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Aggression Toward Veterinary Personnel 38.e3

• Use of standardized stress scales at each should consult with a veterinary behavior by the patient of entrapment can prevent
assessment (including in the hospital) can specialist. or avoid triggering aggression, and reduce
VetBooks.ir • Use of medication before the visit may PROGNOSIS & OUTCOME • Positive reinforcement using treats, massage, Diseases and Disorders
help in minimizing risk and recognizing
fear.
patterns of patient distress.
clickers, and calm praise of all animals at all
help handling and decrease anxiety. Trial
managed with staff and owner education
medication dosages should be tested before Many reactive animals can be successfully stages of a veterinary visit
visit. and compliance using low-stress handling Client Education
○ Serotonin antagonist and reuptake inhibi- techniques. Education regarding normal behavior and
tor (SARI): trazodone (cats: 0.5 mg/kg information about preventing arousal should
or ≈2.5-3.0 mg/CAT PO; dogs: 2-5 mg/ PEARLS & CONSIDERATIONS be routine.
kg PO, given the night before and 1 hour
before a veterinary visit) Comments SUGGESTED READING
○ Gamma aminobutyric acid (GABA) • Punishment of aggression should be avoided Moffat K: Addressing canine and feline aggression
analogs: gabapentin (cats: 3-10 mg/kg PO; because it may aggravate the underlying in the veterinary clinic. Vet Clin North Am Small
dogs: 10-20 mg/kg PO, given 1 hour anxiety and the aggression. Anim Pract 38:983-1003, 2008.
before a veterinary visit) • Physical restraint almost always makes these
○ Alpha-agonists: clonidine (dogs: 0.01- animals worse. ADDITIONAL SUGGESTED
0.05 mg/kg PO); Sileo (dogs: 125 mcg/ • Anxious or aggressive pets should be pre- READINGS
2
m ) scribed anxiolytic medications before planned Hammerle M, et al: AAHA 2015 canine and feline
○ Benzodiazepines: diazepam (cats: 0.2- visits. behavior management guidelines. https://www.
0.4 mg/kg PO q 12h, ≈1-2 mg/CAT PO • Modern, softer, better-fitting Elizabethan aaha.org/professional/resources/behavior_manage-
q 12h; dogs: 0.5-1 mg/kg PO q 8-12h), collars can protect veterinary staff from bites ment_guidelines.aspx/.
alprazolam (cats: 0.0125-0.025 mg/kg PO; without conveying the feeling of being Landsberg G, et al: Behavior problems of the dog
dogs: 0.01-0.1 mg/kg PO) muzzled (which makes some animals more and cat, ed 3, St. Louis, 2012, Saunders.
• Antianxiety medication may also be needed reactive). Overall KL: Manual of clinical behavioral medicine
if there is a traumatic event. • Towels to wrap the cat or dog can help for dogs and cats, St. Louis, 2013, Elsevier.
○ Benzodiazepines beneficial: provide some decrease anxiety and can protect personnel. Rodan I, et al: AAFP and ISFM feline-friendly
handling guidelines. J Feline Med Surg 13:364-375,
retrograde amnesiac effects if given shortly 2011.
after the event before memory consolida- Prevention Stevens BJ, et al: Efficacy of a single dose of trazodone
tion occurs • Puppy and kitten classes in a veterinary clinic hydrochloride given to cats prior to veterinary visits
• Avoid all physical and verbal punishment. to habituate new pets to the veterinary to reduce signs of transport- and examination-
environment related anxiety J Am Vet Med Assoc 249:202-207,
Drug Interactions • Teaching all dogs and cats to allow palpation 2016.
• Benzodiazepines can augment the sedative and handling can prevent much anxiety Yin S: Low stress handling, restraint and behavior
effect of some anesthetic agents and may associated with veterinary visits. modification of dogs and cats, Davis, CA, 2009,
CattleDog Publishing.
suppress respiration. • Muzzles are most successfully used when the
• If already taking psychotropic drugs, these dog or cat is taught to happily wear the
should be continued. muzzle before the visit. RELATED CLIENT EDUCATION
• Cats can be taught (ideally as kittens) to walk SHEET
Possible Complications on a lead/harness and enter carrier crates.
Increased anxiety or arousal with some • Anxious cats can be examined in the bottom Rabies Quarantine
medications half of their carrier, protected by a towel AUTHOR: Kersti Seksel, BVSc (Hons), MRCVS, MA
that allows only body parts of interest to be (Hons), FANZCVS, DACVB, DECAWBM
Recommended Monitoring exposed. EDITOR: Karen L. Overall, VMD, MA, PhD, DACVB
Follow-up examination with the owners after
initial consultation to monitor progress with Technician Tips
behavior modification. If the behaviors also • Using venipuncture and handling techniques
occur outside the veterinary practice, the clients that minimize restraint and the perception

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