Canine and Feline Handling and Restraint: The Basics of Keeping You Safe and Your Patients Happy Meghan E. Herron, DVM, DACVB The Ohio State University Veterinary Medical Center www.vet.osu.edu/behvaior Environmental management Starts when pet enters the facility- for many it may start when enter carrier at home, or when first handled by animal control personnel Is the lobby/intake area calm or intimidating? For stray pick ups what is travel environment? How do you manage the unruly or reactive pet any situation? Do you have quiet areas for stressed animals? Are you looking at the environment literally from the perspective of the animals that enter? Everything that impacts their comfort and well-being happens at their level (visual field, odor, drafts.) Travel environment Visual barrier between animals Frequent drop off Reduce number of unfamiliar animals together Decrease travel time for animal Pheromones Feliway/D.A.P. spray Music Classical music (Through a Dog s Ear) Avoid heavy metal Intake/Lobby Management: Cats ALL cats in carriers Cat Den Provide stable, high points to put carriers on to give cats a feeling of security Segregate the intake between dogs and cats Feliway diffusers Prevent shelter mascot cats from approaching carriers **Intake stress often a major contributing factor to fractious behavior during examination Kennel Management: Cats Provide separate cat wards Feliway TM plug-in Through a Dog s Ear music Keep fearful cats on top cages Provide hiding options
Scientifically proven to reduce stress Cardboard box, towel over half of cage door Solid partition between cats Avoid visual exposure to other cats Provide soft bedding Intake/Lobby Management: Dogs Separate comfort areas for reactive dogs The more reactive they are in holding, the greater the chance for aggression during exam No need for them to increase stress of shelter animals Ask owners turning in fractious pets to wait in car Call cell phone when ready Escort in through a side door o Best to make plan for owner ahead of time o DAP diffusers Kennel Management: Dogs Keep fearful dogs on bottom cages Cover front of kennel DAP plug-in in ward, or spray bedding Food-stuffed enrichment toys (Kongs) for non-npo patients Soothing music Through a Dog s Ear Counter-conditioning (CC) Many animals have been inadvertently conditioned to fear the veterinary setting Animals can easily be conditioned to fear the shelter environment Clinic, kennel, adoption floor, staff This fear often leads to dangerous and undesirable behavior towards the humans in this setting Remember fear is not voluntary Use CC to change an animal s negative (involuntary) emotional response to a positive one Instead of here comes that scary person in scrubs/coveralls, it changes into, here comes that great person that brings me cheese/peanut butter/meat etc. How do we accomplish this? FOOD! Food elicits an automatic (unconditioned) positive emotional response If paired with potentially aversive stimuli (unfamiliar handlers, injections, rectal temperature, nail trims, etc.) the emotional response will transfer to the procedure Counter conditioning (CC & DS) Toenail trim video But treats cause diarrhea!!
Small-moderate amount of treats/human food is unlikely to cause gastrointestinal upset in most dogs Most diarrhea problems in shelter animals likely results from stress, intestinal parasitism, and abrupt, complete diet change But if I feed a dog/cat that is being bad, aren t I rewarding that dog/cat for their bad behavior? The answer is NO Not rewarding something that is under their voluntary control (like a sit) Changing their emotional state about strangers in a stressful environment Once the food reduces the fear, motivation for aggression is reduced Should we reserve food only for difficult animals? An ounce of Prevention is Worth a Pound of Cure! Most shelter animals are at least mildly stressed at intake Want to maintain positive experience to set them up for success for their entire shelter stay What if the animal won t eat? This can mean one of two things: Your patient doesn t like what you offered Your patient is too stressed to eat Here is what you do: Offer food that is highly palatable Ask owners about preferences (if applicable) Mitigate the environment to reduce stress What if the animal can t eat? (NPO patients) Visual- turn down lights, block visual access to other people/animals; let cats hide head Auditory- speak softly and sparingly; select a quiet area; relaxing music - Through a Dog s Ear Olfactory- avoid the pheromones of other stressed animals; use DAP and Feliway. Tactile- Touch animals as little as possible, or when needed touch them firmly & globally. Avoid cold, hot, or slippery surfaces. Safe restraint Assess animal stress levels first See Body language slides Consider presence of familiar handler Approach in a non-threatening manner See Dog vs. Human Body Language slides Use least restraint as necessary, depending on the individual animal and procedure No need to scruff or pin automatically Standing saphenous vs. lateral position
Low-stress restraint When greater restraint needed, support the animal well Provide firm, balanced restraint, preventing flailing, keeping control of head at all times Should be able to move to lateral recumbency slowly and steadily Utilize handling tools early, before animal becomes agitated Head restraint Lateral recumbency Safe restraint Do not put your face directly over or in front of any animal Avoid reaching or petting head of fearful pets Wait until the pet is relaxed and eating (if non-npo) before procedures Safe restraint If pet struggles >3 seconds, stop the restraint and reposition to try again If after 2-3 restarts the pet is not relaxing after 3 seconds, or if arousal is escalating to panic or aggression, STOP If procedure is essential, use chemical restraint If nonessential, return animal to kennel and create a behavior management plan for next attempt Chemical restraint DO NOT WAIT for the animal to become fractious and highly agitated Use judgment to determine appropriate dosages and protocol selection based on age, temperament, and degree of health/disease. Acepromazine AVOID in: Boxers Dobermans Epileptic animals Debilitated animals Hypotensive animals Max dose 3 mg* Dexdomitor AVOID in: Geriatric animals Debilitated animals Animals with heart murmurs, CHF
Sedation protocols: SEDATION young, healthy pet Dog Fractious Dexdomitor (10 ug/kg) + opioid (butorphanol 0.2-0.4mg/kg or Painful Ace (0.05 mg/kg) + opioid (butorphanol 0.2-0.4mg/kg or Cat Dexdomitor (20-30 ug/kg) + ketamine (5 mg/kg) + opioid (butorphanol 0.2 mg/kg or Dexdomitor (20 ug/kg) + opioid (butorphanol 0.2-0.4mg/kg or morphine 0.2 mg/kg) IM Ace (0.1 mg/kg) + ketamine (3-5 mg/kg) + morphine (0.2 mg/kg) IM Ace (0.1 mg/kg) + opioid (oxy 0.1 mg/kg or torb 0.2-4 mg/kg) IM Ace (0.1 mg/kg) + ketamine (0.5-1 mg/kg) + morphine (0.2 mg/kg) IV 2009. Sedation protocol guidelines: Richard Bednarski, The Ohio State University Veterinary Medical Center
SEDATION geriatric pet (over 7 years) Dog Fractious Ace (0.05 mg/kg) + opioid (butorphanol 0.2-0.4mg/kg or Painful Opioid (butorphanol 0.2-0.4mg/kg or morphine 0.2 mg/kg) + midazolam (0.2 mg/kg) +/- ketamine (5-10 mg/kg) IM Cat Ace (0.05 mg/kg) + ketamine (3-5 mg/kg) + opioid (butorphanol 0.2 mg/kg or oxy 0.05-0.1 mg/kg) IM Opioid (butorphanol 0.2-0.4mg/kg or morphine 0.2 mg/kg) + midazolam (0.2 mg/kg) +/- ketamine (3-5 mg/kg) IM 2009. Sedation protocol guidelines: Richard Bednarski, The Ohio State University Veterinary Medical Center
REVERSAL Dexdomitor reversal Mu agonist reversal (hydro, oxy, morphine, fentanyl) Benzodiazepine reversal complete reversal of dexdomitor use equivolme of atipamezole (antisedan) IM complete reversal use 0.01 mg/kg naloxone IM/IV reversal use flumazenil 0.001 mg/kg then work up to 0.01 mg/kg IV partial reversal of dexdomitor use half volume of atipamezole (antisedan) IM partial reversal use naloxone 0.0001 mg/kg or torb (0.2 mg/kg) IM/IV Dexdomitor-lasts 45 min.- 1 hour without reversal (dose dependent) 2009. Sedation protocol guidelines: Richard Bednarski, The Ohio State University Veterinary Medical Center