My resting blood pressure, I assure you, is completely normal. I have to state this fact again and again every time I wind up at the doctor’s office, when the nurse places the cuff and then pulls it off with a thoughtful wrinkle in her forehead. “It’s not normally 200/140!” I plead, hoping she doesn’t direct me to the closest ER. “I just get this way when I’m in the doctor’s office.” She nods, and we get on with our day. I have no idea why it happens, but apparently it’s A Thing. I blame it on the scale. I hate going to the doctor and avoid it as often as possible.
It happens at the vet, too. “The cat’s temperature is 103.8,” the tech will say, shrugging. “I think. She was trying to bite me most of the time, so I didn’t get a heart rate.” White coat syndrome in pets can be so significant that some behavior experts counsel the veterinarian to leave the coat in the back room, so as to trick the pet into thinking you aren’t the dreaded vet. We accept this as a reality of practice, our years of blood sweat and tears in service of our love of animals being reduced to this: told, on a daily basis, “Ha ha! My dog hates you.”
“Fear is the most damaging thing a social species can experience.”
I was talking to Dr. Marty Becker the other day (I know, right? I am so excited to actually say that I am a person who talked to Marty Becker the other day) and he was sharing a conversation he had with Dr. Karen Overall about the effect of stress hormones on physical health. It’s not some theoretical thing; fear causes permanent change to the brain. It is damaging in a profound and terrible way.
I think of my mother, who had such horrible experiences at the dentist as a child that she refused to go back for years until the advent of sedation dentistry. I think of my own memories of childbirth and hospitals and how simply seeing the maternity ward from the side of the freeway gets my heart pumping. Fear is an awful feeling. And what we do to pets in the hospital can only be described in many cases as a terror inducing, fear of death experience. Slapping a cat on a cold exam table, sticking needles in their neck like a predator sinking their teeth into prey, staring at them through the bars of the cage. It can take them days or weeks to recover from the stress of a hospitalization, and as soon as they get put in the carrier for a follow up, it starts all over again. No wonder cat visits to the vet are so infrequent. And we are supposed to be their health champions.
As vets, we often blame clients for not caring enough about their pets. “Don’t you know,” we ask sagely, “how important these visits are?” And we shake our heads at the pet owners, blaming them for not having their priorities straight, for not wanting to spend the money on visits. We have done this for years, without ever looking at ourselves and wondering what part of the blame we shoulder ourselves for making the vet hospital pretty much the worst environment possible for pets. “Shelters are so stressful and sad,” we say, ignoring the PTSD we are inducing in the cat with a urinary catheter in the back who has nowhere to escape the prying eyes of the Husky across the room.
When I really started to think about it, I was mortified.
It doesn’t have to be this way.
Some people get it. I worked with a technician who loved cats, like, in a self professed ‘cat lady’ sort of way. She was always sneaking into exam rooms to place a microwaved towel under a cat, or sprinkling catnip in their cage, making little hidey boxes out of recycled cardboard. It was tolerated. It should have been celebrated.
A lot of people in the profession, like that technician, are intuitively doing what they can to make things easier on pets. After hearing Dr. Margie Scherk lecture on this topic years ago, I started keeping a yoga mat in the back for cats to sit on, on the table. Dr. Becker is taking it one step further: he wants vets to re-envision practice from the ground up, to change them from a vet-friendly hospital to a pet-friendly one. He calls it “Fear Free Practice,” and I love it.
When I was in school, veterinary behavior as a specialty was just getting off the ground. It was scoffed at. It’s not ‘real medicine’ was the prevailing attitude. They were wrong. It is, in my opinion, our biggest oversight as a profession. We blame backyard breeders and lack of affordable spay/neuter for pet overpopulation while neglecting to address behavior issues that eventually result in a pet being relinquished. We make the clinic so unpleasant people would rather let their pet suffer in pain at home than come see us and miss the chance for interventions that can save a life. The consequences: less visits, more health issues, more behavior issues we never got the chance to address.
The veterinary community needs to do a better job, from start to finish, of addressing and incorporating behavior into practice.
Fear Free Practice: Real Life Implications
Anyone who has spoken to me in the past year or two knows I am passionate about encouraging our profession to take a more active role in maintaining a pet’s healthy role in the family. To me, preserving that relationship is just as important as maintaining a good weight. It is vital. As is, I think, this concept of fear-free practice.
While Dr. Becker and other like minded vets work on our colleagues, I encourage you to advocate for your pet’s mental well being at the clinic. Bring a mat or towel. Spray them with Feliway. Ask the vet to give your dog some of his favorite treats before jumping into the exam, or if they can take the heart rate while the cat stays in your lap. Making a visit less stressful doesn’t have to involve rebuilding the clinic from the ground up; it can start with these little steps. It’s a philosophy more than a set of prescriptives.
Has fear kept you and your pet from the vet? Had a vet that went out of their way to make you comfortable by embracing a fear free approach?