Covid Update 10/8/2020 : Currently to protect staff from transmission of Covid, it is necessary to separate dogs from their pet parents for some care until this epidemic is over. Many veterinary clinics have come up with great ways to reduce stress during this time including having the pet parent on the other side of a window during weighing, doing some procedures outside with social distancing, and allowing the pet parent to be “present” virtually using live video platforms. I hope this epidemic will soon be over so that pet parents can return to being present during routine procedures.
Some changes clinic implemented would be great to continue using in the future including :
- Utilizing the parking lot for patients and their pet parents waiting for appointment times.
- Alternatives to making payments at the front desk.
- Doing some basic care like vaccinations in the parking lot.
- Use of video to allow clients to see how their pets did when separation is necessary and to start the conversation about ways the pet parent can help their pets cope better in the future.
Pet parents are what psychologists and animal behaviorists call a stable attachment base for their pets. Our presence reassures our animals and helps them handle scary situations with less stress and fewer negative psychological outcomes [1,2,3].
When I adopted Astrid after a 10 year break from dogs, I was surprised by a veterinary practice trend that I hadn’t encountered before. The technician wanted to take Astrid to the back for her blood draw and vaccinations. With my previous pets I had always been present for these routine procedures. Since then I have found “taking animals to the back” for routine procedures to be standard practice at 3 out of 4 clinics I have visited. This may seem like an insignificant change to make the technicians job easier but it can actually have far reaching consequences.
The “stability effect” has been studied in children and in dogs. Studies have shown that dogs are anticipating negative experiences in veterinary clinics and are coming in stressed, leading to increased heart rate, breathing, cortisol levels, hiding of pain, and increased risk of the dog being less cooperative and more likely to bite [3,4, 5].
Unfortunately, one of the reasons clinics take dogs to the back is that some dogs seem to behave “better” when away from their owners. But in many cases, this “good behavior” is because the dog does not feel secure enough to express fear and anxiety when away from their owner and shuts down.
Why do I care so much about being with my pet for these procedures?
- I want the least stressful and most positive visit for my pet as possible. Being present and supportive is part of how I can achieve this.
- I want to know how well my dog is cooperating with veterinary staff and what specific components are stressing her out. I can use training to improve any sticking points, which will make the veterinary staff’s job easier. I find when veterinary staff take dogs to the back they feel compelled to comfort the owner by saying “She did great” instead of giving me an accurate assessment.
- My dog is dog reactive and the fewer chances for her to cross paths with other dogs in the clinic the lower her stress level will be. Many veterinary staff members may not have the skills to manage her in the clinic without a reactive episode, which would set back our training.
- Veterinary staff often feel compelled to “Get the job done” because some pet parents may expect that. However, if my dog is giving veterinary staff trouble and is so stressed that she needs more than moderate restraint, I want to be present to offer to bring her back another day. Bringing her back after some training and perhaps with drugs on board could make the veterinary staff’s job easier.
- I know my dog’s history and some of her triggers and I am trying to make the veterinary staff’s job with my pet as easy and safe as possible. I even proactively muzzle her for some procedures even though she has never bitten anyone, just to help everyone feel more relaxed.
- My previous human reactive dogs would have bitten a technician if staff tried to remove a dog from me in the manner they have removed Astrid from me. Until these dogs were further along in their training, they were very dependent on the secure attachment base to me when with strangers.
Reasons veterinary staff give for taking dogs to the back and things I would like them to consider.
- “Pet parents may be upset by the restraint needed with some pets.”
If a dog needs more than gentle restraint for routine blood draws and vaccinations, the dog is stressed and intervention alternatives should be chosen as the standard of care. Each time a dog is restrained for something the dog views as scary is done, it only scares the dog more and will escalate the level of restraint needed for this dog over its lifetime.
The “get it done” attitude is useful for emergencies but is harmful for routine procedures. Please look into the Fear Free or Low Stress Handling programs for more information on how to successfully use gentle restraint and involve pet parents in a safe manner.
- “The dog will look stressed and cause the pet parent worry.”
If the dog is stressed, this is a teachable moment, an opportunity to discuss with the pet parent what they can do to reduce the dog’s stress in the future and make life easier. Have a pamphlet ready that teaches the owner how to Desensitize and Counter Condition. Many pet parents do not recognize basic stress signs in dogs and this leads to dog bites, especially to children, and they end up asking veterinary staff to euthanize their pets. These routine veterinary procedures give staff an opportunity to show the pet parent subtle stress signs and what they mean, potentially saving the dogs life.
Find a force free/ positive reinforcement trainer in your local area that would be willing to work with your clients to improve their dog’s comfort and cooperation with veterinary procedures. This can result in happier clients, fewer injuries to your staff, and pet parents who are more willing to bring their dog to the vet at the first signs of problems because they no longer feel guilty for stressing out their dog.
- “The pet parent doesn’t know how to restrain the dog properly and will put veterinary staff and themselves at risk.”
Pet parents can be present without restraining their own dog. If you aren’t comfortable with the pet parent restraining their pet, then have the staff do the restraining. In some cases, it may be helpful to have the pet parent restrain their own dog but this should be a case-by-case decision after a relationship of trust is built up one visit at a time with the pet parent and dog. You can have the pet parent sit in a chair out of the way, or better yet ask the dog to do specific behaviors at your request to aid your work, feeding the dog treats and help to distract the dog. Make the experience more positive so the dog will become more cooperative over time. Give the pet parent clear instructions on what you want them to do. If they can’t follow simple instructions, then it would be appropriate to either communicate things differently or take their dog to the back.
- “The dog might bite someone and then the pet parent might sue or insurance will ask why they were present.”
Learn to read stress signs in dogs to reduce the risk of dogs biting. Use basket muzzles on any questionable cases or when dogs are in pain. Use anti anxiolytics and sedatives on dogs that have a history of being highly stressed at the vet’s office. Consider how your handling and restraint techniques and pet parent communication might be improved. Talk to livestock and horse vets on how they handle the added risk of having the owner present as they rarely separate the owner from the animals and often have the owner helping with restraint!
- “The pet parent will be anxious and make the dog behave worse.”
For owners that are visibly anxious give them the option of not being present and network with some pediatricians to learn how they calm down anxious parents.
Please know that sometimes dogs are better in the back, not because they were feeding off owner anxiety, but because they are actually more stressed and have shut down which can look very similar to a calm dog. These dogs do not feel confident enough to express their fear and anxiety without their pet parent there to back them up. They may eventually reach the point where they can’t contain their fear anymore and suddenly lash out and bite one of your staff while in the back.
- “The pet parent and dog are untrained and we only have so much time to get the job done.”
Preemptively set aside time with new client appointments to help train the pet parent and suggest ongoing training for their dog. Recommend a positive reinforcement trainer or better yet collaborate with a positive reinforcement trainer to have canine cooperation classes at your clinic. Provide clients a discount on services for a period of time or other incentive to participate.
To me, veterinary clinics that taking dogs to the back without their pet parents for routine blood draws and vaccinations is a sign that we need to make improvements in the veterinary clinic and in the education of dog parents. We need more collaboration between veterinary staff, force free trainers and owners.
It is my responsibility as a dog parent to be my dog’s advocate, to support and comfort her, to help her learn how to cooperate effectively with veterinary staff. When veterinary staff separate a dog from their pet parent for these routine procedures, our power to do these things is stripped away. Often, there is a communication breakdown as clinic staff feel obligated to reassure owners that their dog “Did just fine” or “Did great” when separated, even if their dog was freaking out and making the clinic staff’s job difficult.
- Horn L, Huber L, Range F. The Importance of the Secure Base Effect for Domestic Dogs – Evidence from a Manipulative Problem-Solving Task. Dornhaus A, ed. PLoS ONE. 2013;8(5):e65296. doi:10.1371/journal.pone.0065296.
- Gácsi M, Maros K, Sernkvist S, Faragó T, Miklósi Á. Human Analogue Safe Haven Effect of the Owner: Behavioural and Heart Rate Response to Stressful Social Stimuli in Dogs. Kalueff AV, ed. PLoS ONE. 2013;8(3):e58475. doi:10.1371/journal.pone.0058475.
- Erika Csoltova, Michaël Martineau, Alain Boissy, Caroline Gilbert, Behavioral and physiological reactions in dogs to a veterinary examination: Owner-dog interactions improve canine well-being. Physiology & Behavior, Volume 177,2017, Pages 270-281, ISSN 0031-9384, https://doi.org/10.1016/j.physbeh.2017.05.013.
- Bragg RF, Bennett JS, Cummings A, Quimby JM. Evaluation of the effects of hospital visit stress on physiologic variables in dogs. J Am Vet Med Assoc. 2015;246:212–215. doi: 10.2460/javma.246.2.212.
- Dorothea Döring, Anita Roscher, Fabian Scheipl, Helmut Küchenhoff, Michael H. Erhard. Fear-related behaviour of dogs in veterinary practice. The Veterinary Journal, Volume 182, Issue 1, 2009, Pages 38-43, ISSN 1090-0233, https://doi.org/10.1016/j.tvjl.2008.05.006.