Cooperative care training can boost the HAB and reduce stress

Figure 1: Jazzy doing chin: Calming cue indicates safe. Courtesy Erica Tramuta-Drobnis As veterinarians, we aim to help our patients and assist clients in preserving and maintaining a robust human-animal bond (HAB). We can help in numerous ways e.g., via preventive care, emergency medicine, infectious disease prevention, and client education. However, once the pet leaves our office, there is little we can do to help unless we provide a safe and effective way for owners to engage with their pets and teach them how to be comfortable with standard husbandry practices and behaviors. Preserving the human-animal bond with cooperative care training Benjamin Franklin said in an issue of his Poor Richard’s Almanac, “A spoonful of honey will catch more flies than a gallon of vinegar.”1 This was a simple yet poignant statement based on a well-known proverb. While the intent is to be kind to other humans, the same goes for animal interactions. Be it pets, zoo or conservation animals, or wildlife, this age-old adage emphasizing the power of love and positivity over harshness and severity comes to mind when thinking about animal behavior and training our furry, feathery, or scaly friends. Fundamentally, it emphasizes the efficacy of utilizing sweetness and kindness to attain desired results instead of resorting to physical force or animosity. In other words, positive reinforcement goes a long way. Take it a step further, having an animal grant us permission to auscult lungs, cut nails, express anal glands, obtain blood, or insert goal here, without harsh words, unnecessary or painful restraint, and with a mutual understanding between animal and human, accepting actions, is paramount. When a dog willingly consents to a potentially painful endeavor such as a blood draw, nail trim, or anal gland expression without pomp and circumstance, the stress level is lower for all involved, harm is less likely, and a positive experience promotes compliance in future events. Veterinary practice is trending towards Fear-Free methods of care and handling. This goes for pets, zoo animals, and more. Reward-based training without punishment has been shown time and time again to have more favorable outcomes than fear-based or negative reinforcement methods. Still, all too often, owners reach for trainers ill-equipped to handle behavioral issues such as play biting, high prey drives, or anxiety-driven behaviors, often compounding the problems or simply failing to improve outcomes. This can lead to relinquishment or, at minimum, a rift in the HAB. Directing clients toward positive means of working with their pets to achieve a unified goal enhances results and strengthens the bond we strive to protect and maintain. Training methods Positive reinforcement training, including clicker and cooperative care training, refers to any agreeable stimulus administered to an animal following the demonstration of good behavior. Examples encompass edible rewards, playing tug-of-war, vocal commendation, and petting the animal. This is a form of operant conditioning and is currently the preferred training method by veterinary behavioralists as a training method. Scientific studies, published in peer-reviewed, high-quality, medline indexed journals, with high vigor and large sample sizes are less prevalent than ideal. Still, existing studies show that positive reward-based training methods have better outcomes than those with punishment or negative reinforcement.2,3 Another less well-discussed benefit of positive reward-based training modalities, in addition to less stress and anxiety on the part of the animal, is the improvement in the HAB and relationship between trainer and trainee. Studies suggest positive reinforcement training methods impart a better attachment and bond.4 We want to teach our animals what not to do (e.g., screaming no at them when they bark incessantly, jumping on a visitor without giving them the desired expected behavior, or sitting when a visitor comes). More than that, we want to ensure animals understand what constitutes acceptable behaviors in various circumstances. We do this by positively reinforcing and marking those desired behaviors consistently and repeatedly by everyone in the household, training facility, veterinary hospital, or related environment.5 Another reason to favor positive reinforcement modalities revolves around elevated cortisol levels and stress. Induced by fear, negative reinforcement, punishment, and related adverse events and stressors have been shown to increase stress hormones in animals.6–11 Further, several studies suggest disagreeable dog training methods could translate into prolonged negative mood states and, thus, diminished welfare compared to non-aversive training methods.2,12,13 Cooperative care training: a vet’s personal experience What is cooperative care? This modality of positive reinforcement training is simple. It permits the animal to give you consent to continue with an activity, training, or procedure, and as a result permits husbandry training, handling, and more. We engage with the animals when they are ready and allow them to be willing participants in their care and training.14 Figure 2: Jazzy’s Gotcha Day; June 30, 2019. Courtesy Dr. Erica Tramuta-Drobnis Cooperative care training has repeatedly proven itself to me as a step above the rest. Without cooperative care training, I do not know where I would be today with my dog. Jasmine, aka Jazzy, a now over five-and-a-half-year-old female spayed German shepherd, Labrador, goofball mixed-breed dog, gives my life meaning. See Jazzy in Figure 2 on her gotcha day. However, she is not without her challenges. Jazzy fractured her leg at 18 weeks of age and was exercise-restricted (and sadly, socialization-restricted) during a prime critical age of socialization. This and a predisposition towards anxiety (thank you, German Shepherd DNA) likely contributed to her overall anxiety as she matured. Jazzy turned one year old just as the COVID quarantine began. She had already developed some anxiety behaviors, which we worked on and addressed. I started her training with clicker work, providing a great foundation but something was still missing. She developed a few habits that weren’t acceptable, such as jumping on Mom when she didn’t want to go inside, and grabbing my winter coat and tugging. Simple positive reinforcement with a sit, stay, and treat corrected this behavior (with a few sessions). However, developing IBD at seven months worsened anxiety, and as she got a little older, GI stress/pain would manifest with anxiety, and as a result, husbandry suffered. Honestly, so, too, did our relationship. It wasn’t easy to engage her and not lose my cool. Needing the means to address her anxiety and health concerns and strengthen our bond, I consulted with a veterinarian behavioralist. I was directed toward cooperative care training, and it transformed our lives. I will not give you false hope, as cooperative care training requires time, patience, dedication, and commitment. You need to let clients know it isn’t going to provide an immediate fix. When an ear infection has already taken root, this isn’t the time to start cooperative care training on ear cleaning. Instead, cooperative care training for various tasks is warranted when an owner gets a new pet (dog, cat, bird, reptile) or at any time when you feel they would benefit. With modifications, cooperative care can be used for almost any pet or circumstance. It is prevalent in the lab animal, zoo, and wildlife conservation arenas. I have personally seen examples, including a laser pointer-trained Komodo dragon that would eagerly walk into a glass enclosure that permits the limbs and tail to be examined and treated while the head is restrained hands-free but available for feeding the dragon a tasty morsel or 20. I’ve seen large cats, including tigers and lions, permit ultrasound for pregnancy evaluations, and large primates offer a forelimb or hindlimb vein for venipuncture without hesitation. These achievements take time and devotion on the part of caregivers, handlers, veterinarians, and animals, but the result is empowering and rewarding. Thanks to cooperative care training, I can: Do anal glands with my dog's head resting in my husband's hands (“Chin”) and no restraint Administer monthly B12 injections with 100 percent consent and no reaction Have her file her nails down using a scratchboard Brush her teeth twice daily Give vaccines myself Clean her ears Apply ear medications (though rarely needed) Brush her (thankfully, she loves being brushed because she gets treats, and I make it fun, so it is part of her training) Currently healing from left hindlimb lameness (including but not limited to a torn medial gluteal and piriformis damage), cooperative care training made adding physical therapy exercises not quite a piece of cake, but 10x simpler than they would have without it. As a result of our strengthened bond and daily efforts, I am much better at recognizing anxiety-driven behaviors and nonverbal communication when she’s painful and when she’s stressed or frustrated because cooperative care has helped us be more in tune with each other. I still have my work cut out for me with Jazzy. Being injured, she’s not filing her nails down and couldn’t use the scratchboard. We’ve had to do a few nail trims without 100 percent cooperation, but we are currently acclimating to the clippers and working on that, just in case, for the future. Cooperative care resources Consider reviewing the book, Cooperative Care: Seven Steps to Stress-Free Husbandry, by Deborah A. Jones, PhD, who pioneered cooperative care training with her book.6 Dr. Jones outlines ways to work with your pet (though specifically dogs in this book, the modality can be applied to other species) on numerous tasks, establishing Zen and developing a calming cue (position) – aka chin. (See Figures 1 and 3.)14 Classes through Fenzi Academy permit people to train with certificates and guidance or just learn and find new things for their pets to do and experience. Vets and owners alike can benefit from the information provided. Figure 3: Jazzy resting chin on a pillow, calming herself. Courtesy Erica Tramuta-Drobnis 10 training reminders The key things to remember with any training modality include the following: Have patience. A virtue I often lack, patience is necessary for the trainer and the situation. Training husbandry practices and various skills take time. Some days will be better than others. Some days, Jazzy will do all her tricks, use her scratchboard, let me brush her, let me give her meds, and more, while others, she may say no thanks and look away, walk out of the room, or put her head down. Her ability to say no and me recognizing now may not be the right time for that request speaks volumes. Positive training experiences can permit you to be in tune with one’s pet, patient, or charge. Ensure the animal feels safe at all times. Give the animal the ability to say no. Let them express they are uncomfortable with a situation, request, atmosphere, or environment. Never use punishment; it is unnecessary. Rewards do not have to come in the form of food, though food-motivated animals are often easier to train/work with. A favorite toy, a walk, or simply scratches behind the ear and praise frequently suffice. Use cues, words, and hand signals. Capturing the positive behavior you want may include clicking and treating, saying “yes” and treating, and cues may simply come with a hand gesture, not a word. Some dogs may be distracted and not respond to voice commands but will respond to hand signals. Learn to read the animal’s nonverbal communication. A slight turning away of the head in the middle of a training session says, “Mom, I need a few seconds to collect myself.” Looking back to you says, “OK, let’s continue.” Deborah Jones wisely advises one to “Never train an unfocused dog!”15 The same could be said of the trainer; don’t train if your head isn’t in the game. Improving health outcomes and HAB with cooperation Fear-Free handling is a start, but it isn’t the only thing we can do to help our patients. We can help educate clients and work with pets and staff to incorporate cooperation and consent in our clinics and daily lives. Cooperative care permits:16 Emotional health status and medication use Interpretation of body language Aids an animal in learning to accept handling and touch and supports low-stress handling techniques. Targeting and stationing Targeting: An animal learns to direct a body part or the whole body toward something specific g., this is a great way to start a dog with muzzle training. Target the muzzle comfortably before even attempting to use it. Stationing: This is similar to targeting but permits one to condition an animal to stay in place. For example, one could station at a training mat for grooming or other husbandry practices. (See Figure 4.) Choice, control, consent. Giving animals a choice and rewarding them positively for engaging has impressive positive results. Figure 4: Jazzy stationing: Training mat, treats, clicker, brush. Courtesy Dr. Erica Tramuta-Drobnis Fear-Free cooperative care – the wave of the future? It seems even without scientific studies, it makes sense an animal’s willingness to permit handling, actions, engage in training, and acceptance of actions in the face of reward and repetition makes for successful training and human-animal interactions and imparts a joint benefit. Thankfully, we have some research that demonstrates the negative impacts of punishment and negative reinforcement training modalities. However, further research is warranted to aid in demonstrating the numerous benefits that positive reinforcement training can have on the HAB. Further, a clearer understanding of cooperative care by practitioners and client education can help facilitate better animal handling at home and in the office. While sedation protocols and premedication aid numerous pets, what if we didn’t need it at all? Why medicate if we can have owners work with pets at home to readily and willingly accept care and assistance? While not all pets will be amenable to all care and husbandry practices, many can become more comfortable with these things, giving owners peace of mind in the face of challenges such as the need to medicate a pet’s eye or ear, wearing an E-collar or a muzzle, even just letting the vet auscult them. Further, for animals with behavioral concerns at home, cooperative care training may be a means to improve the HAB, permitting the pet parent and pet to bond, and may aid in preventing relinquishment for behavioral reasons. Cooperative care training changed my and my pet’s life. In conjunction with clicker training, love, patience, and the successful treatment of underlying medical conditions (such as GI disease, pain, or endocrine disorders), positive reinforcement training can breathe new life into sometimes strained relationships. It can provide a means for owners to improve and lengthen their time with their loved ones. Erica Tramuta-Drobnis, VMD, MPH, CPH, is the CEO and founder of ELTD One Health Consulting, LLC (https://eltdonehealth.com/). Dr. Tramuta-Drobnis works as a public health professional, emergency veterinarian, freelance writer, consultant, and researcher. She is passionate about One Health issues and believes pet health, food safety, agricultural health, and more can address the interconnection of human, animal, and environmental health. References Franklin B. Poor Richard’s Almanac. Benjamin Franklin. Proverbs, sayings, maxims, adages. Solitaryroad.com. Accessed November 1, 2024. https://solitaryroad.com/prs10.html Castro ACV de, Araújo Â, Fonseca A, Olsson IAS. Improving dog training methods: Efficacy and efficiency of reward and mixed training methods. PLoS ONE. 2021;16(2):e0247321. Laule G, Whittaker M. Enhancing Nonhuman Primate Care and Welfare Through the Use of Positive Reinforcement Training. J Appl Anim Welf Sci. 2007;10(1):31-38. Vieira de Castro AC, Barrett J, de Sousa L, Olsson IAS. Carrots versus sticks: The relationship between training methods and dog-owner attachment. Appl Anim Behav Sci. 2019;219:104831. The Humane Society of the United States. Positive reinforcement training. The Humane Society of the United States. Accessed November 1, 2024. https://www.humanesociety.org/resources/positive-reinforcement-training Packer RMA, Davies AM, Volk HA, et al. What can we learn from the hair of the dog? Complex effects of endogenous and exogenous stressors on canine hair cortisol. PLoS ONE. 2019;14(5):e0216000. van der Laan JE, Vinke CM, Arndt SS. Evaluation of hair cortisol as an indicator of long-term stress responses in dogs in an animal shelter and after subsequent adoption. Sci Rep. 2022;12(1):5117. Cobb ML, Iskandarani K, Chinchilli VM, Dreschel NA. A systematic review and meta-analysis of salivary cortisol measurement in domestic canines. Domest Anim Endocrinol. 2016;57:31-42. Flint HE, Weller JE, Parry-Howells N, Ellerby ZW, McKay SL, King T. Evaluation of indicators of acute emotional states in dogs. Sci Rep. 2024;14(1):6406. Behringer V, Stevens JMG, Hohmann G, Möstl E, Selzer D, Deschner T. Testing the Effect of Medical Positive Reinforcement Training on Salivary Cortisol Levels in Bonobos and Orangutans. PLoS ONE. 2014;9(9):e108664. Bryan HM, Adams AG, Invik RM, Wynne-Edwards KE, Smits JEG. Hair as a meaningful measure of baseline cortisol levels over time in dogs. J Am Assoc Lab Anim Sci JAALAS. 2013;52(2):189-196. Casey RA, Naj-Oleari M, Campbell S, Mendl M, Blackwell EJ. Dogs are more pessimistic if their owners use two or more aversive training methods. Sci Rep. 2021;11(1):19023. Castro ACV de, Fuchs D, Morello GM, Pastur S, Sousa L de, Olsson IAS. Does training method matter? Evidence for the negative impact of aversive-based methods on companion dog welfare. PLOS ONE. 2020;15(12):e0225023. Jones DA. Cooperative Care: Seven Steps to Stress-Free Husbandry.; 2018. Jones DA. About Deb Jones, Ph.D. K9 In Focus. Accessed November 1, 2024. https://k9infocus.com/about/. Tomaselli, JL. Cooperative Care in Veterinary Medicine. Veterinary Partner by VIN. April 24, 2024. Accessed November 1, 2024. https://www.vin.com/doc/?id=8156779

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Cooperative care training can boost the HAB and reduce stress

The author details how this method improved her relationship with her dog and provides tips to pass along to your clients

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