Sedate veterinary patients to prevent anxiety from tainting exams

Sedate veterinary patients to prevent anxiety from tainting exams

We should reach for drugs early and often in the Fear-Free approach to veterinary practice.
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Apr 01, 2015

I remember practicing in the early 1980s and using Pet-Tabs as a treat. Looking back, that’s like giving a toddler a stalk of celery as a reward. Now I use mouthwatering delicacies (like deli lunch meat) to help make a pet feel comfortable. But what about those veterinary visits when the pet doesn’t want a tasty treat—even though she’s hungry?

Use medicine to treat stress and anxiety

Hungry pets that won’t eat are anxious, fearful or both. When a pet ignores or just sniffs a treat, I realize the pet is stressed. I typically a) reach for drugs or b) reschedule if it’s just a wellness visit, and the pet owner is OK with coming back (during the next visit, we try more things to calm the pet).

The trouble is that most veterinarians, while quick to use drugs for infections or metabolic problems, are loath to use them for routine calming or sedation. You might be concerned that routine administration of anxiolytic medications will mask key signs of disease. But think about this: Fear and anxiety also can induce new signs not associated with intrinsic disease, such as arrhythmias, hypertension, urinary obstruction and diarrhea.

3 tips for better sedation—and talking about it with clients and team

1. “Reach for drugs early and often,” says famed veterinary behaviorist Dr. Karen Overall. “If we respond at the first sign of true, unabating distress with a panicolytic (alprazolam) or a medication that alters peak reactivity (clonidine) or a medication that provides small amounts of behavioral calming and anxiety relief (trazodone), we won’t need sedation.”

2. Board-certified anesthesiologist Dr. Heidi Shafford says team members at her Veterinary Anesthesia Specialists in Portland, Oregon, identify pets that are prone to fear when appointments are scheduled and note it in medical records. Pre-hospital oral administration of gabapentin in cats can make providing care easier.

3. Dr. Jonathan Bloom, partner at Willowdale Animal Hospital in Toronto, Canada, uses the term “multi-modal” when explaining Fear-Free tactics to colleagues because they understand it from a pain management aspect.

When antianxiety medications don’t work or work well enough (or you can’t use them) on a specific pet, follow this advice: If you can’t abate, you must sedate.