How to Play Animal Hospital: The Full Gameplay Loop

Animal Hospital (Anomaly) puts you and up to three other players on an endless night shift at a hospital for humanoid animals. The job sounds simple: check patients in, treat them, send them home. The catch is that some “patients” are anomalies — monsters wearing an animal disguise — and letting one in can trigger death rituals, monster attacks, or a Mimic. Your sanity is your health bar, and 0% means death.

The core loop

A shift is complete when every patient shown on the Reception Office monitor has been checked in and treated. Each cycle looks like this:

  1. A patient approaches the check-in window. Register them on the check-in computer so the printer produces their badge.
  2. Inspect before you admit. Anomalies give themselves away through abnormalities in appearance, odd behavior, differences on the security camera, a wrong polaroid from the photo camera, or a Scanner result. If any check looks off, hit the red button to close the shutters and reject them.
  3. Treat admitted patients. A checked-in patient walks to their assigned room and lies on the bed. The room computer tells you which remedy they need — grab it from the wall cases and apply it. Wrong treatment kills the patient.
  4. Watch them leave. Recovered patients exit in bandages. Anomalies you accidentally treated often mutter “I’m hungry…” on the way out, which is as bad as it sounds.

One warning that kills more beginners than any monster: the game does not check whether the item in your hand is a treatment. Interacting with a patient while holding a non-prescribed item can kill them instantly. See the treatments guide for the full remedy table.

The four tutorial shifts

Shift 1 gives you two scripted patients who are never anomalies. Patient one always has a stomach ache (use Herbs); patient two always has Dried Eyes (use Eye Drops). Complete it and you are guaranteed $63 and 5 Animal Coins. At the end, Dr. Harlow unlocks the shutters and the security cameras.

Shift 2 introduces real risk: regular patients, story characters, and anomalies can all appear. Barney, Ron from Accounting, and Ratthew may show up — they can always be allowed in. At the end of the shift, Dr. Harlow opens the Emergency Wing (Rooms 6-8) and the Supplies Shop.

Shift 3 repeats the loop with no new mechanics. At the end, Dr. Harlow reminds you to check cameras and polaroids, and unlocks a free, renewable taser in the Check-In Office.

Shift 4 ends with an anomaly-attack broadcast on the check-in TV, then the first ambulance event: six patients, some possibly anomalies, rush in at once. Completing it adds a bonus to your pay. (Due to a known bug, this event fires on shift 4 instead of 5, and the counter then jumps from 4 to 6.)

Skip tutorial is offered before you start: the run then begins with cameras, shutters, taser, Emergency Wing, and shop already unlocked. You check in and treat four patients, then an ambulance shift immediately brings six more.

Cameras and detection tools

Four security cameras cover the building — check-in, lobby, medical, and emergency — viewed from the TV in the check-in area. Cameras break randomly (“no signal - requires fix”); walk up to the broken camera and hold the interact button to repair it. A Camera Monster can appear on a downed feed and jumpscare you for -20 sanity if you do not exit the camera menu in time.

The photo camera prints polaroids: if the photo differs from the patient in front of you, they are always an anomaly. Viewing a cursed photo costs 10% sanity, so inspect polaroids on the desk rather than in your hands.

What to do between patients

Grab the coffee from the Reception Office machine as soon as a shift starts — that lets the next cup begin brewing, and coffee is your most renewable sanity source. Spend early Animal Coins on a class (Nurse is the cheapest at 20 coins), and learn the building layout with the map guide. When you are ready for the long game, read up on how shifts scale — ambulance emergencies hit every 5 shifts, and Slime Shifts can start appearing from shift 10.

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