Anomalies are fake patients that try to walk into Animal Hospital looking almost normal. Some show a wrong face at the window, some only break on the polaroid, and some only look wrong on CCTV. Miss one and it can start a death ritual, spawn a room threat, or drop the disguise as a Shapeshifter. The whole check is simple once you know which tool catches which tell.
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Appearance Anomalies
These are the window checks. If the face, posture, or movement already looks wrong, you can reject without waiting for the photo or cameras.
Twitching
- Detect by
- Appearance
- Warning signs
- Arms, head, or neck jerk while the patient is standing still. The back often hunches, and the neck can stretch longer than normal. Some variants only twitch on CCTV, so wait a few seconds before you decide.
- Best action
- Close the shutters.
Three Eyes
- Detect by
- Appearance
- Warning signs
- Three slightly mismatched glowing red eyes sit where two normal eyes should be. The real eyes can still show underneath.
- Best action
- Close the shutters.
Hollow Face
- Detect by
- Appearance
- Warning signs
- Dark hollow eye sockets, often with a hunched posture and twitching. Looks drained and empty rather than injured.
- Best action
- Close the shutters.
Realistic Face
- Detect by
- Appearance
- Warning signs
- Large eyes with black pupils, heavy under-eye bags, and a big drawn-on smile. The voice is often low and distorted.
- Best action
- Close the shutters.
Crooked Face
- Detect by
- Appearance
- Warning signs
- A crooked, distorted smile with sharp teeth and large mismatched eyes set high on the face. Eyes can look popped out.
- Best action
- Close the shutters.
X-rayed Face
- Detect by
- Appearance
- Warning signs
- Small but wide circular eyes with black pupils, paired with realistic human-looking teeth.
- Best action
- Close the shutters.
Staring
- Detect by
- Appearance
- Warning signs
- The patient tracks your movement with their head, or locks onto a camera. The head can turn more than a normal patient should.
- Best action
- Close the shutters.
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Photo Anomalies
These patients can look fine in person. Wait for the polaroid to finish, compare it to the live patient, and reject any mismatch, static, or cursed face.
Incorrect Photo
- Detect by
- Photo
- Warning signs
- The finished polaroid does not match the patient at the window. The photo can swap features, markings, or show a face that is clearly not the same animal standing there.
- Best action
- Wait for the photo to finish, compare it to the patient, then close the shutters if anything is wrong.
Different Eyes
- Detect by
- Photo
- Warning signs
- The eyes in the photograph do not match the eyes on the living patient. Pupils, lids, shape, or eye style can all be wrong while the rest of the face looks close.
- Best action
- Compare the photo to the patient before opening the shutters, then reject on any mismatch.
Different Ears
- Detect by
- Photo
- Warning signs
- Ear shape, size, or animal type changes between the patient and the photo, such as bear ears on a rabbit patient.
- Best action
- Check ear shape on both the patient and the finished photo before you admit them.
Static Photo
- Detect by
- Photo
- Warning signs
- The photograph has a grainy static overlay. It can appear alone or with other cursed photo details.
- Best action
- Close the shutters when static covers the photo. Prefer the shutters over tasing or shooting when you are unsure.
Cursed Photo
- Detect by
- Photo
- Warning signs
- The polaroid shows a heavily distorted or horrific face, such as a melted grin, wrong eyes, or other cursed face variants. Picking the photo up drains about 10 sanity, so check it on the desk first.
- Best action
- Let the photo fully develop, inspect it without rushing, then close the shutters.
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CCTV Anomalies
These only show on security cameras. Keep a short camera sweep in your check-in loop, because window and photo can both look clean.
Black Eyes
- Detect by
- CCTV
- Warning signs
- On the security camera, a black bar covers the face and realistic eyes stare back at you. The patient looks normal at the window and in the photo.
- Best action
- Check CCTV before admission, then close the shutters.
Unnatural Body
- Detect by
- CCTV
- Warning signs
- On CCTV the body looks stretched, warped, or detached, sometimes nicknamed boneless. Reopening the feed can change the shape again.
- Best action
- Use lobby and check-in cameras, then close the shutters on any stretched body.
Staring at Cameras
- Detect by
- CCTV
- Warning signs
- The patient keeps looking straight into the CCTV lens while walking or waiting, even when a normal patient would face the desk.
- Best action
- Sweep the security cameras before admission and reject constant camera contact.
Void Body
- Detect by
- CCTV
- Warning signs
- On the security camera the patient is a fully black silhouette with no normal color or detail.
- Best action
- Close the shutters as soon as the feed shows a black void body.
Camera Twitching
- Detect by
- CCTV
- Warning signs
- The patient only twitches on the security feed. At the window they may look completely still and normal.
- Best action
- Leave the CCTV feed open for a few seconds before deciding the patient is safe.
Disguised Shapeshifter
- Detect by
- CCTV
- Warning signs
- Looks normal at the window, but security cameras show the true Shapeshifter form after the patient reaches the check-in spot. Lobby camera side views help. Twitching can appear only in that form.
- Best action
- Check both lobby and check-in cameras once the patient reaches the window, then close the shutters.
Mismatching Ears
- Detect by
- CCTV
- Warning signs
- Ears or horns on the security camera do not match the ears you see at the window.
- Best action
- Compare window ears to CCTV ears before admission, then reject any mismatch.
Mismatching Eyes
- Detect by
- CCTV
- Warning signs
- Eye shape or style differs between the patient at the window and the same patient on CCTV.
- Best action
- Zoom the lobby or check-in camera onto the face and reject any eye mismatch.
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Special Threats
These are not standard three-check patient tells. Head Banger is handled with coffee at the glass, and Shapeshifter is the hostile form you fight after a bad admit.
Head Banger
- Detect by
- Special
- Warning signs
- A hollow-eyed visitor smashes their head against the check-in glass and can block the shutters. This is not a normal queue patient.
- Best action
- Offer coffee so they drink and leave. Avoid tasing, shooting, or forcing them out the hard way, which costs a large sanity hit and can leave the shutters blocked until they crack the glass or leave.
Shapeshifter
- Detect by
- Special
- Warning signs
- A patient that has already dropped the disguise (some guides call this a Skinwalker). Expect a huge mouth, sharp teeth, and an attack on nearby patients or players.
- Best action
- Tase it, shoot it, or hold the interaction to pull it off a victim. If it grabs you, spam the struggle input.
Run the three checks every time
Do not admit from vibes. Use the same loop on every patient.
- Watch the window for face, posture, and twitching. Give it a few seconds if nothing jumps out.
- Stamp the form, take the photo, and wait for the print to finish before you pick it up.
- While the photo develops, open CCTV and compare the lobby or check-in feed to the patient in front of you.
If any of the three checks fails, close the shutters. A clean window face is not enough when the photo or camera still looks wrong.
What each check is good at
Appearance catches the loud ones: three eyes, hollow sockets, crooked grins, human teeth, and open twitching. Photo catches the quiet ones, like ear or eye mismatches, static overlays, and cursed faces that only show on paper. CCTV catches the ones built to fool the desk, including stretched bodies, black void silhouettes, camera-only twitching, and the disguised Shapeshifter that only reveals itself after it reaches check-in.
After a bad admit
If one slips through, stop treating the shift like a normal clinic. Keep the taser ready for a Shapeshifter attack, and watch recovery rooms for death rituals and other emergencies. Those crises have their own rules and tools, so the goal is still to reject anomalies at the desk before they become problems in the wards.
Special cases at the desk
Head Banger is not a normal patient stamp. When a hollow-eyed visitor smashes the glass, offer coffee instead of forcing a hard reject that can tank your sanity. Shapeshifter is the late form after a miss: once the huge mouth shows up, switch to weapons and pull it off patients fast.
FAQ
How do you identify anomalies in Animal Hospital?
Use appearance at the window, the finished polaroid, and CCTV. Some anomalies only fail one of those checks, so skip any step and you will miss them.
What should you do when you spot an anomaly?
Close the shutters for normal patient anomalies. Do not stamp them in and hope treatment will fix it.
What happens if you let an anomaly into the hospital?
It can trigger a death ritual, open the door for later monster events, or transform into a Shapeshifter that attacks patients and players.
How do you deal with the Head Banger?
Give it coffee so it drinks and leaves. Tasing, shooting, or forcing it away the hard way can cost a large sanity hit.
Which anomaly is hardest to spot?
Subtle CCTV mismatches, camera-only twitching, and the disguised Shapeshifter are the easiest to miss when you rush. Photo ear and eye changes are close behind.
