By Sally J. Foote, DVM, Okaw Veterinary Clinic

Do your customer's animals have an aversion to visiting your office? The good news is that you are not in the minority. The Bayer veterinary usage study gave some data for the reasons veterinary patient visits are down. One of the reasons for decreased patient visits is that both dogs and cats do not like to come to the veterinarian. 38% of dog owners and 58% of cat owners say their pet dislikes the veterinarian. I think the really important statistic is that 38% of cat owners and 26% of dog owners become stressed thinking about taking their pet to the veterinarian. There is a lot we can do to change the pet's experience to become more positive. Creating a more positive veterinary exam for the pet also decreases stress for the owner which will result in more patient visits. The key is to decrease the fear and aggression our patients have associated with visiting us.

So, begin by evaluating how anxious this pet is as they enter the clinic. Train your front office/technical staff to read pet body language. If the dog is panting, pacing or has its tail tucked, that animal is already showing signs of fear¹. A fearful cat hisses, cowers and has,wide dilated pupils². Do not rush to begin an examination. Have your staff ask if the pet has ever been upset at the veterinary office. Most clients will not use the word aggressive, but "upset" or "feisty" are clues that this pet is highly stressed at the veterinarian. lf the pet is usually calm but now and is acting upset, this pet is not feeling well! Pain is a significant trigger for aggression and stress in both dogs and cats.

Have your staff offer treats (i.e. Covetrus Lean Treats) and rewards in the waiting area and as they escort the client to the exam room . Assess the pet's body language in the exam room as treats are offered. If the pet is very fearful and tense it may be very difficult to get a good examination. If this is a wellness exam and there is not any history of problems from the owner, perform the exam in the area that the pet is least stressed. Try the exam on floor, the table, or in the arms of a staff person. Use a muzzle with peanut butter smeared inside to reward the dog for wearing it as it provides safety³. If it is very difficult to perform an exam, use sedatives and use them early! Explain to the client that the pet is not bad but rather in pain and they are simply protecting themselves from an uncomfortable situation. Now with the sedation you can perform a more complete exam and treatment.

Dispense anti-anxiety medications such as Alprazolam for future visits and continue to use rewards. Treat this pet's mental state like you would a physical state. It is for the best welfare of the pet,and thus allows for a more complete examination to be performed.

Decreasing fear will help to make examinations more positive for the pets. The pheromone products work well when your staff applies them early giving them time to work. I recently had a Labrador mix that lunged at me during his last exam three years ago. This year, we loaded the muzzle with peanut butter and sprayed some DAP on his back at the beginning of the exam. He was tense and growling but eating his peanut butter as I began the exam. After 10 minutes of history taking and examination he actually relaxed and stopped growling. In his 14 years, he was never this good for exam. I was able to do a complete exam on him for the first time. When your staff sees a dog is tense in the waiting area, have them spray a bandana with the DAP and put it on the dog right then. Feliway can also be sprayed on a towel draped over the carrier and also give this product 10 minutes or so to take effect. Tell your clients what you are using and why. If it works, sell them a bottle and throw in a free bandana . Have the client use the pheromone on the pet at home before the next exam. As the client sees the pet is less upset, they will be more inclined to follow up with rechecks and other care, again increasing your patient visits.

As an animal is less reactive, you can now perform a more complete exam. Clients can see that a blood draw is not as upsetting and will approve testing. A relaxed abdomen is easier to palpate than one tense from fear. When you recommend tests and treatment, clients will trust that you are doing what is in this pet's best interest because you are taking the time to make this pet's exam less upsetting. As compliance increases,so will income without changing fees.

For the reactive pet, use pain relief early before progressing far with the exam. Oral Buprenex can be given to both dogs and cats. If the pet is still reactive, then sedate with a reversible medication. Remember, you want the pet to learn that the exam will not be painful or fear producing. The amnesia from being sedated will help this pet associate less fear with the veterinary office. Charge reasonably for sedation and reversal so the client will approve. Make it easy for the client to agree that this is best for the pet. Use the reversible products so the pet will not go home drunk. You can start the treatment for this improving the client's compliance at home due to less pain. Offer to have the staff treat the pet as a short tech service if the client cannot do home treatment. Your staff can use a peanut butter muzzle or distraction techniques improving compliance, associating positive with the office and you can charge for this.

Be consistent with what this pet prefers for rewards by recording and scoring them on the medical record . One way to do this is using the Bella Behavior Label System (pat pend).³ This product is a method of recording and scoring the preference of rewards for each patient so all of the staff will know how to provide the least stressed exam for this patient. The consistency in handling is the fastest way to get less aggressive behavior from pets,again improving patient exams and care. Less aggression leads to better exams and more complete care. That will result in improved revenue for the office. Most importantly we can decrease those statistics of cats and dogs that hate the vet.