All Animal Hospital Anomalies & How to Spot Them
Anomalies are entities disguised as patients. There are three ways to catch one: look at it directly, take a polaroid, or check the CCTV — and each anomaly type only shows up through one of those channels. A single patient can stack several anomaly traits at once.
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Written by Riley Nook · Last updated July 10, 2026
This update: in-game mechanics cross-checked against community wikis and player reports
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Anomaly Identifier
Mid-game and not sure? Pick where you noticed something off — get the matching anomalies and the correct play, instantly.
↑ Start by picking a channel. Rule of thumb: when in doubt, shutting the window is always safe — tasing a normal animal costs −15 sanity.
Ground rules
- Letting an anomaly in usually triggers a Death Ritual, spawns a monster, or turns it into a Shapeshifter that attacks patients and staff.
- Anomalies can't be knocked out (fainting and fire don't work). A wrong treatment kills them with no penalty but lowers your end-of-shift reward; the taser and gun also work.
- Tasing an anomaly gives +2 sanity; tasing or shooting a normal animal costs −15 sanity — be sure before you pull the trigger.
- If every patient seems handled but the shift won't end (no "The doctor is coming" message), one of the remaining "patients" is an anomaly.
👀 Visual anomalies
Spotted with the naked eye — no equipment needed.
| Anomaly | How to spot it / what to do |
|---|---|
| Realistic Face | Big eyes with dark pupils, heavy eye-bags and a painted-on grin; speaks in a low distorted voice. The smile disappears if you tase it. |
| Three Eyes | Three misplaced glowing-red eyes replace the normal pair — sometimes you can still see the original eyes underneath. |
| Crooked Face | A warped, tilted grin with sharp teeth and mismatched eyes sitting visibly too high on the face. |
| X-rayed Face | Small, wide round eyes with black pupils and unsettlingly realistic teeth. |
| Staring | Its head tracks you (or a random target) constantly — up to ~60° in person, but with no limit on CCTV. Always turns into a Shapeshifter during recovery, so keep watching after treatment. |
| Hollow Face | Deep pitch-black hollow eyes, constant twitching, hunched posture. Always triggers a Death Ritual during recovery — just shut the window on it; rejecting it doesn't hurt your results. |
| Twitching | Arms/head spasms, stretched neck, hunched back. Sometimes only visible on camera. Always becomes a Shapeshifter in recovery. |
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📸 Photo anomalies
Only visible on the polaroid. Regular anomaly photos don't cost sanity — only cursed photos do.
| Anomaly | How to spot it / what to do |
|---|---|
| Incorrect Photo (Different Eyes/Ears) | The polaroid doesn't match the patient at the window — different eye shape, ear shape or ear color (e.g. bunny ears in person, bear ears in the photo). |
| Static Photo | The photo comes out covered in static grain. Since the June 22 update a pure static photo is NOT guaranteed to be a Shapeshifter (shooting it may just knock it out) — but it's still an anomaly and letting it in triggers a Death Ritual. Safest play: shut the window. |
| Cursed Photos | The photo itself becomes a horror image (realistic eyes, warped grin, bleeding eyes and other variants). Picking a cursed photo up costs 10 sanity — let the photo finish printing and look before you grab it. |
📹 Camera anomalies
Only visible on the security cameras — always check CCTV before admitting anyone.
| Anomaly | How to spot it / what to do |
|---|---|
| Black Eyes | On CCTV its face is covered by a black bar with a pair of realistic eyes staring back at you. |
| Unnatural Body ("Boneless") | Severely stretched, warped body on camera — its shape changes every time you toggle the feed, and even its photo distorts while the camera is open. |
| Staring at Cameras | Looks directly into the CCTV lens at all times, even while walking. |
| Void / Black | Appears entirely pitch black on camera. |
| Camera Twitching | Twitches only in the camera feed — looks normal in person. |
| Disguised Shapeshifter | Shows its true Shapeshifter form only on CCTV; in person it looks normal until it reaches check-in. Use the lobby camera to catch it from the side. |
| Mismatching Ears | Ears or horns on camera don't match what you see at the window. |
| Mismatching Eyes | Eyes on camera don't match the patient in front of you. |
Field-tested tips
- A patient idling with a hunched, slouched posture is a Shapeshifter or anomaly — every time.
- After Shift 10, static photos get unreliable as evidence — default to shutting the window instead of shooting.
- The Head Banger is special: tasing, shooting or shooing it costs −20 sanity. The right play is handing it a coffee (drink two sips first and you net +10 sanity).
- A patient dropping slime is not proof of an anomaly.
- If a room catches fire and the patient inside doesn't faint — that's a Shapeshifter, 100%.
- After treating someone, linger outside the room for a minute: Shapeshifters often mutter "I'm hungry..." or "I feel funny..." right before turning.
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Verified against community data. Last checked: July 10, 2026.