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Vaccinations are critical for a pet’s health and safety, but some pet parents may be hesitant to agree with your vaccine recommendations. Pet owners may have needle phobias, be concerned about over-vaccination, or remember past visits when their pets became fearful or stressed about vaccination. Unfortunately, these reservations can mean missed appointments and unprotected pets.Fear Free Certified® Professionals now have a new tool in their arsenal to reduce fear, anxiety, and stress (FAS) surrounding vaccination visits: highly purified, low-volume vaccines from Elanco’s TruCan™ and TruFel™ Ultra line. When vaccinations are more comfortable and less stressful for pets, pet parents are more likely to follow your recommendations and keep their pet’s vaccines up to date.

Fear Free® vaccination techniques

Vaccines are one of the most common services performed in veterinary clinics, which creates daily opportunities to improve the process. Since vaccines are given as subcutaneous injections, we can apply many standard Fear Free principles to reduce FAS. Considerate approach, gentle control, touch gradient, and—of course—a steady stream of treats are great ways to reduce the chances of your patient noticing or reacting to the injection. Allowing vaccines to warm to room temperature, using small-gauge needles, and always changing the needle after pulling up the vaccine are additional techniques you can use to reduce discomfort during injections.

Pets with long-standing needle sensitivities may require pre-visit pharmaceuticals (PVPs) or in-clinic sedation to update vital core vaccines when time is limited. Otherwise, implementing a desensitization and counterconditioning program at home can help pets experiencing fear learn to accept injections.

The Elanco Ultra vaccine technology

Once pets reach a point of vaccine acceptance and cooperation, the last thing you want to do is administer a painful injection that causes them to backslide. Choosing the right vaccines can significantly impact a pet’s reaction to the injection and the likelihood of a successful Fear Free visit. Elanco’s TruCan™ and TruFel™ Ultra vaccines were designed specifically to create a better vaccination experience.

The Ultra vaccine line provides a smaller vaccine volume (0.5 mL) and up to 75% fewer proteins, attributed to Elanco’s PureFil™ technology. Unique combinations, including FVRCP plus feline leukemia for cats (TruFel™ Ultra HC2P-FeLV) and DAP plus leptospirosis 4-way (TruCan™ Ultra DAP + L4) for dogs, ensure that pets are protected with fewer needle sticks and less stress.

Talking points for clients

Vaccine conversations can be sensitive. Vaccine hesitancy isn’t new, but a great deal of misinformation about vaccines during the pandemic may leave lingering doubts in some pet owners’ minds. Clients may also worry about vaccinating their pet too much, and causing pain, discomfort, or a negative reaction.

Elanco vaccines can help you compassionately address client concerns. When a client demonstrates vaccine hesitancy, use the following points to explain how your vaccines support a Fear Free visit and lifestyle.

  • Possible reduced reaction risk — Ultra purification reduces proteins and debris, which may reduce the chance of a negative reaction.
  • Comfortable injections — 0.5mL vaccines, which are often used in human medicine, are half the volume of traditional vaccines and allow for faster administration with a smaller needle.
  • Fewer injections —  A variety of vaccine combinations reduces the number of injections required to achieve complete protection, which means fewer needle sticks.

Together with a Fear Free approach, Elanco Ultra vaccines can help transform the vaccination experience and reduce FAS for pets and their families. Learn more about Elanco’s innovative products here, or visit our Fear Free website to access our continuously updated member resources.

The label contains complete use information, including cautions and warnings. Always read, understand, and follow the label, and use directions.

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

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Brought to you by our friends at Elanco.

Sandra Toney

When she was 12 years old, Karina Salvo, DVM, CTPEP, CVFT, CVMMP, volunteered to work for a one-doctor practice. Cleaning cages, doing laundry, and walking dogs led to watching her first surgeries. From that point, she knew that her career path would lead to veterinary school.

But one thing she and the veterinarians she grew up working for—and later, with—didn’t learn was how to make exams easier on pets. When she became aware of Fear Free®, though, it made sense to her that veterinary visits should be less frightening and more fun for patients.—not to mention for veterinarians and technicians themselves.

“The one thing that I noticed in each and every practice was the frequency in using force to hold a patient,” says Salvo, now an Elite Fear Free Certified® DVM who also has certifications as a palliative and end-of-life practitioner (CTPEP) and in branches of Traditional Chinese Medicine (CVFT and CVMMP). “Some of the staff wrestled what I thought were highly aggressive dogs down to the ground in order to give a single vaccine or draw blood. The end result was someone got hurt, scratched, urine and feces everywhere, and a dog that was left splayed out and panting on the floor in exhaustion or cowering in the corner. This was the ambience of the veterinary field I grew up in.”

As she learned more from Fear Free, she found that in-clinic exams became easier.

Now she owns her own practice, AcuVetDoc Veterinary Reproduction & Animal Care Wellness Clinic, in Royal Palm Beach, Florida, where she treats not only pets but also wildlife. That allows her to see only one patient at a time.

“I can practice 100 percent the way I choose to. I intentionally do not have a receptionist or a technician,” Salvo says. “Patients are scheduled on the hour instead of every 15 minutes. This allows me to work one on one with the patient and the owner. My ‘team’ in my practice is the owner, myself, and the patient. By working together, all of us can better understand the patient and the medicine. Practicing this way has allowed me to build trust in my patients as well as owners because both are comfortable.”

Salvo greets clients and patients at the door so she can watch how the animal walks into the building. If owners have given permission beforehand, treats are on the carpeted floor as they enter.

Animals who have previously had poor experiences at veterinary clinics may be directed into an exam room that resembles a living room—with carpet, a bookcase, leather sofa, chair, and hidden treats. While Salvo sits on the floor, pockets filled with treats, and talks to the owner, patients can explore, approaching when they’re comfortable. If they need more time, Salvo may simply hand out treats during the visit, holding off on an exam. She discusses this possibility with clients beforehand so that they’re aware the first interaction may be a “meet-and-greet,” with the exam portion on a subsequent visit.

Many of her patients enjoy “playtime,” a rewarding exam in which Salvo uses tasty treats to get patients to move on their own but in a fashion that allows her to examine them. For instance, she might get them to sit or turn their head so she can look inside ears or examine the mouth.

One patient who stands out in her memory was a 12-week-old Cockapoo puppy whose first experience at a veterinary clinic had involved being held on an exam table while he screamed, attempted to bite, and urinated and defecated. The veterinarian told the owners that their puppy had mental health issues and should be returned to the breeder. This time they were hoping for a better experience.

Salvo met the owners outdoors, where she had set up chairs and some treats. They sat down, talked about how the puppy was doing at home, and handed out treats to the puppy. Salvo assigned homework: to find tasty, high-value treats that could be dropped on the floor any time visitors came to the home and to be used as rewards during training. She suggested walking the puppy in areas far enough away from people that strangers wouldn’t want to pet the dog but close enough that he could see people, other dogs, and vehicles such as carts. Offering high-value treats during these walks would contribute to forming a positive association with the experience and a connection with the owners.

At the second visit a few days later, Salvo again met the owners outside and had tasty treats already on the ground for her new friend to gobble up. Eventually, the puppy approached her and she was able to perform an exam and give an oral vaccine as the puppy sat next to the clients and received treats.

“On subsequent visits, we sat next to each other outside, and he came and laid on my lap and became more interactive with me and less afraid of the environment,” says Salvo. “With a cheese and Cheerio trail to lead him inside, we made it to the scale and an exam room!”

Three months after that first visit, the puppy frequents farm fairs, Home Depot, and PetSmart, and comes running into the clinic to greet Salvo.

“This is an amazing story with very patient owners who were willing to take their time to understand and provide their dog with what he specifically needed when he needed it, redirection to something positive, protection from being thrown into the middle of a chaotic situation, and to slow introduction to the world around him,” she says.

Fear Free continues to make a difference in her practice. “The best feeling is when the owners are ready to leave and the patient stays behind and makes eye contact with me waiting for another fun treat,” Salvo says, “or when they return and they are pulling their owner into the building.”

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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Kim Campbell Thornton
Reducing fear, anxiety, and stress during visits and procedures takes time, teamwork, and sometimes a little experimentation. Here are three success stories shared by a veterinarian, trainer, and owner.

Tyson’s Turnaround

Tyson is a 12-year-old Schnauzer mix who first came to us last year for a wellness visit. The owner told us that his previous clinic had to muzzle him, and he was handled somewhat roughly. She wanted to get away from that. On his first visit we just got a feel for his comfort level. He barked and growled at us in the room but took treats willingly. He allowed an otoscopic exam but was tense, and when the stethoscope was introduced, he actively tried to bite. Approaching him with a muzzle sent him into a panic. We sent some Trazodone home with him that day for future visits and discussed doing a set of behavioral visits to help desensitize him to handling and instruments.
Tyson returned five months later for scheduled vaccinations. With Trazodone on board he was still on edge but performed tricks for us and approached us for treats. He allowed me to auscult him while he had treats to eat. This was great progress! We still decided to sedate for the remainder of his procedures to avoid backtracking on his progress.
Over the course of the next year Tyson’s owner took her own Fear Free steps at home, buying her own grooming table and clipping him herself. She was patient with him and even learned to Dremel his nails.
When it was nearly time for Tyson’s annual exam she set up behavioral sessions with us, so we could work on desensitization. We discovered Trazodone made him a little grumpy at home, so we switched to gabapentin, which worked well for him. On his first behavioral visit the difference was obvious. He came right up to staff for treats, did all of his tricks, and allowed us to touch him everywhere. We could feel his belly, touch his ears and legs, and look in his mouth. We started doing mock injections with a capped needle with no reaction. The only thing that still triggered him was obvious restraint.
For his annual wellness visit, Tyson allowed a full exam. We applied topical lidocaine at his injection sites and where we planned to draw blood for a heartworm test. We put a donut collar on Tyson prior to his vaccines as a precaution, and asked the owner to hold his harness to keep him steady (he was really into the treats and a bit wiggly). He did not react to his vaccinations and even held still long enough for us to get a blood draw from his back leg.
Tyson made a huge turnaround, and I think the owner’s willingness to do her part played a big role. It has been great to see the difference Fear Free techniques have made!

Susan Sappington, DVM, Rock Bridge Animal Hospital, Columbia, Missouri

 

 

Elke’s Excellent Experience

Elke had her annual veterinary checkup yesterday, and by doing some simple things we were able to make her visit less stressful and even a bit enjoyable. Our veterinarian is part of a Fear Free practice (Thank you, Animal Hospital of North Asheville) and embraces a cooperative care approach that allows animals to have choices and dictate the pace at which we move through the visit.

In the photo, you see that there is a comfortable mat for Elke to use. Having a soft spot to rest on is so much nicer for dogs than just having the cold, hard floor. She was a bit nervous, so we created a treat search for her by hiding treats in the blanket and Kong. It is one of her favorite things to do, and sniffing is an activity that we know helps calm dogs. During the actual exam, all of us (veterinarian, veterinary technician, and myself) gave her treats each time a new body part was examined. While Elke does not love going to the veterinarian’s office, with cooperative care and the Fear Free method she was able to relax and have a calm visit.

Joann Rechtine, CPDT-KA, MS, MPH, RN, The Loose Leash Academy, Black Mountain, North Carolina

Roger’s Routine

We were beside ourselves on how to handle taking Roger to the vet. We put him through basic obedience and advanced obedience classes twice to learn manners and how to act appropriately. He has done great in our home and in our families’ homes as we know how to handle his anxiety. In our vet’s office, though, Roger would go crazy as his anxiety shot through the roof from all the smells and people. Thanks to the Fear Free program and team at Frey Pet Hospital, Roger can feel safer and happier going to the vet now. We are thankful for Fear Free Way!

Nicole Schroeder, Cedar Rapids, Iowa

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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Kim Campbell Thornton
For Fear Free Certified veterinary professionals, job one is reducing fear, anxiety, and stress during visits and procedures. Here are three successful approaches to making the veterinary clinic a safe and happy space for pets!

Slaying Fiona’s Fear

When Fiona first came to us at Gamble Pet Clinic, an examination without a fearful reaction from her was impossible. An attack by another dog at a young age had caused her to be anxious and nervous ever since. She had been muzzled at every veterinary clinic since her attack until coming to Gamble Pet Clinic. She was fearful initially, trying to nip at the doctor and staff when they attempted to examine her.

We began working with Fiona in an Elizabethan collar. When a pet is appropriately acclimated to it, an Elizabethan collar can be a great alternative to a muzzle because it allows the dog’s head, nose, and mouth to move naturally and easily while providing a barrier that keeps the patient and staff safe and comfortable. If used appropriately and only in a positive manner from the start, it can be a great tool for Fear Free work on anxious or stressed patients like Fiona. In this way, Dr. Gamble is able to examine Fiona while she is distracted by treats like cheese and pretzel sticks. Both Dr. Gamble and Samantha, her assistant, are Fear Free Certified, making the whole process go smoothly.

Fiona’s Fear Free journey continued with regular Victory Visits to the clinic where everyone worked slowly and calmly with her to get her used to the environment and build her trust. Gradually, her anxiety about coming to the clinic decreased and she started to see it as a positive experience, looking forward to the treats and trusting the doctor enough to begin letting her touch and examine her. Every time she comes in, we use Fear Free techniques that build on the foundation we have laid. Fiona is still working on her Fear Free process and we are working to gain her full trust. We are so proud of the amazing strides she has made with us so far in the Fear Free setting!

Emily Andrade, CVA, Fear Free Level 3 Certified, Gamble Pet Clinic, Fort Collins, Colorado

 

Networking News

I took the Fear Free course. It was interesting and useful. I’m now working with two local veterinary offices who found me through the Fear Free website.

Getting the Fear Free certificate increased business this year more than any other marketing I’ve done. It seems that more veterinarians in my area are implementing Fear Free concepts in their practices and seeking trainers to partner with.

Delores Carter, MA, KPA CTP, UW-AAB, The Learning Dog Academy, Brighton, Michigan

A Blood Draw for Sal

Sal was brought to us to establish why he had been having chronic vomiting and diarrhea. When I approached him in the lobby, he immediately pinned his ears and retreated under the couch. We brought him into an exam room, and he warmed up a bit but was still wary. Mom and Dad mentioned that in the past at other clinics he was taken to “the back” for vaccines and they could hear him vocalizing from the exam room.

We needed to sedate him to further work up his history of vomiting and diarrhea. Since this would take a while, Mom and Dad went out for lunch and we kept Sal in our treatment area, where he became noticeably more anxious with the absence of his family. We used desensitization and counterconditioning techniques with small pieces of Braunschweiger and he eventually did not even notice when he was being touched along his epaxial muscles. He did not vocalize or notice whatsoever when we gave him his IM sedation. His abdominal ultrasound was normal, which was great for him but meant that we needed to further work up his symptoms. The veterinarian on the case recommended that he come in for an ACTH stimulation test.

The technician working with him mentioned that we needed to provide Sal with some pre-visit medications so it would be less stressful for him. This specific test measures cortisol and if Sal was stressed it could affect the test results. The veterinarian consulted our behavior department about what medications he could come in on that would not affect the test results.

Because Sal vomited during a trial of Trazodone at home, he came in on gabapentin alone. Because this didn’t go well, we called it a day and decided to attempt a different medication combination. The next time Sal received gabapentin, Trazodone, and Cerenia 30 minutes prior to the appointment time. This time when we entered the room, Sal was significantly sleepier and more relaxed. We offered him chicken baby food and he loved it. We placed him on the table, Mom and Dad talked to him and fed him while one technician occluded his vein, and the other technician performed the blood draw and administered the medication. Sal ate chicken baby food throughout the entire process. Then Mom and Dad waited patiently in the exam room with Sal until it was time to draw the 1-hour post sample. We repeated the same process. Sal was a rock star and ate throughout the blood draw. Now we have a set protocol for when he comes in for workups or annual visits, and he stays with mom and dad for any procedure possible.

Maria Marano, RVT, Fear Free Certified, Community Practice, The Ohio State University Veterinary Medical Center, Columbus, Ohio

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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Kim Campbell Thornton
For humans, overcoming fear, or at least learning to deal with it, takes time and practice. That’s even more true for pets, because we can’t communicate that veterinary exams and procedures will help them to feel better or stay healthy. Fortunately, Fear Free techniques can help to send the message to pets that they don’t need to be afraid, and Fear Free education can help humans better understand their animals’ fears and needs.

Happy Hunter

Hunter, a 2-year-old mixed breed, enjoys looking out the windows in the lobby of our clinic. By starting his visit there, asking his mom questions and listening to his heart and lungs, we can make sure he is comfortable enough to continue his exam in the exam room. But it was a different story when he first came in almost two years ago. Because of a previous frightening experience at another clinic, he was wary of us and the handling and procedures being done. He would bare his teeth, growl, and even try to nip at Dr. Gamble’s hands when she tried to touch him. Through consistent Victory Visits, pre-visit training and medications, and desensitization to areas where vaccines and other needle pokes are typically given, we are now able to provide him and his owner with a comfortable and rewarding experience every time he is in. Now he sits patiently and lets Dr. Gamble examine him—with the help of some cheese and marshmallows, not to mention smears of his favorite treats, peanut butter and canned food. During Hunter’s victory visits, we commonly work on the desensitization process without actually following through with an injection. “Happy visits, along with some training classes and behavior work on our part, have made a world of difference to Hunter,” writes his owner, Beth. “Hunter is now excited to see Emily, Heather, Dr. Gamble, and many other staff members as soon as he walks through the front door. He is a much happier dog at the vet thanks to Gamble Pet Clinic’s Fear Free work.”

Emily Andrade, CVA, Fear Free Level 3 Certified, Gamble Pet Clinic, Fort Collins, Colorado

 

Fear Free Education Win

Recently, there was an event called Woof Fest held during a downtown pub crawl. Our clinic sponsored “Dog Trivia,” and I focused the questions on a pet’s emotional health, such as “Is this dog’s body language calm or stressed?” and “A dog wagging their tail is always happy. True or False?” Hundreds of people played our trivia game, and it was such a rewarding experience to educate the public on the topic.

Natalie Gruchow, CVPM, Animal Health Clinic, Fargo, North Dakota

Sammy’s Success

Sammy had grown up in a hoarding situation and was fearful at the time of his adoption. Unless he was sedated, the six-year-old dog would bark and lunge or even eliminate from fear during veterinary visits. A prescription for an SSRI helped and the team tried additional medications at different doses, but Sammy would push through the medications and continue to show fear aggression. At first, he was unable to generalize that humans weren’t scary, so it was important for him to see the same person at the hospital on each visit. That wasn’t easy, but eventually the right person came along who was able to take the time and effort for Sammy to become comfortable. It took six months of Victory Visits spent eating chicken, practicing chin rests and lying on his side, and undergoing desensitization to having his leg shaved, the scent of alcohol, application of a topical product for numbness, and the pretend poke of a needle, but in July Sammy underwent his first successful blood draw. Now we are routinely doing happy visits to keep the momentum going.

Beth Friedman, Canine Companion Consulting, Fort Collins, Colorado

Down Under Wonder

Bruno is a goofy 8-year-old Bull Arab Cross (a type of Australian working dog). He has always been very friendly at the vet, but once pats stopped and the examination started, he would become suspicious and communicate his discomfort with aggressive behavior. Fortunately, Bruno’s owner has been committed to training. They had private training sessions and attended a Ready, Vet, Go! course. As part of Bruno’s training we incorporated a lot of owner education on subtle body language changes, as well as start and stop cues for Bruno. Bruno was trained with a sustained chin target, using a towel on a chair, as his start cue, meaning “I’m ready for procedure.” If he lifted his head, we immediately stopped the procedure. Bruno was also trained to be comfortable with a Baskerville Ultra Muzzle. We spent time teaching Bruno specific body parts such as tail, ear, and scruff, so that he knew what was about to happen. Over time we were able to pair several good vet clinic experiences (training on a Sunday in clinic) with lots of his fave foods, body scratches, and games. We also introduced veterinary equipment, including syringes, blunt needle, alcohol swabs, and stethoscope. When we weren’t actively training, he was taught a default “chill” behavior and rewarded for relaxed head, tail, and big breaths. He had several socialization visits at the vet, and when he required surgery for a lump removal we did  practice runs with pre-visit medication to see what would work best for him. A planned course of action on admission saw him anesthetized as soon as possible to limit buildup of anxiety. Since then Bruno has had further training sessions and socializing vet visits. Recently he had his vaccinations and we were able to give his injection without any restraint by utilizing his muzzle and target training. Bruno is a great example of what teamwork can achieve when you have a committed owner and a Fear Free-trained vet and trainer, not to mention a goofy, food-motivated dog!

Jacqui Johnston, Holland Park and Carina Vet Clinics and Trish Allan, All Pets Education and Training, Brisbane, Australia

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.