After such a warm and sunny start to the summer, we’ve all become aware of how hot and humid a small consulting room can be. This can be particularly problematic for a large, hairy dog already stressed by a visit to the vet. This consulting room environment is not ideal for owners or practice staff, and it is helpful if appointments with dogs on hot days can be scheduled for a larger room wherever possible. This may involve some extra organisation, particularly in larger practices, but client loyalty is a key consideration, and they will notice and appreciate it when your practice goes above and beyond.
What do we need to consider to make our practices more dog friendly?
We live in a world where health and safety are constant considerations, and wet, slippery floors can be a real problem, especially for large dogs and seniors. Other than the obvious risk to dogs and humans alike, many canines find slippery surfaces unpleasant to walk on and may simply refuse to budge. This process makes handling and examination difficult and causes unnecessary, additional stress to the animal. It’s not only the floor that can be slippery – our prized and expensive stainless-steel examining surfaces are often slippery, cold and noisy, which adds additional stress. But this can be alleviated by covering these surfaces with a rubber mat.
Not every practice has the luxury of providing separate wards for cats and dogs, although your feline clients will love you for doing so. Additionally, the ability to separate incessantly barking dogs from the other inpatients in the wards can be especially important when there are dogs recovering from anaesthesia. The advice given by International Cat Care suggests that the layout of kennel areas should prevent any visual contact between patients to help keep down the noise and general arousal levels of both cats and dogs.
Adequate ventilation is also critical and is required to minimise the risks of infection and cross-contamination, as well as regulating ambient temperature. For the adult, healthy dog, the temperature should not fall below 7°C or 10°C in the kennel itself. Frequent, excessively high temperatures can be more difficult to control than low temperatures. The ambient temperature of the ward should not exceed 26°C. This is particularly important for hospitalised dogs and those recovering from anaesthesia, where the temperature should be maintained between 18°C and 23°C. In the case of whelping bitches, it is advised that the temperature should be maintained between 18°C to 21°C. Neonates of one week, two weeks and up to weaning age should have room temperatures of 26°C to 29°C, 21°C to 26°C, and 20°C, respectively.
Creating a positive veterinary experience for dogs
We’re all familiar with the problems caused by lockdown and the COVID-19 pandemic, but one area particularly highlighted has been the inadequate socialisation of puppies and nervous younger dogs. We became accustomed to seeing well-behaved, sociable dogs, always happy to come to the surgery. Sadly, dogs like this are now the exception rather than the rule, and handling shy, nervous and/or aggressive dogs safely yet kindly can be a challenge. But it is in everyone’s interest that veterinary professionals handle dogs in a manner that is least likely to exacerbate the problem the next time they come into the clinic.
Furthermore, when a dog is brought into the veterinary surgery, especially if they are to be hospitalised, they will be exposed to many potential stressors. These will often start with the car journey, especially if the dog is not used to the car. During lockdown, many puppies and young dogs were denied the opportunity to become accustomed to the car. So, what is a joy to many older dogs is, sadly, challenging to the new generation. If we add the strange smells, sights and noises of the veterinary practice, as well as the new people and proximity to other animals, we can begin to imagine how stressful visiting the vet must be for dogs.
So how can we make the veterinary experience less stressful for our canine patients and their owners?
Handling
Being handled by strangers can be extremely stressful, especially if the individual is of a nervous disposition, fearful or under-socialised. Even confident dogs can take several days to become accustomed to strangers handling them, so it’s important to take your time and not rush.
Before you begin a procedure, let the dog sniff and examine the equipment you want to use, such as stethoscopes, auroscopes or nail clippers
In most cases, a dog’s aggressive behaviour is driven by fear, so it pays to start with the least invasive procedures and end with those most likely to upset the dog. As a general rule, dogs are more concerned about examinations around their rear, especially those involving handling the tail, so taking the rectal temperature (remembering to use lubrication to aid insertion) may be something you want to leave until last.
Before you begin a procedure, let the dog sniff and examine the equipment you want to use, such as stethoscopes, auroscopes or nail clippers. You should always handle the body part before using the equipment – simply lifting a front paw and putting it down a few times so the dog can see what you are doing can help reduce anxiety.
When outside, dogs greet each other indirectly and rarely do so head-on. This can be a useful observation in the examination room – it’s better to approach the dog from an angle in a calm and gentle manner. Talk to the dog calmly, slowly and with a relatively quiet tone, moving slowly and quietly without making sudden movements. Some people find that getting down on the floor with the dog can help them relax and make handling easier. Bear in mind that large dogs should be examined on the floor rather than on the examination table.
It’s better to approach the dog from an angle in a calm and gentle manner. Talk to the dog calmly, slowly and with a relatively quiet tone, moving slowly and quietly without making sudden movements
Some nurses enjoy handling shy dogs and are better at it than others, so these nurses should be encouraged to work with other practice members to train their colleagues in technique and confident handling. If no one is particularly confident in this regard, it would be advisable to address this with appropriate training for all practice staff, as dogs and their owners will pick up on this immediately.
Use plenty of treats if you can (with the owner’s permission, of course). Many practices have jars of soft and hard treats of various kinds readily at hand to use as encouragement or reward.
Restraint and sedation
Generally, dogs respond well to minimal restraint provided they are given the time to “make friends”. Adopting a “less is more” approach to restraint will help to prevent the dog from resorting to avoidance tactics. It’s important to pay attention to owners’ warnings that a dog is likely to bite but we shouldn’t rely on owners to hold their dogs safely unless we are familiar with their level of competence.
Adopting a ‘less is more’ approach to restraint will help to prevent the dog from resorting to avoidance tactics
Chemical restraint to avoid or decrease stress caused by physical restraint may be helpful, but be mindful that because the dog has already become highly aroused, they will not be a good candidate for sedation as the dose required will be higher and the effect reduced. It is worth rescheduling non-urgent procedures so they can be planned more precisely. Most owners will understand and appreciate that your concern is for their dog’s welfare.
The veterinary environment
While some considerations may sound like common sense, it’s all too easy to be swept along by the practicalities of the veterinary workplace.
We have already discussed how stainless-steel surfaces may be ideal from a cleaning and contamination standpoint but are cold, slippery and unfamiliar to the dog. Also, metal surfaces and doors can be very noisy, yet minimising sharp, loud noises and avoiding bright lights help to encourage the dog to settle for examination or any other procedures required.
We’ve become used to taking this level of extra care with cats, but it’s equally important with anxious dogs.
Understanding behaviour
Unlike humans, hospitalised dogs do not have the benefit of a rational explanation about their situation, which will inevitably be stressful. Therefore, making their stay as pleasant as it can be is even more important when dealing with anxious dogs, but bear in mind that no two dogs are the same. We need to consider temperament as different dogs react differently to the same type and intensity of stressors. Some are very sensitive and react badly, while others seem to take everything in their stride, although even these dogs will also suffer from a certain level of stress. Some dogs appear to adjust to the hospital environment much more quickly than others, and there may be many possible influences on their behaviour within the practice environment.
In most cases, pet dogs form a strong bond with their owners and may have been in the same home environment for all, or most, of their lifetime. To be removed from a predictable and stable situation and placed in a strange environment is almost certainly going to affect the dog’s mental well-being and could, over time, have physiological repercussions.
Most dogs in the UK are house trained and like to keep their environment mess-free – some dogs find having to toilet in their kennels very stressful and, in some instances, won’t evacuate themselves unless taken out for regular breaks.
Pet dogs are more used to home furnishings than kennel floors and dog beds and thus may not be comfortable with the smell of disinfectant or being confined next to other dogs they do not know. For under-socialised or fearful dogs, being kennelled next to others can be extremely stressful and can also lead to aggression problems and barrier frustration. When dogs find the confinement of kennels stressful, it can lead to a lack of sleep, which, over an extended period, can build into a serious problem – the weakening of the body’s immune system. This can put dogs in a noisy ward in danger of picking up infections that would not normally be a risk for a healthy dog. We sometimes forget that sleep is essential for a dog’s physical and mental well-being and is vital in the process of regeneration and recovery.
Many dogs are used to social interaction, so some may find the loneliness of a hospital ward very stressful
Many dogs are used to social interaction, so some may find the loneliness of a hospital ward very stressful as in a busy practice, the staff are unlikely to have much time to spend with individual dogs. Dogs are creatures of habit, and when they arrive at the clinic, the security of everyday predictability is lost. It’s easy to see how this could be very stressful and confusing.
