Anxious patients lead to less than ideal experiences in veterinary practices. Behaviorist Debbie Martin lays out some dos and don'ts when it comes to managing reactive patients.
In general practice, one of the last things you want to deal with is a reactive patient. Whether it’s reacting due to frustration from being restrained or fear from the presence of a trigger, you and your team want to help the patient and the client have a positive experience.
To give you some tools to make that happen, behavioral specialist Debbie Martin sits down with Dr. Natalie Marks in this Quick Cup of Knowledge interview to discuss best practices for reactive patients.
Don’t: Wait and See
According to Ms. Martin, the biggest mistake many general practitioners and staff make is to have only a reactionary plan rather than a preventative plan—meeting a reactive patient with a reactive plan. She calls this the “wait and see” approach. In other words, we’ll just do this and if the patient reacts, then we’ll do damage control.
Unfortunately, getting the patient back down to acceptance is much harder once they’ve passed their tolerance threshold.
Do: Work Preventatively
Veterinary teams need to be more preventative when it comes to reactive and anxious patients. Getting certified with Fear Free® is a great way to prevent patient stress and anxiety at your practice. The program provides tools to every member of your team so you can ditch the “wait and see” approach.
Don’t: Interpret Any and All Negative Reactions as a Serious Problem
Remember that reactive animals are not all “bad” animals, but they’re scared, uncomfortable, or frustrated. Aggression can be a normal communication tool—just think about how the humans you know (or even you) use it!
People and animals use aggression to create distance between them and something they don’t like. Small instances of a barking or growling don’t necessarily mean that the behavior will escalate into a significant problem.
Do: Take the Behavior in Context
The context of the behavior is important in determining the seriousness of the problem.
For example, if an owner walks past their dog while the dog is eating and the dog proceeds to follow their owner to bark or growl at them—it’s clearly troubling behavior. If a dog barks when an owner accidentally steps on their paw—it’s a different story. The first dog needs help and training; the second dog needs understanding.
Don’t: Treat with Medication Only
Martin stresses the need for medication to be combined with behavioral therapy or training for sustained results. Medication will help the patient learn new coping strategies, but they won’t teach them the coping strategies.
Medications shouldn’t be seen as a long-term crutch for these animals, replacing appropriate coping mechanisms that lessen stress. These medications should be a helpful and temporary tool to make behavioral training easier.
Do: Use Mainstay Medication Combined with Behavior Training
Whether you’re using SSRIs, TCAs, or MAOIs, mainstay medications are a great tool for overly anxious patients. They are generally effective and have minimum side effects.
Ms. Martin recommends sticking to these types of medications combined with behavior training rather than turning first to adjunct medications like Trazodone alone.
General practitioners and others who are interested in implementing practices that help reactive patients can reach out to local positive reinforcement trainers and veterinary behaviorists for consultation.
As a veterinary professional, you don’t only want to help the patient, but the client as well. The Fear Free Happy Homes website is a great resource for clients who struggle with reactive pets.
If you’re a veterinary technician interested in Fear Free practices or in learning from Ms. Martin, join us at the Viticus Center this year for the Veterinary Technician Symposium!
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