Trauma Informed Care in Veterinary Medicine

Do you know what Trauma Informed Care is? I first learnt this term from a client of mine.

This is an approach by medical professionals that brings compassion as the forefront to their patients with the knowledge that 1 in 4 children in the U.S. have experienced some sort of mistreatment be it physical, sexual or emotional abuse.

As this article posted by Harvard Medical School writes, you do not have to ask specific questions about their trauma. The first step is recognition. Approaching every patient as if they have experienced trauma, understanding that trauma can come in any form, and learn to respond to scenarios with empathy and understanding.

The Link

For some reason, The Link was a fact that stuck with me from a lecture in veterinary school. That Link is: if you see evidence of abuse in an animal patient, that there is a link between animal abuse and domestic violence.

And yet veterinary medical professionals are not trained to navigate these complex social, and ethical scenarios.

I have witnessed animal abuse in a veterinary practice. I suspect that I am not the only one who has witnesses this. In trauma informed care we can look at our animals in the light that they may have had previously experienced trauma either through physical abuse, or from neglect.

However, this should not come from a place of judgment. But it should come from a place of empathy and compassion. When we take our veterinary oath, we are the advocates for the individuals that cannot speak for themselves. We also need to be examples for both our colleagues in the medical professional fields, as well as for the pet parents.

In a Fear Free veterinary practice, it is not just about seeing fearful dog and offering sedation, chemical restraint, or oral medications to be given at the next visit. It is also about educating the pet parents on how they can train their pets to allow for a physical examination, to train their pets to consent to medical treatments, and also to educate these clients that if we continue to pressure their pet that fear can escalate into aggression. If you do not listen to their communication signals that they are saying no, or worse yet, punish them for showing fear in the form of aggression, such as growling, then this can make future veterinary visits worse.

I had talked about single event learning in a recent podcast with Dr. Orion. What single event learning is that a fearful animal goes through a traumatic experience, and then becomes more fearful in that scenario, or generalizes to similar scenarios with increased anxiety and fear.

The more that people see their pets as family, the more that we as veterinary professionals need to be trauma informed. Because we are causes of traumatic experience is in our pets.

So when do you report cases of abuse?

A topic in one of my support groups recently was about how to identify if abuse is happening to an animal in the home. Some forms of abuse are obvious, but what about for example, neglecting to provide veterinary care such as comprehensive oral health assessment and treatments?

A few years back, I had someone bring their dog in for a second opinion because their veterinarian had reported them for neglect due to horrible periodontal disease.

My first job as a veterinarian, someone came in with one of those forms that says that they needed to seek veterinary care within 72 hours.

So there are cases that get reported by veterinarians, as this is part of our oath.

But what do you do when the line is blurred? That it isn't so clear.

Well, I found a handbook or guidelines for veterinarians via the BCSPCA website.

Most of the 'cruelty' cases we think of are the mass seizures of puppy mill pups or hoarding of cats.

But many dogs we see with horrible periodontal disease and even obesity is considered neglectful.

We try to give clients the benefit of the doubt. That clients do not realize that just because their pet is still eating does not mean they do not have a painful mouth. The limping or stiff gait without crying out, is a sign of pain. Again, approaching it with our recommendations without judgement so that we can come up with a plan that works for everyone.

Pets are so much more resilient than people. The amount of pain and suffering they endure without complaint really is astounding.

I hope this information helps those current and future veterinarians who are reading this, but also the pet parents to realize how tough being a veterinarian really is.