Better care for animals everywhere. NAVC.com Conflict of Interest Disclosure DISCLOSURE: I have financial interest, arrangement or affiliation with: Name of Organization IDEXX Boehringer Ingelheim CEVA Elanco Relationship Sponsoring this Fear Free symposium Sponsoring Fear Free development Sponsoring Fear Free development Sponsoring Fear Free development Creating Fear Free Veterinary Visits Puts Pets Back Into Practices ® DrMartyBecker.com Facebook.com/drmartybecker Been Focused Too Much on Medicine Fear is the worst thing a social species can experience and it causes permanent damage to the brain. Fear in response to something painful or disturbing can condition the pet to experience more fear in response to those circumstances. NEW FROM DR. KAREN OVERALL! Order at elsevierhealth.com or Call 800-545-2522 $81.95 with free shipping worldwide! We Took An Oath “Cure sometimes. Treat often. Comfort always.” Hippocrates Our veterinary oath requires us to “prevent and relieve animal suffering.” “First, do no harm.” Hippocratic oath Major Signs of Anxiety in a Dog Panting, trembling, whining, pacing, clinging. Yawning, slow motion, staring, sleepy. Piloerection, shedding, self-grooming. Hypersalivation, licking lips, mouth closed. Shaking off, sweaty paws, dribble urine. Restless, sniffing, distracted, hypervigilant. Hiding, freezing, cowering, running off. Turning head, turning away (C-shape). Hardened eyes, blink, squint, furrowed brow. Won’t accept treats or reluctantly. The Calm Instead of the Storm No More NecesScary! Bayer Veterinary Healthcare Usage Study 37% of dog owners and 58% of cat owners said their pets hate going to the vet! 26% of dog owners and 38% of cat owners said that just thinking about going to the vet was stressful. Pet Owners Have Many Choices Problem isn’t lack of enough information to make informed decisions. Problem isn’t the economic downturn. Problem isn’t the fragmentation of the market. Problem IS that visiting the veterinarian isn’t worth the “hurt” to the pet or the “hassle” to the pet owner. Wait and see. The Teachable Moment We Engage in Behavior Modification Every Minute of Every Day We’re Around Pets Some times we do it actively; sometimes we do it passively. Pet owners, veterinarians, and veterinary team members are often reinforcing pet behaviors that are the most distressing to both pets and their people. All pets benefit from learning to be calm and Fear Free®. You Don’t Get an Ingrown Toenail Taken Care of at a Spa Don’t use “pile-o’-techs” to restrain. “Low Stress Handling, Restraint and Behavior Modification” book by Dr. Sophia Yin. Remove anxiety triggers like location of procedure. “Bruticaine” vs. 2.5% prilocaine with 2.5% lidocaine. Trazodone (5-15 mg/kg PO) given as a single dose one half to one hour before vet visit. From Living Room to Exam Room in a Fear Free State ® Remove or reduce anxiety triggers. Pheromones. Withhold food after 6 p.m.. Calm stomach and calm mind. Make sure carrier covered and on a flat surface. From Living Room to Exam Room in a Fear Free State ® No more drama when coming and going. Ideally, pet owner will make practice runs to the veterinary hospital for just rewards (desensitize). If necessary, pet sedation protocols are started before the pet owner leaves home. Start With the End in Mind Pre-visit checklist of anxiety triggers. Pet tricks & cues. Pet owners (staff too) trained on what an anxious and calm pet looks like. Wait management. Prepare exam room like a hotel suite. Show-and-tell Fear Free components. Proactively do nothing. ® Textbook of “Veterinary Internal Medicine” by Ettinger TPR varies widely! Take temp only if you think the pet is sick? By looking after the pet’s “emotional wellbeing” we also help the physical wellbeing of pets. Exam room table – now and future. Fear Free is a Transformational Change ® This problem is not just with cats! Treat anxiety/fear flare-ups like you would if alarms went off during surgery. Speak softly but carry a BIG stick. Catch pet owners doing things right! Do these three things to thrive not strive. You Know It’s Working When… Dogs want to go to the vet. Cats accept going to the vet. Your start getting more accurate TPRs and physicals. Number of injuries from bites, scratches and back injuries goes down. Job satisfaction goes up. Dog’s tail wagging. Cats relaxed. Owner smiling. Think Nice Home Not Cage This is a “set up!” for cats Special calming music and pheromones. Use Hide, Perch & Go Box. Follow The Ohio State U CVM guidelines for setting up a cat cage. Putting the TREAT Into Treatment Practice like the pet owner---who feels exactly what her cat or dog feels---is right there looking over your shoulders. Provide for isolation from anxiety and fear. Species specific treatment areas preferred. Entire staff wears pheromones and have tasty treats in pocket. Putting the TREAT Into TREATment When examining a cat’s mouth or other sensitive area, giving pills or drawing blood, consider Clipnosis . ® Adjust handling based on response. Release restraint at precise moment of delivery (vaccine, ear/eye drops). Physical touch can be magical. Keep track of which Fear Free and low stress handling techniques work best. ® When “Wild” to “Mild” Isn’t Probable or Possible Pharmacy Options @ Home Buprenorphine (0.03mg/kg) given as a squirt between the cheek and gum one to one and a half hours before vet visit. Gabapentin (50 mg small, 100 mg most, 150 large/robust PO) given one to one and a half hours before vet visit. Trazodone (5-15 mg/kg PO) given as a single dose one half to one hour before vet visit. Pharmacy Options in Hospital Butorphanol 0.2–0.4 mg/kg, IM for dogs and cats. High end of range if young/healthy; lower end if older/sick. Acepromazine 0.01–0.05 mg/kg IM dogs; 0.02–0.05 mg/kg IM cats. Dexmedetomidine 2-6 micrograms/kg IM dogs; 4-10 micrograms/kg, IM cats. “Taking the pet out of petrified… puts pets back into practices.” sm Creating Fear Free Veterinary Visits Puts Pets Back Into Practices ® DrMartyBecker.com Facebook.com/drmartybecker From Living Room to Exam Room in a Fear Free State ® Calm stomach and calm mind. Pheromones. Putting the TREAT into TREATment. Remove or reduce anxiety triggers. Puppy & kitten preventive training. Pet handling. From Living Room to Exam Room in a Fear Free State ® Procedures. Trick training. Muzzle training. No more drama coming and going. Addressing areas of concern. If necessary, start sedation protocols before pet owner leaves home.
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