Originally published in the June 2015 issue of Veterinary Practice News I’ve been writing to and on behalf of the veterinary profession for 30 years. You may have seen my columns in magazines ranging from professional veterinary publications to Reader’s Digest and Parade, or online on sites from Vetstreet to HuffPost and DrOz.com. So why another column? I still have important topics to tackle and this magazine gives me the opportunity to focus on an area I know to be vitally important, underappreciated and not covered as much as it deserves. The area I’m referring to is “In the Middle.” I have a unique perspective and experience being in the middle between pet owners and the profession. Having been on network TV for 18 years, having written a syndicated column for about 15 years, and having communicated with tens of thousands of pet owners on radio shows, via column Q&As and at appearances, I know how pet owners’ wants and needs have evolved. I understand the difference between cost and value. Appreciate their need to feel like the bond they share with their pet needs to be celebrated, nurtured and shared. That there’s only one greatest pet in the world, and every family has her. I don’t just play a veterinarian on TV. I’ve been a practicing veterinarian for 35 years and still practice when time permits at North Idaho Animal Hospital in Sandpoint, Idaho, where I’m an associate veterinarian. Plus I’ve owned seven veterinary hospitals in my lifetime. I also know about being caught in the middle between the best interests of pets, the economic realities of the pet owner, hectic demands of practice and still trying to have a healthy personal life. I’m proud to say that I’ve been financially successful and emotionally wealthy as a veterinarian. I still madly in love with my wife of over 36 years, Teresa. I knew what topic I wanted to tackle first and that’s about the urgent need for the profession to embrace offering Fear Free veterinary visits. I can tell you if you make protecting both a pet’s physical and emotional wellbeing a priority, your practice will thrive. If you ignore how pets (and pet owners) feel while under our care — focusing just on the pet’s body, ignoring the mind — you’ll be lucky to survive the end of the decade. I know those are strong words but I believe it to be true. Just as pediatric dentists had to change to comfort and coddle patients as well as do preventive and therapeutic dental care, so must we change to provide emotional care of and compassion for pets to go along with great medicine. Here are the top 10 ways to get started with Fear Free. 1) Pet Owner Has to Deliver a Calm Pet Fear Free veterinary visits, like pain control, is a multi-modal approach that also involves the pet owner, whose role in taking a pet to the veterinarian has to fundamentally change. To keep the pet calm, pet owners will use pheromones, chill pills as prescribed by the vet, carrier covers, refrain from baby-talking, even play special calming music. Some pets will require sedation before they leave home. 2) Withhold Food The pet owners should withhold their pet’s food after 6 p.m. the night before the visit (unless medically contraindicated) so that they respond better to food rewards in the veterinary hospital. 3) Minimize the Use of the Waiting Area If you have adequate exam rooms and the technology to do so, have pet owners take their pets directly into an exam room to be checked in. Alternately, have the pet owner check in alone and then go back out to her vehicle and wait until she can be ushered directly into an exam room. 4) Have Species-Specific Exam Rooms These rooms will have specifies-specific places to examine the animal, pheromones, calming music, wall coverings, even temperatures (can use a silent space heater). 5) Promote a Sense of Calm in the Exam Room Avoid prolonged direct eye contact with the pet, waiting for her to initiate more interaction (give lots of tiny treats!). Lower your voice, don’t be as hurried, let dogs sniff instruments (stethoscope, otoscope, etc.) before they’re used, let both dogs and cats acclimate to the exam room before the technician or veterinarian initially enter, wearing pheromones on their clothes. 6) Offer a Choice of Where to Examine Rather than just hoist the dog or the cat carrier up onto the exam table, explore alternate places to examine the animal, including in the carrier (with the top taken off), on the floor (with a yoga mat or towel) or on the pet owner’s lap. 7) One Best Method of Positional Compliance Gone are the days of wrestling pets to the table. Work with the pet to find a method of control that keeps the pet calm but still allows you to do procedures. Once you know which method works best, note it in the record along with information such as the pet’s preferred place to be examined, favorite treats and her tricks, along with cue words. 8) Make Vaccinations Less Pain/More Gain Use small-gauge needles, reduced volume vaccines and ones that can be administered via a less stressful route (oral bordatella vaccine versus intranasal) and distraction techniques. 9) Sedation Early and Often Depending on the practice, up to 30 percent of the pets are so psychologically damaged that they will require sedation before they leave home. Once he’s in the veterinary hospital, if a pet is anxious or fearful and won’t take a tasty food reward even if hungry, for example, you should either sedate and then wait for it to take effect or reschedule the pet for a later visit where different Fear Free techniques and tools can be utilized. 10) Cradle Every Pet’s Physical and Emotional Well-Being Start first looking after the pet’s emotional well being. Only after you’re confident the pet is either calm or you’ve administered a sedative that’s taken effect, will you continue the exam or procedure where you’ll be looking after the pet’s physical well-being. Use “Manual for Clinical Behavior – for Dogs and Cats” by Dr. Karen Overall (2013).
