There has always been a mix of happy-go-lucky and fearful dogs and cats during visits to the veterinarian. However, since COVID-19, there has been an increasing number of anxious and fear-aggressive dogs and cats during visits with their veterinarians in part due to inadequate socialization. They smell sick patients and other fearful patients. They receive vaccines and have blood drawn. Add in a relief veterinarian who the pets have possibly never met before to an already stressful situation, and now they are confused and scared.
Some dogs and cats are easily calmed with yummy treats, but many are on such high alert at the clinic that they refuse to eat. If the clinic’s regular veterinarian knows an anxious patient will be having a visit with a relief veterinarian, it’s crucial that pre-visit medication, or a “chill protocol,” is prescribed at the appropriate dose to facilitate a smooth and safe visit for the pet, pet parent, and relief veterinarian.
It’s equally important that relief veterinarians seeing a patient with a new fear of vet visits discuss and prescribe pre-visit medication at the time of the patient’s visit, to ensure stress-free and safe future clinic visits.
Pre-visit medications are prescribed with the individual patient in mind and there are various combinations that can be used. The typical “chill protocol” for dogs documented in Clinician’s Brief is a combination of gabapentin, melatonin, and injectable acepromazine given orally (see chart below for recommended administration and dosing).
Some dogs respond well with just trazodone prior to visits, while others require a combination of trazodone and gabapentin. Others need either the typical chill protocol or different medications altogether. There is room to safely increase the doses of medications like gabapentin to achieve stress relief for the individual patient.
Unlike dogs, where there is more variety, the most common pre-visit medication for cats is gabapentin 20-35 mg/kg PO the evening before a scheduled appointment and 1-2 hours before a scheduled appointment.
There is a rise in relief veterinarians in the veterinary field, which can add more stress to a fearful patient, and pre-visit medications for those patients are the key to success for everyone involved. It truly makes all the difference!
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