Facing fear head on: Tips for veterinarians to create a more behavior-centered practice - DVM
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Facing fear head on: Tips for veterinarians to create a more behavior-centered practice
In part 2 of this series, we equip veterinary teams to assess and alleviate fear during veterinary visits to build a more positive patient experience and stronger pet-owner relationships.


DVM360 MAGAZINE


If you're not conducting routine evaluations for common behavior problems, you're not alone. Taking a proactive approach to behavior is almost nonexistent in most of our practices, yet research suggests that implementing a fear and anxiety assessment at each veterinary visit could go a long way toward preventing relinquishment and suffering in pet dogs and cats.


A trip to the veterinarian doesn’t have to be a painful experience for pets—or pet owners. By incorporating a fear and anxiety assessment into each patient visit, you’ll create a better experience for everyone.
In part one of this series ("Fear factor: Is routine veterinary care contributing to lifelong patient anxiety?" September 2013 dvm360), we discussed dramatic research suggesting that a simple veterinary visit can greatly contribute to a lifetime of fearful behavior, starting with the first puppy or kitten wellness exam. The good news: Changing a fearful practice environment into a fun, rewarding and behavior-centered experience is easier than you think.

The fearful 10 percent

A study of 102 puppies between 8 and 16 weeks of age involved videotaping a standardized veterinary examination for each dog.1 The exam included watching the puppy unrestrained on the floor, performing a physical exam on the table and doing a series of manipulations on the floor. The authors used the videos to define and classify the signals and behaviors.

The findings were striking: Most puppies exhibited what we think of as typical puppy exploratory and social behaviors, but about 10 percent of the pups did not exhibit exploratory behavior, did not warm to interactions or did not want to be touched and handled by the staff. A follow-up study, not yet fully published, reexamined these same dogs under the same conditions at 18 months of age, and virtually all the pups that had been fearful when younger were fearful as adults—and fearful in the same contexts.2 Some of the dogs that were considered normal pups had developed behavioral concerns—fears among them.

So what can we do to alleviate these emerging behaviors? First, we can assess puppies for behavioral propensities in a repeatable manner (here's a hint: the exam takes the same amount of time whether or not there's video camera mounted on the wall or on a tripod). We can think of the pup's behaviors in terms of risk assessment and explain any concerns to clients. We can disabuse the clients—and our staff members—of the common notion that these dogs will "grow out of it," as they often don't. In fact, to assume they will is to potentially condemn them to a lifetime of mental suffering. Finally, we can treat these fearful pets early and often and explain that treatment is always best when brains are developing.

Fast, effective assessment


Assigning a ’stress value’ to dogs
We cannot accomplish a behavior-centered practice that's fun for the patient until we recognize and measure behaviors that are occurring and remeasure them after we have attempted interventions. A study provided some simple assessment scales,3 which I've expanded and adapted to routine veterinary practice (see the table below; a downloadable packet of these and other scales can be found in the Manual of Clinical Behavioral Medicine for Dogs and Cats [Elsevier, 2013] and on the accompanying DVD).


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Source: DVM360 MAGAZINE,
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