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| cat carrier = fear if exams are scary |
Last week as I was holding a spoon of baby food that an
anorexic cat was finally eating, my tech laid the ear thermometer on the floor
next to me. The cat took one look at the thermometer, stopped eating,
turned away and crept to the back of the cage as I stayed motionless with the
baby food. I asked her to remove the
thermometer and when she did, the cat came right back up to me eating the baby
food.
So what was happening here?
The thermometer was an anxiety trigger to this cat. That one item - an ear thermometer- was
enough to shut this cat down. How often
have you had a happy dog suddenly snarl and become agitated just before an injection is given? Very likely this dog saw the syringe and that
triggered the aggression. That dog
remembered the pain and irritation that the syringe injection gave.
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| If you don't have a reward, all this dog will remember is the pain |
When I present to
veterinarians and technicians, some of
the audience acknowledge the trigger effect of our equipment. They too have had an episode like the one I
had with the cat. Others can not believe
that something so innocuous as a thermometer could set off that much
anxiety. These instruments are triggers. They are items, or settings that predict for
the pet what is coming next which may be unpleasant.
These are some of the most common triggers that I see ( and my face book friend
have added!)
Stainless
steel topped tables small room
syndrome - the close quarters of an exam room
syringe
and needle attached white
coat/smock/scrubs - especially on the DVM
thermometers otoscope
Stethoscope
nail trimmers electric trimmers
Here is the challenge.- how do we perform our work, needing
to use these instruments and avoid setting off fear
aggression and anxiety? Here are a few tips
that have helped reduce the anxiety and aggression we see from patients.
1. Hiding these triggers is a first step. Be creative.
When you have drawn up the vaccines, keep the syringes hidden under a
paper towel or piece of paper. Hold the
thermometer palm down so the pet cannot see it.
Cover your table with a beach
towel to hide the stainless steel. Use a
towel or blanket as a hood or a calming
cap ( from the thundershirt
company) over the pet( dog or cat's)
face so they cannot see what is happening.
2. Reduce pain and
discomfort when using these instruments. Use lidocaine cream around the rectum and
wait a few minutes before using a fecal loop or rectal thermometer. Smaller gauge needles (25ga for most
injections) reduces pain during injection. Give pain relief before a procedure such as
oral buprenex.
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| Latex gloves + pain unless you use lidocaine |
3. Reduce the anxiety
the pet is feeling. Try the pheromone
products early and often. Adaptil may
take 5-15 minutes to help reduce anxiety.
Give the client a bandana to put on their dog so it is taking effect in
the waiting room and during history taking. Spray
feliway on a paper towel to rub on the door of the carrier and on the exam
table. Offer food reward, verbal praise
and petting that the pet enjoys throughout the steps of the exam and treatment.
Here is a video showing how varying the triggers helps a nervous dog in for an exam nervous dog exam you tube video
Whatever steps you
take with a patient to reduce anxiety,
record it in the record. This
will save staff time and improve every
visit for that pet. I have a medical
record labeling system Bella Behavior Label System available at wwwldrsallyjfoote.com to make this easy. It is essential that the doctor is a part of stress reduction for this pet. Technicians can
take the lead by suggesting they removing
the lab coat or hold the syringe so the pet cannot see it. Tell your doctors what you notice when the
pet became tense and that you want to try reducing anxiety by removing a
trigger or 2 and see the effect. Some of
us doctors get so engrossed in doing the tasks of diagnosis and treatment we
don't pay attention to what may be
triggering the patient's anxiety. We
can't see how the animal is responding as we bend over to look in an ear or are
at the rear of an animal. Doctors - be
open to changing a few things for the benefit of your patients and your
staff. Everyone wins when we decrease
fear in the veterinary clinic.
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| This little dog took rewards because I left my lab coat off - the Bella system reminded me to do this Bella Behavior Label System |
Dr. Sally J Foote DVM CABC-IAABC www.drsallyjfoote.com
