Every year hundreds of veterinarians, veterinary technicians, animal behaviorists, and others search for new and better ways to treat and train animals both in the veterinary practice and in the home. A few years ago pioneering animal behaviorist and veterinarian, Dr. Sophia Yin, developed a system for recognizing brewing fear and aggression, while reducing this through specific handling techniques that decrease stress by improving patient comfort and safety. The program: the Low Stress Handling™ Silver Certification. As of October 2016 the program has certified hundreds of individuals, clinics, hospitals, and other agencies.
In trying to gauge the success of the Low Stress Handling™ Silver Certification program, Dr. Sally J. Foote (Executive Director of CattleDog Publishing) interviewed seven licensed veterinary technicians who have recently graduated from the certification program. She wanted to focus on how long these veterinary technicians had been in veterinary medicine, what kind of low stress handling training they had received in their academic training programs, and how being Low Stress Handling™ Silver Certified has made a difference in their jobs and in their lives.
We thank you for joining us as we talk with Robyn Fox, Debbie Gass, Gina Gillombardo, Rachel Green, Amanda Havens, and Jennifer Stanslaski about their experiences with the Low Stress Handling™ program.
How long have you worked in veterinary medicine?
RF: I started in 2005.
DG: 28 years.
GG: As a licensed technician, since 2013. However, the hook into veterinary medicine was my first day volunteering at the San Francisco SPCA in 1999. After 15 minutes of socializing cats I realized I wanted to delve more deeply into medicine. I continued volunteering not only there, but also at a wildlife rehabilitation hospital and at a cat sanctuary in Rome, Italy before I decided to leave my corporate job and return to school to study veterinary technology.
RG: I’ve worked as a technician for 13 years.
AH: 16 years.
JS: 14 years. I started as an assistant and changed my mind about becoming a tech several times before I finally finished school.
What year did you graduate and from what school?
DG: 1996. Parkland College, Champaign, IL.
GG: I graduated from San Juan College’s Veterinary Technology Distance Learning Program in 2012. I transferred to San Juan College from Purdue University’s Distance Learning Program. San Juan College was a much better fit for me.
RG: I graduated from Parkland College in 2003.
AH: Blue Ridge Community College, 2009.
JS: Argosy University, 2007.
How much education did you receive in tech school about behavior or making handling less stressful for patients?
RF: I do not recall receiving any specific Low Stress Handling™ tips, just more how to recognize stressful behavior.
DG: ZERO for both.
GG: We studied behavior by learning the visual cues that an aggressive, calm, anxious and fearful animal will exhibit. We also studied animal restraint techniques required in order to perform medical procedures. For the study of restraint techniques we used a text that discussed “fight or flight”, the “herd instinct”, aggression, hierarchy in a pack, and territorial instincts as an introduction to the principles of restraint before delving into the techniques of animal restraint. The textbook we used was “Animal Restraint for Veterinary Professional” (Sheldon, Sonsthagen, Topel)
RG: We didn’t receive much education about behavior and handing animals in a way that would be less frightening for them. We were shown some hand drawn pictures of happy and upset body language. We were taught to pin animals down so they couldn’t move or bite anyone.
AH: Very little, in fact scruffing cats was taught as the number one restraint method.
JS: We had very minimal information about behavior in school, and no information about how to make handling less stressful for patients.
For dogs we learned about some cases of aggression, like dominance, redirected aggression, and submissive behaviors (the submissive behaviors were listed as that, but did not address the fear or anxiety that was behind these submissive behaviors when displayed in a clinic setting). I did have an instructor in school that liked behavior and she had a friend that was a dog trainer, and this allowed her to provide our class with a little more information and some handouts on ear positioning and facial expressions, and if I remember a slight introduction on body language. We learned how to be reactive to what the dog was doing, not proactive. We were taught how to use several types of muzzles, nylon, gauze, leashes, our hands, and physical force for restraint techniques like the head lock, scruff hold (yes even for little dogs), and lateral recumbency with people laying on the dog to hold them still.
For cats we received even less information. They did talk about the cats tail and ears a little bit, but basically it was taught that restraint for cats was less is always more, but if the cat is fractious or moving too much we were to scruff the cat and if that made them worse you would muzzle, scruff, and stretch the cat in lateral recumbency to hold them still.
I do not remember having any discussion about fear and animal feels, or how to help them through it. It was basically they tolerate what we do and they do not have a choice in the matter. People would always “win.” If animals even looked nervous we were instructed to muzzle or scruff for our safety. If the animal showed any resistance our job was to hold them still to be able to have the DVM accomplish the task at hand.
How does being Low Stress Handling™ Certified enhance your work day?
RF: It makes a world of difference. Working in a teaching environment it is very important for us to recognize stress before it escalates and redirect that behavior as soon as possible.
DG: It makes working so much more fun. Our patients love coming in to see us now. Pets drag their owners into the clinic. I love when dogs put on their brakes and do not want to go home because they love it here so much.
GG: Becoming low stress handling certified has changed everything about the way I approach my work day. My patient’s experience while under my care is my primary concern; from the moment I greet them in the lobby to the completion of their visit. The Low Stress Handling™ curriculum, grounded in science, elevated my knowledge of animal behavior. Coupled with the techniques Dr. Yin devised for handling patients, I now have more tools at my disposal to minimize my patient’s stress while in a highly stressful environment.
RG: Low Stress Handling™ helps with my stress level at work. Pets are happy to see us. I enjoy holding a dog or cat who is relaxed and happy instead of an animal that is stressed out and fighting against me and the doctor. I also have more handling techniques to use. If one hold doesn’t work, I can try something else. I have more tools in my tool belt, as they say. I also feel more confident going into a situation with an animal that is upset because I have multiple handling techniques to try.
AH: It makes the patients much more comfortable. My day is not altered in a negative way at all. I enjoy teaching the 4th year veterinary students more appropriate ways of handling to ensure a low stress visit.
What do you appreciate most about the Low Stress Handling™ Certification?
RF: I appreciate that it gives us the license to start each appointment in a positive way and explain to students and clients why we are doing things the way we are and how that is helping their pet.
DG: While it is a long course, the knowledge gained from it is pretty much priceless to me. I use what I learned on a daily basis … which is more than I can say about the old restraint methods I was taught in school that do not work near as well. I am less than 5ft tall, so the old techniques were really hard on me and my body. The Low Stress Handling™ techniques are easy to do and since you are not using all your strength to restrain them it is less stressful on me too!
GG: I am grateful that the certification exists! I respect Dr. Yin’s return to school to study animal behavior and I marvel at the enormity of her efforts. Her decision to share her knowledge with other veterinary professionals with the design of the Low Stress Handling™ curriculum speaks volumes about her dedication to veterinary medicine. The credibility of the Low Stress Handling™ Certification is that it is rooted in science. This gives the curriculum weight which drew me to it almost immediately.
RG: I love that we are using Low Stress Handling™ and lots of treats. Pets love to come see us. Owners love that their pet is pulling them into the building. We’ve had dogs and cats who were very upset in the past, and with a few visits of less restraint and yummy treats, they’ve decided we aren’t so bad. We can get a much more thorough exam on the pet and they are less stressed. The owners are also more willing to bring in their pet because it isn’t as stressful for them or their pet.
AH: The confidence it gives me in providing a low stress visit and reassurance for owners that we are doing everything we can to make the visit stress free.
JS: What I appreciate the most is when we can help the animal become an active member of their own medical care and get them excited to come into the practice. It is a great feeling when clients use to have to drag their dogs into the clinic, and now the dog is dragging them in to see us because they are actually excited and happy to come and visit. This makes me feel good. It makes the patient feel good. It makes the client feel great! We have built a bond with this animal and the client that will last a lifetime. They will promote the clinic better than I could increasing the client base and revenue to the practice.
What do you love about being a Veterinary Technician?
RF: I love working with animals first and foremost and also being able to help a relationship between pet and owner grow.
DG: I love helping pets feel better and getting to know my patients and their humans.
GG: I love patient care! For me it goes beyond the Doctor’s prescribed treatment, though I really enjoy the challenge of drawing blood, placing catheters, and administering meds. The “beyond” is taking an extra minute to observe the patient before closing the door to their cage. If they’re not eating I can warm their food and spend time with them while encouraging them to eat. Is their bedding dry? Do they seem comfortable? Are they having any concerning reactions to the meds I just gave? Do they just need some reassurance? I love giving that!
Now that I am Low Stress Handling™ certified I love explaining to owners why I am choosing to take the lid off their cat’s carrier rather than pulling them out, or why I am desensitizing their pet to the thermometer before inserting it, or choosing to trim their cat’s nails in a burrito wrap in the exam room, or counter conditioning their kitten to a vaccination by pairing the vaccination with some wet food, or minimizing their terrified dog’s stress by drawing blood for their heartworm test in the exam room rather than asking them to venture into the hectic treatment area … the list goes on and I think the owners appreciate the knowledge and the effort.
RG: As a tech, of course, I love playing with the doggies and kitties that come in. I also enjoy educating owners by writing handouts and articles, and putting together our newsletter and website.
AH: The day to day diversity with cases and never knowing exactly how your day will go.
JS: I really enjoy educating clients and new staff. The role I play in our clinic is one that really promotes education on behavior and the Low Stress Handling™ techniques from Dr. Yin. I like being able to educate and teach staff and clients how to develop better ways to do things by looking outside of the box. It is such an accomplishment when you can change the way that animals feels about coming to the clinic which also promotes a better balance for the client and patient relationship in their home as well.
How has being Low Stress Handling™ Certified allowed you to enrich the animal experiences of your coworkers and clients?
DG: We have had several vet students volunteer that are always shocked at how “little” we “restrain” our patients…and that it works! I love being able to show others what a great thing we have in the Low Stress Handling™ Certification course. Clients really like being included (we tell them what we are doing and why it is important) & they love that we consider how their pets feel while they are being examined, having their blood drown, et cetera.
GG: Since becoming Low Stress Handling™ Certified my coworkers have been pretty open to me showing a few of the techniques I learned from Dr. Yin. We now keep a jar of peanut butter in the treatment room to counter condition dogs for nail trims or anal gland expressions. I have introduced a few of Dr. Yin’s techniques for cats. I believe change comes slowly.
I think clients are grateful when they see that extra time and attention was given to minimize their pet’s anxiety during an office visit.
RG: We had a new employee who came from a clinic that used some traditional handling techniques that included pinning animals down to force them to hold still for procedures. We showed her the new techniques that we learned during the Low Stress Handling™ course. She was amazed at how we were able to get the job done and that the animals enjoyed coming in. We have had several tech and vet students come through our practice over the past few years and they were all interested in how the handling worked and saw how much our clients and patients appreciated it.
We have also shown clients how to clean ears, apply medications, and more in a low stress way. We have them give food and treats before, during, and after treatments. Pets are much more accepting of the treatment. Clients are much happier not having to chase their pet down, and they don’t feel like their pet hates them.
JS: When our clinic has interns or new staff come into the practice we are able to help train them in low stress techniques and help them learn better ways to handle animals instead of forcing them to tolerate exams or vaccinations; how to develop a better thought process and to look at new ways to change the animals underlying emotional response when they come into the clinic. These interns or assistants that learn a new approach can start to educate other clinics they go to, or people at school and spread the word and show them that we do not have to be forceful to accomplish our goals, and that we are actually causing this animal more harm and stress by ignoring their needs. If our clinic can educate as many people as possible then they can see how much more successful we are by not using force to accomplish our goals and they can then turn around and educate more people; we will have a better chance at helping more animals.
When I am able to educate clients about their animal’s normal behavior, I can help them understand that their pet is not “bad” for growling or hissing, but rather that it is a normal response that is stemming from fear. Our clinic understands and will listen to what they are saying and find a better way to work with them. Most clients feel like their furry child is behaving badly and become embarrassed, stressed, and even anxious themselves. It is very rewarding to have them witness the transformation from an animal that behaves badly, to one that will tolerate and sometimes even enjoys coming into our clinic.
Is there anything you would like to say to someone considering becoming a Veterinary Technician and learning about Low Stress Handling™?
RF: I feel that as a veterinary technician our job is to care for patients and that can only be enhanced by learning Low Stress Handling™ techniques. With a better understanding of behavior and stress in the patient, you can create a better work environment for everyone involved. Positive experiences with patients lead to a positive work atmosphere and happier clients.
DG: DO IT! If you have the chance to take the Low Stress Handling™ course, take it. It is well worth the cost and the time. You will use what you learn daily and your patients and clients will thank you for it!
GG: I am a huge proponent of education. So I would tell someone considering becoming a veterinary technician to go to school and get licensed. I believe that Dr. Yin’s Low Stress Handling™ curriculum ought to be incorporated into the veterinary technology college curriculum. Until then, get certified in Low Stress Handling™! Its science-based approach will round out your education.
RG: Take your general courses first! Tech school is very demanding and you need lots of time to study. I started reading more about behavior several years ago. I have read several books by various authors. Our vet was talking about Dr. Yin’s book: Low Stress Handling, Restraint and Behavior Modification of Dogs & Cats. I read this book too. I loved that there were lots of photos and a companion DVD. Our clinic staff went through the Low Stress Handling™ Certification course a few years ago. There are several lectures with videos showing the right way to do holds and other techniques. She also showed several common mistakes people make. This course has lots of useful information. I would recommend the book and course for anyone wanting to know more about Low Stress Handling™ and behavior.
AH: Work in a practice for a while before making your final decision. You can learn a lot from observing and learning to read animal behavior.
JS: Being a veterinary technician can be a very rewarding career, especially with the changes that are happening in the profession regarding handling techniques and looking at the animals needs from an emotional and physical aspect to promote an overall medical plan. Take the time to educate yourself on how to help these fearful animals. Unfortunately, the education that our profession receives in school is still very minimal at best. One of the best books that you can invest in is the Low Stress Handling, Restraint and Behavior Modification of Dogs and Cats by Dr. Sophia Yin. It will be one of the best books you will ever purchase; mine is falling apart because it is a great reference that is used frequently, every time you read it you pick up something new. We are in a role to help change our profession to see the whole picture and to look at the emotional and physical well-being of our patients while providing the best care possible. Please educate yourself as much as possible so you can help others learn about low stress techniques and we can get to a point when all of the old school “holding down the animal to provide medical care” techniques are nonexistent.
You do not need to be passionate about behavior to utilize the low stress techniques. If you are considering a career in the animal field you are already passionate about animals. Low Stress Handling™ techniques will make you better at your job and give you more satisfaction in your career and daily life as a Veterinary Technician.
What are some things you wish you had learned in your veterinary technician training programs? Are there any methods or techniques you would like to see become a part of the curriculum at veterinary and veterinary technician training programs?
DG: I would love to see some teaching on how to read dog & cat body language. It is so important for us to know how our patients are feeling and not just that that they are not relaxed and may bite (this is all I was taught to watch out for). Many bites may never have happened if the knowledge of body language was taught in class. The teaching of Low Stress Handling™ techniques in a classroom would be wonderful to show that we do not need to pin down our patients and make them submit to “just get it done.”
GG: Our understanding of animal behavior has evolved. We recognize that animals are under great stress within a veterinary hospital. It makes sense that we learn to minimize their stress for today’s appointment as well as future appointments. With the evolution of animal behavior should come more evolved techniques for restraining animals. I would like to see the veterinary technology colleges embrace Dr. Yin’s Low Stress Handling™ curriculum so that as medicine evolves our understanding and treatment of patients can also evolve. I think most of the AVMA accredited colleges deliver solid curriculum. Sadly the study of animal behavior and restraint is missing and/or outdated. I believe that Dr. Yin’s program would fill in this gap.
RG: In tech school we learned things that I don’t use that often, but there are skills that I didn’t learn in school that I use quite often. I wish we had received more information about subtle body language, as well as handling skills for cats, not just the scruffing technique. It would be nice to see treats being used and recommended for exams and treatments. I would love to see towels being used with cats. Towels help cats feel safer. And towels protect people from teeth and claws if the cat gets upset.
JS: What is being taught today in academic veterinary technician training programs is, unfortunately, not much better than what I learned in school several years ago. A lot of our assistants who are in tech school, new tech grads, and even DVM’s are going through school learning minimal information about how to handle animals in ways that cause less stress or fear. They do not learn much about body language, how to interpret what the animal is trying to say, or how to find alternate ways to handle these animals. I frequently ask what is being taught in technical schools and training programs about restraint, animal’s reactions to fear, an animal’s body language, and I am always disappointed. I have even looked through some current school notes and it makes me very sad that we are still teaching outdated information. Yes, we need to know how to use a muzzle, but that should not be our first line of defense. Using Low Stress Handling™ training techniques, I am able to help new staff members understand how to practice the philosophy of our clinic. It will be a great day when academia is at the front of the line teaching all of the students in our profession about body language and handling techniques that promote a healthy relationship with their medical team.
Dr. Sally J. Foote, DVM
minor updates Mar 2021
Dr. Sophia Yin: “Low Stress Handling™: Examining a Feral Cat”
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