The New Breed of Veterinary Clinic, a Godsend for Fearful Pets

Analysis by Dr. Karen Shaw Becker

fear free veterinary

Story at-a-glance -

  • Nutraceuticals are now being used in at least one conventional, fear-free certified veterinary practice to calm patients with fear, anxiety and stress (FAS)
  • Hopefully, the fear-free movement will provide an incentive for other veterinarians to investigate the benefits of nutraceuticals and other nontoxic calming remedies
  • In addition to calming agents for dogs and cats with FAS, there are many other steps veterinary clinics and pet parents can take to ease the stress so many dogs and cats feel during vet visits
  • Some of these strategies begin at home and are designed to help pets arrive at the vet’s office in a calm state
  • Others involve creating a low-stress clinic environment and handling techniques

Recently I ran across an article in a conventional veterinary journal about the use of calming nutraceuticals in fear-free veterinary practices. The author of the article, Dr. Julie Reck, a veterinarian whose practice is fear-free certified, writes:

"I found myself unsure that they ['calming' nutraceuticals] had a place in my daily recommendations to clients. I found myself reaching for what I 'knew' would work, such as trazodone and gabapentin. As I gained more experience with Fear Free practices, I began to find myself in a variety of situations where pharmaceuticals didn't fit all the needs of my patients."1

Reck admits that prior to becoming a fear-free practice, she had zero experience with and was skeptical of complementary over-the-counter remedies. Interestingly, the fear-free certification process seems to have made her more open to learning about the potential of nontoxic remedies to reduce fear, anxiety and stress (FAS) in her patients.

I consider this an encouraging sign, because at this point, almost every veterinarian in the U.S. is at least familiar with the term "fear-free." In fact over the last few years, the terms fear-free and low-stress have become com­mon­place in the veterinary community, as more and more vets come to the realization that terrified, stressed-out dogs and cats at veterinary visits shouldn't be considered "normal."

As a profession, veterinarians are awakening to the idea that their patients' emotional state is just as important as their physical health — including during vet visits. Hopefully, as was the case with Reck, the fear-free movement will cause more veterinarians to investigate the myriad of nontoxic alternatives available to veterinarians that we didn't learn about in vet school pharmacology class.

A Step in the Right Direction: Nutraceuticals Before Pharmaceuticals

Reck's initial dilemma involved dealing with new patients prone to FAS whose owners sought out her practice because it was fear-free certified. Since she had no prior relationship with these patients, she couldn't legally prescribe traditional pharmaceuticals to calm them before their first visit.

"Suggesting an over-the-counter calming supplement for an initial consultation is often helpful to begin the process of reducing fear, anxiety and stress (FAS) associated with the veterinary visit," she writes.

Once she meets and examines the pet, if he or she is still suffering high levels of FAS, Reck is then legally able to prescribe drugs. Needless to say, this wouldn't be my approach. I would try a variety of nutraceuticals, herbs and other calming techniques and leave drugs as an option of last resort.

However, I recognize most veterinarians follow the Western medicine model because that's what is taught in vet schools, and unlike holistic and integrative practitioners, conventional veterinarians haven't struck out on their own to learn about complementary healing modalities.

The good news is more and more veterinary schools around the globe are offering elective courses in integrative medicine, because students are asking for more diversified training.

Nutraceuticals Play an Important Role in Nontoxic Healing Protocols

While she still clearly prefers the use of pharmaceuticals, Reck concedes that "Some pet parents are more comfortable using the gentlest, most natural option as a first-line treatment approach." For these clients, she starts with a nutraceutical and then if on a follow-up visit the pet is still showing signs of fear and anxiety, Reck recommends a drug or drugs.

It's been two years since Reck's practice was certified fear-free, and she continues to use nutraceuticals, but only on a limited basis. She seems to use them primarily with new patients and to "begin the process of addressing FAS in a gradual, progressive fashion," which suggests she probably views nutraceuticals as a stepping stone toward pharmaceuticals.

"Nutraceuticals are an effective tool to build trust with pet parents and forge a long-lasting relationship that focuses on the pet's emotional health and well-being," Reck states.

If you're a regular visitor here at Mercola Healthy Pets, you know that in my view, effective nutraceuticals and other nontoxic healing modalities are almost always my first choice. In my experience, many disorders in pets — including fear, anxiety and stress — respond just as well or better to natural interventions that are free of side effects.

Whenever possible, my goal is to help patients remain healthy or heal without resorting to substances or treatments that may create other problems for them down the road.

10 Strategies for Fear-Free Veterinary Visits

There are many things both veterinary clinics and pet parents can do beyond offering nutraceuticals or drugs to help dogs and cats feel less stressed during vet appointments. The following 10 tips by Dr. Marty Becker (Fear Free: Taking the pet out of petrified) were written for veterinarians and their staff, so I've edited them a bit so they're helpful to pet parents as well.2

I've also fine-tuned them where appropriate to reflect my own approach to reducing fear and anxiety in pets (which almost never involves pharmaceuti­cals or chemicals).

1. Arrive at veterinary visits with a calm pet — This involves making sure your dog or cat is crate-trained (or is conditioned to wear a car seat harness) and is comfortable during car rides. To keep your pet calm on vet appointment days, use pheromones — Adaptil for dogs or Feliway for cats, calming nutraceuticals and carrier covers.

Products I use, always in conjunction with behavior modification, include homeopathic aconitum or Hyland's Calms Forte, Bach Rescue Remedy or a Spirit Essences stress or fear blend. Calming nutraceuticals and herbs that I've found helpful include holy basil (Tulsi), valerian, l-theanine, rhodiola, ashwagandha, GABA, 5-HTP and chamomile.

As your pet's advocate, it's also important that you remain calm. If you find it helpful, play calming music on the drive to your vet appointment.

2. Limit food before veterinary appointments — Especially if your appointment is around your pet's mealtime, offer a smaller amount of food or hold off feeding her until you're back home (if you can do so safely). If your dog or cat is a bit hungry during her appointment, she's more apt to respond to treats offered by the vet staff. You can also bring a small supply of your pet's favorite treats with you to the appointment.

3. Minimize time spent in the lobby of the vet clinic — The main lobby or waiting area of many veterinary practices can be a trigger for fearful pets, due to the smells, sounds and sights of other animals and unfamiliar people. If you can't take your pet directly to an exam room after check-in, let the receptionist know you'll be waiting with your pet in your vehicle until an exam room is available.

If your vet consistently runs late, call ahead and ask if he or she is on schedule. If they are running late, time your arrival so that you spend the least amount of time waiting.

4. Choose a veterinary practice with species-specific exam rooms — If your current veterinary clinic doesn't offer separate exam rooms for dogs and cats, you might consider finding one that does. Ideally, species-specific pheromones should be used in exam rooms, along with cat- or dog-specific calming music, wall coverings and temperature settings.

5. Create a sense of calm in the exam room — There are a whole host of things your vet and the clinic staff can do to reduce your pet's stress, including:

Arriving in the exam room before you and your pet do

Talking in a low voice and making unhurried movements

Removing the top from your cat's carrier (or unzipping a soft carrier) and providing a towel for kitty to hide under while he gets used to the room

Allowing dogs to sniff instruments before they are used

Avoiding direct contact with your pet, and waiting for him to initiate interaction

Offering topical pain management before touching a painful area on your pet's body

Tossing treats close to your pet instead of offering them in their hands

Providing non-slip surfaces on the exam table and floor, if the vet is examining the patient on the ground

6. Whenever possible, examine the patient where she's most comfortable — Exam tables tend to be a source of anxiety for many pets (thus the need for non-slip surfaces to help reduce stress). When feasible, a fearful dog or cat should be examined on the floor (cover slick floors with a non-skid rug), on the pet parent's lap or in the case of kitties, in the carrier.

7. Work with the pet to determine the best method of "positional compliance" — Positional compliance simply means a way of holding or controlling your pet that is most comfortable for him, while allowing your vet to perform necessary procedures. Once your vet learns what works best for your pet, it should be noted in his patient record, along with where he prefers to be examined, and any other information that helps reduce his stress.

8. Make injections less painful — This was originally written as "make vaccinations less painful" because unfortunately, in many vet clinics, vaccines are still given without identifying if pets have been previously immunized or not. That's not the way I practice veterinary medicine, as my regular visitors here know.

Once animals have protective immunity from core vaccines, they rarely need additional "booster shots," and giving more vaccines actually doesn't boost anything (or provide "more immunity"), except the potential for autoimmune reactions. A simple titer test will tell you if your pet is protected or unprotected from life-threatening diseases, which is highly unlikely if they've received a set of puppy or kitten vaccines in their lifetime.

With that said, in my opinion, we need to make all injections (especially microchips, if your pet must receive one), blood draws (including for antibody titer tests in lieu of automatic revaccinations) and other potentially painful procedures as comfortable for our patients as possible. This can be accomplished using smaller needles, topical anesthetics, distracting pets with treats and praise, and other techniques.

9. Sedate pets as necessary — Sedation isn't necessarily a bad word, or an option of last resort. In certain cases, it's the kindest thing we can do to manage a pet's fear and stress. Some poor dogs and especially cats are so traumatized by vet visits they benefit from sedation.

For example, very aggressive cats may be best managed by breathing in sevoflurane gas (similar to the "laughing gas" used for highly stressed dental patients) to reduce anxiety. I am a big believer in injectable sedatives that can be easily reversed for all procedures that would otherwise elicit a panic response in a pet, the most common one being nail trims and deep ear cleanings.

10. Cradle every pet's emotional and physical well-being — It's important that you, as your pet's advocate, and the veterinary staff focus first on your dog's or cat's emotional well-being. Only after your pet is calm (or a sedative has taken effect) should the exam or procedure be attempted.

Just because our animal companions can't tell us they're feeling anxious or scared doesn't mean they aren't, and so it's critically important that both pet parents and veterinary staff take steps to make pets as calm and comfortable as possible before and during vet visits.

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