In addition to a dog’s age, weight, appetite, and other familiar questions, sometimes it can be important to ask about the yard, if the family has moved to a new home, if furniture placement has changed, or any number of things. Something small to a human can be a big deal to a dog. Initiating a successful veterinary exam begins long before a client and pet enter a veterinary practice. It begins during the first phone call, when the client and receptionist schedule an appointment, and continues with the veterinary nurse at the time of check-in. Integrating a holistic approach into this process allows for appointments to run more efficiently from a clinic perspective, and will allow for the clinic experience to be less stressful and more compassionate for both the client and the patient. The definition of “holistic,” when spoken in regard to medicine, is: Treating the whole person rather than just the symptoms of a disease. In veterinary medicine, this definition holds true for our non-human patients. A holistic approach in medicine includes assessing environmental, social, and emotional factors when determining the proper treatment protocol. During the initial check-in process of an exam, well rounded, open-ended questions fostering curiosity about these different aspects of an animal’s life will not only provide potential insight as to what may be going on with the patient medically, but can additionally aid in educating a client on enrichment options for their pets either during the exam process or hospitalization, and at home. This is important because reducing stress in an animal’s environment will likely reduce certain medical and behavioral conditions (examples are hypertension or inappropriate litter box use in cats), as well as increase the human-animal bond. From the beginning From a receptionist standpoint, there are many opportunities to pre-emptively (and holistically) screen a new patient during the initial contact. These include: Has the pet ever needed sedation for a veterinary exam or procedure? Many clients are apprehensive to include this information when scheduling a new patient exam. They may have felt shame or judgement from a previous clinic, or may just assume something is “wrong” with their pets. From a holistic perspective, it is important to create a shame-free environment. Asking the question allows clients to know this is a common scenario in veterinary medicine, and allows for more open and transparent dialogue. Having this information, and potentially the exact sedation protocol that was or was not successful for the pet, allows for a less stressful experience for the patient, client, and veterinary team, as well as reduces the risk of danger or bites during the exam process. It may also reduce multiple trips back to the clinic. Addressing fear and anxiety through chemical restraint is sometimes the most compassionate and holistic approach that can be taken for a patient’s mental well-being. Ask clients to send pictures of their pets’ environment. Seeing pictures of a client’s home or yard can provide important insight into how a patient is living. Having these pictures received and attached into a patient’s exam notes prior to the visit is ideal. It allows the veterinarian to review them before the appointment and can provide a more well-rounded understanding of the client and patient’s environment before the exam has even started. Gathering information like the layout or flooring of a home for a senior or arthritic pet, litter box locations for cats experiencing inappropriate elimination or aggression, and outdoor availability or yard size for athletic or young dogs, can allow veterinarians to continue providing valuable and helpful recommendations from a medical perspective, and from social and emotional perspectives. Just like people, an animal’s environment can either positively or negatively affect these important aspects of their life. Whole approach Here are a few holistic approaches a veterinary technician can take during the exam check-in process: Ask for specifics on everything. Train nurses to ask very specific, open-ended questions about a pet’s lifestyle. For example, ask a client for more details about their dog or cat’s daily exercise. What kind of walks are they going on and for how long? Are they experimenting with different routes, or taking the same walk daily? Have there been significant changes in the home like new pets, changes with residents, travel, new grief, moves, adjustments in the guardian’s work schedule or profession, or even furniture changes? These questions help provide a bigger picture of an animal’s daily schedule and enrichment activities. This information can also provide perspective as to how the clients themselves are doing, and where they may need additional support in their pet parenting. A holistic approach to veterinary medicine should include how to better support the client themselves; ensuring they have all their resources and needs met. In turn, they will also ensure the pet’s quality of life is also optimally supported. Consensual touch. Discussion around consensual touch for pets is on the rise within the animal behavior and training community, and is a topic veterinary professionals should be keeping a close pulse on, as well. Similar to people, some dogs and cats like to be touched more than others. Some pets enjoy lots of touching and a lot of petting, while others prefer a gentle scratch or an approach of long pauses between each touch. Whenever possible in veterinary medicine, we should actively take the role of consensual touch with a patient. Consensual touch for pets is not the same as consensual touch in humans. Its purpose is more about training and conditioning a pet to become comfortable with a specific procedure. The “consented activity” should always be reinforced with some kind of high-value treat or praise! This is also another great opportunity to further assess a patient’s behavior. Teaching pet owners about consensual touch has great benefit, as well; using these techniques at home can help to continue desensitizing pets to certain touch aversions (like touching their paws or trimming their nails, for example), and can also further educate a client on their pet’s body language and behavior cues. Discuss mental health. As veterinary medical professionals, it’s so easy to get tunnel vision. While we are not formally dog and cat therapists, we do play that role a bit! As a pet’s health care team, we need to be looking more into their mental health and how we may be able to improve it. How is each pet enriched at home, and with what activities? How does their exercise program look? Are all of these aspects species- and breed-specific? (This is very important.) Putting it all together There are many behavioral components of an animal that can easily and quickly cross over to becoming medical. Alternatively, many medical conditions can cause stress, anxiety, and other behavioral challenges. Create a checklist of questions pertaining solely to enhancing a patient’s mental well-being and help the client implement them into their daily or weekly routines. There are so many ways veterinary staff can implement a more holistic approach to a patient’s check-in. This simple approach equates to gathering more information from all aspects of a pet’s life, and using this information to provide and implement even better care for our patients and clients. Claire Primo, CVT, CCMT, is a veterinary nurse and certified animal massage therapist residing in Lyons, Colo. She offers animal massage therapy, laser therapy, hospice and palliative care, and veterinary nurse needs through her practice, Peak Animal Wellness & Massage, while also managing a holistic veterinary house-call practice, Boulder Holistic Vet. Primo specializes in senior pet care, holistic veterinary nurse care, and empowering guardians with all the appropriate tools and guidance needed for a healthy and nurturing relationship with their pets. In her spare time, she can be found in her small mountain town playing and connecting with her husband, two-year old son, two dogs, and cat.
