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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.

 

How Cats Say Ouch: Feline Pain Scoring & Treatment Made Easy

Cats don’t speak our language and cannot tell us when they are painful. It is up to us to learn how they express pain. Pain is an unpleasant emotional experience and we can gain insight into how our feline patients feel by looking for changes in behavior and facial expressions. Because a picture is worth a thousand words, this webinar will use images and videos to demonstrate how cats with acute pain behave. A scoring system that is suitable for clinical use will be discussed.

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.

Course Overview

In this module, we will review the signs and risk factors associated with infectious diseases in dogs and cats. We will cover how to minimize disease risk when training pets as well as how to properly disinfect and manage the training environment.

This module has been approved for 1.5 RACE CEU and 1 CEU from CCPDT, IAABC and KPA.

The one-hour course is only for trainers with renewal credits and costs 1 credit.

Lesson One: Common infectious diseases of dogs and cats

After completing this lesson, you will be able to:

  • Recognize possible signs for various types of infectious diseases in dogs and cats
  • List common modes of transmission

Lesson Two: Minimizing disease risk when training

At the end of this lesson, you will be able to:

  • Identify ways of minimizing the spread of disease in the training setting
  • Recognize the components of a clean environment and how to achieve it
  • Identify when to liaise with veterinary professionals over preventative health concerns

Postcards from the Cat: Highlights of Feline Communication & Natural Behavior

Learn about the facets of feline communication and behavior, as it relates to working and living with this truly fascinating species.

Dr. Marie Hopfensperger is one of two board-certified veterinary behaviorists in the state of Michigan. She graduated with honors from the College of Veterinary Medicine at Michigan State University in 2009. She was a small animal primary care veterinarian in northern Michigan before returning to academia to pursue her passion for behavior. She completed a non-traditional residency, spending time at North Carolina State University and Michigan State University. She has taught primary care and behavior medicine at Michigan State since 2013. Her areas of interest are behavioral medication, aggression, and feline inappropriate urination. Her household includes a human son, two cats, two dogs, two parakeets, and a rabbit, most of whom were adopted from area shelters.

By Linda Lombardi
Do clients have questions about how their cats and dogs get along – or if they can get along? Information from a recent study may help you advise them.

We use the phrase “fighting like cats and dogs” as if it’s a law of nature, but many households include both species and they get along fine – or at least tolerate one another. Still, cats and dogs have very different communication styles and social structures, so harmony isn’t a given. A recent study analyzed a survey of 748 owners mostly in the United Kingdom and the United States to see what factors contribute to having an amicable multi-species family.

What Makes a Good Relationship?

Overall, most owners reported that their pets seemed to get along well. On a scale of 1 to 10 where 1 was “can’t stand each other” and 10 was “close companions,” few ratings of 4 and below were found. Most relationships fell in the middle although there were a few “best buddy” scores of 9 or 10. Pets with the best relationships were reported to sometimes play together or groom one another, and some even shared food, toys, and beds.

The details suggest that if harmony is the goal, owners should pay special attention to the feline side of the relationship. While owners only rarely perceived their pets as seeming uncomfortable with one another, when they were, it was far more often the cat who was uneasy. Although pets were rarely reported to have injured each other, scuffles more often involved the cat threatening the dog than vice versa.

Age and Environment are Important

When researchers looked at factors found to correlate with better relationships, what was most important was the cat’s comfort level with the dog. The best relationships were those that reported a low frequency of incidents in which the cat appeared uncomfortable. Frequency of the dog’s discomfort was less crucial. Of the demographic factors, the most important was that the cat had been introduced to the dog at a young age – the dog’s age was less important.

Cats who lived indoors full time had better relationships (letting cats go outdoors is still common in the UK compared to the US). This suggests that the more time cats spend with others in the household, the more likely they are to eventually develop good relationships.

Dealing with Conflict

It’s important to note that the study was based on owner observations, not those of trained behavior experts.

“It would be a good follow-up study to see whether behaviorists’ views of how well they’re getting on match up with owners’ views,” says Zazie Todd, Ph.D., author of the website Companion Animal Psychology and the Psychology Today blog Fellow Creatures. “Some signs of stress, like avoiding being in the same room, people might be a bit more likely to miss, but we haven’t assessed that directly so we can’t be sure.”

Since people may not notice subtle signs of conflict and discomfort, dealing with the more obvious ones is important, even if they aren’t ending in bloodshed. Dogs chasing cats is sometimes seen as inevitable, so you may need to explain to clients that it is possible to train a dog not to pester a cat using positive methods.

Appropriate expectations are also important. “It does sometimes happen that a cat and a dog become good friends, but I think one of the striking things from the study is that the relationships mostly weren’t that close,” says Todd. Owners should see lack of conflict as a success, even if the pets don’t seem to be best buddies.

Along with training the dog, though, it’s important to give the cat some control. Make sure owners are providing high places and secluded spots where the dog can’t follow and feeding the cat in an area inaccessible to the dog. Try to see things from the feline point of view – what can be done to help the cat avoid conflict in the first place? Says Todd, “You have to think about helping the cat not to be stressed and to feel safe, as well as training the dog how to behave.”

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

Every pet’s final visit to the veterinarian should be as Fear Free as the first. In this one-hour module, you will learn how to utilize pre-planning to create a meaningful and low-stress experience for pet and owner. It will cover uses of pre-euthanasia sedation and anesthesia to give the pet a gentle euthanasia and the benefits and downsides of different euthanasia techniques. Also explored will be the dangers of compassion fatigue and how to prevent or alleviate it.

This course was written by Kathleen Cooney, DVM, MS, CHPV, founder of the Companion Animal Euthanasia Training Academy.

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By Linda Lombardi
Introducing Fear Free techniques to colleagues who aren’t familiar with them or who may be resistant to change can be daunting, but Fear Free principles apply to people as well as pets. Here’s how they can help.

Tabitha Kucera, a veterinary technician, has learned a lot from her experiences teaching Fear Free to other veterinary professionals, and maybe the biggest lesson is the importance of using the same principles on people as you do on animals.

“Positive reinforcement encourages initiative and creativity, it forgives mistakes, it creates enthusiastic learners and accelerates learning,” she says. “It’s the same for people.”

Build a Constructive Culture

The benefits should seem obvious once you’ve worked with animals that way. But applying these methods doesn’t always come naturally, she says. She recalls a class she attended at the Karen Pryor Academy. Most of the students were trainers, along with Kucera and two other vet techs. At one point, each person did an exercise in front of the class and then fellow students were asked to talk about what they thought had been done well.

“For the techs it was harder than for the dog trainers, and that was an epiphany for us,” she said. “We talked about it later—it’s that we’re not used to getting constructive feedback.”

Not only was it more difficult to give positive comments, it was also frustrating at first to get them.

“We were like, why don’t you tell me what I did wrong? Just tell me what I did wrong so I can fix it.”

But if you’ve studied behavior, you know all the reasons why “Just tell them when they’re wrong” is a bad way to train. One is that just saying “no” to the wrong behavior doesn’t tell the learner what the right behavior is. If you want staff to use less stressful techniques, saying “Don’t do this,” while well-meaning, doesn’t communicate the desired alternative.

“If you’re used to scruffing, I can’t just tell you not to scruff, which is what I see a lot of,” she says. “I hear a lot of ‘less is more,’ but what does that mean? You need to define the behavior you want.”

Say No to No

Maybe even more important is the effect of all those “nos” on the recipient.

“With positive reinforcement, the biggest difference is we focus on the good,” she says. “The way some other training techniques work—and the way people often work with each other—is we focus on the negative: I’m going to tell you what you did wrong and completely ignore all the good stuff you did. That creates an environment where people are afraid to make mistakes and afraid to ask questions.”

Being told that you’re wrong is essentially a form of punishment, and learners who are afraid to make mistakes because of repeated punishment soon shut down and are afraid to try anything. That makes it impossible to learn something new. And imagine the frustration of doing the same thing for years and then being told it’s wrong. We wouldn’t do that to an animal, but we often don’t realize we’re doing exactly that to our fellow humans.

“You can’t punish them when this is how they were taught,” she says. “I say, ‘You’re not wrong in what you’re doing, but fortunately medicine progresses, and we’ve learned a lot of great new ways to handle animals that make it easier for us and for them.’”

Be careful, too, of how interactions can convey the message “You’re wrong” without saying exactly that out loud. “You can’t run over and say, ‘Let me take over,’ because then you just insulted that person,” she says. “When I see things that are concerning, I’d just say, ‘Hey, you guys need some help?’”

Show, Don’t Tell

Simply using the techniques and letting people see what happens can be the best way to start. “First thing first, wherever I am, I use these skills, and people notice,” Kucera says. “Soon they’re coming to me and asking if they can learn this.”

It’s important to remember that trying something new can be anxiety-provoking, especially if you’re invested in and comfortable with techniques you’ve been using for years. Make it clear that it’s okay to try and fail. “I also don’t say ‘It’s do this or die,’” she says. “Try it one time, and if it doesn’t work, we’ll do it the way that you’re comfortable.”

Another thing that we know for our animals but often forget for our fellow humans is that different reinforcers work for different individuals. When she’s trying to persuade people of the benefits of Fear Free, Kucera says, everyone cares about decreasing fear and stress in the animals, but other motivators can differ by role. For a practice owner, she’ll talk about the business advantages, while for a tech who restrains animals, she’ll say, “You’re in your 30s; you need to go home and not be in pain every day.”

Set Realistic Goals

When Kucera talks to people who are excited by her presentations, she often has to talk them down a bit. “I say, ‘I love your enthusiasm, but I don’t want you to go back to your shelter or hospital and say we have to do all this right now,’” she says. “Because I did that in the past, and it shuts people down.”

Remember that new skills need practice. “I set realistic expectations for people: I don’t expect you to do this perfectly tomorrow,” she says. And start slow, just like you would with a pet. “Pick one or two things for your practice or shelter and start there, because from there it’s going to spread like wildfire but not if you don’t set your staff up for success.”

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

By Amy Shojai, CABC, Fear Free Certified® Professional
Pet owners may object to having their animals “taken to the back.” Here’s what to consider when deciding whether it’s necessary.

Jill Breitner, a former vet tech and Fear Free certified professional and dog trainer, frequently writes about pet issues. She has also trained vet techs on low-stress handling techniques. When her 8.5-pound dog Timber recently ate a guest’s dark chocolate candy bar, they hurried to the emergency clinic.

As vitals were taken, Breitner used Fear Free techniques to restrain Timber and even talked with the veterinarian about the program. “I asked to be in the room for the injection to induce vomiting,” Breitner says. The vet pushed to take Timber “to the back” for immediate treatment instead, arguing that Breitner might have to wait an hour for treatment if she insisted on being present. “That made no sense to me,” Breitner says.

After she pressed for an explanation, the upset vet walked out. Anxious to get Timber the care she needed, Breitner threatened to write about her bad experience. “Within three minutes, the veterinarian and a tech were back in the exam room with the drug injection to induce vomiting,” Breitner says. Within two minutes, Timber brought up the chocolate, wrapper and all.

Why Pet Parents Object

There may be good reasons for treating patients “in the back” but many pet parents object and have valid concerns. For Fear Free practices, it is incumbent to acknowledge these concerns, provide explanations, and perhaps take a closer look at ways to reduce fear, anxiety, and stress in both pets and pet parents.

Pets are calmer. Many veterinarians believe pets act calmer without the owner present. In some instances, this is true. Yowling cats fall silent, and struggling pups go limp. Others argue, however, that certain pets seem calm only because they’ve shut down out of fear. Motionless doesn’t equal fear free.

At the same time, very protective or sensitive dogs may become more upset by their owner’s emotional state. Veterinarians must be able to evaluate each individual situation.

Restraint issues. It’s true that not all pet parents know how to safely and effectively restrain pets in a stress-free manner. There may also be liability issues if someone is bitten.

Breitner says, “It would be appropriate in an emergency, life or death situation needing immediate attention. Still parents can ask that the dog be sedated in their arms, before they bring them to the back, even at this time of emergency. Pets feel safer and less fearful with their parents.”

When concerned about proper restraint, pet parents can still be present perhaps by holding a lickable treat while the staff restrains and performs the treatment. Teach clients how to distract, gently restrain, and restrain animals for less stressful future visits for all involved.

Staff discomfort. Having the pet parent present may raise the practitioner’s FAS level. It may take longer to perform a blood draw, for example, when the owner inadvertently interferes. Maybe the vet worries about getting the perfect needle stick with a non-professional audience. As a former vet tech, I’ve assisted in many surgical procedures, but it’s different when the patient is your own animal. Very few clients have the temperament to witness surgery on their own pets, but may still be eager to be with them up until sedation takes effect.

Equipment access. The standard clinic design can make the back a much more convenient location for treatment. Staff has ready access to proper lighting, sinks, supplies, emergency equipment, and more.

Exam rooms that are tiny and awkward to maneuver in can make large dogs feel trapped. Open spaces of “the back” reduce this stress. There may also be insurance concerns that prevent non-clinic personnel from entering certain areas. Radiographs, for instance, require protective gear and exposure data records.

Habit. The trend to take pets to the back appears to be a uniquely American veterinary habit. If you’ve always done it that way, it’s time to explore other options. In fact, some pets do much better with their owners present. Cats and dogs may be given vaccines while on a pet parent’s lap as a treat is offered, or even in the waiting room in certain instances.

How to Make it Work

Communication is key, as is mutual respect. Pet parents have become more educated and are learning to be better advocates, Breitner says. Nobody wants to resort to threats to make themselves heard, and it’s unfortunate when veterinarians feel put on the defensive. Find out what clients want and expect.

Ask if a cat or dog does better or worse with them present. Is the client phobic about seeing needles or blood, or so upset they’re not helping the situation? Does someone have special skills—a dog trainer, perhaps? Are they familiar with low-stress handling?

Breitner agrees that communication goes both ways. She suggests that pet parents plan for time to wait or offer to reschedule during a less busy time to make it easier to stay in the room with the animal.

When your professional opinion means taking the pet “to the back” offers better treatment options and less stress, explain why. Think about offering the option to come to the back with the animal.

“When vets listen better, they can communicate better,” Breitner says. “This relationship of trust between parent, pet, and vet goes a long way toward ensuring that their patients and clients feel safe while in the clinic.”

Every pet parent and animal is different. Being inflexible about your procedures may actually increase FAS in the animal and the owners—and you. It may also hurt your practice when clients choose to stay with their animals and walk away from your practice.

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