Top 10 Ways to Get Started with Fear Free^TM Veterinary Visits

Are you, your hospital team members, or clients some of the millions of pet owners who've seen recent Internet slideshows featuring frightened pets at the vet? Meant to be funny - with images of huge dogs in people's laps, cats inside the exam room garbage can, canines trying to hide in a tiny toy box, felines hunkered down behind canisters of Q-tips and gauze on the counter - are actually so sad they make me, as a veteran veterinarian and lifetime pet lover, want to cry. Why?

Pets that go to the veterinarian in a fearful state often end up with repeat, severe psychological damage. Like PTSD, these pets don't even have to suffer the stressful circumstances - such as being hoisted on the exam table, poked, pricked or restrained - to have fear. Just the sight of the carrier coming out or being loaded in the car can be enough to bring back the traumatic memories of a previous veterinary visit. Imagine the added stress of a pet that's been languishing in the shelter or just recently moved from the cage to your couch. And interestingly enough, once you know the signs of anxiety and fear, you will see it in most animals, even the ones pet owners think like going to the vet.

But just as dentists changed from focusing just on oral health to looking after children's dental and emotional health (I hated to go to the dentist as a child, and now my granddaughter looks forward to it!), as a profession we're now embracing our obligation to look after both a pet's physical and emotional wellbeing.

Can you imagine an environment where most dogs want to go to the vet and remain calm throughout the process of moving from the living room to the exam room and back home? A process through which cats find going to the veterinarian less stressful than having a stray cat wander through their yard, taking a bath or oral medications? You don't have to imagine, because veterinarians, technicians and practices across the country are learning the techniques and protocols to provide for Fear Free veterinary visits for all pets. Stress less. Fear Free. Whatever you call it, it just means that pets won't hate going to the vet, and pet owners won't cringe at the thought of taking them.

Fear Free requires an extra effort, not just on the part of the veterinary healthcare team, but also the pet owner (compared to past veterinary appointments). Here are my Top 10 pet owner tactics and tips for a Fear Free veterinary visit:

1.  Remove or reduce anxiety triggers - Does your cat or small dog cringe when the carrier comes out? Then take it out several days before the wellness visit and feed high-value food or treats in it. But don't force your pet - let it find the goodies on its own. Do you have pets that hate to be separated? Take them both to the vet. The one will get examined and treatment, but both will get treats.

2.  Make the carrier a little slice of heaven - If you're one of those people whose carrier only comes out when it's time to go to the vet, you can make it more like a condo than a cage by a) leaving it out all the time, b) treating it like a safe room for the pet, c) frequently putting toys and treats inside of it. If you don't have the space or desire to leave it out, then at least take it out three days before the scheduled visit.

3.  Magic carpet ride of pheromones - "Ask your veterinarian for a recommendation of a synthetic version of naturally occurring dog or cat pheromones," recommends Gary Landsberg, a boarded veterinary behaviorist and the author of Behavior Problems of the Dog & Cat. Landsberg warns that pet owners need a product that's clinically proven to work, not just one that has "Veterinary Recommended" on the label, which means nothing. By spritzing or wiping the pheromones onto surfaces like the pet's bedding, the door and walls of the carrier, the upholstery of the car, you deliver a magic carpet ride that extends from carrier to car to clinic.

4.  Just chill out - Many pets require some chill pills, compression (calming) wraps, ear covers that reduce auditory stimuli and eye covers that reduce visual stimuli, some calming music (classical, not heavy metal), or all of them. I recommend starting out with products you can get from your veterinarian that work in a natural way. One of my favorites is a green tea extract in a chewable tablet (has amazing palatability in both dogs and cats); another is a capsule containing milk proteins. The compression wraps act like the deep hugs you get when someone wants to comfort you, swaddling a baby or the tightening some autistic people find so relaxing. And if you know from previous experience that the visit will be stressful, discuss in advance with your veterinarian whether anxiety-reducing medications might be right for your pet. "There are medications which in combination with supplements (such as melatonin or Suntheanine) that are generally safe and may help decrease anxiety and fear in dogs and cats," says Dr. Alicia Karas, who teaches and practices anesthesia and pain medicine at Tufts University's Cummings School of Veterinary Medicine. "These can be prescribed by your vet and given an hour or so prior to leaving for the clinic. Very strong sedatives are not suitable for pet owners to give, but if coordinated with the veterinary staff, can be given immediately upon arrival to permit examination and minor procedures such as radiographs or ultrasound or even suture removal." Realize that being sleepy or groggy is often preferable to recovering from a severely stressful experience, and just let them safely "sleep it off." Talk to your vet about this - especially if you have had tough visits in the past.

5.  Hungry will mean happy - Withhold the bulk of your pet's food within 12 hours of the veterinary visit so that they enter the clinic very hungry and more likely to accept food rewards from the veterinary team. Landsberg warns, "If your pet is a puppy, kitten, a miniature breed or has any health issues, check with your veterinarian on how long to withhold." A great thing to do is to bring your pet's most favorite treats to the clinic so that they are delighted when they flow copiously.

6.  Ready, steady, go - Pet owners typically put the carrier containing the cat or small dog on the car seat. Problem is the cant of the seat bottom makes the carrier tilted, which is discomforting for the pet. There are commercial products available for keeping pizzas flat on the car seat that can be used, or you can just use rolled-up towels. A seat belt can provide further restraint for the carrier.

7.  See no evil - Face the level carrier toward the front of the vehicle. Cover the carrier with a light sheet, leaving only the front door uncovered. This greatly reduces visual stimuli (such as dogs being walked, vehicles whizzing by) and increases chances for a state of calm.

8.  Forget the baby talking - We put GoPro cameras in pet owner's vehicles and watched and listened to what happened. What a hot mess! The problem was pet owners saw their pets stressed or were stressed themselves, they baby-talked the pet, the pet got more anxious, the pet owner got stressed, and they kept feeding upon each other until both pet and pet owner were ready to boil over by the time they pulled into the veterinary clinic parking lot. In short, what you say and do will affect how your pet feels. Don't force the issue, raise your voice, or get angry or upset. A better thing to do is to remain calm and quiet or upbeat (pretend it's a trip to the dog park or the pet store). Bringing along a favored toy may also help to keep your pet occupied and happy.

9.  Don't just check in as usual - For decades, pet owners have followed the well-rehearsed route of stopping in the veterinary hospital parking lot, grabbing the carrier or the leash, and taking the pet inside to check in at the receptionist desk, waiting in the reception area with other pets and pet owners for your turn, and then going into the exam room. The reception area is nothing short of a stewpot of stress. Ask your veterinarian if you can either a) be taken straight into an exam room to be checked in, or b) park the vehicle, call or text the front desk to let them know you have arrived, and wait with your pet until an exam room clears and it's your turn to be seen. Note: It's worth reminding to keep AC on if it's hot outside.

10.  Building on success - Having a stress-free, positive veterinary visit puts your pet on the road to success. After a negative experience, future visits become increasingly more traumatic for the pet. But following positive visits, future visits become increasingly easier and more enjoyable for all.