Is your pet scared of your veterinarian? Does she turn into a quivering mass of fur at the first turn in the direction of the veterinary hospital? Do his hackles rise at the sight of the kitty kennel? Does she put on the brakes, hide under chairs or howl when the fecal rod is revealed? Or is he so terrified he’s transformed into a growling, snapping land-shark when the veterinary staff approaches?
Veterinary phobia is not a hot button issue among veterinarians. Most of us don’t lay awake at night thinking about the many pet patients who fear us. Nor do we typically spend as much as a tiny fraction of our working life attempting to change our hospital policies to address our patients’ anxiety-based issues.
It’s not that we don’t care…because we do—if not for our patients’ feelings, then for the integrity of our own skin. But we accept it as the price of doing business in a field we love, even if it does strike us as a tremendous irony, this veterinary phobia our patients experience.
After all, most of us adore animals and don’t particularly enjoy the display of fearful emotions we’re treated to—especially when we’d love nothing better than a mascara-smearing swipe of the tongue or a delicate purr and a forceful head-butt.
Yet not everyone agrees that we should take our lumps when it comes to our patients’ veterinary phobia. Some veterinarians are progressively pushing our profession to reconsider its tacit acceptance of terrified pets as the veterinary hospital norm.
Moreover, they see many of the hospital tactics we’ve always employed as justifiably inciting undue fear. They want us all to rethink our strategies at the hospital policy level to create a warmer, gentler environment for our patients.
Dr. Rolan Tripp is one such veterinary professional. He’s so dedicated to this concept that he’s launched a campaign to raise awareness of veterinary phobia with a fee-based "Pet Perception Management" manual and "Pet Centered Practice" online program.
Via these materials, Tripp aims to educate veterinary hospitals and pet owners on how to prevent veterinary phobia. He runs the online, Animal Behavior Network by way of distributing this basic information widely. Through it, he also offers a range of for-profit services in his capacity as a behavior consultant of sorts for veterinary practice.
Sure, it’s a profit-building enterprise for Dr. Tripp, but the concept of a gentler pet practice is one that deserves more than just glancing consideration. Here are some of his basic recommendations:
1-Veterinarians and staff should routinely administer treats to distract pets from any noxious stimulus that might increase their sensitivity to future visits (during vaccines, blood draws and rectal temperature-taking, for example).
2-Fecal samples should be collected at home and brought in (whenever possible) to spare our pet what’s often the worst moment in their entire visit.
3-If possible, pets should have good experiences at the vet’s place independent of their healthcare visits. This includes drive-by visits for weighing, treats and pettings…or play sessions for puppies and non-aggressive candidates.
Aside from the obvious animal welfare and staff-safety arguments proposed by this “pet centered” philosophy of practice, Dr. Tripp and others (myself included) believe that calmer pets produce less stress-clouded results on diagnostic testing. Physical exams are more complete. And owners are more satisfied with our services.
For my part, I’ve always been a big believer in gentle medicine’s benefits. Not only does it mean that cats are quieter, dogs are more docile, clients are contented and the medicine’s more doable, it also means that my job’s significantly less stressful and infinitely more fun. And how can you argue with that?
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Not to mention considerably less dangerous for all involved...
Kim January 21st, 2009 11:19:23 AM
I've been so happy that as part of the new layout at Angell Memorial, there are separate waiting rooms for dogs, cats and exotics. Ferrets don't tend to be that anxious about new places, but they definitely get anxious if surrounded by barking dogs and hissing cats, especially if a dog is too interested in them (and a dog's owner isn't containing their dog, but that's another issue). And *I* get anxious about other animals, especially big dogs who might mistake a ferret for a squirrel, and the ferrets pick up on my anxiety. Vaccine reactions are always a serious concern with ferrets and stress levels are thought to contribute to the likelihood of a reaction. So the separate waiting rooms, as far as I am concerned, provide a concrete health benefit, as well as a more pleasant environment for everyone. I'm sure the cats appreciate it tremendously as well.
Of course not every clinic or office has the space for separate waiting areas. But those who do should strongly consider it, if they haven't already instituted them.
regina January 21st, 2009 12:17:10 PM
This is something easy and cheap that really helps with dogs who get so worked up on the exam table they skitter and slide all over the place--a yoga mat. We have a couple mats that we cut in half and put on the exam table. The mat doesn't slide, and we've found that dogs are more relaxed on the non skid surface. It is also easy to clean. We get our mats from the local TJ Maxx for $10-14.
I would love to say this is something we thought of, but a client came up with the idea and gave us the first yoga mat!
I agree--being gentle and patient with pets and owners makes for a more rewarding experience for everyone.
drsteggy January 21st, 2009 01:01:48 PM
Dang, Dr. Steggy - that's genius! Give that client a gold star and a pat from me. I'm going out to get one today to take to work tomorrow. Thank you!
KateH January 21st, 2009 01:11:20 PM
Happily my new vet also brings out a rubber-backed pad for the stainless steel examining table so my small - med sized dogs don't slip and slide. It makes them easier for me to hold during the exam, which I appreciate - and I hope the dogs do too!
I do try to make the vet visit as low key and non stressful as I can. Seems like the best step towards that has been cutting my own dog' nails! That always seemed to be the WORST thing they could have done. Shots? Sure, no problem. Blood draws? Not happy, but no panicking. Cut nails? Struggling, screaming, scratching - I'm sure anyone in the waiting room was convinced my poor dog was being MURDERED! I made that mistake with my first dog - since then, I trim nails. Hey, whatever works, right?
robinsdogs January 21st, 2009 01:23:45 PM
Non-stressful visits have another plus: No confusing symptoms that are just anxiety based. My vet was a bit concerned about my dogs coat -- which is usually gorgeous -- but within minutes of being at the vet, she looked like she had the worst case of dandruff EVER. I'd never seen anything like it (heck, we'd never BEEN to this vet before, so god only knows why she was anxious about it... but she's got some anxiety issues regardless, so strange place + strange animals would probably be enough.)
Luckily, my vet is awesome, so when I explained that I'd never seen her flake up so badly before and that 20 minutes earlier, there'd been NO flakes, the anxiety was a good answer. :)
As for the stainless steel table... my vet doesn't have one. There's a large vinyl chaise we can sit on if we need to, but he was happy to just get down on the floor with her. Much less scary!
Donna January 21st, 2009 01:55:03 PM
The local veterinary clinic where I take my former skittish stray follows suggestions 1 & 3. Maybe it's because of his months as a trash picking alley cat, but #1 absolutely won him over. He is always in the mood to go to the vet. But it's too that he's unusually food oriented. I've been meaning to get help clipping his claws so I'll see if that turns things around!
My other cats love going to their vet too, though he doesn't give them treats or seem to put any particular effort into relaxing them. But that clinic just has a very chill vibe: there are some clinic animals that live there, wandering about, etc., and the employees all seem basically happy and relaxed themselves.
Actually, the environment for PEOPLE might play no small role here. The young assistants at the other clinic seem scared of the vets and scared of the animals, and I've seen animals pick up on their mood. The vets seem more harried as well. I hope that doesn't set up a catch 22!
Sarah January 21st, 2009 02:07:10 PM
I always bring a fecal sample when my dogs go for a check-up. I learned long ago that it does help if the dogs do not have to get a sample taken at the vet. When I call to make an appointment, I think it would be helpful if the receptionist would recommend bringing a sample.
This post reminds me how much I miss my old vet in south Florida. His office was in an old strip mall and was not pretty. However he and his staff went out of their way to make sure my dogs were comfortable.
Susan G. January 21st, 2009 02:22:58 PM
I just had the pleasure of attending a lecture by Temple Grandin last night, and these were her recommendations to us for how to keep animals from being scared at the vet:
Megan January 21st, 2009 02:40:45 PM
Also, the clinic I work at uses lavender diffusers, as lavender has been shown to have a calming effect on dogs as well as people :)
We use catnip for the kitties, since most won't take treats in the room.
Megan January 21st, 2009 02:44:44 PM
How about letting the pet stay with the owner as much as possible? It isn't really necessary to take an animal "to the back" for a blood draw or centisis.
Stefani January 21st, 2009 02:45:38 PM
Stefani- My clinic does procedures in the room when we can, but for the sake of the owner (in cases of needle-phobic clients) or the animal (in cases of anxious owners passing their anxiety onto their pet), going "to the back" can often make the whole experience less traumatic for everyone. My own dog is a saint as soon as she's out of my sight, but if the techs try to do a blood draw while I'm nearby, she's a terror.
I've found owners are far less tolerant of watching cystos than blood draws, but I've seen owners pass out from witnessing both procedures.
I don't think clinics should have a blanket policy that all procedures should be done in the exam room or in the treatment room- animals are individuals and should be handled on a case-by-case basis.
Megan January 21st, 2009 03:10:05 PM
i hate to say but my cat does not like her regular vet. at first she did, but she has HCM, asthma, had a FLOR and a few pouts of FLUTD, and the list goes on. she does however like her cardiologist not that she is loves on him but she does hiss, growl or scream at him like she has with her regular vet. what is even worse is her regular vet is female her cardiologist is male so she doesnt trust females except for me. i have taken her in for just visits where she sees them but they just touch her or look at her which helps but if they are busy (and they usually are when i can easily take her in) that stresses her out. they take her to the back to do blood draws and such because i know i make it worse even though i try to remain calm. catnip is a good idea megan- belle wont eat treats either even her favorites at the vet. i do think quiet is best and quick as possible. the longer belle is at the vet the more upset and angry.
katy January 21st, 2009 03:45:29 PM
Both my cats head for the hills when the carriers come out (which is why I take them out about a week before we go to the vet). One of my cats is Ok at the vet. She's the one with the most medical problems. The other one has virtually no problems but did have one tooth out about 2 years ago. He's been a wreck ever since. I now give him a tranquilizer before we go and that seems to help. He even came out of the carrier all on his own and explored the room a little, last time we went. I do wish the vet had separate areas for cats and dogs. We've never had anything alarming happen, but its a very small room, packed beyond capacity which doesn't make the experience any less stressful.
2CatMom January 21st, 2009 04:04:41 PM
I agree with Megan - not every procedure can be done in front of every owner. I prefer to have most things done with me in the room, but if the vet feels she can handle something better in "the back", I trust her to make that decision. I've only gone to this vet for a little over a year and that hasn't happened yet, but just in case. Maybe she's waiting to find my "gross-out" point. LOL! (That cyst she cleaned out prepatory to scheduling surgery almost did it - yuck!)
I love that this vet also has a scale in the waiting room - what better reason to drop by than get a weight on one of the dogs? Walk through, get the weight, move on to the cookie jar, and we're out. A nice quick visit, nobody gets hurt or scared. And I can monitor the fat rescues or my skinny boy.
robinsdogs January 21st, 2009 04:27:31 PM
Sarah: It DOES set up a catch-22 in all the hectic hospitals I've worked at. The busier and more harried the vets and staff, the more barking dogs and swirling stress, the greater the chance that our patients will experience stress. It's inevitable. That's why big, busy hospitals (like Angell in an above example) modernize by building in physical solutions or professional policies that mitigate against the inevitable stress.
Dr. Patty Khuly January 21st, 2009 05:19:23 PM
A helpful tip for cats who freak out when the carriers come out is to take a pillowcase, arrange the closed end on your shoulder, and have the open end in your hands. Walk up to kitty very calmly, as if nothing is going on (gotta get those thoughts calm, too), and in one smooth motion, put the open end over the kitty and 'scoop' them into it. You are so much less likely to get scratched, the kitty is controlled, and you can then put the whole kittencaboodle (sorry, I couldn't resist) in the carrier, or even get a big twist-tie and fasten the top closed for transport. The cat can breathe just fine, often because they can't really see what's happening they are calmer, and they can be placed on the floor in the back or front footwell, where they are safe from falling off a seat (although blocking off access to underneath the seat is best). This tip is also vital to remember if you need to evacuate your home, especially at night, as the pillowcase is much closer than anything else, even towels, which let kitties struggle out and scratch.
I agree wholeheartedly with Megan's comment about no quick, darting motions - along with as few loud noises as possible. If the noise level is too loud, ask when the clinic is least busy and try to make appointments then. Also, find out when surgeries are done and try to make appointments before they start or at least an hour or so after surgeries are finished, so that animals coming out of anesthesia aren't 'crying' (confused/unsteady/thrashing) when you come in. That's a horrible sound for any person to hear, let alone your pet, who doesn't why the animal is in 'distress' and often will get even more upset themselves. If things are too loud and distressful, if you can keep your pet outside until right before their appointment, that might help, too.
If the staff moves too fast or are too loud, ask them to slow/quiet down, don't rush up to or loom over your pet, stand sideways to them and either crouch or sit next to them before going back to the exam room (sometime busy clinics don't have much time for this, but they should at least make an effort), and never drag your dog or let the staff drag your dog by its leash. If your dog weighs less than 60#s, then pick him/her up (even if you need 2 people), and talking nicely and calmly, carry them back. If your dog is bigger, then bribe them with food and gentle 'herding' with your legs to maneuver them down the hall. Big dogs should be examined on the floor, if possible (bring a blanket from home to make them comfortable), as getting them up on a table can be difficult (and most techs/assistants can't hold them well when they're up that high anyway. Close exam room doors to prevent people/other animals going by to startle or distract them (and prevent escapes). Also, metal (or other) instruments that get tossed onto the (metal) exam table or counter can make sudden, loud noises. Ask if the vet or tech can lay them down more gently (it doesn't take but a nanosecond longer) - tell them that the noises bother you, if you feel that will work better, as some vets just don't even notice how the animal jerks every time things clash/clatter like that.
KateH January 21st, 2009 05:36:08 PM
regina: I'll have to do a drop by, next time in Boston! Twenty-five years ago, Angell had long benches, crowded beyond belief waiting area, full of sad people & pets. I was one of them, sitting with my Scottie wrapped in towels--She was on lasix, waiting for hours. Lot's has changed since then.
Dr. Steggy: Bath mats w/ suction cups onsale at WalMart for as low as 3-5 dollars!
Never a "pulled" stool sample!! Makes for a bad memory forever!
Hate being ushered into a small, non-ventilated room way before appointment, too stressful on both of us.
LOVE an exam room with a running-water sink, must be psychological!
And with most terriers, the "hold" should be like a football, not loose & dainty to fumble, but firm & confident without squeezing the air out. Personally, I'd rather be the one for the strongarm if needed, to prevent "the remembered" association with the staff and/or Vet
Barbara A. Albright/NH Pocket's Story
http://walnut-hill.bravehost.com January 21st, 2009 06:57:00 PM
When my boy was diagnosed with Typical Addison's he was critically ill and spent several days in hospital and as a result he was absolutely terrified to go back, which of course we had to do. Even trying to weigh him was difficult. Since stress like that certainly has a negative effect on Addiison's our vet had us do "drive by's" where we would take him in and the staff would make a fuss over him and give him treats and leave, no treatments. Then drive by's just to be weighed with treats. At visit's where we had to draw blood he was given lots of treats and snuggles. It took us months but now when I ask him if he wants to see Melissa ( our vet ) he is all lab butt wiggles... You would never know it was the same dog.. It certainly worked for him, everything including blood draws are easy but he always looks for his treats before and after.. It was worth the effort it took.
Elizabeth - From Nova Scotia January 21st, 2009 07:02:03 PM
Wish I knew how to relax Socks, about the vets... The poor guy goes into a panic a few blocks away.. It's a little funny, as my office is two blocks before. I don't know what his story is.. He's been going there from eight weeks.. The guys are great with him.. I don't worry about him taking a piece out of them.. as he likes them.. He even will lick them.. I think it's his fear.. He's a timid fellow.. Doesn't like to be touched.. It is important to get him to relax.. I wanted the vet to listen to his sinus arrhythmia, and it took a while to get his heart rate down to hear it..
barri January 21st, 2009 07:57:01 PM
What about humans that are terrified to go to the vet??? I had an espescially difficult situation about a year ago. After leaving my beloved at an emergency specialist referral veterenarian for 8 hours for a noninvasive procedure he was returned to me with a laceration on his side and a contusion under his chin. We not only recieved an incorrect diagnosis but were given the test results for an animal of a different species. I am so afraid to take him back to our regular vet after this specialist was recommended. We have gone to a large university small animal hospital for follow up treatment and diagnosis.
I believe my beloved pet is over it. I still suffer large amounts of guilt over this terrible situation. Does anyone have any advise to help me get over this terrible guilt and anger about what happened?
jojo22 January 21st, 2009 08:14:15 PM
jojo22: I had a worse experience than yours. I left my pet at an emergency and specialty referral hospital for an exploratory surgery since my home town was 100 miles away and, when they released him ( 4 days later), he was in a horrible condition. I thought he was recuperating slowly due to his age (13), but he DIED 3 days after release! He was also misdiagnosed and mistreated by two specialists! So thank God your companion is still alive!
I have two more companions and the thought of taking them to any vet TERRIFIES ME! So I checked with various vets in my area if it would be OK to be with my pets at all times, no back room exams. I found one terrific vet who had NO problem with me being with my pets at ALL TIMES! My companions are calm during any kind of procedure because I AM PRESENT, holding them while the vet either examines them or draws blood.
It's been almost a year since I had the worst nightmare of my life, but I am still experiencing your feelings: GUILT and anger for not being with him during his surgery and hospitalization! Details:
http://alabamavetboardwatch.110MB.com
Fotini January 22nd, 2009 12:54:19 AM
"transformed into a growling, snapping land-shark" Very accurate description of my first Lab who came to me at 15 months of age from a poor background and, as it turned out, had heartworms. The Vet and I weren't the least bit sure we could treat her for it, IV's etc. almost 20 years ago. He said he'd give it a try and, between us, we got her treated. Lots of visits and always with a wire muzzle on her but she made it and was heartworm free when we were done and her seizures stopped after the heartworms were gone. (Even now, I don't know enough to understand why her first two heartworm tests were negative; how it could be that she had such a serious case of heartworms and not be positive. Got a blog somewhere on that one?) Gotta say he was one of the special Vets. That dog was always hesitant at the Vet after that but she'd get down right excited and happy to see him. I can't help thinking she knew or at least picked up on his positive intent.
It seems critical to me that owners "man handle" their pets at home; otherwise, there's nothing a Vet can really do if a pet is accustomed to getting its way by objecting. I have wire muzzles for all my dogs almost from day one. I don't use them a lot but enough so they know what they are. I do muzzle them for the first couple of Vet visits to see how they'll react and, if they behave, remove them during the exam. I know a Vet can't do a complete check with a muzzle on but sometimes... And they almost always become accustomed over time and practice. Seems to me that a lot of it is just whether or not the pet knows who's the boss. My brood is almost always better behaved when I'm present because I don't take any guff at all when we're at the Vet.
Several months ago, my new Vet took my Shiba down the hall for some X-rays. She was so well behaved they didn't anticipate problems but said they might have to sedate her. I said I was sure they would and to go right ahead; offered to muzzle her and/or go with to hold her for the sedation process; they declined. She did exactly what I expected; got down the hall out of my sight and hearing and did the "you're not my mom, I don't have to do anything you say and wait until you see how I can squirm, run, slip away from you!" and I suspect she even got snappish although that's really rare. After they'd been gone nearly an hour, the Vet stuck his head in, eyes the size of saucers, to apologize for the delay. I just smiled and said "no problem, I expected it" but then I'm fully aware of the ancient dog that lives inside my cute little Shiba. She was much better at the surgeon's center but (poor them) they got treated to the notorious ear piercing Shiba SCREAM repeatedly.
Separate waiting room or hold in vehicle, in back door, directly to an exam room that's set off from other rooms - these are really nice when available.
Yoga mat for non-slip. Not sure I'd want my Vet to provide these for sanitation reasons. Love the idea though and will probably make my own to take with. Really nice idea to put in an "intro to our practice" document as a suggestion for clients but then I'm one of those people who walks into the Vet with a Doggie Gear bag over my shoulder.
PJBoosinger January 22nd, 2009 01:54:24 AM
Fotini, thanks. I'm becoming less and less hesitant to ask questions and insist on "informed consent" and competence too as the years go by. My first two Vets were so good that it took me by surprise the first time I encountered a bad one and my lousy experiences pale compared to those I read about from others. I think all you can do is become more informed and take more control but it really takes a toll on trust generally and more so in emergency situations.
PJBoosinger January 22nd, 2009 02:03:21 AM
In my puppy classes, I require that they take puppies to the vet for a nice visit just to get treats and pets. But. . . our vet does NOT want puppies to come in for visits because of the risk of picking up something - especially during parvo season. Puppy socialization has to start before vaccinations are complete, so it's a fine line between saving their lives by having them well-socialized and saving their lives by not exposing them to parvo.
Nita January 22nd, 2009 07:42:09 AM
JoJo, Re: "What about humans that are terrified to go to the vet???"
You are in good -- and ever-growing -- compnay, JoJo. Count me among those who are terrified to go to the vet.
My cat was given a MASSIVE overdose of insulin (10 times the amount he was supposed to get) and then left alone in a cage overnight. This was done by an unlicensed, unsupervised young person who happened to be the vet's son, who was home on college break. His father was letting him live in the hospital basement apt in return for going "upstairs" and "cleaning cages and doing treatments." He wasn't even on the clock. He wasn't a veterinay technician. He used the wrong size syringe. And this happened at an "AAHA" hospital, so you can throw that certification in the trash as far as I'm concerned.
As best I can tell, the following day he also was left alone for over 13 hours and received no treatment for the overdose until 24 hours after it had been given. He had been seizuring for so many hours alone they don't even know how long. He was nearly dead when he was found. His temperature didn't even register. He lived but only after 1 month in an ICU, and although he lived, he was severely and irretrievably brain damaged: Blind, unable to eat without help, unable to drink, walking into walls, walking in circles, barely able to groom at all, totally F_d up. Every day I watched him I wept and held my head in my hands and prayed that I would wake up from our nightmare, and cursed myself for trusting a veterinarian.
More even than vets, I am terrified of all those people in scrubs they call "tech" but who really are not. They are not legally required to have any training and vets often allow them to do -- or order them to do -- medical tasks that they are NOT properly trained in and do not know how to do, at great peril for our pets.
I guardedly trust the place I go to now, but only because I went to them long before this bad thing ever happened (if I'd never moved and switched vets this would never have happened) and the fact that they use only licensed veterinary technicians is a big deal to me. Still, I secondguess everything, ask tons of questions, and worry all the time.
If I had to find a new vet now, I think that I would implode mentally from stress and fear.
The Toonces Project
Stefani January 22nd, 2009 08:44:31 AM
LOVE the bath mat idea. I'm getting one at Target today. Thanks.
I have to say that I'm also big on mild sedatives. Xanax-Benadry is very safe for the most fearful. Feliway works for some. Bach flower extracts? Not so much but worth a try. Lavender? One study showed it helped for travel anxiety but never on the pet directly--especially not a cat (essential oils are toxic to cat livers).
Dr. Patty Khuly January 22nd, 2009 08:53:10 AM
Love the yoga mat idea, I always bring a towel from home but it still slips - the other thing I do which is more preventative is I always walk into the clinic first without my pet (weather permitting, no dog in car hot day)
I check in, let em know we are there, scope out the waiting room (see if there are any out of control dogs/cats/humans), sometimes I can tell right away they are running behind so I will ask very nicely how long it will be if it is more than a few minutes I go walk my dog around and stay outside if possible until a room is ready. (granted this is all in a normal visit)
I also take my dog to the scale while waiting since I know that is coming anyways, so when they call me I can tell em the weight and its one small time saving thing for the person checking us into our room.
I read alot of posts about how Vet clinics can run better, vets can be better, how bout how clients can be better ? or helpful ?
LC January 22nd, 2009 09:34:49 AM
LC: Great idea. I'll do a top-ten on that one. Thanks!
Dr. Patty Khuly January 22nd, 2009 12:08:23 PM
I have always done the "drop in for a cookie and a weigh-in" vet visits with pups, and my dogs have always loved the vet. (Cats don't like the car ride, but are easy patients -- I've always started with kittens and done a lot of handling.)
But a caveat. Vet waiting rooms are NOT the place to "socialize" a pup with other dogs.
The dogs there may be sick, they are often cranky, and they are almost always cranked. Stress pheromones suffuse the air, and maybe someone shot an anal gland an hour ago. Often this leads to a bad experience for the pup. And there is the risk of contracting a disease.
I prefer to come in during quiet time, weigh, cookie, visit the techs, maybe a couple little obedience exercises, and then if a stressed-out or sick animal appears, quietly get out of Dodge.
H. Houlahan January 22nd, 2009 01:40:49 PM
The very worst experience I ever had at any vet's office (and really, the only truly bad one at my current vet's) was when I took my beloved orange kitty, Quincy, in for what I knew would probably be a euthanasia. It was the most crowded waiting room I've ever seen there, either before or since; many many barking dogs, yowling cats, and loud humans. I sat scrunched as tightly as I could in a corner, trying to shield poor Quince as best I could, crying as quietly as I could...It's a small office with no extra room, but I'd have been happy to wait in a broom closet. I don't really blame them; I should certainly have asked to wait somewhere--anywhere--else. But I was already a mess because I was 99% sure what was going to (and did) happen. They were nice about taking his body out the back for me to pick up, so I wouldn't have to carry it out through the waiting room (though they still sent ME--weeping--out that way), but I'd much rather have had that consideration (which, after all, was more about not freaking the waiting clients than it was about my feelings) shown for me and for him while he was in his last minutes of life. And the staff knew why I was there, since I'd been quite clear when I called how bad he was, and he'd been in a number of times quite recently leading up to this last trip. In the same situation now, I would ask, but as I said, I wasn't in any condition to be assertive, especially right in front of that room full of observers. Would have been nice had someone acted on my (and Quincy's) behalf.
PLEASE skip the lavendar (and other) oils and perfumes. Even aside from any effects on cats,
lavendar allergies in particular can be severe; a cousin of mine very nearly died from complications of an asthma attack brought on by an involuntary exposure to lavendar oil. I'm allergic to most perfumes and scented oils; at best I'd end up with a migraine; at worst, I'd start choking right in the office. Which most definitely would add to my pet's distress. Too many smells are imposed on us already, especially at a vet's office! If it's a pheremone for the animal, that's one thing. But please, no bludgeoning of my senses with perfumes, thank you very much!
Judy January 22nd, 2009 02:29:07 PM
My dog has always HATED being at the clinic, ever since the vet who always did anal sac expressions, even though we never asked for it and the dog never scooted. We always use a basket muzzle on her, even though the 'anal' vet is no longer at the practice. We tried the walk-by 'weigh-in and treat' for awhile, but I think the treats were not high value enough, and the vet was never available for a visit (Pup is wary but okay with staff) Yoga mat is an Excellent idea, thanks very much. Interestingly, whenever we've had to take the dog to the emergency clinic, they've never asked for her to be put on the exam table, whereas they always do at the regular vet. Mr. Kitty, who's a tolerant sort, has been petrified of the vet's since he's had to give several urine samples. For some reason, they haven't been able to get any through bladder expression (even though I give him chicken broth to drink right before the visit), and have to use a catherer, and even had to hold him at the clinic for several hours to get a sample. On the other hand, as a kid, I, too, always dreaded seeing the pediatrician, and would only behave with a promised reward of comic books and visit to the candy store.
lin January 22nd, 2009 02:45:35 PM
lin: I always tell the owners of fraction/stresed pets to take their pet somewhere fun after every visit. The McDonald's drive-thru, even, if it'll help them associate the stress with an eventual reward.
On that note, my own dog LOVED going to have her radiation done. After receiving food and treats and galavanting about the hospital in search of pettings the first time, she always ran happily to the hospital door after the long drive. I was most thankful to the great people at Cooper City Animal Medical Center (vVterinary Specialists of South Florida) for their attention to her comfort in this regard.
And the anal gland thing? Not necessary as a matter of course. Drives me crazy.
Dr. Patty Khuly January 22nd, 2009 03:37:55 PM
Judy: Thanks for your perspective on the fragrances. I've never heard of a lavender allergy in pets but it's definitely an irritant for some.
On the euthanasia: It's never cool to leave anyone waiting for this procedure--ever. The only time that ever happens is when every single room is full. And then I use X-ray--a glorified broom closet! For others: call ahead and ensure that you won't have to wait. Sit in the car until they call you. Anything so YOU don't have to suffer more than you already are.
Dr. Patty Khuly January 22nd, 2009 04:12:19 PM
And the anal gland thing? Not necessary as a matter of course. Drives me crazy.
I agree that it isn't necessary to express anals at every visit, but our oncologists are encouraging us to perform rectal exams during annual check-ups, since the prognosis for anal sac adenocarcinoma is so much better if it's caught when it's small. I know I've never been to a clinic that does routine rectals... what do you think?
Megan January 22nd, 2009 07:51:34 PM
The thought of walking into the vets with fragrance sprayed, scares me.. Think we should leave the fragrances to Macy's, or Bloomingdales.. I have major issues with allergies to cats, and fragrances.. Even someone near me wearing clothes that were dried with dryer sheets will send me over the edge.. Imagine picking up the dog from being groomed, and having to give him a bath to get the offending fragrance off..
I don't see a problem with waiting in the car until being called in..
Yes.. I totally agree with stopping at the drive thru, after.. Socks, and I usually hit Wendy's
barri January 22nd, 2009 09:04:18 PM
A clarification on the lavender- we only use it in the treatment room (not exam rooms), and it is certainly not something you can smell on yourself or the animal. We use a small diffuser, usually intermittently after a particularly stinky animal has been through, or when we have anxious animals or animals waking up from surgery. I have a sensitivity to chemical odors (i.e. Glade plug-ins, even many instant hand sanitizers), but have never been bothered by our essential oils. Not saying that there aren't people who can have allergies to the oils, but it isn't as though you'll walk into the clinic and be bowled over by the scent of lavender. It is more for keeping the staff happy and relaxed without resorting to chemically-scented air sanitizers.
We would never consider applying oils to pets directly. We do have owners who try essential oils as alternatives to flea or tick products, with quite horrible effects on their pets' respiratory systems and skin- especially cats. Ish.
Megan January 22nd, 2009 10:59:04 PM
Megan: Every intact male should have a rectal. But I don't do it routinely on young dogs. Older dogs? Yep...if they're at all amenable. Anesthetic procedures are a great time to do more complete physicals and whenever possible I defer more uncomfortable parts of the exam to their anesthetic procedures. This is when I do rectals, deeper abdominal palpation, thorough ear cleanings and, of course, the dreaded nail trim.
btw, we do a LOT of ear cleanings under anesthesia. IMO it's the only way to do a good job. We use a videoscope and I now diagnose a LOT more middle ear infections than I previously thought existed in my patient population.
Dr. Patty Khuly January 23rd, 2009 07:54:24 AM
Another nice thing about the new Angell is that they now have a dedicated goodbye room in a quiet corner of the building, right near a back entrance. Because the room is not used for anything else, clients can take as much time as they need to say goodbye, and have privacy in which to do it. Angell is lucky in having had a very large tract of land to build on, which not many clinics have, and they've used that space well.
regina January 23rd, 2009 12:22:57 PM
Top ten strategies for pet parents who want to help prevent veterinary phobias in pets by Rolan Tripp, DVM and Susan Tripp, MS/P 1. Kennel Train - Kennel train your pet and make being in the car for a short, fun rides a part of life. Many pets are only put in kennels and cars to go to the veterinary hospital. 2. Fun Visits - Go to the veterinary hospital for fun visits. Go in, weigh your pet, give your pet a treat and leave. Bring your pet when you go in to purchase food, prescriptions or other products. Participate in puppy socialization classes and daycare programs offered at the veterinary hospital. 3. Hungry Pet - Always skip the meal before the veterinary visit so your pet is hungry. Food tastes better when you are hungry. Bring in a special food as treats that your pet only gets for these visits. Ask each veterinary staff person you meet to offer your pet one of your treats. Ask the DVM to give your pet a treat when he or she first enters the exam room. 4. Pheromones - Put a fresh new dog appeasing pheromone (DAP) collar on your dog the night before the visit. Ask your veterinarian if you can bring in and apply Feliway to the exam room table and scale before bringing in your cat from the car or lobby. 5. Extended Exams - Ask your veterinarian if you can separate out the exam from the vaccine visit for the same fee. Ask if you can pay for an extended exam to avoid a rushed physical exam. 6. Medications - Ask your veterinarian about options to lower anxiety and prevent pain similar to what dentists offer to fearful patients. Be willing to pay for anti-anxiety and pain medications to protect your pet from both emotional and physical pain. Tell your veterinarian that your goal is for your pet to enjoy visiting the veterinary hospital. 7. Hiding Place - Bring cats in kennels covered with a bath towel or in pillowcases. Cats are less stressed if they can hide. If your cat needs to stay for a procedure, bring in a brown grocery bag and ask the veterinary staff to put the bag in the kennel, BEFORE they put the cat in. 8. Exercise -Take dogs on long walks before the veterinary visit. Engage your cat in a long session of interactive play. Being tired helps to reduce anxiety. 9. Be Relaxed - Resist the temptation to soothe your pet in ways that may reinforce fearful behaviors. What gets rewarded gets repeated. Instead, act happy and relaxed to provide your pet emotional leadership. Your pet is more likely to relax if you are relaxed. 10. Wait in Car - If your pet is fearful of other pets, especially for cats who fear dogs, ask to wait in your car with your pet until an exam room is ready. Then, ask for cooperation from others in the lobby such as ask if they would mind being out-of-sight for just a minute because your pet is afraid. Cover the kennel with a big, fluffy towel.
Susan Tripp, MS/P January 24th, 2009 09:42:57 AM
Thank you, Susan!! Sorry for the formatting issue on your comment! I'm glad you found us here at Dolittler. Keep up your excellent work and keep me posted on future developments in your work. (You can always reach me through the "contact us" section of this blog so I can email you with my private email address).
For those who don't know, Susan is a psychologist. No doubt that helps her engage with the very human aspects of this concept.
Dr. Patty Khuly January 24th, 2009 09:56:37 AM
I think a pet centered neurologist could be extremely useful! My dog recently had to have a neuro exam and now is generally scared of vets (we just got back from his weekly visit to hang out and eat treats to rememeber that his vets office is a good place.) I don't blame him, I've had neurology exams and they aren't fun when you know what they are doing to you. To make it worse for him, they wanted fasting blood levels for something and didn't take the blood til last so didn't give him treats through out. (Really bad planning IMHO!)
Juli January 24th, 2009 03:39:32 PM
I've had a lot of cats, but never one that would consider a trip to the vet's to be weighed and have a "treat" as anything remotely "fun."
Judy January 25th, 2009 01:11:54 AM
What a great post and I too LOVE the yoga mat idea. We created our hospital along these comfort lines. We even have pet friendly flooring - ground concrete and carpet...yes I said carpet. They are tiles that can be bleached and we pull up and replace them if there is an unfortunate "accident". I can't tell you how cool it is to see a client lying on the floor with their pet when I walk in! I prefer to do exams on the floor since my knees still allow it and the carpet is nice. We also have a sunken scale with carpet over it so it's not so scary. No stainless steel in the rooms either - just nice furniture with an exam platform. We also give out tons of treats!
We do a lot of food distraction for pets and we do have a general policy that all blood draws/cystos/procedures that aren't done sedated are done in the room. Clients are educated and offered to leave if they are uncomfortable but they must go...not the pet. I find moving them to make them more nervous. Clients love to be there and learn and if the pets are not compliant for a procedure they can see why alternatives like sedation are in order. If we have a messy procedure like an anal gland expression, we go to the back and the client is invited to go with!
One great trick we learned in our pet friendly practice is for intranasal bordetella vaccines - a small bowl smeared with squeezy cheese (bacon flavored) and pill pockets squished to the inside edges. As the dog tries to get the pill pocket off the side of the bowl with their front teeth the nose is all set up for you. Most dogs don't even notice the vaccine! Now if only I could perfect the Vet Jet leukemia vaccine distraction...we do okay with that one but it's not nearly as satifying.
P.S. You can check out pictures of the practice at http://client.mttaborvetcare.com/tour.aspx
Dr. Kristin Sulis January 27th, 2009 01:36:27 AM
Judy, If you start with a kitten for the suggestions above, you can shape the future adult cat's perceptions and behaviors. It is easier to reduce trauma by taking the steps above from day one. A combination of early kennel training with strategies to make those first vaccine visits more positive help prevent natural fears. We have over 50 veterinary hospitals in our Network who have stopped the man-handling for nail trims, and use distraction techniques to prevent the pain and fear (and betrayal of trust)caused by being "shot in the back" by vaccines. Preventing veterinary phobia is easier than treating it. However, it is never to late to begin kinder, gentler options for pets in the veterinary setting.
Susan Tripp January 28th, 2009 12:42:31 AM
Stefani--and everyone else with a such a horrific experience at the vet--I would just like to say, as a Certified Veterinary Technician, I am so sorry you & your pets suffered as a result of bad medicine. I work in an emergency/referral hospital and as such we frequently get cases transferred by smaller practices where the veterinarian, tech, or assistant has made a terrible mistake (or a series of them). While I definitely can't say that larger hospitals don't screw up, having worked in both small general practices and large specialty hospitals, I firmly believe that better medicine is routinely practiced by emergency doctors and specialists (DVMs who have completed internships and/or residencies--things that are NOT required of vets to get those letters behind their names!).
...And on the technician side, practices which employ primarily Certified, Licensed, or Registered Veterinary Technicians. The state laws differ on whether or not practicing technicians are required to be certified in any way, but the laws are changing and the goal is to require licensure of ALL techs starting in 2010--meaning the technician has to have graduated from an accredited institution with a degree in veterinary technology, and they have to pass a national exam.
My advice to those of you who are (justifiably) afraid to go back to the vet is to look for hospitals which:
1. Employ Certified, Licensed, or Registered Vet Techs (CVT, LVT, RVT) primarily. Practices may also have a few unlicensed assistants who restrain or assist with technical procedures, but should have 50-75% educated & qualified nursing staff.
2. One or more veterinarians who are specialists (extra letters after the DVM) or who have completed one or more year-long internships (if the practice has a website, this will usually be stated in the vet's bio). In terms of a vet's experience, a one year internship at a high-volume emergency or referral hospital is considered academically equivalent to five years experience in general practice!
3. ARE AAHA accredited! This may not make a difference, as Stefani said, in the technical staffing department, but it does make a difference in safety and health issues which can affect your pet's care!
4. Let you set up an interview. Most good hospitals will be more than happy to give you a tour of the facilities and let you meet some of the staff so that you feel comfortable. Ask questions about how closely pets under anesthesia are monitored, or how hospitalized pets are cared for overnight.
5. DO NOT EVER leave your pet overnight at a hospital which DOES NOT HAVE OVERNIGHT STAFFING. MANY day practices will recommend "overnight care" for a sick pet when they do not have a single person in the building between closing & opening the next day. It baffles me beyond belief why anyone thinks this is appropriate, as a pet who is sick enough to spend the night is sick enough to need continual attention during that time. (Not to mention that even a fairly healthy dog can chew out his IV and bleed to death within a matter of hours!) In most areas there are 24 hour hospitals where your pet can be transferred with a technician and a doctor on all night to take care of him.
Having seen what kinds of things can go wrong, I know I wouldn't leave my pets in the hands of anyone besides the doctors & nurses I know personally and whose medical opinion I trust. However, not everyone has the benefit of that inside info. I hope that list is helpful to the rest of you who have had such traumatic experiences. It hurts me to read such things about my profession!
J.B. April 21st, 2009 11:59:38 AM
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