Training a Voluntary Blood Draw: It Can Be Done

About a year ago, when my veterinarian was unable to get a blood sample out of my reactive and extremely opinionated young Pug, I got to thinking. I have a background working in zoos, where it’s now common to train animals to cooperate in their own medical care. Animals of many species, including bears, hippos, big cats, elephants, apes, marine mammals, and giraffes, willingly participate in procedures such as blood draws, reducing the need for and risks of anesthesia.

With these animals, restraint isn’t an option. You can’t even be in the same space with some of them. But a gorilla can put an arm up to the mesh of an enclosure for a needle stick, and everyone can stay safe.

If we can do this with wild animals, why do we need to manhandle our pets?

We don’t. The same principles used at zoos work with your dog or cat: Break the procedure down into small steps and use positive reinforcement. Even if you can’t get the whole thing down perfectly, it’s worth doing at least parts of this training with your pets.

The Gold Standard

Alicea Howell, RVT, VTS (Behavior), coauthor of Cooperative Veterinary Care, trains what she calls the “gold standard” for blood draws without restraint. Just like with zoo animals, every part of the procedure is voluntary on the dog’s part.

“First we train a consent behavior – that’s a behavior so the dog can tell you that he’s ready to go,” she says.

For her dog, it’s getting up on a special platform. “He turns on the training session by getting on the platform. If at any point he gets nervous he can get down off the platform and that ends the training,” she says. “But that also ends all the good stuff, so he doesn’t really want to do that.”

The first step in training the blood draw is to get the dog to offer his leg to the tech so it can be held in the correct position. To start, she trains him to touch his paw to a small sticky note. Then she can place that target on her hand and treat for placing his paw there. By moving the target further up her arm, reinforcing at each new step, she gets to the goal: “When I put my hand out and say ‘arm’ he can put his paw right on the crick of my elbow.” Then she can stop using the paper target.

Once the dog is used to having his leg held in this position, she starts training each step of the blood draw: feeling the leg with her fingers like she’s looking for the vein; rubbing the area with alcohol; poking with a syringe that has a cap over the needle; then, poking with a blunted needle (it feels something like being poked with a paper clip). Once he’s good with all that, he’s ready for the actual needle stick.

Training for the Rest of Us

If you’re intimidated by the idea of attempting the gold standard, it’s worth doing just parts of it, in a way that works for you.

Howell uses a clicker, which she believes is ideal for this kind of training. But if you’re not comfortable with one, it’s better to skip it and do your best to treat with good timing than not to train at all. Or use a verbal marker–I use “yes” in a distinctive tone of voice– which keeps your hands free.

If you need to modify the details, stick to the concept: Break it down into steps, treat for each step, and don’t move on until that step is easy. For example, my dog’s leg is much too short for the paw-in-elbow position. Instead, since she already offers a paw for a treat, I started there, increasing the time I held her paw, moving on to holding and manipulating her leg, and then adding the syringe poke.

Even if you don’t train the whole sequence, working on just parts of the procedure is still useful. This kind of training is also worth doing even if you haven’t had problems yet. Handling is stressful even for dogs who don’t show it as fervently as mine does. And a dog who seems fine now may change his mind later if you don’t work on making veterinary care a positive experience.

“A lot of times, young puppies will accept a paw hold, but then they get to 9 to 12 months old and start pulling it away,” Howell says. “So at home, work on touching the foot and giving food reinforcement, just like you’d treat for a sit.”

Some dogs may be stressed by seeing unfamiliar objects (ask me how I know), so simply showing the dog the syringe or alcohol pad and treating is also worthwhile.

And don’t give up if you don’t get around to doing the training at home. Every vet visit is an opportunity.

“Our silver standard is to make sure that every time you go to the vet you bring a training pouch that has a lot of high-value food reinforcement in it,” says Howell. “Treat every time the vet touches the dog and every time a procedure occurs.” That can be enough to convince some dogs that being poked and prodded is cool.

People Problems

Even if you’re up for trying the training, you may encounter another obstacle. As most trainers will tell you (maybe after a few drinks), animals are easy; it’s people who are hard. I did the training, but then couldn’t persuade my veterinarian to try the procedure without restraint.

I felt pretty terrible about this; after all, I write about training for a living, so it’s my job to be persuasive about the benefits. But Howell was not surprised. She says an individual pet owner is not likely to change the mind of a veterinarian who is committed to using restraint.

“I don’t know anything a pet owner can say that will change that veterinarian’s mind,” she says.

This doesn’t mean you have to put up with techniques you or your dog are not comfortable with. It does mean that the only solution may be what I did: find another veterinarian.

If you do move on, Howell says, let them know why. That’s the only way pet owners will be able to drive change. “Don’t just leave the practice. Tell them why you’re going. If we just disappear, then there’s no education that occurs.”

Finally, even if you train this behavior and have a cooperative veterinarian, Howell says it’s a good idea to work on restraint tolerance as well. “Because in an emergency situation, somebody’s going to restrain your dog. It’s best if they have a good history of that being a really positive thing,” she says. “Get other people to do it with them and make it a game, so they learn that no matter what monkey puts their arms around you, a cookie will follow.”

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Linda Lombardi writes about the animals that share our planet and our homes for magazines including The Bark, websites including National Geographic and Mongabay.com, and for the Associated Press. Her most recent book, co-authored with Deirdre Franklin, is The Pit Bull Life: A Dog Lover’s Companion.