Yesterday’s patient, Boo Boo the Shar-Pei/Rottweiler mix (a striking animal, I assure you), lent me the brilliant idea of penning this post in his honor. Poor Boo Boo. He was not exactly pleased to have been [literally] dragged in by his owners.
First, we had to empty the waiting room. (No dog could be risked within ten feet of Boo Boo’s lunging distance.) Then we corralled him into an exam room. One harness, two opposing leashes and one vet with a locked and loaded, syringe-full of sedative greeted him. (“Say hello to my little friend.”)
Lots of urine, stool, saliva, blood (he always bites his tongue) and anal glands later, we had our sleepy, newly-tractable patient. Physical exam, vaccines, bloodwork, nail trimming, etc. Had he required dentistry, he would have been anesthetized and treated immediately. We wanted this dog done and out of our hospital ASAP.
This happens for Boo Boo only once every three years. Despite the use of oral sedatives before his visit, he always manages to “rally” at the last minute. Why? His owners are scared of giving him too much sedation. I’m always scared they’ve given too little. For the record, I’m always right on this count (hence the disaster and the inevitable need to administer more sedative).
Granted, Boo Boo’s combination of fear, inter-dog and dominance aggression isn’t common—at least not in a powerful dog. But we see our fair share, as does every small animal vet in the world.
Lest you think I’m ignoring the felines, let me now say that cats are potential nightmares, too. Thing is, sedating them’s a cinch as long as they’re already confined to a box. Out in the real world—that’s another story. But I’d love to get a dart gun to trap my neighborhood cats (so much easier than a Have-A-Heart trap but oh so slow that the cat could be halfway across Miami before he’d fall over in a stupor).
But I digress…so on to the real point of this post:
This post is not just for the benefit of this world’s Boo Boos. Its express intent is to convince you of the importance of sedation in more than just the extreme cases—perhaps even in your pet’s.
Though you may deem sedatives unnecessary for your own beast, let me just say at the outset that the ones who rightfully deserve to make that decision are those who put themselves in harm’s way and know exactly how stressed out your pet is likely to get.
Because most owners underestimate their own pet’s stress level and because vets understand well the risks and rewards of sedation, it’s usually worth following their recommendation. Of course, you’re always free to decline. But if we feel strongly about it, we’re always free to show you the door.
Though it may sound like I take rather a harsh stance on sedation, I’ll confess here that I personally don’t sedate as often as I should according to the standard of care guidelines followed by most vets. Too often, I let my clients talk me out of it.
Why? Because I dislike knowing the pet will end up going home in a stupor that may well last a day or more (depending on their reaction to the meds). I dislike knowing that in some cases I may well be doing more harm than good. And I hate trying to convince unconvinceable people to see things my way—I always end up feeling like a car salesman.
Truly, though, every time I do suggest sedation it’s for a good reason. I don’t suggest it lightly, nor do I consider it a time-saving convenience (typically, it’s quite the opposite). Aggression, anxiety, pain and a medical need for muscular pliability are the only reasons sedation should be employed. And the procedure’s necessity better be commensurate with the potential risks of such medication, safe as they generally are.
Despite my personal reluctance and the relative infrequency of “routine sedation” for the above-mentioned reasons, I still find that many of my most trusting clients strongly object. They are either in denial of their pet’s behavior (common) or they fear physical harm (due to the inherent evils of mind-altering medication) more than the psychological harm that comes from living through what they perceive as an extremely stressful experience.
In the event of such obstinacy, I’ve always explained that, from a pet’s point of view, the two (mental and bodily harm) are perhaps indistinguishable. And now I have some human studies on the effects of torture—yes, torture—to back me up on this long-held belief of mine.
While it might seem like a stretchy extrapolation, recent research out of the UK demonstrates that the psychological effects of torture (mock killings, threatening family members, etc.) lead to as much or more PTSD (post traumatic stress disorder) in these subjects.
The upshot? Judiciously undertaken, “chemical restraint,” as we call in in the biz, is infinitely more humane (and far more effective) than the over-used “bruticaine” (sedation through brute force). The suffering of a terrified animal (almost always the case) is not an acceptable alternative to the relatively simple act of sedation.
So next time your vet suggests you take home a few pills to administer before your next visit, think not of the safety or convenience afforded the hospital—this is absolutely secondary. Rather, think long and hard on the degree of psychological stress your pet may be suffering.
And consider the following: experiencing stresses may lead to sensitization to anxiety-producing situations. In other words, the anxiety will be greater with each experience. As with Boo Boo (who started his life as a normal pup and progressed into this frenzied fearfulness), failure to sedate in the past has surely contributed him to the extremes of anxiety he feels today.
While you may well be better off not sedating your pet for some of the quicker, less noxious services your vet offers, and while you may well eschew all meds in an ill pet (call your vet first to find out), if you trust your vet (switch if you don’t) you should pop those babies down his/her gullet and feel more than justified in doing so.
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I'm really glad you brought this subject up. My 8lb pomeranian does NOT like to be messed with. He's all sugar when he wants to cuddle, but all vinegar when he doesn't. Our vet suggested we give him half of a child's benadryl before taking him in. Is this safe? Have you heard of that before? Should I just call before I take him in and have them give me something prescription? Any light you can shed would be nice. I really like my vet, and have had him for the last 6 years with another of my dogs.
Kar March 11th, 2007 07:49:00 PM
First, I'm not a vet, so I'd wait for Dr. Patty's call on that one, but we've done that at our clinic before. So, though I don't know if it's "right" or not, it's not unheard of. :)
Amber March 11th, 2007 08:29:00 PM
Huh.
I guess I must be in the minority, then. I've socialized Roxie so that she is completely unflappable in new situations. She trusts me, and more importantly, she loves going to the vet. There are always new dogs there, she loves the reception staff, they have cookies, and whenever we go, she quite literally drags me into the clinic at the end of her leash.
She says hello to the reception staff and licks the face of the vet. While waiting for the vet to arrive after her exam by the tech, we play fetch in the waiting room. The only time she shows anything other than absolute glee is when they take her temperature. She doesn't like having her rear end messed with.
But even then, she just creeps to me, hides her head under my arm, and is resigned to her fate.
She gets a cookie after we are all done and I have to tug at her to get her to leave. She always looks forward to the next time, and recognizes the word 'vet' with wagging tail and smiling face.
I had thought that all properly socialized dogs reacted like this. I guess not. Is Roxie unusual?
Whitewater
Whitewater March 11th, 2007 08:57:00 PM
You've got a key phrase in that, Whitewater. Properly socialized dog. Congratulations for making sure you have one. Not all of us have been so kind. The basset is. My other dog is Not. She's much better than she used to be, but a trip to the vet is a resigned thing for her. She doesn't want to be groped and she doesn't want her temperature taken, and she certainly doesn't want to be in the back room. If she was actually at home, she'd be biting ankles. At the Vet's office she won't bite when held correctly (and when they bring in a vet tech to hold her, I let them). She's never actually bitten anyone at the vet's, but she's tried.
My cats vary between Sassy fat cat whom you could do almost anything to and she'd purr, to Spider who refuses to be touched by anyone. My complete sympathies to the Vet's office on this and their coping with our pets. I am at least honest about their and my failings.
Georg March 11th, 2007 09:13:00 PM
Proper socialization...yeah. It's great to have, but not always there, especially with rescue dogs. After a lot of work Amber's got to the point now where she's great in public, but still stressed at the vet's. She behaves well, if reluctantly. Most of the exam is fine- mess with her mouth, ears, tail and feet all you want. She's not too keen on the thermometer, but all it gets is the 'I'm going to sit down now so you stop messing with my butt' reaction. Shots? Whatever. She Hates to have her belly palpated...she tenses so much that I doubt the vet can actually feel anything in there. No biting attempts or throwing a fit, just tensing for all she's worth. She has abs of steel.
If there ever were concerns that involved her belly, I know she'd have to be sedated to get any useful information. If they wanted to get a sterile urine sample? Yeah...I'd <i>want</i> them to drug her senseless for everyone's mental and physical health and safety. So what if she's loopy for the rest of the day? At least she's not traumatized.
Our other female LOVES the vet. Vet visits are just as good as going to the park. She's a favorite there too because she'll stand still for and tolerate anything with good humor. Blood draw? Sure, 'sit, stay, done.' Hell, we do her nail trims by telling her to 'play dead' so her feet are all up in the air and easy to get to. It's nice that she's comfortable there because then when she does get into trouble, going to the vet is an automatic, not something that's going to stress her more.
lindabcs March 12th, 2007 03:07:00 AM
It's not that my pomeranian, or either of my dogs, has not been properly socialized. They are both fine around people, other dogs, new situations etc. It's only that my pomeranian (and this may be a bit more breed specific-from what I've heard) does not like to be messed with. He only wants attention when he wants it, not when you do. He's never bitten anyone, and is mostly quiet, loves to play fetch, etc. He just simply does not like to have anyone examine him, otherwise he is a lovable properly socialized animal.
Kara March 12th, 2007 12:16:00 PM
I don't think it's really an issue of socialization either. Yes, good socialization certainly helps, but animals vary in their temperaments, their tolerances, how much they want to be handled.
And time can play a role. Our dog, when young, loved going to the vet, but as he has aged he now just tolerates it and is always aiming for the exit, which, despite being blind, he's quite capable at identifying.
He has always been very cooperative at the vet, tolerant of whatever the vet needs to do, including ultrasounds, x-rays, blood draws. He has always hated and actively resisted nail trims, at home and at the vet, but has never tried to bite.
I don't think we had anything to do with that. It's hard-wired into who he is. Just as his not being a lap dog or particularly fond of cuddling is hard-wired into who he is.
Our cats... a whole different story. They are foundlings with barn manners and I always have to apologize to the vet for bringing them in.
Natalie
Natalie March 12th, 2007 01:12:00 PM
Heck, there are days when *I*'d like a sedative before I get examined. A cocktail before a Well Woman examination anyone? :) And really, I've had enough dental trauma that I'd love to be completely knocked out for a cleaning. I'd like to be tagged while out running errands with an anesthetic dart, and then come to slowly back on my couch with my teeth all cleaned.
Georg March 12th, 2007 01:16:00 PM
Nothing against sedation, but I'm going with my usual view on these types of issues.
Instead of masking the behavior, the owners should deal with it. Sure animals get stressed about going to the vets, but that's life. The great thing about dogs is that they may be mad for alitle while, but they get over it.
Stacy March 12th, 2007 01:40:00 PM
Stacy said:
"The great thing about dogs is that they may be mad for alitle while, but they get over it."
You've never owned a pekinese or one of the more ornery breeds? I know of one who quietly waited to jump up on a bed - she never jumped - to soak it in revenge for being wrongfully scolded.
I know another peke who pouted - as in not so much as look at one person in the household - over a similar issue for 3 days. And if there was reminders of the circumstances, he would pout all over again.
My current (rescue) peke is a great dog with people - including kids - but HATES other animals. He grew up being socialized with other dogs and cats. Makes no nevermind.
There are some other breeds that are known for their long memories. And sometimes they don't fully forget/forgive.
Pax,
MLO
MLO March 12th, 2007 02:31:00 PM
My big guy (57kg German sheperd/Ridgeback X) thinks going to the vet is much much better than the park! The last time we were there though, he did demonstrate some rather inappropriate behaviour.
He went to have a couple of small lumps on his nose and ear checked out, and while the doc was kneeling next to him having a close look, he got her with a full-on tongue kiss just as she was about to say something..... He thought it was great - when she finished getting the dogspit out of her mouth she did ask him nicely not to do it again!
jcat March 12th, 2007 03:28:00 PM
The problem with owners "dealing with it" is that we usually do. BUT, when in public, why make our vets' jobs harder? Why should they have to deal with a difficult job, because I choose not to sedate my pet? Better yet, why should a waiting room full of clients have to deal with it? (my dog doesn't go to those extremes,though) I think sedation is definitely a double edged sword, but if it makes it easier for all parties involved, I say sure....go for it. And Georg....I'd like quite a few cocktails before my exams, as well!
Kara March 12th, 2007 04:42:00 PM
Kara: I'm always clear to point out to my clients that it's not about my job being easier or harder. It's about the pet's experience and overall health.
Stacy: On the socialization thing. It absolutely helps to have a well-socialized animal. But some animals with generalized anxiety require so much more to become socialized that--in some cases--the process is nearly impossible. Others have serious chemical imbalances, etc.--just like humans. Some animals require sedation from the very first visit. It's amazing how many growling eight-week olds I see. Those people get a very special conversation, indeed.
Kar: The half a baby Benadryl might help. If it works--great. If we're still a nightmare when we go to the vet then ask for something safe and effective. If that's the only place your dog acts out consider yourself lucky. BTW, I had a dog like that. A vision of sweetness everywhere, a nervous wreck at the vet's. We did everything we could to socialize her early on. She got top honors in obedience. She was fabulous--except in that funny-smelling office, I guess.
Dr. Patty Khuly March 12th, 2007 05:12:00 PM
Oh, I simply must throw my two cents in! I agree w/Dr. Khuly about the necessity of chemical restraint to avoid staff/animal injury and psychological trauma; in fact, I'm more than happy to have a stash of ace at home for pre-vet visit use, and I know that one of my kitties will go psycho once he hits the door - "this one will claw your eyeballs out, so medicate as necessary to do what you need to do!", I tell the staff (as if they didn't already know!) BUT, there is another end of the spectrum: vets who adore the telazol b/c it makes their life easier, especially when it comes to cats. I happen to work for one.
The scenario usually unfolds as follows: owners bring in kitty, who does fine in the room but is obviously a little timid. Kitty needs further diagnostics, so we have owners leave kitty with us for the afternoon. We proceed to place kitty in a kennel surrounded by canine neighbors. Some kitties don't mind the dogs, but others are scared crapless. Scared kitty is later taken out to be more thoroughly examined by Dr.X, who examines kitty as he/she would a big, playful rott: "HELLO MR. KITTY!!!" (all booming voice and high-pitched baby-talk noises). Oh, and did I mention that Dr. X's dog hangs out at the clinic most days, walking around the treatment areas, and said dog loves to bark and lunge at kitties? Inevitably, the terrified and less-than-gently handled kitty is all claws and poufy tail...and gets loaded up w/telazol or some other form of chemical restraint.
Now I understand all too well (as I own four and have worked w/a ton of ferals) that kitties can get super-aggressive simply by being in a new situation or even just by hearing (or smelling!) another psycho kitty. I also understand that aggression during physical manipulation/palpation may be due to pain. What I don't understand is how 90% of kitties (even ones in for routine exams!) that come into our clinic leave loaded up on telazol...kitties that, while maybe a little wary, dealt w/the preliminary exam just fine. In fact, I can honestly say, in my humble tech opinion, that if Dr. X wasn't so arrogant in her kitty-handling skills (i.e., not rolling eyes when I suggest we put timid kitty in a back kennel away from dogs...or that we put roaming dog into a kennel while kitty is being examined), more of our feline patients would go home lucid.
So...not to play bash-the-vet, but please, everyone, make sure you trust your vet enough to know that he or she is judicious in their chemical restraint use...don't deny your pet's bad behavior, but make sure that it's your pet, not the person handling it, that is causing the problem.
anna March 12th, 2007 05:32:00 PM
Anna: I, too, have worked for vets who treat cats like small dogs. Then they wonder why all cats are mean. I even worked at one hospital where I'd swear every cat was the meanest cat in the world. At the time I was in college. When I went back home for the rest of the summer I was amazed at how sweet all the kitties were. The difference? Staff who know how to handle cats, vets who don't expect every cat to be wrangled down for "safety" reasons and a minimum of barking dogs. So I agree. Nothing's worse than a clueless hospital environment--especially for cats. Vets who feel they must Telazol every feline that needs a procedure are vets who need a new staff, fewer dogs and/or a personality adjustment.
Dr. Patty Khuly March 12th, 2007 06:34:00 PM
All points taken, but what happens to patients like Boo Boo that are only seen every three years and develop something like heartworm disease? Unless I'm completely missing something or heartworm tests are only done every three years in FL, wouldn't patients like Boo Boo also have some serious issues with being kept in hospital so he / she can undergo heartworm treatment?
Are these types of patients kept sedated the whole time they are in the hospital?
I'm not intentionally being a pain in the butt, but things like Heartworm Disease or Lymes Disease even are pretty serious illnesses that need medical attention and should be checked for yearly along with intestinal parasites, ect.
As far as owning a dog that can go from being a complete doll to a total land shark in less than 30 seconds, yes I have one. His name is Taz and he's a Jack Russell. He, my vet and myself have an understanding. He's not allowed to as much as grumble when he goes in for his yearly exam. Since I'm the one holding him usually, he has to deal with my wrath if he even looks at me or her funny. If that doesn't work, he has to deal with my vet's wrath and not too many dogs are willing to "go there."
It has nothing to do with what she does to the animal, it's just her no B.S approach of dealing with dogs that would love nothing more than to give her a hard time. She uses the same approach with her own dogs when they get out of line and it's very effective.
Maybe I'm completely over thinking the whole thing?
Stacy March 12th, 2007 08:16:00 PM
Ok, after reading all of these comments re animals that need to be sedated to be examined I must say that I agree there are some for whom this last resort measure must be given.
That said, I firmly believe that there are no bad animals, just bad owners (caveats about genetically crazy animals and the tiny minority who *are* bad notwithstanding). My Roxie is a rescue and when I got her, she had no socialization with people whatsoever. She didn't particularly care about people, one way or the other, which is very wierd for a Poodle, usually Poodles are all over humans.
I got her in early December and it's only now in March that she's figured out that people inhabit her world for a reason.
I've had to overcome her rescue background, yes indeedy! But the one thing that helped with the vet when all other methods failed was that I brought her there when she wasn't sick (and at midnight when there was hardly anybody there). She got to meet everybody at her own pace, sniff around, learn what the deal was, and she got treats (this is big) and praise for staying calm and polite.
After a few times doing this, when she went in for her upset tummy it was no big deal.
I would recommend, if at all possible and if your vet will let you, to familiarize your animal with the vet's place first, when they're NOT sick, and to make that experience a positive one, so that it gets into your pet's brain that the vet is a good place to go -- after all, they get to meet new animals/people, they get treats, they get a ride in the car if they're into that, and best of all, they get to go on an outing with you! How could that be bad? After a while, they'll be dragging you in like Roxie does.
Hey, I'm no expert, just a woman who's owned many dogs. But it seems to me to be common sense -- if you are nervous and upset and think the vet is a bad place to be, your dog will pick up on that. And if all your dog gets when they go to the vet is to be scared and poked and prodded and hurt, it makes sense that they'll remember the Bad Things for next time. Why not replace the fear with happy anticipation?
It worked for me.
Whitewater
Whitewater March 12th, 2007 08:19:00 PM
One of my girls, Daiya, is a long haired cat who doesn't groom herself well. The vet we use will do the "potty trail" cut for us, but the groomer doesn't "do" cats. Daiya had so many knots in her fur she had to be shaved. I took her to another vet who's groomer does cats. It almost required a trip to the ER Vet. They sedated her without permission and when I picked her up that afternoon, she could barely stand. It took her three days to recover from the sedation. She would walk a couple of steps and fall over. At one point, I didn't think she was going to make it. I was so scared. She'll never go back to that groomer. Now that summer is approaching, I don't know what to do. She'll need some kind of grooming assistance, but I am very scared after this experience. She does fine when our vet cuts the potty trail so I didn't understand why they sedated and I don't want to do sedation again.
ERC March 14th, 2007 11:02:00 AM
ERC: How horrible! and wrong...and illegal...and...Icould go on...
Dr. Patty Khuly March 15th, 2007 02:13:00 PM
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