Basic Concepts

Before implementing low stress handling (LSH) in practice, we must first explore the science behind behavioral responses and learning in animals. Fundamental to understanding how behaviors develop is a solid grasp of classical conditioning. This is the traditional “Pavlov’s dog concept” where dogs learn to anticipate food and salivate at the sound of a bell, after this bell has been repeatedly paired with this same bell. The response elicited from classical conditioning is an involuntary, emotional response. This response can be a positive (pleasant) emotion, or a negative (fear-eliciting) emotion.

How does this apply to low stress handling? Unfamiliar smells, sounds, and sights, and potentially threatening pets and people assault our patients the moment they enter or care. We perform unpleasant, sometimes painful procedures, often by force. A single such experience can condition a negative emotional response where the animal learns to fear us. This learned fear can result in fidgeting, attempts to flee, and/or aggression at subsequent visits.

Using Food to Reduce Stress

So, what can we do? Work to condition a POSITIVE emotional response. This approach can prevent fear from developing, as well as counter-act a fear that has already been established by previous encounters elsewhere. To create a positive emotional response, we pair the experience with something that naturally elicits a positive emotional response in the animal - food. Food is the easiest and most powerful means of providing this response because we are all programmed with an innate positive response to food (otherwise we would not survive for long).

We offer food just before and during the experience, particularly aversive procedures:

o Injection
o Toenail trim
o Otoscopic exam
o Restraint by a stranger
o Rectal temperature/palpation
o Placement onto a cold exam table

Use only easy to administer and highly palatable foods; dry biscuits seldom suffice. Instead, use high value food items to make the association most powerful. Children don’t get carrots from the pediatrician, they get an ever-so-delicious lolli-pop so they will want to return!

Examples of highly palatable foods we use include:

o Chicken baby food
o Peanut butter
o Squeeze cheese
o Kong paste
o Braunschweiger

These foods are easy to offer on a spoon or the end of a thick pretzel, tongue depressor (careful your patient does not get overzealous and try to eat this!), or board. Animals with food allergies can be fed the canned version of their special diet, or the owners may bring safe, special treats from home.

Offering food keeps our patients from feeling stressed or fearful and displaying undesirable defensive behaviors. It also helps create a positive emotional response to the veterinary context so they will be even more manageable on subsequent visits. This will also help us feel better about seeing them again, so everyone benefits!

For example, patients with chronic ear infections or receiving monthly injections quickly learn that the sight of the otoscope or syringe means discomfort and pain for them. By pairing these procedures with food you can change the negative to a positive response. From the animal’s point of view, the sight of the items associated with these procedures now means “I get peanut butter/cheese/meat/etc”.

Pets who have already developed a strong negative emotional response to a clinic setting may need a slower, more systematic approach as they may be too stressed to find food appealing at that point. These pets are best helped by setting up a series of “Happy Visits”. If the care needed is urgent, then chemical restraint is recommended before beginning any aversive procedures.

Creating a Low Stress Environment

Soothing visual, auditory, and tactile stimuli and pheromones can further reduce stress to create a positive experience for our patients.

Visual stimuli

• Soft lighting, 60 vs. 200 watt bulbs ? may need a guideline) is visually soothing.
• Cover cat carriers in the clinic with a towel until the time of examination.
• Use the towel to cover the cat’s head during all parts of the exam and procedures that do not involve the head.
• Use a box or partially cover the cage door to permit hospitalized cats to hide.
• Admit nervous dogs through a side or back door to avoid the lobby, especially if they are not well-socialized.
• Use a Calming Cap as needed during any portion of their experience to reduce visual stimulation.

Auditory stimuli

Barking dogs, ringing phones, chatting personnel, and banging cage doors can heighten animal stress quickly. Minimize these by:
• Separating dogs and cats in the waiting area
Put stressed animals into a separate room upon arrival.
• Play the CD “Through a Dog’s Ear” or similar at a soft volume to help relax animals (and staff).
• Use a “white noise” generator (e.g., to mask extraneous sounds, especially in kennel and ICU areas where animals need quiet to rest and recover.
• Speak softly and sparingly around animals to help them stay calm.

Tactile stimuli

• Cover metal exam tables with towels or a no-slip mat to provide a warmer, more comfortable tactile sensation.
• Use a padded mat when placing animals in recumbency on the floor.
• Place soft bedding inside the cage or kennel to promote rest, provide warmth (cats prefer temperatures in the mid 80s F) and help prevent cats from resting in their litter box.


Pheromone products are available to increase comfort and decrease stress in our patients. Each product is species-specific and is available in a plug-in diffuser as well as a spray. Place a feline and canine pheromone diffuser in exam rooms and treatment areas. You can also spray the pheromones on bedding and in carriers. For outpatients, you can spray a bandana with pheromones and place it on the pet, which the pet can then wear home as an advertisement for your clinic and a special gift for your patient. Please see the sections on Feliway and D.A.P. for more details on pheromone products.

Avoidance of force

Finally, avoid and discourage the use of punishment or force with patients. Yelling, scolding, hitting, kicking, pinning to the ground/ “alpha rolls”/”dominance downs”, leash corrections, and shock quickly escalate stress and fear levels, may push some animals to show aggression, and are guaranteed to create a negative emotional response to the person administering it, as well as to your clinic, which may result in loss of valuable clients.