Aggression: Protecting Yourself in the Work Place
By Amy N. Breton, CVT, VTS (ECC)

Introduction
Fear aggression in both dogs and cats is one of the most common forms of aggression that a veterinary nurse or assistant sees in a clinic setting. Being able to recognize early warning signs and then protecting yourself is key to keeping yourself safe. Many animals are fearful in a veterinary hospital setting, but this does not necessarily mean they will act aggressively. Because it is sometimes difficult to determine which ones will act aggressively, it is strongly recommended that whenever an animal is showing any signs of fear they be treated like they are a fear aggressive animal. It is better to assume they may become aggressive rather than be taken by surprise and end up being injured.

Stress Behaviors
Most dogs and cats usually show subtle, as well as obvious, signs that they are fearful before they act on it. These stress behaviors can also be termed “conflict” behaviors, meaning they are having a conflict with you. By recognizing these behaviors you will be able to recognize the animal is stressed and that you are in a potentially dangerous situation.

Protecting Yourself
If you notice any of the above listed signs it is important to protect yourself. Force and loud noise (including voices) will only cause the animal to become more fearful. Rarely will fear aggressive animals charge to attack. Most frequently, these animals just want to run away and hide.  Animals that undergo prolonged medical treatments may develop fear aggression. This means that the dog that may have been fine three days ago may suddenly start to show fear aggression signs.

Most fear aggressive animals are kind enough to give warning signs that he/she is fearful. However, once they have issued the warning they may turn to attack. The warning signs may be small and quick, so it is important to act quickly. If possible, you should immediately back off and take a moment to come up with a plan on how to better approach the animal. Handling a fear aggressive animal by your self should be a last resort. There are some animals that do better with only one person, but the second person should be nearby in case help is needed. Remember the animal is afraid of you. If you leave them alone, the aggression will stop.

Be sure to talk to the veterinarian on staff at your hospital. Sedation may be an option for animals that require a large medical work-up. It’s a lot nicer to be able to sedate a fearful animal, than fight with it while attempting to perform various procedures. The difficulty is being able to get close enough to your patient to give an injection. Most drugs used for sedation can be given subcutaneously, intramuscularly or intravenously. Both the intramuscular and subcutaneous routes generally require little restraint. Certainly, another staff member will need to distract the head of the animal by putting a large blanket or Elizabethan-collar over it.

If sedation cannot be used the staff must protect themselves as much as they can. If you want to muzzle an animal, be sure to approach it from its back or side. Approaching your patient head on with a muzzle will cause it only to become more frightened. It also puts you at greater risk because you are standing right in front of its mouth. If you cannot get close enough to a dog to put a muzzle on it, then you should try a gauze muzzle. Be sure to make the loop of the gauze large enough that it will easily slip over the dog’s nose.  Once you have it tightened on the muzzle, be sure to loop it under the nose again and tie it behind the head. If you are unable to get a muzzle on the pet, you can try slipping an Elizabethan-collar on them.  Be sure that it is a big enough size so that it will easily slip over their head. This will help protect you from their teeth. An owner should never be asked to muzzle a pet unless all other options have been exhausted. If an owner gets injured in your veterinary clinic, they can hold both you and the hospital owners liable for asking them to do something to their pet that caused them to be injured.

When working with any aggressive dog be sure to have a leash on them they cannot slip out of. Many owners put their dog’s collars on too loosely. After all, fear aggressive dogs want to escape and many will try to back out of their collars. Many fear aggressive dogs will not allow you to reach down and clip on a leash to their collar. Most clinics have slip leads that can be quickly put on or removed without you getting too close to the dog’s face. Rabies poles are very effective when you need to get a dog out of a corner of a cage who is growling at you. Be sure to treat the rabies pole like you would a leash. Gently put it around the dog’s neck and then tighten it just enough so the dog can’t slip out. Once the dog is out of the cage you can put a slip lead over the dog’s neck and remove the pole. If the dog continues to try to bite, you can continue to use the pole.

Cats and small dogs can be restrained using large wildlife gloves. There are several brands out there, but the ones that give the most protection are the ones that have large metal staples in the hands. The staples help to prevent the cat from biting through the glove. Since the gloves take some getting use to, you should use them with non-aggressive animals first to practice. Cats and small dogs can be wrapped up in a large blanket or in a “cat-sac” for restraint as well.

It is important to remain calm when handling a fear aggressive animal. If the animal has tried to bite you and  you are upset, another technician should step in to take over. When you are nervous or upset, you will only cause the animal to become more fearful. Remember to speak calmly and move slowly around fear aggressive animals. With dogs you can try to calm them by talking to them with words they know. Ask them to “sit”, “down”, “stay”. Even telling them you have a “cookie” or “treat” may calm them. Many dogs are frightened because they simply don’t know what’s expected of them.

Most fear aggressive animals do better with less restraint. Instead of laying the pet on its side to restrain it, you can try leaving it sitting up. Rather than trying to obtain blood from a cephalic vein where both the leg and head need to be restrained, try obtaining blood from a jugular vein. This way the animal can remain seated and the technician restraining just has to pick up the head.

If a fear aggressive animal needs to be hospitalized, you can protect yourself by putting an e-collar on the pet. An e-collar not only prevents a pet from chewing out its intravenous catheter, but it can also act as a shield from teeth. Leaving leashes on dogs in cages should be avoided because they can get caught on the cage causing the dog to become injured. If the dog likes to back up into the corner, most rabies poles can generally be made large enough to fit over any size e-collar.

Conclusion
Remember that your fear aggressive patients just want to get away from you. They are likely not going to attack you if you leave them alone. If a pet is showing any signs of fear, they should be treated like they could become aggressive. Sedation should be used whenever possible.  Talking to your patients with words they know and in a calm soft voice is important in dealing with fear aggression. Remember that the safety of you, your team members and clients is the most important factor.