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This article reports on video analyses of 110 veterinary appointments in which pet-directedI knowreceipts were uttered by 15 veterinarians as responses to companion animals’ vocal and visible signals of distress. Patients’ distress was typically occasioned by medical activities constituting the appointment. The dual functions ofI knowas a claim of (a) prior knowledge of animals’ experiences and (b) shared feelings and affiliation with animals’ experiences made it an interactional resource for addressing client anxiety arising from the disalignment of animal patients with the goals of the appointment. Analysis of prosody, prefacing, the presence or absence of repeats, and postpositioned components demonstrated the flexibility of theI knowreceipt in modulating veterinarians’ stances toward their patients’ expressions of distress. Findings are discussed in relation to studies on the management of patient distress and pain in pediatric procedures and to previous research on clinician–patient empathy in veterinary medicine. Data are in Canadian English. [ABSTRACT FROM AUTHOR]