-sayers complain that Fear Free techniques take too much time. But is that really true? We went to an expert to find out.

Using Fear Free techniques can require additional time, no doubt about it, but in the long run they can save time and reduce stress. Smart scheduling is the secret, says Fear Free Certified hospital manager Taryn Lambert at VCA Manito Animal Hospital in Spokane, Washington.

Extra Time Pays Off

Fear Free success relies on allowing animals more time to become accustomed to being in the exam room and the presence of technicians and the veterinarian. It means making time for Victory Visits or fun visits so that pets associate the clinic with good treats, good times, and good friends. As Lambert says, it’s important to make deposits into a patient’s “trust account.”

But that doesn’t mean adding hours to the day. At VCA Manito, advising clients about the best times to bring in pets for fun visits, planning which patients come in when, and explaining desensitization and counterconditioning techniques all contribute to a smooth-running hospital.

For instance, “happy visits” for anxious pets are encouraged. They can come in, get treats, and maybe get weighed.

“I just let them know, ‘If you see that we look like Costco parking lot, that probably is not the day to come in and weigh your pet,’” Lambert says. “But otherwise, you just come on in.”

Careful Planning

Patient records note the animal’s typical FAS score. If it’s a 4 or 5, an additional 15 minutes is scheduled for the appointment.

“We know which ones take time and which ones don’t, and we schedule accordingly,” Lambert says. “If I have a whole bunch of zeroes and ones, those pets are going to go a lot faster. I would not have five fives in a row. That is not strategic scheduling.”

Receptionists play a key role. They manage the logistics of patient flow to ensure that bottlenecks don’t develop. The result is less stress for team members.

Messaging Matters

Communication with clients is also an important part of Fear Free time management. If arrival of an emergency case has veterinarians running late, clients may be called and asked if they’d like to come in a little later or reschedule the appointment. That ensures that they don’t have to put their dog or cat in the car, drive to the clinic, and then have to wait for an extended period before being seen. That’s less stressful for all the animals and humans involved.

Clients are also more willing to return for additional visits if they think it will result in less FAS for their pets. Take nail trims, the bane of most pet owners—and their pets. Lambert says VCA Manito has begun “bundling” nail trims into multiple visits, using desensitization and counterconditioning techniques to get pets through the procedure without fuss and teach them that it doesn’t have to hurt or be scary.

“Pets come in five to nine times,” she says. “The owners do not mind this. You would think that owners will not come back, but yes, they do.”

Implementing Fear Free may take more time upfront and it can require more time for certain patients, but overall it’s a win for veterinarians, staff, clients, and most important, pets.

“I can’t imagine ever not doing Fear Free,” Lambert says. “I think once you understand it and actually walk the walk, it just changes your view.”

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

Course Overview

This course will discuss chronic pain, its causes, and its impact on animals’ wellbeing. It will include case studies, as well as a discussion of alternative and complementary treatment.

This course, approved for 1 RACE CE hour, was written by Dr. Michael Petty, DVM, CVPP, CVMA, CCRT, CAAPM.

There are six lessons in this course.

  • Lesson 1: Review of Causes of Chronic Pain
  • Lesson 2: A Brief Discussion of Acute vs. Chronic Pain
  • Lesson 3: Measuring Chronic Pain
  • Lesson 4: Effects of Chronic Pain
  • Lesson 5: Pain Cases
  • Lesson 6: Alternative and Complementary Treatments

This course is endorsed by the International Veterinary Academy of Pain Management.

Course Overview

This course will teach you how to maximize the efficacy of your analgesic protocols. You will learn how and where core and adjunctive medications work along the pain pathway, and the importance of multimodal analgesia.

This course, approved for 1 RACE CE hour, was written by Dr. Tamara Grubb, DVM, PhD, Diplomate ACVAA.

There are four lessons in this course.

  • Lesson 1: Pain and Analgesia: Introduction and Integration into Fear Free
  • Lesson 2: Pain Pathway: Where Do Analgesic Medications Work?
  • Lesson 3: Core Medications for Treatment of Acute Pain
  • Lesson 4: Adjunctive Medications and Techniques for Treating Acute Pain

This course is endorsed by the International Veterinary Academy of Pain Management.

Course Overview

This course provides specific protocols for treating patients experiencing a variety of acute pain conditions, including various surgeries, trauma, dentistry, and more. We will look at several case examples typical of what you might encounter in daily practice.

This course, approved for 1 RACE CE hour, was written by Dr. Tamara Grubb, DVM, PhD, Diplomate ACVAA.

There are three lessons in this course.

  • Lesson 1: Designing Analgesic Protocols: Importance and Strategies
  • Lesson 2: Analgesic Protocols for Elective Soft-Tissue Surgery and Dentistry
  • Lesson 3: Analgesic Protocols for Urgent Soft Tissue and Orthopedic Surgery, Trauma and Medical Conditions

This course is endorsed by the International Veterinary Academy of Pain Management.

Course Overview

This course empowers you to begin or increase your pain management business by offering suggested improvements to both the culture and physical layout of your clinic. It will discuss skills you might want to consider learning, how to effectively communicate with clients, and ways to acquire new pain patients.

This course, approved for 1 RACE CE hour, was written by Dr. Michael Petty, DVM, CVPP, CVMA, CCRT, CAAPM.

This course consists of five lessons.

  • Lesson 1: Acquiring a “Pain Attitude”
  • Lesson 2: The Clinic
  • Lesson 3: Skill Sets to Consider
  • Lesson 4: Treatment Goals and Outcome Measures
  • Lesson 5: Acquiring Patients

This course is endorsed by the International Veterinary Academy of Pain Management.

International Veterinary Academy of Pain Management

Susan M. Ewing

Both dogs and cats rely heavily on scent to interpret their surroundings while humans rely more on sight. Blindfold a human just before a visit to a doctor or emergency room, and the stress level would be higher than if the person could see, but most people would at least be able to hear and understand what was happening in the way of treatment. We can’t explain to our pets what is happening, or why they are in a hospital. Take away their sense of smell and you’ve taken away their ability to interpret their world, adding more stress to an already stressful situation. By understanding the effects of scents, you can help them stay calm.

Ban Bleach

No one intentionally stops a dog or cat from smelling, but disinfectants can do just that. Bleach and other disinfectants with a harsh odor can make a pet “nose blind,” creating stress when they try, and fail, to learn about their environment. In one study, “Minimising Stress for Patients in the Veterinary Hospital: Why It Is Important and What Can be Done About It” (published online in Veterinary Sciences, April 13, 2017), lead author Janice K.F. Lloyd cites Karen L. Overall, VMD, in the Manual of Behavioral Medicine for Dogs and Cats: “A solution of bleach, even as low as 1 percent, can destroy olfactory neurones, resulting in a loss of information and heightening anxiety.”

While disinfecting is essential, using one that doesn’t have a harsh odor may help to lessen the negative effect on a pet’s nose. At Applebrook Animal Hospital in Ooltewah, Tennessee, Kathryn Primm, DVM, uses Rescue disinfectant, a hydrogen peroxide product with little odor, which also dries quickly.

Scents From Other Animals

When pets are able to smell, identifying stress in other animals can increase their own level of stress. Secondarily, humans may also experience some stress when smelling clinic odors. Most pets are quick to respond to their owners’ emotions, and if that emotion is stress, it’s going to affect the pet.

“When we have bad odors suddenly, like anal glands,” says Dr. Primm, “it is critical that they be cleaned and deodorized completely, or they will cause fear in all the pets that perceive them.” For those kinds of odors, Primm uses K.O.E. (Kennel Odor Eliminator) by Thornell, a product that quickly eliminates odors and comes in a concentrate, a spray, and individual wipes.

Sometimes, when possible, opening a window can help. Many pets will become distracted from their environment as they process scents from outdoors. Synthetic pheromones may also help to calm a dog or cat. Plug-in pheromone diffusers may reduce stress in a waiting room, and doctors or technicians can spray their clothes with the pheromones. Use diffusers or sprays with caution around birds and fish.

Many people appreciate the calming effects of lavender and chamomile, and both of these scents seem to calm pets, too. Be careful how you use them, though. Certain diffused essential oils can cause some respiratory distress in cats so use them with caution, and alert clients to the risks of active diffusers in the home to pets.

With so many pets depending on their noses for information, it makes sense to pay attention to scents.

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