You work the night shift at Animal Hospital, and your job is simple. Look at each animal at the check-in window and decide whether it is a real patient or something pretending to be one. The fake ones are called anomalies, and there are 17 types of them.
Here is the part that catches most players out. The anomalies are split across three different checks, and each check only reveals its own group. If you just stare at the window you will miss more than half of them. This page lists all 17, sorted by the check that actually catches them, and shows exactly what every mistake costs you.
Quick answer: Run all three checks on every patient. Look at the window, take a photo, then flick through the cameras. Seven types show at the window, two only in the photo, and eight only on the cameras. If you are not sure, close the shutters, because that is the one choice that never costs you sanity.
What an anomaly actually is
An anomaly is a fake patient. It walks up to your window like anyone else, but something about it is wrong. It might have too many eyes. It might have a face that only changes on camera. Or its photo might not match the animal in front of you.
Let one through and you get one of three problems. It can trap a patient in a Death Ritual. It can burst into tendrils during surgery. Or it can drop the disguise and turn into a Mimic that eats your other patients. Some even say “I’m hungry” after you treat them and attack someone on the way out.
The one test that never lies: anomalies cannot faint. If a room is on fire and someone walks straight through it without dropping, you are looking at an anomaly.
The three checks, and how much each one catches
The wiki sorts every anomaly by which tool reveals it. We counted each group, and the split is the most useful thing on this page.
| The check |
Types it catches |
What it is good for |
| Look at the window |
7 of 17 |
Faces, staring and twitching. No tools needed. |
| Take a photo |
2 of 17 |
Wrong face, wrong ears, or static. |
| Check the cameras |
8 of 17 |
The biggest group, and the easiest to skip. |
Do the maths on that: the cameras alone hold 8 of the 17 types, which is nearly half. If you only look at the window you are catching 7 of 17. Even window plus photo only gets you to 9. The cameras are not optional, they are where most anomalies hide.
Two types, Staring and Twitching, can show up at the window or only on the cameras depending on the patient. That is another reason to run all three checks even when the animal looks fine.
Anomalies you can see at the window
These seven need no tools at all. Just look at the animal properly before you press anything.
| Anomaly |
What it looks like |
Worth knowing |
| Smiling with Creepy Eyes |
Big eyes with black pupils, heavy bags underneath, and a huge drawn-on smile. |
Tase it and the smile disappears. |
| Three Eyes |
Three slightly mismatched glowing red eyes where the normal ones should be. |
The real eyes sometimes still show behind them. |
| Crooked Face |
A crooked smile with sharp teeth, and big mismatched eyes sitting high on the face. |
The 3D eyeballs stay visible whatever face it pulls. |
| X-rayed Face |
Small round eyes set wide apart with black pupils, plus realistic teeth. |
One of the four face swaps, so listen for the voice too. |
| Staring |
It stares straight at you, turning its head up to 60 degrees each way. |
Always becomes a Mimic during recovery. |
| Hollow Face |
Dark hollow eyes, constant twitching and a hunched back. |
Always starts a Death Ritual during recovery. |
| Twitching |
Twitching arms and head, a stretched neck and a hunched back. |
Always becomes a Mimic during recovery. |
Listen as well as look. The first four in this list are all face swaps. Every one of them is guaranteed to have a low, distorted voice. If the voice sounds wrong, look harder at the face.
Anomalies only the photo shows
Take a photo of every patient at the window. These two never show up any other way.
| Anomaly |
What it looks like |
Worth knowing |
| Incorrect Photo |
Something in the photo does not match the animal standing at the window. |
Check the face, the ear shape and the ear colour. |
| Static Photo |
The photo develops grainy and full of static. |
After shift 10 this one is not a guaranteed anomaly. |
Cursed photos cost you 10 sanity. Some photos develop into something horrible. If you pick the photo up before it has finished developing, you lose 10 sanity on the spot. Leave it on the desk, wait for it to finish, then look. A normal photo anomaly costs you nothing to inspect.
Anomalies only the cameras show
There are four cameras: check-in, lobby, medical and emergency. These eight anomalies look completely normal at the window and only give themselves away on the screens.
| Anomaly |
What it looks like |
Worth knowing |
| Black Eyes |
A black bar covers the face with realistic eyes staring out of it. |
Easy to spot once you know it. |
| Unnatural Body |
The body looks stretched and twisted out of shape. |
Close and reopen the camera and the shape changes again. |
| Staring at Cameras |
It looks straight into the CCTV camera the whole time, even while walking. |
Keep watching as it moves, not just when it stands still. |
| Void Body |
The whole patient shows up completely black on camera. |
One of the simplest to catch. |
| Camera Twitching |
It twitches, but only on the camera feed. |
It looks perfectly normal at the window. |
| Mimic on Camera |
It shows up as a Mimic on the cameras only. |
Use the lobby camera for a clear side view. |
| Mismatching Ears |
The ears or horns look different on camera than at the window. |
One of the hardest to notice. |
| Mismatching Face |
The face is different on camera than at the window. |
It often only shows the first time you look. |
Buy a Deployable Camera for $600 if you can afford it. You can drop it anywhere and view it like a normal camera, so you can cover the angle the fixed cameras miss. The Security class gets one free at level 2.
Fix broken cameras when you see them. A broken camera is not just a blind spot, it is also where the Camera Figure spawns, and that jumpscare costs you 20 sanity.
What to do when you spot one
You have three ways to deal with an anomaly at the window, and they are not equal. This is where most runs are won or lost.
| Your choice |
If you are right |
If you are wrong |
| Close the shutters |
The anomaly leaves. No sanity change. |
A real patient waits outside. Still no sanity change. |
| Tase it |
You gain 2 sanity. |
You lose 15 sanity. |
| Shoot it |
It is knocked out and runs off. No sanity gained. |
The patient faints and you have to treat them fast. |
One wrong tase wipes out eight correct ones. A correct tase pays 2 sanity. A wrong one costs 15. That means you need 8 correct calls to undo a single mistake. One wrong tase also costs a full pot of coffee, and a pot takes 3 minutes to brew.
It gets worse when you look at where you start. You begin every shift with only 61 to 65 sanity. Four wrong tases is 60 points, so four mistakes leaves you almost empty and the fifth one kills you. Meanwhile the shutter button costs nothing whether you were right or wrong.
So the rule is simple: tase only when you are certain, and close the shutters every other time. Turning away a real patient hurts your shift grade a little. Tasing a real patient hurts your run a lot.
Every sanity number in the game
Sanity is your health bar. You start each shift somewhere between 61 and 65, and if it hits 0 you die. Below 35 the music slows down and the colour drains out of the hospital, which is your warning sign.
Here is everything that puts sanity back.
| How you gain it |
Sanity |
Notes |
| Drink a coffee |
+15 |
Three sips worth 5 each. A fresh pot brews every 3 minutes. |
| Eat a chocolate bar |
+60 |
Three bites worth 20 each. The biggest heal in the game. |
| Tase an anomaly or Mimic |
+2 |
Your reward for getting a call right. |
| Finish a surgery |
+1 |
Paid out when the patient is treated. |
| Check a patient in as Secretary |
+1 |
Class perk, one point per patient. |
| Heal a patient as Doctor or Surgeon |
+1 |
Class perk, one point per patient. |
And here is everything that takes it away.
| How you lose it |
Sanity |
Notes |
| Ask a Head Banger to leave |
-20 |
Hand it a coffee instead and it costs you nothing. |
| Get jumpscared by the Camera Figure |
-20 |
Switch cameras before it zooms all the way in. |
| Tase a real patient |
-15 |
The single most expensive mistake at the window. |
| Look at a cursed photo |
-10 |
Let it finish developing before you pick it up. |
| Get grabbed by the Bed Monster |
-10 |
Then another 6 every 2 seconds it holds on. |
| Look at the Stalker |
-10 |
Look away and keep moving. |
| Get attacked by a Hider |
-10 |
They wait inside the walls. |
| Get bitten by a Mimic |
-6 |
Every bite, and it bites about twice a second. |
| Shoot a teammate |
-6 |
They lose 2 as well. Watch your aim. |
| Look at the Mass of Eyes |
-3 to -5 |
Every single second you keep looking up. |
| Stand near fire |
-1 to -3 |
Every second. Use the extinguisher, not your hands. |
| Put out a ritual candle bare handed |
-1 to -3 |
Free if you hold eye drops, IV drops or coffee. |
| Get too close to the Ghost |
-2 |
Every second it is next to you. |
| Get tased by a teammate |
-2 |
You both lose 2. |
| Job stress |
-1 |
Every 50 seconds, all shift long, no matter what you do. |
The clock is always running. Job stress removes 1 sanity every 50 seconds no matter how well you play. The game wiki works out that as 1 hour 23 minutes from a full bar, but you never start on a full bar. From a real 61 to 65 start, doing nothing at all kills you in about 51 to 54 minutes. Keep drinking coffee.
The wiki lists fire two ways: 1 sanity a second on one page, and 1 to 3 on another. Treat it as up to 3 a second, and use the extinguisher.
The Psychologist trap
The Psychologist class doubles your sanity effects, and most people hear that and assume it is a straight upgrade. It is not. It doubles everything, including the bad half.
| What happens |
Normal class |
As Psychologist |
| Drink a coffee |
+15 |
+30 |
| Tase an anomaly |
+2 |
+4 |
| Tase a real patient |
-15 |
-30 |
| Ask a Head Banger to leave |
-20 |
-40 |
If you already play carefully it is the strongest class in the game. If you are still learning which faces are wrong, it will end your runs twice as fast. Pick it once your calls are reliable, not before.
Monsters that are not check-in anomalies
Some things in the hospital are not patients at the window at all. You cannot shutter these out, so it helps to know what each one wants.
| Monster |
What it does |
How to handle it |
| Head Banger |
Bangs on the office window and blocks your shutters. |
Give it a coffee. You can take 2 sips first. |
| Ghost |
Floats around invisibly after a patient dies. |
Sneak up behind it with the taser or gun. The extinguisher makes it visible. |
| Camera Figure |
Appears on broken cameras and zooms in for a jumpscare. |
Fix broken cameras. If one appears, switch away fast. |
| Mimic |
What an anomaly turns into once it gets inside. |
Keep it out in the first place. That is the whole job. |
| Bed Monster |
Hides under a patient bed and drags patients under. |
Feed it maple syrup, an organ or a transplant. |
| Mass of Eyes |
Covers the ceiling of a room. |
Do not look up. Treat your patient and leave. |
| Tendril |
Bursts out of a patient during surgery in room 8. |
Finish the surgery minigame. Never tase or shoot it. |
| Stalker |
A black figure that follows you around the hospital. |
It cannot be tased or shot. Break line of sight. |
The Head Banger is the big one. While it is at your window you cannot close the shutters at all, so real anomalies can walk straight in. Hand it a coffee and it leaves quietly for free. Asking it to leave costs 20 sanity, which is the second most expensive thing that can happen to you.
When you get each tool
You do not start with everything. The first few shifts hand you your kit one piece at a time, so early runs feel very different from later ones.
| Shift |
What you get |
What changes |
| Shift 1 |
Nothing yet. Tutorial. |
Two scripted patients who are never anomalies. Stomach ache needs herbs, dried eyes need eye drops. |
| Shift 2 |
Shutters and security cameras |
Real anomalies start arriving. The Emergency Wing and the shop open at the end of the shift. |
| Shift 3 |
A reminder, not a tool |
Dr. Harlow tells you to keep checking the cameras and the photos. |
| Shift 4 |
Free renewable taser |
It sits in the Check-In Office. The first ambulance event also lands: 6 patients at once. |
| Shift 6 |
The rules get real |
Dr. Harlow’s last visit. Three animal deaths and your run is over. |
| Every 5 shifts |
Another ambulance |
More critical patients each time, and a cash bonus for clearing it. |
If you would rather not wait, the Supplies Shop opens at the end of shift 2. A taser is $150 for one use, or $250 for three. A gun runs $400 to $410 and holds 20 to 25 shots. A Deployable Camera is $600. The free taser in the Check-In Office recharges every 180 seconds after you fire it.
A small wiki conflict. Most pages say the shutters and cameras both switch on for shift 2. One page says cameras arrive on shift 3 instead. Either way they land very early, so start checking them the moment the buttons work.
Mistakes that end runs
- Only looking at the window. You are covering 7 of 17 types. The cameras hold more anomalies than your eyes do.
- Grabbing the photo too early. Wait for it to finish developing. A cursed photo you picked up early costs 10 sanity for nothing.
- Tasing when you are only pretty sure. The shutter is free. Use it.
- Asking the Head Banger to leave. Twenty sanity, instantly. Keep a coffee spare for it.
- Staring at a broken camera. Fix them, and switch away quickly if something is already on the feed.
- Forgetting to drink. Job stress never stops. If a coffee is ready, take it, even at high sanity, because a new pot starts brewing the moment you pick the old one up.
Animal Hospital anomaly FAQ
How many anomalies are in Animal Hospital?
There are 17 known anomaly types. Seven you can see at the window, two only show up in the photo, and eight only show up on the security cameras. New ones get added in updates, so the list grows over time.
What happens if I let an anomaly in?
One of three things. It can start a Death Ritual on a patient. A monster can burst out of a patient during surgery. Or it can turn into a Mimic and start eating the other patients. Some also say “I’m hungry” after treatment and attack a patient on the way out.
Should I tase an anomaly or close the shutters?
Close the shutters unless you are certain. Tasing an anomaly gives you 2 sanity, but tasing a real patient by mistake costs you 15. The shutters cost nothing either way, so they are the safe choice whenever you are not sure.
Is a static photo always an anomaly?
Not after shift 10. Early on a static photo is a reliable sign, but later in a run a normal patient can show static too. Close the shutter on it instead of tasing or shooting.
How do I get rid of the Ghost?
The Ghost only appears after a patient dies or after you throw a fainted patient in the bin. It drains 2 sanity every second it is near you. Sneak up behind it and use the taser or gun. Spraying the fire extinguisher makes it visible for a moment so you can find it.
How do I stop the Head Banger without losing sanity?
Give it a coffee. You can drink two sips yourself first and it still works. Never pick the option to ask it to leave, because that costs you 20 sanity. You can also just let it bang until the window breaks, which is free but blocks your shutters until it finishes.
What is the best class for spotting anomalies?
Security is the easiest pick. It starts with an X-Taser and gets a Deployable Camera at level 2, which you can park where the cameras cannot see. Secret Agent starts with a gun and a scanner. Be careful with Psychologist, because it doubles every sanity effect including the bad ones.
Are there any Animal Hospital codes?
No. The game has no code system at the moment, so any site listing working codes for it is guessing. Your money and Animal Coins come from finishing shifts with good grades.