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Ideally, our patients should be relaxed enough to explore the room. This kitten was bold enough to take on the exam table. |
When I went through uni, one of our lecturers shared this: people become vets because they love animals, only to realise that they are the thing that animals fear most. Certainly I don't think this is the case for all animals, but it is devastating to see a patient hide under a chair when you walk into the waiting room. Now I know how my dentist feels!
Dr Zenithson Ng is a veterinarian who has developed a professional interest in fear and stress reduction in veterinary settings. He is a clinical assistant professor in small animal clinical sciences at the University of Tennessee, and took the time out to explain the rationale behind proactive stress reduction.
What
is your current position?
Clinical assistant professor of Community Practice
(primary care medicine and surgery for dogs and cats)
Why
did you become interested in animal welfare and stress reduction in veterinary
settings?
Animal welfare has always been a passion of mine since I
became heavily involved in shelter medicine as a veterinary student. I recognized the stress and anxiety dogs and
cats suffered from in shelters and had veterinary and behaviourist mentors who
taught me so much about recognizing and managing these signals. After understanding stress and the impact it
has on animal health and wellbeing, I began to implement stress reduction
techniques in veterinary practice. I saw
immediate positive differences in the way animals responded to low-stress
handling which have become a part of my practice since it is best for my
patients, clients, and me.
Were
there any particular experiences which made you realise this was important?
Hindsight is always 20/20, and knowing what we now know
about low-stress handling, I remember countless times in practice where we
manhandled dogs and cats, wrangling them to the point of exhaustion, pinning
them between doors, using rabies poles, and creating a terrible negative
experience. We always thought we were
smarter and stronger than these animals and they had to give in. I think back to these moments, and my heart
breaks for these animals that are only acting in this way because they are
scared and stressed, and all we did was exacerbate and worsen their
experiences. I regret all the times I have
witnessed these events and wish we could have done differently by them.
How
does stress impact on an animal’s wellbeing at the vet?
Stress is a natural phenomenon for all living beings
which should be recognized and embraced to alleviate their exaggerated
responses. When animals are stressed at
the veterinary office and we do nothing to help them, we cannot provide them
with the quality care they deserve. Our
physical examinations are limited, procedures such as blood draws are time
consuming and difficult, and diagnostics such as blood pressure and bloodwork
parameters may be inaccurate to assess.
When clients see that their animals are stressed, they can be reluctant
to bring them back to the veterinarian for essential preventive care or end up
waiting on medical problems rather than coming in early.
What
can owners do to reduce stress associated with veterinary visits?
There are numerous things owners can do to reduce stress,
but the three most important things that can be done are:
- Don’t feed the pet the morning of the appointment so they will be hungry for positive reinforcement in the form of tasty treats. Bring the animal’s favourite treats and toys to have during the appointment.
- Bring the pet in for routine, preventive health wellness appointments so the animal can have a positive experience and not see the vet’s office only as a place where they are restrained and poked and prodded with needles.
- Remain calm, cool, and collected. I believe strongly that animals are sentient beings that can be empathic to human’s emotions, especially owners. Often times, pet stress and anxiety parallels the stress and anxiety of their owners at the veterinary clinic. The best thing to do when an owner is nervous with the pet is to remain calm and breathe deeply to remain strong for his or her loved one.
What
are three things veterinarians and nurses can do to reduce stress in patients?
- Use lots of positive reinforcement throughout the entire appointment.
- Patience makes perfect. Go slowly and methodically when approaching and handling animals that are stressed.
- Recognize the pet that is beyond behavioural modification and low-stress handling techniques. This animal would likely benefit from chemical restraint early in the appointment if it is safe to do so. Often times, the staff continues the same or alternate handling techniques with different staff members over and over again, which causes the patient’s anxiety to escalate exponentially. If the animal had been sedated earlier, it would have been a much smoother and faster process.
How
would you like to see veterinary practice change in the future?
Fortunately, I have already seen great changes in
veterinary practice regarding animal stress and welfare in the past
decade. We have come a long way in the
“fear-free” movement by educating and implementing low-stress handling techniques
in practice. I would love to see the
profession recognize Low-stress handling certification (http://drsophiayin.com/lowstress/certification) and
Cat-Friendly Practice certification (http://www.catvets.com/cfp/cfp) as standards
of care in all hospitals. In addition, I
would like to see more research on the outcomes of such certifications and
practices. Currently, we are researching
the effect of the approach of 4th year veterinary students to
clients and patients on stress behaviours in dogs. Hopefully, the knowledge we gain from such
studies can provide evidence for the changes that need to occur in
practice.
Any
advice you’d like to share with veterinarians and future veterinarians?
Understand that animals are empathic living beings that
react to their environments. Animals are
not intentionally malicious and should never be punished for perceiving a
situation as stressful. Use these
observations of stress and fear behaviours as opportunities to educate the
owner in recognizing and managing stress.
With this knowledge, we can transform potentially negative experiences
into positive ones that keep client and patient coming back again and again.
Thank you, Dr Ng. If you want to learn more about the UT College of Vet Medicine, click here.