Make behavior counseling an integral part of every visit

A typical Monday at your veterinary clinic...

9:00 a.m. Mrs. Henry brings in Muffy, a 10-year-old spayed female Maltese having trouble breathing because of congestive heart failure. Mrs. Henry is unable to medicate Muffy because the dog often bites her. The late Mr. Henry was able to medicate Muffy.

Melissa Bain, DVM, DACVB, MS

10:00 a.m. Charlie, a 3-year-old castrated male cocker spaniel, is brought in for an otitis recheck. The owner says Charlie's ears are no better. With further questioning, you determine the owner hasn't been able to get any medication into Charlie's ears.

11:00 a.m. Herbie, a 2-year-old intact male fox terrier, is presented for suturing of wounds he received at the dog park that morning. The owner also decides to have you castrate Herbie, hoping it will make him less aggressive toward other dogs.

Noon While eating a sandwich, you evaluate urinalysis results from Fluffy, a 7-year-old spayed female domestic shorthaired cat with recurrent urinary tract inflammation that is unresponsive to medical management. You pore over your notes from the recent lecture you attended on feline interstitial cystitis.

1:00 p.m. Ginny, a 12-week-old spayed female German shepherd mix, is in for her second series of vaccinations. With her tail tucked and hiding behind her owner, Ginny seems worried about being in the office. When questioned, the owner says Ginny runs away when she or her husband yell at her for urinating in the house.

2:00 p.m. Figment, a 5-year-old male Moluccan cockatoo presented for a routine check-up, has feathers only on his head.

3:00 p.m. You meet with a pharmaceutical representative offering a new flea and tick product containing amitraz.

3:30 p.m. You meet with a pharmaceutical representative offering a new medication to treat separation anxiety.

4:00 p.m. Thelma and Louise, two 10-week-old kittens, are in for their first vaccinations. "They are a handful," says the owner, adding that they continually chase her older cat.

6:59 p.m. Hershey, a castrated male Border collie who frequently escapes from his yard, is brought in after being hit by a car.

What do all of these visits have in common? They all involve behavior issues, which should influence how you treat and follow up with these patients. In addition, you must be mindful of specific drug interactions since there can be serious side effects due to drug interactions with some of the behavior-modifying medications.

Behavior is an important piece of the fabric of veterinary medicine. We need to be knowledgeable about the effects of behavior on a patient's welfare, stress levels, and medical problems and on the human-animal bond. Problem behaviors are the No. 1 reason for dog relinquishment and are the second most common reason for cat relinquishment.1 It is estimated that six million animals enter U.S. animal shelters every year and that about three million are euthanized.2 If an infectious disease emerged that killed that number of cats and dogs every year, there would be a huge uproar from veterinarians and pet owners.

Your role

Practitioners are often the first people owners approach regarding their pets' problematic behaviors. Do not overlook this opportunity to have a direct impact on keeping the human-animal bond healthy. If an owner does not bring up a problem during an appointment, it is up to you to open the lines of communication.

Veterinarians have the unique ability and duty to care for all aspects of an animal's health, including its mental health. We should all know how to prevent behavior problems with housetraining and socialization strategies and how to treat problem behaviors.

We all have different comfort levels in treating problems, both medical and behavioral. But not having taken behavior classes in veterinary school is no excuse for a lack of knowledge about animal behavior. Continuing education classes, journals, and books are all available for our lifelong learning. And behavior counseling does not have to be time-consuming, especially if you concentrate on offering owners advice to prevent problems. Many resources are available to help the transfer of information from you to the owner, such as handouts and videos.

Referring

In some cases, you will want to refer patients to someone more knowledgeable about behavior problems. So when do you refer and to whom? It essentially boils down to what goals you and your client have, the problem at hand, and your expertise.

Although obedience training with a good dog trainer does not cure behavior problems, it may be just what the doctor ordered for a rambunctious young Labrador retriever. Excellent articles are available that explain how to choose an appropriate trainer.3,4 Never refer clients to anyone you or your staff members have not objectively observed.

For an aggressive dog, referral to a veterinarian board-certified in behavior (www.dacvb.org ) or a certified applied animal behaviorist (www.certifiedanimalbehaviorist.com ) is in order if you feel underqualified to treat it yourself. With increased media attention given to aggressive animals and the litigiousness of society, liability is another factor to think about when considering when and to whom to refer. If the dog has a known history of aggression and you do not recommend treatment, you could be held liable for not recommending appropriate treatment.

Final thought

In behavior—perhaps more than in all other areas of veterinary medicine combined—there is a flurry of incorrect or incomplete information. It is a critical to daily practice that veterinarians know the scientific background of behavior, help their clients prevent problem behaviors, treat problem behaviors that arise, and refer to appropriately trained animal behaviorists when necessary.

Melissa Bain, DVM, DACVB, MS, Department­ of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

REFERENCES

1. Salman MD, Hutchinson J, Ruch-Gallie R, et al. Behavioral reasons for relinquishment of dogs and cats to 12 shelters. J Appl Anim Welf Sci 2000;3:93-106.

2. The Humane Society of the United States. Common questions about animal shelters and animal control. Available here. Accessed March 19, 2008.

3. Brammeier S, Brannen J, Brown S, et al. Good trainers: how to identify one and why this is important to your practice of veterinary medicine. J Vet Behav 2006;1(1):47-52.

4. Hetts S, Estep DQ. Educational information: selecting an obedience trainer or behavior consultant. Available here. Accessed February 28, 2008.