A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting

Abstract

A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. We briefly summarise the available evidence for the interventions discussed. The set-up of the waiting area (e.g., spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended, both to prevent and address existing negative emotions. Short-term pain from injections can be minimised by using tactile and cognitive distractions and topical analgesics, which are also indicated for painful procedures such as ear cleanings. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease fear and stress in patients and consequently their owners, thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

Keywords: aggression; anxiety; anxiolytic medication; behaviour modification; cats; counterconditioning; dogs; fear; low-stress handling; psychoactive drugs; stress; veterinary visit.

Figure 1

A spacious waiting area with visual barriers is ideal. Due to the layout of the benches, waiting animals do not need to face each other. Cat carriers should be placed on an elevated surface; ideal would be an additional covering of the carrier. Photo: Stefanie Riemer.

Figure 2

Owners can be advised to bring a blanket from home and to distract the animal with food or toys in order to decrease stress during the waiting time. However, the potential for resource guarding when using toys or chews needs to be considered. Not suitable when sufficient spacing between animals in the waiting area is not possible. Photo: Stefanie Riemer.

Figure 3

A non-slip mat improves the animal’s comfort. By feeding the animal during the examination or treatment, positive associations can be created. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 4

Use of high-value food (or toys) can increase cooperativeness and promotes positive emotions. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 5

Performing the examination in a position that is most comfortable for the individual and using the minimal amount of fixation needed improves the patients’ compliance and well-being. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 6

Towels and blankets can be used in various ways for safe restraint of cats and small dogs. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 7

Muzzles increase safety. Food can be used to entice the dog to place its nose into the muzzle and should be offered repeatedly during wearing in order to create positive associations. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 8

‘Happy Visits’ enable positive experiences in the clinic environment. In this setup, several forms filled with lickable food (normal wet food works well) are spread throughout the examination room and the dog is free to choose without any pressure. A reduced version of such a ‘happy visit’ can also be offered during normal consultations—the dog can lick some food while the veterinarian is taking the history. Photo: Stefanie Riemer.

Figure 9

During counterconditioning, a potentially unpleasant or fear-inducing stimulus is paired with a high-value incentive. For optimal results, the start of the potentially aversive stimulus should precede the start of the positive desired stimulus, so that it becomes a predictor of something positive. Thus, the ideal sequence of events is as follows: start touch, then start feeding and continue feeding throughout the touch. When you stop touching, also stop feeding. Photo: Christine Arhant, Vetmeduni Vienna.

Figure 10

Animals can be trained to perform a ‘consent behaviour’ such as stepping onto a target mat to indicate when they are ready for manipulations. When the animal interrupts the behaviour, any manipulations are stopped, thus giving the animal control. Photo: Stefanie Riemer.