Amy Shojai, CABC, Fear Free Certified Professional
In March of this year, my Bullmastiff began limping. Stay-at-home orders delayed Bravo’s diagnosis of osteosarcoma.
Since then, we’ve endured an emotional roller coaster of multiple visits with specialists while also navigating COVID-19 restrictions. Pre-visit notes and resources from our general practitioner and specialists provided a welcome guide for us to help Bravo.
Handouts especially help pet owners during COVID-19 challenges to reduce the pet fear, anxiety, and stress (FAS) that can develop from treatment or simply from having to enter the clinic without their pet parents. And being prepared can help calm people, too.
An online downloadable handout for clients can be customized to the illness or condition. When possible, email resources to the client ahead of the visit. Refer to this handout for ideas. Here are more suggestions to consider.
The turmoil of new veterinary visit protocols means medication offers an important way to mitigate FAS. Used in conjunction with training, PVPs (pre-visit pharmaceuticals) help reduce FAS during the veterinary visit. I reached out to Dr. Robin Downing of the Downing Center for Animal Pain Management in Windsor, Colorado, for her insights.
“FAS is a monolithic barrier to my being able to do my job as a doctor,” Dr. Downing says. “FAS interferes with an accurate examination when terrified pets want to escape handling or restraint. They may respond with fear-based aggression, or ‘freeze’ so their rigid posture interferes with accurate feedback from their physiology.”
The use of PVPs allows practitioners to honor ethical obligations to patients experiencing fear. They transform the fearful pet’s experience, in turn transforming the pet owner’s experience. A good measure of success is a patient who is willing to take treats when benefiting from PVPs. It’s also important that pet owners deliver the PVP two to three hours before their appointment, Dr. Downing says.
The PVPs that Dr. Downing uses in her practice, that do the best job for her patients, are as follows:
PVPs for Dogs
Trazodone is Dr. Downing’s preferred first step in canine patients. “If trazodone alone does not seem to get the job done, we add gabapentin. This combination has been a big winner for some of our patients who particularly resent having their feet handled and their toenails trimmed.”
Dr. Downing notes there are other PVP options for dogs. “We had inconsistent results when we employed alprazolam. That does not mean it could not be effective for another practice, but we have had such consistent results from trazodone, +/- gabapentin, that we have narrowed our focus accordingly. I do not have personal experience with clonidine yet and may use it in the future.”
PVPs for Cats
“For cats, we rely most often on gabapentin at 100mg per cat (no matter the size of the cat), with the occasional cat requiring 200mg. Timing is critical, so two to three hours ahead of the scheduled appointment is optimal,” she says. “I have occasionally used trazodone in cats, but I find that the ‘smoothness’ of the gabapentin experience for most cats has narrowed our focus. I do not yet have personal experience with lorazepam but have an open mind about the potential for future use.”
When discussing PVPs with clients, explain that these medications do not “drug” or sedate the pet, but instead alleviate FAS, which can interfere with effective treatment. These tend to act quickly with an hour or two, and then leave the system within about 12 hours. Because they are used off-label, it’s a good idea to learn how the medication acts on the individual pet in a home trial. Here’s another good resource to share with clients.
Some dogs may react poorly to face coverings, in the same way they fear Halloween costumes. Pets may be concerned when they encounter gloves as well. Advise clients in advance what to expect.
Owners should wear masks around the pet a day or two in advance of the vet visit. They should speak to the pet and reward calm behavior with something he loves, such as treats or a game. Drilling with tricks the dog knows can engage his brain so he thinks less about being concerned. Perhaps also offer special treats while wearing gloves or scent them with something pleasant. Bravo suggests bacon.
The type of safety restraint can make a difference in the pet’s FAS level. That also affects the technician’s ability to safely retrieve the animal from the car.
The client should ensure the pet is safely leashed. She should remove the dog from the car prior to the technician arriving to collect the pet. Otherwise, a dog could act protectively out of fear or aggression when faced by a masked stranger approaching and opening the door.
Leave the owner’s leash attached until the technician’s slip-lead is safely placed. Ask the client to remove their own lead only after the slip-lead is securely in place. If the dog isn’t used to this type of lead (which can tighten on the neck), provide one and ask clients to practice with the pet at home, and to have the slip lead on the dog on arrival. Bravo has a slip lead with the oncology clinic’s phone number on it.
Some dogs feel calmer when they wear a basket muzzle that takes teeth out of the equation. When needed, offer specific how-to tips on selecting an appropriate muzzle and how to teach dogs to accept these.
Explain to pet parents how to turn the basket muzzle into a treat bowl. Feeding the dog treats through the muzzle while holding it (aerosol cheese, for example) can teach the pet to associate wonderful things with wearing this protection. They should ask the dog to wear the muzzle only after he is comfortable placing his face inside to get treats on a regular basis.
Make Carriers Fear Free
Suggest that owners leave carriers out in the home all the time. That helps them become positive places for pets. Toss in favorite toys and treats for the pet to discover. Turn the carrier or crate into a fuzzy warm cave where pets can nap (take the door off the carrier while at home). Our new puppy eats all his meals, as well as treats, inside the crate, so he begs to go inside.
They can ramp up the carrier “love factor” by placing a treat or toy inside that the pet only gets when closed inside. Shut the carrier door—with the treat inside, and the pet locked out. Wait for the pet to beg to go in and get the treat, and gently shut the door for increasing longer intervals. Pets busy munching won’t mind the closed door.
Carriers with top openings, sides that collapse down, or bottoms that slide out with the base work well for frightened cats. That way, the cat won’t be forced inside, or dragged out, but can be treated while still comfy on the familiar-smelling bedding. Using pheromone products inside crates and carriers also can help reduce FAS.
Calm Car Rides
Have owners associate car rides with all good stuff for the pet. They can start by feeding inside the car (without it moving) for a week. Next, feed treats in the car and turn the car on but don’t move. Finally, drive around the block if the pet has previously remained calm. Gradually increase the duration of trips, perhaps stopping at a fast-food drive-through to purchase a healthy pet treat.
Once the car starts moving, have pet parents give tiny, tasty tidbits only if the dog is prone to car sickness. Sometimes ginger snap cookies help settle the tummy. Adjust to the individual pet. Pets with severe car sickness may benefit from Cerenia.
Incidentally, Bravo (now a tripod dog) finished his final chemo treatment September 23. Thus far, he has beaten cancer and could care less about COVID-19 shenanigans.
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.This post is brought to you by our sponsor, Elanco, the makers of Credelio® (lotilaner) and
Interceptor® Plus (milbemycin oxime/praziquantel).
Amy Shojai (www.SHOJAI.com) is an IAABC-certified behavior consultant (cats/dogs), and Fear Free certified pet care expert. She’s the award-winning author of more than 30 pet care titles including MY CAT HATES MY VET and MY DOG HATES MY VET: Foiling Fear Before, During & After Vet Visits.
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