Today’s VETgirl online veterinary continuing education sponsored blog is written by Dr. Jacqueline C. Neilson, DVM, DACVB. Thanks to Elanco Animal Health for sponsoring this blog. Please note the opinions in this blog are the expressed opinion of the author, and not directly endorsed by VETgirl.

The Fear Free initiative, dedicated to reducing patient fear, anxiety and stress associated with veterinary visits, has become one of the most popular welfare movements in the history of companion animal veterinary medicine. Veterinary professionals can readily appreciate the multitude of benefits associated with a less stressful patient visit: improved patient welfare, staff morale, safety, owner satisfaction, medical care and ultimately practice revenue. There is no downside to Fear Free.

So, what’s holding us back from all being Fear Free all the time? It is the same thing that sabotages most worthwhile initiatives, such as healthy eating, exercise programs, etc. – it is the power of habit. If we have been doing something the same way for a long time (e.g., eating dessert after dinner, immediately scruffing a cat for restraint), we are neurologically wired to repeat that behavior. There are hundreds of habits we do during a veterinary workday that impact the patient experience. Trying to alter too many of those simultaneously can be overwhelming and lead to abandonment of the entire program. A successful strategy to overcome the power of habit is to achieve some small wins with relatively simple process/protocol changes that then can act as the foundation for additional interventions. Here are four simple, easily adopted/staff-friendly Fear Free strategies for wellness visits you can implement today:

1) Leave the Loop
• Discontinue use of a fecal loop to obtain feces for a routine parasite screening
o Fecal loops are associated with discomfort, which can contribute to fear, anxiety and stress
o Fecal loops provide a substandard sample size for diagnostic purposes; 1-2 grams of feces is the minimum recommendation for fecal oocyte analysis1
o The pet voluntarily provides daily fecal samples; let them donate their fecal sample!
o If a fresh rectal fecal sample needs to be obtained, collect it during a digital rectal exam, which also serves as a medical evaluation

2) Use ULTRA TM ½ mL vaccines
• ULTRA vaccines are formulated for effective disease protection with half the volume of traditional vaccines
• ULTRA vaccines are designed for a more comfortable vaccine experience
• Reduced volume of injection translates into shorter restraint times
• Reduced volume facilitates compliance with vaccination location guidelines (e.g., AAFP recommends vaccination on distal limb of cats)

3) Carry Combination Vaccines
• When pets are due for multiple vaccines at the same visit (e.g., Lepto and Lyme), limit the number of injections by using a combination vaccine product (e.g., Lepto and Lyme in same vaccine)
• Fewer injections reduce the number of painful events, restraint time and likelihood of sensitization to needles
• Data shows that vaccine-associated adverse events (VAAEs) are linked to the number of injections, and not necessarily the number of antigens, administered during a single visit2

4) Adopt an oral Bordetella bronchiseptica vaccine
• Maintain the benefits of a mucosal Bordetella vaccination, while reducing the negatives of intranasal administration, by using an oral Bordetella vaccine
• A single oral mucosal dose is effective against Bordetella
• With millions of doses sold, Bronchi-Shield® ORAL has given dogs a happy vaccine experience with fast, one and done* protection against Bordetella bronchiseptica

As a profession, we are recognizing how important it is to consider both the physical and the emotional well-being of our patients when we deliver care. The tips above provide four simple strategies that every practice can readily embrace to work towards a Fear Free environment. For additional Fear Free training and information about practice certification, visit

For additional information about ULTRATM, the comfortable, clean, ½ mL vaccines or Bronchi-Shield® ORAL visit (,,

2Moore, GE, et al. (2005). JAVMA, 227(7), 1102-1108

* For initial vaccination, only one dose is required.
* Always read, understand and follow the label and use directions.

Bronchi-Shield, Fel-O-Vax, ULTRA, ULTRA Duramune, ULTRA Hybrid FVRCP, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates.
Other company and product names are trademarks of their respective owners.
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