By: Eileen Koval, CDBC, CBCC-KA, CPDT-KA, MSc
The vet clinic lobby is the first exposure a pet has to the veterinary care experience. The cheerful colors, soft comfortable seating and happy-face pet photos on the walls are common features. The seating usually offers an open, clear view of the front desk.
The vet clinic lobby is a pet patient’s first encounter when they enter the vet clinic. Is it a calming environment? Is it stressful? Or is it a terrifying place for the pet patient? Does the experience there help set them up for success in the exam room?
Since the COVID pandemic, the number of aggressive and reactive dogs has skyrocketed due to many reasons including poor genetics, lack of proper socialization, and lack of proper training. The number of pets (especially dogs) added to homes exploded during the pandemic, leaving vet clinics stretched thin to accommodate. This has led to sometimes over-crowded waiting areas with dogs who are completely unprepared for encountering other dogs and people in close proximity. I have met countless owners who have regularly skipped routine and/or urgently necessary veterinary care for their pets because they feel that taking them into the clinic is too stressful. Many have described chaotic waiting area experiences with their reactive dogs, or the inability to avoid encountering numerous dogs in very close proximity on their way to the exam room.
Dogs who are lunging, growling, or barking at everything in their vicinity are not the only ones who are stressed. They cause distress to all the other animals present. Animals may be flooded with the stress hormones from a fight/flight response by having to be seated near reactive dogs in the over-crowded waiting areas. Unfortunately, it can take several hours (or more) for those stress hormones to dissipate, so the animal’s comfort and cooperation during the vet appointment is very likely going to be significantly affected from any prolonged nerve-wracking situations in the waiting/lobby area. It is my experience that few clinics have protocols to accommodate reactive dogs, despite the huge influx of reactive dogs in recent years. Probably because clinics are in a constant struggle to maintain the mental health and well-being of their staff while keeping up with the relentless demand for patient care. I am often asked by veterinarians to work with dogs on body handling skills so they can eventually be examined comfortably. However, that only goes so far if a dog is being (inadvertently) terrified while having to wait for 30 minutes in close proximity to highly reactive dogs or in an otherwise noisy, unpredictable environment. It is not unusual to also see some reactive dog owners allowing their reactive dogs to freely approach people and animals in the waiting area while they stare them down, growl and/or lunge. Perhaps they do not understand the negative impacts these confrontations can have on their own pet in addition to the others around them.
Whenever I work on training and behavior modification plans with clients, the first thing we discuss is setting an appropriate environment to reduce stress and optimize their potential to perform the behaviors we are teaching them to do. In the case of a veterinary visit, we want animals to be cooperative and accepting of handling and care by staff.
What are pet patients learning when they are in the vet clinic waiting room?
Some dogs are learning that the vet clinic is an unpredictable and unsafe place so they better be hypervigilant while there.
Now…how can this be addressed?
Everyone has an important role to play in setting pets up for success in healthcare and grooming, both in the immediate term and lifelong: pet parents/owners, behavior consultants and/or qualified trainers, vet clinics and their staff.
It can be helpful for front desk staff to be trained to identify highly stressed pets upon check-in. These dogs/owners can be asked to wait in their cars until an exam room is available, or if rooms are available, to be immediately taken to a room. A separate back-door entrance for highly reactive dogs is extremely helpful for avoiding other dogs. Alternatively, it could be helpful (if possible) to schedule these pets at the beginning - or- end of the day when fewer pets are around the waiting area. Of course, a referral to a qualified behavior consultant or qualified trainer is also important for addressing this behavior in the long term through behavior modification. Some veterinarians also choose to employ situational medications, if/when suitable, to relieve animals’ anxieties during vet appointments. This has been extremely helpful for some of my clients to help create positive (or at least less-stressful) experiences while we worked on behavior modification for long-term solutions.
Calming music, soothing (and safe) scents like lavender, and/or pheromones can also help to set the right tone that this is a calm space. Avoiding putting seating right next to hallway entrances can keep animals from being surprised when another pet walks down the hallway and enters the lobby. Requiring owners to keep animals secured on standard-length (non-retractable) leashes next to their owners may also be helpful. Biscuit containers with tasty treats available for owners can also go a long way with helping pets to stay calm and owner-focused in the waiting area. Barriers that block views of the entrance and/or heavily trafficked pathways can also reduce stressful visual stimuli and keep pets calmer.
Keeping animals with their owners – whether that is in the car, in the lobby, or in the exam room -- also can greatly help to reduce stress. While it may be quicker to whisk them to the back of the clinic for fast routine care, they are much more likely to go over-threshold in a sympathetic nervous system response (fight/flight/freeze). Yes…that “cooperation” is often an animal in shutdown/freeze response. While this can sometimes be helpful, it is not good for positive emotional learning and long-term outcomes. I think the stress animals experience being separated from owners is significantly underestimated, especially when encountering strange smells, medical equipment, unfamiliar people and animals, and being held/handled/manipulated in ways that may cause discomfort. Maintaining close proximity to the owner is a huge comfort for pets. Quicker is not always better. Socialization and/or training classes (if sanitized, safe, and positive-reinforcement based) can also be conducted in larger waiting area spaces after clinic hours to help create positive experiences with the vet clinic environment.
Pet parents should engage in early puppy socialization (before 12 weeks) and continue this through adolescence when social maturity occurs and breed-specific traits begin to take hold. They can also bring puppies for regular “happy vet visits” to receive treats and/or petting (if the animal desires it) from the staff to create positive emotional associations.
But these efforts only go so far if the waiting area is over-crowded, noisy, or otherwise scary for pets.
Cooperative care/body handling training is essential so pets are accepting of handling by strangers. This is best started when pets are puppies, but it can be started at any age. However, it only goes so far if the environment is one of unpredictability and extreme stress. Owners can also teach pets to accept wearing a basket muzzle so that the first time they wear one is not a frightening experience at the vet clinic.
Creating calm starts by creating a space that touches the senses of the animal patients themselves to convey and promote calm emotions. It also is crucial to create protocols to identify pets who are not prepared for that environment, and to have suitable alternatives available for them. There can be logistical limitations based on space size and layouts, staffing, as well as pet parents’ abilities – both skills/knowledge and financial. Thoughtfulness and awareness can help everyone improve situations together to create lifelong lower-stress vet visits for all pets.
Please reach out if we can help your vet clinic with a behavior specialist's perspective on how to improve experiences and outcomes for your patients.
I am always here to work as a team with pet parents, veterinarians, and vet clinics to bring about the best behavioral and welfare outcomes for pets.
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References:
Döring, D., Roscher, A., et al. (2009). Fear-related behaviour of dogs in veterinary practice. The Veterinary Journal. Vol 182, Issue 1. https://doi.org/10.1016/j.tvjl.2008.05.006.
Gácsi, M., Maros, K., Sernkvist, S., Faragó, T., & Miklósi, Á. (2013). Human analogue safe haven effect of the owner: behavioural and heart rate response to stressful social stimuli in dogs. PLoS One, 8(3), e58475.
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Eileen Koval, CDBC, CBCC-KA, CPDT-KA, MSc (in Operations Management) is a fully certified dog behavior consultant with the International Association of Animal Behavior Consultants (IAABC). She believes the foundation of a good cross-species relationship is understanding the needs and normal behavior patterns of each dog as an individual, as he/she was bred to be. She enjoys helping humans and dogs communicate more effectively to create brilliant relationships with joy, purpose, and fulfillment for all species involved. She offers private consulting for serious dog behavior issues, obedience/manners, and agility training. Eileen developed a unique online course to help pet parents and trainers develop reliable snake avoidance behavior off-leash through positive reinforcement techniques. These techniques have been applied by trainers worldwide to teach dogs reliable avoidance of dangerous environmental hazards and off-leash property boundaries. She lives on a small ranch in Las Vegas, Nevada with her husband and their Nederlandse Kooikerhondjes.