Top 5 Aids to Calm Anxious Patients

Print/View PDF

Sign in to continue reading this article

Not registered? Create an account for free to read full articles on www.veterinaryteambrief.com.

To access full articles on www.veterinaryteambrief.com, please sign in below.

Busy? Sign in Faster. Sign into www.veterinaryteambrief.com with your social media account.

Teaching Target:

PATIENT COMFORT AND SAFETY SHOULD BE A PRACTICE POLICY AND PRIORITY, SO ENSURE ALL TEAM MEMBERS ARE FAMILIAR WITH THE MANY WAYS PATIENT ANXIETY CAN BE REDUCED.

Many veterinary patients experience anxiety in the practice. Changing their emotional state by offering items they enjoy can help prevent or reverse their fear and enhance cooperation1 during current and future treatments. Following are 5 ways to help calm anxious patients.

1 Treats & Toys

Treats should be palatable and easy to eat. Keep a variety of soft, sticky, and crunchy treats on hand to meet patient needs because they have different preferences. For patients with food allergies, provide hypo-allergenic choices, or instruct clients to provide treats from home.

Figure 1. Toys can help make a visit to the practice less stressful.

There are many options practices can consider. A good starting point includes commercially available dog and cat soft treats, canned pet food, baby food, canned spray cheese or cream cheese, freeze-dried pet treats (eg, liver), canned whipped cream, and kibble pieces. Offer fresh or frozen flavored broth to patients that cannot have solid food. Toys are often helpful, especially for puppies and kittens. (See Figure 1.)

Create a conditioned emotional response by giving patients treats and toys during and immediately after treatments.1 Use treats as a distraction to facilitate physical examinations, measuring body weight, and other basic treatments (eg, vaccinations). Always record a patient’s treat preferences in the medical record. 

Related Article: Stress Reduction for Canine Patients

2 Comfortable Surfaces

Veterinary practices have many slick surfaces (eg, scales, floors, examination tables, cage and kennel bottoms, radiography tables). When animals feel poorly supported or unstable in their footing, they may slip or struggle, increasing their anxiety.

Create a conditioned emotional response by giving patients treats and toys during and immediately after treatments.

Place nonslip mats on common surfaces (eg, waiting room floors, scales, examination tables, cage bottoms, kennel floors, radiography tables) to improve patient safety and comfort and decrease anxiety.2,3 Nonslip options include yoga mats cut to fit, rubber-backed rugs and carpets, rubberized shelf-liners under mats or towels, and commercially available disposable products (eg, HotDog table covers). 

Machine wash and air-dry yoga mats, or wipe with disinfectant. Rugs, carpets, and shelf-liners can also be laundered. Wipe HotDog table covers with disinfectant between patients and discard at the end of the day or if damaged. 

Use yoga mats and table covers when taking radiographs, alone or in addition to radiolucent patient-positioning V-trays or foam bracers, always ensuring image quality is not compromised.

For pets wary of slick floors and reluctant to enter the practice, create a trail to the examination room of rugs, runners, or mats that will provide good traction and reduce fear. 

[ad override]

3 Pheromones

Pheromones (ie, species-specific chemicals used for social signaling) are commercially available in synthetic form. (See Resources.) For veterinarians, the most useful synthetic pheromones include:

  • Adaptil: simulates the mammary pheromones of lactating dogs.
  • Feliway: simulates the feline F3 fraction facial pheromone used for social boundary marking. 
  • Feliway Multicat: simulates the mammary pheromones of lactating cats.

Pheromones have been shown to improve relaxation in dogs and cats during veterinary visits.4,5 Each product is available as a diffuser, wipe, or spray, as well as a collar for dogs. Placing diffusers in the examination and treatment rooms, and spraying surfaces, towels, carriers, and even the clothing of team members handling patients may enhance patient relaxation and make the practice more welcoming. Pheromones may also help facilitate transport to and from the practice if applied by the client beforehand. 

Related Article: Top 5 Feline Environmental Needs

4 Towels, Blankets, & Places to Hide

Use towels and blankets to facilitate patient handling, make patients more comfortable, and help them relax during practice visits or prolonged hospitalization. (See Figure 2.)

Figure 2. A box placed in the kennel provides cats with a place to hide if desired. Photo courtesy of Monique Feyrecilde

Related Article: Techniques for Towel Restraint of Cats

Provide opportunities for cats to hide to help reduce their stress levels.6 Allow them to hide in a carrier or carrier bottom covered with a towel while they are waiting or to hide under a towel with only the necessary area exposed while examined. In treatment rooms or kennels, provide cats with a sheltered area or cover half of the kennel door to give them the choice of being concealed. 

Use towels and blankets to position and stabilize patients safely and comfortably. Team members should learn how to use towel and blanket wraps for cats, who usually respond well, and avoid methods that increase anxiety (eg, scruffing, stretching, muzzling). Use thick blankets to remove cats from kennels during emergencies to allow safe sedative administration. (See Resources.)

[ad override]

5 Supplements & Medications

Even when the veterinary team goes to great lengths to provide a welcoming environment, uses anxiety-reducing aids, and employs patient-friendly handling methods, some patients still experience a high level of stress, fear, or anxiety during examination and treatment. Anxiety-relieving supplements and medications often help.1,2,3,7 

Related Article: How to Recognize and Treat Anxious Dogs and Cats

Many well-researched, anxiety-relieving supplements for veterinary patients (eg, Anxitane, Novifit, Senilife, Solliquin, Zylkene) are commercially available, as well as numerous short-acting and long- acting anxiolytic medications. Veterinary use of these medications is often extralabel but well-documented as safe and effective. Individual patient response may vary, so ensure all team members are educated about and comfortable with the use of anxiolytics (eg, benzodiazepines, trazodone, clonidine). Sedatives and general anesthesia can also help. Protocols for medication should always address anxiety as well as somnolence or immobilization. Veterinarians should be familiar with the synergistic and additive effects of medications and supplements and possible adverse effects. Acepromazine is never appropriate as a single agent for fear, stress, or anxiety.

Related Article: Acepromazine

Conclusion

These methods can improve the care and welfare of anxious patients and make visits less stressful for them and team members. 

Team
Takeaways

Veterinarians:

Use anxiety-reducing tools and techniques with all patients to make visits easier and less stressful for both patients and team members.

Management Team:

Make reducing patient anxiety a focus by providing these tools and resources and training all team members on how to implement them.

Nursing Team:

Use treats and toys, be cognizant of slick surfaces, and watch for every opportunity to help anxious patients.

Client Care Team:

As patients are arriving or departing, take special note of areas where changes could be made to help reduce patient anxiety.

References and author information Show
References
  1. Shaw JK, Martin D. Canine and Feline Behavior for Veterinary Technicians and Nurses. Ames, IA: Wiley-Blackwell; 2014.

  2. Hellyer P, Rodan I, Brunt J, et al. AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg. 2007;9(6):466-480.

  3. Carney HC, Little S, Brownlee-Tomasso D, et al. AAFP and ISFM feline-friendly nursing care guidelines. J Feline Med Surg. 2012;14(5):337-349.

  4. Mills DS, Ramos D, Estelles MG, Hargrave C. A triple blind placebo-controlled investigation into the assessment of the effect of Dog Appeasing Pheromone (DAP) on anxiety related behaviour of problem dogs in the veterinary clinic. Appl Anim Behav Sci. 2006;98(1-2):114-126.

  5. Kronen PW, Ludders JW, Erb HN, et al. A synthetic fraction of feline facial pheromones calms but does not reduce struggling in cats before venous catheterization. Vet Anaesth Analg. 2006;33(4):258-265.

  6. Vinke CM, Godijn LM, van der Leij WJR. Will a hiding box provide stress reduction for shelter cats? Appl Anim Behav Sci. 2014;160(1):86-93.

  7. Moffat K. Addressing canine and feline aggression in the veterinary clinic. Vet Clin North Am Small Anim Pract. 2008;38(5):983-1003.

 

Resources

Author

Monique Feyrecilde

BA, LVT, VTS (Behavior) Teaching Animals, Mercer Island Veterinary Clinic

Monique Feyrecilde, BA, LVT, VTS (Behavior), is a full-time veterinary nurse in general practice, specializing in behavior. She is also president of the Academy of Veterinary Behavior Technicians. She enjoys coaching pets and their owners both in the practice and through her consulting business, Teaching Animals. Monique has a passion for stewardship of the human–animal bond through educating veterinary professionals on compassionate animal-friendly techniques. 

FUN FACT: Monique competes at the national level with her dogs in both agility and sheepherding events.

Material from Veterinary Team Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Veterinary Team Brief delivers practical skills for team-based medicine—with clinical strategies for team training, peer-reviewed credibility, concise content, essential training modules, and easy-to-implement protocols. From the publisher of Clinician's Brief.