Fear Free℠: Learning to Listen to Our Patients
World Small Animal Veterinary Association Congress Proceedings, 2017
Debbie Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior)
TEAM Education in Animal Behavior, Spicewood, TX, USA

“The goal of Fear Free℠ is to improve patient health, welfare, and well-being as well as enhance the client and team experience.” In order to accomplish this goal, we need to be able to understand how our patients might perceive the veterinary hospital, recognize behavioral indicators of relaxation as well as fear, anxiety, and stress in our patients, and realize how pleasant and unpleasant associations can be formed.

Sensory Perception

Stimuli in the veterinary hospital can create fear, anxiety, and stress in our canine and feline patients. Understanding how our patients perceive the veterinary hospital, allows us to not only empathize, but also develop solutions to make their experience more pleasant. In order to understand a dog or cat’s perception of our hospital, we need to have an understanding of their senses. We will explore how dogs and cats’ sensory perception compares to human perception.


Compared to humans, dogs and cats have poor visual acuity, a wider field of vision, and a smaller area of binocular vision. Cat see about 20/100–200, have a field of vision of 200° and a binocular vision overlap of 90–100°.1 The visual acuity of the dog is about 20/75 with a field of vision of 245° binocular overlap of only 30–60° pending facial morphology.2 In comparison, a human generally sees 20/20, has a field of vision of 180° with a binocular field of vision overlap of 140°. Although dogs and cats do not have very good visual acuity, they are very good at motion detection. Compared to humans, both cats and dogs can see better in dim light because of the increased number of rods in the retina and the tapetum lucidum, a reflective layer located behind the retina. Color vision is less developed in dogs and cats. Cats most likely have dichromatic vision with sensitivity to greenish-yellow and blue. Dogs are considered red-green color blind.

According to Heather E. Lewis, AIA, “The ability to see the UVB spectrum is interesting because it means that some materials appear to fluoresce to dogs (and cats), including organic material like urine that contains phosphorous as well as bright white, manmade materials such as paper, plastic, and white fabrics, Lewis says. Because these white items are more visually jarring to dogs (and cats), their use should be avoided.”


Cats and dogs hear a wider range of frequencies than humans. The range of frequency for the cat is 20 Hz up to 85,000–100,000 Hz with the useful range probably up to 60,000 Hz.1,4 The range for dogs is 15 Hz up to 65,000 Hz with hearing best at around 4,000 Hz.2 The range for humans is 20 Hz up to 19,000.2 Because dogs and cats have moveable pinnae they are better able to locate the source of sounds.


Dogs and cats have more epithelium dedicated to smell than humans; Dogs 20–200 sq. cm, cats 20 sq. cm, and humans 2–4 sq. cm.2 Smells are an important form of communication for dogs and cats. The vomeronasal organ is located in the roof of mouth. In dogs it does not open into the nasal cavity as it does in cats. The vomeronasal organ is important for detecting pheromones and in social communication.2


The dog’s perception of taste is similar to humans. They are sensitive to sweets and prefer novel/fatty foods. Palatability is affected by texture, smell, temperature, and flavor. The typical adult cat responds to salty, sour, and bitter tastes. The cat ‘s response to sugars is inconclusive.4


Touch is important for maintaining social relationships. Touch receptors are located at the base of every hair and the vibrissa are especially sensitive. Skin receptors sense proprioception, pain, temperature, chemical stimulation, and pressure. Touch can be calming, arousing, or aversive, depending on the type of touch, the circumstances, and the individual.

Sensory Perception Chart

Make a list of stimuli that the pet or client will see, hear, smell, taste, or feel in your hospital. Visually transport yourself from the parking lot to the housing/kennel area. Group the stimuli in categories of potentially pleasant and potentially unpleasant.


Being able to recognize signs of a relaxed or stressed patient is critical to creating a Fear Free℠ environment. Dogs and cats communicate primarily through visual (body language), auditory (vocal), and olfactory (pheromone and scent) communication.


Often high pitch sounds are considered distance decreasing, meaning coming closer. Examples of distance decreasing sounds in the cat and/or dog are meowing, purring, whines, whimpers, or high-pitched barks. Low pitch sounds are generally considered distance increasing, meaning go away. Examples of distance increasing sounds in the cat and/or dog include the hiss, yowl, shriek, deep or guttural growl, and/or bark.


Olfactory communication is extremely important to the cat. Each cat has his/her own signature scent. When one cat in the house visits the veterinary hospital, he/she will return home smelling differently. This can result in the resident cat being unable to recognize his housemate.

Dogs and cats release pheromones that can be detected by other members of their species. These pheromones can communicate pleasant and unpleasant information. A stressed cat may leave chemical messages behind that will act to create fear and anxiety in other feline patients throughout the day.

Body Language

Being able to interpret body language in dogs and cats involves not only analyzing the entire pet (facial expression, tail carriage, and body posture) but also assessing the context of the interaction.

Human Communication with Dogs and Cats

Threatening gestures include prolonged eye contact, approaching directly, and distance increasing vocalizations (deep, guttural sounds). To provide our patients with a considerate approach, we should avoid direct eye contact and a direct approach, turn sideways to look smaller and less threatening, move smoothly and calmly, talk slowly and softly, allow the pet to approach you, offer treats if medically appropriate to do so, avoid aversive scents and use calming ones instead.


Associations are being made all the time. Because we tend to be systematic in our approach to veterinary medicine, animals quickly learn the order of things to come. For example, when placed on a table and the tail is touched, the thermometer will follow. When the technician gets the nail trimmers out of the drawer, nail trimming is about to occur. We can create pleasant associations rather than neutral or negative ones with stimuli in the hospital by pairing pleasant stimuli with a neutral or possibly unpleasant one. For example, nail trimmers can become associated with getting canned dog/cat food. Consequently, the dog or cat becomes excited when he/she sees the trimmers.


Our patients are often more sensitive to environmental stimuli than we are. By taking into consideration how cats and dogs perceive the environment, we can create pleasant experiences and minimize unpleasant ones for them. Through early recognition of behavioral signs of fear, anxiety, and/or stress and intervention on our end, we can prevent the escalation of fear in our patients. Thus, we can facilitate pleasant associations with the veterinary hospital and the procedures we want to perform.


For more information on the Fear Free℠ certification program and resources visit: www.fearfreepets.com.


1.  Bradshaw JWS. The Behavior of the Domestic Cat. Wallingford, UK: CABI Publishing; 1992.

2.  Shaw JK, Martin D. Canine and Feline Behavior for Veterinary Technicians and Nurses. John Wiley & Sons, Inc.; 2015.

3.  Lewis H. Fear-free: what you see is not what the cat or dog gets. 2015. http://veterinaryhospitaldesign.dvm360.com/fear-free-what-you-see-not-what-cat-or-dog-gets. Accessed on May 19, 2016.

4.  Beaver BV. Feline Behavior: A Guide for Veterinarians, 2nd ed. St Louis, MO: WB Saunders Company; 2003.

Speaker Information
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D. Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior)
TEAM Education in Animal Behavior
Spicewood, TX, USA

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