Desensitisation courses
Longer-term treatment includes a desensitisation course, during which a VN will work with the patient and owner on specific areas of anxiety. The course should ideally span a minimum of 4 weeks, as this has been found to improve signs of fear [ 14 ]. However, as Stellato et al. [ 14 ] conclude, further research should explore the effects of longer and more intense sessions, tailored to the individual dog ' s progress. A desensitisation course should be used only if the dog ' s anxiety is solely associated with the veterinary practice; if there are broader behavioural issues, these should be addressed by consultation with a canine behaviourist or veterinary-qualified behaviourist before proceeding.
The first session should be outside the practice, if possible, to reduce the first interaction being heavily associated with the practice. This allows the interaction to be on more neutral ground. The use of high-value treats to create a positive association combines desensitisation with counterconditioning. Using positive reinforcement in this way allows the VN to train the dog to allow touch, and over time this can be extended to being touched with veterinary equipment, such as a stethoscope.
As described by Landsberg et al. [ 15 ], positive reinforcement is the presentation of a stimulus immediately following a desired behaviour, thereby increasing the likelihood of the desired response being repeated. The use of a high-value reward will increase the dog ' s motivation to provide the‘ correct’ response.
This method can be linked to classical conditioning, which was famously studied by Ivan Pavlov in 1849. Classical conditioning consists of pairing a positive stimulus, for example, a favoured food, with a neutral stimulus and a response, until the neutral stimulus alone produces the response. In Pavlov ' s experiment with dogs, a ringing bell( the neutral stimulus) became associated with a response( salivation) even once the positive stimulus( food) was no longer offered [ 16 ]. Whereas conditioning actively builds an association from scratch, counterconditioning aims to change an existing negative association into an opposite, positive one.
Not all dogs respond to the same behavioural correction methods. Dogs with a high food drive are found to be more receptive in desensitisation clinics if treats are used as a reward, because they gain satisfaction from the treats given( Figure 1). In dogs without a high food drive, using their favourite toy or ball instead may produce positive results.
The following sessions are dependent on the presenting issue. For some dogs it is simply walking through the practice doors, which should be‘ desensitised’. This involves walking around the practice, slowly decreasing the distance between the dog and the practice doors with each lap. The next step involves bringing the dog into the reception at a quiet time, to try to prevent hitting the dog ' s behaviour threshold. Owners will have different goals for their dogs. For some this will be for their dogs to be examined and for others it could be fear-free blood sampling or being neutered.
Figure 1. Treats can be helpful in providing a positive association with the veterinary practice.
46 Veterinary Nursing Journal