Reducing Vet Clinic Anxiety: Fear Free, Low Stress Handling and Cat Friendly Veterinarians

Reducing Vet Clinic Anxiety: Fear Free, Low Stress Handling and Cat Friendly Veterinarians

By Victoria Schade and comments by Diane Weinmann

A visit to the vet clinic can be stressful for both pets and their people. For many cats and dogs, a simple wellness exam is actually a series of increasingly scary and uncomfortable manipulations that might result in the animal lashing out at the practitioner. And for pet parents, the stress of watching their best friend go through necessary yet anxiety-inducing exams might deter them from returning to the veterinarian for important health checks.


That doesn’t have to be the case. Three revolutionary certifications are changing the way veterinarians interact with their patients, and in turn, are changing the way pets and their people view their time in the vet clinic. Practitioners report less stress on both sides of the exam table, which leads to better diagnostics and happier, healthier patients.


What Is Fear Free Certification?


Developed by Dr. Marty Becker in 2016, the mission of Fear Free Certification is to prevent and alleviate fear, anxiety and stress in pets by inspiring and educating the people who care for them. The certification process includes a series of courses, both online and in person, that is available to veterinary professionals as well as all individuals employed at a vet clinic, from veterinarians and nurses to customer service representatives and practice managers.


The Difference Between Traditional and Fear Free Handling


According to Dr. Joanne Loeffler, DVM and Fear Free Certified Practitioner at the Telford Veterinary Hospital in Telford, Pennsylvania, the primary difference is the way the practitioner interacts with the patient.


“The traditional way of doing veterinary medicine was to make the pet deal with whatever procedure we needed to get done,” says Dr. Loeffler. “That would mean pinning an animal down, forceful restraint, etc., for sometimes unnecessary things, like a nail trim.”


Dr. Loeffler says that using Fear Free techniques allows the practitioner to change their approach to consider the animal’s emotional state in order to accomplish procedures. She adds, “Fear Free is a culture change from the way most of us were taught how to handle animals. In the time I’ve been involved in Fear Free, I’ve seen such a change in the compliance rate of my patients and clients. Fear Free is about treating the animal with respect and working with them to realize the vet’s office isn’t such a scary place.”


Fear Free Certification and the Diagnostic Process


“Lower stress means better diagnostics,” says Dr. Loeffler. “By having a more compliant patient, we can get more accurate heart rates, temperatures and blood pressures, and even some bloodwork values (like glucose) are more accurately assessed on a calm patient versus a stressed one. Also, when a pet has continued low-stress visits with us, a pet owner will be more likely to bring them in earlier if they get sick, which often translates into a better and quicker response to treatment.”


What Is the Cat Friendly Practice Program?


Established by the American Association of Feline Practitioners (AAFP) and the International Society for Feline Medicine (ISFM), the Cat Friendly Practice program (CFP) is a global initiative designed to elevate care for cats by reducing the stress for the cat, the caregiver and the entire veterinary team.


According to Dr. Elizabeth J. Colleran, DVM, MS, Diplomate Feline Specialty Practice and Cat Friendly Practice Task Force Chair, CFP is a self-paced online program that walks veterinary practices and professionals through all the tasks necessary to reduce the fear and stress of a cat’s visit to the vet clinic.


How Cat Stress at the Veterinarian Is Different Than Dog Stress


“Cats have a very deep connection to their home. They don’t like to leave it. Ever.” Dr. Colleran explains. “The anxiety begins as soon as they leave their ‘home range.’ From there, each new experience adds a bit more stress: strangers, loud noises, unusual odors, quick movements. Once fully anxious, they will stay that way for a long, long time. Cats have uniquely heightened senses and are more sensitive to stimuli than many other animals—sensations can be overwhelming for cats.”


Cats can also show redirection anger, which means that they will lash out at anyone in front of them at the peak moment of stress. Many owners will try to calm their cats during stressful times, putting themselves at risk of scratching, or even worse, a cat bite.


Benefits for Veterinarians Using Cat Friendly Practice Protocols


Cat Friendly Practice veterinarians note that the designation can decrease anxiety for everyone in the exam room. In a 2017 survey, CFP veterinarians said that their patients are less stressed; their clients are happier about the visit experience; and their clients noticed that how much these specialized vets care about cats. “Understanding how cats experience the world gives CFPs the tools to make the changes essential to make health care easy,” Dr. Loeffler says.


What Is Low Stress Handling Certification?


The Low Stress Handling Certification program was developed by Dr. Sophia Yin and released in 2014. Certification involves completing 10 online lecture and lab courses, passing a multiple-choice exam at the end of each lecture, and passing a final multiple-choice exam. Dr. Sally J. Foote, DVM, CABC-IAABC, LSHC-S and Low Stress Handling Silver Certified veterinarian states, “This is an in-depth program in the fundamentals of behavior, understanding the patient in front of you right now, and how to approach and deliver care right now to this animal in a less stressful way.”


The Difference Between Traditional and Low Stress Handling


Dr. Foote notes a connection between the traditional use of force during an exam and the animal’s stress levels. “The most common misstep by veterinary clinics not using Low Stress is adding more people for restraint to get the job done, like vaccinations, nails or blood draw, and not removing or reducing the triggers that are increasing the stress in the animal.” She adds that recognizing when the animal has had enough, and either using medication to assist the exam process or splitting up care, is also important for the health of the animal and safety of the practitioner.


How Does Low Stress Handling Aid Veterinarians and Pets?


Low Stress Handling techniques teach veterinarians to better understand the emotional states of the animals they’re examining, which can reduce the animal’s reactivity, and in turn reduce injury risk to the practitioner. Dr. Foote states that clients are more likely to come in when care is needed rather than trying to avoid the stress of care on the pet.


“I have also heard many veterinarians say that the client finds the veterinarian more credible because the veterinarian recognizes what this pet is feeling,” says Dr. Foote. “So if this vet can recognize stress and fear, they certainly must be able to recognize a bigger medical problem.”


Helping Your Pet Feel More Comfortable at the Vet


Dr. Foote says that creating a handling plan based on the animal’s needs and combining the efforts of both the veterinarian and pet parent in reducing the patient’s stress is the most effective approach.


She suggests open communication with your veterinarian as a way to reduce stress in the exam room. “Tell the veterinary staff and veterinarian before the exam begins what part of your pet’s body they do not like touched [and] how they like to be approached—for example, no reaching or avoid looking in the eye.”




Much like with dogs, the process of traveling to the veterinarian often sets the stage for intensifying anxiety. Dr. Loeffler says that one of the most powerful ways cat parents can reduce this stress buildup is to teach their cats to love their cat carriers. Leave the carrier out and place bedding and cat toys inside well in advance of a scheduled visit, so that when the time comes to head to the cat veterinarian, the cat will already have a positive association with the carrier.




Dr. Loeffler believes that the first step to a happier vet visit for dogs is a stress-free car ride, as well as teaching your dog simple placement cues that are helpful during the exam. Dr. Loeffler says that teaching a dog to stand for an exam and blood draw can go a long way in making the exam more comfortable for everybody involved.


Bringing a hungry pet and high-value dog treats can also help, as well as establishing a comfort level with muzzling beforehand, since veterinarians often need to examine areas that may be painful, which puts them at risk for biting.


You can also talk to your veterinarian about using anxiety management products for dogs or cats, like holistic calming treats or sprays that can help to diffuse stress.  Diane recommends rescue remedy the premade Bach Flower Essence.  Give 5-6 drops to your dog or cat directly into their mouth or on food 10 minutes before leaving your house.  You can re-dose with no issues and there are no interactions with any meds your pet may be on!


Conventional vs Alternative Animal Healing Methods

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Conventional (Traditional) western veterinary medicine is exactly what you have known all your life. You take your pet to the vet when they are sick or for an animal check- up much like you would do for yourself. If your pet is ill, the vet may prescribe antibiotics, pills, salves etc. Your vet will use diagnostic tests like x-rays, MRIs, ultra sounds and even exploratory surgery could be an option to obtain information to enable your veterinary professional to make a diagnosis. If your pet is healthy, they will perform several techniques to verify you pet’s health, for instance, listening to their heart or looking in their mouth and ears. They will probably run their hands over your pet looking for “issues”. You may be required to bring in a stool or urine sample for analysis. You can obtain maintenance prescriptions like heartworm or flea and tick medicines from your neighborhood vet.

While there is nothing wrong with using traditional western medicine to help your pet, there are; however, options for expanding the care you provide to your beloved animal companion. When you use alternative medicine to help your pet feel better or remain healthy you employ many different tactics for wellness.

Complementary medicine refers to healing practices and products that work in conjunction with traditional medicine. For example, a cancer patient receiving chemotherapy may also undergo acupuncture to help manage chemo side effects.

Alternative medicine is not used as a complement to, but rather as a substitute for traditional therapy. An example would be a pet with cancer whose owner forgoes recommended chemotherapy or surgery and instead chooses to treat the disease with specific dietary changes.

Complementary and alternative medicines are categories of medicine that includes a variety of treatment approaches that fall outside the realm of conventional medicine. Employing holistic therapies and medicine is about viewing and treating the body as a whole. This is very different from the conventional medical approach.

Integrative medicine draws from both complementary medicine and alternative medicine and combines these with traditional Western therapies.

Many pet owners find that the common sense principles integrative medicine relies on really resonate with them. Often, common sense principles for creating wellness are overlooked in the search for hard-core science but not without consequences.

Lots of different therapies fall under the umbrella of alternative medicine (also called holistic medicine). Many of these therapies have this philosophy in common: consider and treat all aspects of the pet’s life, not just the symptoms. Check in with my blog next week to learn more about alternative and complementary medicine.