(2/2021) FAS refers to pets (dogs and cats) that are Fearful, Anxious, and Stressed when they come to the veterinary hospital/clinic. Let me define some terms:

Fear - noun meaning an unpleasant emotion caused by the threat of danger, harm, or pain

Anxiety - an emotion characterized by feelings of tension; the opposite would be calm

Stress - the body’s reaction to any change with physical, mental, and emotional response

The symptoms of these factors in dogs are tense face, lips drawn back, tail down, body lowered (cowering), dilated pupils, snarling or growling. The symptoms in cats are tucked tail, crouched posture, hissing, dilated pupils, ears pinned back/down to the side.

A lot of pets (and their pet parents) are stressed coming to the veterinary office. These days, during Covid-19 time, pet parents are even more stressed. Our pets can read and be influenced by this stress as well. The stress of a vet visit often begins with leaving the house. A cat should go in a cat carrier for its safety in the car. However, the cat realizes what that confinement will mean. A dog has to get into the car. That act alone may be stressful, or the stress starts as the car gets closer to the veterinary clinic from down the street to being in the parking lot to approaching the ominous front door.

In order to reduce stress, the process can start at home. Acclimate your cat to the carrier without a vet visit by leaving the carrier out, not hidden away. Leave the door open or the top off. Put favorite toys or treats inside. There are pheromones, pleasing hormones that can be sprayed in the carrier or on a bandana for dogs before they leave the house. Acclimate dogs to the car gradually by just sitting in it to start without going anywhere. Use treats to reward a dog for getting in the car and staying still. Then back down the driveway, go around the block take a longer drive to build up tolerance for trips.

Some pets really benefit by giving them calming nutraceuticals or medications prior to vet visits. After all, just like a person, if your pet has anxiety, they cannot control that and may need help. Trazodone and Gabapentin are human medications that can be prescribed by your veterinarian for dogs and cats. Some pets are a danger to themselves and others when they experience high anxiety. Vet staff wants to keep your pet safe, as well as you the owner, and the veterinary team. We want to make the visit more bearable for all involved.

There has been a tremendous shift in the veterinary profession to promote fear free visits for all pets. The concept of Fear Free was started by Dr. Marty Becker, "America’s Veterinarian." The idea is based upon recognizing and taking steps to reduce FAS. The tag line is taking the pet out of petrified. Some suggestions are to use pre-visit medications, sometimes delay/reschedule visits if the pet is not prepared, in-clinic sedation, and happy visits (nothing happens, just happy hellos and giving treats for positive reinforcement).

When we recommend medication, it is not just to drug your cat or dog. It is meant to facilitate what needs to happen during the visit once again keeping all parties safe.

One of the tasks that can be an extreme trigger for anxiety is the nail trim. It is a necessary task to prevent injuries by overgrown nails getting caught and tearing or breaking or even growing around into the pads of a cat or dog.

Fear free visits involve determining favorite treats for your pets. The benefit of treats is helped by not feeding your dog or cat after 6 p.m. the night before the vet visit. We use peanut butter, squeeze cheese, cat treats and hot dogs for dogs. Cream cheese, squeeze cheese, and cat treats are used for cats. In addition, we play calming music (typically classical) in each of our 4 exam rooms. We use non-skid mats and towels (sprayed with cat pheromones called Feliway) on counter tops. Also we will use rubber mats on the floor for large dogs with mobility issues.

Trazodone and/or Gabapentin can be used when needed. There is something called the Chill Protocol which works extremely well for very reactive and stressed dogs. That involves starting with Gabapentin the night before the vet visit. Then repeat the Gabapentin along with Melatonin 2 hours before the visit. Finally, a small dose of acepromazine, a mild tranquilizer, is given 30 minutes before the visit. This helps tremendously with those pesky nail trims and any situations when dogs are highly reactive, stressed, and anxious.

The key to making vet visits go smoothly is communication between pet parents and the veterinary office when the appointment is made. The more we know ahead of time, the more we can do to help you prepare your pet before the stress begins. For more information I suggest the following books: From Fearful to Fear Free by Marty Becker, et. al. or Decoding Your Dog by the American College of Veterinary Behavior.