Reducing Fear of Veterinary Visits for Dogs

By Debra Horwitz, DVM, DACVB & Gary Landsberg, DVM, DACVB, DECAWBM

Why might my dog show aggressive responses at the veterinary office?

Many dogs are afraid when they come to the veterinary office and may show this fear as submissive urination, panting, drooling, avoidance, growling, snapping or biting. Aggressive behaviors toward strangers in a veterinary situation should not be mislabeled dominance or status related aggression. Most dogs that are aggressive at the veterinary office are exhibiting fear related aggression.

How can I help my pet get over this fear?

A gradual training program of desensitization will help your dog become more comfortable with visiting the veterinary hospital. A visit to the veterinarian is an overwhelming situation for some dogs and their owners. The goal is to start at a level of challenge the dog can handle and then progress to more challenging situations while teaching the dog to be calm and relaxed. It is also important for the owner to feel calm, relaxed and in control. Any anxiety the owner feels is transmitted to the dog. If the owner feels anxious and unsure, then the process should be slowed down even if the dog is doing well.

Learn to observe your dog closely for subtle signs of anxiety like yawning, licking, raising a front paw or looking away (see Canine Communication – Interpreting Dog Language) and be sure you understand your dog’s communication.

What is systematic desensitization? veterinary_visits_examinations_-_desensitization_reducing_fear_1

Systematic desensitization is a training method used to reduce an animal’s undesirable behavior in response to a given object or situation. It is the most effective means of treating fears and phobias and is often combined with Counter-Conditioning (see Desensitization and Counter-Conditioning and Implementing Desensitization and Counter-Conditioning).

How does systematic desensitization work?

The situation that evokes the undesirable response, fear or phobia is usually capable of being broken down into separate components, which often stimulate separate senses. For example, consider a pet that is terrified at the veterinary hospital.

It may be the sight of the veterinarian in a white coat, the smell of disinfectant used at the practice, the fact that it is in proximity with other animals in an anxious or excited state, or the memory of receiving a treatment such as an injection. The object of systematic desensitization is to identify the separate elements of the problem, which can then be presented to the animal separately so that your dog can be gradually trained to relax in their presence.

How is this organized?

veterinary_visits_examinations_-_desensitization_reducing_fear_2

In the example given, if the veterinarian wears a white coat, it is useful to start by exposing your dog to people in white coats in the home. The stimulus has to be presented to the animal at a level high enough to arouse interest without causing the problem behavior, in this case, fear. Members of the family can wear a white coat and handle the dog, play with him, etc., and then try placing him on a table or worktop. Rewards can be used as soon as the animal starts to relax. The use of a head halter for training can help ensure safety as well as better control and may calm some pets; this may be extremely useful during the actual visit (see Head Halter Training and Head Halter Training – Synopsis).

Next, it may be possible to repeat the situation away from the home. Local trainers are often prepared to help in situations such as these. The process has interest in the stimulus and shows no signs of anxiety. Another component is then introduced (e.g., the particular disinfectant associated with the clinic).

The next component is then introduced, for example the presence of a number of other animals, and so on. It is important that the response is positive and can be reliably repeated before you move to the next stage. It is also important to occasionally present lower level cues to which you know your dog will respond reliably; in other words, give your dog a refresher.

"Your dog is systematically trained to each individual cue before
some of them are combined together."

If the fear response is elicited by the sight of a syringe, using a toy syringe in a similar sequence with copious food distractions often works well, but rapid progress should not be expected. These treatment techniques work provided sufficient repetition is provided and you are prepared to spend a lot of time with your dog.

Your dog is systematically trained to each individual cue before some of them are combined.

Acceptance can be improved if it is possible to distract your dog when the stimulus is presented. Here food rewards are useful. For example, when taking your dog for a veterinary visit, it can be very useful to withhold food on the day of the visit and bring along your dog's favored toys and treats. The mere sight of the toy or treat may be sufficient distraction for your dog. If he shows no inappropriate response, lavish praise should also be given. At the veterinary clinic, it may be possible to arrange with your veterinarian to not wear a coat during the examination. If any of the stimuli that incite fear can be avoided or your dog can be sufficiently distracted, the fear might be substantially reduced or entirely prevented. Therefore if the veterinarian and staff avoided wearing white coats that previously incited fear, if the syringe is hidden from view while the dog is distracted with a favored toy or treats by the owner, or the examination were to take place on the floor rather than the table, the dog might be less fearful. Behavior products can also be invaluable in that the head halter can keep the head focused on the owner and not the veterinarian (provided the owner is calm and positive) and can also control the head and muzzle to ensure safety, while a calming cap that covers the eyes can reduce some of the visual stimuli that might incite fear.

veterinary_visits_examinations_-_desensitization_reducing_fear_3

For other pets, “happy visits” to the veterinary clinic, which are associated with food rewards, fun, games, and nothing else can help ease the anxiety associated with a veterinary visit.

Are there any other tips for desensitization training?

1.   DO NOT TIRE YOUR PET
Training sessions should never go on too long otherwise your dog's attention level will drop and no progress will be made.

2.   REPEATED SHORT TRAINING SESSIONS ARE BEST
When starting a new training session, always start several levels lower than the point at which the previous session finished.

3.   REVIEW IS NECESSARY

What we want is relaxed and calm body postures and facial expressions that will let us know the dog is more comfortable. So when the dog sits on command, we want to reward relaxation, not tense, scanning, or shaking behavior. If your pet does not know how to do this, practice this task before beginning any part of the desensitization program (see Teaching Calm – Settle and Relaxation Training).

In order to achieve this, management of the stimulus (such as the veterinary hospital personnel) will be quite important. The distance to the clinic, the number of people and other dogs present will all factor into his response.

All cues and most treats should come from the owner and not the veterinary staff. Corrections should be firm but not forceful and involve pulling up on the Gentle Leader until the dog sits and appears calm and settled. This should occur within 60 seconds, if not, make the situation easier for your dog by lessening the stimulus either by increasing the distance or turning the dog around so he cannot see things as well. Do not punish or get angry with your dog. If your dog is aroused and reactive then recognize the need to slow down and progress at a less stimulating pace. Remember the goal is for your dog to have a positive, pleasant experience.

“Any behavior you reward is likely to occur again.”

Positive reinforcement is used to reinforce desirable behaviors. Remember: any behavior you reward is likely to occur again. Use small, pea-size pieces of a soft special treat; try tiny bits of hot dog, cheese, boiled chicken. For small or finicky dogs try peanut butter or squeeze cheese on a wooden spoon. Do not reward your dog every time, reward his best efforts or anytime you are pleasantly surprised by his behavior. If your dog refuses treats he would normally take then this is a sign of anxiety and you should make the task easier for him by manipulating the stimulus intensity, try a better treat and/or repeat the task when your dog is hungrier (see Reinforcement and Rewards).

If there is any question about aggressive behavior then the dog should wear a cage or basket style muzzle over the top of the head halter.

Avoid a standard mesh muzzle which often fits snug around the dogs muzzle and restricts the dogs ability to pant, eat or communicate (see Muzzle Training).

Remember that progressing slowly is often fine – progressing too quickly can be detrimental and counterproductive so it is better to progress too slowly than too fast. You may also take a break as needed. The number of sessions will vary depending on the severity of the dog’s behavior. Remember if your dog begins to show any fear or anxiety, this indicates that you are proceeding too quickly. Often a dog will refuse treats as a clear sign of anxiety. However, by using a Gentle Leader you should calmly and safely be able to get your dog to focus on you and the rewards with a gentle pull and release and reward when your dog is calm.

Related Articles