Nervous Pet at the Vet?

Michael Forney, DVM

Why your furry friend may be unhappy and actions you can take to help

Do you hate going to the doctor or your dentist for a checkup? Your cat or dog may be in the same boat. Do you dread having to take Simon in once a year to the vet clinic for his annual exam and vaccinations? Do you get anxious wondering how on earth you might try to coax Sassy into her cat carrier and worry about getting scratched? Just like you, your pet may experience a great deal of fear related to veterinary visits. And similar to people, their fear may be rational or irrational. There are numerous reasons an animal may be uncomfortable at any point throughout the steps involved with going to the clinic, and there are various remedies that can be employed to help allay those fears.

Reasons an Animal May Fear the Vet

Patient temperament/breed. Certain animals have a genetic predisposition toward higher anxiety and level of arousal. For example, working-dog breeds like Shepherds were selected over hundreds of years to have increased vigilance in order to protect the flocks of sheep or herds they were intended to protect. I own a German shepherd, her name is Gertrude, and she loves coming to the vet (that’s me, haha), but compared to some dogs, she is definitely more high-strung. There are, of course, exceptions with every breed of dog or cat, but in general, we can see trends toward higher anxiety and potential fearfulness based on breed. Again, there is a genetic component and there is a spectrum (many genes are involved). The takeaway point, I think, is for owners to be aware of what a pet’s expected temperament may be, and therefore realize that one pet may benefit from additional strategies to help make him comfortable at the vet clinic.

Socialization. Cats and dogs both have well-defined socialization periods as they mature. For kittens, the age is around 3–7 weeks, and for puppies around 6–14 weeks. This stage of development is a time when kittens and puppies are starting to learn about their environments, explore, and develop emotional responses to the abundant stimuli they encounter. Visiting the veterinarian most often does not occur during a kitten’s socialization period. I do often see puppies during this period, but generally only one or two visits. Breeders and owners have the most control over how well an animal is socialized.

Prior history at vet office. A component of how an animal learns to respond in a given situation is based on its prior experiences in said situation. Therefore, each encounter with the vet hospital builds the emotional data from which a patient learns what to expect and how to feel. I would say most, if not all, veterinary facilities aim to treat patients with the utmost care and employ strategies to reduce fear in our furry friends (some hospitals and staff have better tools and training than others). Unfortunately, certain aspects of medical care do carry a component of potential discomfort or pain – needles for vaccinations and blood draws, restraint for examination, aversive smells from cleaning agents, loud, unfamiliar noises, strange doctors, and the list goes on. Additionally, patients may be experiencing pain related to their medical condition, and this pain can become associated with the hospital environment.

Medical conditions. Occasionally, dogs and cats may start to dislike going to the vet as a result of a disease or medical illness. I occasionally see some patients that used to be content being examined, but now hiss, growl, try to bite or want to escape. In these instances, there is often a component of underlying orthopedic pain or gastrointestinal upset, but other rule-outs include hormonal diseases (e.g., hyperthyroidism in cats), neurologic changes (e.g., cognitive dysfunction, brain tumors, spinal injury), and some infections (e.g., rabies). Even once the medical issue is addressed, those fearful behaviors can, in some cases, persist since the emotional response is now associated with the clinic.

Now that we know why veterinary visits may be scary, we can utilize some appropriate strategies and tools to reduce our furry friends’ fear and anxiety.

How You Can HelpDesensitization and counterconditioningDesensitization and counterconditioning»

Puppies/kittens: socialize, socialize, and socialize! Covid-19 has definitely complicated socialization, but there are still many creative ways owners can socialize their puppies and kittens. The most important takeaway for owners is that socialization does NOT mean exposure. Simply exposing your pet to number of variable stimuli does not equate proper socialization. The whole point of introducing your puppy or kitten to new experiences is to ensure that they have a happy emotional state while doing so. This will provide them with confidence – we want them to expect “good things” to be happening so they continue to look forward to new places, new people, and new experiences. I am aware of some positive reinforcement trainers still offering puppy socialization classes – this can be one great option to consider. The AVMA (American Veterinary Medical Association) has a page under resources and tools titled, “Socializing dogs during Covid-19.” Fear Free Pets (fearfreepets.com) has puppy and kitten socialization bingo cards that owners can play and help their pets at the same time. There are many other resources online for sophisticated ways of socializing pets.

Socialize,socialize,socialize!
Socialize,socialize,socialize!»

Adults: desensitization/counter-conditioning. Desensitization and counterconditioning refers to slowly exposing patients to low intensity levels of the fear-inducing stimulus and providing some sort of positive reinforcement to try and change a patient’s underlying emotional response. A good example that owners can understand is when humans with a particular phobia are undergoing treatment. If someone has a severe fear of heights, do we start by taking them to the top of the Empire State Building and expect them to get better? No, that would likely be disastrous. Instead, we maybe start with pictures of tall buildings, or go up one step as a patient slowly gains confidence. The idea is similar for pets. Now it does require a certain degree of finesse, and depending on a patient’s severity of fear, it is always a good option to consider consulting a board-certified veterinary behaviorist or a trainer with certification in behavior and positive reinforcement techniques.

Below are just a few major components of a veterinary visit and exam on which owners can work to start desensitizing their pets at home:

Husbandry: nail trims, blood draws, restraint. Know that when your cat or dog goes to the vet hospital, there is at least going to be some restraint (e.g., a hand) involved. As a doctor, I have to be able to touch your pet to examine her. The technician will have to either carry or walk the patient to a room. Fido will need to have his temperature taken and heart rate listened to as part of obtaining his vital parameters. These are all necessary steps in evaluating a patient’s health. Of course, both the staff and I take steps to reduce patient’s fear while doing so – e.g., examining a dog off the table and on the floor, looking at a cat in its carrier where she may be more comfortable, etc. – but these are simple and predictable aspects of a veterinary visit that owners can “practice” first at home. Dr. Sophia Yin’s website (drsophiayin.com) and Chirag Patel (www.domesticatedmanners.com) both have exemplary videos and resources demonstrating creative and simple ways to practice these sort of husbandry skills.

Departure/car rides. Another component that presents a challenge for some owners is simply getting to the veterinary clinic. Dogs and cats are smart. Just like us, they can recognize patterns. And when you go and bring the cat carrier out of the closet, Sophie has learned that this means she is going to that awful smelling hospital with loud barking dogs and a rude woman in a white coat sticking a strange probe up her butt. So what can you do? For one, make the cat carrier a safe place. Leave it out in your living room or somewhere easily accessed with the door always open. Occasionally put Sophie’s food or treats in the carrier if she’ll willingly go inside. Use products like Feliway® or Adaptil® for cats and dogs, respectively, in the carrier or in the car to help reduce stress. Bring a favorite toy. Car rides should also be to fun places other than the vet. Start with short jaunts. Carry treats with you and actually give them to your pet (unless of course there is a contraindicating medical reason). With time and repetition, if patients are exposed to these variable components at a low threshold (meaning they’re not already freaked out), they learn to expect good things and can become more comfortable.Gilbert as a kitten when I adopted him from school – he had quite an affectionate and exploratorytemperament.

Gilbert as a kitten when I adopted him from school – he had quite an affectionate and exploratory temperament.
Gilbert with spray cheese to keep him happy for his first vet visit.

Gilbert with spray cheese to keep him happy for his first vet visit.»

Hospital: arrival, lobby, exam room, treatment room. Similar to departure and car rides, the hospital itself may present a trigger. With many facilities providing curb-side service, it can be a little more challenging to address a patient’s fear in this case. Before Covid, I would recommend owners bringing in their fur friend in as often as possible just to stop by the lobby and pick up a treat or maybe go on the scale (of course as long as they were under threshold). This way, a dog or cat builds a bank account of positive experiences at the vet clinic that can offset the once or twice a year poke with a needle. I am sure many clinics would still be willing to take your pet in for a treat and around the hospital if the pet is comfortable with strangers (call in advance!). You could take a walk around the premises yourself with Bella and give her treats and simple cues all the while ensuring she is below threshold (see UC Davis School of Veterinary Medicine website on “canine threshold thermometer”).

Medications. Lastly, some patients may be so anxious and fearful at the vet in spite of owners’ and the staff’s best intentions. In these cases, I will generally recommend a prevet visit anxiolytic (drug to reduce fear and anxiety). Drugs that reduce fear and stress can be helpful to get patients to a threshold level where they are less reactive and therefore, able to learn that “good things” will happen (e.g., a happy vet visit). There are several medications that veterinarians may utilize for such a purpose. Generally, I will select drugs that have a relatively rapid onset (within 2 hours), short duration, and work to reduce anxiety. This way owners can give the medication around 2 hours prior to bringing their animal in to the hospital and the effects should have worn off by the afternoon or evening. Gabapentin and trazodone are common drugs for cats and dogs, but sometimes I will also reach for alprazolam or other medications, depending on how a patient responds. Of course, this is a discussion that you must have with your primary veterinarian, and the doctor will first need to establish a relationship (i.e., physical exam) with your pet. Even with medication on board, the aforementioned tools and behavior-modification strategies should still be utilized.

Your pet’s fear of the veterinary clinic is likely not going to resolve immediately, especially if no actions are taken to address it. However, if you can empathize with your fur friend and learn to anticipate and predict the challenges faced by Sophie, or Bella, or Max, or Gilbert, then you can employ preventative strategies and training sessions that help build his or her confidence. Talk with your veterinarian, the hospital staff, and your positivere-inforcement certified trainer to troubleshoot. Fear does not disappear immediately, but with time and a bank account full of good practice at home, our pets can learn to love the vet, too.

VCA Rancho Mirage Animal Hospital is located at 71-075 Highway 111, Rancho Mirage, CA. (760) 346-6103. Visit vcaranchomirage.com

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