Tyson’s Recent Librela Injection
These few seconds in this video are the sum total of many months of daily cooperative care work. Initially I was going to write ‘hard work’ but the reality is the work wasn’t actually that hard. It was simply consistent. It was fun. It was intellectually stimulating. Most importantly, it improved Tyson’s life emotionally and physically. Every day Tyson and I worked on some element of what the big picture might look like on the actual day of his Librela injection at our amazing vet clinic @broadviewveterinaryhospital. We were able to arrive on this day with a sense of predictability, safety and relaxation because of the amazing training and guidance we received (and continue to receive) from the brilliant and incomparable @laura.monaco.torelli.
The backstory: over Tyson’s lifetime he’s had a few very stressful vet visits which appeared to impact him at future vet visits (none of these occurred at our current vet). In addition, I didn’t work on building cooperative care vet protocols. I basically pretended vet visits weren’t that stressful until they were. Repeat for years.
About a year ago I attempted to start Tyson on monthly Librela injections due to worsening arthritis. The first injection was done at our vet clinic. It went okay but Tyson seemed stressed. I attempted to do the second Librela injection at home on my own. I thought if it came from me and in our home it would be easier and less stressful for both of us. I was wrong. Tyson screamed as the injection went in, I panicked and pulled the needle out, he avoided me for several days and he never actually received the medication. At that point I gave up. I said to my partner that was just the way it was going to be. We would not continue to try Librela because it’s an injection. In my mind, no amount of behaviour modification using positive reinforcement could change this situation. Specifically, I couldn’t practice the part where the needle crosses the skin barrier and the medication is injected ~ which I was certain was the worst part for Tyson.
About 6 months went by and I still wasn’t comfortable with the decision to walk away from trying as I continued to see Tyson’s arthritis worsen. I kept asking myself ~ had I really fully explored cooperative care in this context? The answer was obviously No. That’s when I reached out to Laura and Tyson and I began our journey with her. Here are a few things I’ve learned from Laura and our amazing vet team over the past 6 months:
Pace: I had a time goal in mind for my work with Laura and Tyson. This evolved from thinking about time in a linear way to simply working on pieces of a puzzle that look like the original goal. We worked on each component part of the overall injection picture. We sliced out pieces of the picture and worked on them alone (e.g. muzzle re-training) and then mixed various parts together (e.g. muzzle on while I tented Tyson’s skin the way Steve does in during the actual injection). It was beautiful. It felt like a symphony. Tyson told me with his behaviour that he was eager to participate. As soon as I grabbed tools (e.g. his muzzle ) he would slowly wag his tail and follow me to wherever we were training that day.
Space: Laura reminded me that space is a reinforcer for many dogs ~ including Tyson. My amazing vet clinic agreed to meet with me and Tyson in their back parking area for many of our vet visits. We now arrive a few minutes early so that Tyson can sniff around in the back. Most of our vet visits occur in the parking lot. As soon as the procedure is over, he can easily gain access to space outside.
Protective Contact: Tyson wears a muzzle at the beginning of every vet visit and if his vet team is comfortable because his behaviour tells them/me he’s relaxed, then we remove the muzzle after the procedure is complete. He has on several occasions solicited attention from our vet team at the end of an appointment.
Planning: Prior to a vet appointment, I’ll send the clinic an email running the plan by them and asking if they are comfortable with the plan and will ask if they have any suggestions.
Medication: My vet (Dr. Amanda Low. Also brilliant and kind) prescribed pre-appointment medication to help reduce Tyson’s feelings of anxiety at the appointment. It’s been a game changer.
Right to Refuse: We always have an out. If Tyson’s behaviour suggests he’s uncomfortable under certain conditions, we don’t have to move forward or we can try to change the conditions. Everyone is in agreement about this.
Expertise: I am not a vet or vet tech. One area that I will now forever leave to the experts are injections. The video says it all. Steve knows exactly where to put the needle and how, he’s fast and calm and he moves backwards as soon as the injection is finished to offer Tyson additional space. Thank you Steve, RVT. You’re a superstar!
Who’s On Your Shoulder?: Laura will often share during our training sessions (I’m likely paraphrasing) ~ “I have Dr. Susan Friedman on my shoulder saying ~ We train for resilience.” These words helped me immensely while Tyson and I worked on this project (and will for the rest of my life in many other contexts). I was really stuck for a long time. I couldn’t imagine a universe in which we could actually make meaningful progress with injection training without everything falling apart the moment of the actual injection. As you can see in the video, Tyson’s back end drops just as Steve pushes the medication in but immediately pops back up. He was eating from my hand the entire time Steve was doing the procedure with the exception of the few seconds that the medication was injected ~ which I’ve come to realize is very normal given that the injection probably was uncomfortable. Needles suck. I know this personally. It now seems odd that I would expect Tyson to have no reaction to a needle piercing his skin and medication being injected (possibly the cold was aversive for him?). He didn’t even look back at Steve during or after (when Tyson is hyper aroused he usually stares. Hard stares). His eyes were soft vs in the past when his pupils were dilated and he looked terrified. His body language was largely relaxed throughout. His tail was lowered but that’s where it sits most of the time these days. It wasn’t positioned between his legs. As we walked back to my car at the end of the procedure, Tyson did some casual sniffing. He wasn’t in a rush to leave. He took his sweet time. I loved it. I thought, please take all the time you want handsome man. Tyson’s behaviour just before, during and after the injection suggests that there were many more components that made up the “injection” picture than I hadn’t initially accounted for. It likely wasn’t just the injection that was creating a stressful response. It was probably some combination of the complex elements that make up Tyson’s previous learning history with vet clinics over his lifetime (the bad and the good).
The Power of + Reinforcement: My work with Laura has been incredibly empowering. I went from totally writing off the possibility of Tyson taking Librela to where we are today. Laura has many gifts, one that really works for me is her focus on the things I’m doing well during a training session. Her feedback allows my nervous system to take in and process what she’s saying. There’s room to play and find levity now. I hope Tyson feels this too. Tyson and I keep building on these beautiful moments. Magically a sense of joy around this previously very stressful situation has emerged for both of us. My brain isn’t in panic mode anymore ~ which ultimately means I can make better decisions for Tyson. And let’s be honest, the name of the game is fun. The plan is for Team Tyson to continue our learning journey and keep finding pleasure in the magical slices of behaviour that emerge.