Owner-absent examinations

Early this year, before the COVID-19 lockdown began, I was discussing – with a long-standing friend and veterinary nurse colleague – a list of things to do during a consultation to ensure canine patients are as amenable as possible to examination and treatment.

This was for inclusion as the first chapter of “dos and don’ts” in a book I’ve been commissioned to write by Taylor and Francis; working title Demystifying Dog Behaviour. As such, it will also strongly advise against doing anything that will result in a deterioration of behaviour – particularly if culminating in aggression.

Ostensibly for vets and other veterinary professionals in general practice, dog owners and their children, teachers, police, magistrates and judges will all be invited to read it when complete. If no one gets further than the first chapter, I will consider this to be essential reading.

Sound observation

One observation my friend brought up as we discussed this was the tendency in her practice for human voices, like that of budgerigars, to become louder as the consultation progressed.

This could be for several reasons reflecting the emotional content of the discussion at the time, including happiness, sadness, anxiety and even anger – any emotion that may result when the health of a loved pet is at stake.

Given the reverberant nature of most consulting rooms, the sounds were amplified. Yet no account was taken of the behavioural effect of the increase in decibel level on the patient. I therefore included keeping voices low and the need to be aware of the dog’s responses at all times to my list of essential things “to do”.

A while into the lockdown, we returned to this subject. By then her practice was taking dogs from their owners in the car park and conducting owner-absent examinations (OAEs) – with the consultation, results of the examination and discussion being carried out by video link or telephone.

She remarked she had found, to her surprise, how very much calmer dogs were when separated from their owners. She was very knowledgeable about dog behaviour and many precautions were already being taken to routinely avoid behavioural damage in the surgery. Yet dogs seemed to be automatically calmer and more amenable to examination.

Why should this be?

Question

Intrigued, I posed a simple multiple-choice question on the Veterinary Voices closed discussion group on Facebook. Did the members feel the behaviour of canine patients was better, the same or worse since lockdown and the imposition of OAEs?

The response was overwhelmingly in agreement that dogs were far better behaved in their owner’s absence. Dogs were described as “calmer”, “chilled”, “tolerant” and “compliant”.

This change had caused amazement in some quarters and it was a “revelation” how much could be done (taking rectal temperatures, administering kennel cough vaccine and examining ears) without assistance or restraint.

Dogs previously requiring muzzles no longer did. “Hiding behind chairs” was less of an occurrence, with more “gravitating towards the vet when writing up notes”.

The respondents felt examinations were more enjoyable, dogs could be given time to explore the room for (imaginary) monsters and that they were able to engage in play with the dog, resulting in a positive experience all round.

Several said they would miss this change or that they “loved this new world”. One went as far as to admit they wished they “could keep owners out forever”.

Not all were positive, with some vets feeling the dogs seemed more “shut down” and inhibited rather than less anxious, supported in one or two views by the fact fewer dogs were willing to take food treats. One respondent stated a dog resumed its habitual snarling on return to the owners.

The observation was also made that dogs seemed disconcerted by the wearing of masks, highlighting the importance that human facial expression and its correct interpretation has for dogs.

Discussion

So, what to make of these anecdotal findings? What are the physical and emotional differences for all parties (human and canine) between conventional and COVID‑19 consultations? And, most importantly, should they be acknowledged, fully researched and acted on to create a new “normal” once the pandemic is over?

Some reasons for the changes were suggested. Dogs not experiencing the inevitable social stress of the waiting room and the avoidance of getting “wound up” before they got into a consulting room was considered a major advantage, as was dogs avoiding picking up on owner anxiety.

Simple by-products of owner absence were the prevention of annoyances, such as owners having no opportunity to talk to their dogs all the way through a consultation or to engage in unsuccessful attempts to assist in handling their dog. The irritation caused by owners “waving goodbye” to their pet through the window as it was led away persisted.

Awareness also arose of changes in the behaviour of veterinary staff. They were more able to focus on a dog’s behavioural cues without distractions from the owner. They admitted to feeling more relaxed and less under pressure if owners were absent, and able to concentrate fully on the pet instead of being obliged to enter into conversation.

To carry out an examination without feeling the need to explain their actions every step of the way was a blessed relief. Being able to “think out loud” to a nurse was, however, a huge advantage.

It was also felt owners were more able to listen to advice and instructions when they were not distracted by the physical examination of their dog. Owners were, however, disappointed – even “dismayed” – to find their assumption their dog “would not cope” without them was entirely wrong.

Conclusion

In conclusion, at the very least it can be hoped these discoveries will be reflected on, and allowed to affect how dogs and their owners are managed in veterinary surgeries in the future.

At best, the subject of OAEs is worthy of study. The focus so far has been on educating veterinary staff regarding dog behaviour and how to alter it for the better in the veterinary context.

Perhaps vets should be able to confidently and routinely instruct owners how best to behave to help their dog, in the same way as information and instructions regarding physical disease are given?

Maybe owners should be disabused of the false assumption that dogs will fall apart emotionally in their absence, and told a happy dog with or without them is a far more healthy one in the behavioural sense? And should vets not feel able to play with their patients, regardless of whether an owner is present?

No doubt many COVID-related changes will occur in the way businesses are being conducted that – although first thought temporary – will become permanent, purely owing to the advantages they are found to have brought. Could the consideration of OAEs be one of them?