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Alyson Evans, RVT, CVT, Elite FFCP, CCFPSix months ago, I wrote about my experience with burnout. I thought then that I had reached my lowest low, but I was wrong. Here’s what has been happening since then.

I have been doing nail trims and anal sac expressions in my neighborhood for the last three years.  Recently, one of my neighbors had asked on our community Facebook page if someone in the veterinary field could answer a question. Her dog was limping, and she didn’t know what to do.  One of the neighbors offered her some doggy aspirin she had bought at the pet store. I quickly advised against giving unprescribed medications to her pet.

The conversation turned into a bullying session. One of my neighbors told me I shouldn’t try to act like a veterinarian. I have never felt so disrespected in the 15 years I have been in this career.

I shut down.

The next thing I knew, I was in my closet, crying, repeating to myself, “I don’t care, I don’t care anymore. Why should I care about others’ pets if I am going to be treated like crap? I’m done.”

I may have been improving with burnout, but I had just hit a whole new level of compassion fatigue.

I had a full weekend’s worth of nail trims to do and was going to make a little more than $200 in five hours. I didn’t care about the extra money anymore and canceled all appointments for the foreseeable future.

In tears, I explained to my husband why I had given up making extra money on the side. It was clear he wanted to help but didn’t know what to say or do. I knew I needed professional help.

Now I’m in the process of finding a therapist I can connect with. Until then, my family and I have adopted the following tools to help reduce stress:

–Simple Habit, a meditation app. My son uses it to fall asleep and settle down. He will ask to meditate to go to sleep now.

–A “coming home” routine: The spouse who is home first allows the second spouse to “finish coming home.” This gives them some quiet transition time to put their bags down, change clothes, and relax. When they’re ready to engage with the other spouse to prepare for the evening, they come out of the bedroom or wherever they choose to decompress.

–Boundaries with kids: I explain to my son that I need time to talk with his dad and ask him to sit quietly and watch a short show or play ABCmouse, a reading app. I also set timers in the house called, “Time to get ready for bed,” “Time for bed,” and “Quiet time is over.”

–Communication: When I start to feel like I’m getting anxious, I communicate how I am feeling and what I need to be able to come back down to earth.

Most of all, we continue to remind each other to slow down, be present, engage, and take time to listen to one another. My husband and I are working to improve our communication with our 3-year-old son so we can help him become an emotionally intelligent person, something his dad and I still work on ourselves.

We make time to have difficult conversations, and when we get into arguments, we try to make it a conversation, being mindful of raised voices, body language, and facial expressions. When necessary, we call each other out in a respectful way, in the moment, to help the other become aware of what they are doing.

The Fear Free way of thinking has helped me in so many aspects of my life. I use the techniques with my own son when he has doctor appointments as well as in everyday life. I communicate with him, making sure he knows what is coming up next, where we are going, what the doctor will do next. He is better behaved and calmer when things are explained to him, in most settings. I think that most children would respond to situations in a calmer manner when a Fear Free or Considerate Approach is taken.

In a work setting, my current team is emotionally intelligent, and all know the battle that I am fighting, which helps. Openly discussing things with your team can not only help you to become stronger but also to be seen with more respect and empathy than if you suffer in silence to spare everyone else’s feelings. Maybe someone on your team is suffering as well and doesn’t have the courage to speak up. Sharing your battles may give them strength to seek help for theirs. I wish more practice managers and owners would spend a day, at least, in a Fear Free certified hospital.

The most important message I want to send is that the battle of burnout is ongoing, and it’s not one you can win on your own. It doesn’t fix itself overnight or with a couple of therapy sessions.

Here is a quote I read frequently from Rachel Ashwell’s book “Painted Stories”:

“There is a time for taking action and creating work, and there is also a time for rest and seeking new ideas. Learning when you need space will help you to build a more sustainable creative practice.”

Check out our Fear Free on the House page for resources on wellness, quick tips, and more!

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, DVMNo sooner do you read the alert, “Caution, will bite!” on your next patient’s chart when you hear him enter the building: loud yowls in the waiting area, followed by hissing, growling, striking, and screaming when you dare to peek at him through the carrier in the exam room. Is it a scene from a veterinary horror movie? Nope, just a senior cat who’s been losing weight for a couple of months, is overdue for rabies, and oh by the way, can you also trim his nails?

Fear of the veterinarian is a common finding among our feline patients and unfortunately, left unaddressed, can often escalate to aggression and worse veterinary care. Cat parents may put off bringing their cat to the vet due to the stress involved, and veterinarians are often unable to perform an exam, diagnostics, or treatments due to risk of injury. If you’ve ever attempted to “examine” one of your feline patients by observing them solely from the carrier, a recent JAVMA study1 may bring hope.

In the double-blinded, randomized, placebo-controlled study, two groups of healthy cats at least 6 months of age were given either gabapentin or a placebo capsule two hours before the first of two veterinary visits. One group had a history of fear-based aggressive behaviors (FAB), and the other did not.

During the vet visits, the cat parent was present but did not interact with the cat, and the vet attempted to go through the following steps with a standardized clinical exam, corresponding to a compliance score of 0 through 9: no handling; removing the cat from the carrier; cardiopulmonary auscultation; abdominal palpation; intraoral exam; ocular exam; otic exam; rectal temperature; and finally, return of the cat to the carrier. The exam was stopped if the cat tried to bite or scratch the vet, but the exam continued if the cat hissed or growled. On the second of the two visits, performed a mean of about 15 days after the first visit, the cat received the opposite treatment of either placebo or gabapentin and the steps to attempted clinical exam were repeated.

The results suggested that the compliance scores of cats in the FAB group that received gabapentin were significantly higher (median, 9) than the same cats with FAB that received a placebo (median, 0.5). Forty-two percent of the cats receiving gabapentin did experience some side effects, most commonly drowsiness and myorelaxation. However, all adverse effects had resolved after approximately 10 hours, which is a reassuring point to make with concerned cat parents. In addition, most cat parents in the study rated the gabapentin and the placebo as being fairly easy to administer with regular food.

If you’re not using gabapentin routinely for your feline patients to reduce stress, now is a great time to start. An easy way to get cat parents on board is to send home a “Fear Free goody bag” that includes two free doses of 100 mg gabapentin (a trial dose and a day-of dose), an individually packaged Feliway wipe, and the Fear Free handout “How to Prepare Your Pet for a Veterinary Visit.”2 Cat parents who balk at having to pay a dispensing fee for a gabapentin prescription may welcome a sample, and gabapentin is so inexpensive that the cost vs. benefits of actually being able to handle and treat your feline patients will pay off a thousandfold. Just make sure you discuss potential side effects and recommend that they give the gabapentin in a tasty treat such as Churu to avoid causing a food aversion with their regular canned food.

If the cat parent does their part by administering the gabapentin to their fearful cat, we as Fear Free Certified Professionals must do ours and use feline-friendly handling. A perfectly mellow cat floating away on a cloud of gabapentin is going to come crashing to earth if they’re scruffed or dumped out of their carrier. While removal from the carrier was the second step in this study’s standardized physical exam, if a cat doesn’t want to come out of the carrier on their own, they’ll often become much more stressed when they’re removed from the familiar environment of their carrier. Try removing the top of the carrier and allowing your feline patient the option of hiding in the towel–you’ll find that you can often do an entire exam, vaccines, and sample collection this way without the cat escalating to FAB.

For more info on feline-friendly handling, check out the updated, amazing, and free AAFP webinar by Dr. Ilona Rodan.3 Even experienced cat people will learn some great tips on ways to keep their feline patients as relaxed as possible.

  1. Kruszka, M., Graff, E., Medam, T., & Masson, S. (2021). Clinical evaluation of the effects of a single oral dose of gabapentin on fear-based aggressive behaviors in cats during veterinary examinations, Journal of the American Veterinary Medical Association, 259(11), 1285-1291.
  2. https://fearfreepets.com/wp-content/uploads/2017/09/Preparing-for-the-visit-store.png
  3. https://catvets.com/education/online/webinars/feline-friendly-handling-interactions

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 is a veterinarian and freelance writer based in Austin, Texas. In addition to advocating for Fear Free handling, she is passionate about felines and senior pet care. Learn more about Dr. Liu and her work at www.drjulieliu.com.
 

Course Overview

This one-hour course is for Fear Free Certified veterinarians considering relief work and relief vets considering Fear Free certification—both of which have an opportunity to positively impact the profession but also face unique challenges. Throughout this course, you will learn how to practice Fear Free as a relief vet and address different types of communication unique to this role. In addition to bringing Fear Free to general relief practice, we’ll also cover some of the situations you may encounter in emergency or shelter relief practice. You’ll also learn tips for identifying compassionate clinics who share your Fear Free philosophy.

This course contains nine short lessons:

  • Lesson 1: The Benefits of Being a Fear Free Relief Vet
  • Lesson 2: Challenges in Fear Free Relief Practice
  • Lesson 3: The Fear Free Relief Vet Toolkit
  • Lesson 4: How Self and Situational Awareness Support Fear Free
  • Lesson 5: How to Be a Fear Free Leader
  • Lesson 6: Communicating Fear Free
  • Lesson 7: Special Considerations for ER and Shelter Practice
  • Lesson 8: Passing on Fear Free After Your Shift
  • Lesson 9: How to Find Clinics with a Like-Minded Fear Free Culture
  • This course was written by Julie Liu, DVM, and Cindy Trice, DVM and is approved for 1 hour of RACE CE.

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    In part due to the excellent veterinary care that we deliver to our patients, we are presented with more geriatric cats and dogs now than we were 10 years ago. Most of us didn’t learn much about how to recognize and treat cognitive dysfunction syndrome (CDS) in dogs and cats. In this session, attendees will learn the most up to date prevention strategies and treatments of CDS in dogs and cats.

    In this webinar, Lisa Radosta, DVM, DACVB, will cover:

    1. The most common clinical signs of CDS
    2. The most commonly used treatments
    3. How non-medical treatments can be effective in the management of CDS patients

    About the Presenter

    Lisa Radosta, DVM, DACVB, graduated from the University of Florida College of Veterinary Medicine in 2000. After completing an internship in small animal medicine and surgery at Coral Springs Animal Hospital, she worked as a primary care veterinarian for two and a half years. She completed a three-year residency in behavioral medicine at the University of Pennsylvania in 2006 and passed the board examination later that year. During her residency, she received the Resident Research Award from the American College of Veterinary Behaviorists (ACVB) two years in a row.

    Dr. Radosta lectures nationally and internationally for veterinary professionals and pet owners and is the author of a number of textbook chapters and scientific research articles, She also co-authored “From Fearful to Fear Free: A Positive Program to Free Your Dog from Anxiety, Fears, and Phobias” with Dr. Marty Becker, Mikkel Becker, and Wailani Sung.

    She is the section editor for Advances in Small Animal Medicine and Surgery and served on the 2015 AAHA Canine and Feline Behavior Management Guidelines Task Force.

    This webinar is brought to you by our friends at Zoetis Petcare.

    Behavior Solutions for Declawed Cats with Dr. Lisa Radosta

    An important part of setting a declawed cat up for successful life at home is understanding and molding their behavior. Join Lisa Radosta, DVM, DACVB, a leader in behavior and a member of the Fear Free Advisory Team, as she discusses behavioral solutions for declawed cats to help reduce their fear, anxiety, and stress both at the clinic and at home.

    About the Presenter

    Lisa Radosta, DVM, DACVB, graduated from the University of Florida College of Veterinary Medicine in 2000. After completing an internship in small animal medicine and surgery at Coral Springs Animal Hospital, she worked as a primary care veterinarian for two and a half years. She completed a three-year residency in behavioral medicine at the University of Pennsylvania in 2006 and passed the board examination later that year. During her residency, she received the Resident Research Award from the American College of Veterinary Behaviorists (ACVB) two years in a row.

    Dr. Radosta lectures nationally and internationally for veterinary professionals and pet owners and is the author of a number of textbook chapters and scientific research articles, She also co-authored “From Fearful to Fear Free: A Positive Program to Free Your Dog from Anxiety, Fears, and Phobias” with Dr. Marty Becker, Mikkel Becker, and Wailani Sung.

    She is the section editor for Advances in Small Animal Medicine and Surgery and served on the 2015 AAHA Canine and Feline Behavior Management Guidelines Task Force.

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    Join world-renowned animal behaviorist, award-winning author, and subject of an Emmy-award winning film Temple Grandin, Ph.D., as she takes a tour of a veterinary hospital with Fear Free founder Dr. Marty Becker and describes what she sees, hears, and experiences. Learn through Dr. Grandin’s first-hand observations how we can better “see” things from animals’ perspectives and how even small improvements, exactly like the ones taught in Fear Free’s Veterinary Certification Program, can make a world of difference for cats and dogs.

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    Helping Our Feline Friends Feel Fear Free with Dr. Tony Buffington

    In this webinar, Tony Buffington, DVM, PhD, Clinical Professor UC Davis School of Veterinary Medicine, will remind participants “who cats are” and why they are particularly prone to fear in confined situations (i.e., hospitals, shelters, homes, etc.) After defining fear and stress in cats, Dr. Buffington will explain what people can do to minimize their fear, particularly in caged contexts—including how to enrich the cat’s surroundings, both inside and outside of the cage, and how to recognize both red and green flags by “asking” the cat. Resources for training staff and where to learn more about effective environmental enrichment for cats will also be provided.

    After this presentation, attendees will be able to:

    1. Recognize fear in confined cats
    2. Identify threats that may be causing the fear response
    3. Reduce fear by making changes in the cat’s environment

    Brought to you by our friends at Virox, makers of Rescue disinfectants

    Sandra ToneyHanover Veterinary Hospital in Cedar Lake, Indiana, has the distinction of being the first veterinary hospital in the Northwest Indiana region to become Fear Free Practice certified.

    Lindsay Pollard, FFCP (Veterinary), the hospital’s practice manager, says they began trying out some Fear Free methods after hearing about the concept. “A few of our staff members obtained individual certifications,” Pollard says. “After learning more and attending a few conferences where Fear Free was highlighted, we decided to go all the way.” Hanover Veterinary Hospital completed the program to become Fear Free certified in December 2018.

    When deciding to become a Fear Free Practice, the biggest difference has been in the way he interacts with the animals after certification, says owner Jeremiah Bieszczak, DVM. “The biggest change has been reading body language and emotional state/stress level and addressing that instead of pushing through it. We are better able to read pets and have more tools and knowledge to deal with these situations.”

    Many long-term clients are delighted with the constructive visits they’ve had with Fear Free, and new clients are thrilled with the difference between them and their previous veterinarian, says Pollard. Oftentimes they mention the care and compassion used when handling their pets. Pollard feels they’ve made much progress with many of the patients since becoming Fear Free certified.

    Fear Free helps all pets, but scared pets often need Fear Free much more to turn their lives around. Pollard has one patient in particular whom she’ll always remember and says Fear Free methods changed everything for this dog.

    The pet was a 14-year-old female shepherd mix. Sally, who has since passed away, desperately needed help. “Prior to our Fear Free certification, both Sally and her owner, Sara Zilz, dreaded coming to the vet. She also had some fear aggression and anxiety issues at home. She had a very high FAS and was fearful to the point of aggression,” says Pollard. “Our exams with her were very limited at best and it took several staff members to accomplish anything with her at all.”

    Sally had been adopted by Zilz from the humane society when she was 9 weeks old. She didn’t notice any problems with Sally until she took her for training and Sally became spooked by large signs in the store hanging over her head. Then she began showing other fearful behaviors. Zilz says Sally disliked smoke from the grill and even hated when someone blew out a candle. She started having food-guarding issues and was even afraid of shadows on walks.

    Zilz says she never thought about potential problems at the veterinarian’s office. “I had her boarded at Hanover. Dr. Bieszczak came out when I picked her up and nicely said something along the lines of ‘She needs to be medicated before we will take her for another boarding.’ This broke my heart. I did not realize she was that bad.”

    A veterinary technician named Bobbi became Sally’s best friend when she was boarded. Bobbi would sit in her kennel with her and try to get her to come out. She wouldn’t even go outside to potty.  Bobbi called Zilz several times and asked if she could do some things to help her. After that, Bobbi became Sally’s veterinary technician of choice.

    After they became Fear Free certified, Bieszczak started Sally on fluoxetine, an anti-depressant. This medication was a game-changer for her. Pollard says they also started doing happy visits with Sally, using treats with her during exams and treatment, and including calming pheromone products during her happy visits and exams/treatment.  They also tried to keep the same staff member working with her all the time, and kept detailed notes on her likes and triggers, constantly adapting their plan and approach to better suit Sally individually.

    “She made more progress with each happy visit and regular visit until eventually she was happy to see several staff members,” Pollard says, “and she was happy coming into the building. Sally would readily accept most treatment from us with the help of some treat distractors and enforcers.”

    “At one point, I felt everyone wanted to give up on Sally. Once I saw the Hanover Veterinary Hospital staff was not giving up on her, I knew things would be okay,” says Zilz.

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

    Sandra Toney has been writing about cats for over 25 years and is an award-winning member of Cat Writers Association and Dog Writers Association of America. She has written for many print and online magazines about cat health and behavior as well as authoring eight books. She lives in northern Indiana with her cat, Angel.
     
     
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    Dr. Marty BeckerOne of my first memories as a child was of my father, R.J. Becker, walking slowly back into our southern Idaho farmhouse, supported by my mother, Virginia. He slowly turned his head and looked at me and I didn’t see my dad.

    R.J. was a farmer, rancher, and dairyman. Why all three? He broke the back of our 160-acre farm to make farm payments, pay loans for seed and fertilizer, make repairs to aged farm equipment, and have enough for necessities and a few niceties. He was strong of build. There are black-and-white photos of my older brother, Bob Jr, and I holding onto his Popeye biceps as if they were chin-up bars. Athletic, he could make a baseball smoke, throw a football 50 yards, and do Herculean feats of lifting. He could carry a 100-pound haybale in each hand. Folks in our Castleford, Idaho, community nicknamed him Charles Atlas (look it up). But everyone also knew dad was weak. Weak of mind.

    They knew because there were many times when he was so depressed, he couldn’t get out of bed for months at a time. My brother and I milked the cows before and after school. Neighbors pitched in to help us harvest our crops and take our steers to market. Then the switch would flip, and Dad would be manic. Mania meant excessive drinking, philandering, gambling, wanting to sell the ranch, and constant threats of splitting up our family through divorce. I remember a pastor cautioning that Dad might take his life with depression but would ruin his life with mania.

    Back to when dad looked at me. When he turned his head, I could see where the hair had been cut short on the sides of his head and I could see circles burned into his scalp. I only learned later in life that he’d had shock treatments to try and jump-start his brain out of depression. To get out of the darkness, he was willing to fry his brain (this isn’t much of an exaggeration as the shock treatments of the day were not microdoses and were not done under anesthesia like they are today).

    The treatments turned Dad into sort of a zombie. No short-term memory, no joy, a 1000-yard stare. Manic depression is hereditary. Dad’s father, brother, and sister all committed suicide. So did Dad. I’ve had suicidal thoughts as well. My Mom’s genetics gave me a Mensa brain, photographic memory, creativity, and a can-do spirit. Mom’s seemed to define me until my 40s when the “dark clouds,” as Dad used to call them came rolling in.

    I’ve always felt that God has played favorites with me. I’ve been married for 43 years to the love of my life, Teresa. I have a great family. I love where I live, love what I do, and feel blessed. But I also have manic depression. My lows aren’t as low as Dad’s; I’ve never been bedridden or had to have shock treatments. Nor are my highs. No excessive drinking, gambling, or risky behavior; just a propensity to spend too much money or give too much money away. In some ways, mania has been a great blessing.

    Mania allows you to think that nothing is impossible, and creative ideas can come at you like a summer hailstorm. I know that Fear Free came out of mania. I knew it was something that had to be successful because it helped all stakeholders. The only “no” I knew was “no problem.”

    People in our community growing up were either heartbroken for R.J. Becker or scared of him. They didn’t want to see the strongman weak. They also didn’t want to see the strongman intoxicated and angry. Dad? He hated himself, even during the periods when he wasn’t depressed or manic. He was embarrassed. Felt weak and worthless. Even though through his efforts he put all four of his children through college; a physician, an attorney, and a veterinarian. His suffering and shame ended when he mouthed a shotgun just after his 80th birthday.

    I’ve taken a different route. Dad wouldn’t take his medication because he didn’t need it. I always take mine because I know I have to have it. Dad would only talk about his problems with a minister. I trust boarded psychologists and therapists. Dad covered up his mental illness. I share mine with the world because I know that I can help others be successful in treating their mental illness.

    I can’t tell you how many times I’ve had people say, “You have depression? You have everything!” Yes, I’ve got a successful relationship with God, Teresa, my family, my friends and neighbors. Yes, I’ve had a very successful career by all measures. Yes, I’ve seen the world (89 countries) and live in a beautiful log home on a drop-dead gorgeous horse ranch in the mountains of northern Idaho. Yes, I’m part of something that’s changing the world for animals, literally and figuratively, with Fear Free. I do have everything. Except for the right brain chemicals to be happy, healthy, and alive.

    In 2020, at age 66, I had my first serious suicidal thought. It was right at the start of COVID, and as I drove home from the airport in Spokane, Washington, to our ranch in Bonners Ferry, Idaho, I looked over at a frozen lake I’d driven by hundreds of times and thought, “I think I’ll just drive over the railroad tracks, onto the thin ice of the lake, and sink.” Blessedly, because of my faith, family, and the mental strength I’ve developed from therapy, my next action after this sinking feeling was to stop the pickup, call my doctor, and make an appointment.

    I hope that this message serves to let you know that if you’re depressed, anxious, or suffer any other mental health issue, you’re not alone. To let you know that there are dozens of crazy-happy people you know who are so sad and depressed inside. To paraphrase an old drug message, “Just Say Know.”

    If you are in the U.S. and suffer from depression or suicidal thoughts of any sort, please call the National Suicide Prevention Lifeline (800-273TALK800-273-8255suicidepreventionlifeline.org). It’s available 24 hours a day, seven days a week. No matter what problems you are dealing with, people on the other end of the line will help you find a reason to keep living. You can find resources outside the U.S. here.(https://www.drmartybecker.com/this-and-that/merry-christmas-and-support-for-those-who-arent-merry/)

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

    Dr. Marty Becker, “America’s Veterinarian,” is the founder of Fear Free, which works to prevent and alleviate fear, anxiety, and stress in pets by inspiring and educating the people who care for them. This includes veterinary and other pet professionals as well as pet parents through FearFreeHappyHomes.com and animal shelter and rescue group staff and volunteers through FearFreeShelters.com.