There needs to be a shift in veterinary medicine, and it can’t happen too soon. It isn’t about the medicine. It is about the way we view our patients. And it is all about behavior.
A long time ago in a galaxy far far away, I earned a shiny degree in veterinary medicine and started work in small animal practice. I graduated into the culture of “dominance”, the lens through which we viewed all canine behavior. We held unexamined, unspoken beliefs that our canine patients should submit willingly and patiently to our various administrations, painful or otherwise. If they refused, they were being dominant or naughty, disrespectful of our authority over their bodies.
The result of this mindset is that we behaved in some appalling ways to the patients our clients entrusted us to treat. The dog that howled in protest when we tried to insert a rectal thermometer? He was restrained in a neck hold and told to be good. If he progressed to snarl and struggle? He was muzzled and restrained on his side with more, bigger, stronger people. If he protested yet more violently, he might have been pinned to the floor and yelled at by an impatient, frustrated veterinarian.
I have seen dogs hung up by their choke collars until their tongues turned gray in misguided attempts to punish them for struggling for a blood draw. I have seen veterinarians shaking muzzled dogs by the scruff of their necks, yelling at them to stop misbehaving. In one memorable sad case, I saw a dog who developed life-threatening noncardiogenic pulmonary edema shortly after particularly vigorous restraint for a nail trim. I have heard veterinarians and their staff call their canine patients assholes, jerks, idiots, piranhas, landsharks and a variety of other creative pejorative labels. I wish I could say that since it was a long time ago in a galaxy far far away, none of this ever happens now, but I still work in small animal practice, and I know it does. Even in practices that advertise with pictures of smiling vets being licked by happy dogs.
I am a vet with a specialty degree in critical care. Most of my ICU patients are too sick to complain about what we do to them; I don’t have a lot of dog wrestling matches these days. My recent little rescue dog came packaged with a host of behavior problems, sending me on an inquisitive search to understand them. I discovered that in the years since I have owned a new dog, there has been a change in comprehension of dog behavior, but misinformation abounds in the mind of the public and most veterinarians remain similarly ill-informed. I work with a lot of new interns, and while behavior is starting to be taught in veterinary college, there is still lots of work to be done to get vets up to speed.
It seems to me that many veterinarians are still blindly immersed in the now debunked dominance culture and have no training in normal canine behavior, a stunning oversight in veterinary education. This unfortunate combination leads to profound misunderstanding and stress on both sides of the exam table. Yes, both sides, because when you see through the dominance lens, you believe your struggling patient is deliberately misbehaving or worse, is malicious. Your own stress response is triggered, and a grim, escalating match of power and anger ensues.
Veterinarians don’t want to be bullies. They don’t want to yell at their patients and most are likely ashamed of themselves for engaging in aggressive dog wrestling, but they get drawn into a battle because they hold the belief that the dog is being “bad” and if they could only dominate the dog with physical or verbal power it would submit and be “good”. Patients become enemies. How crazy stressful is that to add to all the other issues a veterinarian can be stressed about?
Now, let’s imagine how much different these battle scenes could be. Imagine that veterinarians understood that the primal, evolutionarily honed response to fear is fight or flight and that almost all but the most well- socialized, cheerful kind of dog is experiencing anxiety and fear in the veterinary hospital. The flighty dog might submit in a learned-helplessness sort of way and cower passively until the horrible experience is over. The veterinarian will see that the quiet behavior is not because the dog is “good” but because he is frightened, can’t escape and has given up. That dog needs lots of help to feel more comfortable.
The fighty kind of dog will growl, snarl or snap in escalating attempts to make the scary person with a stethoscope, thermometer and sharp-stick-that-always-hurts-a-lot go away. The veterinarian’s heart might melt a little, recognizing the intense fear behind the scary snarling teeth. She would respond not by piling on more restraint and aggression of her own, but by backing off, reconsidering, searching to find a way to make this dog’s experience less terrifying. She would narrate to her less educated staff about how this dog is afraid, how this is fear, not a malicious character trait or a dog trying to avoid being “dominated”. She would understand too, that dogs do not come naturally to being touched, poked, prodded and handled. This is something most need to be taught.
Dogs who resist when their feet are handled, legs are restrained, tails jacked up or are being hugged tight by a stranger are being normal, evolutionarily well-adapted mammals whose innate response is to avoid body handling. They are not “weenies”, “wusses” or spoiled, ill-tempered cranks who need a firm hand or stern voice. They need intelligently applied classical conditioning to accept these administrations with no fear.
This is a message veterinarians with an understanding of behavior need to trumpet loudly and persistently to our colleagues:
“Most aggression in a vet clinic is fear.”
“Most aggression in a vet clinic is fear.”
“Most aggression in a vet clinic is fear.”
Dogs are afraid of you, your staff, the needle you have poked them with, the thermometer you put up their bum, the big barking dog next to them, the abdominal probing that could hurt, the stranger who holds them tightly. They associate your hospital with scary things. They want to get away or to make you go away, and that often looks like aggression. We need to change our language from “good” and “bad” to “comfortable” and “afraid”. Dominance as a paradigm has had its day.
The pervasive silent influence of the dominance mindset is getting in the way of us doing our jobs, of doing the best for our patients, of being the kind and caring veterinarians our youthful selves envisioned when we submitted our application to veterinary college. Let’s be a collective voice and kick dominance to the curb. Maya Angelou wisely says do the best you can until you know better. Once you know better, do better. When I graduated more than two and a half decades ago, we did not know better. Now we do. Let’s all of us do better.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.
ABOUT THE AUTHOR
Dawn Crandell DVM, DVSc, DACVECC
Student of The Academy for Dog Trainers
Dawn Crandell is a small animal veterinarian with a specialty degree in critical care, working in the ICU of a busy, urban referral practice. She also has an interest in animal behaviour and is currently immersed a 2 year course by the Academy for Dog Trainers.
