The acute and chronic stress response

A visit to the veterinary clinic has the potential to impact a dog's behaviour. Discover why.

owner petting labrador in waiting room

The ‘stress response’ is a term commonly applied to an individual’s physiological, psychological, and behavioural reaction to any perceived threat to wellbeing.

Any triggering stimulus of this change within the body could therefore be considered a stressor. 

The acute stress response

In evolutionary terms, the acute, or immediate, stress response places a dog into a state of biological preparedness. This optimises the physical ability of the dog to respond appropriately to the challenge, with the aim of surviving long enough to reproduce and pass on genetic material.

This might be achieved through avoidance or repulsion of the stressor as we discuss in our section on canine behaviour.

The acute stress response increases arousal to prepare the dog for potential action. This involves activity within the sympathetic nervous system such as:  

  • elevated adrenaline (epinephrine) and noradrenaline (norepinephrine) released from the adrenal medulla 
  • increased blood glucose – due to increased glucocorticoid release from the cortex of the adrenal gland which promotes gluconeogenesis (formation of glucose) and antagonises insulin production, which helps to provide energy in anticipation of required action-taking 
  • potential for immune suppression in response to elevated glucocorticoid levels  
  • potential emptying of the bladder and bowel might also occur as part of the individual’s physiological preparedness to attend to perceived danger 

Stressors will be relative to the individual, for example, some dogs might be more sensitive to auditory rather than visual stimuli.

However, potentially triggering stimuli might have a greater impact if combined – as is likely within the veterinary clinic – and particularly where a dog might have learned, through repeated previous exposure to these contextual stressors, to anticipate negative outcomes here.

Repeated exposure to a stressor

Repeated exposure to a stimulus with the potential to trigger a stress response might affect the individual in one of two ways:


This is a decrease in the behavioural response to a stimulus through repeated exposure. Here, the stimulus is perceived as neutral, neither threatening nor positively exciting, and exposure results in no change in arousal.

If a dog becomes habituated to a stimulus it is unlikely to trigger any physiological response and change in behaviour. 


This is an amplification of the physiological and emotional response to a stimulus through repeated exposure. Here, exposure elevates arousal.

Once a dog becomes sensitised to a stimulus, exposure to it is likely to trigger an involuntary physiological and behavioural response.   

Sensitised dogs may appear to be in a state of heightened arousal in which additional stressors, previously experienced as mild or low-level, might now elicit a physiological response of greater intensity or of extended duration.

This is often accompanied by hypervigilance, for example, a dog actively scanning the waiting room, unable to settle, with an increased propensity to startle.   

Coping with stressors

The intensity and duration of a stressor can also impact a dog’s ability to cope with its presence.

For example, a dog might be able to tolerate coming into the veterinary clinic waiting area for a ‘visit’ to collect a repeat prescription, but might be unable to continue to cope when taken into the consultation room for a clinical examination and held for a blood test this is known as situation stacking

Through associative learning, dogs can become so classically conditioned to stressors that their lowest-level presence and even the anticipation that they might present (triggered by environmental contextual cues) will elicit anxiety and distress.  

In general, most individuals are less anxious and better able to cope if they have one or both of the certainties below. 

  • predictability: this allows an individual to prepare to deal with a recognised stressor. 
  • control: an individual who has a means of controlling their own exposure to a stressor can take steps to reduce its impact.

    For example, a dog who is frightened of unfamiliar visitors to the home might choose to hide within a designated safe den (as long as it is provided for them) as a means of controlling their own environment in order to feel safer. 

The chronic stress response

Chronically persisting stressors to which the individual is sensitive result in the hypothalamic-pituitary-adrenal axis (HPA axis) and sympathetic nervous system being perpetually stimulated.

This can lead to several maladaptive outcomes including: 

  • gastroenteritis – with the potential for gastric ulceration  
  • increase or decrease in appetite 
  • suppressed reproductive activity (in entire individuals) or changes to the regularity of reproductive seasons
  • immunosuppression and associated increased disease-risk 
  • delayed wound healing 
  • metabolic and circulatory changes, such as elevated blood pressure 
  • depressed demeanour  
  • the apparent loss of habituation – reacting to a stimulus that did not previously cause a response
  • stereotypical behaviours, such as repeated self-licking/chewing or spinning, performed in an attempt to provide relief  
  • age-related cognitive dysfunction, such as altered sleep-wake cycle, reduced ability to concentrate, impaired memory, impaired sensory function – and the increased vulnerability associated with this. 

Within the veterinary clinic, it is unsurprising that a hospitalised patient could start to show signs of chronic stress response.

Find out more about how to make hospital wards more dog-friendly in our section on hospitalisation

Learned helplessness 

An individual experiencing chronic stress might eventually abandon any attempt to alleviate the situation for themselves. Instead, they'll enter into a state of learned helplessness, in which they feel absolutely without the means to help themselves in any situation.

It is important to remain mindful of this during any veterinary consultation or hospitalisation. Learned helplessness might simply look like the dog is accepting what is happening to them.

Their behaviour might easily be misinterpreted as stoicism and tolerance, with the emotional experience of the individual therefore disregarded.

It is therefore important to really look at the whole of the dog for subtle body language signals which can help us to understand how the dog is feeling. 

Building resilience 

It is unrealistic to perceive that life for a pet dog might be entirely without stress. Even when attempts are made to minimise stress as much as possible, complete avoidance is highly improbable.

Dogs can therefore benefit from building up resilience. This means they will be better able to cope when experiencing mild stress and be able to recover more quickly from exposure to significant stressors.  

Some approaches to building resilience to the stressors involved with veterinary care are listed below: 

  • Gradually building up the intensity of stressors the dog is exposed to- as seen in habituation and socialisation appointments for puppies
  • Providing the dog with some means of feeling in control over the veterinary environment, such as providing a safe space for the dog to settle.   
  • Teaching the dog to accept incremental examination and handling procedures, as well as settling on their own, in order to develop coping mechanisms for the veterinary environment.

Advice for owners regarding the above is found within the owner-facing resources part of the dog-friendly clinic website.


  • Mills, D., Braem Dube, M., & Zulch, H. (2013). Stress and Pheromonatherapy in Small Animal Clinical Behaviour. Chichester: Wiley-Blackwell  
  • Hedges, S. (2014). Practical Canine Behaviour: For Veterinary Nurses. CABI: Oxfordshire

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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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