here - Dr. Marty Becker

Better care for animals everywhere.
Conflict of Interest Disclosure
I have financial interest, arrangement or affiliation with:
Name of Organization
Boehringer Ingelheim
Sponsoring this Fear Free symposium
Sponsoring Fear Free development
Sponsoring Fear Free development
Sponsoring Fear Free development
Creating Fear Free
Veterinary Visits Puts
Pets Back Into Practices
Been Focused Too Much on Medicine
Fear is the worst thing a social
species can experience and it
causes permanent damage to the
Fear in response to something
painful or disturbing can condition
the pet to experience more fear in
response to those circumstances.
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We Took An Oath
“Cure sometimes. Treat often.
Comfort always.” Hippocrates
Our veterinary oath requires us to
“prevent and relieve animal
“First, do no harm.” Hippocratic
Major Signs of Anxiety in a Dog
 Panting, trembling, whining, pacing, clinging.
 Yawning, slow motion, staring, sleepy.
 Piloerection, shedding, self-grooming.
 Hypersalivation, licking lips, mouth closed.
 Shaking off, sweaty paws, dribble urine.
 Restless, sniffing, distracted, hypervigilant.
 Hiding, freezing, cowering, running off.
 Turning head, turning away (C-shape).
 Hardened eyes, blink, squint, furrowed brow.
 Won’t accept treats or reluctantly.
The Calm
Instead of
the Storm
No More
Bayer Veterinary Healthcare
Usage Study
37% of dog owners and 58% of
cat owners said their pets hate
going to the vet!
26% of dog owners and 38% of
cat owners said that just
thinking about going to the vet
was stressful.
Pet Owners Have Many Choices
Problem isn’t lack of enough information
to make informed decisions.
Problem isn’t the economic downturn.
Problem isn’t the fragmentation of the
Problem IS that visiting the veterinarian
isn’t worth the “hurt” to the pet or the
“hassle” to the pet owner. Wait and see.
We Engage in Behavior Modification
Every Minute of Every Day We’re
Around Pets
Some times we do it actively;
sometimes we do it passively.
Pet owners, veterinarians, and
veterinary team members are often
reinforcing pet behaviors that are the
most distressing to both pets and their
All pets benefit from learning to be
calm and Fear Free®.
You Don’t Get an Ingrown Toenail
Taken Care of at a Spa
Don’t use “pile-o’-techs” to restrain. “Low
Stress Handling, Restraint and Behavior
Modification” book by Dr. Sophia Yin.
Remove anxiety triggers like location of
“Bruticaine” vs. 2.5% prilocaine with 2.5%
Trazodone (5-15 mg/kg PO) given as a
single dose one half to one hour before vet
From Living Room to Exam
Room in a Fear Free State
Remove or reduce anxiety triggers.
Withhold food after 6 p.m..
Calm stomach and calm mind.
Make sure carrier covered and on a
flat surface.
From Living Room to Exam
Room in a Fear Free State
No more drama when coming and
Ideally, pet owner will make practice
runs to the veterinary hospital for just
rewards (desensitize).
If necessary, pet sedation protocols
are started before the pet owner
leaves home.
Start With the End in Mind
Pre-visit checklist of anxiety triggers.
Pet tricks & cues.
Pet owners (staff too) trained on what
an anxious and calm pet looks like.
Wait management.
Prepare exam room like a hotel suite.
Show-and-tell Fear Free components.
Proactively do nothing.
Textbook of “Veterinary
Internal Medicine” by Ettinger
TPR varies widely!
Take temp only if you think the pet is
By looking after the pet’s “emotional
wellbeing” we also help the physical
wellbeing of pets.
Exam room table – now and future.
Fear Free is a Transformational
This problem is not just with cats!
Treat anxiety/fear flare-ups like you
would if alarms went off during
Speak softly but carry a BIG stick.
Catch pet owners doing things right!
Do these three things to thrive not
You Know It’s Working When…
Dogs want to go to the vet. Cats
accept going to the vet.
Your start getting more accurate TPRs
and physicals.
Number of injuries from bites,
scratches and back injuries goes
down. Job satisfaction goes up.
Dog’s tail wagging. Cats relaxed.
Owner smiling.
Think Nice Home Not Cage
This is a “set up!” for cats
Special calming music and
Use Hide, Perch & Go Box.
Follow The Ohio State U CVM
guidelines for setting up a cat
Putting the TREAT Into Treatment
Practice like the pet owner---who feels
exactly what her cat or dog feels---is
right there looking over your shoulders.
Provide for isolation from anxiety and
Species specific treatment areas
Entire staff wears pheromones and have
tasty treats in pocket.
Putting the TREAT Into TREATment
When examining a cat’s mouth or other
sensitive area, giving pills or drawing
blood, consider Clipnosis .
Adjust handling based on response.
Release restraint at precise moment of
delivery (vaccine, ear/eye drops).
Physical touch can be magical.
Keep track of which Fear Free and low
stress handling techniques work best.
When “Wild” to “Mild” Isn’t
Probable or Possible
Pharmacy Options @ Home
Buprenorphine (0.03mg/kg) given as a
squirt between the cheek and gum one
to one and a half hours before vet visit.
Gabapentin (50 mg small, 100 mg
most, 150 large/robust PO) given one
to one and a half hours before vet visit.
Trazodone (5-15 mg/kg PO) given as a
single dose one half to one hour before
vet visit.
Pharmacy Options in Hospital
Butorphanol 0.2–0.4 mg/kg, IM for
dogs and cats. High end of range if
young/healthy; lower end if older/sick.
Acepromazine 0.01–0.05 mg/kg IM
dogs; 0.02–0.05 mg/kg IM cats.
Dexmedetomidine 2-6 micrograms/kg
IM dogs; 4-10 micrograms/kg, IM cats.
“Taking the pet out of petrified…
puts pets back into practices.”
Creating Fear Free
Veterinary Visits Puts
Pets Back Into Practices
From Living Room to Exam
Room in a Fear Free State
Calm stomach and calm mind.
Putting the TREAT into TREATment.
Remove or reduce anxiety triggers.
Puppy & kitten preventive training.
Pet handling.
From Living Room to Exam
Room in a Fear Free State
Trick training.
Muzzle training.
No more drama coming and going.
Addressing areas of concern.
If necessary, start sedation protocols
before pet owner leaves home.