Better compliance and health with low stress handling of dogs

Last changed: 06 March 2025
picture of a dog

"Freedom from pain, injury, and disease through prevention or rapid diagnosis and treatment. Freedom from fear and anxiety by ensuring conditions and treatments that avoid mental suffering." These are two of the five freedoms for animal welfare. However, many dogs become very stressed during veterinary visits, as well as when the pet owner tries to treat or groom the dog at home.

Risks when a dog gets stressed

Less stress = better health

A stressed dog may try to escape the unpleasant situation. Escape behavior can range from pulling away a paw when the veterinarian wants to examine it, to jumping off the examination table, and sometimes even displaying aggressive behavior such as biting the person trying to examine or hold it. If the dog becomes very stressed, it can make examination and treatment very difficult for the veterinary staff and also for the pet owner. This poses a risk for slower healing and reduced quality of life. It can also lead to a shortened lifespan (for example, if the dog develops a disease requiring regular treatment at home and/or at the clinic, difficulty treating the dog can be a factor in deciding whether to treat or euthanize the dog).

Stress itself can cause suffering for the dog, and it also affects the dog's physiology (e.g., blood pressure, heart rate, respiratory rate, temperature, etc.), which can make it more difficult to make an accurate diagnosis, thus increasing the time it takes to provide the correct care and recovery. Stress and pain interact, can intensify each other, and can be difficult to distinguish, which means it may be hard to assess whether the dog is in pain or is mentally stressed (or both) – again making it more difficult to determine the appropriate treatment.

Stressed dogs means stressed people

Pet owners, veterinary staff, and students in veterinary and animal nursing programs report feeling stressed and/or uncertain when handling stressed, fearful, and/or aggressive animals (1-4). By having knowledge about common stress behaviors in dogs, and understanding how to adapt the care situation, it may be possible to prevent the dog to escalate to severely stressed and thus aggressive behavior.

Example: by being aware of one's own body language and by recognizing and understanding the dog's common stress signals, veterinary staff and pet owners can pause, interrupt, and change their plan BEFORE the dog escalates trying to break free or risk biting someone. This often provides immediate benefits, for example, in conducting an examination, taking blood samples, administering injections, treating wounds, and even during aftercare at home (5).

Project plan and methods

Part 1

  • Develop and practically evaluate a Swedish-language visual tool to support the assessment of dogs' stress levels in the clinic and during training. (A "map" where one can observe the dog’s body language and compare it with images in the tool to help assess whether the dog is stressed). The aim is for the tool to be clear, concrete, and useful for both animal health professionals and dog owners.

The relevance of the tool will be evaluated by ethologists and other experts in dog behaviour. The evaluation will be done through simultaneous assessments of the dog’s stress level by dog owners and animal health professionals and through reliability testing.

This will result in a publication tentatively titled "Development of a visual aid to assess dogs' stress and anxiety based on body language."

As part of this, a literature review will be conducted with the question: "What scales and behavioural assessment tools are used to evaluate (situational) stress in dogs, and how have these tools been validated?"

Part 2

  • Develop training guides (in Swedish) based on positive reinforcement ("rewards") for teeth brushing and ear care in dogs. The training guides will be structured in a way that is useful for both animal health professionals and dog owners.

The guides will be developed using literature studies, site visits, courses in the field, as well as practical training and evaluation by veterinarians, dog owners, and students.

Part 3 

Changes may occur regarding Part 3.

  • Teeth Brushing
    Study with dogs diagnosed with periodontitis during PTR (professional teeth cleaning) under anesthesia at SLU University Animal Hospital or Anicura Albano/Gärdet.

The dogs' "stress level" during the oral examination will be assessed according to the protocol developed in Part 1, and oral health will be assessed using the previously used protocol (6, 7). Clinical examinations will be filmed. Follow-up will occur after 1 year regarding stress levels and oral health.

  • Ear Care
    Dogs requiring topical anti-inflammatory treatment in their ears, following a similar approach as outlined above.

  • Survey/Interview Study regarding treatment in both intervention groups, potential behavior change in dog owners, and perceived applicability of the training and knowledge in stress assessment. 
Description of method
(in Swedish) Flow chart over the steps included in the PhD project. Photo: Lena Olsén

Facts:

Project period: Began in 2024 and is planned for completion in 2032, running part-time.

Funding: The project is funded by Stiftelsen Djursjukvård i Stor-Stockholm.

Project group

PhD student: Elin Lindell, licensed veterinarian, student at Institutionen för kliniska vetenskaper (KV). www.slu.se/cv/elin-lindell/

Principal supervisor: Lena Olsén, Universitetslektor vid Institutionen för kliniska vetenskaper (KV); Anestesiologi. www.slu.se/cv/lena-olsen/

Supervisor: Karolina Brunius Enlund, Universitetsadjunkt vid Institutionen för kliniska vetenskaper (KV); Smådjurskirurgi www.slu.se/cv/karolina-enlund/

Supervisor: Katarina Varjonen, licensed veterinarian, specialist i hundens och kattens sjukdomar, specialist i dermatologi (steg 2) samt Europeisk specialist i dermatologi (Dipl ECVD) www.anicura.se/hitta-klinik/stockholm/djursjukhuset-albano/vi-som-jobbar-har/veterinarer/katarina-v/

 

References

1) L Olsén, T Rehn, B Forkman, A Valros, E Hartmann. Veterinary nurse and veterinary students in Nordic countries want education in low stress handling included in the curricula. The Veterinary Schools Council Veterinary Education Symposium (VetEd), 7- 9 July 2021, School of Vet Med, University of Surrey, UK. Short communication.

2) L Olsén, T Rehn, E Hartmann. Both veterinarians, veterinary nurses and students in the Nordic countries want more education in low stress handling. Poster-presentation Veterinär-kongressen 2021.

3) Enlund KB, Brunius et al.Dental home care in dogs - a questionnaire study among Swedish dog owners, veterinarians and veterinary nurses. BMC Vet Res. 2020 PMID: 32188446

4) Enlund KB, Brunius et al. Dog Owners' Perspectives on Canine Dental Health-A Questionnaire Study in Sweden. Front Vet Sci. 2020 PMID: 32582779

5) Riemer S, et al. A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting. Animals 2021 PMID: 33445559

6) Olsén L, Brissman A, Wiman S, Eriksson F, Kaj C, Brunius Enlund K. Improved Oral Health and Adaptation to Treatment in Dogs Using Manual or Ultrasonic Toothbrush or Textile of Nylon or Microfiber for Active Dental Home Care. Animals. 2021 PMID: 34573447

7) Scherl DS, et al. Application of the Gingival Contour Plaque Index: Six-month plaque and gingivitis study. J of Vet Dentistry. 2009;26:23-7