10 Ways to Take the Stress Out of Veterinary Visits

Analysis by Dr. Karen Shaw Becker

fear free vet visits

Story at-a-glance -

  • A recent study suggests that a dog’s breed can predict whether he’ll be fearful during veterinary visits; other influences include lifestyle, where the pet was acquired, his size, and his social environment
  • The study authors also conclude that the prevalence and severity of fearfulness during vet exams is most heavily influenced by the veterinary clinic environment and human-animal interactions
  • To address pet fearfulness, fear free vet visits and low stress handling are up-and-coming trends in the veterinary community; the goal of both approaches is to focus first on a pet’s emotional well-being
  • There are many things pet parents and veterinary staffs can do to help pets de-stress before and during vet visits

A recently published large-scale study by researchers at the School of Animal and Veterinary Sciences at the Roseworthy Campus of the University of Adelaide in Australia suggests that fear of veterinary visits is linked to a dog's breed, size, and other factors.1

The general concerns that prompted the study were that fearful dogs can cause injury to veterinary staff, owners, and themselves, and in addition, owners of fearful pets are less likely to make appointments for routine veterinary exams. It’s worth mentioning that another and in my opinion more important concern is that, according to studies, the stress of living with fear or anxiety can have negative effects on the health and lifespan of dogs.2

Over Half of 26,555 Dogs Showed Some Degree of Fear During Vet Visits

The data the University of Adelaide researchers mined came from dog owner responses to an online survey using the Canine Behavioral Assessment and Research Questionnaire (C-BARQ). The team was able to obtain an extraordinarily large sample describing the behaviors of 26,555 dogs.

The C-BARQ provides dog parents with examples of signs their pet may exhibit when they feel mild to moderate fear. These include avoiding eye contact, avoiding the feared object, crouching, cringing, a lowered or tucked tail, whimpering, whining, freezing, and trembling or shaking. Signs of extreme fear include exaggerated cowering, and vigorous attempts to escape, retreat or hide.

With these examples in mind, survey respondents were asked to indicate the level of fearfulness shown by their dog during veterinary visits. Over 55% of all the dogs in the study showed some fear during veterinary visits, with 41% exhibiting mild to moderate fearful behavior, and 14% experiencing extreme fear.

When It Comes to Fear During Vet Visits, a Dog’s Breed Takes the Lead

The researchers found that the single biggest factor in predicting whether dogs will be fearful is their breed (27.1%), followed by their history of roles or activities (16.7%), where they were sourced (15.2%), their weight (12%), the age of other dogs in the household (9.5%), and dog owner experience (6.3%).

By breed group (according to Australian National Kennel Council breed groups) the most fearful dogs were Toy Dogs, followed by Mixed Breeds and Hounds. The least fearful breeds were Utility Dogs (e.g., guard dogs such as the Doberman Pinscher; draft dogs like the Siberian Husky and the Bernese Mountain Dog).

Gundogs such as spaniels and retrievers tended to exhibit extremely low fearfulness during veterinary exams. Other important factors influencing levels of fearfulness:

  • Lifestyle (history of roles or activities) — Dogs used for breeding, show dogs, and dogs with a working history exhibited the lowest levels of fear during vet visits. Most likely to be fearful were companion dogs with no history of working roles or activities.
  • Sourcing — Dogs acquired from a breeder or bred by their owners were least fearful; dogs who came from a friend or relative of the owner or who were purchased from a pet store had the highest fear scores.
  • Size — Not surprisingly, larger dogs (over 48 pounds) were significantly less afraid of veterinary staff than smaller dogs.
  • Social environment — Dogs living alone in single-dog households were more fearful than dogs living with other dogs.
  • Owner experience — Dogs belonging to first-time dog owners exhibited higher scores for fearfulness during veterinary exams.

Prevalence and Severity of Fearfulness Is Most Heavily Influenced by the Environment of the Veterinary Clinic and Human-Animal Interactions

Since the risk factors listed above only explain a total of 7% of variance of fear noted during veterinary exams, according to the study authors:

“This suggests that fear exhibited during veterinary visits is common in dogs, but that the environment or human-animal interactions are likely to contribute more to prevalence and severity of this problem than the demographic factors measured here.”3

Now we’re getting somewhere! In my opinion, none of the risk factors examined in the University of Adelaide study are as important as the environment of the veterinary clinic and the handling dogs receive during wellness exams.

Fortunately, over the last few years, the terms fear free and low stress have become com­mon­place in the veterinary community. A growing number of vets are coming to the realization that fearful, stressed-out pets at veterinary visits shouldn’t be considered “normal.” As a profession, veterinarians are beginning to embrace the idea that their patients’ emotional state is just as important as their physical health — including during vet visits.

10 Steps for Fear Free Vet Visits

There are countless strategies veterinary clinics and pet parents can use to help dogs and cats feel less stressed during vet appointments. The following 10 tips by Dr. Marty Becker were published in the veterinary journal dvm360.4 They were written for veterinarians and their staffs, so I’ve edited them a bit so they’re helpful to pet parents as well.

I’ve also tweaked 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 is crate-trained (or is conditioned to wear a car seat harness) and comfortable during car rides. To keep him calm on vet appointment days, use pheromones such as Adaptil and calming nutraceuticals.

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 that can be used during travel to the vet, as well as during the appointment.

Calming nutraceuticals and herbs that I've found helpful include holy basil (Tulsi), valerian, l-theanine, rhodiola, ashwagandha, GABA, 5-HTP and chamomile that can be administered a few hours before the vet visit.

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 dog’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 she’s 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 her 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 dog directly to an exam room after check-in, let the receptionist know you’ll be waiting with him 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’re running late, time your arrival so that you spend the least amount of time waiting.

4. Choose a vet 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 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 (if it can be opened from the top).

7. Work with the pet to determine the best method of “positional compliance” — Positional compliance simply means a way of holding or controlling your dog that is most comfortable for her, while allowing your vet to perform necessary procedures. Once your vet learns what works best for your pet, it should be noted in her patient record, along with where she prefers to be examined, and any other information that helps reduce her 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 at most if not all visits. This results in many pets being unnecessarily over-vaccinated, which can have negative long-term consequences. I believe in determining the need for vaccines before automatically administering them via a blood draw called a titer test.

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), 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 (such as a TTouch body wrap).

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.

I am a huge 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. This is especially important for pets that have been traumatized from previous veterinary visits that ended badly.

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 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 staffs take steps to make pets as calm and comfortable as possible before and during vet visits.