Chemical restraint: a vet's take on the routine use of sedatives in pet medicine
Yesterday’s patient, Boo Boo the Shar-Pei/Rottweiler mix (a striking animal, I assure you), lent me the brilliant idea of penning this post in his honor. Poor Boo Boo. He was not exactly pleased to have been [literally] dragged in by his owners.
First, we had to empty the waiting room. (No dog could be risked within ten feet of Boo Boo’s lunging distance.) Then we corralled him into an exam room. One harness, two opposing leashes and one vet with a locked and loaded, syringe-full of sedative greeted him. (“Say hello to my little friend.”)
Lots of urine, stool, saliva, blood (he always bites his tongue) and anal glands later, we had our sleepy, newly-tractable patient. Physical exam, vaccines, bloodwork, nail trimming, etc. Had he required dentistry, he would have been anesthetized and treated immediately. We wanted this dog done and out of our hospital ASAP.
This happens for Boo Boo only once every three years. Despite the use of oral sedatives before his visit, he always manages to “rally” at the last minute. Why? His owners are scared of giving him too much sedation. I’m always scared they’ve given too little. For the record, I’m always right on this count (hence the disaster and the inevitable need to administer more sedative).
Granted, Boo Boo’s combination of fear, inter-dog and dominance aggression isn’t common—at least not in a powerful dog. But we see our fair share, as does every small animal vet in the world.
Lest you think I’m ignoring the felines, let me now say that cats are potential nightmares, too. Thing is, sedating them’s a cinch as long as they’re already confined to a box. Out in the real world—that’s another story. But I’d love to get a dart gun to trap my neighborhood cats (so much easier than a Have-A-Heart trap but oh so slow that the cat could be halfway across Miami before he’d fall over in a stupor).
But I digress…so on to the real point of this post:
This post is not just for the benefit of this world’s Boo Boos. Its express intent is to convince you of the importance of sedation in more than just the extreme cases—perhaps even in your pet’s.
Though you may deem sedatives unnecessary for your own beast, let me just say at the outset that the ones who rightfully deserve to make that decision are those who put themselves in harm’s way and know exactly how stressed out your pet is likely to get.
Because most owners underestimate their own pet’s stress level and because vets understand well the risks and rewards of sedation, it’s usually worth following their recommendation. Of course, you’re always free to decline. But if we feel strongly about it, we’re always free to show you the door.
Though it may sound like I take rather a harsh stance on sedation, I’ll confess here that I personally don’t sedate as often as I should according to the standard of care guidelines followed by most vets. Too often, I let my clients talk me out of it.
Why? Because I dislike knowing the pet will end up going home in a stupor that may well last a day or more (depending on their reaction to the meds). I dislike knowing that in some cases I may well be doing more harm than good. And I hate trying to convince unconvinceable people to see things my way—I always end up feeling like a car salesman.
Truly, though, every time I do suggest sedation it’s for a good reason. I don’t suggest it lightly, nor do I consider it a time-saving convenience (typically, it’s quite the opposite). Aggression, anxiety, pain and a medical need for muscular pliability are the only reasons sedation should be employed. And the procedure’s necessity better be commensurate with the potential risks of such medication, safe as they generally are.
Despite my personal reluctance and the relative infrequency of “routine sedation” for the above-mentioned reasons, I still find that many of my most trusting clients strongly object. They are either in denial of their pet’s behavior (common) or they fear physical harm (due to the inherent evils of mind-altering medication) more than the psychological harm that comes from living through what they perceive as an extremely stressful experience.
In the event of such obstinacy, I’ve always explained that, from a pet’s point of view, the two (mental and bodily harm) are perhaps indistinguishable. And now I have some human studies on the effects of torture—yes, torture—to back me up on this long-held belief of mine.
While it might seem like a stretchy extrapolation, recent research out of the UK demonstrates that the psychological effects of torture (mock killings, threatening family members, etc.) lead to as much or more PTSD (post traumatic stress disorder) in these subjects.
The upshot? Judiciously undertaken, “chemical restraint,” as we call in in the biz, is infinitely more humane (and far more effective) than the over-used “bruticaine” (sedation through brute force). The suffering of a terrified animal (almost always the case) is not an acceptable alternative to the relatively simple act of sedation.
So next time your vet suggests you take home a few pills to administer before your next visit, think not of the safety or convenience afforded the hospital—this is absolutely secondary. Rather, think long and hard on the degree of psychological stress your pet may be suffering.
And consider the following: experiencing stresses may lead to sensitization to anxiety-producing situations. In other words, the anxiety will be greater with each experience. As with Boo Boo (who started his life as a normal pup and progressed into this frenzied fearfulness), failure to sedate in the past has surely contributed him to the extremes of anxiety he feels today.
While you may well be better off not sedating your pet for some of the quicker, less noxious services your vet offers, and while you may well eschew all meds in an ill pet (call your vet first to find out), if you trust your vet (switch if you don’t) you should pop those babies down his/her gullet and feel more than justified in doing so.