applied animal and health welfare 1 - practical solution to mananging behaviour problems in practice

lathrogenic welfare harms

• Animals attend vets to improve their welfare e.g.,

• Preventative care to avoid future problems e.g., infectious disease, parasite burden, reproductive disorders – pyometra, urogenital cancers

• Treatment of current welfare problems e.g., diseases that cause pain, discomfort distress; many breed-related problems, accidents/injuries

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• Attending practices may cause welfare harms inadvertently – ‘iatrogenic’ (relating to illness caused by treatment )

• VNs play key role in reducing and where possible, avoiding, these harms

stressors in practice

• Separation from caregiver

-Heightened for animals with pre-existing separation related behaviour

• Separation from bonded animals (social group)

• Unfamiliar conspecifics

• Unfamiliar humans

• Unfamiliar animals of other species

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• Heightened in prey species

• Sensory challenges – loud noises, bright lights, strong smells

-Anthropocentric view: we may not be aware of things other species can sense

cumulative stressors

Vet approaches with stethoscope

Nurse pulls them by their lead to move them onto the scales in the waiting room

Receptionist bends over them at the desk to stroke their head

Noisy child runs around waiting room

Forced to sit close to a barking dog in waiting room

ARROW FACING UPWARDS MORE STRESS

What are fear, anxiety and stress (FAS)? Fear 

• is a direct emotional response experienced by an individual when it identifies a harmful situation, e.g., restraint for venepuncture.

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• Anxiety 

•  differs from fear because it is based on the individual’s perception that a threatening situation may occur, e.g., when placed in a kennel environment. 

• Stress 

• is a physiological response to a situation or event that causes a negative impact on the individual’s health, welfare or behaviour which can be evoked by fear or anxiety (Casey, 2002)

Human perspective

• The physical well-being of patients - a primary concern in veterinary practice, but emotional well-being = equal consideration.

• Reduction of patient stress can reduce the incidence of harm to both animals and staff by more effective patient handling  , making your job easier!

• Decreased bite injuries to staff = reducing need for time-consuming accident investigations and staff shortages due to inability to work

physical perspective

• Stress, particularly when chronic→contribute to disease progression → a negative effect on a patient’s welfare.

• The hormones involved in stress, adrenaline and cortisol, stimulate a shift in immunity which:

• increases vulnerability to infections

• increases blood glucose levels

• impedes wound healing

• Could result in longer stays in the hospital  vicious cycle contributing to chronic stress responses.

emotional perspective

• Stressful experiences cause a negative emotional state, which pets learn to associate with veterinary practice environment  lead to future visits → an unpleasant experience for the animal ( challenging for caregiver and veterinary professional)

• Risks future emotional distress: Puppies that were fearful in the veterinary environment at 2–4 months of age were fearful as young adults (12 months later) in the same contexts

• Risks future undertreatment: A major reason clients failed to bring their pets to the veterinary hospital because they were unwilling with the stress to the animal and to themselves

individual differences in expression FAS

some patients actively respond sign of aggression, bark, chew, pacing

some patients may freeze and not move

some patients may cope passively with behaviour inhibition e.g not urinating or eating within an hospital - further stress to patient when intervention are needed such as tube feeding

• Working with patients in a way that reduces fear, anxiety, and stress (FAS), requires you as a VN to become proficient in recognising behaviours associated with FAs

• Signs of stress in can be very subtle and careful monitoring is required

• Signs of stress are often species-specific and it is important to be aware of these differences

FAS SIGNS IN DOGS

• Avoidance of people

• Defensive aggression

• Panting

• Salivation

• Pacing

• Excessive activity

• Visual scanning

• Dilated pupils

• Inappropriate soiling of kennel area

• Vocalisation

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• Hiding

• Attention-seeking behaviour, i.e. pawing

• Appeasing/low posture

• Flattened ears

• Low tail position

• Anorexia

• Digging

• Paw lifting

• Body shaking

• Tachycardia

FAS signs in cats

• Withdrawn/hiding away

• Increased sleep

• Reduced tolerance to handling

• Aggression

• Reluctance to utilise resources (litter tray, feeding bowls)

• Inappropriate elimination in kennel

• Sitting in hunched position/flattened posture

• Reduction in play and interaction with people

• Reduced appetite and thirst

• Overeating

• Vocalisation

• Increased fear

• Sleep disturbance

• Pacing, circling or restlessness

• Under- or over-grooming

• Flattened ears

• Dilated pupils

• Visual scanning

• Panting (in extreme cases)

• Climbing

• Spraying

• Lip licking

stress reduction plans

Used in conjunction with a nursing care plan, it ensures each patient is considered as an individual, accounting for temperaments and current illnesses, and how potential problems can be avoided

Can be used alongside normal hospitalisation sheets to encourage the nursing team to monitor patients for signs of FAS

Think HAPPY!

Health of the patient -  is the patient’s health affecting their mental well-being?

Anticipation - does the patient have time to anticipate what is going to happen? Take time to get to know your patient and allow your patient to feel secure/relaxed

Perception - What is the patient’s perception of you? Are you rushing and therefore heavy-handed?

Peace - Does the patient experience periods of calm and peace at appropriate and relevant times? Are lights switched off at night?

You – You are in control of your patients and must ensure the best care possible is given

greeting - handling techniques

• Care taken when initially greeting animals.

• Direct eye contact should be avoided

• Avoid leaning over or reaching for an animal, as this can be menacing

• avoid squatting down with your face close to the animal; rather, squat (or sit) from further away and avoid facing head-on.

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• Squatting, sitting or standing sideways is less threatening than looming over an animal.

• Very fearful dogs can be approached by moving sideways

• important to allow the animal to gradually get used to you, even after a successful greeting.

• Slow, smooth movements, allowing the animal the opportunity to move away.

• Greater routine use of treats should be considered: before, during and after consultations, and during hospitalisation.

• Use of treats can reduce fear during practice visits by conditioning pets to view visits as a positive experience and used throughout the consultation to reward positive behaviour.

• Small pieces of high-value treats can change emotional responses!

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• Scatter feeding on consult room floor to reduce initial stress

• Use of soft/wet treats like liver paste for distraction during procedures e.g., on a lickymatt

• Asking for basic commands (if known) and rewarding appropriately with high-value treats – i.e., not just kibble, something special and stinky!

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• Some vets are reluctant to use treats due to the potential risk of aspiration pneumonia, if sedation is later required. limited evidence shows that treat feeding actually increases the risk of aspiration pneumonia in cats and dogs

• Over-restraining an animal is frightening and painful.

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• Knowing how to provide adequate restraint, support and direction to the animal will help it feel balanced and safer.

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• Handling starts before you have even touched the animal; e.g., it is better to disassemble carriers for cats and small dogs that are reluctant to exit the carrier rather than dumping the animal out or grabbing them by the scruff – use treats to encourage, give them choice and autonomy

more tips of restraint in animals

• The minimal amount of restraint that is necessary for immobilisation should be used.

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• Examine patients where they are most comfortable; cats and small dogs may feel more comfortable being examined on your lap than on a table.

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• Cats often prefer being examined in a structure with sides (e.g., on weighing scales or in the bottom half of their carrier) and can be partially hidden under a blanket.

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• Many dogs are more comfortable being examined on the floor, rather than on the exam table

Practical tips for your stress reduction plan
Kennelling

• Species-specific wards where possible; maximal distance of species if not

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• Some dogs value visual access and benefit from higher levels of interaction with staff

• Others be fearful of other dogs or staff

• Use of barriers to block visual access

treatment are should be..

• Separate from the kennel area, as primary accommodation → safe haven for the patient

• Treatments with potentially negative interactions (e.g., restraint) should be carried out elsewhere

• Only positive events such as TLC, rest and feeding should take place within the hospitalisation area

dog with separation related behaviour may need

• Regular visual contact with humans to cope; think about kennel position, whether they can safely be in another space.

• enrichment in kennel to reduce stress e.g., long-lasting chew/lick toys like stuffed kongs, licky mats

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• Provided with psychopharmacology (e.g., gabapentin, trazodone, oral transmucosal dexmedetomidine, alprazolam;

cat benefits from being kennelled at..

• Height to feel safe, plus the ability to hide away (e.g., boxes/hides).

• Providing a hide and perch box as enrichment for kennelled cats compared to an open bed reduced signs of stress

• increased signs of relaxed behaviours such as sleeping, laying out

pheremonotherapy

• Pheromones such as Feliway (cats) and Adaptil (dogs) are synthetic pheromone preparations that have been shown to reduce signs associated with anxiety

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• Feliway and Adaptil are indicated for use on wards. Animals are only sensitive to pheromones from their own species

• ideally, species-specific wards offer greater benefit to patients