Reducing Fear of Veterinary Visits for Dogs

How can I prevent my puppy from becoming frightened at the veterinary hospital?

Visiting the veterinarian’s office can be scary; there are many novel objects, odors, and sounds. There may be barking dogs. Unfamiliar people are standing very close, and some will need to handle your puppy.

Your puppy may be asked to stand steady on the examination table. Even when veterinary team members are very gentle, puppies may still be a little worried.

You can help set the stage for a positive experience.

• Let your veterinarian know you want to create a positive learning experience for your new puppy.
• If possible, arrange happy visits with your puppy. During these visits, your puppy can get snacks and positive attention from staff members. It may even be possible to “play doctor” and put your puppy onto an exam table for special treats paired with fun, gentle touches.
• Schedule your appointment when the veterinary team will not likely be rushed. 
• If possible, do not feed your puppy for at least two hours before the visit, so your puppy is a little hungry for treats. Bring bits of your puppy’s kibble as well as some delicious treats and a favorite toy.  
• Give your puppy snack and play breaks during the visit. 
• Allow your puppy to nibble on something tasty during an invasive (thermometer) or uncomfortable (injection) procedure. 
• Ask the veterinary technician to use food to keep your puppy from squirming or trying to escape. A food distraction usually works well and is better tolerated than restraint. Puppies can become frightened when heavy restraint is used—just a gentle hand to steady the puppy should be plenty. 
• If a painful procedure is needed, ask if sedation would be appropriate.

How can I determine whether my dog is afraid of the veterinary office?

Fear is expressed in many ways. Physiologic responses to fear include salivation, defecation, urination, and panting.

You are probably familiar with the phrase “fight or flight”, but you may not know “fidget or freeze”; many frightened dogs either fidget or freeze in place. Even if your dog looks fine, lying completely still or standing rigidly on the table, they may be “frozen” with fear. Here is a test: try offering a treat or toy or asking for a fun trick your dog knows. If they do not respond, their subdued behavior may reflect fear.

If your dog takes flight and tries to escape by retreating behind you or under a chair, they are frightened and should not be pursued. You may be able to lure them out with a treat or toy, but if they do not respond, then they are very fearful. If there is no immediate health concern, your veterinarian may choose to modify the exam, focusing on only the most essential parts. Or your veterinarian may recommend a prescription for anxiety-reducing medication to prevent your dog’s fear from escalating.

"A dog that growls, snaps, or tries to bite should not be scolded, punished, or physically overpowered."

The fight response is a sign of fear that is easily recognized yet often misinterpreted. A frightened dog may growl, snarl, snap, or bite. If your dog displays any of these signs during an examination, your dog is frightened; they are not misbehaving or trying to be dominant. Interventions based on that assumption will worsen their fear and aggression. Your dog needs relief from the fear as quickly as possible. Step back for a moment to communicate to your dog that the message “Stop, I am afraid”, was received.

To avoid a physically and emotionally dangerous escalation, it may be necessary to stop the interaction immediately for the safety of your dog, yourself, and the veterinary team. For a non-urgent situation, your veterinarian may suggest a behavior modification plan and reschedule the examination for a date after the behavior treatment has been successfully completed. A dog that growls, snaps, or tries to bite should not be scolded, punished, or physically overpowered.

Watch your dog for signs of fear (fight, flight, fidget, freeze) related to veterinary visits from start to finish. Some dogs are afraid as soon as they enter the car, while others only show fear once they reach the hospital parking lot. Some dogs remain unafraid until they reach the waiting room, while others do not show fear until they are inside the exam room. Finally, some dogs appear quite happy until the examination starts. Try to determine the point at which you can identify signs that your dog’s mood is changing.

My dog used to squirm and tremble at the vet, but now he tries to bite. Why did he change?

Dogs use body language to communicate their underlying emotions. When we send a message, we expect it will be received and understood; dogs are no different. Dogs that express their fear by retreating may become frustrated and even more frightened when people do not back away and give them space. Unfortunately, it is easy to disregard a quiet signal such as a growl, but most people only listen when a dog tries to bite them. Dogs quickly learn that using a strong signal is the only way to get relief.

For example, perhaps your dog tried to pull away in response to an ear exam but, instead of releasing them for a breath and reset, the assistant tightened their hold so the doctor could finish this quick procedure. During a subsequent appointment, your dog will recall that squirming did not bring relief – no one listened. Now, instead of struggling to move away, your dog will try stronger communication – a snarl or growl. Finally, if the assistant continues to hold your dog tight, the dog will use the strongest communication signal possible – a snap or bite.

Dogs learn from every experience. It is essential to recognize and respond to even mild signs of fear. Otherwise, fear and aggression can worsen over time, making it difficult for the veterinary team to provide the best possible medical care.

Can I measure the degree of fear my dog is experiencing to know whether I should reschedule an appointment?

It may not be possible to prevent all fear-related to veterinary visits. After all, most people feel a little uneasy about going to their doctor, even if they do not anticipate any pain and fully understand what to expect. But it is possible to keep the fear to a minimum.

"If your dog does not take food, if they try to escape, or if they exhibit an overtly aggressive response, then their level of fear is high."

One way to measure the level of fear is to try to give your dog a delicious snack. When dogs are very fearful, they usually will not accept a snack. If your dog takes snacks before and during a procedure, then their level of fear is likely to be relatively low. Perhaps your dog takes snacks until a specific intervention, such as a vaccination or ear check, then stands quietly and resumes eating as soon as the procedure is done. This suggests a slightly higher level of fear, but it should be safe to continue as long as they continue to take the snacks happily, and you give some breaks for relief. If your dog does not take food, if they try to escape, or if they exhibit an overtly aggressive response, then their level of fear is high.

Are there medications to use if my dog is fearful at the veterinary office?

There are many safe medications that your veterinarian can prescribe before the visit to help reduce fear. When fear is very mild, non-prescription medications may be effective. Your veterinarian will determine the safest and most effective medication for your dog based on their health, level of fear, and the procedure that will be done. Full sedation may be recommended if an invasive or painful procedure is needed. Sedation may involve having your dog remain in the hospital until the medication is out of their system, but sedation can prevent an escalation of fear and aggression during future visits.

How can I reduce my dog’s fear of the veterinary experience?

Behavior modification can help your dog become more comfortable with the entire veterinary experience. The starting point for training should be the starting point for fear. If your dog is afraid during the car ride, help them relax by taking many car trips to fun destinations. If the parking lot is scary, visit the hospital but stay outside and play.

If your dog is worried in the waiting room, schedule happy visits. Stop in at the veterinary hospital to play with your dog, feed treats, and hang out while your dog settles on a mat. If your dog generally likes new people, let the veterinary team members give your dog treats and pets. You may even be able to visit an empty exam room on a quiet day and use the room for pretend exams and tricks for treats.

For many dogs, fear is evident only during the examination. In that case, behavior modification, including desensitization and counterconditioning, can be very helpful. If your dog does not show aggression toward you, you can start this training at home, where you can put your dog onto a low bench and do practice “examinations”. Feed tasty treats while you pretend to check ears and paws and gently squeeze your dog’s belly. Peek into your dog’s mouth to check their teeth, then reward them for letting you.

Next, you can bring your dog to the veterinary office and feed treats while your dog is on a table. If your dog is large or prefers an exam on the floor, you can practice on a mat. Feed many treats, just as you did in your home practice sessions.

Once your dog takes the treats easily in the veterinary setting, one of the team members can perform a practice exam. Again, begin with one or two non-invasive manipulations. At first, you may need to let your dog nibble on snacks during the entire manipulation. Eventually, your dog will learn to stand quietly until the manipulation is finished to get a treat.

Do not overdo the practice sessions; keep them fun and take many short breaks for play and tricks for treats. Be sure your dog is relaxed before adding more challenging manipulations, such as ear checks and blood tests.

It is always helpful to work with a trainer or behaviorist skilled at providing desensitization. Some trainers have taken continuing education and have achieved certification in gentle handling. For example, you may find a Fear Free Certified trainer or technician well-versed in preparing dogs for veterinary examinations. There are many more exercises designed to help dogs relax, cooperate, and participate in their veterinary care.

If you are concerned your dog might exhibit an aggressive response during this training, it is appropriate to introduce a basket muzzle. Help your dog adjust to the muzzle at home. The muzzle will ensure that you are not bitten if your dog is unexpectedly frightened. Basket muzzles can be fitted so that your dog can easily accept treats. 

How can I get through the veterinary examination before the behavior training is completed?

If your dog can take treats, you may be able to keep them comfortable enough for your veterinarian to do an exam.

• Deliver high-value treats frequently, particularly when your dog receives an injection. If a basket muzzle is needed for safety, bring lickable treats like wet food that can be spread onto a large pretzel or spoon and inserted into the muzzle. Some dogs can lick food-filled mats or toys through their muzzles. 
• Bring a familiar towel dabbed with a calming pheromone (e.g., Thunderease®).
• Ask your veterinarian if the exam could be performed in stages. You may need to return later in the day or another day. The exam should end on a happy note.
• Ask your veterinarian to focus on your dog’s most immediate needs first. Less urgent items may be postponed. For example, if your dog is uncomfortable with nail trims, save those for another day. Your dog can be desensitized to having their nails trimmed, but that will take time.