Less stress! Tips for calmer dogs

Contributors

E'Lise Christensen, DVM, DACVB

Sherrie Yuschak, RVT, VTS-Behavior, KPACTP, CPDT

Mikkel Becker, CPDT

Kathryn Primm, DVM

Welcome to  Firstline's Team Training in a Virtual Box, your complete guide to team training. Each lesson is designed to give you all the tools you need to plan an educational staff meeting on a single topic.

Using specially designed team tools, engaging videos, and other useful resources, this four-part team meeting will help your team educate dog owners about behavior problems in the home and work to create a calmer, safer and lower-stress experience for dogs in the clinic. Many myths exist about canine behavior, and your veterinary team needs to understand why your practice believes in-and recommends-behavior counseling for happier pet families. This team meeting, sponsored by VPL, will get your entire team on the same page-for less stress and calmer dogs!

Click the headlines below to access the meeting tools.

Part 1: Team knowledge

Many myths exist about dog behavior, and you play an important role by illuminating the facts so team members understand why your practice believes in-and recommends-behavior counseling for happier pet families. View Part 1.

Part 2: Implementation

This section discusses how to implement a successful program that identifies signs of stress, anxiety and depression or other signs of a behavior problem in dogs. You'll also cover how each member of the team can be crucial in helping clients identify and manage their dogs' stress. View Part 2.

Part 3: Client communication

This section covers the communication tools your team can use to listen for and address pet stress. View Part 3.

Part 4: Marketing and follow-through

You'll pull all that you've learned together, including locking in rechecks, talking about products and what to do with difficult cases. View Part 4.

Part 1 resources

Download these handouts and tools before your team meeting:

• Part 1: Meeting guide: Explains the thinking behind the meeting and activities

• Part 1: Trainer's script: Step-by-step meeting dialogue

• Behavior pretest: 3-minute activity

• Questions your team can ask clients to uncover behavior problems in their dogs: 3-minute activity

Part 1: Team knowledge

To start your team meeting, you'll want to frame the issue of stress and how it affects a dog's relationship with his family. Many myths exist about dog behavior, and you play an important role by illuminating the facts so team members understand why your practice believes in-and recommends-behavior counseling for happier pet families.

To make sure your team understands the gravity of addressing behavior, start with this startling statistic: 2016 data from the Humane Society estimates 30 percent to 40 percent of relinquished pets were given up due to behavior problems. Your veterinary team plays a critical role in watching and listening for signs of behavior problems the pet is experiencing at home and identifying problems you observe in the clinic.

This team meeting will address how you can educate pet owners about behavior problems in the home as well as creating a calmer, safer and lower-stress experience in the clinic. These efforts require a two-pronged approach. First you must identify behavior problems in the home and educate pet owners about the importance of treating this as a medical issue. And second, you must address the ways your team can reduce pets' stress in the veterinary clinic. In this team meeting, you will see the “Home” icon next to two activities that are designed specifically to help owners relieve and avoid pets' stress in the home. Otherwise, the activities are geared toward teaching your practice's team ways to identify and address pets' stress in both home and clinic environments.

Begin with a pretest to test your team's knowledge-and to prepare them for the topics you'll cover in this team training.

3-minute activity: Behavior pretest

Pass out a copy of “Stress less: A behavior pretest.” The pretest will be an overview of materials covered in all four parts of the team meeting. Tell your team you don't want them to stress about the answers. Your goal is to get an idea of how much your team members already know about this topic and help you tailor the team meeting to offer the education to get the whole team on board with behavior counseling, support and, when appropriate, referrals.

2-minute discussion: Don't panic! A low-stress approach is easy and fun

Changing your team's habits to move to a lower-stress approach can seem daunting, and it may even trigger a fight-or-flight response in your members. The key: Start small and try a few tricks.

Show this video featuring E'Lise Christensen, DVM, DACVB, a CVC educator with Behavior Consultations of NYC and Colorado.

Ask your team to stay open to change, and remind them that there are some great payoffs to a lower-stress approach: patients will be happier, pet owners will be happier and team members will enjoy their work more.

What does stress look like (and why your team should care)

Now it's time to boost your team's vocabulary about stress, anxiety and depression in dogs. First, set the stage to help your team understand that clients might not be watching for signs of stress in their dog-or be able to connect their dog's behavior and responses with the idea the dog is stressed. Ask them to consider this: Many times when an owner arrives with a limping pet and you ask, “Is your dog in pain?” the client will respond, “No.” So remember that your clients may need help to identify behavior issues and put themselves in their dog's place to understand how the dog might be feeling.

For example, your team might explain that when the owner can see the whites of the dog's eyes or when the dog turns his head or backs away, these are signs the pet doesn't want to interact.

When team members note signs of stress in pets, it's a good idea for them to verbalize the signs to clients. Pet owners can be reluctant to accept their pets are fearful, stressed or aggressive. As examples, you might say, “Rex is turning his head away from me right now,” or “When I went to reach for him, he pulled his head back.” Other signs that might indicate stress that team members might note and verbalize:

• the dog's panting and it's not hot

• the dog's yawning and he's not tired

• the dog refuses to eat the treats he normally loves

Consider using the alien abduction analogy to educate clients. If an alien tried to touch them, even if a friend told them it was OK, their first instinct would probably still be to back away. Their dogs may experience the same feeling when they anticipate being touched by a stranger.

The key: teaching pet owners to honor their pet's temperament, personality and comfort level and encouraging them to build a relationship of trust with their pets, instead of the client expecting a dog to tolerate everything the pet owner wants the dog to tolerate.

In Part 2: Implementation, you'll introduce your team to identifying dogs' body language so they're ready to verbalize the signs they see to clients.

3-minute activity: Identify problems at home

Distribute the “Questions your team can ask clients to uncover behavior problems in their dogs” handout. Discuss how to effectively use the provided general behavior questionnaire and appropriate follow-up questions and action.

For example, you might encourage team members to sit with the client and make the questionnaire more of a one-on-one conversation and less of a quiz. Emphasize a conversational and inviting tone without judgment. Clients who feel they're being judged might be less likely to share some of the difficulties they're facing with their pets. So remind your team that you cannot fix problems you don't know about.

Finally, once you've identified a problem, you'll need to discuss your practice's protocol to make sure you address any concerns you've identified with the questionnaire. You will cover action steps for each member of the team to support your behavior goals in Part 2: Implementation.

1-minute acitvity: Thank your team

Thank your team for their participation today. In Part 2, you'll discuss how to implement a program that focuses on identifying stressed pets and how your team can play a role in reducing pets' stress. 

Part 2 resources

Download these handouts and tools before your team meeting:

• Part 2 Meeting guide: Explains the thinking behind the meeting and activities

• Part 2: Trainer's script: Step-by-step meeting dialogue

• Brainstorming tool: Crafting your canine behavior protocol: 5-minute activity

• Canine ladder of aggression: 7-minute activity

• Tips for calmer pets-and pet owners: 7-minute activity

Part 2: Implementation

Welcome your team to Part 2 of your team meeting on how to reduce dogs' stress. Today you'll talk about how to implement a successful program that identifies signs of stress, anxiety and depression or other signs of a behavior problem in dogs. You'll also cover how each member of the team can be crucial in helping clients identify and manage their dogs' stress.

5-minute activity: Dish out data on behavior discussions

Start your meeting by talking about how often team members are having behavior talks with pet owners in practice. The 2016 dvm360 Spectrum of Care Study shows that 28.8 percent of practices say they have a written protocol that specifies they discuss potential behavior problems as part of the patient's history at every wellness appointment. And 16.7 percent say it's not part of their protocol, while a whopping 54.5 percent say they don't have a protocol.

Also worth noting: While 100 percent of respondents reported they discuss behavior with new puppy owners or clients who say they have a problem, only 35 percent discuss behavior problems when they see adult dogs and cats. Thirty percent say they discuss behavior only when it's brought up by a client, and 15 percent say if the client doesn't indicate behavior problems on a wellness form, they don't discuss.

Ask your team members to think about the patients they've seen most recently in your practice. How often did they discuss behavior? Invite team members to raise their hands and share stories. How did the conversation begin? Did the pet owner identify the problem? Did you observe a problem or signs of anxiety or stress when the pet owner visited your practice? Your goal is to get your team members thinking about how-and how often-they talk with pet owners about behavior.

The next part of your team meeting will depend on whether your practice has a behavior protocol.

Option 1: Your practice has a protocol: 2-minute activity: Practice your protocol

Print out a copy of your practice's protocol and pass it out to your team. Read through it together, and ask questions. What does this protocol look like in the exam room? Based on the protocol, what do your team members think they should be asking pet owners, and what should they do if they identify a problem? What tools do you have in place, such as a behavior questionnaire, to help uncover behavior problems?

Option 2: Your practice does not have a protocol: 5-minute activity: Brainstorm your protocol

If you don't have an existing protocol, spend five minutes as a team to brainstorm what might go into your protocol. Pass out the tool, “Brainstorming tool: Crafting your canine behavior protocol” to guide your discussion. What would a successful protocol look like in the exam room?

What do team members think they should be asking pet owners, and what should they do if they identify a behavior problem? What tools do you have in place, such as a behavior questionnaire, to help uncover behavior problems?

Once you've finished the discussion, ask for a couple of volunteers to participate outside of the meeting to work on developing the protocol, which, of course, will be subject to the practice management's approval. Set a specific time to meet and commit to having your practice's protocol created by the next time you meet for Part 3 of your team meeting.

7-minute activity: How can the team reduce stress?

A low-stress approach to dealing with pets relies on one important factor: individualization. Every pet is different, so remind your team that they'll use different tools in their toolbox for different parts of the exam. 

Every member of the veterinary team needs to know basic canine body language. Distribute copies of “The Canine Ladder of Aggression” to your team. Spend the next two minutes reviewing the escalating postures and visual cues that can be signs of a dog's perceived stress. Ask your team members to think about these signs so they can start to watch for them in every dog that visits your practice.

Next, distribute the tip sheet, “Tips for calmer pets-and pet owners.” Review the list as a team. It's a good idea to pick a few you'd like to implement right away. Once you've selected the steps you'll try, discuss as a team how you'll use these tips with your patients.

Commit to practicing these techniques for one week. Then, at your next team meeting, take two minutes to review your experiences. What worked? What didn't? What did you change, and what do you still want to try?

Discuss which tools you'll continue using, and choose a few more to practice in the next week to add to your toolbox of low-stress approaches for pets.

5-minute bonus activity: Take your learning further

For this activity, use the pretest to help you identify the area you'd like to explore with your team. Choose from the tools below, and discuss how you might use these ideas and tools for calmer canine visits at your practice.

Options include:

A low-stress approach to getting pets to the veterinarian

Low-stress exam room tips and tools

Low-stress hospital design

5-minute activity: Oh, behave!

With all of the conversations and activities you must squeeze into a routine veterinary visit, it can be difficult to make space for behavior conversations. Dr. E'Lise Christensen offers these tips to help your team get canine behavior cases under control in the first five minutes. Although your medical team members may take the lead in managing and referring these cases, it's still a good idea to review this advice with your team so everyone's on the same page.

The medical team will start by triaging the case. In these circumstances, you're looking to quickly identify trigger situations and eliminate unsafe situations. For example, if you've got a dog that's been causing injuries to children, the veterinarian may recommend the animal be removed from the household for the time being. Consider these three steps:

1. Set a schedule of avoidance. Exposing the dog to the trigger may not be healthy or helpful for these dogs. So you may also need to educate pet owners that avoiding the trigger can be an important first step in their dog's care as you work toward solutions to address the pet's stress and fear.

2. Remove anything that's making the problem worse. For example, eliminate any punishment that may be happening in the home, such as yelling, pinching, kicking, shock collars and so on. 

3. Develop a modification plan or make a strong, sound referral to a behavior specialist. Often, in general practice, your role will be to triage the case, get the pet stable and refer them to a recognized and accessible specialist as needed.

1-minute activity: Thank your team

Close your meeting be thanking your team for their time and attention today. Remind them everyone has a valuable role to play in recognizing stressed pets and communicating with the clients and the rest of the team to find solutions. Remind your team that in Part 3, you'll discuss communication tips to work with clients. 

Part 3 resources

Download these handouts and tools before your team meeting:

• Part 3 Meeting guide: Explains the thinking behind the meeting and activities

• Part 3: Trainer's script: Step-by-step meeting dialogue

• Red flags: Words and phrases that signal behavior issues:10-minute activity

• Client education videos to share on the practice's website (and in social media):

Video: Why is your dog stressed?

Video: Stop stressing your dog!

Video: Downward-facing dog: Calming your canine 

Video: Make car rides fun for Fido

Part 3: Client communication

Welcome your team to Part 3 of your team meeting on recognizing and addressing stress in dogs. Today you're going to cover the communication tools your team can use to listen for and address pet stress.

10-minute activity: What's your role?

The 2016 dvm360 Spectrum of Care Study asked practices whether they have someone in their practice who's particularly passionate about talking to clients about behavior issues. About 37 percent said their behavior advocate was their veterinarian, while 8 percent said it was a credentialed technician and almost 9 percent said it was another member of the team. The takeaway-46 percent of respondents said their practice has no behavior advocate on the team!

Take a minute to identify any behavior advocates on your veterinary team. If no one is currently filling this role, remind team members this is a great area to grow in your practice and develop their skills to help patients. Remember, every member of the team can play a crucial role in identifying dogs' stress and communicating with pet owners. Take a minute to quickly recognize how each member of your veterinary team can be a behavior advocate.

Sometimes clients think a pet's behavior problem can't be fixed, and they're just trying to live with it and not be too embarrassed about it. But you see or hear the evidence of behavior issues all the time. It's the difference between a calm, alert pet in the waiting area and a frightened, aggressive one. The client may be OK with it now, but somewhere down the road, these behaviors may get worse or become too hard to live with:

• “We used to have visitors, but now we have our dog JoJo.”

• “Oh, no, we couldn't get another dog. JoJo doesn't like other animals.”

• “We avoid the dog park. He barks and just won't stop.”

• “We have to go out late, late at night for our walks. It's embarrassing how much he barks and growls at others.”

• “Oh, haha! I used to always dream of going hiking, but we just can't, not with other people around.”

• “Dang it, JoJo! Stop pulling on the leash!”

• “JoJo, calm down! Stop barking!”

• “Leave that dog alone, JoJo!”

Maybe the patient's in pain. Maybe the patient just doesn't like a particular environment. Maybe the patient has been poorly trained to be around other animals and people. You'll never know until you ask more questions.

Pet owners may be giving you small signals of behavior problems and anxiety. So you can help your team by teaching them what to listen for in every interaction with clients. Pass out the team tool “Red flags: Words and phrases that signal behavior issues.”

Break your team into small groups of two to four team members. For the next five minutes, ask each team to discuss the words and phrases on the handout. They can practice by taking turns role-playing the client and the team member designated to respond. They can also discuss specific cases where clients have used similar words and phrases.

After five minutes of discussion in small groups, ask a representative from each team to summarize what they learned for the whole team. Discussing these examples will help grow the team's knowledge about real cases they'll see and give your team some experience in responding. After each group has had a chance to present, thank the team. 

What do team members think they should be asking pet owners, and what should they do if they identify a behavior problem? What tools do you have in place, such as a behavior questionnaire, to help uncover behavior problems?

7-minute activity: How can pet owners reduce pets' stress?

Pet owners can play a huge role in managing their dogs' stress. Your team members can help with these tips, tools and solutions.

First, recognize as a team that your time with pet owners in the exam room is limited. As you discussed in Part 2 of the meeting, your team can make great progress to identifying signs of stress and behavior problems in five minutes or less. But your communication about a pet's behavior doesn't end once the pet leaves the exam room. It should follow the pet and owner through the hospital and home again.

One caveat: remind your team to avoid offering behavior advice. Your goal is to start a conversation that helps your doctors and behavior experts create a behavior modification plan tailored to the pet and the owner.

To extend your communication with clients, consider these tips and tools you can use to keep connected with dog owners.

1. Send the pet owner home with handouts that explain signs of stress they can watch for. It's a nice touch to email these handouts to clients after their visit as well, with a short note that encourages them to reach out with any questions or concerns between visits. This is a great opportunity for any member of your team-receptionists, technicians, kennel assistants-to take a leadership responsibility in behavior.

2. Post educational videos on your website or social media or send links in your enewsletters that keep the topic of reducing pets' stress top of mind for clients. Watch these videos from dog trainer Mikkel Becker, CPDT, and discuss how you might use these in your practice. (Note: these videos vary in length from two to four minutes, so if you watch them as a team, plan a little more time to view all of them and discuss.)

Video: Stop stressing your dog!

Video: Why is your dog stressed?

Video: Downward-facing dog: Calming your canine

Video: Make car rides fun for Fido

Find an extensive list of behavior-themed client handouts to share with pet owners at dvm360.com/lowstress.

3. Brag about your efforts. This may be an uncomfortable step for your team, but every team member needs to have the vocabulary and education to be able to say what you're doing and how it's helping the pet stay calm.

For example, if your team decides to start offering treats to take the scary out of the scale, make sure you explain what you're doing-and why-to pet owners:

“Mrs. Smith, when Bingo has visited us before, he's been a little nervous stepping onto the scale. We want to make this a less scary experience for him, so we're going to offer him lots of treats to lure him onto the scale. With enough practice, we're hoping Bingo won't be so nervous. In fact, he may even learn to love it!”

As you model some of these lower-stress approaches, you're helping to educate pet owners about better ways to interact with their dog that don't involve fear or punishment.

Your team also needs to know about the medications, supplements and products you recommend-and possibly sell-so you can answer any questions clients have and offer support to make sure they're using these tools correctly for their dog's benefit. In Part 4 of the meeting, you'll discuss and review available products and talk about which ones your practice uses.

1-minute activity: Thank your team

Thank your team for their time and participation today. Clear, consistent communication with your team is a cornerstone of a good relationship. It can both help you preserve your relationship with clients and help clients keep good, positive relationships with their pets. In the next meeting, you'll discuss marketing and implementation ideas to make your lower-stress approach a success.

Part 4 resources

Download these handouts and tools before your team meeting:

• Part 4 Meeting guide: Explains the thinking behind the meeting and activities

• Part 4: Trainer's script: Step-by-step meeting dialogue

• Checklist: Lock in rechecks: 5-minute activity

• Canine behavior products: 3-minute activity

•Making referrals: A guide: 7-minute activity

• Behavior post-test: 3-minute activity

Part 4: Marketing and follow-through

Welcome your team to the final part of your four-part meeting on reducing dogs' stress. In this final meeting you'll pull all that you've learned together.

5-minute activity: Role-play how to lock in rechecks

Follow-up is key to managing behavior cases. Pass out the “Checklist to lock in rechecks.” Break into groups of two and use the list to practice scheduling follow-up appointments and manage phone rechecks to make sure pets and pet owners receive the behavior counseling they need. Have team members take turns being the client and the team member and practice responses that use the advice on the checklist. Ask them to think specifically about what they can say to clients to show encouragement and keep the momentum going with regular visits.

For more advice on the technician's role in behavior cases, check out dvm360.com/techbehavior.

Sometimes your team members won't hear about a behavior problem until the end of the visit, when you're walking the client and her dog to the front desk. Common issues dog owners mention at the last minute:

• Nuisance behaviors: barking, destruction, hyper activity, jumping up, rough play

• Fear: loud noises, gunshot, construction, fireworks, thunder

•  Upcoming lifestyle changes: vacation, new pet, new baby, family visiting, new roommate

•  Social behavior: hiding, growling at guests, clinginess

3-minute activity: Take a peek at products

Many products and tools are available to help pet owners manage their pets' stress. Pass out the handout, “Canine behavior products” to your team. This form is a brief overview of some of the categories of products your practice may choose to use or recommend to clients. Once your team has had an opportunity to review, take two minutes to discuss which products you use, how they work and whether you recommend or sell them to clients. Use the blank spaces to fill in the tools your practice uses or recommends. Then take a minute to discuss any products you don't currently use but may consider adding to your list.

7-minute activity: Difficult cases: What to do

When you let pet service providers, including dog trainers, leave their business cards on your front desk, you are unwittingly making a medical recommendation to clients. So it's a good idea to discuss the topic of referrals with your team and make sure your recommendations are consistent, thoughtful and intentional.

When the 2016 dvm360 Spectrum of Care Study asked “Do you have a behaviorist in your area to whom you feel confident referring patients with behavior issues?” only about 53 percent answered “Yes.” It's critical for your team to develop relationships with behavior experts so you can offer referrals.

All referrals are not created the same. Is a behaviorist is worth the money? A frustrated pet owner may reveal to you that they feel pushed to relinquish the pet if the behavior doesn't improve-it's too hard to live with the behavior, it's taking too long to see improvement, it's costing too much money. In those cases, sending a devoted client to yet another dog trainer to try again or try something different may be throwing more good money after bad, says veterinary behaviorist Dr. E'Lise Christensen. “It's relatively common for me to see patients who have cycled through up to six or seven different trainers over time,” Dr. Christensen says, “with clients spending thousands of dollars on behavioral interventions that don't work or are even contraindicated.”

Use this quick vocabulary guide to educate your team on the different levels of behavior issues and when you will refer patients to professionals in each of these categories. Pass out the team training tool “Making referrals: A guide.” Spend a few minutes discussing each of these professionals. Identify when you might refer to these professionals as well as specific people in your area who work in these fields. (Note: After the meeting, you may select a smaller group of team members to research the professionals in your area so you have a list of preferred professionals you consistently refer clients to.)

When should you refer to a veterinary behaviorist?

• The pet is a physical threat to people or other animals

• The pet is hurting itself

• The pet shows signs of a fear, phobic or panic disorder and doesn't show improvement after your treatment

• The client requests a referral

An important note: One of the most critical factors in handling behavior cases is maintaining a good relationship with your clients. If you fail to refer, make a bad referral or don't refer soon enough, you can damage your relationship. So take the time as a team to learn about the professionals in your area and identify the trusted professionals you choose to refer to.

3-minute activity: Behavior test

Take the pretest again to see how team members' knowledge and attitudes have changed through the course of the meeting. Distribute “Stress less: A behavior test.” Allow team members two minutes to complete. Spend one minute discussing your results, including how team members' attitudes have changed throughout the course of the team meeting.

1-minute activity: Thank your team

Close the meeting by thanking your team for their time and attention this week. Managing dogs' stress makes for happier pets, happier dog owners and happier veterinary visits. Taking the time to talk about behavior can preserve clients' relationships with their dogs-and with you, their dog's healthcare providers. You're now armed to take some of the stress out of dogs' lives-and that should help you stress less too!