Episode 120: Fear Free for Puppies

We are joined by Maria Marano, a Registered Veterinary Technician, to discuss her work in helping puppies have positive experiences at the vet. Learn about Maria's experience as a technician, what a fear free vet entails for puppies, and what "happy vet visits" are.

There are also ways owners can prepare for vet visits to make the experience as low-stress for their puppy (and themselves) as possible. Listen to learn more!

Your Litter A to Z is the leading, science-based course for dog breeders. It includes expertly designed 18 modules, checklists, and reports that cover before breeding, getting your bitch pregnant, whelping your litter and raising your pups. If you're already a member of Good Dog, you can access the course here! And if you're not a member, you can join our community here.

Transcript

Mikel Delgado [0:23] Hello everyone, and welcome to this week’s edition of the Good Dog Pod. I am your host, Dr. Mikel Delgado, from Good Dog’s Health Standards and Research team. Today, we are here with Maria Marano. She is a registered veterinary technician who works in Ohio. She previously worked at the Ohio State University College of Veterinary Medicine, as both a technician and an instructor. She now works in a VCA clinic while also working in veterinary telehealth. Maria is both Fear Free and Low Stress Handling certified, which is why we thought she’d be the perfect candidate to discuss helping our puppies and dogs have good experiences at the veterinarian. Maria, welcome to the Good Dog Pod!

Maria Marano [1:02] Thanks for having me!

MD [1:05] Yay! We’ve been planning this for a little while, so I’m really excited to chat with you. I always start with “Tell me a little bit about yourself.” I like to get to know my guests a little bit, so maybe tell us how you became a veterinary technician and what you love the most about your job. 

MM [1:18] I originally, like many others like me, wanted to be a veterinarian. I loved animals from a young age, and I just thought that working as a veterinarian was the only thing you could do. I learned very quickly once I got into undergrad that that was not the case. I was exposed to some fellow students in the vet tech program and saw what they were learning, and I was like I like that. It just seemed really fun because we had animals at the school that we could interact with. It was definitely more hands-on than the veterinary path. I was just really attracted to it and ended up loving it, especially once I got into my clinicals.

MD [1:58] And you’re registered, right? So that’s not just showing up at a vet clinic and learning the ropes. You have to go through a lot more. 

MM [2:05] Exactly. I actually have my bachelors in animal sciences as well, so that was kind of the path that everyone follows to be pre-vet, and then I just continued on. I did a sub-major/major-specific in veterinary technology, so I have an associates and a bachelors. It was like: by day, doing my animal sciences degree; by night, doing my vet tech degree. It was very busy, but my last year of college was essentially externships where I was working as an RVT, preparing for my boards and everything while working in a clinic and getting the hang of it, my clinical skills. It was really fun! 

MD [2:46] What’s your favorite thing about your job? 

MM [2:48] There are so many things that I love about being a technician. I love seeing the human and animal bond happen in the room. There are so many times when I see a client come in with their pet and the way that they love them is so adorable. Today, I had a client that was being kind of harassed by her cat in the room. It was so funny! I can just picture them doing that at home every day. The cat’s begging her for food, and she’s like, “He wants treats!” Just seeing that interaction is so great, and I love seeing it, and I love being a part of it. 

MD [3:27] Very nice. You went above and beyond getting your registration as a vet tech and got certified in both Fear Free and Low Stress Handling. To do that, you obviously were interested in that concept. What really attracted you to going for that extra certification? 

MM [3:43] The Fear Free thing kind of attracted me in one of my undergrad classes, actually. We had a guest speaker who was a Fear Free certified dog trainer, and she came in to guest lecture one day. She started talking about how she works with veterinary staff on how to do training and behavior modification and extrapolate that to the veterinary clinic. I just thought that was the coolest thing. She did a demonstration in class, and I was like I like that; that is awesome. She just taught in a way that made me think and challenged me. After that, I sought out certification during a symposium. I went to an all-day 9-hour CE event and became Fear Free certified by Dr. Marty Becker, who was there speaking. It was really cool! Especially because I was still in school, so I hadn’t even graduated yet, but I just knew it was something that I was really interested in. After that, once I was in practice, it essentially became a requirement for my job at Ohio State. I just kept up my certification there, and they gave me the opportunity to do the Low Stress Handling University. 

MD [5:04] We’ve had Marty Becker on the podcast and in a webinar for Good Dog before, so we’re big fans. He’s a great guy. 

MM [5:10] He’s super fun! 

MD [5:12] He’s really fun, yeah. Definitely fun. Let’s talk about puppies! That was really the reason we wanted to get you to come chat with us, to talk about that formative stage. We want our listeners to be able to provide their dogs with lifelong medical care. We don’t want it to be a bad experience. We know that for a lot of pet owners, giving their pets medical care, getting them to the vet clinic, giving them pills/injections can be really stressful. We want to help our breeding community know what they can do before their puppies even go home to set them up for success. Do you have some suggestions for our readers when they’re raising those puppies? What can they do to help them be good patients in the future? 

MM [5:54] There’s a ton of different things that breeders do that impact the pets lifelong. One of the things that I wanted to mention is even before your puppy exits their mother’s womb, there are things that they can do. There are studies that show that prenatal stress does play a factor in puppy behavior and future anxieties and things like that. Keeping mom calm, comfortable, happy, and vibing is kind of the best thing they can do while the puppies are not even born yet! That’s one thing that happens way early on. I want to mention that a lot of people think socialization is this thing that happens lifelong, but it really is a period during 3-12 weeks of age. Those weeks 3-8—8 weeks being when most puppies go to a new home—it’s super important that they have positive experiences to novel things. The most important thing I want to say is having positive experiences. We like to say neutral is not good enough! If they’re having a neutral experience, it’s not good enough. It needs to be positive.

MD [7:04] Let’s dive into that a little bit, because I think a lot of the dogma (no pun intended) about puppy socialization was just that they have to have a lot of experiences. They have to meet 100 people. They have to experience 100 different things. Like you mentioned, that might be a neutral or even scary or negative experience. How can people ensure that meeting a new person, hearing a blender for the first time, hearing the doorbell—that that can be positive instead of neutral or scary? 

MM [7:33] It can be really difficult because it takes a lot of controlling the whole environment, which sometimes we can’t do. Nobody is perfect, but we want to do our best, especially during those weeks. Exposing them to different things and having that be a positive experience by coupling it with food, treats, toys or redirecting and slowing it down can be a thing that you can do. They definitely don’t need to meet 100 different people. I think that sometimes people who have really good intentions, especially new puppy owners, are like, “I want my dog to love everybody, so I’m going to show them all these people and all these things!” But what happens is that they can get really overwhelmed. Those neutral experiences, which already aren’t good enough, become negative experiences. And then they become fearful of those things in the future. So it’s really easy to overwhelm a new puppy, especially when this puppy just got off a flight, it just left all of its littermates for the first time, and now you’re taking it in, and it’s just sitting there like Oh no! What is happening? I think it’s really important to advocate for your puppy and take it slow and say, “I think my puppy is a little bit scared. Can we approach a little bit slower or can you please offer this treat when you approach? Or can you let my puppy approach you first?” It’s really important to, as a pet owner, be an advocate for your baby!

MD [9:04] I agree, 100%. It’s such an important thing, and people aren’t always comfortable. I mean, we’re not always comfortable doing it for ourselves. Maybe it’s easier to do it for our puppies, because we do want to protect them. So, I always remind people: People want to pet your puppy. Your puppy is very cute. Strangers are going to come up and ask if they can pet your puppy. You don’t have to say yes every time someone asks if they can pet your puppy or pick them up. We can say no. Always keep in mind what’s best for your puppy and how your puppy is doing. I think that’s great. Thinking of the veterinary setting, let’s translate that to not just socializing them to people or social experiences, but the big experience of going to the vet, which hopefully they don’t have to do a lot in their life. They probably need a few visits when they’re puppies, because they have a lot of vaccines they need, but hopefully not until they’re older do they need more frequent visits than yearly. But there’s something called a happy visit. How does that work? How can someone give their puppies happy vet visits?

MM [10:00] Some clinics might define happy visits differently, but in my experience, what we do with happy visits are vet visits where—I don’t want to say nothing happens because things are happening. But nothing scary happens. Or at least we try to limit the scary things. Absolutely no pokes. If the pet is really afraid of the scale, we don’t get on the scale or maybe we just have to stand next to the scale or look at the scale or lick some cheese off the scale. No pokes, no negative experiences. Only positive things happen, and then you leave! This shows our puppies, and even our adult dogs, that sometimes when you come in, these weird people just give you snacks and then you go. You don’t always get pokes. Lots of offices will offer happy visits for free or at a very low cost, like X amount of happy visits are for free. If you are looking for a new vet clinic and you’re a new puppy owner, I would call and just ask. “Can I bring my puppy in for a happy visit before I come in and schedule its first shots?” You can do your own happy visits, especially if you have an adult dog that is too afraid to even enter the hospital. We’ve recommended clients come in, drive into the parking lot, walk around the parking lot, and then turn around and go home. Sometimes that really helps. You just have to tailor it to your specific pet or your specific patient, but that’s what a happy visit is. 

MD [11:28] Is everyone in the clinic like, “I’ll do the happy visit! I’ll do the happy visit!”?

MM [11:30] That’s the thing. We can overwhelm puppies by doing that, too. So everyone is like, “A happy visit. That’s easy. I just have to go feed treats, right?” But then you have 5, 6, 7 vet assistants come in and do the happy visit, and you can tell the puppy is like Oh no. More people! My colleague and I call each other the puppy police, because when we used to work with students at Ohio State, they would bring in a puppy. They’d bring it to the back and have it in their arms and be like, “Look at the puppy!” and then all of our 18 students would be like, “Puppy!!” We’d grab the puppy and we would say, “You can’t pet the puppy unless you give it a treat.” Everyone, jokingly, called us the puppy police because we don’t want any shut-down puppies at our clinic.

MD [12:19] I can see how easily that would get out of hand. There’s a lot of squealing humans excited about the puppy, and the puppy is not happy. So it’s not thoughtless, just bring the puppy in. Wheee! It’s really more of a controlled experience in an ideal world. Let’s talk about at home preparation. There are some common areas that dogs might need to be touched throughout their lives: their ears, their paws for nail trims. What are some ways that owners can help prep their puppies and dogs for this in a positive way at home?

MM [12:49] There are a lot of different things that owners can do. Again, I feel like the theme of today is neutral is not good enough. I do see a lot of clients who have really, really good intentions. We do that puppy nail trim, and they’re tugging on their foot, even though they’re getting snacks, and they go, “I don’t know what’s going on. I play with his feet at home.” I think something that’s really important is to make sure that you’re not just playing with its feet over and over again until he is hating it, right? Instead of desensitizing them to it, you’re sensitizing them to it. You want to keep the sessions just like training sessions: short, positive, end on a good note, things like that to make sure that the handling doesn’t become scary or uncomfortable for them. It becomes fun. Some specific areas that I see that we need to handle a lot that are difficult to handle are paws (obviously; toenail trims are one of the biggest phobias in pets) and ears (can be really hard, especially in patients that have recurring ear infections like Cocker Spaniels, Golden Retrievers, dogs that will typically need to have their ears handled if not for ear infections just for regular maintenance because of the breed). Their bum is a really difficult one. We have a lot of pets that are really like, “Don’t touch my bum!” They get rectal temped, and they seem to tolerate it at first, but then it becomes really difficult. Looking in the mouth can be really hard for a lot of pets, and then looking in the eyes is hard for a lot of pets. Focusing on those things and pairing it with desensitization all the way up to cooperative care where it’s almost like hands-free they are consenting to this thing. “I give you my paw and then I eat the treat, and you trim my nails,” almost like a zoo animal pretty much. Again, neutral is not good enough. Good things only. Positive things only. That’s the rule. 

MD [14:58] That’s great. We all have to do our best. It’s not like something that happens overnight. It takes time and practice. You touched on this a little bit, but when animals are scared of the vet clinic, they have a stressful experience at the vet. Then we know the owners are much more hesitant about bringing them into the vet in the first place. They’ll delay, postpone care. If your dog is already afraid of the veterinary office, what can we do to get them feeling better about the experience?

MM [15:23] There’s a lot of different things that people can do to help pave that road between “I had all these negative experiences and now I don’t even want to enter the hospital.” It’s hard because it limits their care. Pet owners don’t want to bring their pet in, because they don’t want to see their pet scared or they are embarrassed by how their pet is acting, or they think their pet is the only one that acts that way. If you’re listening, that’s not the case! You are not the outlier! You are not alone. My dog is afraid of the vet. Even if you think about the portrayal of veterinary medicine in pop culture, it perpetuates that. Any time you see the veterinarian in pop culture, we’re evil. We’re scary. The dogs are hiding under the chairs in cartoons. I think that’s just going to take time to change. As far as having pets work on those fears and phobias, really coupling with a veterinarian that is committed to lifelong care for your pet and having them have the best experience possible. Maybe that doesn’t mean that they come in and consent to everything we’re done, but maybe that just means that it’s not a terrifying thing that they are dreading and they put the brakes on when you walk in the door. Doing things like happy visits or working on desensitization and counterconditioning at home—the other 364 days that you’re not at the vet—and working with your veterinarian on doing some telehealth visits for things that don’t need an in-person visit or when you do need an in-person visit, have a handling plan so your pet knows what to expect. Utilize event medications to make that visit a little less scary. We have pets that we sedate every time. We see over time that they become less and less fearful of the vet because they are having not as many negative experiences. 

MD [17:32] Those experiences aren’t as extreme either. 

MM [17:35] There are studies that show that patients’ fear at the veterinarian does worsen over time. If we keep having bad experience over bad experience over bad experience, then it’s just continuing to get worse. A lot of veterinarians want to make your life easier and want to give your pet good care, so sometimes it just takes a bit of advocating and asking questions.

MD [18:02] Great. I would love to hear an example of how you’ve seen Fear Free in action at your clinic and what it can do for both dogs and veterinary staff.

MM [18:53] I could talk all day about all the Fear Free wins that I have. They’re so great! I submitted a couple of stories to the Fear Free blog, so you might see a couple of my stories on there. One that comes to mind is we had a dog that reached out to us when I was working in community practice at Ohio State. We work really closely with the behavior department there, so sometimes we would get a lot of cases that had been fired from previous clinics, our really high-end behavior cases. 

MD [19:26] When you say fired from another clinic, the veterinarian says, “Don’t bring your dog back”?

MM [19:30] Yes. “We will no longer see you.” Which is really sad, right? But I think that that’s because they just didn’t have the tools or the experience to handle a patient that was as fearful as this pet. So, luckily, we were there. They had sought out behavior services, which is great. We had come up with a handling plan. This dog was 5 years old and had never had blood work, had never had a full physical exam in its entire life! He came in on top dosage of all the preventative event medications that he could come in on. He came into the parking lot, and he had to park in the large animal parking lot, because the small animal parking lot was a no-go for him. He came into the large animal parking lot, basically on the side of the building where no one else was. He had on a calming cap, which is (if you’re not familiar) something that goes over their face and covers their eyes, which doesn’t completely block out their view, but it lowers that visual stimuli. We weren’t able to go out to the car. The owners actually Zoomed us in the room. The dog was on an amount of drugs that meant he should’ve been asleep, and he was up and looking (even though he had the calming cap on). He knew something was up. We had given the owners a drug called Dormosedan, which is actually I believe for horses, but we use it in certain dosages in dogs, oral transmucosally, so it absorbs by them eating it. That takes about 90 minutes for onset. So we got him to the point where he was sleepy enough for us to give him an injectable sedation. This entire time, we’re on Zoom with the owners, and we’re like, “Is he sleeping yet? Make this noise. Okay, he’s not asleep yet.” It was a very time-consuming appointment. We eventually got him sedated enough to where he was laying in the backseat and non-ambulatory able to lay down and safe to handle. That was the biggest thing. This dog was not safe to handle unless he was sedated. I walked out there with my colleagues, and we had a gurney, and we had planned to move him into the hospital to perform all the things. Game-time decision, we all look at each other, and we’re like, “Let’s just leave him in the car. Why do we need to bring him into the hospital? This is silly.” So we brought all of our stuff and things. My doctor was able to do a full physical exam. She was able to look in his mouth, in his eyes, in his ears, listen to his heart, his lungs, feel his abdomen, do a rectal (on a 5-year-old dog, that’s really important), and just do the best physical exam while he slept through it. We gave vaccines. I drew blood. We reversed him, and they drove off. I just still remember being out there next to their car, and after we had finished everything, we all did this silent little happy dance. The owners were so, so grateful because this dog had never had vet care before. Now we had all of these things. We were able to know your dog is healthy and do your dog’s blood work, and the best part of it is we had a plan that works for the future for your dog. The owners, again, were just so thankful. They were in tears. They were so thankful and grateful that we gave their dog a chance and worked with what he needed from us. That’s one of my favorite stories because we were able to care for a pet that had otherwise had the door closed on them or had not been able to receive proper vet care because he was so afraid. That’s one of my favorite things that makes all the hard days worth it. 

MD [23:51] That’s a great example because it’s not just a one-size-fits-all approach that is Fear Free or Low Stress. It is really tailoring the approach to that animal. Sometimes it means medication. Sometimes it means training. Sometimes it means managing the environment or changing human behavior, so that’s really beautiful. That leads me to a question. I’ve encountered this a lot doing behavior work and training and working in different environments, veterinary and non, in shelters, which is the resistance to the concept of Fear Free or Low Stress in that it’s too difficult; “we should just hold them down and get it over with” or “it takes too long and is not necessary,” etc. I’m curious what kind of resistance you see to the concepts of Fear Free and Low Stress handling in both the veterinary clinic and also from pet owners.

MM [24:41] Unfortunately, you’re right. There is a lot of resistance to Fear Free. I’m hoping that it is just because this is a new thing in veterinary medicine. This is cutting-edge stuff. There’s always going to be the people who are like, “Well, we used to do it this way” or “This way is better because this is how I’ve always done it.” There are a lot of things that people just have a lack of understanding of what Fear Free truly is. They maybe haven’t seen it in action or have seen people say that they’re practicing Fear Free and then it’s not really. Some people think that Fear Free equals no restraint at all, which is not true, so they have a resistance to it for that reason. Others—and I don’t find this in the veterinary setting often from veterinary professionals—some owners are just old fashioned, and they feel that he’s just a dog, and “You don’t have to do all that for him; just give him his vaccine. It’s fine.” Others have been doing things that way for so long that they don’t want to change, or they’re afraid of change. Some feel like it takes too much time. Owners are often, like I said, embarrassed of how their pet acts, so they’d rather just get it done and over with. The busy day-to-day pushes the time. They don’t want to have to come back, or they don’t want to have to make multiple appointments, or they don’t have the time to work on training at home. Others have fallen into the outdated dominance theory kind of thing, where they think “I’m not going to let him boss me around. I’m not going to listen to my dog.” Or they scold him for growling or something like that. I think the way that I found works for me is I continue fighting the good fight and continue doing what I do. Almost using Fear Free and Low Stress handling on the people I interact with. Extrapolating that to humans and, instead of saying, “This is a better way; we’re going to do it this way,” just saying, “I have an idea! Do you mind if I show you this?” or “What if we tried it this way?” or “Humor me. Let me see. Let’s try this.” Just having a really open, transparent conversation with people but getting to the root of things. Sometimes owners don’t want to sedate their animals because sedation is scary! Maybe they had a pet have a negative experience under sedation or something like that. Just having an open, transparent conversation and saying, “I’m sensing some hesitancy. Can you tell me what you’re nervous about? Tell me what the restraint is. Are you really busy and have three kids and two jobs and you took vacation to come in here today?” I think it’s really important just to be really transparent and see what’s holding them back and try to work with that.

MD [27:42] You’re setting a great example through your writing for Fear Free and your strong communication skills and the example you set in your clinic, so that’s all fantastic. As we get ready to conclude… She’s been present for this interview, but we’ve not heard from her. Maybe you would like to tell us all about Momo, the Chinese Hairless Crested. 

MM [28:03] Miss Momo! I call her the Chinese Crestless because she’s a 3-pound, completely hairless dog, apart from one shoulder tuft of hair. She’s my baby. I happened upon her. I was working in a clinic, and we had a client who got her at 8 weeks and then wanted to move. I ended up with her. It was funny because when I was younger, I always said that I wanted a Great Dane. 

MD [28:36] Now you have a 3-pound dog! 

MM [28:38] Yes, I know!! My mom was like, “I like those hairless dogs. They’re cute!” And I was like, “No. They’re so ugly. I hate them, and I want a big dog. Down with the little dog!” I was so not a little dog person, and here I am. I find myself to be a little dog person now. She is just a little spitfire. She definitely has some sort of American or Mexican Hairless Terrier in her because she is so little, but she has so much personality. She will tell you off. She’ll tell it like it is. But she is just the cutest little nakey baby, and I love her. 

MD [29:18] Excellent. Well, I think that’s a great way to end this. I’ve seen Momo. She’s very cute. I think she’s online. Does she have an online presence?

MM [29:25] She does have an online presence. She has a Facebook page: Momo the Chinese Crestless, and her Instagram page is lifesa_peach (because Momo means peach in Japanese).

MD [29:40] Ah, that makes sense. So, if you want to see Momo for yourself, you know where to go. Well, thank you so much Maria, for taking the time to chat with us today about Fear Free and puppies and helping our dogs have better experiences. I wish that everyone could see what I’m seeing right now, because Momo is spectacular. Thank you again!

MM [29:59] Thank you so much for having me!