Hospitalisation
Discover how to make hospitalisation as stress free for the dog as possible.
Where a dog needs to be hospitalised, there are lots of things that can be done to make the experience as stress-free as possible.
Ward systems
Dog Friendly Clinic ward systems should consist of individual kennels that allow dogs to stand up, turn around and lie fully stretched in lateral recumbency without coming into contact with ceilings or walls.
Ideally, kennelling should be species-specific and consideration should be given as to whether a dog will benefit from being kennelled at floor level or at height, on an individual basis. Some dogs may benefit from being kennelled at height due to their medical or surgical condition, and this can also benefit the physical health of the clinical team. Other dogs might find being lifted and examined at height stressful, and would therefore prefer being kennelled at floor level where they can easily walk in and out.
Situating dogs in kennels will be decided by clinical staff so that eye contact is avoided while dogs are hospitalised. For example, by not being kennelled directly opposite each other.
Of course, this isn’t always possible, so visual screening aids can be used to put partitions between species and obscure visual access in the very least. Barriers can also provide a dog with choice. For example, securing a towel across half a kennel-front offers the opportunity for an individual to avoid the sight of any other dogs.
Stimulus
If possible, the ward system should be soundproofed, and staff should be able to adjust the temperature, ventilation, and lighting levels. And where dogs are hospitalised for more than 24 hours there should be a period of time overnight, during which sound and light levels are minimised to optimise the opportunity for sleep.
Bedding
Bedding material should be comfortable and deep enough that all body parts may be protected and supported in recumbency. The bedding material should also enable any fluids to drain and be checked and changed regularly to avoid soiling the dog’s coat.
Additionally, orthopaedic mattresses are available to offer further joint support for non-ambulatory patients while hospitalised.
Toileting
Regular toileting opportunities are essential for all dogs and may need to increase in frequency if their symptoms include polydipsia and polyuria. As well as when receiving intravenous fluid therapy or medications that might increase fluid throughput.
Dogs should also ideally have outdoor access for appropriate activity dependent upon their mobility, age, and health, and for regular toileting. Ideally, these will have different urine substrates available.
For example, grass, soil and/or gravel. Asking owners upon admission whether their dog has a substrate preference for urination can be helpful, particularly with bitches who prefer to urinate on grassy areas.
Hospitalisation plan
A pre-hospitalisation questionnaire could be included within the admittance and general anaesthetic permissions, to establish the additional information required to design the hospitalisation plan. It should include as much of the normal daily home routine as possible.
Suggested additional information for the hospitalisation plan:
Medication or treatment requirements
How they normally have tablets (e.g. in food), type of treats they have, whether they use a pill popper, if there are any issues.
Diet
Make and type of food they have, size and timing of meals, types of bowls used for food and water, their preferred treats, whether there are any allergies and if they are hand-fed or not.
Exercise requirements
Normal daily exercise routine including duration and times.
Enrichment
Favourite play, types of games, activity feeders, toys, stroking and petting preferences.
Behavioural issues
Whether they are nervous, have noise phobias, or dislike certain people or animals.
Grooming
Frequency, type of brush or comb, main areas and method, plus areas to avoid, if any.
Toileting
Preferred substrate and normal daily routine, owner's specific verbal cue for toileting, such as 'do you need a wee-wee?'.
Other
Known training commands, whether they wear a harness, or have a preferred lead type.
Kennel enrichment
Where dogs are hospitalised for more than 24 hours, enrichment should be offered.
Some examples achievable within a hospital kennel are:
- hand feeding, where appropriate to do so and interactive feeding toys
- tactile stimulation like stroking or massage and proximity to a person – sitting quietly with a dog
- training exercises for dogs hospitalised longer term. For example, giving a paw or, for the non-ambulatory patient, touching a person’s hand with their nose in order to receive a treat.
Contraindications for enrichment might include medical or surgical reasons. For example, if enrichment negatively impacts the efficacy of treatment interventions. Or if staff safety is compromised. For example, if a dog is frightened or uncomfortable about human presence within their kennel, likely to protect an enrichment item, or become frustrated.
Admitting and discharging patients
If possible, dogs should be admitted onto the ward with an item from home to provide olfactory support.
However, owners should be made aware that there is a risk of such an item becoming dirty, being discharged soiled or becoming lost within clinic laundry facilities. To avoid this items should be labelled or placed in a bag to be hung up on their kennel.
Where dogs are admitted wearing their own collar, lead and harness combination, these should be tested for function before the patient is admitted. Some clinics might use in-house slip leads for convenience. However, where these are used it is important that they are not permitted to tighten around a dog’s neck or used in such a way that they risk causing accidental airway constriction.
Pain management
Appropriate interventions to address pain should be provided for in and out-patients.
Medicating
Medication is often a necessary part of a patient’s hospitalisation routine. However, where this might cause the dog to feel pain or discomfort, it can be something they learn to try and avoid.
Therefore, it is important to introduce enrichment into the hospital routine so that the dog learns that a clinician arriving at their kennel can be a source of enjoyment.
Where medication is to be administered orally, a variety of foods or treats to aid administration should be available, unless contraindicated.
Should a dog’s preference be identified, this information should be readily available on their kennel and medication charts and/or medical notes.
Preparation of the patient for anaesthesia, medical or surgical intervention
Approaches to handling and restraint should be consistent throughout the clinic facility.
Localised topical anaesthesia should be considered, where appropriate for the individual dog, ensuring the instructed amount of contact time and consent for use, to facilitate intravenous catheter placement.
Wound interference prevention
Dog Friendly Clinics should offer a range of cones and dressing protectors constructed of a variety of materials that offer comfort while meeting individual needs.
Transparent cones are often tolerated better than the traditional opaque variety, as they enable greater vision. However, inflatable or soft collars (donuts) may offer greater comfort and be more acceptable to a dog.
Depending upon the position of the wound, consider alternative forms of protection such as wound boots, recovery sleeves and bodysuits.
Suitable analgesia should be used to reduce motivation to interfere with wounds.
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Disclaimer notice: The advice given on this website [in these materials] is intended for your general information only and should not be relied upon as specific advice for any veterinary practice or clinic. Each veterinary practice or clinic will be unique in its physical environment and each dog attending the veterinary practice or clinic will have specific needs and requirements, which the veterinary practice or clinic is solely responsible for. Unless prohibited by law, Dogs Trust and the British Veterinary Behaviour Association do not accept liability to any person veterinary practice or clinic relating to the use of this information.
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