The Fear Free approach to veterinary care

Fear Free

Practice owners Dr Andrew Hemming and practice manager wife Sarah are enthusiastic advocates of the Fear Free approach to vet care. Photography: Richard Whitfield

If you’re worn out by having to deal with frantic pets and their frazzled owners struggling to get them through the door, maybe it’s time to consider the Fear Free approach to veterinary care. By Heather Vaile

In the city of Ipswich south-west of Brisbane, a young vet called Dr Andrew Hemming and his practice manager wife Sarah have just opened a $750,000 new practice called Ripley Veterinary Hospital. It is the couple’s second veterinary business; they also own Flinders View Veterinary Surgery about 4km away. 

It’s an impressive achievement for the pair who made their first move into practice ownership six years ago. Dr Hemming attributes their business growth and expansion to attention to detail, high clinical standards, selecting highly skilled and efficient employees, and says the secret of their success is putting lots of training into their staff.

Both practices also proudly offer a Fear Free environment for pets. Fear Free is the trademarked name of an initiative, often described as a movement, founded by high-profile American vet, Dr Marty Becker. It grew out of the low-stress handling techniques pioneered by animal behaviourist gods in the industry, Dr Karen Overall and the late Dr Sophia Yin. 

The Fear Free approach is based on looking after animals’ emotional wellbeing as well as their physical health, by providing what animals perceive to be a calm and safe environment, tasty treats where appropriate, and using gentle control techniques, if required.

In recent years, Dr Becker and his team have been very successful in bringing the Fear Free philosophy to a much wider audience, including a growing number of Australian vets and animal lovers. They now offer a range of in-person and online training for vets, trainers, other pet professionals and pet owners under the Fear Free banner. 

Dr Hemming says he and Sarah first heard about Fear Free from some colleagues at a veterinary conference in Sydney in 2017 and it immediately resonated with them.

“I think we’ve been practising a degree of Fear Free for a long time, just not officially and without knowing that there was a term for it,” he says. “I guess that’s why it appealed to us, because it was similar to what we were already doing. 

“We were already taking more time to work through problems with animals that most vets do. We have a standard 30-minute consult time and probably in the industry, the average is about 15-20 minutes. But if I have half an hour, I have more time to talk to the owner and while I’m talking to them, nothing ‘bad’ is happening to the dog. It’s relaxed as well.

“I think having that extra time, our vets are less stressed, and when our vets are less stressed the animals are less stressed. And hopefully the nurses too!

“Our staff members ask clients on the phone if they’ve got an anxious pet before they come in and for those that do, they talk through ways they can bring them in in a less stressed way.

“We use pheromone sprays for dogs and cats, so if we know a very anxious cat is coming in, I’ll probably get the owner to pick up some pheromone spray before the consultation and to spray it on to a towel and put it over the cat’s cage and have it on the cage in the car as well. 

“We also encourage clients to bring in their pets for ‘happy visits’, just to say hi and get treats. 

“The days of ‘brutacaine’ where we forcefully held down animals and got more and more people to hang on to them are long gone.”—Dr Kersti Seksel, veterinary specialist in behavioural medicine, Charles Sturt University

The practice also has a large waiting room area so clients and patients have room to breathe and move, and it has soundproofing between consult rooms to create a quiet, calmer environment. And the vets use fluffy memory foam mats on the consult room tables, so it’s more comfortable and less slippery for the animals.

All the staff at both Ripley Vet Hospital and Flinders View Surgery are Fear Free certified and Dr Hemming says the staff were enthusiastic about the training from the get-go.

“The team was keen straight away, as soon as we brought it up. We talked about it on a Saturday afternoon and they started it on the Monday. 

“We are all totally committed to Fear Free,” he says. “We’ll be doing it forever.”

Dr Kersti Seksel is a leading registered veterinary specialist in behavioural medicine based in Sydney. She’s also a past president of the Australian Veterinary Association (AVA), an adjunct associate professor at Charles Sturt University in NSW, Fear Free certified, and she’s in Dr Becker’s Fear Free advisory group.

“The days of ‘brutacaine’ where we forcefully held down animals and got more and more people to hang on to them are long gone,” Dr Seksel says. “We can’t use brutal force on these animals any longer.

“I’m not convinced we can make everything totally stress-free but we can certainly do a better job than we’re doing. It horrifies me that vets are still scruffing cats and holding dogs down for basic husbandry procedures such as nail trims. She shares three simple ideas for vets who want to make visits easier on nervous or frightened animals.

“The first thing I’d say to vets is to ‘walk in their paws’! Think about what they see, what they hear, what they smell. It’s because animals perceive the world very differently to us. Their sense of smell’s a thousand times better, their hearing’s more acute, so look at it through the animals’ eyes, ears and noses. 

“And once you’ve done that, you’ll find there are some pretty simple things you can change or do—the type of music you play, having pheromones in the practice, the cleaning products you use, the lighting—nothing majorly expensive, it’s just understanding the world from the animals’ perspective.

“The second thing I’d do is make sure you’re up to date with behavioural medicine, the newer medications and things you can do to make a fearful or anxious animal’s life happier because if you have a happier animal, you’re going to have a happier client and you’re going to have happier staff. These days we have many medication options that can help fearful/anxious pets. They should not be traumatised anymore.

“The third thing is learning to read body language. If you can read body language, you can tell when it’s time to stop, slow down or go. We use the traffic-light system a lot. If the animal’s cool, calm and collected, it’s in the green zone—you can keep working with it. But when it gets to that orange or amber traffic light, slow down and take a step back, and if it’s in the red zone, stop.”

Another eminent registered veterinary specialist in behavioural medicine is Dr Jacqui Ley, who is based in Melbourne. Dr Ley is the current president of the Australian Veterinary Behaviour Interest Group (AVBIG), the AVA’s Australian Veterinary Behaviour Interest Group, and she is also Fear Free certified.

“We know that animals that are stressed and frightened are much, much harder to examine and it’s much harder to get good baseline information on them.”—Dr Jacqui Ley, president, Australian Veterinary Behaviour Interest Group

Dr Ley shares many of Dr Seksel’s views on Fear Free veterinary care. “We know that animals that are stressed and frightened are much, much harder to examine and it’s much harder to get good baseline information on them. 

“We also know that animals that are coming in stressed and having anaesthetics, their anaesthetics are harder to do, they need more to keep them asleep, they have rougher recoveries and they need more pain relief. 

“And then you’ve got to factor in the risk to staff. If you’ve got 40 to 50 kilos of dog that’s frightened, that’s potentially a big danger. 

“If a dog is being aggressive in a clinic, it’s because they’re frightened or worried. Now Fear Free techniques are not going to completely remove that but we know we can be smarter—we can use medicines that relieve anxiety before the animal comes into the clinic and we can do things in the consult room to make life easier for the animal. 

“Little things like encouraging owners to teach their dog to wear his own muzzle, so he comes in wearing something that’s familiar and safe—something that doesn’t smell like everybody else who’s been inside it and been frightened can really help.”

The final word goes to Dr Janice Lloyd, an award-winning researcher, teacher and associate professor in Veterinary Science at James Cook University (JCU) in Townsville. 

Dr Lloyd teaches students in all years of the JCU undergraduate veterinary science degree program and she is passionately committed to making veterinary experiences easier on patients. Final-year vet students at JCU are taught in small groups about low-stress handling of animals, and as part of their assessment, are tested on what they have done to mitigate stress for their patients.

She agrees that it doesn’t have to be difficult for veterinary staff to incorporate low-stress ideas and techniques into their practice.

“With a few simple approaches, you can actually make huge headway in a small space of time. And it  saves a lot of time later. 

“Often people don’t realise that anxiety is accumulative and so an animal that is anxious is going to be even worse next time it visits the vet. So, it’s worth taking a bit of extra time with animals. They make mental associations with bad experiences incredibly quickly and they remember.”

In April 2017, Dr Lloyd published a fascinating article called: ‘Minimising stress for patients in the veterinary hospital: why it is important and what can be done about it’. It appeared in the journal Veterinary Sciences, 4 (2). pp. 1-19 and is freely available online. The article contains a wealth of information and practical tips for veterinary staff, pointers to other helpful free resources available online, and a comprehensive list of references.

Dr Lloyd sees the low-stress approach as not just the right thing to do for animals but also a valuable business opportunity for practice owners.

“It is a very sound business decision. Clients see that the staff are caring, which can go a long way to retaining your clientele. So, you’ve got a low-stress environment, improved health care and you’ve got loyal satisfied clients who are much more likely to come back. It’s much safer for the staff and the bottom line is healthier too. It’s good for everybody.”  

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