February 28, 2018
We switched to a new veterinarian last year. We made the change on a good friend’s recommendation and could not be happier. Our new vet is thorough, compassionate, smart as a whip, and an outstanding diagnostician. Her staff members are also competent and welcoming. An additional virtue of this clinic (All About Animals, in Mahomet, IL) is the topic of this essay. Dr. Koss’s standard policy is that owners remain with their dogs and cats for physical examinations and for all health care procedures that good veterinary practice allows.
Here is an example.
Last summer, Cooper (aka Coopa Doopa Doo) developed an ear hematoma.
HOW COOPER SPENDS HIS SUMMERS
I was away, so Mike took him into the clinic. After examination, Dr. Koss recommended a relatively new approach to hematoma treatment in which the site is drained with a large gauge needle and an anti-inflammatory agent is directly injected into the remaining pocket. It is out-patient, does not require anesthesia, and is less invasive than traditional treatment protocols. Because it is a sterile procedure, Cooper would need to be treated in the clinic’s pre-surgery room. Dr. Koss told Mike, who was holding and talking to Coop during the examination, that the room has a large observation window and so Mike could watch as Cooper was being treated, if he so desired.
Mike did so desire. As Coop looked back at him through the window (wagging his tail the entire time), Mike witnessed both the procedure and the gentle way in which Cooper was handled and spoken to throughout treatment. After the procedure, Caleb, the veterinary technician and Cooper’s new best friend, brought Cooper back out to Mike, and they were good to go. Throughout the entire examination and treatment, Cooper was either with Mike (for weighing, examination and diagnosis) or Mike could see him through the window (during treatment).
Standard Operating Procedure? As many dog folks know, this level of clinic transparency and owner involvement is no longer standard practice at many veterinary clinics. It is quite common today for clinics to require that owners relinquish their dog to a staff person while still in the waiting room. All physical examinations, vaccinations and treatments are then conducted out of sight of the owner in a treatment room and the dog is returned to the owner at the end of the appointment.
Disclaimer: I am going to be blunt. I have a strong opinion about this. There is not a snow ball’s chance that I would allow any of my dogs to be taken “into the back” at a veterinary clinic for anything, short of surgery. Our new vet does go up and above with her clinic’s degree of owner involvement, but we have never been clients at a clinic that required our dogs to be taken away from us for examinations. Just as I assume that parents would not accept such a policy from their child’s pediatrician, I think it is not even remotely acceptable to expect owners to not be present during their pet’s veterinary examinations. Yet, this is not only standard protocol in many clinics today, but a requirement of some for acceptance as a client.
YOU MAY NOT WANT TO TRY TO SEPARATE ME FROM MY DOG.
Yeah, not going to happen. I am my dogs’ advocate as well as their source of comfort and security. Our dogs trust us to have their backs and at no time is this more important than when they are nervous or frightened, a common state of mind of many dogs during veterinary visits.
Until recently, this has only been my opinion. However, a new study, conducted at the National Veterinary School of Alfort in France, examined whether a dog’s stress level during a veterinary examination was influenced by having their owner present and providing comfort (1).
The Study: A group of 33 healthy dogs and their owners were enrolled. The dogs were at least 6 months of age and all had previous experience at a veterinary clinic. The objectives of the study were to measure dogs’ physiological and behavioral responses to a standard veterinary examination and to determine if having the owner present and providing comfort reduced the dog’s level of stress. Heart rate, rectal temperature, ocular (eye) surface temperature, salivary cortisol, and stress-related behaviors were recorded before, during and after a physical examination conducted in a clinic setting. Two conditions were studied: (1) Contact; the owner stood next to the examination table at the dog’s side and comforted the dog by talking to him/her quietly and using gentle petting; (2) Non-contact; the owner was in the room, but did not interact with the dog and sat quietly in a chair located ~ 10 feet away from the examination table. A balanced, cross-over design was used. This means that each dog was subjected to both conditions and experienced two visits (timed 1 to 2 weeks apart). To control for an order effect, the sequence of the conditions varied and was randomly assigned. Examinations lasted approximately 5 minutes and included mild restraint, examination of the dog’s eyes, ears, mouth and teeth, palpation of the lymph nodes and abdomen, manipulation of joints, and heart and lung examination with a stethoscope.
Results: Unsurprisingly, veterinary visits are stressful to dogs:
- Waiting room stress: All of the dogs experienced at least a low-level of stress during the pre-examination period, in the waiting room. As they waited, many of the dogs showed frequent yawning, which is considered to be a displacement behavior during periods of emotional conflict. Some of the dogs also whined and vocalized.
- Examination stress: The researchers found that all of the dogs, regardless of whether or not their owner was comforting them, showed a measurable stress response during the veterinary examination. Heart rate, ocular temperature, and lip licking all increased during the examination period.
- Owner being there: However, when owners stood close to their dogs and provided comfort by talking to and petting, the dogs’ heart rates and ocular temperatures decreased when compared with the condition in which owners were not interacting with their dogs. Both of these changes are associated with a decrease in stress. Dogs also attempted to jump off of the examining table less frequently when their owner was comforting them compared with when the owner was not providing comfort.
UP ON MY SOAP BOX
I know, these results are a no-brainer for many dog folks.
Veterinary visits are stressful to dogs and being present to comfort and reassure our dogs reduces their fear and stress. Unfortunately, in my view, this study did not go far enough, since it did not study the condition that I am most interested in learning about – when dogs are taken away from their owners and examined out of the owner’s presence. Interestingly, the argument that is made to support this practice at the clinics that insist upon it is that they remove dogs from their owners because the presence of the owner can cause the dog to be more stressed, not less so. Well, at the very least, these results provide evidence against that excuse.
And, an excuse it truly is. Perhaps this sounds harsh, (but remember, I am standing on a soap box… that is what it is for), but my belief is that these policies are in place more for the convenience of the clinic than for the benefit of the dogs. Reducing client interactions in an examination room no doubt is more expedient and efficient (for the clinic). And, there is also that pesky issue of transparency. An owner who does not have the opportunity to witness how their dog is handled, spoken to, examined or treated cannot question or criticize. There is really no other way to say this – the risk of owner displeasure and complaints is reduced by not having owners present while dogs are being examined and treated.
So, personally, I am happy to see these results, as they can be used as evidence when responding to a clinic that insists it is less stressful for dogs to be removed from their owner during examinations and routine procedures. Petting and talking to our dogs when they are upset during a veterinary visit reduces their stress. We have the data. (Not to put too fine a point on it, but these results also provide more ammunition to combat the still-present [and false] belief that calming a fearful dog “reinforces fear“. I address that particular issue in more depth in “Dog Smart”).
Hopefully, we will see a follow-up study that examines dogs’ responses to “no owner present” policies. Regardless, the data that we currently have encourage us to stay with our dogs during veterinary visits and examinations. It is quite simple really.
Just Be There. Insist upon it.
Study Reference: Csoltova E, Martineau M, Boissy A, Gilbert C. Behavioral and physiological reactions in dogs to a veterinary examination: Owner-dog interactions improve canine well-being. Physiology & Behavior 2017; 177:270-281.
This article was originally published and shared by Science Dog Linda Case is a dog trainer, canine nutritionist and science writer who specializes in topics about canine health, nutrition, behavior and training. See her Bio at https://thesciencedog.wordpress.com/about