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Why might my dog show aggressive responses at the veterinary office?

Veterinary Visits/Examinations – Desensitization/Reducing Fear in Dogs

Many dogs are afraid when they come to the veterinary office and may show this fear as submissive urination, panting, drooling, avoidance, growling, snapping or biting. Aggressive behaviors toward strangers in a veterinary situation should not be mislabeled dominance or status related aggression. Most dogs that are aggressive at the veterinary office are exhibiting fear related aggression.

How can I help my pet get over this fear?

A gradual training program of desensitization will help your pet become more comfortable with visiting the veterinary hospital. A visit to the veterinarian is an overwhelming situation for some dogs and their owners. The goal is to start at a level of challenge the dog can handle and then progress to more challenging situations while teaching the dog to be calm and relaxed. It is also important for the owner to feel calm, relaxed and in control. Any anxiety the owner feels is transmitted to the dog. If the owner feels anxious and unsure, then the process should be slowed down even if the dog is doing well.

Learn to observe your dog closely for subtle signs of anxiety like yawning, licking, raising a front paw or looking away and be sure you understand your dog's communication.


What is systematic desensitization?veterinary_visits_examinations_-_desensitization_reducing_fear_1

Systematic desensitization is a training method used to reduce an animal's undesirable behavior in response to a given object or situation. It is the most effective means of treating fears and phobias and is often combined with Counterconditioning.

 "The situation that evokes the undesirable response, fear or phobia is usually capable of being broken down into separate components, which often stimulate separate senses."

How does systematic desensitization work?

The situation that evokes the undesirable response, fear or phobia is usually capable of being broken down into separate components, which often stimulate separate senses. For example, consider a pet that is terrified at the veterinarians.

It may be the sight of the veterinarian in a white coat, the smell of disinfectant used at the practice, the fact that it is in proximity with other animals in an anxious or excited state, or the memory of receiving a treatment such as an injection. The object of systematic desensitization is to identify the separate elements of the problem, which can then be presented to the animal separately so that the pet can be gradually trained to relax in their presence.

How is this organized?

veterinary_visits_examinations_-_desensitization_reducing_fear_2In the example given, if the veterinarian wears a white coat, it is useful to start by exposing your pet to people in white coats in the home. The stimulus has to be presented to the animal at a level high enough to arouse interest without causing the problem behavior, in this case, fear. Members of the family can wear a white coat and handle the animal, play with it, etc., and then try placing the animal on a table or worktop. Rewards can be used as soon as the animal starts to relax. The use of a head halter for training can help ensure safety as well as better control and may calm some pets; this may be extremely useful during the actual visit.

Next it may be possible to repeat the situation away from the home. Local trainers are often prepared to help in situations such as these. The process has to be repeated many times until the pet reliably shows no more than a cursory interest in the stimulus and shows no signs of anxiety. Another component is then introduced; for example, the particular disinfectant associated with the clinic.

The next component is then introduced, for example the presence of a number of other animals, and so on. It is important that the response is positive and can be reliably repeated before you move to the next stage. It is also important to occasionally present lower level cues to which you know the animal will respond reliably; in other words, give the pet a refresher.

"The pet is systematically trained to each individual cue before
some of them are combined together."

If the fear response is elicited by the sight of a syringe, using a 'toy' syringe in a similar sequence with copious food distractions often works well, but rapid progress should not be expected. These treatment techniques work provided sufficient repetition is provided and you are prepared to spend a lot of time with your pet.

Acceptance can be improved if it is possible to distract the pet when the stimulus is presented. Here food rewards are useful. For example, when taking your pet for a veterinary visit, it can be very useful to withhold food on the day of the visit and bring along the pet's favored toys and treats. The mere sight of the toy or treat may be sufficient distraction for the pet. If the pet shows no inappropriate response, lavish praise should also be given. At the veterinary clinic, it may be possible to arrange with your veterinarian to not wear a coat during the examination.  If any of the stimuli that incite fear can be avoided or the pet can be sufficiently distracted, the fear might be substantially reduced or entirely prevented. Therefore if the veterinarian and staff avoided wearing white coats that previously incited fear, if the syringe is hidden from view while the dog is distracted with a favored toy or treats by the owner, or the examination were to take place on the floor rather than the table the pet might be less fearful. Behavior products can also be invaluable in that the head halter can keep the head focused on the owner and not the veterinarian (provided the owner is calm and positive) and can also control the head and muzzle to ensure safety, while a calming cap that covers the eyes can reduce some of the visual stimuli that might incite fear.veterinary_visits_examinations_-_desensitization_reducing_fear_3

For other pets, "happy visits" to the veterinary clinic, which are associated with food rewards, fun, games and nothing else can help ease the anxiety associated with a veterinary visit.

Are there any other tips for desensitization training?

1.   DO NOT TIRE YOUR PET
Training sessions should never go on too long otherwise the pet's attention level will drop and no progress will be made.

2.   REPEATED SHORT TRAINING SESSIONS ARE BEST
When starting a new training session, always start several levels lower than the point at which the previous session finished. 

3.   REVIEW IS NECESSARY
Once the goal has been achieved it is important there is regular reinforcement of the learning. This is done by regular exposure to what were the original problem elements. Injection fears in particular need attention in this respect.

4.  CONSIDER THE ENTIRE EXPERIENCE
If your dog is anxious about the car ride or is likely to need a head halter, muzzle or calming cap, then systematic desensitization to each of these should be completed prior to the veterinary visit.

5.   REDUCING ANXIETY
To reduce anxiety during training the use of pheromones, which are naturally produced chemicals, may help. Dog Appeasing Pheromone® (DAP) is an artificially synthesized version of a pheromone produced by lactating female dogs that has a reassuring affect and is available as a collar that the dog can wear to reduce anxiety.  The spray form may be placed on a towel to reduce anxiety related to car rides, and a diffuser plug in can be used in the veterinary office. A dose of a drug to reduce anxiety before the veterinary visit may also be beneficial for some fearful pets.

Desensitization program step by step:

Good head halter control is essential before you begin this desensitization process.

Key features of good Gentle Leader head halter control:

1.    Loose leash 90% of the time - this means NO pressure on the leash

2.    You give 1, maybe 2 sit commands, and then use the halter to guide the dog to sit.

3.    Use firm steady pressure to guide your dog into a sitting position. Your dog should respond to the pressure and sit within 15 seconds most of the time and rarely up to 60 seconds.

4.    No yelling, jerking, or yanking.

5.    No punishments or severe corrections

6.    Offer small highly delectable treats only for his best behaviors

What should I try to teach him?

What we want is relaxed and calm body postures and facial expressions that will let us know the dog is more comfortable. So when the dog sits on command, we want to reward relaxation, not tense, scanning or shaking behavior. If your pet does not know how to do this, practice this task prior to beginning any part of the desensitization program.

In order to achieve this, management of the stimulus (such as: the veterinary hospital personnel) will be quite important. The distance to the clinic, the number of people and other dogs present will all factor into his response.

All cues and most treats should come from the owner and not the veterinary staff. Corrections should be firm but not forceful and involve pulling up on the Gentle leader until the dog sits and appears calm and settled. This should occur within 60 seconds, if not, make the situation easier for your dog by lessening the stimulus either by increasing the distance or turning the dog around so he cannot see things as well. Do not punish or get angry with your dog.If your dog is aroused and reactive then recognize the need to slow down and progress at a less stimulating pace. Remember the goal is for your dog to have a positive, pleasant experience.

Positive reinforcement is used to reinforce desirable behaviors. Remember "Any behavior you reward is likely to occur again." Use small pea size pieces of a soft special treat; try tiny bits of hot dog, cheese, boiled chicken. For small or finicky dogs try peanut butter or squeeze cheese on a wooden spoon. Do not reward your pet every time, reward his best efforts or anytime you are pleasantly surprised by his behavior. If your dog refuses treats he would normally take then this is a sign of anxiety and you should make the task easier for him by manipulating the stimulus intensity, try a better treat and/or repeat the task when your dog is hungrier.

If there is any question about aggressive behavior then the dog should wear a cage or basket style muzzle over the top of the head halter. Avoid a standard mesh muzzle which often fits snug around the dogs muzzle and restricts the dogs ability to pant, eat or communicate.

Use the following schedule as a guideline and progress to the next step only if your dog is doing well and seems relaxed. Progressing slowly is often fine - progressing too quickly can be detrimental and counterproductive so it is better to progress too slow than too fast. You may also take a break as needed. Number of sessions will vary depending on the severity of the dog's behavior. Remember if your pet begins to show any fear or anxiety, this indicates that you are proceeding too quickly. Often a dog will refuse treats as a clear sign of anxiety. However, by using a Gentle Leader you should calmly and safely be able to get your dog to focus on you and the rewards with a gentle pull and release and reward when your pet is calm.

Desensitization schedule (ONLY REWARD CALM BEHAVIOR).

STEP 1 - Practice in the parking lot at the veterinary office at a quiet time of day. Do 1 to 3 10-20-minute sessions. This should be after hours or when there is little activity at the veterinary office. Note that if the problem does not begin until you get into the veterinary clinic you can proceed more quickly through this step. Also practice these sessions outside the entry door before moving into the lobby or reception area.  

STEP 2 - Practice in the lobby at the veterinary office at a quiet time of day. Do 1 to 3 10-20-minute sessions. As employees are working nearby - give him special treats. They do not have to give him food - you should give treats when someone walks by. You can then have veterinary staff walk by and drop the treats or sit quietly for treats if your dog shows no fear.

STEP 3 - Practice in an exam room at the veterinary office at a quiet time of day. Do 1 to 3 10-20-minute sessions.

STEP 4 - Practice in an exam room at the veterinary office at a quiet time of day. Do 1 to 3 10-20-minute sessions. Staff members may toss food to dog or drop it on the floor. Staff members should walk in and out of the exam room. The owner should be rewarding the dog only when a staff member is nearby.

STEP 5 - Practice in an exam room at the veterinary office at a busy time of day. Do 1 to 3 10-20-minute sessions. Staff members may toss food to dog or drop it on the floor. Staff members should walk in and out of the exam room. The owner should be rewarding the dog only when a staff member is nearby.

STEP 6 - Practice in an exam room at the veterinary office at a quiet time of day. Do 1 to 3 10-20-minute sessions. Staff members may toss food to dog or drop it on the floor. Staff members should act out things that may occur in a routine visit - open/close drawers, reach over dog, drop things, shake owner's hands, reach for dog, etc. If your dog seems relaxed and eager then handling/petting by the staff should be rewarded.

STEP 7 - Any procedures that might cause fear in the veterinary office can be practiced at home while giving food rewards. Identify what might frighten your pet and use favored treats to lift, have your dog stand on a small table, gently massage different parts of the body, shine a small light in your dog's eyes or ears, etc.

A final word of caution if any of these procedures leads to fear or anxiety or there is any chance of aggression: do not practice these exercises unless you have received professional guidance on how to proceed. This is a long process and requires dedication from both owners and the veterinary staff. The benefit is everyone will be rewarded by a dog that enjoys coming to the veterinary clinic and is a safe, enjoyable patient.


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