How To Make Visits To Your Veterinarian Go Smoothly

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Visits to your dogs’ veterinarian can be a difficult and stressful event for all involved.  Not only are they “difficult” for you dog, they are often terrifying as well.  Even the most laid back and mellowest of dogs can be stressed at the local animal hospital, throw fear into the mix and you are dealing with a dog that literally fears for his safety and well being.  There are several things that can be done to help things go smoothly.

Exercise, Exercise, Exercise

If you have been reading my blog I’m sure this is nothing new to you.  Set yourself, and your dog, up for success by properly exercising him before the appointment.  Running around in the back yard does not count, even if you have acres of land.  Fast bursts of running/sprinting are not the same as sustained cardiovascular activity for at least 30 minutes.  Walking is one of the best forms of exercise.  The walk should be one with a purpose, not a “sniff and pee” type of walk.  It is okay for your dog to sniff around on a walk, as long as you control when sniffing starts and stops, but the purpose of this walk is to tire him out.  Treadmills are excellent options for busy people.

 

Watch Your Verbal and Nonverbal Language

When our dogs are stressed and afraid, it is a very natural for us humans to try to some how convey to them that this really isn’t something to be afraid of.  Or in other words “it’s okay.”  Well, often times it’s simply not okay.  When a fearfully aggressive dog is trying to attack the vet tech or vet it is not okay :-).  I understand this approach.  In this time of stress (for the owner) owners are reverting to what they know, human psychology.  That may work is we are dealing with another human, although it didn’t seem to help much the last time I took my daughter in for vaccinations, it sends the complete opposite message to your dog.  The average dog has a very limited capacity to understand what you are saying.  This is not because they are not capable of learning, it is simply because they have not been trained or taught properly.  The time to do that training, or any training for that matter, is not when we need it.  Stress and anxiety inhibit learning.  For many dogs, a visit to the vet is one of the most stressful things they will experience.

Look at the situation from a dogs’ point of view.  The entire appointment is a scary threat.  He is anxious and stressed (I’m sure he even knows where he’s going before he gets there), strangers (vet tech and vet) are approaching, making direct eye contact, leaning over him, reaching over him, and are trying to poke and prod and restrain him.  Then, he looks to his owner who has suddenly has changed their body language from one that was relatively relaxed to one of concern and anxiety.  The concerned look the owner is showing is because they feel bad for their dog and they want to some how convey that concern to their dog, along with trying to relieve the stress the dog is experiencing.  However, the dog is interpreting that concerned body language to be motivated by the same thing he is concerned with, the big bad vet!  The behavior of the owner in this situation only serves to reinforce the fear that their dog is experiencing.  In some cases, it does seem that this behavior helps to calm the dog, but these are the exceptions.  The general rule is that this behavior makes the situation worse.

So, what should you do?  First, remain calm and make sure your body language and your facial expressions convey that.  Do not give that worried/concerned look, try to smile :-).  If your dog is freaking out and giving you the look for “please help me” as he is struggling and trying to escape, look away from him.  This will convey to your dog that you do not agree with the behavior he is displaying MUCH more so than anything you can verbalize.  When he calms down, then you can look at him, but not with the look of concern.  Remain relaxed and calm, or at least appear that way :-).  It is best to be silent.  He is already over stimulated.  Adding more sound to the situation only serves to add more stimulation, when what we need is less.

Your Veterinarian’s Behavior

Something you cannot control is how the vet and the vet tech behaves.  I will discuss this so you can have some insight into why some vets, with the kindest of hearts and noblest of intentions, make the situation worse.  Many vets just simply do not understand canine behavior.  This does not make them bad people or bad vets anymore than it makes your child’s pediatrician or your own family doctor a bad doctor for not having a complete understanding of human psychology.  It is simply a fact.  Many vets greet their patients the same way that many people greet a strange dog.  They walk in and immediately focus on the dog, saying his name in a happy tone, making direct eye contact, making a direct approach, reaching and leaning over the dog, and trying to “make nice” or comfort him by petting him.  The intention is one of kindness and compassion, but it is all wrong.

Another factor that plays into this type of greeting is the fact that many owners would think the vet to be cold if they do not greet their dog in this manner.  This absolutely plays a role in things.  If a vet is viewed as cold, it will affect the bottom line as many owners will find another one that will greet their dog in a warmer manner.  I’m not implying that this is a direct thought process in all cases, but this, at the very least subconsciously, plays a role.

There are a few things that I find go be helpful. When I see that a dog is fearful I will usually not say hello or try to interact at all in the beginning. I speak to the owners, get a complete history, set up my vaccinations, and basically do everything I need to in order to delay interacting with the dog.  Some owners will feel like I’m ignoring their dog and I can tell they may be a bit put off because I don’t give an overly exuberant greeting, but when they see how much better the appointment goes, and when I explain my approach, they usually get over it quickly. When I do greet the dog, I squat down, turn my body sideways so I’m not facing the dog head on, squint my eyes slightly while looking in their direction & avoiding direct eye contact, extend my hand palm open and up just above ground level and try to give them a moment to approach me. If they do not, I creep a little closer to them. Getting them to sniff you and allowing it to happen helps a lot. Then my assistant does the same type of thing. A lot of times less restraint is more. When examining the face and eyes, making my eyes smaller by squinting helps a lot. If they start to struggle while I’m handling their face, I’m already squinting, so I slightly avert my gaze downward and to either side. I always give them the option to sniff my scopes before I use them. They don’t seem to find them as scary if they say hello to them first. If they start to struggle during part of the exam, I do not back away. I hold what I have as gently as I can to maintain my hold, but I let up the instant they do, if they begin to struggle, I tighten up again. Sometimes I don’t really have a choice and have to left go, but that’s kinda rare. Silence is paramount. I have sent owners out of the room because they cannot overcome their compulsion to “reassure” their panic stricken dog with a constant stream of “it’s okay” or “you’re a good boy”. I don’t speak because I found that many fearful dogs react to the “ggrrrrr” sound in some of the words I say, same goes with “hhhmmmmm.”. Plus, it’s just another source of stimulation that their brain has to process.

Sedation

Many people are against sedation because of moral issues concerning “drugs.”  Drugs are not always a bad thing.  Millions of lives would be lost every year if drugs were not around, yet drugs that cause sedation are seen in a very negative light.  This is because many of them are abused by humans.  I’m not talking about turning your dog into a drug addict.  I’m talking about a legitimate use of a medication to help a panic stricken dog to relax.  This is a much better situation for all involved.  I have seen dog physically injure themselves in a number of ways trying to escape the clutches of the evil strangers that are accosting him, something that is definitely avoidable.  The medications I recommend in this situation are :  Benzodiazepines – Medications such as Valium, Xanax, and Klonopin.  They are anti-anxiety medications that start to work about an hour after administration.  I usually recommend giving them and hour and a half before the appointment.  Acepromazine is one that is very commonly dispensed, and one that I am NOT a fan of.  Ace does not help to decrease anxiety.  It just makes the dog unable to respond to the stress that he is experiencing.  His brain is under the exact same amount of stress, but his body is unable to respond.

Desensitization and Counter-Conditioning

In a perfect world, the gold standard for helping a dog over come his fear of the vet would be to desensitized him to the event and counter-condition his response.  This is no doubt the best approach, however it is very labor intensive for the owner and the veterinary staff.  It would involve multiple visits to the hospital when we do not need to go.  I like to call them happy visits.  Basically you would bring your dog to the hospital and just hang out without getting an examination or shots or anything else that is scary.  This would have to be done several times a week, daily would be optimal.  The duration of treatment is highly variable and would depend on how fearful the dog is, how long the fear has been present, what happened (or did not happen) during the dogs’ critical socialization period, and how/if the fear has been reinforced just to name a few.  If you have a vet that is willing to work with you in this capacity and you have the time and patience to do it, it is definitely a great idea.  If you would like a detailed protocol on what should be done, let me know.

The world in general can be a scary place for some dogs, but the vets office is a special location that causes a great deal of stress and anxiety in even the happy-go-luckiest of dogs.  I hope this post will help you understand what goes on in the mind of your dog and how you can help him and not inadvertently make things worse.  Thank you for reading and please feel free to comment and/or ask questions :-).

 

Pictures provided by : otakuchick, normanack, stefernie, and Tobyotter via Flickr.

13 thoughts on “How To Make Visits To Your Veterinarian Go Smoothly

  1. Adequate exercise takes the edge off any stressful situation.

    We are lucky, as our dogs love their vet and he is really great dealing with them. So Jasmine actually looks forward to seeing him.

    • A tired dog is a happy dog. Too many people overlook the importance and the benefits of adequate exercise, both in themselves and their dogs :-). I love when my patients are happy to see me!

  2. I had a schnauzer mix that was extremely fearful about handling. I hired a trainer who was a former vet tech and she came with me to an appointment to observe and we worked out some things. One, Missy was better when I wasn’t in the room with her. Who knows what was in her head? but it worked. Two, I put her up on a table at home and did mock exams on her daily for about two weeks before her annuals. She was an angel for annuals and for about half of her other visits. When she was in extreme pain from a torn cornea she was a tasmanian devil, but the vet didn’t need to examine her for more than a second to know she needed surgery. She was an angel in surgery :-)

    • The mock exam is part of my treatment plan for dogs with extreme phobias of the vets office. That was a great suggestion by your trainer. The reason she is better when you are not in the room is likely because she is unable to read the stress that your body language is announcing. It can be very difficult, if not impossible for some people to hide what they are feeling. We can hind it from humans, for the most part, but dogs are MUCH better at reading body language than we are. It’s really difficult to lie to your dog :-).

  3. We’re definitely on the same page about exercise as a way to prevent problem behavior in many situations–the vet’s office included. I’ll be linking to YOUR blog too!

    • Thanks for the kind words Carrie. I love your site :-). Proper diet and exercise are at the heart of good behavior and good health in general.

  4. Dr. Mark, I WISH I could find a vet like you in my area. I have yet to find a vet that knows about desenitization and counter conditioning. I have an over the top fearful dog. He was abused and I imagine had severe trauma at the vet before we got him. That has been compounded by several horrible visits and him being forced. He has urinated and defecated on himself, he is so afraid. I have conditioned him to wear a muzzle and he is friendly, but fearful until they start to try to examine him. Do you know any vets in Eugene, Oregon or nearby that would be a resource for my dog? I have worked with a certified behaviorist and used positive reinforcement. He is extremely smart and a single instance learner, so it makes it hard to work with negative experiences. Thank you.

    • Hi Jessica,

      Fearful dogs in a veterinary hospital setting can be very difficult to counter condition. Everything we do while examining them is scary. Also, time is a factor. It’s important to go slow with these dogs, but that’s not always a luxury we have when there is a waiting room full of patients. Attempts at making “happy visits”, just going to the hospital to hang out without examinations, etc…, can help, but when it comes to the time when they need an exam they know the difference and will often revert to the fearful reaction. These dogs NEED anti-anxiety medications (Xanax or Valium) to make it easier on them and safer for everyone involved. It’s no difference than the person that has a fear of flying and needs a little something to take the edge off. Unfortunately, I do not know of anyone in Eugene, Oregon.

  5. Just a quick tip I’ve found with my dog: having him up on the table will make him calm and accepting of handling, but people bending over him on the floor or crouching down next to him will freak him out completely. I find a lot of vets tend to treat big dogs on the floor and only have the smaller breeds up on the table, so these days I always make sure to ask to get him up as soon as we enter the room.

    It’s not an alternative to teaching your dog to trust and remain calm of course, but it’s a good help while you’re working on it.

    • Very true! Leaning over and reaching for a dog can be a scary thing. On the other hand, if we are dealing with a dog that weighs as much as my assistant, it can be difficult to get them onto the table. Keeping them there can be quite amusing (for me) as well :-)

  6. Hi. I have a 14 month-old golden retriever. He is really sweet and playful. He is a little afraid of the vaccum cleaner sound but other than that he is not scared of strong sounds or strange objects. He is always active and friendly towards dogs and people. The problem is with the vet. We wanted to neuter him last year, when he was nine months-old. I left him early in the morning with the vet and I received a call like three hours later saying that they could not do it because he bit one of the doctors. I don’t know what could have happen. the only thing i know is that when i went to get him he was in a dark corner of a crate soaked in his own pee and poo. After that he didn’t even want to get close to the clinic. I changed the vet, and went there a few times. He is ok getting into the waiting room, but as soon as he sees the vet office, he puts his tail between his legs and start trembling like crazy. As much as it hurts me to look at him like this, i try to ignore him. When the vet takes him to the examination bed hi starts peeing and shaking stronger. he breaths really fast too. As soon as we come out of the office into the waiting room, he forgets everything and start playing with whoever is there and walks home sniffing around as if nothing happen. I wanted to neuter him but i am afraid that he is going to die of a heart attack if I do it. what kind I do to help him calm when he is with the vet? Any ideas?

    • Hi Sol,

      The vets office is a very common place for dogs to be fearful. Everything about the visit is scarey, and many vets have not idea that they are actually making things worse. More than likely what happened on the day you dropped him off for neutering is that he was really scared, and his early calming signals were unnoticed (many people, even vet techs and staff, have no clue), so he then began showing more obvious signals. That likely lead to and increase in physical restraint and worsening fear, and round and round we go. That left a VERY strong impression on him about vet hospitals. Desensitization and counter-conditioning are not very practical, although it is by far the best approach. I would recommend Xanax about 1.5 hours before the appointment, and show your next vet this post. Many vets have an over exuberant greeting for 2 reasons, #1 – they love animals, and #2 – most owners love it because they feel the vet really cares. A quiet, low key greeting is greatly appreciated by the dog, who is likely fearing for his life as this strange person is rapidly approaching, while reaching over his head and making eye contact. It’s a recipe for a bad experience.

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