A recent patient, a ginormous chow-chow mix named Nana, gave me the brilliant idea of penning this column in her honor.
Poor Nana. She was not exactly pleased to have been dragged in by her owners at the end of her mostly ineffectual retractable leash. And seeing as she was too busy being freaked out to notice, little did she realize the commotion her behavior was causing.
First, we had to empty the waiting room. (No dog could be risked within 10 feet of Nana's lunging distance.) Then we corralled her into an exam room where one harness, two opposing leashes and one veterinarian with a locked and loaded syringe full of sedative greeted her. ("Say hello to my little friend.")
Lots of urine, stool, saliva, blood (she always bites her tongue) and anal gland secretions later, we had our sleepy, newly tractable patient. Physical exam, vaccines, bloodwork, nail trimming, etc. Had she required dentistry she would have been anesthetized and treated immediately.
Crass as it sounds on the surface, we wanted this dog out of our hospital ASAP. Though truth be told, it's largely because doing so was undeniably in her best interest.
This happens for Nana only once every couple of years or so. Despite the use of oral sedatives before her visit, she always manages to "rally" at the last minute. Why? Because her owners are scared of giving her too much. Meanwhile, 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 injectable sedative.)
Granted, Nana's combination of fear and inter-dog and dominance aggression isn't common – at least not in a dog of her proportions. But we see our fair share, as does every small animal veterinary hospital on the planet.
Lest you think I'm ignoring the felines, let me now say that all cats are potential nightmare patients, too. Thing is, sedating them's a cinch as long as they're already confined to a box. Loose in the exam room – that's another story.
But I digress ...
This column should serve not just to showcase the stress that veterinarians and pets share when they're forced to interact. Its express intent is to convince you of the importance of sedation in more than just the extreme cases. Perhaps it's even in your own pet's best interest.
Though you may deem sedatives unnecessary for your own, let me just say at the outset that the ones who typically 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 our recommendation. Of course, you're always free to decline. But if we feel strongly about it, we're always free to say, "No way am I handling this land shark."
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.
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 the animal's 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 persuade unpersuadable people to see things my way (I always end up feeling like a used car salesman).
Truly, though, every time I do suggest sedation, it's for a good reason. I don't recommend 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 even 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 understandable 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.
Recent research out of the U.K. demonstrates that the psychological effects of torture (mock killings, threatening family members, etc.) lead to PTSD (post traumatic stress disorder) in these subjects.
The upshot? Judiciously undertaken, "chemical restraint," as we call it 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 stress may lead to sensitization to anxiety-producing situations. In other words, the anxiety will be greater with each experience. As with Nana (who started her life as a normal pup and progressed into this frenzied fearfulness), failure to sedate in the past has surely contributed to the extremes of anxiety she 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.
By Patty Khuly,
Special for USA TODAY