Fear Free Veterinary Visits

Photo Credit: Daanfranken on Flicker, Dr. Marty Becker is one of the most enthusiastic veterinarians I know, and he is an amazing advocate for the veterinary profession. Not only does he run a small animal practice in Idaho, he is a nationally recognized speaker, columnist, and television and radio spokesperson.

Most recently, Dr. Becker has been busy promoting his concept of “Fear Free veterinary visits” by encouraging his colleagues to focus on their patients’ minds as well as their bodies. After all, the calmer the animal, the more successful the visit is apt to be. Dr. Becker writes, “Just as pediatric dentists had to change to comfort and coddle patients as well as do preventive and therapeutic dental care, so must we change to provide emotional care and compassion for pets to go along with great medicine.”

Dr. Becker’s Ten Fear Free strategies

Here are the ten steps Dr. Becker recommends to achieve Fear Free veterinary visits:

  1. Arrive with a calm pet. Arriving with an animal that is relaxed sets the tone for a calm visit. This might involve the use of pheromones, sedatives prescribed by the veterinarian, cat carrier covers, and playing special calming music. I’ll throw in my two cents here by saying that, the calmness of my client (the human in the exam room) usually influences the calmness of my patient. Playing some special calming music for both species might be just the ticket!
  1. Withhold food. Dr. Becker recommends no food after 6:00 PM the night before the office visit (unless the animal’s medical condition dictates otherwise). This way, the dog or cat is more likely to respond to food rewards offered by the veterinary staff.
  1. Minimize the use of the waiting room. Waiting in a private exam room or even in the family car may create less anxiety than spending time in a busy waiting area.
  1. Have species-specific exam rooms. Dr. Becker recommends species-specific places to examine the animal, pheromones, calming music, wall coverings, and even adjusted temperatures. I would add that direct exposure to the smell of “Eau de Dog” might just tip a skittish kitty over the edge.
  1. Promote a sense of calm in the exam room. Actions such as using a lower voice, avoiding direct eye contact, providing treats, allowing the animal to check the veterinarian out first rather than vice versa, and wearing pheromones can have significant calming effects.
  1. Offer a choice of where to examine the patient. Some animals feel far more comfortable on the floor than up on a metal exam table. (I find this to be particularly true for larger dogs.) Dr. Becker recommends exploring alternate places including the inside of the cat carrier (with the top taken off), on a yoga mat or towel on the floor, or on the pet owner’s lap. I agree wholeheartedly and would add that for some dogs, performing my exam outside on the lawn, inside the car (the animal’s home away from home), or in the back of the family pick up truck can help create calm.
  1. Determine one best method of positional compliance. What this means is working with each animal to determine which method of restraint has the most calming impact. Once the method is determined, it is wise to make note of it within the medical record along with the pet’s preferred place to be examined and favorite treats. My own experience has taught me that many animals do best with a “less is more” method of restraint.
  1. Make vaccinations less pain/more gain. This means using smaller needles, distraction techniques when the needle prick occurs, and administering vaccinations via less stressful measures. For example, a kennel cough vaccination can be administered orally rather than into the nose.
  1. Use sedation early and often. If an animal appears anxious, Dr. Becker recommends administration of sedation and then waiting for it to take effect. When sedation is warranted, I encourage selecting a drug that is a true anxiolytic (reduces anxiety) rather than one that simply produces a sleepy dog or cat.
  1. Cradle every pet’s physical and emotional well-being. Lastly, Dr. Becker encourages beginning the office visit with the animal’s emotional well-being. Only after a calm attitude is achieved should assessment of the animal’s physical well-being begin.

As a “p.s.” to Dr. Becker’s recommendations, I will add my belief that some dogs and cats are less fearful about being taken beyond the exam room and into the bowels of the hospital when their favorite calm human is allowed to accompany them. Keep in mind, this applies to some but not all animals. I encourage you to discuss access to the “back of the hospital” with your veterinarian.

Lastly, I want to let you know that I am a huge fan of the book, Low Stress Handling, Restraint and Behavior Modification of Dogs and Cats: Techniques for Developing Patients Who Love Their Visits. The late Dr. Sophia Yin (every animal’s true best friend) wrote this fabulous book. If you are “interviewing” veterinary hospitals, finding a copy of this on the bookshelf is an excellent selling point!

What Fear Free methods would you add to Dr. Becker’s list? Which Fear Free methods do the staff members at your family veterinary hospital utilize?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.


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9 Comments on “Fear Free Veterinary Visits

  1. Thanks for sharing Dr. Becker’s campaign! I didn’t know about it but now I understand why he’ll be presenting next week at Purina’s Better with Pets Summit in NYC, the focus of which is the emotional well-being of animals. We’re thrilled we’ll be there for his talk. Meanwhile, we’ll be sharing this with the Tripawds community, who are all too familiar with repeated vet visits over a short period of time. Thanks again.

  2. Stacy,
    Fear-free is a compound adjective. With, or without the hyphen, the meaning is the same.

  3. Great article. One additional recommendation is Tellington TTouch® is extremely helpful for stressed and fearful pets. TTouch practitioners are around the world who can help you with your companion animal or horses. Check out http;//ttouch.com.

  4. Great article! Nit-picky tip, though – a dash in your title would change it’s mean from “you should be afraid of free vet visits” to “vet visits with no fear”. “Fear-free” makes for one adjective, while “fear free” means “be afraid of it”!

  5. Great question Ardis. The drugs I prefer are benzodiazepines such as Valium (diazepam) or Ativan (lorazepam). In most cases, they provide an excellent decrease in anxiety.

  6. Good morning Dr. Nancy,

    Can you specify a sedative that isn’t anxiety-producing? We know that Ace Promazine knocks the dogs down for the 4th of July and thunderstorms, but from what we’ve heard, they are still just as anxious; they just can’t do anything about it because their muscles are somewhat paralyzed. True?

    Valerian Root is a natural calming herb, but not necessarily highly effective in some dogs.

  7. The only thing I disagree with and I deeply disagree with is the idea of withholding food from 6pm the night before a vet visit. Imagine that you are going to the doctor’s for a 4pm appointment and you were asked to not eat from 6pm the evening before! You would be hungry and likely grouchy to boot. Withholding food for three hours is usually sufficient to ensure that the pet will take treats, but withholding food for long periods of time results in an animal who has low blood sugar and will learn that being at the vet’s means being hungry and uncomfortable. Instead, I would suggest that owners be encouraged to come to the veterinary office and feed treats on a regular basis in order to teach the animal that taking treats at the vet’s and from the vet is a safe thing to do.

    Sue Alexander CPDT-KSA, CBCC-KA, CDBC

  8. Hi – This is wonderful to read and so important. I will add that vets would do well to offer clients some training at the vet with a certified trainer who understands about fear and arousal, relaxation protocols, some tricks, and how to assist with getting the pet used to travel and handling. Perhaps a “free to client and potential client” class at the office where the handlers and dogs work in the space and learn what to practice at home. This helps EVERYONE, including trainers who deal with this frequently. In many places, the only time an animal is transported is to the vet, which makes this training help invaluable.

  9. Equally important is for you to be calm and upbeat during the visit. And be vigilant! Newly adopted, my small dog and I entered the waiting room of a vet new to me. We were ambushed by a large lab mix with its clueless owner on the other end of a long line. No physical harm was done, but it frightened my dog badly. Now I always carry, or use a carrier, for my small dog when entering a waiting room.