Quick Tips For Low-Stress Vet Visits

Imagine your mother dropped by this morning with a very large box; without words or explanation she unceremoniously forced you into it, then tossed you in the car and took off. Eventually the car stops and she lugs you into the doctor's office (she's stronger than she looks, that mother of yours). She doesn't seem to understand your repeated questions, so you still have no idea what's going on or why you're here. However, several others seem to be in similar situations. Some are in boxes like you, others are tied to ropes - there's one person who won't stop shouting nonsense, another urinating on a chair leg, and one guy who won't stop trying to lick everyone in the face. Eventually you're taken into another room, dumped out of the box and onto your keister, then poked and prodded for no apparent reason by some strange woman in a white coat. They finish off with a couple of unexpected shots in the rump, then good ol' mom shoves you back in the box and drives you home.

Yeah, I guess that might be a little stressful. 

A little food cajoles most cats...

For some pets there may be no such thing as a "stress-free" vet visit, but we can reduce that stress to manageable levels. It's also important to note that animals deal with stress differently, just like people - some may growl or cower, but acting overly submissive or affectionate can be less-obvious signs too. Today's article covers several simple things you can do to make veterinary visits easier on your furry housemate's nerves (and in turn, your own).

Setting Expectations
Animals are bright, fast learners. If that cat carrier, leash, or car ride always culminates in getting poked in the butt by a stranger, it won't take them long to start freaking out at the first sign trouble is on it's way. I have one diabetic patient whose owner tells me Tiny's fine in the car if they turn left out of the driveway - but turning right always means the vet, and blood draws, and one instantly ticked-off Tiny. Fortunately, pets make positive associations just as easily, so you can undo most of this stress with a little effort.

....and the odd dog. This one
is more odd than most.

• Get in the habit of setting the cat carrier out once or twice a week with a treat or toy in it. They'll be eager to get in the next time you need to use it for travel.
• Likewise, take your dog on fun leash walks around the neighborhood regularly if you don't already.
• Once they are good with the paraphernalia, start taking your dog or cat on short car trips. Bring a food reward or two to make it fun - some fast food places like Sonic keep dog treats at the drive-thru so you can both get a little positive reinforcement.
• Placing a familiar-smelling item like a blanket in the car or carrier also helps pets relax.
• Drop by the vet clinic occasionally with Muffy, just to say hello or check their weight. Bring a favorite reward and ask a staff member to offer it.

On a related note, I highly recommend the pet carriers with snap-on tops. It's so much less stressful on everyone to just pop the top off, instead of prying Muffy out only to force her back in afterwards.

There's Stress In Numbers
Stress is additive and contagious. It's tempting to try getting all the pets in at once, and make it a family-fun event, but....Take two hyperactive kids, one mother shouting for them to calm down, then add in your incessantly barking Beagle-buddy to boot, and even the calmest Shih Tzu in the world is going to be on edge.

• Making veterinary visits an adults-only, single pet endeavor can really go a long way toward lowering the stress levels for everyone - you included. Plus, you get a lot more for your money when you can focus on asking questions and listening to the staff's recommendations without extra kids, furry or otherwise, vying for your attention. 
• If your significant other likes to argue or won't let you get a word in edgewise, get them a sitter too (my wife says her spouse is like that...). 
• On the other hand, if you are stressed out - which is okay, and often understandable - your pet will sense that and follow suit. It's always okay to ask to wait outside during the exam, and sometimes it really is less stressful for everyone.

The same strategies can be applied when choosing a vet or setting an appointment:

• Some clinics have started providing separate waiting areas for cats and exotics, since a room full of barking dogs is pretty much guaranteed to stress them out. 
• If you're flexible, asking for an appointment at a slower time of day is a good move too.
• Lastly, the discount walk-in shot clinic is almost guaranteed to have a waiting room full of chaos; that's one of many arguments for paying a little more to see the doctor down the street.

Better Living Through Chemistry
Of course, there are a few pets out there who just aren't going to adapt well to the clinic, car, or carrier no matter what you try. For those guys, there are varying levels of "chemical intervention" we can try to help them out.

What, you don't recognize Benadryl?

• Mild Anxiety: Pheromone sprays or collars like Feliway and D.A.P. may be helpful. They're also useful initially in conjunction with the above techniques to take the edge off.
• Moderate Anxiety: Ask your vet about trying Benadryl. It often provides some sedation and is quite safe for most animals at the proper dose - again, ask your vet.
• Severe Anxiety: There are several sedatives and anxiolytics that can be life-savers for dogs that truly need them; all have the potential for significant side-effects and require a prescription, however, so a good chat with your vet is in order. Furthermore, pets who need this level of intervention for a trip to the vet likely have other behavior issues that need addressed.

Lastly, but probably most important - if the stress of veterinary visits is truly tough on you and your pet, consider making an appointment solely to discuss this issue and come up with a plan of attack. You can even consider a consultation without your pet, if need be. Fortunately, though, most dogs and cats can learn to manage a trip to the vet with a just a bit of work and forethought on your part. I'm really not that bad. Plus, I have treats.

Quick Tip - Dealing with Firework Fears

It's so pretty! I think I'll go hide behind the toilet! 

Independence Day is here, when we celebrate our freedom to blow stuff up in the backyard, and consequently send half the dogs in the neighborhood cowering underneath the bed. With that in mind, I thought I'd share a few suggestions for easing everyone's stress this holiday. Some are short-term help that might be useful today; others are long-term projects geared towards a more well-adjusted canine companion. All are also equally applicable to similar fears, such as thunderstorms.

Safety First

• All dogs should be kept inside today, and leashes should be used for potty breaks/walks. This is one of the biggest days of the year for lost pets and hit-by-car accidents. Some firecrackers go off in the distance, and suddenly Muffy is over the fence and five blocks away.
• Likewise, make sure your pets have identification and your phone number on their collar. Microchips are good as well.
• We generally see a few firework-ingestion toxicities this time of year, too - keep that stuff put away!

Feeling Safe

• If you have a basement that's relatively sound-proof, it may be the perfect place for Fido to hang out today. What you don't know can't scare the living daylights out of you.
• Ever notice that your pet seems calmer when you hold them close, or that they tend to hide in tight spaces? Tight-fitting wraps may dramatically improve your pet's feeling of security and lessen anxiety. One good product is the Thundershirt; you can try improvising to help Spot out today by dressing him up in an appropriately-sized human tee-shirt and knotting the bottom to make it fit tighter.
• Many dogs that struggle with noise fears have already figured out a "safe place," usually a tight spot in a closet, under the bed, in their crate, or in my dog's case....behind the toilet. Often we're tempted to drag them out and console them, but it's generally best to leave them be - even to encourage them to seek these spots out.

Long-Term Improvement

• Try to desensitize fearful pets by exposing them to the problem at low levels in a controlled environment, gradually working up to full stimulus. For example, get a thunderstorm video and play it on low to start (guys - this a good wife-centered excuse to upgrade the home theater). Here's a good article that goes into more depth on desensitizing.

Better Living Through Chemistry

• Working through a desensitization process to overcome fears is always the best option. That's not always possible, though, and your veterinarian can prescribe medications to ease anxiety and lessen destructive or dangerous behaviors if necessary.
• There are a variety of nutritional supplements and pheromone-based products marketed over-the-counter that claim to calm pets. Always talk with your vet before putting anything in your dog - there's very little regulation of this stuff and lots of money to be made. One product that's safe and sometimes helpful is dog appeasing pheromone (DAP) - it's rarely enough for severe fears, but it can help some dogs. Tryptophan-based products may provide some helpful sedation, too (it's the stuff in turkey that leaves everyone passed out in front of the TV on Thanksgiving).
• A word about acepromazine, a drug sometimes prescribed for these problems. It is only a tranquilizer - it removes the ability/will to act out, but it does not reduce fear. That means Fido may sit there calmly, but inside he's likely still terrified - he just can't do anything about it. For dogs who become so panicked they are a danger to themselves and others it can be a valid option to keep them safe - but usually there are better choices.

Have any suggestions or questions of your own about dealing with noise phobias? I'd love to hear them; just click on the "comment" link below.

Bad kitty! Or…sad kitty?

Litter box problems, or “inappropriate elimination behaviors," are among the most common complaints I hear from cat owners.  If it has ever happened in your home, you're probably thinking “inappropriate” is a rather mild way to describe urine or feces in the middle of your carpet, but bear with me.  With some investigative work and patience, we can help most cats get over bad bathroom behavior. And, with the right information you may prevent future problems.

Medical causes

The first step in these situations should always be a visit to your vet to rule out underlying medical causes.  Conditions like kidney disease, diabetes, and hyperthyroidism can increase urine production, while urinary tract infections and bladder stones are uncomfortable and may result in frequent urination.  Likewise, issues such as parasites, constipation, and inflammatory bowel disease may make defecation urgent or uncomfortable.  Even arthritis can affect bathroom habits – imagine if you had to climb over a waist-high wall to get to the toilet!  So, it’s possible your feline friend doesn’t feel well and just can’t make it to the litter box.  A thorough physical exam, blood work, urine analysis and/or fecal exam will establish your cat’s general health status and help guide treatment if necessary.

Unacceptable, Human!

Behavior

Now that we’ve ruled out medical conditions, it is safe to start questioning behavioral causes… But before you send kitty to a psychiatrist to work out his anger issues, we need to talk about YOUR behavior too.  You may think that your cat doesn’t deign to notice you unless it’s dinner time, but cats are actually quite sensitive critters.  They can’t tell you with words that they are stressed out by something in the house, but peeing outside the litter box is one way to get your attention (my two cats prefer to barf in my shoes or self-mutilate, respectively).  Here are some things that might be ruffling kitty’s tail feathers.

Litter box issues:

• Hygiene – Is it possible that you and kitty have different standards when it comes to cleaning the bathroom, so he decided to seek out a cleaner facility?  Most cats are quite fastidious, so litter should be scooped daily and changed out completely on occasion (non-clumping litter should be dumped every few days). You might also consider tossing your box for a new one if it’s really worn, as plastic can retain urine smells.
• Availability – Are there enough litter boxes in the house?  I recommend having one box per cat plus an extra (e.g. 3 cats, 4 boxes) unless you have a very large number of cats, and then you will probably get into trouble despite the number of boxes.  There is a scientific study from the 80s showing that individuals with 10 or more cats have a 100% probability of becoming a victim of inappropriate urination, and a 90% probability of eventually being a crazy cat person (ok, maybe only the first half was shown in the study).
• Location – Maybe kitty was just settling down in his laundry room litter box to “read the Sunday paper” when that really loud timer on the dryer buzzed and startled him into Tuesday.  If you think location could be the problem, leave the current box in place but add one somewhere else in the house.
• Type of litter – Cats have preferences about their potties, and it may be your cat doesn't care for that fresh pine scent as much as you do.  Try a few different types (clumping, clay, recycled newspaper, etc.) at the same time to give kitty a choice of textures and smells.  Be sure to include a finely-textured clumping litter in your test, as it was chosen more than twice as often as other types in a thorough study by behaviorist Dr. Peter Borchelt.
• Type of box – Try out a new box shape or size.  However, a word of caution on covered boxes…  Many people favor covered litter boxes for obvious reasons, but I find most cats do not, especially in multi-cat households. For example, my cat thought his sister was playing hide-and-seek in the covered box we used to have, so he would wait outside and ambush her upon exit.  Needless to say, she did not enjoy this.

Environmental stressors – Pretty much any event or change in your cat’s life can fall into this category, but common issues include:

• New people – Houseguests, new spouse or roommate, new baby, etc.
• Disruption of environment – Moving, renovations, holiday decorations and celebrations
• Change in your schedule – New job, leaving for vacation
• Visiting the vet – I wish they all loved seeing me…
• Inter-cat aggression – self explanatory, and common.
• New pets – Introducing a furry family member can be a very delicate process, and strategy may depend on the personalities of your current critters. I recommend talking to your veterinarian if you are thinking of adding a pet.

These issues are tricky, as it’s often difficult to control them unless you plan on letting your cat completely run your life.  What you can do is implement some practices that will hopefully make kitty more resilient to life’s little blips. We've already discussed litter box recommendations, but additionally all cats should have fresh food and water, something they’re allowed to scratch, and a safe space where they can go to get away from other pets and people if they choose.  Perches can often provide such a space, and when placed near a window also serve as a source of entertainment.  You should also carve out some time each day to interact with your cat via play, grooming, or even training (yes, cats can be trained!).  Toys and catnip are great stimulation for some kitties, while others will be engrossed by “cat TV” or nature videos.  Feliway (http://www.feliway.com/us), a synthetic pheromone product, may also help reduce stress.  Be creative and try different things to find what lights your cat’s fire, but the message is that your cat may be bored or stressed if his basic needs are not met, and this can lead to health and behavior problems.  Ohio State University's Indoor Pet Initiative (http://indoorpet.osu.edu/cats/) has done a lot to further our understanding of how environmental enrichment can help our feline friends live happy lives.

No dice, Doc.  Now what?

So you’ve had kitty vetted, offered a Pu-Pu platter of litters and boxes, enriched his life and pheromoned the heck out him, and he’s still “thinking” outside the box.  Now may be the time to head back to your veterinarian, or a veterinary behaviorist if one is available and finances permit.  If the problem has been going on for a long time or your cat is particularly sensitive to environmental stressors, finding a solution can be very specific to the individual animal and situation.  There are anti-anxiety medications that can help, especially in cases where feline housemates are not getting along, but they are not magic pills and must be used in conjunction with environmental modifications, many of which have been discussed above.

To sum up…

• Rule out medical causes
• CLEAN the litter box
• Try different types of litter in different boxes in different locations
•  Reduce stress with environmental enrichment and interaction with your cat
• Medications can be useful in conjunction with behavior and environment modifications

-Dr. Courtney Smock

Quick Tip: Training Your Dog Not to Jump

Dude. Chill.

Clients often ask me how to get their pets to stop jumping up on them. If you're patient and consistent, it's a very easy behavior to change. You just need to keep in mind two basic principles: all behavior is reward-seeking, and it's easier to learn a new behavior than to unlearn an old one.

First, we have to remove the reward the dog is seeking - attention. When asked how they've tried to get their dog to stop jumping, many say they yell "stop!" and push them away. Well, that's not the best attention in the world, but for a dog it's better than being ignored. To get rid of the behavior you have to stop rewarding it: ignore the dog completely by silently turning away.

Secondly, the real trick is to teach the dog to do different, acceptable behavior to get the reward. The simplest example is teaching them to sit instead. At some point while bouncing around, trying to get your attention, the dog will likely sit on its own - immediately look at them and give a verbal reward ("good dog!"). If they don't do it on their own, you can issue your "sit" command once they stop jumping, but do not look at or otherwise interact with them until they sit. Whenever they stop sitting, ignore them again.

Much like a child throwing a tantrum , the dog may escalate the behavior in an attempt to get your attention, but be patient and consistent - they'll give up eventually. A useful trick if they won't settle down is to walk into another room, then quickly turn and shut them in when they follow, instituting a time-out without actually interacting with the pet (which would reinforce the undesirable behavior). Being patient and consistent are the toughest, most important parts. But stick with it - your dog will learn that the way to get the attention they want is to sit obediently in front of you, rather than bounce annoyingly on top of you.