Textbook for the Veterinary Assistant. Lori Renda-Francis

high probability that they will bite if cornered or feeling threatened. Extreme caution must be exercised when trying to handle or restrain the dog exhibiting fearful or aggressive body language. The dog will exhibit aggressive body language by lowering its head to the level of the shoulders, giving a level and intense stare, positioning its tail out straight (sometimes with a slight wag), and growling or baring the teeth. Dogs exhibit fear or aggression through body posture. Dogs might show that they feel threatened by a human looking directly at their eyes or approaching them from the front.

      Dominance aggression can be defined as aggression toward other members of the animal’s social group. This behavior is exhibited to prevent lower‐ranking members of the social group from performing actions or engaging in activities for which the higher‐ranking individual claims priority.

      All dogs should be handled with the knowledge that they may bite at any time, and health‐care team members must be prepared for this. In dogs exhibiting fearful and aggressive body language, this is especially true.

      The fight or flight principle is quite evident when talking of the behavior of canines. A dog’s typical defense mechanism will be to retreat (take flight) if it feels threatened. However, this is not true of all dogs, especially if the dog believes danger or threat is imminent. In this case, it may resort to the fight principle. We know that the canine dentition is designed for crushing and tearing and if a dog bites, that is the intent. Remember to observe the body language of the dog before restraining it. If the dog is baring its teeth, growling, curling its lips, and/or raising its hackles, the health‐care team must take precautions and control the muzzle of the dog or risk being bitten.

      The health‐care team must also be prepared to control the dog’s legs and/or paws. Although a dog’s toenails are not generally thought of as dangerous, the dog may use them to attempt to ward off restraint. The dog’s thrashing of the legs and paws may cause serious scratches on members of the health‐care team, and these scratches have a high probability of becoming infected.

      Appropriate steps must be taken by the health‐care team to insure the safety of the patient and the health‐care team. There are a variety of physical and pharmaceutical restraints that will aid in handling dogs to insure a safe hospital experience for the team and patient. It is important for the veterinary team to be familiar with physical restraint techniques. The veterinarian will diagnose and prescribe a pharmaceutical restraint when and if it is needed to insure the team’s and the patient’s safety.

      The veterinary health‐care team should always record the behavior of a patient in the medical record. Aggressive behavior should be clearly marked in the patient’s record with a warning; this will help insure the safety of both the health‐care team and the patient. It is important to abide by the following when approaching a dog in the hospital.

       Use the dog’s name.

       Approach the dog quietly but confidently.

       Lower yourself to the dog’s level but at a safe distance.

       Slowly offer the back of your hand for the dog to smell.

       Do not attempt to handle/restrain dogs in confined areas, as the dog may feel trapped.

       Restraint

      The health‐care team should be aware of situations where a dog may not be handled safely and restraint equipment should be employed for the overall safety of the team and the patient. It is important to insure that all dogs have a collar and leash fitted during handling. The following list contains a variety of mechanical restraint devices that will be discussed in more detail.

       Leash

       Gauntlet

       Muzzle

       Catchpole

       Voice

One of the most readily available and simple tools for restraining dogs is the leash. Leashes in the hospital setting are typically a nylon rope with a handle at one end and a slip loop (for quick size adjustments) on the opposite end (Figure 4.1). The leash should be held open above the dog’s head and readily available to place around the head or body when restraint is indicated. The slip loop allows for easy tightening or loosening when restraining or releasing the patient. It can be used cautiously on feline patients as well, although this use is not as common as with canine patients. All health‐care team members should keep a rope or leash available at all times.

      To protect health‐care team members, heavy leather gloves known as gauntlets are often indicated. These are used to protect the hands and forearms when dealing with aggressive or fearful animals. Although gauntlets are made of thick leather, dogs, cats and birds have been known to bite or pinch through them. The thickness of the gloves typically allows the wearer to feel the bite or pinch before major injury occurs, thus enabling them to circumvent a potentially serious situation. Remember, the gauntlets may reduce the wearer’s overall sense of touch and strength. Therefore, the wearer must take care not to exert excessive pressure on patients during restraint procedures. A decreased sense of touch and strength coupled with the restrainer’s increased excitability and adrenaline can be a very dangerous mix.

      Using a muzzle is another way to protect the health‐care team, the owner, and the dog if the patient is nervous or aggressive. There are a number of muzzles available and a recommendation of a type or brand should be given by the health‐care team to the owner. The muzzles most often used are a wire/Baskerville muzzle, a nylon/Mikki muzzle, or a gauze muzzle. In place of a commercially manufactured muzzle, health‐care team members can utilize a roll of gauze, a nylon sock, or even a piece of rope. However, the dog needs constant monitoring when it is muzzled to ensure there is no obstruction to the airway. Care must also be taken to ensure the muzzle can be removed efficiently and quickly. If the dog is thought to be likely to bite, its head should be safely restrained by a health‐care team member while the muzzle is removed. Muzzles should be used only short term because they prevent dogs from panting and could thus lead to overheating if left on for extended periods. The health‐care team should be especially prudent when using muzzles on brachycephalic breeds. Typically, a gauze muzzle is to be used for brachycephalic breeds. Scissors should be close at all times in case a muzzle needs to be cut off and quickly removed.

Figure 4.1 Rope leash.

      Source: Sheldon, C.C., Topel, J. and Sonsthagen, T. 2006. Animal Restraint for Veterinary Professionals. Elsevier, St Louis, MO.

      Care should be taken when applying muzzles. When applying muzzles to an animal on the floor, you should never kneel or sit, instead you should squat so that you can move away quickly if needed. Ideally, a second person should be restraining the animal when a muzzle is being placed. If you must place a muzzle alone, you should carefully approach the animal and apply the muzzle from the back or side of the animal.

      Application of a gauze muzzle

      When applying a gauze muzzle to a dog, you will want to utilize a nonstretch gauze. Cut a large piece of gauze to ensure that you have enough to wrap around the muzzle and behind the dog’s head and still have enough to tie in a bow. It is better to have too much versus too little, since you may only have one good chance to muzzle the upset dog before someone gets injured. The dog should be in sitting or sternal or sitting recumbency.

Start by making a loop in the center of the gauze strip and cross one end under to create a half‐knot. Once the loop is made you can carefully approach the dog from the back or the side. If the dog is being restrained you can approach him from the front. Bring the open loop down in front