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Linda LombardiSome aspects of the experience of visiting the veterinarian are generally recognized as stressful to pets, such as strange noises, unfamiliar people and animals, and being handled in uncomfortable ways. Less clear – and now even more relevant in the wake of the pandemic – is a question asked by a recent study: how are pets affected by whether or not their owner is present during the exam?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Linda Lombardi writes about the animals that share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, coauthored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.
Linda LombardiThe veterinary clinic or hospital can be a stressful place for cats, full of strangers and strange noises and sights. A recent study suggests a simple and inexpensive way to reduce this stress by use of plexiglass sheets hung over the front of the cage.

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

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

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

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

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

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

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

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

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

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

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

Linda Lombardi writes about the animals that share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.