Low Stress Handling, Restraint and Behavior Modification of Dogs and Cats

PUBLISHING YEAR: 2009

SUMMARY: Illustrated manual of handling procedures for dogs and cats that promote calm and collaboration over struggle and panic.

AUDIENCE: Mainly aimed at the veterinary clinic (technicians and vets), this book will also benefit behaviourists and shelter workers who routinely deal with aggressive dogs. The chapter on preventive behavioural health for puppies was also full of original and useful suggestions for a puppy class curriculum.

REVIEW

The author
Before her passing in 2014, Sophia Yin was one of the world’s leading veterinary behaviourists. Sophia Yin was a prominent advocate of effective and respectful animal handling rehabilitating and training methods. She was also a prolific science communicator and her body language posters and videos continue to be shared the world over.

Style and contents
The book is mainly a technical manual for veterinary technicians and veterinarians. It comes with a DVD illustrating each technique, and links to downloadable protocols for clients.

Whilst it uses technical terminology (e.g. lateral recumbent, caudal to the elbow, etc.), it is highly readable and you don’t need a degree in veterinary medicine to enjoy reading it.

It is roughly divided into four parts:

1. The basics of behaviour modification: e.g. sensitisation, sensitive period of socialisation, habituation, etc. These passages are a little basic for seasoned behaviourists but are clearly explained, rigorously researched and have original twists and perspectives.
2. Advice on the physical set-up of your veterinary practice for promoting calm: e.g. fabric rather than metal; partitions; reception desk as first thing the patient sees rather than other patients; pheromone diffusers; a quiet exam room for nervous patients rather than the crowded waiting room; etc.
3. Finely illustrated handling and restraint techniques for every veterinary handling situation imaginable. The techniques have variations that are adapted to the patient’s breed, size, level of arousal, emotional state and medical needs. This section forms the bulk of the book.
4. Must-have socialisation/habituation exercises for puppies (and kittens). It has inspired some of our own exercises at our puppy school in Den Haag (The Hague).

Allow me to zoom in on the details and run through some of the original and detailed protocols that have been extremely useful for my behaviour therapy practice and dog training school:

1. Crate training which includes advice about vocalisation (p. 126)
2. The collar grab exercise focusing on classical, rather than operant, conditioning (i.e. redirecting the dog to a treat straight after tugging the collar rather than waiting for calm behaviour before treating)
3. A two-for-one recall/play manners exercise using dragging leashes during puppy play time
4. A quick and elegant protocol to get the pups to love oral examinations and pilling, none of the ginormous multi-staged protocols you normally see for this exercise.
5. How to break the vicious cycle of a dog who refuses to eat out of attention/pickyness.
6. A protocol on muzzle training with many interesting details, including:
   1. the play element of running away from the dog to make the muzzle even more attractive,
   2. what form of food to use
   3. starting the exercise again from a different place in the room each time and
   4. how to run your hand along the strap to get to the dog’s collar, stopping the aggressive dog from pulling out.

The constraint techniques get you to have most surface from your own body make contact with the dog’s, effectively turning you into a ceiling, a wall, or a roller-coaster seat belt as Sophia Yin puts it. This can be counter-intuitive given how stressed out dogs get when we get into their personal space. It makes sense in practice, though. It creates a predictable, neutral restraint technique that indicates to the dog that there is no space for wriggling out or struggling. It beats the stress of giving the dog half-baked escape opportunities with loose or inconsistent restraint.

The handling techniques could be boiled down to this: if it is contributing to the dog’s agitation beyond a couple of seconds, change technique. i.e. Do not proceed with your medical procedure until the dog is calm and secured. See my points for improvement about how unrealistic this can be at the clinic.

The gems

• I found she did a great job at the exhaustiveness of the pictures in the book. She not only illustrated the right technique, but also anticipated the many pitfalls in pictures too, allowing the reader to first try to spot the mistake, then elucidating it in the picture’s caption. This is crucial in a book describing physical techniques where placing your hand one centimeter further back can mean failure.
• Sophia Yin explicitly couches her counter-conditioning protocols as a two-phase process between classical and operant counter-conditioning. In the early stage, one continually feeds treats in the presence of the stressor and stops when the stressor is removed. Once the animal is showing calm curiosity towards the stressor, one can move to operant conditioning: e.g. the dog has to put his nose in if he wants the treat. This elegant framework consistently supported most of her protocols.
• Sophia Yin appeared to share my reservation against protocols commanding the dog to sit through a stressor to – so the reasoning goes – associate the stressor with feeling calm. Sophia Yin argues – as I do – that acting calm (operant) does not equate feeling calm (classical). Further, constraining a dog into a sit position can make them feel even more cornered and powerless, and thus exacerbate their fear.
• This leads me to a closely related point that, on the surface, appears to contradict what I just wrote. Sophia Yin reminds the reader not to allow the dog to act agitated (e.g. pacing, wriggling) as this contributes to his/her arousal. Instead, the reader is advised to calmly block wriggle attempts with their body and to relax their gentle hold only once the dog relaxes. This is in line with a calm, predictable approach that guides the dog into the desired position rather than demand it off him/her.
• I liked reading the confirmation for things I see in my dog behaviour practice:
  • e.g. It is OK for a counter-conditioning technique to accidentally teach the dog to bark (operant) in the presence of the stressor. It is much easier to reverse now the dog is no longer barking out of (classical) arousal (p. 118).
  • e.g. Letting another dog carry out the exercise in front of the patient to increase the patient’s interest in food.
• Some sections start with a story putting the human in a similar situation (e.g. alien abduction to medical facilities where you don’t speak the language followed by forceful restraint and shouting, etc.). Many pictures were also intelligently anthropomorphic (e.g. the vet technician wearing a scary death mask and monster gloves, backing a dog to the back of his post-op crate). These are badly needed reminders that dogs don’t know why we inflict these medical procedures upon them, and why some revert to defending themselves.
• The book did not just touch on the idea that different dogs will be motivated by different things in different situations, it brought it to life. Many protocols had variations for different motivators (e.g. voice praise, food, play, petting), denoting a much richer approach than the standard “give ’em a treat”.
• The book also discussed ‘jollying’, arguing that a calm, repetitive, low voice could stress a dog more than a cheerful banter would – with a citation to boot. This one gave me pause and I will also apply it in my practice.
• If you are familiar with Sophia Yin’s body of work, you will know that she often used pack-theory-like terminology. At first, I was irritated by the liberal use of ‘leadership’, for example. But her definition of the word was precise, and she discussed interesting points around the concept from management science (e.g. the most effective feature of effective leaders = predictability). She boils leadership down to acting in a way that promotes the dog wanting to follow your guidance and directions. She makes the point that being overly retiring, hesitant, jittery, nervous, or on the contrary bossy, aggressive or pushy, do not promote this state of mind. The ‘calm and confident’ mantra, bantered around as it has been by the usual leadership peddlers, had almost become a joke to me. But put in that way, it spoke volumes to me.
• Finally, the book was full of useful material suggestions for specific anatomies: e.g. SnootLoop for bracchiocephalic dogs or the air muzzle for small dogs.

Possible points for optimization

No book review would be complete without mentioning its sub-optimal points:

• The chapter on handling was 99% pictures and captions. This made for suuuuch monotonous reading. These chapters are perhaps best seen used as and when needed, or as support for a structured workshop.
• This is unforgivable for a trained scientist: some assertions were made but not backed up by modern references (e.g. desensitisation works better than flooding, p. 114; desensitisation and counter-conditioning permanently affect the dog’s emotional state, p. 118; modulated barking indicates playful emotional state, p. 118; using lavender oil can calm down some dogs, p. 125).
• Mastering all these handling techniques in all their variations would take years of practice and incredible dedication. This book may be a better tool as a veterinary handling handbook than a casual read. Without professional guidance and a workshop, most of the contents will not be mastered by the reader just on the basis of the pictures and DVD, I fear.
• Veterinarians often only have ten minutes per consult and can’t spend it counter-conditioning and desensitising the dog over several sessions. This is a vicious circle as the fearful animal takes more and more manpower in time, but that’s how incentives work: what seems to deliver the most immediate results (force) seems the most appealing. Sure it’s a wasteful initial shortcut leading to much time and energy wasted down the line, but one lonely technician embracing these techniques won’t be sufficient to counter the overall culture of force in veterinary restraint. Unless a cultural revolution sweeps veterinary universities, low stress handling will not become the standard of care. The advice to (e.g. p. 220) try a new position if the dog can’t relax; then a quieter location; then chemical restraint and/or send the owner home with a counter-conditioning and desensitisation plan runs 100% counter to how veterinary clinics are run. Whilst the book and all her work have made an incredible contribution to changing this, I fear it is a lost battle.
• I was uncomfortable with the idea of chemical restraint without elaboration about the compounds used. Are we talking of minor or major tranquilizers? In other words, are we talking of a chemical straight jacket (as eloquently put by Claude Beata in La Psychologie du Chien)?
• A passing comment in the book appears to put Sophia Yin on the same boat as many veterinary behaviourists: seemingly wanting to restrict professional dog behaviour advice to PhD behaviourists and veterinary behaviourists. Given the cost of educating oneself at that level and the scarcity of these professionals, this is denying many dogs excellent standards of behavioural care from non-doctoral professionals (p. 408).
• I missed instructions about how to build exposure duration in a low stress way. Once you have desensitized and counter-conditioned a dog to having a muzzle strapped on, how long should you keep continuously feeding the dog? Handlers do not have days to gradually get a dog who started out with a strong aversion to the muzzle to increasingly longer exposures. In my experience, this is a common stumbling block and I’d hoped to find a solution in this book.
• Whilst American behaviourists (veterinary or otherwise) often argue for early participation to puppy class (from the first vaccination onward, from seven week old), the picture in Europe appears to be less clear. It is not the standard of care to admit very young pups to class in Europe and even some behaviourists are pushing back on early registration. Given how controversial this point is, it would have been good to back up this advice with more than the often cited AVSAB position statement, citing epidemiological studies too.

The verdict: This book should be part of any course training students to handle dogs: veterinary technicians, veterinarians, dog shelter staff, dog trainers and behaviourists. It should, however, be accompanied by a practical workshop. I look forward to the day when man-handling a dog into submission at the vet practice is a dog of the past and this book is a significant, if a little over-optimistic, step in that direction.

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