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Game guide
Animal Hospital Guide: Your first shift
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About
OverviewAnimal Hospital is a horror survival game where you work the night shift at a hospital for anthropomorphic animals, treating real patients while spotting and turning away anomalies — creatures disguised as patients. This guide covers how to get started, how to use the four detection systems, how to keep your sanity up, how to handle the harder shifts, and what the items and recurring characters can do for you.
What is on this page
Contents
01
Your first shift
Step
02
Four ways to detect an anomaly
Tips
03
Live and upcoming events
Events
04
Keeping sanity above 40 percent
Check
05
Items worth knowing about
Tips
06
Handling the ambulance event and later shifts
Step
07
Recurring characters and what they offer
Summary
08
Classes and free-to-play range
Summary
09
Room 8 surgery and the tentacle event
Warn
10
Glossary
Words
11
Common questions
FAQ
01
Your first shift
Step
In short
Shift 1 has no anomalies, so use it to learn the layout and treatment flow before the pressure starts.
Shift 1 gives you two scripted patients — the first always needs eye drops, the second always needs herbs. Nothing will attack you, so use the time to find every room and get comfortable with the check-in routine. Item slots are limited, so get into the habit of dropping anything you no longer need in a bin or returning it to a shelf. Memorise what Ratthew looks like now, because later shifts send a shapeshifter in his place.
- Learn the layout walk the hospital and locate the reception desk, all eight treatment rooms, and the coffee maker near the front.
- Treat patient one with eye drops and patient two with herbs those are the fixed conditions for every Shift 1 run.
- Read the diagnosis before acting giving a patient the wrong item kills them and costs you a life.
- Note the coffee maker it sits near reception and produces a free coffee every 180 seconds; grab it immediately so the next one starts brewing.
- Remember Ratthew's face the Mimic anomaly copies him in later shifts, and spotting the difference matters.
02
Four ways to detect an anomaly
TipsIn short
Combining all four detection methods — appearance, photo, camera, and paperwork — is the only reliable way to catch every type of anomaly.
Some anomalies are obvious the moment they walk up: their face, posture, or voice is clearly wrong. Others look normal at the window but show something disturbing only in a photograph. A third group looks fine in person and in photos but behaves strangely on the security cameras. Finally, some anomalies have no appointment on file, which shows up in their paperwork.
Tips worth knowing
- Check appearance first — an unnatural face, three eyes, a hunched posture, an extremely small body, or a low distorted voice are instant tells.
- Never pick up a photo before it finishes developing — picking it up early costs 10 sanity; just look at it on the desk.
- Watch the security cameras for mismatched ears, a body that appears entirely black, or a patient that stares directly at the camera lens at all times.
- A patient listed as having no appointment is almost always an anomaly — check that paperwork every time.
03 Live and upcoming events
Events
Events running now or coming soon. They have fixed dates, so check them first.
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Upcoming
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Halloween - Part 2
04
Keeping sanity above 40 percent
Check
In short
Sanity starts at 61 percent and drops faster than most players expect, so treat the coffee maker as a regular stop rather than an emergency measure.
Reaching zero sanity ends your run immediately. Coffee restores 5 percent per sip and has three sips per cup, for 15 percent total, and is free from the maker every 180 seconds. Chocolate is more efficient — 20 percent per bite, up to 60 percent per bar — but costs either money or Robux. The Head Banger is a special case: tasering, shooting, or rejecting it drains 20 percent of your sanity, so always hand it a coffee instead. Death ritual candles can also be removed without any sanity loss if you use a taser, eye drops, IV drops, or coffee rather than your bare hands.
- Check whether you are collecting coffee every 180 seconds from the maker near reception.
- Check whether you are leaving photos on the desk rather than picking them up before they develop.
- Check whether you are giving coffee to the Head Banger instead of using your taser, gun, or shutter on it.
- Check whether you are using a taser or an approved item on death ritual candles rather than your hands.
- Check whether you are staying out of burning rooms standing near fire drains 1 to 3 sanity per second.
- Check whether you have completed Barney's questline without turning him in, which rewards a second coffee machine that brews independently of the first.
05
Items worth knowing about
TipsIn short
Several items double as both sanity tools and combat tools, so knowing what each one does beyond its obvious use saves you in tight situations.
Beyond coffee and the taser, the supplies shop stocks items that handle specific problems. Knowing what each one does before you need it means you spend less time reading menus under pressure.
Tips worth knowing
- Mint Tea slowly restores sanity over time and can also be given to Dr. Harlow for an achievement.
- Run Fast Cola lets you move faster for up to 30 seconds — the Paramedic class gets a Large Run Cola version with five uses and 120 seconds of speed.
- The fire extinguisher, available free from the right of the supplies shop at Shift 3, puts out room fires fastest, extinguishes burning patients without requiring follow-up ointment, and can also defeat Hiders and temporarily reveal the Ghost.
- The Scanner costs 150 in-game dollars for one use and tells you whether a patient is an anomaly; the Secret Agent class starts with one.
- A Deployable Camera costs 600 in-game dollars and works exactly like a security camera but can be placed anywhere — Security class gets one free at level 2.
- The Teddy Bear costs 1000 in-game dollars and revives one dead teammate; it cannot be used on yourself.
- Pizza is free from Liz's house after completing her questline and restores 35 percent sanity total across three bites.
06
Handling the ambulance event and later shifts
Step
In short
From Shift 4 onward the pace jumps sharply, and splitting camera-watching from front-desk work with a teammate makes a real difference.
The ambulance event fires every five shifts starting at Shift 4, sending six patients in at once with anomalies mixed among them. The number of critical patients matches the number of players currently alive in the lobby, so keeping teammates alive directly affects how much pressure you face. Completing the event earns a bonus of 150 in-game dollars.
- Assign roles one player watches the security cameras while another handles the reception window, so neither job gets neglected.
- Watch the critical-patient timer it shows through walls, so locate it fast and move immediately.
- During a death ritual, clear the candles within 40 seconds using a taser or an approved item to avoid sanity loss.
- From Shift 10 onward, Slime Shifts can occur: Slimebert roams the wings and catching you drains 20 sanity instantly plus 3 per second while it holds you hire Sam for 250 in-game dollars after a Slime Shift to help with cleanup for three shifts.
07
Recurring characters and what they offer
SummaryIn short
Following each recurring character's questline through to the end unlocks bonuses that make later shifts noticeably easier.
Several characters visit the hospital across multiple shifts and give you perks or items if you meet their needs. None of them ask to be checked in as patients.
- Barney hiding him from Officer Duckman instead of turning him in rewards you with a second coffee machine that brews on its own five-minute cycle.
- Ratthew a recurring rat patient who also holds the key to Room 5's safe; later shifts send a Mimic in his form, so learn his normal appearance early.
- Liz a feline ex-reporter who appears from Shift 7 onward and lends you her UV camera for a questline; completing it lets you visit her house and collect free pizza.
- Dr. Harlow give him Mint Tea after Shift 7 to ask him questions about other characters.
- Sam appears after Slime Shifts and can be hired for 250 in-game dollars to clean slime, remove Hiders, and extinguish room fires for three shifts.
08
Classes and free-to-play range
Summary
In short
Nine of the eleven classes can be unlocked with Animal Coins earned in-game, and the free Intern class is genuinely usable all the way through.
Classes change your starting stats, item slots, and abilities. You begin with Intern for free; buying others costs Animal Coins earned by treating patients (2 coins each), checking in visitors (0.5 coins each), and rejecting anomalies (0.5 coins each). Only Head Nurse and Secret Agent require Robux.
- Intern free, higher starting sanity, solid for learning the game.
- Nurse small coin cost, one extra inventory slot, great early upgrade.
- Surgeon larger coin cost, all three stats start high, best for solo play.
- Paramedic coin cost, starts with a Large Run Cola good for five uses and 120 seconds of speed.
- Security coin cost, starts with an X-Taser worth five uses, and gets a free Deployable Camera at level 2.
- Head Nurse Robux only, three extra inventory slots, biggest carrying capacity in the game.
- Secret Agent 790 Robux, starts with a gun and scanner, built for players who want more combat.
09
Room 8 surgery and the tentacle event
WarnIn short
Room 8 has a strict 45-second timer and its own item list, so knowing the order before you walk in is the difference between saving the patient and losing a life.
Surgery in Room 8 uses items not found in other rooms — Antibiotics, Scalpel, Scissors, Transplant, and Organ alongside the standard Medkit, Bandages, IV Drops, and Medicine. Completing a surgery successfully restores 1 percent sanity. If tentacles emerge mid-surgery, a second surgery starts immediately with a fixed opening sequence: scissors, transplant, scissors, transplant, then three random treatments.
Worth watching out for
Do not tase or shoot a patient when tentacles appear
the tentacles do not mean the patient is an anomaly, and attacking them counts as an animal death.
Do not ignore the two-second overlap after the final treatment lands
the timer keeps running briefly, so finishing at the last second can still result in death.
Do not skip reading the diagnosis
Room 8 treatments must match what the computer screen shows, and guessing wrong kills the patient.
Glossary
Glossary- Anomaly
- A creature disguised as a patient that will attack and kill other patients or players if let inside.
- Sanity
- A percentage gauge that varies by class but starts at 61 percent for the Intern; hitting zero ends your run immediately.
- Shutter
- A rejection button at the reception desk, available from Shift 2, used to turn away anomalies at the door.
- Shift
- One round of play; completing it earns Animal Coins and in-game dollars and advances the story.
- Death Ritual
- An emergency event where candles appear in a room and must all be removed within 40 seconds; touching them bare-handed drains 1 to 3 sanity per candle.
- Ambulance Event
- A mass-arrival event starting at Shift 4 that sends six patients at once, some critical and some anomalies, every five shifts.
- Mimic
- An anomaly that copies a recurring patient like Ratthew; spotted by subtle differences in posture or appearance, and formerly called Skinwalker.
- Animal Coins
- The main currency earned during play, used to buy and upgrade classes and cosmetics.
- Ratthew
- A recurring rat patient who holds the key to Room 5's safe; later shifts send a Mimic in his form.
- Slimebert
- An enemy that appears during Slime Shifts, catching players for 20 sanity damage plus 3 per second, and turning any anomaly it attacks into a Mimic.
- Rainy Shift
- A special shift type starting as early as Shift 3 where only fish patients arrive and puddles on the floor grant 1 sanity when stepped in.
- X-Taser
- A five-use version of the taser available from the supplies shop for 250 in-game dollars, or as a starting item for the Security class.
Common questions
FAQWhat should I do if an anomaly gets inside?
From Shift 4 onward a free taser is available in the reception office, and successfully stunning an anomaly with it recovers 2 sanity. Note that shooting an anomaly with a gun does not recover sanity unless you are playing the Secret Agent class. A gun can also be purchased from the in-game store.
Which class should I pick first?
Start with the free Intern — its higher starting sanity gives you more room to make mistakes while you learn. Once you have a small amount of Animal Coins, buying Nurse adds an inventory slot that makes carrying treatment items much easier. After that, saving up for Surgeon gives you the strongest all-round stats for solo play.
Where do I get coffee, and how often?
The coffee maker near the reception desk produces a free coffee every 180 seconds, and each cup gives 5 percent sanity per sip for three sips — 15 percent total. If you complete Barney's questline without turning him in, you receive a second coffee machine that operates independently on a five-minute cycle.
How is my end-of-shift rating calculated?
Your score is based on four things: how many patients you treated, how many visitors you checked in, how many anomalies you rejected, and how many animals died on your watch. Getting an Excellent requires treating every patient and rejecting every anomaly; admitting any anomaly drops it to Good, and animal deaths push it to Poor or Critical.
How do I handle Room 8 surgery without losing the patient?
Read the diagnosis on the computer first so you know which items are needed, then work through them within the 45-second timer. Completing a surgery successfully restores 1 percent sanity. If tentacles emerge, do not tase or shoot the patient — start the second surgery immediately using the sequence scissors, transplant, scissors, transplant, then three random treatments.
What happens if I tase a normal patient by mistake?
Tasing a patient who is not an anomaly costs you 15 sanity and causes them to run away. Tasing a patient already on the ground will kill them outright.
Updated Oct 3, 2026
Game updates can change what is on this page. If you spot something, get in touch and let us know.
Game updates can change what is on this page. If you spot something, get in touch and let us know.
