Fear Free Flashcards

1
Q

Emotional Medical Record

A
  • document detailing a pet’s likes & dislikes
    • Favorite treats, people
    • prefered treatment area
    • stressful procedures
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2
Q

Gentle Control

A
  • How the pet is safely positioned with minimal restraint to provide needed care
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3
Q

Touch Gradient

A
  • Using a considerate approach & gentle control during examinations
  • Moving from less to more sensitive areas
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4
Q

Why FAS Matters

A
  • FAS can mimic pain, nausea, & neurological disease callenging a diagnosis
  • 78.5% of dogs demonstrated fear on the examination table
  • less than 50% of dogs willingly entered the hospital
    • 13.3% dragged or carried
  • Routine puppy and kitten visits can create lifelong FAS
  • Cats are #1 most popular pet in USA but feline visits are limited
    • Lack of knowledge of needed care
    • Cost
    • Resistance to carriers and travel
    • Stress in the clinic
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5
Q

Receptionist’s Role

A
  • Scheduling
    • Reveiw emotional record
    • Travel
    • Being hundry
    • Carrier acclimation
    • Toys and Treats
  • Arrival
    • Elevated surfaces for cats
    • Floor scale for dogs
    • Treats near reception and scale
    • Limit wait time, reduce chaos, and noise
    • Separated spaces as possible & visual barriers
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6
Q

Exam room

A
  • Elevated surfaces or perches
  • Reduce background noise
  • Non-slip, not cold, non-relective surfaces
  • Thermostate control
  • Examine where comfortable
  • Use gentle congrol & touch gradients
  • Owner present if its helpful
  • Prepare supplies ahead of time
  • Ventilation (1% bleach decreases olfction & increases anxiety)
  • Toys, treats, or grooming tools
  • Good dimmable lighting
  • Soft colors
  • Privacy, avoiding unfamiliar animals
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7
Q

Sound Therapy for Dogs

A
  • Classical music
    • more sleeping/resting
    • less vocalizing
    • lowered respirations & heart rates
    • Owner satisfaction increased
  • Audio books
    • Calmer during kenneling vs. classical music
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8
Q

Sound Therapy for Cats

A
  • Species specific music before, during, & after exam
    • lowered stress
    • improved handling
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9
Q

Fun Visits

A
  • Informal (not scheduled) no cost visit
  • Help prevent FAS in the hospital
  • No procedures
    • treats and attention if positive!
  • Completed by the client without the aid of the staff
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10
Q

Victory Visits

A
  • Formal (scheduled) with a fee
  • Team member involved
    • desensitization
    • counterconditioning for a specific fear
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11
Q

Feline Passive Restraint

A
  • Upright position
  • minimized restraint
  • Stayed on the table 6.1x longer
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12
Q

Feline Full Body Restraint

A
  • On their side
  • Immobilized head, body, and limbs
  • 8.2x more attempts to flee
  • 6 seconds longer to achieve positioning
  • Increased respiration and lip licking
  • Increased incidence of pupil dilation and holding ears back or to the side
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13
Q

Optimal Anxiolytic

A
  • Reliably effective (even with current FAS)
  • Rapid onset
  • Large safety margin
  • No client abuse potential
  • Easy to administer
  • Reversible
  • Inexpensive
  • Readily available
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14
Q

Gabapentin

A
  • Less effective is already fearful
  • Peak effect 1.5-2 hours after administration
  • Anxiolytic properties not fully understood
  • Potential benefit in pain management
  • Pilled or mixed into treat/canned food
  • Can use acutely or chronically
  • Inexpensive
  • Can combine with other drugs including trazodone, benzodiazepines & injectables
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15
Q

Gabapentin in Cats

A
  • Cats given gabapentin had significantly lowered stress during transport
  • Decreased agression
  • Increased examination compliance
  • Side Effects:
    • Resolve within 8 hours
    • none (most cats)
    • sedation
    • ataxia
    • hyersalivation (rare)
    • Vomiting (rare)
  • 50-100 mg/cat 2 hours before stress
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16
Q

Gabapentin in Dogs

A
  • 10-40mg/kg 1.5-3 hours before an examination
    • repeat every 8-12 hours as needed
  • Avoid human liquid forms
    • xylitol in mix - hypoglycemia and acute liver necrosis
  • Side effects:
    • none
    • mild sedation
    • ataxia
    • GI upset (rare)
17
Q

Trazodone

A
  • Less effective if already fearful
  • Serotonin antagonist and reuptake inhibitor
  • Peak 1-3 hours (dogs)
  • Widely used in Dogs: 4-12 mg/kg repeat every 8-12 hours MAX 600 mg/day
    • travel anxiety
    • separation and noise phobia
    • Veterinary visits
    • hospitalization
    • crate confinement
  • Acute or chronic dosing is acceptable
  • Inexpensive
  • Can combine with other anxiolytics, sedatives or injectable drugs
  • Side Effects:
    • none
    • sedation
    • GI
    • Aggression (rare)
  • CAUTION with severe heart, liver, or kidney disease
18
Q

Trazodone in Cats

A
  • Reduces anxiety for transport
  • improved examination handling
  • Side effects
    • None
    • Mild sedation
    • may lower blood pressure at doses above 50mg/kg
19
Q

Dexmedetomidine

A
  • Anxiolytic, Sedative, and analgesic effecting the locus coeruleus
  • Fast onset
  • Can reverse with IM atipamezole (Antisedan)
    • Standing in 5-15 minutes
  • Side Effects:
    • Stings IM
    • Vasoconstriction with reflex bradycardia
    • arrhythmias
    • hypothermia
    • Decreased respiration
    • Vomiting
  • Avoid using withL
    • hear disease
    • Respiratory disorders
    • liver or kidney disease
    • shock
    • debilitated
    • caution with geriatic and young animals
  • IV route:
    • Peak sedation 2-45minutes
  • Oral transmucosal route to dogs
    • similar heart and respiration rates and sedation
    • OTM peak 30-60 minutes
    • effects last longer
20
Q

Cat Dexmedetomidine Sedation

A
  • Combine IV/IM with
    • Ketamine
    • Opioid (buprenorphine may take longer)
  • Onset sedation and lateral recumbancy about 1-5 minutes
  • Reverse with Atipamezole IM
    • sternal to standing in 5-15 minutes
    • extralabel use
  • No reversal recovery in 60-90 minutes
21
Q

Oral Transmucosal (OTM) Dexmedetomidine

A
  • FDA approved for noise phobia
  • Need gloves to administer
  • 2 hours between doses
    • max of 5 doses
  • Discard opn syringes after 48 hours
  • Benefits:
  • Anxiolytic
  • non-sedating
  • reduced vocalizatinos (whining, yelping, etc)
  • reduced avoidance
  • reduced trembling/ panting
  • reduced urination / defecation
  • effect in 30min- 1 hour
  • Side Effects:
    • Pale at administration site
    • sedation
    • emesis
  • Avoid use with cardiovascular, respiratory, liver, kidney, or dental disease
22
Q

Adjunct Therapies

A
  • Drugs:
    • Opioids
    • Ketamine
    • Acepromazine (tranquilizer)
    • Benzodiaxepines- diazepam, alprazolam, lorazepam
  • Clothing:
    • Basket muzzle
    • Thunder shirt
    • Thunder cap
  • Pheromones:
    • Dog Appeasing Pheromone
    • Feliway
  • Supplements
23
Q

Pateient and Client Centered Approach

A
  • Acknowledge client’s expertise on their pet
  • Explain FAS impact on pet
  • Give options when possibe
    • reversible sedation
    • sending anti-anxiety meds and returning
  • Check in
  • Reflective listening
  • Empathy
    • Verbal
    • Non-verbal: pausing for Qs, nodding, leaning in
  • Practice and roleplay scenarios with colleagues