– for example , posters or handouts in waiting areas – on choosing a safe and sturdy carrier , or opting for a quieter mode of travel , where possible , such as a taxi rather than public transport .
Ultimately , however , some stress factors will be outside our clinical control , furthering the need to reduce any stress experienced by patients on arrival to the clinic and during their stay . If a patient comes into the practice already stressed , and particularly if the animal is already unwell , the aim should be to reduce any further stress as much as possible to minimise any associated detrimental physiological effects [ 4 ] .
Attachments and interaction
Veterinary staff spend a lot of their time interacting with patients , particularly hospitalised patients . There has been a great deal of research into the formation of attachments between dogs and caregivers , and how this can have a positive emotional impact on patients . A study by Mariti et al . [ 5 ] demonstrated the positive and calming effect that clinical staff can have on patients when staff have an awareness of the stress the patients may be experiencing . Furthermore , Gácsi et al . [ 6 ] outlined how quickly attachments can form between dogs and their caregivers , suggesting that an attachment between a dog and veterinary staff can form quickly and be beneficial to the dog ' s wellbeing , particularly if staff spend time on social interaction with the dog . Awareness of this relationship can be used to create a more positive environment for hospitalised patients , which may be subject to unavoidable stress caused by the increased duration of separation from their owners and / or other animals in the household . This separation anxiety will also be a contributory factor to ‘ stressor stacking ’.
As patients can form close bonds with alternative caregivers , adding social interaction to our hospitalised patients ' routine could help minimise the effect of social anxiety . This could be through general interaction with patients , such as stroking or grooming them , or , if appropriate , using toys and playing with them . Increasing social interaction with a patient and factoring in time for play could reduce separation anxiety . Although this could be a valuable part of a patient care plan or daily hospital plan , there are likely to be limitations due to the caseload of the practice and availability of staff . However , even small changes to allow interaction with a patient should create a more positive experience for them .
Environmental enrichment
Enrichment is the addition of a stimulus to the environment , with the aim of improving psychological and physiological welfare . If we are trying to make the veterinary environment as comfortable as possible for our patients , environmental enrichment should be a strong consideration . A study [ 7 ] carried out in a dog shelter concluded that dogs provided with an enrichment programme demonstrated an increased number of desirable behaviours and fewer stress / anxiety-related behaviours compared with those that did not receive the enrichment programme . The enrichment programme included food-filled toys and twice-daily training .
Although the enrichment programme outlined in the study is not something that could be implemented in a veterinary practice , as daily training would not be feasible , there are other ways to add enrichment to the patients ' environment to reduce anxious behaviours . For example , when feeding patients , dogs can be provided with a slow feeder or food-filled Kong toys ( Figure 2 ); cats can be fed with small frequent meals , or have food hidden around their kennel to mimic their natural feeding behaviours and provide mental stimulation [ 8 ] . These types of programme benefit the patient , client and the staff [ 9 ] , and help to improve patient wellbeing and welfare .
Figure 2 . Food-filled toys can provide enrichment for dogs .
Olfactory enrichment
Pheromones are chemical compounds produced naturally by animals to promote positive physiological and behavioural effects . The use of pheromone therapy has become more prevalent in recent years , with products such as Feliway and Adaptil being available . Feliway is a synthetic pheromone , similar to the pheromone released by cats when marking an object [ 10 ] . Adaptil is a synthetic ‘ dog-appeasing ’ pheromone , similar to the pheromone released by mothering bitches to calm and reassure their puppies [ 11 ] . Another product , Pet Remedy , uses natural essential oils in low concentrations , but is potent enough to produce calming effects [ 12 ] .
A number of studies have demonstrated the efficacy of these therapies across a variety of situations , including groomers and rescue centres , as well as clinical settings . For example , a study by Vaghela [ 13 ] concluded that the use of Pet Remedy reduced the number of stress-type behaviours . Pet Remedy products are available in multiple forms , including sprays , plug-ins and wipes , making implementation easy , cost-effective and non-invasive .
30 Veterinary Nursing Journal