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Reducing the fear factor

Four veterinarians share how incorporating Fear Free techniques into daily practice has made the difference to pets and owners

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Not even her owner could handle her, and he told his veterinarian, Jonathan Bloom, DVM, of Willowdale Animal Hospital in Toronto, that he just wasn’t going to bring Dakota in anymore.

“I was within a few minutes of losing Dakota to healthcare altogether,” Dr. Bloom said.

Instead, he stopped the exam and suggested to the owner that they work together to make veterinary visits a better experience for Dakota. He talked him through some of the steps he could take and tools he could use to help Dakota relax.

Now Dakota comes to Bloom without hesitation, and she gets better health care to boot.

Bloom is one of the 1,930 veterinary professionals who have become Fear Free certified. Their goal is a practice that is not only friendlier to dogs and cats that may view veterinary visits with a jaundiced eye but also alleviates the stress of clients who hate having to wrestle pets into carriers, into and out of the car, and through the clinic door. A bonus is a staff that is more efficient, more productive, and more engaged.

But going Fear Free isn’t as simple as stocking up on treats and pheromones—two of the techniques with which it’s closely associated. It’s a serious commitment to a large organizational change, but veterinarians who have been successful say they have seen improvements in their ability to get more accurate vital signs, examine pets and perform diagnostic procedures without fight or bite, and develop a closer alliance with pet caregivers. Sometimes they find that they are seeing more pets.

“We’re probably seeing more patients now because we can,” said Dawn Mehra, DVM, at North Idaho Animal Hospital in Sandpoint, Idaho, the first practice to adopt Fear Free techniques. “The cats and dogs that weren’t coming in before are now coming in; they’re now able to get care.”

Making the switch

The key to success is getting everyone on board first, especially the veterinarians, said Bob Beede, DVM, who has practiced for 46 years and is a partner at Intermountain Pet Hospital in Meridian, Idaho.

“If they’re not on board and there’s a busy day, somebody will say, ‘Well, we don’t have time to sedate this animal; let’s just hold him down and get the X-ray or trim the nails.’ That’s not how we want to do things. We met one evening, all the veterinarians and team leaders, and came up with nonnegotiable things we would all live by. That really worked well.”

Good recordkeeping helps, too. At Dr. Mehra’s clinic, a pet’s chart includes notes about any fear, anxiety, or stress exhibited by the animal and what treats or techniques worked with that pet. Those things may change over time, and the record is also helpful if a different veterinarian sees the pet at the next visit.

Recognize that there will be frustration, said Julie Reck, DVM, owner of Veterinary Medical Center of Fort Mill in South Carolina, and a member of the Fear Free Advisory Panel. There can be emotional struggles when it takes more time initially to handle animals in a Fear Free manner and to learn what does and doesn’t work with a specific pet.

Dr. Reck recommends making changes slowly and consistently, with input from everyone. At her practice, all employees contribute ideas on the best ways to implement Fear Free techniques, and everyone agrees on such things as how to communicate with clients and handle animals. They make small changes consistently, give them time to become habits, and then implement more small changes.

“For us, success in Fear Free has come from small changes that we’ve done consistently as opposed to ‘We’ll try this,’ but we didn’t really commit, and we didn’t do it consistently,’” she said. “If you do that, you won’t end up with a Fear Free practice. But if you implement small changes and do them consistently and are a little bit patient, it’s going to be beautiful.”

Getting clients on board

Preparing pets for visits starts at home, well before the appointment. Receptionists are on the front lines. It’s their job to ask questions about a pet’s demeanor and provide clients with the information they need to bring in a dog or cat who is cool, calm, and collected instead of amped and anxious. This includes helping the pet develop a positive association with the carrier through use of treats and pheromones, making the car trip a positive experience through carrier placement and relaxing music, and if necessary, providing the client with medication to calm the pet before the drive.

Clients usually are sold when they see how the pet responds. Dr. Beede recalled the case of a fearful Chihuahua who was a biter.

“We had him come in for a fun visit with treats, and before we were done, we had that little dog jumping up from the bench to the exam table to get treats, wagging his tail and totally happy,” he said. “We did not try to touch the dog or do anything at that visit. Then we gave the owner some previsit pharmaceuticals and had her come back so I could do an exam and vaccines, and it worked pretty good. The client was ecstatic.”

While some clients appreciate the extra care for the pet’s emotional needs, others may not feel that it’s important. That can be a challenge.

“The ones who don’t respond well really don’t understand their pets’ behavior very well,” Mehra said. “We just give them time. It could be a year before they understand it.”

In Reck’s practice, only two clients have not appreciated the Fear Free concept. It may be best for them to find a new practice, she said.

“We’re not going to change our practice just to accommodate their time schedule,” she said. “Everybody else, once they understand what you’re advocating for, they’re more than happy. Pets are now such a part of the family, they want us considering how that pet’s feeling.”

Prepping patients

How the pet feels about the visit begins with the preliminaries at home and on the way to the clinic, but the real test is when he walks through the door. To enhance their experience and keep them wanting to come back, “create awesome experiences in the exam room,” Bloom said.

At his clinic, pets receive treats when they walk in the door, when they leave the reception area, when they get on the scale, and when they enter the exam room. Some dogs know the drill: They walk into the hospital, go to the reception desk, hop on the scale, and run into the exam room.

“Some dogs put on the brakes going into the veterinary hospital,” Bloom said. “Some of our dogs put on the brakes going out of the veterinary hospital. There are some dogs I have to take out to the car or they won’t leave.”

The techniques carry over to more invasive or potentially painful procedures such as nail trims, getting blood samples, giving injections, or taking X-rays. Sedating a pet for X-rays or having the pet lick baby food or peanut butter off a tongue depressor during an injection generally leaves everyone happier with the experience. During a talk at the 2017 AVMA convention, Fear Free founder Marty Becker, DVM, recommended numbing the area with lidocaine gel three to five minutes before inserting an IV catheter or injecting a microchip. It’s an easy way to increase the pet’s comfort.

“Why wouldn’t you use it?” he asked.

It’s not just dogs that respond to and benefit from Fear Free techniques. Cats are some of the more surprising success stories. According to the Bayer Veterinary Care Usage Study, only half as many cats receive annual veterinary visits as dogs, largely because 58 percent of cat owners believe their cat hates going to the veterinarian, and 38 percent of cat owners are themselves stressed at the thought of taking their cat to the vet.

Geriatric cats have learned that crankiness gets them whatever they want, which is usually to be left alone. Fear Free techniques allow them to be handled more easily.

“We can draw blood on them, we can do physical examinations,” Mehra said. “Now we’re extending their lives comfortably for three to five more years. That’s a big deal.”

One of Bloom’s patients was a cat who had to be anesthetized simply for an examination because he had bitten or scratched almost every staff member in the hospital. Using Fear Free techniques, they were able to work with the cat so successfully that he came to enjoy coming in for visits and would accept getting his blood pressure read and blood samples taken in the exam room while his owner gave him treats.

“The more we did it, the more we realized we were creating really comfortable, exceptionally happy experiences for these pets,” Bloom said. “And that’s our motto: ‘We want your pet to have the best experience imaginable.’ And we live by it.”

To learn more about Fear Free and how to become a Fear Free certified veterinary professional, visit fearfreepets.com.

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