Minimising pet stress at veterinary practice visits

Vet Times The website for the veterinary profession https://www.vettimes.co.uk Minimising pet stress at veterinary practice visits Author : Tamara Montrose, Grace Carroll, Alison Wills Categories : Companion animal, Vets Date : December 19, 2016 ABSTRACT Practice visits are frequently stressful for pets. High proportions of dogs and cats exhibit fear and distress during trips to a veterinary centre. Reducing the stress pets experience during practice visits is important to maximise their welfare and ensure owners do not attempt to minimise their pets distress by avoiding veterinary visits. Practices could do more to ameliorate the stress experienced by pets. They can help to make visits less stressful through the design and management of the waiting room, timing of and use of rehearsal appointments, appropriate approach and handling techniques, positive reinforcement methods, such as treat feeding, and use of sensory stimulation. While many of these recommendations are non-controversial, they are not always implemented and greater consideration would benefit veterinary staff, clients and patients. Visiting the veterinary practice is frequently a stressful experience for pets. 1 / 6

Familiarising cats with carriers before a vet visit can help reduce stress. Image: Fotolia/Syda Productions. Stress and fearful behaviours are displayed by dogs 1-3 and cats 4 during veterinary practice visits. While the stress exhibited by exotic pets during veterinary visits has not been investigated to the authors knowledge, similar issues and solutions to those discussed in dogs and cats are likely to apply. Research has demonstrated a large proportion of dogs display signs of fear at all stages of the veterinary visit 60% of dogs (279/462) showed signs of fear on entering the practice1, 28.9% of dogs (13/45) were highly stressed in waiting rooms and showed signs of resistance when going inside the consultation room 3, and 78.5% of dogs (106/135) displayed fear during the consultation, particularly during examination on the treatment table 2. Cats also display fear at the veterinary centre, with distress being shown before entering the practice in 77.8% (864/1,111), in the waiting room for 73.2% (813/1,111), in the consultation room for 79.2% (880/1,111) and on the examination table for 85% (944/1,111) 4. Minimising the stress experienced by pets when visiting the practice is important not only for maximising their welfare, due to the impact of stress on health and well-being 5, but also as owners may avoid visiting veterinary clinics to avoid distressing their pets 6. This may impact on the willingness of owners to bring animals in for routine health checks or procedures perceived as nonessential. This is concerning as regular health checks are important and serious conditions may sometimes present innocuous clinical signs. While owners can help to make practice visits less stressful for their pets through strategies such as daily gentle handling and rehearsing clinical examinations at home, familiarising cats with carriers and using appropriate carriers for exotic pets 4,7,8, practices could also do more to ameliorate the stress experienced by pets. Waiting area management The design and management of the practice waiting area can impact on the stress experienced by pets. A larger proportion of cats than dogs demonstrate signs of stress in the waiting room 3,4 and having individual waiting rooms for dogs and cats may help reduce stress for feline clients8. Separate waiting rooms for exotic pets to keep them isolated from both canine and feline patients may also be beneficial for their well-being 9. While strategies requiring redesign or structural changes may not be feasible to implement in many practices, reducing noise from telephone calls by not having reception and waiting rooms in the same area10, as well as avoiding engaging in loud cleaning of waiting room areas (such as vacuuming) during consulting hours, should be considered. Where separate waiting rooms are not 2 / 6

feasible, having appointments at different times to separate dogs and cats can help reduce feline stress 8, and similar approaches could be used for exotic pets. Rehearsal visits to the practice, with positive rewards, have been proposed as beneficial in mitigating stress in future visits. Such visits are useful for familiarising pets with the practice environment and staff 8,11. However, difficulties with owner engagement and fitting rehearsal visits into busy practice routines may render this approach problematic for some. Handling techniques Many practices attempt to reduce stress in animals through gentle handling and the importance of appropriate handling techniques in mediating animal stress is well recognised. When approaching and handling pets in practice, the body language of the animal tends to be considered to gauge its emotional state. In cats and dogs, indicators such as ear, eye, mouth and tail position, as well as general body posture, are often used 11. Knowledge of subtle and species-specific stress indicators also need to be considered for exotic pets. This can be challenging in species where these are not well characterised, or in stoic prey species where stress indicators may be harder to detect. It is also important to consider approach and handling methods perceived negatively by pet owners may result in the client switching practices seeking a more attentive or considerate vet 4. Greater routine use of treats should also be considered. Use of treats can reduce fear during practice visits by conditioning pets to view visits as a positive experience and be used throughout the consultation to reward positive behaviour. However, some vets are reluctant to use treats due to the potential risk of aspiration pneumonia, if sedation is later required. This is despite limited evidence showing treat feeding actually increases the risk of aspiration pneumonia in cats and dogs 12. Even if vets wish to avoid giving treats to animals that may later need sedation, this does not negate their use before, during and after routine consultations to help reduce stress and improve welfare. Vets may also be reluctant to provide treats as this could be interpreted as promoting an unhealthy diet or even obesity. Discussion with owners of the importance of providing treats as part of, rather than in addition to, a balanced diet would help avoid this 12. Sensory stimulation Another approach for reducing stress involves the use of sensory stimulation. While use of dog appeasing pheromones13 and synthetic feline facial pheromones14 have been suggested to reduce stress in dogs and cats during consultations, much greater scope exists to use sensory stimulation in the practice environment. 3 / 6

Research carried out in rescue shelters on the use of olfactory or auditory stimuli to reduce stress in pets has considerable application to veterinary centres. These approaches are relatively cheap, effective and easily used in practice. For example, exposure to classical music can reduce stress in dogs in rescue shelters 15-17, as can exposure to odours such as lavender and chamomile 18. Species-specific consideration is important, though, as cats have been found to show increased preference for species-appropriate music rather than classical music 19, and to show little response to exposure to lavender 20. Instead, exposure to odours such as catnip results in reduced activity, such as increased sleeping and reduced standing and exploration, which may be beneficial in the veterinary visit context. The differing findings regarding sensory stimulation in dogs and cats requires consideration in a clinical environment. However, for those clinics with separate waiting rooms, differing interventions are easily implemented. It is also worth noting that sensory enrichment approaches, such as the use of classical music and lavender, can also reduce anxiety in humans 21,22. Since owners are often suggested to increase their pets anxiety during clinic visits, using strategies with the potential to mitigate stress in both pets and their owners may have two-fold benefits. Conclusion While a high amount of stress is experienced by pets during visits, much of this may be alleviated through appropriate implementations in veterinary centres. Many of these recommendations are non-controversial; however, these are also not always widely implemented and greater consideration would benefit staff, clients and patients. While amendments to the veterinary clinic environment, such as species-specific waiting rooms, may not be feasible in all cases, approaches such as noise reduction, gentle handling, positive reinforcement via treat feeding and use of sensory stimulation should be considered. Further research into the strategies that are most frequently used in practice and the efficacy of these strategies in reducing stress in the veterinary environment is warranted, as is investigation of the stress experienced by exotic animals during practice visits. References 1. Stanford TL (1981). Behavior of dogs entering a veterinary clinic, Applied Animal Ethology 7(3): 271-279. 2. Döring D, Roscher A, Scheipl F et al (2009). Fear-related behaviour of dogs in veterinary practice, Veterinary Journal 182(1): 38-43. 3. Mariti C, Raspanti E, Zilocchi M et al (2015). The assessment of dog welfare in the waiting room of a veterinary clinic, Animal Welfare 24(3): 299-305. 4. Mariti C, Bowen JE, Campa S et al (2016). Guardians perceptions of cats welfare and 4 / 6

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