Top 5 Aids to Calm Anxious Patients

Many veterinary patients experience anxiety in the practice. Changing their emotional state by offering items they enjoy can help prevent or reverse their fear and enhance cooperation¹ during current and future treatments. Following are 5 ways to help calm anxious patients.

1. Treats & Toys

Treats should be palatable and easy to eat. Keep a variety of soft, sticky, and crunchy treats on hand to meet patient needs because they have different preferences. For patients with food allergies, provide hypo-allergenic choices, or instruct clients to provide treats from home.

There are many options practices can consider. A good starting point includes commercially available dog and cat soft treats, canned pet food, baby food, canned spray cheese or cream cheese, freeze-dried pet treats (eg, liver), canned whipped cream, and kibble pieces. Offer fresh or frozen flavored broth to patients that cannot have solid food. Toys are often helpful, especially for puppies and kittens. (See Figure 1.)

FIGURE 1

Toys can help make a visit to the practice less stressful.

Create a conditioned emotional response by giving patients treats and toys during and immediately after treatments.¹ Use treats as a distraction to facilitate physical examinations, measuring body weight, and other basic treatments (eg, vaccinations). Always record a patients treat preferences in the medical record.

2. Comfortable Surfaces

Veterinary practices have many slick surfaces (eg, scales, floors, examination tables, cage and kennel bottoms, radiography tables). When animals feel poorly supported or unstable in their footing, they may slip or struggle, increasing their anxiety.

Place nonslip mats on common surfaces (eg, waiting room floors, scales, examination tables, cage bottoms, kennel floors, radiography tables) to improve patient safety and comfort and decrease anxiety.^2,3 Nonslip options include yoga mats cut to fit, rubber-backed rugs and carpets, rubberized shelf-liners under mats or towels, and commercially available disposable products (eg, HotDog table covers).

Machine wash and air-dry yoga mats, or wipe with disinfectant. Rugs, carpets, and shelf-liners can also be laundered. Wipe HotDog table covers with disinfectant between patients and discard at the end of the day or if damaged.

Use yoga mats and table covers when taking radiographs, alone or in addition to radiolucent patient-positioning V-trays or foam bracers, always ensuring image quality is not compromised.

For pets wary of slick floors and reluctant to enter the practice, create a trail to the examination room of rugs, runners, or mats that will provide good traction and reduce fear.

3. Pheromones

Pheromones (ie, species-specific chemicals used for social signaling) are commercially available in synthetic form. (See Resources.) For veterinarians, the most useful synthetic pheromones include:

• Adaptil: simulates the mammary pheromones of lactating dogs.

• Feliway: simulates the feline F3 fraction facial pheromone used for social boundary marking.

• Feliway Multicat: simulates the mammary pheromones of lactating cats.

Pheromones have been shown to improve relaxation in dogs and cats during veterinary visits.^4,5 Each product is available as a diffuser, wipe, or spray, as well as a collar for dogs. Placing diffusers in the examination and treatment rooms, and spraying surfaces, towels, carriers, and even the clothing of team members handling patients may enhance patient relaxation and make the practice more welcoming. Pheromones may also help facilitate transport to and from the practice if applied by the client beforehand.

4. Towels, Blankets, & Places to Hide

Use towels and blankets to facilitate patient handling, make patients more comfortable, and help them relax during practice visits or prolonged hospitalization. (See Figure 2.)

FIGURE 2

A box placed in the kennel provides cats with a place to hide if desired. Photo courtesy of Monique Feyrecilde

Provide opportunities for cats to hide to help reduce their stress levels.⁶ Allow them to hide in a carrier or carrier bottom covered with a towel while they are waiting or to hide under a towel with only the necessary area exposed while examined. In treatment rooms or kennels, provide cats with a sheltered area or cover half of the kennel door to give them the choice of being concealed.

Use towels and blankets to position and stabilize patients safely and comfortably. Team members should learn how to use towel and blanket wraps for cats, who usually respond well, and avoid methods that increase anxiety (eg, scruffing, stretching, muzzling). Use thick blankets to remove cats from kennels during emergencies to allow safe sedative administration. (See Resources.)

5. Supplements & Medications

Even when the veterinary team goes to great lengths to provide a welcoming environment, uses anxiety-reducing aids, and employs patient-friendly handling methods, some patients still experience a high level of stress, fear, or anxiety during examination and treatment. Anxiety-relieving supplements and medications often help.^1,2,3,7

Many well-researched, anxiety-relieving supplements for veterinary patients (eg, Anxitane, Novifit, Senilife, Solliquin, Zylkene) are commercially available, as well as numerous short-acting and long- acting anxiolytic medications. Veterinary use of these medications is often extralabel but well-documented as safe and effective. Individual patient response may vary, so ensure all team members are educated about and comfortable with the use of anxiolytics (eg, benzodiazepines, trazodone, clonidine). Sedatives and general anesthesia can also help. Protocols for medication should always address anxiety as well as somnolence or immobilization. Veterinarians should be familiar with the synergistic and additive effects of medications and supplements and possible adverse effects. Acepromazine is never appropriate as a single agent for fear, stress, or anxiety.

Conclusion

These methods can improve the care and welfare of anxious patients and make visits less stressful for them and team members.

This article originally appeared in the June 2016 issue of Veterinary Team Brief.