69,99 €
Mehr erfahren.
- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Cooperative Veterinary Care A new and improved edition of the original guide to veterinary care and husbandry putting the emotional welfare of animals first Every pet needs medical care in the veterinary clinic and husbandry at home. Fear and stress can present significant barriers to good care while also compromising safety for animal care professionals and pet owners. It's possible to help pets learn to allow and even willingly participate in veterinary care, husbandry, and grooming. With a foundation in learning theory and emphasizing practical techniques, Cooperative Veterinary Care is a groundbreaking guide to encouraging voluntary participation in veterinary care. Now updated to reflect the latest research and clinical information drawing on years of professional hands-on experience, it's a must-own for any small animal practice or pet professional looking to increase patient comfort and facilitate excellent care. * Foundations of learning and training to prepare any professional to get started right away * Unique exploration of the veterinary environment and how Cooperative Veterinary Care can help * Integration of the Fear Free(sm) Spectrum of Fear, Anxiety & Stress to quantify patient experiences * Step by step training plans for veterinary care and husbandry with photo and video demonstrations * Practical applications for all common procedures. * Foundation techniques which can be expanded to virtually any veterinary care or animal husbandry and grooming need Cooperative Veterinary Care is written for the veterinary professional team but will help anyone and everyone who cares for and interacts with pets.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 587
Veröffentlichungsjahr: 2024
Ähnliche
Table of Contents
Cover
Table of Contents
Title Page
Copyright
Preface
Acknowledgments
About the Companion Website
1 Introduction to Patient Centered Veterinary Care
1.1 First, Do No Harm
1.2 Stress, Fear, and the Veterinary Clinic
1.3 Freedom, Wants, and Needs
1.4 Iatrogenic Behavioral Injury
1.5 Focusing on Welfare Rather than Animal Restraint
References
2 Perception and Communication
2.1 Sensation and Perception
2.2 Stress and Fear
2.3 Body Language
2.4 Causes of Stress in the Veterinary Setting
References
3 Learning, Conditioning, and Training
3.1 Classical Conditioning
3.2 Operant Conditioning
3.3 Habituation, Sensitization, Desensitization, Counter Conditioning, and More
3.4 The ABCs of Behavior
3.5 Fundamental Training Skills
3.6 Conclusion
References
4 Successful Visits: Environment and Protocols to Prevent Fear and Stress
4.1 Setting Up for Success: Before the Visit
4.2 During the Visit
4.3 Happy Visits and Other Preventative Planning
4.4 Hospitalization, Treatments, Diagnostics, and Boarding
References
5 Type One Patients and Training: Distraction Techniques and FAS 0–2 Pets
5.1 Introduction to the Types of Training
5.2 Identifying Type One Patients (FAS 0–2)
5.3 Type One Training: Dog Exam Room and Examination
5.4 Type One Training: Cat Exam Room and Examination
5.5 Type One Training: Injections and Sample Collection
5.6 Administering Medications and Grooming
5.7 Conclusion
References
6 Type Two Patients and Training: Conditioning Plans for FAS 0–3 Pets
6.1 Type Two Training: Desensitization, Counterconditioning
6.2 Identifying Type Two Patients (FAS 2–3)
6.3 Type Two Training: Dog Exam Room and Examination
6.4 Type Two Training: Cat Exam Room and Examination
6.5 Type Two Training: Injections and Sample Collection
6.6 Administering Medications and Grooming
6.7 Conclusion
References
7 Type Three Patients and Training: Incorporating Operant Techniques, FAS 0–5 Pets
7.1 Type Three Training: Incorporating Operant Techniques
7.2 Identifying Type Three Patients (FAS 4–5)
7.3 Preparing to Train
7.4 Making a Training Plan
7.5 Getting Started: Reinforcement, Stillness, Approaches, Target, and Station
7.6 Teaching Consent, Touch, and Restraint
7.7 Muzzle Training and Protected Contact
7.8 Physical Examination Training
7.9 Treatments, Sample Collection, and Imaging
7.10 Grooming
7.11 Additional Consent Options
7.12 Type Three Cats
7.13 Conclusion
8 Additional Patient Resources
8.1 Introduction
8.2 Nutraceuticals and Pharmaceuticals
8.3 Professionals and Their Roles
References
9 Implementation Strategies
9.1 Change Is Never Easy
9.2 Proposing Change
9.3 Overcoming Obstacles: Common Concerns and Questions
9.4 Making Change for the Right Reasons
9.5 Conclusion
References
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 The Five Freedoms.
Table 1.2 Steps for planning treatment.
Chapter 2
Table 2.1 Sensation: vision: a summary of human, canine, and feline visual s...
Table 2.2 Sensation: hearing: a summary of human, canine, and feline auditor...
Table 2.3 Canine body language: comparison of body language indications conn...
Table 2.4 Displacement behaviors: examples of behaviors that may communicate...
Table 2.5 Feline body language: comparison of different signals associated w...
Table 2.6 Label replacements to use during conversation and in the medical r...
Chapter 3
Table 3.1 Example reinforcement hierarchies: Individual preference and the c...
Table 3.2 Primary and secondary reinforcers: Primary reinforcers require no ...
Table 3.3 The four factors of stimulus control.
Chapter 4
Table 4.1 Checklist for scheduling appointments.
Table 4.2 Reception and lobby checklist.
Table 4.3 Exam room preparation checklist.
Table 4.4 Puppy wellness visit discussion topics.
Table 4.5 Kitten wellness visit discussion topics.
Table 4.6 Most common unwanted behaviors according to owners surrendering do...
Table 4.7 Most common unwanted behaviors according to owners surrendering ca...
Table 4.8 Checklist for procedures outside the exam room.
Chapter 5
Table 5.1 Checklist for Type One dogs: each dog assessing at Type One should...
Table 5.2 Checklist for Type One cats: each cat assessing at Type One should...
Table 5.3 Least invasive first: One possible examination order.
Chapter 6
Table 6.1 Checklist for Type Two dogs: each dog assessing at Type Two may ha...
Table 6.2 Checklist for Type Two cats: each cat assessing at Type Two may ha...
Table 6.3 Desensitization and counterconditioning worksheet: a basic templat...
Table 6.4 Desensitization and counterconditioning worksheet for subcutaneous...
Table 6.5 Desensitization and counterconditioning worksheet for ear cleansin...
Table 6.6 Desensitization and counterconditioning worksheet for nail trims....
Chapter 7
Table 7.1 Checklist for Type Three dogs: each dog assessing at Type Three ma...
Table 7.2 Checklist for Type Three cats: each cat assessing at Type Three ma...
Table 7.3 Type Three training plan worksheet: this is a basic template for t...
Table 7.4 Sample of a possible Type Three training plan to introduce station...
Table 7.5 Sample of a possible Type Three training plan for session 2 of 3 f...
Table 7.6 Sample of a possible Type Three training plan for session 1 of nai...
Chapter 8
Table 8.1 Breakdown of professionals recommended by the authors and their qu...
Chapter 9
Table 9.1 Sample proposal worksheet: A worksheet to guide proposals for chan...
Table 9.2 Risks, benefits, and associated costs with sedation for otitis tre...
Table 9.3 Developing a behavioral standard of care.
Table 9.4 Flipping the script.
List of Illustrations
Chapter 1
Figure 1.1 Relaxed dog accepting food in the exam room.
Figure 1.2 The same dog shown in Figure 1.1 when restraint is applied. Note ...
Figure 1.3 Chloe, a young puppy, displays avoidance behaviors when asked to ...
Chapter 2
Figure 2.1 The vomeronasal organ location in the domestic cat. This organ is...
Figure 2.2 Color vision. Color vision based on anatomy of the eye. Top left:...
Figure 2.3 Field of vision. From left to right, human, dog, and cat field of...
Figure 2.4 Comparison of canine eye set and head shape. Different head shape...
Figure 2.5 Equipment that may sound different or startling to animals in the...
Figure 2.6 Sensitivity to touch in dogs. Darker shaded areas are often more ...
Figure 2.7 Sensitivity to touch in cats. Darker shaded areas are often more ...
Figure 2.8 Flight response. This dog is fleeing from a fear-provoking stimul...
Figure 2.9 The Fear Free
sm
Spectrum of Fear, Anxiety and Stress for dogs. Co...
Figure 2.10 The Fear Free
sm
Spectrum of Fear, Anxiety and Stress for cats. C...
Figure 2.11 (a and b) Two relaxed canine patients.
Figure 2.12 (a) The dog is nervous about touching. (b) Touching is paired wi...
Figure 2.13 (a and b) Two mildly stressed dogs.
Figure 2.14 (a and b) Two moderately stressed dogs.
Figure 2.15 (a and b) Two severely stressed dogs.
Figure 2.16 (a and b) Two relaxed cats.
Figure 2.17 (a and b) Two mildly stressed cats.
Figure 2.18 (a and b) Two moderately stressed cats.
Figure 2.19 (a and b) Two severely stressed cats.
Figure 2.20 Trigger stacking occurs when stressors build one after another, ...
Figure 2.21 By providing more pleasant than unpleasant experiences in the en...
Chapter 3
Figure 3.1 Roadmap of interventions. Dr. Susan Friedman’s guideline for leas...
Figure 3.2 Classical conditioning in the veterinary hospital. The neutral st...
Figure 3.3 (a) Classically conditioned gag response. (b) Classically counter...
Figure 3.4 Operant conditioning. A visual representation of the quadrants of...
Figure 3.5 (a and b) Clickers are a tool often used in marker-based training...
Figure 3.6 (a and b) Cutting treats into tiny pieces helps make the food eas...
Figure 3.7 Mechanics of marking and delivering rewards when introducing mark...
Figure 3.8 The steps of desensitization. Desensitization is generally used i...
Figure 3.9 Sensitization and habituation. When a stimulus remains the same, ...
Figure 3.10 Classical counterconditioning. Counterconditioning replaces an u...
Figure 3.11 (a and b) Differential reinforcement of an incompatible behavior...
Figure 3.12 ABCs. The antecedent, behavior, and consequence breakdown for en...
Figure 3.13 Flow chart to improve food acceptance. Animals will not accept f...
Figure 3.14 (a–c) Primary reinforcers include food for most dogs and cats. M...
Figure 3.15 Correct luring means the animal is willing to move freely toward...
Figure 3.16 Stepping stones. When luring, shaping, or trying to achieve any ...
Figure 3.17 Cue transfer steps. A known behavior can be placed on a new cue ...
Figure 3.18 A variety of objects used to train nose targeting.
Figure 3.19 This dog is targeting the trainer’s hand with his nose.
Figure 3.20 This cat is targeting the stick with her nose.
Figure 3.21 A variety of objects used to train paw targeting.
Figure 3.22 (a–c) Three different stations. These are just a few examples am...
Figure 3.23 Nail boards are an alternative to conventional nail trimming.
Chapter 4
Figure 4.1 CALM or FEAR? Patient assessment is complex and fluid. Use these ...
Figure 4.2 Patient-handling plans. This detailed algorithm outlines planning...
Figure 4.3 Reception area. (a) Divided waiting area at Mile High Animal Hosp...
Figure 4.4 Keep a variety of treats near the scale, and assure the scale has...
Figure 4.5 (a–c) Nonslip surfaces should be provided in the exam room, as we...
Figure 4.6 (a–b) Using carriers with quick-release clips and alternate openi...
Figure 4.7 (a–c) Choose a place where the cat is comfortable, such as in a s...
Figure 4.8 Happy visits help build positive associations with the veterinary...
Figure 4.9 Puppy classes help build skills such as housetraining to set up p...
Figure 4.10 Treat flowchart. Each major change in the environment, such as g...
Figure 4.11 (a–c) Dogs using food toys in the hospital.
Figure 4.12 Examples of hiding places for cats in the hospital.
Figure 4.13 Partially covering the door of a kennel gives the cat an option ...
Figure 4.14 Communication between team members and using visual barriers pro...
Figure 4.15 Using nonslip surfaces and soft positioning aids increases patie...
Figure 4.16 Sticky treats delivered in a food toy help this excited patient ...
Chapter 5
Figure 5.1 The types of training. Type One, Type Two, and Type Three patient...
Figure 5.2 Type One canine patient.
Figure 5.3 Type One feline patient.
Figure 5.4 Type One patient assessment.
Figure 5.5 Many dogs prefer an angled greeting rather than face-to-face.
Figure 5.6 (a–d): A technician safely stabilizes and supports a small dog wh...
Figure 5.7 Cat following food treats while coming out of the carrier.
Figure 5.8 Feline patient allowed to remain in the bottom of her carrier for...
Figure 5.9 Positioning for cephalic venipuncture using a food distraction.
Figure 5.10 (a–c) Several options for lateral saphenous venipuncture using f...
Figure 5.11 Begin touch near the hip, then glide to the venipuncture or inje...
Figure 5.12 Positioning for Type One feline cystocentesis.
Figure 5.13 Positioning for Type One canine standing cystocentesis.
Figure 5.14 (a) Correct paw positioning for a standing canine nail trim. The...
Figure 5.15 Correct and incorrect tail position for temperature measurement ...
Chapter 6
Figure 6.1 Evaluation guide for Type Two patients.
Figure 6.2 Type Two canine patient.
Figure 6.3 Type Two feline patient.
Figure 6.4 (a) A treat trail on the floor and (b) having the owner move can ...
Figure 6.5 Example exposure ladder for table training.
Figure 6.6 This cat is relaxed in the presence of her carrier.
Figure 6.7 Example exposure ladder for injection training.
Figure 6.8 Example exposure ladder for venipuncture.
Figure 6.9 Positioning for medial saphenous blood collection with a Type Two...
Figure 6.10 Exposure ladder example for ear treatment.
Figure 6.11 Exposure ladder example for eye treatment.
Figure 6.12 Exposure ladder example for nail trimming.
Figure 6.13 Exposure ladder example for anal gland expression.
Chapter 7
Figure 7.1 Assessment of Type Three patients: FAS 0–5.
Figure 7.2 (a) Type Three canine patient. (b) Type Three feline patient.
Figure 7.3 Canine patient choosing to move onto the station (a) and choosing...
Figure 7.4 A dog working with a trainer in protected contact. The dog is ins...
Figure 7.5 Named examination example cues.
Figure 7.6 One example of a position for cooperative cephalic venipuncture t...
Figure 7.7 (a–b) Emergency sedation technique for dogs.
Figure 7.8 Example of cooperative nail care training.
Figure 7.9 Steps for constructing your own nail board. Many designs are comm...
Figure 7.10 (a and b) Two examples of a chin rest behavior, one where the do...
Figure 7.11 Positioning a cat under a towel for cephalic venipuncture. The t...
Figure 7.12 (a and b) Placing a towel over a soft-sided cat carrier and then...
Figure 7.13 (a and b) Sliding a towel into a hard-sided cat carrier and then...
Figure 7.14 Voluntary lateral radiograph position training with a puppy as p...
Guide
Cover
Table of Contents
Title Page
Copyright
Preface
Acknowledgments
About the Companion Website
Begin Reading
Index
End User License Agreement
Pages
iii
iv
xiii
xv
xvii
1
2
3
4
5
6
7
8
9
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
Cooperative Veterinary Care
Second Edition
Monique Feyrecilde
Copyright © 2024 by John Wiley & Sons, Inc. All rights reserved.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey.Published simultaneously in Canada.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 750-4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permission.
Trademarks: Wiley and the Wiley logo are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates in the United States and other countries and may not be used without written permission. All other trademarks are the property of their respective owners. John Wiley & Sons, Inc. is not associated with any product or vendor mentioned in this book.
Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
For general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic formats. For more information about Wiley products, visit our web site at www.wiley.com.
Library of Congress Cataloging-in-Publication Data is applied for:
Paperback ISBN: 9781394163595
Cover Design: WileyCover Image: @Monique Feyrecilde
Preface
Thank you for taking the time and energy to care about the emotional and behavioral lives of pets. Veterinary care and husbandry, home medical care, and grooming are a necessary and important part of the life of every animal. By making space for the emotional welfare of the animal while focusing on providing high-quality veterinary care and husbandry, we can achieve Cooperative Veterinary Care.
Cooperative Care can be a series of complex behaviors, but it is limited neither to fancy trained behaviors nor to entirely voluntary and choice-based interactions. Cooperative Care is based in the understanding of how animals learn, how we can create the best possible experiences for them, and how our interactions in the present will inform the pet’s decision-making process in the future.
I know some of the information in this book will be outdated even before the publishing process is complete! In a way, I find that very encouraging because it highlights the ever-growing community interest in Cooperative Veterinary Care. Innovation, exploration, and creativity abound. I welcome the contributions of my colleagues, clients, and the pet professional community as a whole in working to better the lives of our animal companions.
My hope is to bring to you a unique blend of my high-level clinical experience and a sophisticated understanding of learning and training to help my readers achieve their goals and have fun at the same time.
Happy training,
Monique Feyrecilde
Acknowledgments
I would like to thank my team at Mercer Island Veterinary Clinic for their ongoing support and desire to treat every patient and client with compassion. With your teamwork, my passion became our mission. Every patient, every day benefits from these methods and our desire to treat patients with gentleness and respect.
Thank you to Dr. Micah Brodsky for believing in me, for nurturing my ambitions, and for your friendship. Thank you to my wonderful friends for supporting me and this project, and my loyal clients for trusting and allowing me to care for their beloved family members. Thank you, my colleagues and mentors, for elevating the art of veterinary medicine to include the science of learning and behavior.
Thank you to Sophia Yin for all your support and encouragement. You are missed and remembered with great love and respect.
Thank you the entire team at Fear Free Pets for embracing change for the better and helping spread the word about Cooperative Veterinary Care.
Most importantly, thank you to my loving and patient husband, Salamandir, without whose support this project would not have been possible. My deepest debt of gratitude is to the animals, who are my most eloquent teachers and among my most treasured companions.
Monique Feyrecilde
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/feyrecilde/cooperative
There, you will find valuable material designed to enhance your learning, including:
Videos showing procedures described in the book
Puppy class syllabus
Puppy Level One homework
Patient Evaluation and Training Plan Worksheets
Marketing and Client Education Materials
Details of Stimulus Control
Images
The videos are clearly signposted throughout the book. Look out for .
1Introduction to Patient Centered Veterinary Care
1.1 First, Do No Harm
1.1.1 Veterinary Technician’s Oath
I solemnly dedicate myself to aiding animals and society by providing excellent care and services for animals, by alleviating animal suffering, and promoting public health. I accept my obligations to practice my profession conscientiously and with sensitivity, adhering to the profession’s Code of Ethics, and furthering my knowledge and competence through a commitment to lifelong learning.
1.1.2 Veterinarian’s Oath
I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.
First, do no harm. While these four words do not appear in the oaths, this short sentence certainly describes our mission as health care professionals. Our oath to prevent, relieve, and alleviate animal suffering and the oath’s implication of doing no harm apply to both physical and mental or emotional suffering and illnesses of the body. Stress and fear are subjectively harmful and unpleasant on their own, but their physiologic effects of increased heart rate, respiratory rate, blood pressure, temperature, blood glucose levels, cortisol levels, and so many more clearly hold the potential for harm as well.
Recognition and treatment of stress and fear in veterinary patients is not a new concept, and the progress over recent years within our industry is admirable. Dr. Sophia Yin was a pioneer in this field, and the concepts highlighted in her work are still timely and relevant today. She brought the idea of low-stress veterinary care to the mainstream. Fear Freesm has continued this work, providing visibility as well as educational content and certifications. A variety of organizations now offer education and even titling and award programs for pet owners in Cooperative Care. We owe thanks to these people and so many more who have come before us and walked beside us, supporting and contributing to this text which will continue the work of improving veterinary care for patients, clients, and the entire veterinary team. This guide will help the veterinary team take low-stress, compassionate, patient-centered handling to the next level. Creating a care model prioritizing patient welfare, developing training programs for fearful patients, and embracing the techniques used by progressive zoos and aquariums in their husbandry training programs will all be taught in this guide.
We deserve to take great care of ourselves as well. Veterinary professionals are at high risk for burnout, compassion fatigue, depression, and suicide [1]. Turnover in the veterinary profession is common, with technicians in particular citing burnout. Experiencing stress and potential emotional harm when we are trying to make patients healthy can take a serious toll on veterinary professionals. By using methods that allow patients to relax and cooperate for care, we can make it easier to fulfil our vocation of relieving and preventing animal suffering while keeping our own emotional and mental wellness.
1.2 Stress, Fear, and the Veterinary Clinic
Stress is how the body reacts to a challenge, or stressor. The stress response allows the body to be prepared and respond when necessary. Not every stress response is linked to fear, but in the veterinary setting that is often the case. The fear response is a mechanism that prompts an animal to flee, fight, hide, or react in another helpful way to defend its own safety and well-being. Fear and anxiety can be provoked by either real or perceived threats, or stressors. These stressors and potential threats are abundant in the veterinary setting. How an individual animal responds to specific events or stressors is unique to each pet, and can change over time with learning history – for better, or for worse.
While the stress of veterinary visits can provoke avoidance, hiding, and defensive aggression, stress and fear can also induce the state of learned helplessness [2]. Learned helplessness is a state where an animal (or person) learns that avoidance, escape attempts, or other responses to something unpleasant or threatening are ineffective, and eventually gives up attempts to escape [2]. In pets, this often looks like the pet is “a statue,” “frozen,” or “stoic.” Learned helplessness can mask important findings on physical examination like changes in range of motion, pain in the abdomen, or other findings that rely on patient responses. Conversely, animals who are defensively aggressive because of fear may react by vocalizing, snapping, or moving away during examination. This response may be difficult to discern from a pain response, making diagnosis and treatment more challenging. Fear and stress impact blood test results, vital signs, cause changes in gastrointestinal and urinary signs, and more. Minimizing fear improves the validity of diagnostic processes. Every animal in our care deserves our empathy and respect. Each time the pet visits our office and has a negative experience, the fear will potentially worsen. This learned fear of the veterinary hospital is much easier to prevent than it is to reverse.
Preventing fear in the veterinary office isn’t just about stopping the problems associated with fear; it is also about reaping the great benefits of working with patients who are less anxious. Patients who are comfortable and less anxious will allow more complete physical examination; allow better positioning for tests; have more accurate parameters, such as blood pressure, heart rate, temperature, and respirations; have more accurate lab results; and enjoy visits much more. Wouldn’t it be wonderful to see patients who are happy to see you? We think so, too!
1.3 Freedom, Wants, and Needs
Dr. Temple Grandin is a world-renown expert in animal behavior and animal welfare. In her book Animals Make Us Human, she discusses what are called “The Five Freedoms” in animal care, originally developed by Dr. Roger Brambell in 1965 (Table 1.1) [3]. When we cause fear and anxiety in our patients while we are trying to care for them, we are infringing on their freedom from environmental discomfort, freedom from anxiety and distress, and freedom to express normal behaviors. One of the first steps in restoring these freedoms is identifying the difference between wants and needs in the veterinary office.
Table 1.1 The Five Freedoms.
Freedom from hunger and thirst
Freedom from discomfort
Freedom from pain, injury, or disease
Freedom to express normal behavior
Freedom from fear and distress
Animal welfare is a crucial factor in animal care, and The Five Freedoms were developed by Roger Brambell and popularized by Temple Grandin.
To protect freedom from anxiety for our patients, we recommend setting up guidelines for assessing animals during procedures. We will discuss assessment tools throughout the book including a three-level system and the Fear Free Fear Anxiety and Stress (FAS) Scale. Patients should be observed and evaluated throughout treatment and handling to determine if it is appropriate to continue, or if a procedure should be paused. One guideline for when to stop a procedure involving restraint is to use the 2-2-3 rule. If it requires more than two arms to gently stabilize the patient, if a dog struggles for more than two seconds, or if a cat struggles for more than three seconds, pause the procedure, assess the patient and the situation, and then make a plan for how to best continue. Further guidelines and more detail will be presented in later chapters.
Determining when to perform a procedure relies on identifying the difference between wants and needs. Needs are urgent, life-saving treatments. Wantsare everything else. While we may not want to pause or postpone some procedures, pause, retry, or postpone is always an option for wants. By keeping our priorities clear about wants versus needs, we can avoid causing unnecessary harm, and do our very best to keep the stress and fear levels as low as possible for our patients. Keeping fear levels low helps to protect our patients from emotional harm.
1.4 Iatrogenic Behavioral Injury
Iatrogenic means an illness or injury caused by medical treatment. Iatrogenic behavioral injury (IBI) is a term to describe mental, emotional, and/or psychological harm caused to patients while we are trying to provide veterinary care. Preventing IBI is one of our responsibilities as veterinary professionals. There are many modalities we can use to prevent IBI, including: recognizing the risks of IBI; using the human pediatric model for many treatments [4, 5]; embracing early and frequent medical intervention for fear, anxiety, and stress; and using low-restraint and no-restraint veterinary care.
The pediatric health care model has changed considerably over the past 20 years. A new emphasis has been placed on the importance of reducing stress for children and parents during medical care. Some techniques used in the pediatric model include explaining procedures to children using words and pictures prior to treatment, bringing comfort items such as a blanket or favorite toy from home, playing music clinically established to have a calming effect, allowing children to sit in a parent’s lap and be held or hugged, using distraction techniques, practicing good caregiver continuity, and helping children to cope with pain levels [5]. Medication is given when needed for anxiety or fear, and ongoing research is investigating effective calming methods for children in medical settings. While we can’t mirror all of these techniques in veterinary medicine due to the communication barrier between people and pets, we can certainly make use of the concepts to improve patient care.
Veterinary medicine will benefit from the experiences of pediatricians by implementing similar stress-relieving strategies. By explaining a treatment to a child, the doctor or nurse is telling the child what to expect and providing an opportunity for predictability and trust. The veterinary equivalent of this method is “explaining” procedures to pets by using touching and training techniques that help the pet understand what is expected, what to anticipate, and how to cooperate. We can allow pets to remain with their owners for many procedures and coach owners on how to remain safe and helpful during visits. Receptionists can instruct owners to bring a mat or bed, favorite treats or toys, and a hungry patient to each visit. Animal handling staff can become proficient in distraction techniques and training methods to reduce animal stress and promote cooperation. We can use medicines and supplements to mitigate fear and stress. For animals who need repeated treatments, we can help them cope by establishing a consent protocol for treatment, instructing the animals how to cooperate, and even sometimes teaching them to look forward to treatments.
It is the author’s opinion that three components will promote the biggest improvement in patient welfare in the veterinary setting: veterinary professionals having a clear understanding of how animals learn, owner presence during examination and treatments (and observation from afar if hazard regulations prohibit presence), and the use of medication and sedation early and often. Working with animals with the owner present allows owners to see precisely what happens between person and pet, and opens the conversation when training and/or medical relief of fear, stress, and anxiety are needed. Allowing pets to remain with their owners does not mean expecting owners to assume the role of a veterinary professional. Owner presence can be done safely and has numerous potential benefits. When the owner is present, veterinary professionals are less likely to resort to “brutacaine” (strong physical restraint rather than appropriate medications) and excessive physical force to accomplish medical care. Furthermore, it helps clients bond with the practice and trust that we have their pet’s best interests, both physical and emotional, at heart. Clients can learn how to participate in treatments when appropriate, and how to successfully performed prescribed treatments such as giving pills, ear medicine, eye medicine, injections, grooming and nail care, and much more at home.
1.5 Focusing on Welfare Rather than Animal Restraint
We will never be able to explain to our animal patients the important protection a vaccine provides, why an antibiotic is needed, what x-rays are for, or any of the other treatments we perform. In veterinary medicine, we have a history of being procedure focused. We tend to make a treatment plan and execute it, with the goal being skilled physical restraint for rapid completion of the procedure. Historically, the education provided was limited to how to perform a procedure without staff injury. Imagine you are sick and need to give a blood sample. You are on vacation and become ill, you must go to the hospital. You do not speak the language of the health care provider. You have never given blood before. The provider points to a chair with padded armrests. You sit and the provider reaches for your arm, pulls it out, and uses straps to secure your arm to the armrest. When you are slow to comply or try to pull your arm away the provider says something to you in a language you don’t understand. They place a tourniquet and poke your arm two or three times before getting a blood sample. This is an example of procedure-centered treatment. What might you feel during this encounter? Would your heart race and respiratory rate increase? Do you notice the pain of the needle more? Perhaps you experience fear, confusion, or the desire to escape the straps. How do you feel about the provider, the chair, the environment in general? This happens with veterinary patients regularly. They do not have the ability to understand what we are trying to do, nor why. Physical restraint is often unfamiliar to pets, and only paired with uncomfortable moments or potentially painful procedures. Look at the body language of the dog in Figures 1.1 and 1.2. Restraint alone causes a significant change in this dog’s body language. Notice the ears pulled back, leaning away, and stiffness the animal shows in response to the restraint without any medical procedures being performed. By focusing more on patient-centered treatment, and less on the procedure, we can enhance care and well-being.
Figure 1.1 Relaxed dog accepting food in the exam room.
Working with animals comes with a risk of injury to the veterinary team and to the animals. We can decrease that risk and increase safety for both the team and our patients by skilfully applying methods which rely more on understanding the patient than on applying strong physical control or restraint. Skilful and effective restraint is an important part of what veterinary technicians should know for procedures which are immediate needs to save the life of a patient. For all other handling, a deep understanding of the alternatives to strong restraint will keep veterinary team members and animals safe. This author has almost 30 years of experience working full-time in veterinary medicine, and has sustained only three animal bites, with only one of those occurring during an actual interaction between the author and the animal. In the other two cases, the bite occurred without the author approaching the animal. The reason I have included this information is to highlight the fact these methods can indeed be applied safely. But they must be part of a larger vision of animal and human safety to be successful.
Animals use body language and body position to communicate with us. Animals can tell us if they are comfortable, conflicted, fearful, and anxious, all without any vocalizations or aggression. Violence is a biologically costly strategy: it comes with risk of harm for the aggressor. Most animals will exhaust nonviolent means of communication before resorting to defensive aggression [2]. The exception is when animals have been scolded or ignored for nonviolent means of communication. When an animal feels its safety is threatened, the first response most animals use is the flight response: running away from the threat. When we remove the animal’s opportunity to leave a threatening situation, we limit their available responses to freeze or fight. In the veterinary setting, we can become accustomed to ignoring nonviolent communication. When we ignore these important signs, we put ourselves at risk for injury, and the animals at risk for IBI as well.
Figure 1.2 The same dog shown in Figure 1.1 when restraint is applied. Note the change in body language.
When we move very close to an animal for manual restraint, we lose the ability to objectively observe the animal’s responses and body language. We also send a series of potentially stressful messages to that animal. Research shows that using force when training dogs, such as attempting an alpha roll where the dog is forcibly placed on its side or back, can lead to aggression [6]. Placing an animal into lateral recumbency or dorsal recumbency can similarly provoke aggression. These dogs are not “bad” or “mean”; they are simply responding in a way that is normal for some dogs. When we are working with an animal in sternal recumbency or standing, and we “hug” them to provide restraint, what message does the hug actually send? The word hug may hold a positive connotation for humans, but for dogs, hugging is not a natural form of communication. Even for humans, only some people like hugs, and very few like hugs from strangers. If one dog grasps another around the middle, this is usually displacement, ritualistic conflict behavior, or sexually motivated [7]. It is easy to understand why a hug from a stranger at the veterinary clinic may not seem friendly, and may provoke avoidance or aggression.
There is no such thing as an unprovoked bite in the veterinary hospital. The simple act of bringing an animal into this environment is provocation in itself. It is easy to miss subtle signals in the hospital environment. When we are too close to the animal, we may not see all the signs. Restraint can mask warning signs as well. If the animal is leashed or held, the ability to flee is removed, which masks attempts at communication. Removing the option of flight is provocation. Animals who try to get away are warning us about possible future aggression. Animals who freeze, move away, turn to the side, yawn, look away, purse their lips, flatten their ears, vocalize, advance–retreat, snap, and more are all asking us to stop what we are doing. Chloe, the dog in Figure 1.3, is asking the trainer to move away and communicating she is uncomfortable with what she is being asked to do. If we ignore these requests, we run the risk of provoking the animal into self-defense.
Figure 1.3 Chloe, a young puppy, displays avoidance behaviors when asked to target the technician trainer’s hand.
Excessive restraint carries physical risks for the veterinary team, including bites and scratches, sprains and strains, and more. There are emotional risks to the veterinary team as well. When our mission, our vocation, is to relieve animal suffering, and we are constantly causing fear and distress in animals while we are trying to heal their bodies, it can take a significant emotional toll. Turnover in the veterinary profession is high [8]. Many technicians and veterinarians leave the profession after a short time, while others experience depression and compassion fatigue. Suicide rates among veterinary professionals are staggering [1]. Reducing patient stress may help protect us from these types of emotional harm.
In Video 1.1, the beagle Chloe is expressing anxiety by approaching and retreating. She will come to take food and will make contact with the technician, but immediately backs away between interactions. This backing-away behavior shows the internal conflict this dog is experiencing. She is very anxious, but has not yet escalated to threat displays or defensive aggression. The shepherd mix Max shows a similar pattern of approach–retreat and is conflicted, but he is also vocalizing and lunging, so some would describe him as more aggressive. Both of these patients are doing their best to communicate their discomfort and anxiety by leaving the situation. If we ignore these nonviolent signals, and muzzle and heavily restrain these dogs, we are teaching them that nonviolent communication is ineffective. The dogs will learn the veterinary clinic is a place where subtle signals are ignored, and there is a real risk these dogs will escalate to biting in the future. We don’t have to use heavy restraint as our primary tool for these patients. We can work with them and even train them to cooperate in their own health care.
Table 1.2 Steps for planning treatment.
Pause, assess, prioritize, proceed: steps for planning treatment
(1)
Before treatment or if a treatment is paused: assess patient and plan
(2)
Assess whether the planned treatment is a want or a need
(3)
Prioritize needs first, then wants
(4)
Prioritize wants in order of medical importance
(5)
Evaluate the animal’s stress level, and the anticipated response to the procedure
(6)
Assess if medical therapy for fear, stress, anxiety, pain, etc. is indicated
(7)
Make a training or handling plan to help the animal cooperate with as little fear and stress as possible
(8)
Proceed with treatment in a fashion that considers the emotional welfare of the animal
If a patient is showing signs of stress or fear, remember to pause, assess the patient and the plan, prioritize, and proceed while observing the patient closely.
When working with little or no restraint, we will find some animals are unable to allow treatment. They may move away, they may never let us approach them, or they may become defensively aggressive. When an animal can’t tolerate treatment, the veterinary team needs to have a plan of action. Table 1.2 provides a quick reference.
(1)
Pause treatment, and assess the patient and the plan.
(2)
Assess whether the planned treatment is a want or a need. If the treatment is truly a need, it is life-saving treatment. There are very few situations like this in veterinary practice. A few examples include Gastric Dilation and Volvulus
(GDV)
in distress, emergency
dystocia
, animals in severe
shock
, serious traumatic injury with significant active bleeding or respiratory compromise, or the animal is at immediate risk for severe self-harm.
(3)
Prioritize needs first, then wants.
(4)
Prioritize wants in order of medical importance.
(5)
Evaluate the animal’s stress level, and the anticipated response to the procedure.
(6)
Assess if medical therapy for fear, stress, anxiety, pain, etc. is indicated.
(7)
Make a
training plan
or handling plan to help the animal cooperate with as little fear and stress as possible.
(8)
Proceed with treatment in a fashion that considers the emotional welfare of the animal.
Change is never easy, but it is also often extremely rewarding. This guide will give you the knowledge you need to understand how animals perceive their environments, how they communicate, and how they learn. You will learn how to assess a patient, how to tell when to stop a treatment, the steps for making a training plan appropriate for each patient, and assessment of the patient’s response to training. Some training plans discussed may take only a few seconds, while others require several visits and compliance from the owner at home. We will also give you the tools you need to help introduce and promote change in clinic culture toward compassionate cooperative care. Methods for working with the veterinary team and for approaching topics of concern with clients will be discussed. The animals can be our very best teachers if we allow them, and the rewards associated with a move toward patient-centered practice for both pets and people are worth the effort.
References
1
Skipper, G. and Williams, J. (2012). Failure to acknowledge high suicide risk among veterinarians.
Journal of Veterinary Medical Education
39 (1): 79–82.
2
Overall, K. (2013).
Clinical Behavioral Medicine for Small Animals
, 2e. St. Louis, MO: Mosby.
3
Grandin, T. and Johnson, C. (2009).
Animals Make Us Human: Creating the Best Life for Animals
. Boston: Houghton Mifflin Harcourt.
4
Kain, Z., Mayes, L.C., Caldwell, A.A. et al. (2006). Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery.
Pediatrics
118 (2): 651–658.
5
Visintainer, M. and Wolfer, J. (1975). Psychological preparation for surgical pediatric patients: the effect on children’s and parents’ stress responses and adjustment.
Pediatrics
56 (2): 187–202.
6
Herron, M., Shofer, F., and Reisner, I. (2009). Survey of the use and outcome of confrontational and non-confrontational training methods in client-owned dogs showing undesired behaviors.
Applied Animal Behaviour Science
117 (1–2): 47–54.
7
Handelman, B. (2009).
Canine Behavior: A Photo Illustrated Handbook
. Spokane, WA: Direct Book Service.
8
Welborn, L., Brunt, J., Coffey, M. et al. (2013). 2013 U.S. Veterinary Workforce Study: Modeling capacity utilization. In:
Report for the American Veterinary Medical Association
. State University of New York: The Center for Health Workforce Studies.
2Perception and Communication
2.1 Sensation and Perception
Sensation is the way we gather information about the environment around us. Think of sensations as the raw data collected by our sensory organs before the data is translated into meaningful information in the brain. When the sensory data travels to the brain via the nervous system, the brain processes this data into how we think, feel, and react to our environment: our perceptions [1]. One example is hearing. Sound waves enter the ear canal. The waves cause movement within the eardrum and middle ear, and eventually reach the cochlea. The waves then encounter the auditory nerve, which transmits the sound signal to the brain. The brain translates this raw sensory data into meaningful information, such as music or speech.
Pets, like people, have a variety of sensory organs. Their senses include vision, hearing, smell, touch, and taste. Animals can also sense pheromones using a specialized organ called the vomeronasal organ (VNO), which is part of the olfactory system (Figure 2.1). Humans have a VNO as well, but experts disagree about whether humans communicate using pheromones in the same way animals have been confirmed to do. We will discuss sensation and perception in dogs and cats, to help us understand why animals may react in certain ways and make the decisions they do about their environment, particularly the veterinary environment. Dogs and cats have evolved specialized sensation and perception mechanisms.
Sensation and perception are how animals learn about the environment and develop feelings, opinions, and skills. Understanding how animals interact with the sensory environment, and especially noting individual variation, can significantly improve interactions between veterinary professionals and patients. Trying to understand the environment and experience from the animal’s perspective is relevant to our work. Providing spaces, interactions, and experiences tailored to what pets most likely perceive will decrease stress and enhance safety for everyone involved.
2.1.1 Vision
Vision contains many separate components, each of which contributes to the total experience of sight [2]. These components include color, acuity (sharpness), brightness (luminosity), depth perception or depth sensation, and motion sensitivity. How an animal sees their environment depends upon the anatomy and placement of the eye, and how the brain processes visual data. Humans have a visual field of about 190–240°, with 120° of binocular overlap in the center, where both eyes can access the same visual data, combining the images to assess depth of field [1]. Table 2.1 shows differences between human, dog, and cat vision.
Figure 2.1 The vomeronasal organ location in the domestic cat. This organ is used to detect pheromones.
Table 2.1 Sensation: vision: a summary of human, canine, and feline visual sensations.
Species
Detail acuity
Color
Field of vision
Light receptors
Feline
20/100–20/200
90% fewer receptors than humans
200 – 295°
total
130°
binocular
High
Canine
20/80
Bichromatic blue-yellow emphasis
240°
total
40 – 120°
binocular
Moderate
Human
20/20
Trichromatic
190 – 240°
total
120°
binocular
Low
2.1.1.1 Canine Vision
How the eyes are placed in the head determines how much overlap there is between what each eye sees. Humans have forward-facing eyes and a 120° field of binocular vision, where what the left and right eyes see overlaps to allow depth perception and perspective. Dogs have a field of vision of about 250°, but only 40–120° of binocular overlap, depending upon breed and conformation of eye placement. For breeds with the eyes closer together (e.g. Pug), there is greater overlap, resulting in a broader binocular overlap and better depth perception but less peripheral vision. For breeds where the eyes are further apart (e.g. Greyhound), there is less binocular overlap but improved peripheral vision. In general, dogs have broader peripheral vision than humans [2].
Color is bichromatic for dogs. Many pet owners believe dogs see in black and white, but they actually do see in limited color. Based upon the distribution of cones in the dog’s eye, they are thought to see the blue and yellow portions of the color spectrum best, with other colors lacking good differentiation [3]. When you see a dog’s eyes shining at night, this effect is caused by light reflecting off of the tapetum lucidum. The tapetum lucidum and the number of rods dogs have, give them improved vision in low-light situations. This is an excellent adaptation for hunting, but not helpful for reading. Because of the ratio of rods to nerve fibers, dogs have decreased visual acuity for fine detail, and their vision is more focused on movement and contrast. Their vision is best in close-up situations. We would consider dogs to have 20/80 vision, while humans have 20/20 visual acuity.
In the veterinary setting, if we want to draw a dog’s attention to an item like a mat, station, or target, choosing something blue or yellow in color, and placing it on a contrasting background, may help: for example, a yellow or white spoon or a blue plate to deliver treats. Conversely, items we do not wish to draw attention to should be low-contrast and in other colors. When moving ourselves or items around a dog, we can move smoothly and steadily, so as not to trigger a motion-activated overreaction. To draw extra attention to something like a piece of food or a toy, tossing the item so it has added movement, and choosing something of a contrasting color, can improve the dog’s awareness of the item. For instance, tossing white cheese bits onto a dark-colored floor, or rolling a dark ball across a white floor, will make these clearer for dogs.
2.1.1.2 Cat Vision
Cats have a visual field of about 200–295°, with up to 130° of binocular overlap, depending upon the source cited [4]. Their peripheral vision field is similar to that of dogs. Like dogs, cats have less visual acuity for detail, and more focus on movement and contrast. They also have a diminished spectrum for color vision compared with humans. Based on the distribution and variety of cones present in the eye, cats are thought to see few colors. Having only about 10 percent of the color receptors that are present in the human eye, cats certainly see less differentiation in color than humans do, and based upon research findings, color seems to hold little importance for cats [3]. Like many other animals, cats have a tapetum lucidum that all primates lack, assisting with low-light vision. Even more than dogs, cats excel in low-light situations. Cats would be described as having 20/100 to 20/200 vision acuity if we attempted to classify it in human terms [4].
As when working with dogs, items that may be alarming to cats should be similar to the background in color, while targets, stations, feeding mats, and toys are best in high contrast. Toys and treats that move around and are high contrast will better draw a cat’s attention as well, such as a white spoon or tongue depressor to give food against a darker mat or towel.
Figure 2.2 shows a simulation of the differences in color vision in a common clinic scenario: the exam room. Figure 2.3 demonstrates the comparison between visual fields in humans, dogs, and cats. Figure 2.4 shows a variety of dogs with different eye positions. Consider the impact these eye positions may have on the individual dog’s overall field of view, and which areas have best depth perception.
2.1.2 Hearing
Hearing sensitivity or strength is generally defined in terms of what frequencies an animal can hear, and how broad the audible frequency range is. The frequencies heard depend upon the anatomy of the ear, which also changes over time. Humans can hear frequencies in the range of 20–20,000 kHz. Most human speech falls between 1000 and 5000 Hz. As humans age, our ability to hear higher frequencies diminishes. The fine hairs within the ear become stiffer, and the aqueous material in the cochlea thickens. This makes our hearing less acute and sensitive with age. Animals experience similar age-related changes. Like some humans, some animals may be born with changes in hearing or deafness, or may develop these problems prematurely [5]. Table 2.2 shows a hearing comparison between species.
2.1.2.1 Dog Hearing
Dogs hear a considerably larger frequency range than humans, at 67–45,000 Hz. The frequencies heard best by dogs are around 4000 Hz, which is well within the comfortable range of human hearing [5]. The ultrasonic scalers used in dentistry emit frequencies between 15 and 39,000 Hz. Think about how different your clinic may sound to a dog.
Figure 2.2 Color vision. Color vision based on anatomy of the eye. Top left: human view. Top right: what we believe dogs see. Bottom: what we think cats see.
Figure 2.3 Field of vision. From left to right, human, dog, and cat field of vision. The darker shaded area is seen with both eyes (binocular overlap where depth perception is possible), while the lighter shaded areas are peripheral vision fields for each individual eye.
Figure 2.4 Comparison of canine eye set and head shape. Different head shapes and distances between the eyes, as well as where the eye is positioned on the head, will impact the dog’s visual field.
Table 2.2 Sensation: hearing: a summary of human, canine, and feline auditory sensations.
Species
Frequencies (Hz)
Common sounds at this frequency
Feline
55–79,000
Piano’s low a note: 55 HzBat echolocation: 50,000–100,000 Hz
Canine
67–45,000
Lowest cello note: 68 HzUltrasonic dental scaler: 18,000–45,000 Hz
Human
20–20,000
Lowest pipe organ note: 20 HzSpeech: 1000–5000 Hz
Figure 2.5 Equipment that may sound different or startling to animals in the veterinary clinic. Clippers, ultrasonic dental scalers, and x-ray machinery are a few examples.
2.1.2.2 Cat Hearing
Cats hear a considerably larger set of frequencies than even dogs, at 55–79,000 Hz [5]. While they may not be able to hear an elephant’s long-range call at 21 Hz, they can hear everything happening inside our hospital. Cats can even hear the lower ranges of bat echolocation, which can span 50,000–100,000 Hz and is completely inaudible to humans.
Think about things in the hospital that may sound different to our patients (Figure 2.5).
2.1.3 Olfaction and Pheromones
Olfaction, or sense of smell, is our ability to sense and perceive odors in the environment. For humans, these smells are detected when molecules of volatile (floating) compounds reach a special area of nerve endings high inside the nose, which is about the size of a postage stamp and contains about 5 million olfactory receptors of 450 different types. Once the odor reaches the olfactory receptor, a chemical signal is sent to the nearby olfactory bulb in the brain. Humans can differentiate about 10,000 different odors, and some of the most noxious odors can be detected in very small quantities, such as one drop in a swimming pool of water! However, most odors are not so easily detected.
Pheromones are detected by the VNO. While humans have a VNO and also secrete pheromones, experts do not agree on whether pheromones are useful for intentional social signaling as an adaptation in humans. There is some evidence suggesting that stress-related pheromones trigger an enhanced startle reflex in humans, which may support subconscious pheromone communication.
2.1.3.1 Dog Olfaction and Pheromones
Dogs are the experts of olfaction. Their olfactory sensors cover a large part of the surface area of the nasal epithelium. Dogs have a staggering 220 million olfactory receptors in the nose, of about 900 different varieties [6]. Once the odor molecule reaches the receptors within the nose, signals are sent to a comparatively large olfactory bulb, and often the signal must traverse a tiny distance of only one neuron before perception can begin in the brain. Their nostrils can be used to direct and intensify certain odors, and sniffing is done intentionally to obtain olfactory information.
Pheromones are also used extensively by dogs [6]. Pheromones are secreted in association with estrus, pregnancy, lactation, fear, excitement, sexual maturity, health status, and more. When a dog is fearful, it may secrete pheromones associated with fear, and those pheromones can be detected by the next dog who is in that part of the hospital. Pheromone signals can trigger a fear response as the VNO is linked with the limbic system
