Behavior triage: How to handle the behavior Emergency (Proceedings)

Behavioral problems often elicit high emotions among owners and veterinary staff. Owners often have been dealing with these problems for a long time and, for reasons that are real for them, now feel that they have an emergency.

Four options

In all of veterinary medicine we have 4 options:

• Do nothing

• Find the fairy godmother/shelter/home on the farm that will take this pet and treat it humanely, not let it bite anyone, and not sue me if it does (or corollary ‘fix the broken leg/treat the diabetes')

• Euthanize

• Do something

Do nothing

Not an option in veterinary medicine

Find a new home

Rehoming an animal with a history of a problem behavior is risky at best, both for the safety of people and the particular animal I question, as well as other animals that it may encounter. The animal may be at risk for inhumane treatment or yet another rehoming. Animal shelters and rescue agencies are often over-run with pets available for adoption and may have limited resources to rehabilitate a pet with a problem behavior. Of course there are shelters and other organizations that can and do work with the animals to make them adoptable and offer support to new adopters, and if an owner is going to rehome a pet, they need to do their due diligence.

Owners also have to consider the potential liability that they face if they rehome a pet with a history of aggression. They should be counseled to consult with a lawyer, or at least their home owner's insurance company.

Euthanize

If an owner is not able or willing to work with the pet, or to find it a new home, then euthanasia is the only viable option.

Do something

These options vary widely, from pure management to full behavior modification.

Imagine a ven diagram with three things that affect recommendations…the animal, the environment, and the owner. We need to look at the intersection of these three when evaluating the situation and, while they are separated into different sections, they occur interchangeably.

Animal factors

Size

This affects the owner's ability to control the dog, as well as the increased danger that it poses to others if it were to bite a person or another dog or animal.

Breed

Humans have bred dogs for many years for specific purposes. If an owner complains about their Border Collie herding their children, it will be difficult to stop this behavior. Likewise, if an owner comes to you with their Pit Bull-type dog for fighting with other dogs, it will be difficult to stop this behavior as well, as they were bred to fight dogs. Owners of Pit Bull-type dogs may also feel more scrutiny from the public, therefore, they may feel more pressured to euthanize their dog.

Age of onset

If the behavior started at a young age, there could be a stronger genetic predisposition vs. another animal for which the behavior started at social maturity. Likewise, if the behavior started at an older age, there is a higher likelihood that there is an underlying medical condition predisposing it to a behavioral change.

Diagnosis and motivation

It is up to the veterinarian to determine the diagnosis and motivation for the animal's problem behavior. Most cases of aggression are due to an underlying motivation of fear. However, some dogs have been continually punished for expressing any type of aggression, such as growling, so that eventually the dog doesn't display ANY warning sign, but instead goes directly to biting someone.

Rarely do dogs display aggression based purely in confidence. However, if you diagnose a dog with this motivation, the prognosis is much poorer for a more complete resolution of the problem. Additionally, there are breeds with a stronger genetic predisposition for some behaviors (terriers bred to hunt rodents-kill the pet rabbit; Border Collies bred to herd-nipping the kid's heels), which make it more difficult to manage. Predatory behavior is a normal (but unacceptable) behavior, and can be very difficult to manage.

Animals can also have severe anxiety that must be medically managed. If an owner is resistant to treating the animal with medication, it will suffer.

Bite inhibition

It is a much worse prognosis if the animal has bitten, and bitten hard, than if the animal growls over many things, but it never escalated beyond a growl. It is not necessarily true that the bite severity increases over time, but it could if the owners continue to ignore the early warning signs.

Environmental factors affecting the decision

People and pets in the household

Children, elderly, infirm people, and other pets MUST be kept safe, both physically as well as emotionally. The presence of any of these factors makes for a poorer prognosis. Also, other pets need care and time with their owners, and behavior modification of the pet with the problem can interfere with that.

Cats in multi-cat households are more likely to urine mark. Feeding outside/feral cats can also contribute to this problem, and if an owner is reluctant to stop this practice, the prognosis for resolution of urine marking is worse.

The people living in the house have to buy into the program of working with the pet. It could be due to biases, or it could be due to a broken bond with one of the owners.

Location of the home/type of home

Do the owners live on 2 acres of fenced property in the country, or do they live in a studio apartment in the city? Can the dog go outside to eliminate? Or does it have to be leashed multiple times per day to be taken outside to eliminate, encountering noises, people, and other dogs? The neighbors and community also can affect the decision, especially if there is are certain emotions around specific breeds like Pit Bull-type dogs.

Cats require a good amount of space per cat, and the more cats that are living in a house, the more likely there will be a cat with inappropriate elimination. Depending on toileting preferences, some cats prefer carpeting, while others prefer hardwood, and the presence of one or the other can affect the prognosis.

Predictability of triggers

Owners often claim that they cannot predict when an animal will display the unwanted behavior, but when asked specific questions, often can identify what happened before the animal displayed the behavior. However, it gets very problematic if they truly cannot identify the trigger, or if the trigger remains relatively similar, the animal reacts only some of the time, leaving them to wonder “when” will it actually happen.

Avoidability of triggers

Also the avoidability of the triggers is important. Some things are avoidable, such as aggression just around a rawhide or only at the veterinarian's office. It is very problematic if the triggers are unavoidable, such as petting, any type of food object dropped on the ground (especially if there are children in the house), looking at, walking by in the house, or whatever else is not avoidable for a specific owner.

Owner factors affecting the decision

Previous experiences

We can never truly understand how previous experiences affect a person's view on things, and have to understand that, at least to a point, that perception is reality. One owner may have been bitten severely as a child, thus, not able to take risks, while another grew up in a house with rescue dogs and NO pet should ever be euthanized for behavior problems.

Owners are also exposed to a lot of incorrect information, perhaps more so in behavior. Celebrity trainers and television personalities color what an owner thinks about pets, especially when television shows an animal ‘magically' improved over the course of a 30 minute episode, not considering that it is heavily edited.

Ability to take risks

This is an individual decision. We cannot live in another person's home, and what they can or cannot risk. Some owners are unable to take ANY risk, such as ‘my dog can never, ever growl at my son, ever.' Some others take risks that no one else would, such as ‘even though my dog killed my other dog, I will do everything to keep him alive.' If an owner is taking an unwarranted risk, such as not supervising interactions between a dangerous dog and a child, we are obligated to protect those who cannot be protected. This can range from having a serious (and documented) conversation with the owner, to reporting the situation to authorities.

Time

Owners have time constraints on what they are able to accomplish regarding behavior modification for their pet. For some owners it is a major concern, and sometimes this barrier can be overcome with behavior modification appointments that you and your technician staff can implement.

Expertise

Pet owners usually do not have the expertise that you or other animal care professionals have. Timing in the delivery of a reward is difficult to impart to owners. The ability to identify body language and vocal cues is also something that takes time to learn, even for veterinary staff. Videos, websites, and printed material can help owners identify the earliest warning sign that an animal is uncomfortable, which will allow them to avoid having the animal needing to go to more extreme measures.

Emotional blackmail

“My cat is ruining my furniture and this is the last straw!” “If my pet doesn't stop x/y/z I'll have to rehome/euthanize him.” These are some of the least favorite words a veterinarian wants to hear. But these are likely some of the least favorite words an owner wants to say. A lot of owners are suffering when they have a pet with a problem behavior and it may look callous and heartless when an owner brings in a ‘perfectly healthy animal' in for euthanasia.

Sometimes there is little that can be done at this time, as the human-animal bond is broken beyond repair. Sometimes you can talk with these owners to have them consider working with their pet. However, the BEST thing that you can do is PREVENT these problems from occurring. Ask your owners each and every visit about the behavior of their pet. As in all other areas of veterinary medicine, an ounce of prevention is worth a pound of cure.

Asking the owner of the rambunctious 8 month old Pit Bull about how things are going on walks may get them to open up about how hard it is to walk him. THAT is your opportunity to help the owner by referring them to a good trainer to work on the problem then, versus them bringing the dog in for euthanasia because he jumped on their grandma and knocked her over.