06/03/2026
Excellent post about behavioral considerations in the veterinary setting. Kudos to this practice!!
Something happened this week (already, and it’s only Tuesday!) that never needed to happen. It’s heartbreaking and absolutely, completely, utterly unnecessary.
The team here takes safety very, very seriously. Sure, we crack jokes and have (very) dark humor, but we also will do whatever we need to do to keep everyone safe. That means ourselves, each other, our feline and canine patients, and their human families. Our practice is designed to work with the unique behavioral and emotional considerations of our patients and we fully embrace cooperative care (more on that that in a second), behavioral modification (more on that, too), and what we call better living through chemistry.
What does all that mean?
Cooperative care goes by a few different names, but the gist is that we work with our patients over time and with repeated experiences with training and rewards to help them learn that we are here to work WITH them, and to establish expectations. We want every cat and every dog to know what to expect, and to understand what we are asking of them. This approach is gradual and in our highly aroused (Skeptical? Challenging? Anxious?) patients, it can take a lot of work. At the same time, this is how facilities like zoos and aquariums train lions and tigers and bears to get onto scales, or elephants or hippos to allow us to get blood from them, safely. If they don’t want to do it, it isn’t going to happen.
Cooperative care uses behavioral modification. That’s a fancy term to say we use rewards to encourage a response and behavior that we’d like to see so that, over time, instead of a dog having a full blown panic attack when they see the inside of the veterinary clinic lobby, they get excited because that’s where the good treats come from. We have modified or changed their response to seeing the lobby from panic, to pleasure.
Finally, we firmly believe in better living through chemistry. Dogs and cats can have excessive anxiety, just like humans do. And just like in some humans, some dogs and cats need medications to help feel better and experience life in a more positive way. There’s nothing wrong with appropriate medications. Some humans do better with a dose of Xanax before getting on a plane. Some humans do better with a bit of daily Prozac to bring down their baseline anxiety level. In our opinion, that’s not bad or some kind of reflection on their value—it’s kind and considerate. Dogs and cats are much the same. Some of them come to us with a history of trauma or abuse, and some are just plain born that way and benefit from some help. We want the best quality of life a dog or a cat can have, and sometimes, medications are an integral part of that quality of life.
When we have a patient who is distressed or reactive when they come to see us, we will do everything we can to find what works for that particular cat or dog. What works is different in every situation. At the end of the day, our goal is to have the needs of that cat or dog met, without causing them, us, or their families, harm. For some patients, that means we need to break up their visits so that they only have so much done any given day to keep them from being overwhelmed. For some, it means they get pre-appointment medications at home to help prevent the panic before it happens. For others, it means we do blood draws in completely bizarre positions or postures because that’s what makes the patient most comfortable and least upset. If a cat or dog is having a bad day, sometimes we don’t do anything at all and come back to try another day. And we have some patients who get too distressed no matter what’s been tried, so we opt to sedate them every time to avoid trauma.
As veterinary professionals, we rely on our team to help us keep each other safe. We also rely on our pet parents to be transparent and tell us if there are known considerations, and for the pet parents to be willing to be flexible, and to trust our judgement.
If I say that your cat or dog needs medications before appointments, I mean just that.
If we say that we are not going to proceed with a procedure or exam because your cat or dog is too upset, then we are not going to proceed.
If we ask a pet parent to start working on muzzle training for their dog, it’s to keep the dog and our staff and the dog’s family safe. Some triggers are just too overwhelming for some dogs and asking a dog to wear a muzzle is not some kind of judgement. I myself have had 2 dogs in my adult life who were muzzle trained for specific things to help keep everyone safe. There’s nothing wrong or ugly or abusive with proper muzzle training, when it’s done correctly.
This week, we were contacted by another practice looking for information about a former patient. While under our care, the former patient did not hurt anyone, but I think that the only reason it didn’t happen is we wouldn’t allow it. We never pushed that patient past their comfort level and when the patient was brought in without having been given the required (yes, required) pre-appointment medications because their pet parent didn’t feel like it was necessary, we did not attempt any procedures or treatments because it wasn’t safe. Simple as that—no meds, no treatments.
When the pet parent pushed for us to do things anyway and just ‘man’ our way through it, we refused. We will ALWAYS refuse. I am not interested in physically restraining an animal once to get something done—I am interested in maintaining a long-term relationship with that pet that gets better over time.
In this case, we informed the pet parent after the last appointment here that we would no longer see their pet if the pet parent was unwilling to heed advice and recommendations and insisted on doing things that made their pet increasingly agitated and reactive and indeed, dangerous.
We haven’t seen them back here in a while, and this week, a team member at another practice was seriously injured after this same pet was brought in to see them. Their pet parent opted not to pre-medicate the pet and insisted that the practice examine and treat their pet anyway.
This is not okay. This is never okay.
Veterinary medicine is not a low risk occupation, but we have a right to be as safe as possible.
We have a right to enact rules to keep us safer.
We have a right to enforce those rules, and to refuse service in any situation where we feel threatened.
My heart breaks for the staff member who was injured. My heart hurts for that entire practice family. It’s hard on both the person who was directly injured, as well as the staff that support them. The physical trauma is one thing, but there’s also emotional trauma and PTSD is common in our profession.
A small bite to a finger of a fellow veterinarian resulted in numerous surgeries because of nerve damage. Several of my friends who are veterinarians have had serious injuries to their faces, legs, hands, and elsewhere. One had to have facial reconstructive surgery.
As a practice owner, I WILL protect my staff as much as I will protect your dog and cat. I will ban pet parents who do not follow recommendations made to keep everyone safe, and we will extensively document those recommendations in the permanent record. We have an obligation to help protect our staff and the community at large.
I hope that the person who was injured by this particular pet doesn’t have permanent physical trauma, and that the emotional trauma also heals. I hope that the actions of this pet parent haven’t pushed yet another valued team member out of veterinary medicine.
With all that we sacrifice in this profession, it is any wonder that it’s so hard to keep fantastic people in our profession when we have to deal with unsafe situations?
We can do better.
~Kathleen Werden, DVM
Pictured: One superstar patient who gets very distressed with restraint. To safely draw blood, they were hugged by Kristina, given lots of head pets by Dr Werden, and Kristin had to work her Jedi-Magic to get blood from the rear leg as it dangled in the air while Lizzie held off on the vein. This patient felt that this weird and awkward position was (for some reason) much more comfortable and less stressful than laying on the table.
