Veterinary Behaviour Blog
The New Normal!
By Lynne Taylor

Challenges for cats and dogs in the new normal of Veterinary Practice

Jun 14, 2020 | Veterinary Blog

As the complete Covid-19 lockdown is being eased, in accordance with RCVS and BVA guidelines, practices are not limited to providing emergency care, and are gradually providing a more complete service.   The admission of clients to practice buildings with their animals will involve new challenges for the pets, their owners and the veterinary staff.  Being prepared for these will benefit all concerned.

Veterinary and reception staff interacting with clients will be likely to be wearing face masks and/or visors with which many animals are totally unfamiliar.  Many dogs are initially fearful of people wearing clothing and carrying accessories that they have not been habituated to, so the sight of several staff members wearing PPE could cause them significant distress.  This could be avoided by advising any clients who contact the practice to start familiarising their dogs with face coverings.  It could also be mentioned in practice newsletters.

The process should involve gently exposing the dogs to homemade cloth masks or any other types that are available to the clients.  Initially the owner should just hold a mask in their hand and allow their dog to approach, sniff and investigate it if they choose to. 

The owner should use an excited, jolly voice when talking to the dog when the mask is present and it may be helpful to offer them some treats at the same time.  The owner can then slowly bring the mask up to their face while the dog is watching and can clearly see that the owner is behind the mask.  This can be repeated on a regular basis and by other members of the household.

When the dog is used to seeing everyone in a mask, and is showing no signs of fear or avoidance, family members can start entering the room or house while already wearing the mask.  This process should enable dogs to cope with the sight of unfamiliar or familiar veterinary staff wearing masks when they arrive at a practice. The same process could be carried out to habituate dogs to the sight of visors.  Access to these may be more difficult for most clients and may require some ingenuity to construct mock visors.

Even if habituated to the sight of humans wearing masks, many dogs will find it difficult not being able to read the facial expressions of staff members who are wearing masks.  It is therefore even more important than usual for vets and nurses to talk in a happy, calm voice to canine patients, without making prolonged eye contact with them, to ensure that their presence is not perceived as threatening.  They should also approach dogs sideways rather than head-on and avoid sudden movements and arm gestures.

Cats should also be habituated to the sight and smell of masks at home in order to help them cope with those at the veterinary practice.  Masks should be gently presented to cats when they are relaxed and comfortable, allowing them to sniff and investigate if they choose to, while the owner talks quietly to them.  If they shy away, the mask should be taken away and later left on the floor or a chair so that the cat can check it out when they feel ready to.  In the next stage the owner can sit close to the cat when it is relaxed, talk in a quiet calm voice and slowly lift the mask to their face while the cat is watching.  This can be repeated by other members of the family.

Most cats feel more secure being transported in an enclosed or covered carrier so their first view of veterinary staff wearing PPE will be as they emerge from the carrier.  They will need gentle handling to help them cope with the altered appearance of staff and consulting-room.

When the carrier is placed on the table, the veterinary staff should talk quietly when greeting and observing the cat in the carrier.  If the cat is showing relaxed body language, the door can be quietly opened and a closed hand offered for the cat to sniff.  Dry treats placed on the table or soft paste smeared on it will encourage relaxed cats to leave their carrier.  Staff should avoid looking at them head-on while wearing masks or visors so these face coverings appear less obvious.

For more anxious cats, draping a cover over their carrier that has been sprayed with the synthetic pheromone ‘Feliway classic’ 15 minutes previously can help to promote relaxation while the owner is being questioned about the cat’s history.  For cats who do not leave the carrier voluntarily, if the top of the carrier is removable, this should be quietly unclipped and lifted off, allowing the cat to be examined inside the base or lifted out if necessary.  If the carrier only opens from the front, the cat can be gently lifted out by scooping under the bedding and removing this with the cat on top.  Very anxious cats, and those showing aggression to the veterinary staff, may need to be covered with a large towel and gently lifted by tucking this underneath them.

 

Searching for food is a calming activity.  It would be beneficial to request that owners of food-motivated dogs and cats bring some high-value treats that their pets really enjoy, when attending the practice.   For dogs, these could then be sprinkled on the floor on arrival in the consulting-room which would promote calmness as well as deflecting the dog’s attention from the veterinary staff.  As already mentioned, for cats, treats sprinkled on the table, or soft food treats smeared on it, may encourage them to leave their carrier and as well as promoting calmness.  Exceptions to this would be animals experiencing gastrointestinal symptoms and those that are likely to require sedating or anaesthetising during their visit.  It can be a useful indication of the level of stress an animal is experiencing if they fail to show interest in treats that they normally love.

Being handled by veterinary staff wearing gloves may be another source of anxiety to some dogs and cats,  since they are used to obtaining olfactory information from hands and the unfamiliar appearance and smell of the gloves is likely to be unpleasant to them.  It may be preferable to engage in frequent hand-washing as an alternative.

 

Another new feature of veterinary practices will be additional barriers between veterinary staff and clients to reduce potential transmission of Covid-19.  For pets who are already familiar with the practice, the barriers will create a further change to the environment that they will need to adjust to.  As well as altering the appearance of the consulting-room, barriers are likely to move and make noises that could be very alarming to the patients, so they will need extra time to get used to this before being examined.  The presence of the barriers will also make handling and examination of pets on consulting-room tables more difficult, as clients may not be able to reach across to effectively hold their pet in a safe and secure manner.  This may necessitate the assistance of nursing staff in veterinary consultations.  Many anxious pets depend on the close proximity of their owners for their emotional security.  When being examined on the table, some cats and small dogs who are used to being able to ‘bury’ themselves into their owners will experience increased anxiety if they are prevented from doing so by the barriers.  It might be worth suggesting to owners of such animals that they bring one of their worn unwashed garments for their pets to stand on or be wrapped in if restraint is required.  The requirements of social distancing between veterinary staff and owners may also make it impossible for large anxious dogs who are being examined on the floor to maintain physical contact with their owners.

 

There is a cohort of puppies and kittens that did not receive their primary vaccination course at the appropriate time due to lockdown restrictions.  These young animals had no opportunity to become accustomed to the veterinary premises and staff during the sensitive period of their emotional development.  In addition, they may have had limited opportunities to socialise with humans and other animals, since the owners of the puppies were reluctant to take them out due to the potential disease risk and no-one received visitors during lockdown. 

These puppies and kittens will need to be dealt with particularly sensitively to reduce the risk of them developing a negative association with the veterinary practice.   This may necessitate longer consultation times than are normally allowed for vaccination. Sprinkling dry treats or smearing paste and allowing the animals time to relax on the floor or examination table will help them to cope with the approach of unfamiliar veterinary staff.  Ideally, they should be encouraged to come towards the staff members before a gentle examination is started, while treats continue to be provided.  For very avoidant individuals it may be necessary for the vet or nurse to gently move the animal towards them and enclose them in their arms to avoid having to reach out repeatedly towards them, which is likely to appear threatening.  The veterinary staff should gently feel over the puppy or kitten’s body and lift the skin of the scruff a few times so that touch in that region will not be a sudden surprise when the vaccination injection is administered.  It will be well worth the expense of using a fresh narrow gauge needle to administer the vaccination after drawing the liquid into the syringe with a thicker one to avoid the puppy or kitten experiencing pain at this time.

There are some positive aspects to the changes in veterinary practice.  Social distancing will require that few clients are present in the practice at one time.  At least for the foreseeable future, there will be no more crowded waiting-rooms with barking dogs and loud conversations.  Anxious and/or reactive dogs and most cats (and their owners) may actually have lower stress levels when entering the consulting-room now than they did in the ‘old normal!’

If an animal is really struggling despite using the measures suggested contact a qualified behaviourist – Find a Behaviourist