"I made the decision to build 23 years into my career, and I'm looking ahead to practice another 23 years," says Vicki Petsche, DVM. "I'm so happy that I did it and in a Fear Free fashion. The staff is happier, pets and owners are happier. I feel very rewarded."
The following pictures and observations on Fear Free veterinary hospital design are all the result of Dr. Petsche's collaboration with Hospital Design Conference speaker Heather Lewis, AIA, NCARB, at Animal Arts in Boulder, Colorado.
Don't be afraid. Dive in and check out Loyal Companions Animal Hospital and Pet Resort in St. Charles, Illinois, in the far western suburbs of Chicago.
What are the two most effective Fear Free touches in her hospital's final design, according to practice owner Dr. Vicki Petsche? Building separate cat and dog entrances and eliminating waits in the reception area (top photo above).
"The minute the client enters, the staff is there ready to greet them, leave a trail of Cheerios to the recessed scale and usher them into the exam room," Dr. Petsche says. "The cat entrance awning (bottom photo) faces the busy road my practice is on, so that's attracted a lot of people. I didn't really anticipate that. The parking lot is closer to the dog entrance, but cat owners who don't even have their cats with them will still go to the cat entrance."
Pheromone diffusers sprays—and specific, calming music for cats and dogs plays—throughout the hospital. Nervous dogs (and sometimes cats) get ThunderShirts. And the dog runs (photo above) have larger window ledges so the dogs can get up and look out and chill in that space. Here's Dr. Petsche's take on dogs in the hospital:
"I try to minimize the number of dogs that come and stay because of the stress level a dog experiences and the stress they induce in surrounding pets. We try really hard to explain the Fear Free benefits of dropping off dogs near the procedure time and then getting them out promptly after the procedure.
"All of my patients that come in to spend time here come in on anti-anxiety medication. They're much calmer than what you're accustomed to seeing in a veterinary hospital. We just don't have that crazy barking. If we have a really anxious dog, we'll put them in our isolation ward, which has sunlight and windows. Some dogs just feel the need to bark, even on anti-anxiety medication."
Dr. Vicki Petsche loves her cat-only exam rooms (photo above, with one of her team members):
"The best thing is, I don't have an exam table. I have a window with a window ledge and a bird feeder right outside the window. There are shelving units in cat exam rooms, and one of them is a little box where cats that like to be hidden can get a Feliway-infused towel and have their exam there.
"I've never never been a fan of forcing pets to do things they weren't comfortable doing, especially the poor cats. One hospital I worked at had one bank of cages with cats on the top and dogs on the bottom. The dogs would bark bark and wagg their tails against the metal cages, and when I would come back a couple of hours later, the cats looked like they thought they were going to die."
Cat boarding was important to Dr. Petsche:
"The cages have glass on the back, side and front, so when we put cats in their cages for the day, they're able to turn around and look outside, with squirrels and birds running around. Each cage has a shelf, a little hidey space, so cats can get a secure feeling.
"Cats prefer horizontal bars, and the composite material keeps down reflections so cats don't startle themselves. The TV screen shows a live feed of the birdfeeder outside the window. Cats that have to stay with us for a while start off nervous, but by the end they're pretty comfortable and their stress level seems low."
Check out that seat! Dr. Petsche is particularly proud of it:
"I found a company that makes furniture for dogs to custom-make ottomans for our exam rooms. I had them use the material they said was most durable and cover them up with crib sheets that change with every patient. The dog hops up on the ottoman, the pet owner's on one side, I'm on the other. The pet owner can see what I'm seeing, and they're helping me hold or cuddle. Pets just think they're up on the couch at home and being held."
Fear Free veterinary medicine is definitely a team sport at her practice, according to Dr. Petsche:
"My entire staff is Fear Free certified, and they do a great job communicating our vision to our clients. We don't want clients to drop off pets for the whole day—we want to schedule a day where they can do dropoff and pickup closer to procedure time to minimize their stress around other animals or just being in the hospital.
"On their first time coming into the veterinarian, we'll never push pets past the point where we can't safely do medical procedures. My receptionists tell them this on the phone. We schedule a 'happy visit,' with no holding down, no nail trims, no needles, no medicine. We send them home with the anti-anxiety medication.
"I tell clients that the majority of the time, I can get everything done on that second visit. On that first visit, we just give treats to help pets equate us with food. When they come back on anti-anxiety medication, they remember I'm the one who had that treat pouch."
Dr. Petsche used to do veterinary medicine the way lots of her colleagues did—in the back:
"I used to do everything away from the owner. I took the cat or dog into the treatment area for ultrasounds, blood draws, everything. But then I sat in a lab about low-stress care where I learned that all the work we do to calm down an animal in the reception area and then in the exam room has to start all over again in the treatment area, with its new sights and smells. Now, I do absolutely everything in front of the owners, who are helping with distracting attention or treats."
What's one of Dr. Petsche's biggest takeaways about Fear Free? It's extremely rewarding, but it takes time. All good things do, she says:
"People can go down the street to three or four other veterinary hospitals. I want them to commit to me and to my practice style, and I'll devote an hour to that first visit to cover all the client education and to really get to know the patient and the owners. On the next visit, after we've started treating the pet and have noted what the cat or dog likes and doesn't like—even sometimes conditioning a dog to enjoy wearing a muzzle—we can have a more normal appointment."