Reducing Vet Clinic Anxiety: Fear Free, Low Stress Handling and Cat Friendly Veterinarians

By PetMD Editorial on Jun. 27, 2018

Reviewed and updated for accuracy on June 27, 2018 by Katie Grzyb, DVM

A visit to the vet clinic can be stressful for both pets and their people.

For many cats and dogs, a simple wellness exam is actually a series of increasingly scary and uncomfortable manipulations that might result in the animal lashing out at the practitioner. And for pet parents, the stress of watching their best friend go through necessary yet anxiety-inducing exams might deter them from returning to the veterinarian for important health checks.

That doesn’t have to be the case. Three revolutionary certifications are changing the way veterinarians interact with their patients, and in turn, are changing the way pets and their people view their time in the vet clinic. Practitioners report less stress on both sides of the exam table, which leads to better diagnostics and happier, healthier patients.

What Is Fear Free Certification?

Developed by Dr. Marty Becker in 2016, the mission of Fear Free Certification is to prevent and alleviate fear, anxiety and stress in pets by inspiring and educating the people who care for them.

The certification process includes a series of courses, both online and in person, that is available to veterinary professionals as well as all individuals employed at a vet clinic, from veterinarians and nurses to customer service representatives and practice managers.

The Difference Between Traditional and Fear Free Handling

According to Dr. Joanne Loeffler, DVM and Fear Free Certified Practitioner at the Telford Veterinary Hospital in Telford, Pennsylvania, the primary difference is the way the practitioner interacts with the patient.

“The traditional way of doing veterinary medicine was to make the pet deal with whatever procedure we needed to get done,” says Dr. Loeffler. “That would mean pinning an animal down, forceful restraint, etc., for sometimes unnecessary things, like a nail trim.”

Dr. Loeffler says that using Fear Free techniques allows the practitioner to change their approach to consider the animal’s emotional state in order to accomplish procedures. She adds, “Fear Free is a culture change from the way most of us were taught how to handle animals. In the time I've been involved in Fear Free, I've seen such a change in the compliance rate of my patients and clients."

"Fear Free is about treating the animal with respect and working with them to realize the vet’s office isn't such a scary place,” says Dr. Loeffler.  

Fear Free Certification and the Diagnostic Process

“Lower stress means better diagnostics,” says Dr. Loeffler. “By having a more compliant patient, we can get more accurate heart rates, temperatures and blood pressures, and even some bloodwork values (like glucose) are more accurately assessed on a calm patient versus a stressed one."

"Also, when a pet has continued low-stress visits with us, a pet owner will be more likely to bring them in earlier if they get sick, which often translates into a better and quicker response to treatment,” adds Dr. Loeffler.

What Is the Cat Friendly Practice Program?

Established by the American Association of Feline Practitioners (AAFP) and the International Society for Feline Medicine (ISFM), the Cat Friendly Practice program (CFP) is a global initiative designed to elevate care for cats by reducing the stress for the cat, the caregiver and the entire veterinary team.

According to Dr. Elizabeth J. Colleran, DVM, MS, Diplomate Feline Specialty Practice and Cat Friendly Practice Task Force Chair, CFP is a self-paced online program that walks veterinary practices and professionals through all the tasks necessary to reduce the fear and stress of a cat’s visit to the vet clinic.

How Cat Stress at the Veterinarian Is Different Than Dog Stress

“Cats have a very deep connection to their home. They don't like to leave it. Ever,” Dr. Colleran explains. “The anxiety begins as soon as they leave their ‘home range.’"

"From there, each new experience adds a bit more stress: strangers, loud noises, unusual odors, quick movements. Once fully anxious, they will stay that way for a long, long time," adds Dr. Colleran. Cats have uniquely heightened senses and are more sensitive to stimuli than many other animals, he says.

Cats can also show redirection anger, which means that they will lash out at anyone in front of them at the peak moment of stress. Many owners will try to calm their cats during stressful times, putting themselves at risk of scratching, or even worse, a cat bite.

Benefits for Veterinarians Using Cat Friendly Practice Protocols

Cat Friendly Practice veterinarians note that the designation can decrease anxiety for everyone in the exam room. In a 2017 survey, CFP veterinarians said that their patients are less stressed; their clients are happier about the visit experience; and their clients noticed that how much these specialized vets care about cats.

“Understanding how cats experience the world gives CFPs the tools to make the changes essential to make health care easy,” Dr. Loeffler says.

What Is Low Stress Handling Certification?

The Low Stress Handling Certification program was developed by Dr. Sophia Yin and released in 2014. Certification involves completing 10 online lecture and lab courses, passing a multiple-choice exam at the end of each lecture, and passing a final multiple-choice exam.

Dr. Sally J. Foote, DVM, CABC-IAABC, LSHC-S and Low Stress Handling Silver Certified veterinarian states, “This is an in-depth program in the fundamentals of behavior, understanding the patient in front of you right now, and how to approach and deliver care right now to this animal in a less stressful way.”

The Difference Between Traditional and Low Stress Handling

Dr. Foote notes a connection between the traditional use of force during an exam and the animal’s stress levels. “The most common misstep by veterinary clinics not using Low Stress is adding more people for restraint to get the job done, like vaccinations, nails or blood draw, and not removing or reducing the triggers that are increasing the stress in the animal.”

She adds that recognizing when the animal has had enough, and either using medication to assist the exam process or splitting up care, is also important for the health of the animal and safety of the practitioner.

How Does Low Stress Handling Aid Veterinarians and Pets?

Low Stress Handling techniques teach veterinarians to better understand the emotional states of the animals they’re examining, which can reduce the animal’s reactivity, and in turn reduce injury risk to the practitioner. Dr. Foote states that clients are more likely to come in when care is needed rather than trying to avoid the stress of care on the pet.

“I have also heard many veterinarians say that the client finds the veterinarian more credible because the veterinarian recognizes what this pet is feeling,” says Dr. Foote. “So if this vet can recognize stress and fear, they certainly must be able to recognize a bigger medical problem.”

Helping Your Pet Feel More Comfortable at the Vet

Dr. Foote says that creating a handling plan based on the animal’s needs and combining the efforts of both the veterinarian and pet parent in reducing the patient’s stress is the most effective approach.

She suggests open communication with your veterinarian as a way to reduce stress in the exam room. “Tell the veterinary staff and veterinarian before the exam begins what part of your pet’s body they do not like touched [and] how they like to be approached—for example, no reaching or avoid looking in the eye.”


Much like with dogs, the process of traveling to the veterinarian often sets the stage for intensifying anxiety.

Dr. Loeffler says that one of the most powerful ways cat parents can reduce this stress buildup is to teach their cats to love their cat carriers. Leave the carrier out and place bedding and cat toys inside well in advance of a scheduled visit, so that when the time comes to head to the cat veterinarian, the cat will already have a positive association with the carrier.


Dr. Loeffler believes that the first step to a happier vet visit for dogs is a stress-free car ride, as well as teaching your dog simple placement cues that are helpful during the exam. Dr. Loeffler says that teaching a dog to stand for an exam and blood draw can go a long way in making the exam more comfortable for everybody involved.

Bringing a hungry pet and high-value dog treats can also help, as well as establishing a comfort level with muzzling beforehand, since veterinarians often need to examine areas that may be painful, which puts them at risk for biting. 

You can also talk to your veterinarian about using dog anxiety medication, like holistic calming treats or sprays that can help to diffuse stress.

By: Victoria Schade

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