Offer basic behavior counseling for every pet at every visit

Misbehaving is the most dangerous thing a companion animal can do. A study of a dozen shelters nationwide in 2000 found that 40% of dogs and 28% of cats were surrendered because of one or more behavior problems reported by the owners.1

What Works for Dr. J.C. Burcham

Janet M. Scarlett, DVM, PhD, the director of the Maddie's Shelter Medicine program at Cornell University, thinks these findings underestimate how many animals are likely surrendered for behavior problems.2 Many owners are reluctant to admit that their pets have behavior problems when they bring their pets to shelters because they believe their pets will be euthanized.

"If you look at the dogs who are relinquished to shelters, you find that the single largest group is young adolescents, 6 months to 25 months of age," Dr. Scarlett says. "Why? They're unruly. That's where the veterinarian enters. Between the time a dog finishes its puppy shots and the time it reaches 6 months of age, the bond either never cements, or the bond is formed but the dog's behaviors are so obnoxious that the owner no longer wants to keep it." These problems include digging holes in the backyard, chewing up shoes, or pulling too hard against a leash on walks.

"The problem with behavior," Dr. Scarlett suggests, "is that most veterinarians are not well-trained in and have a level of discomfort with behavior issues. Few have a behaviorist on staff." But veterinarians can learn behavior basics that will help them identify annoyances before serious problems develop and lead to relinquishment.

ROUTINE QUESTIONING CAN RAISE RED FLAGS

Prevention is always key. Bonnie V. Beaver, DVM, MS, DACVB, a past AVMA president, says, "Behavior problems are the number one cause of euthanasia for dogs and cats, resulting in a loss of approximately 10% of the total population each year. This is not acceptable for any reason. Prevention is the only way to stop this horrific loss."

Behavior Assessment Checklist--Download this form at www.vetmedpub.com/BehaviorChecklist, and have your clients fill it out at each visit.

In 1998, Gary J. Patronek, VMD, PhD, and Nicholas H. Dodman, BVMS, MRCVS, DACVB, DACVA, conducted a mail survey of 2,000 randomly selected veterinarians.3 Their study's objectives included determining the number of dogs euthanized in practices for behavior -related reasons and assessing practitioners' attitudes about behavior services. Extrapolating from the survey's results, the researchers estimated that in 1998 as many as 224,000 dogs and cats were euthanized in small-animal practices for behavior problems. Significantly, four in 10 veterinarians reported discussing behavior infrequently during office visits for new adult pets, and half discussed behavior infrequently during annual checkups. Drs. Patronek and Dodman were surprised by the disconnect between the willingness of veterinarians to discuss behavior and the emerging emphasis on behavior in the veterinary literature.

Dr. Patronek, a clinical assistant professor at Tufts University Center for Animals and Public Policy and the director of animal welfare and protection at the Animal Rescue League of Boston, suggests veterinarians ask clients to complete a short behavior checklist in the waiting room at every visit. "A one-page sheet where you can ask how frequently certain behavior problems are occurring will help you systematically assess behavioral risk factors for relinquishment," he explains. "You might ask if there are situations coming up that could be a problem—acquiring another pet maybe. All the red flag questions. With that you could start working early to prevent relinquishment." (For a sample behavior assessment checklist, see the form top right created by Veterinary Medicine.)

"VACCINATE" EARLY AGAINST BEHAVIOR PROBLEMS

Behavior problems are easier to prevent than they are to correct, says Wayne Hunthausen, DVM, a Westwood, Kan., veterinarian nationally known for his work in behavior management. And the exact time you most frequently see pets—during their first year—is the biggest risk period for dogs and cats, he says.

Advice from the Veterinary Medicine Practitioner Advisory Board

"What veterinarians need to do is take advantage of puppy and kitten vaccination visits to get good solid information in the owners' hands," Dr. Hunthausen says. "If we can get clients off to a good start, then puppies and kittens are less likely to develop destructive problems, housesoiling or aggression, which may get them booted out of the house."

Stephen Zawistowski, PhD, CAAB, executive vice president of the ASPCA, puts it succinctly: "When veterinarians are seeing young animals and going through their vaccination procedures to save them from life-threatening diseases is the time to vaccinate them against the behavior problems that kill more pets than anything else."

John Ciribassi, DVM, DACVB, is a small-animal practitioner in the Chicago area who also handles referral cases on behavior. He says the initial appointment with a new puppy is critical. In his practice, this visit focuses on several key topics including housebreaking, diet, destructive chewing, handling techniques, puppy socialization classes, use of the yard, food bowl issues, and collar choices (see "Behavior topics to cover in the first puppy or kitten visit"). His practice schedules 40 minutes for every new puppy or kitten appointment.

Behavior topics to cover in the first puppy or kitten visit

He recommends new puppy owners begin by teaching their dogs to go to a spot. "The front door is one of the areas people have a real problem with," he says. "You can train the puppy to automatically go to a spot a few feet from the front door. Put a mat down. Do a lot of sit and stay exercises. Use rewards. Eventually convert to somebody coming through the door from the outside."

Veterinarians must also practice model behavior in the examination room, Dr. Ciribassi says. For example, don't hold puppies upside down to examine them, and don't scruff them. And be liberal with treats. "How often would you go back to work without a salary?" he asks.

For Dr. Ciribassi, the second and third visits also include behavior counseling, and his practice typically schedules neutering between 4 and 6 months of age.

Advice from the Veterinary Medicine Practitioner Advisory Board

Drs. Hunthausen and Ciribassi agree that one of the biggest problems in talking to owners about behavior is having to counter a plethora of bad advice. From television to the Internet to Uncle Charley, clients are surrounded by bad information. Saving animals from relinquishment means cutting through the static with knowledgeable, accurate advice on preventing or managing behavior problems.

Management options include pharmacologic therapy in appropriate cases. In the 1999 study by Drs. Patronek and Dodman, most veterinarians responding to the survey reported "seldom" or "sometimes" using pharmacologic agents for behavior problems.3 The most frequent use of drugs was to treat inappropriate elimination in cats.

If a problem seems beyond your capabilities, many behavior resources can help you gain expertise, or you can refer the case (see "Behavior Resources").

Behavior Resources

TWO KILLER BEHAVIORS

Two behavior problems, in particular, lead to the most relinquished pets—aggression and inappropriate elimination.

For dogs, aggression is a killer

A clear danger sign for dogs is aggression. Olathe, Kan., practitioner J.C. Burcham, DVM, reports that when people call about a dog that has bitten someone, the conversation is often one-sided. "They're not even in negotiation mode," she says. "They're saying, 'I need to get rid of my dog right now.'"

The concurrent problem is that fixing aggression issues takes time. Dr. Burcham says clients must be willing to spend the time and make the commitment to at least a year's work to turn around aggressive behavior. "There is no overnight fix," she says.

Again, prevention is key. Dr. Burcham takes the unusual approach of holding classes to teach children and adults how to handle a dog so they won't be bitten.

"Play biting is one of the reasons dogs are unnecessarily relinquished," Dr. Ciribassi says. He suggests distinguishing between play biting in puppies and aggressive biting in adults. Pay attention to posture. If biting is done "in a playful manner, in a calm happy-go-lucky way, tail wagging, mouth relaxed," it is normal, and the trick is to channel it to socially appropriate behaviors. If the ears are back and the tail is tucked, something more serious is happening.

In either case, he points out, visiting a behaviorist is a good recommendation for the owner. So are puppy socialization classes. "People think of puppy classes only for dogs 6 to 8 months old," Dr. Ciribassi says. "For the most part, the open window of socialization is over at 14 weeks. Formal training can occur later, but puppy classes are meant for those young puppies."

"The important thing is to recognize behavior problems early and get the owner some help before he or she gives up," Dr. Hunthausen says. "A lot of owners don't know there are people who can help aggressive pets."

Inappropriate elimination: Also a deadly sin

The primary reason for relinquishment in dogs and cats is elimination. In a report in 2002, Dr. Scarlett and others stated that "dogs and cats urinating at least weekly in the home were approximately two to four times and two to six times, respectively, more likely to be relinquished to a shelter, compared with animals occasionally or never displaying these behaviors."2

Jacqueline Neilson, DVM, DACVB, who owns her own behavior practice in Portland, Ore., says, "If I'm focusing on making the most impact on relinquishment to shelters, I'm discussing the litter box with cat owners. Cats like you to keep it clean. You have to scoop every day. It seems simple, but it is critical."

Dr. Neilson thinks just impressing this single point on cat owners could save many cats from relinquishment. She also says to tell owners not to be deluded by the advertising on litter products. "Nothing really does the job like getting waste out of there," Dr. Neilson says. "Product developments may help control odor, but nothing replaces the simple act of scooping out the waste."

Beyond cleanliness, veterinarians should discuss the various types of litter with owners. Most cats, Dr. Neilson says, prefer clumping litter. The average time clumping litter should stay in the box is one month, with constant topping off. No one knows the perfect depth, she says, but cats prefer 1 cm to 3 cm. Scent is important, but most scents have been developed with human considerations, not feline. Density is important. Cats like to scratch.

In fact, Dr. Neilson says that if cats don't dig enough in the litter, it is a warning signal. Normally, they like to pre-dig in the litter, and if they do this in an abbreviated manner, the litter may not be to their liking, and elimination problems may follow.

CONCLUSION

Behavior problems are an important cause of pet relinquishment. Through basic behavior counseling, practitioners can help make sure a lifelong bond is formed and prevent relinquishment.

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 Welfare Sci 2000;3:93-106.

2. Scarlett JM, Salman MD, New JG, et al. The role of veterinary practitioners in reducing dog and cat relinquishments and euthanasias. J Am Vet Med Assoc 2002;220:306-311.

3. Patronek GJ, Dodman NH. Attitudes, procedures, and delivery of behavior services by veterinarians in small animal practice. J Am Vet Med Assoc 1999;215:1606-1611.