Resolve common behavior problems by offering training advice to clients

The most common reasons pets will be lost from the average veterinary practice involve concerns about the pet's behavior: the pet either is exhibiting behaviors that the clients consider problematic or the pet's behaviors are not matching the clients' expectations. Humane concerns, aside, pets that are lost from practices because of behavioral concerns cost each practice more than $20,000 per year in lost income. If the practice sells toys, supplies, leashes and training services the financial losses are more substantial. How can we end the epidemic of unwanted, problematic pets and address the attendant humane concerns involved in euthanasia and re-homing? We can either educate clients before they obtain a pet, or afterward when problems arise, but the best choice is probably some combination of these.

Educating clients before they get a pet

Every time one of your clients asks your advice about their next pet or about training, you have a chance to save a life and build your practice. These questions, like others involving behavior, are often sloughed off as either so obvious that they do not warrant an in-depth discussion, or they are considered too time-consuming to warrant allocation of additional effort. Both approaches are hugely in error. While it is true that it is difficult to give behavioral advice within a standard 20-minute office visit, it's important to remember that most clients will understand and appreciate this constraint if provided with an alternative. Alternatives can include the following:

1. Have your receptionist schedule a 30-minute appointment to discuss the issue. This appointment can be the first or last appointment of the day, or scheduled at a time when you will not feel rushed. You will need to think about these cases. You can charge either an introductory fee or by the hour. If you are concerned about fees, consider that the clients are really subsidizing your continuing education, so you may feel that you can charge less - at first - while you build behavioral services into your practice. If the fee schedule, justifications and options are made clear in advance, clients will understand your reasoning and will come to see the value of such "wellness" services. In fact, you may wish to post a fee schedule for informational consultations and routine procedures or give each client a handout that explains the behavioral and other "wellness" services and costs. Many clients are unfamiliar with the costs of modern veterinary medicine, know nothing about salaries, and are uncomfortable about discussing finances, anyway. Providing a handout that charts your services and time costs, and those of your staff (associate veterinarians or those who may have a special interest in a specific discipline like behavior, nurses, certified dog trainers), both anticipate and respect the clients' concerns, and leads to clear communication.

2. Train your staff to answer common and routine questions that clients ask. Start to keep a list of all questions regarding behavior posed by clients and create a Q & A sheet. If correctly trained, your staff can answer all questions about training and pre-purchase counseling, and the clients can schedule an appointment with them. Such appointments can either be gratis, as part of the overall educational service provided by a full-service practice (in which case your other fees will have to address the $35-45/hour your certified or registered technician is costing you in salary and full benefits, should you provide benefits), or the service can be offered at an hourly fee different than that for a veterinarian. If you choose the latter, you are obligated to ensure that your staff has the requisite training. Such training can be obtained through continuing education opportunities provided by veterinary associations, technicians' training programs, and the Association of Pet Dog Trainers (APDT).

3. In your waiting room you can provide a loose-leaf book containing entries provided by clients who have the types of pets or breeds in which your inquiring client has an interest. Clients who are willing to act as 'guides' or 'advocates' for the novice can provide terrific information that will be useful to the prospective owner. You can structure this information which may include photos of the pets, the story of how the 'advocate' obtained their pet, reasons why they chose the type or breed, the 'advocate's' personal estimates of time required for exercise and grooming based on their own pets' needs, and other practical management tips that can only be provided by someone who actually lives with an Australian Shepherd, to pick a random example. If the 'guide' or 'advocate' client is willing, they can provide their telephone number or e-mail address and help mentor the new owner through the adoption and family-integration process. Written and signed disclaimers can prevent any liability that could accrue to you or to your clients.

4. You can provide your clients with a library that can be offset in a section of your waiting room. Included in this library should be a series of breed books, a series of popular - but humane - training and management books, a series of newsletters that would have broad appeal for clients (e.g., The APDT newsletter, The Whole Dog Journal), a loose-leaf bound set of copies of articles, handouts, CE notes, that you, personally, have found useful, organized by topic, and a set of handouts that you are comfortable with distributing to and discussing with the client. You can either write these handouts yourself or use handouts available from other published or internet sources. One cautionary note: please make sure that what you are distributing is not a copyright infringement. If the handout is written by someone other than you, you can put your name and practice information on it if and only if:

• The material is not copyright protected;

• You make it clear that your role is distribution, only and that you did not write the material, and;

• The source and the author(s) are all fully acknowledged and clearly presented. Many newsletters that have copywritten articles will send you these same articles in handout form for a reasonable fee, and you have complied with all legal and ethical concerns.

• Videos or posters illustrating types of animals used as pets and information about their maintenance requirements can be displayed in the waiting room. If the practitioner has photogenic patients and responsible clients in his or her practice, the clients can help make such posters using their own pets, including testimonials about their own questions, difficulties and experiences.

• You can, either alone or in collaboration with other veterinarians in the area, host pet open houses. If you do this during National Pet Week, the American Veterinary Medical Association (AVMA) will help provide materials. Open houses can be conducted in schools, in shelters, in shopping malls with the help of a shelter, or in your practices, but for all venues the emphasis must be on education. A more instantaneously gratifying type of open house can be a virtual one that provides 'on-demand' viewing. Slide shows or videos can be kept ready to be shown when a client asks your advice. With or without an accompanying handout, these presentations can be run by the clients and used as needed.

• Make up your own handout on how people should choose pets - or trainers - and place it in your waiting room with a sign that tells clients that they can take copies for friends. If you include your name and practice information, you will build a clientele of caring clients who will address their pets' behavioral concerns.

If you comply with this advice you will minimize the change that a pet is recycled because of unreasonable expectations.

Educating clients after they get a pet

Every visit is a chance to assess behavioral health. Routine behavioral screening should be incorporated into every appointment, in addition to routine medical and biochemical screening. We ask about the physical health of the pet; why wouldn't we ask about the behavioral health? If the clients have concerns about a pet's behavior, the earlier the concern is addressed the more likely it is to resolve, keeping the human-pet family happy, safe and intact. If the practitioner does not have a sufficient comfort level to create their own basic routine behavioral survey screen, there are published ones. The easiest and most comprehensive way to assess behavioral health is by having the clients complete these written assessment tools that evaluate specific target behaviors at each visit. An example of a subset of the types of questions that produce reliable information when assessed at each visit is in Table 1. Such screens will take the client minutes to complete if they have no complaints, and will give them an opportunity to discuss their concerns with their veterinarian. These tools also provide the client with a venue in which they can raise issues that they may not even have known were a problem. The most valuable facet of this screening tool is it provides a written chronology of the dog's behavior, along with attendant changes throughout life, while providing a forum for dialog.

Table 1: Sample of types of issues to be evaluated at each visit by using a standard screen for problematic or changing behaviors

The latter is critical: most veterinarians still attend veterinary schools where their exposure to veterinary behavioral medicine is limited. Such training is a gross mismatch with the magnitude of the behavioral concerns - whether they are management related, issues about what's "normal" or involve true behavioral pathologies - extant in the patient population.

Mandatory information for clients

Regardless of the information transmission route you choose, if your clients are considering getting a pet they should ask themselves the following questions:

1. Why do they want a new or another pet? Vanity purchases tend to become old fast. Dogs bought for guarding purposes can be a real handful, especially later in life if the clients did not understand what they were getting. Big dogs, particularly if they are breeds associated with protective or guarding behaviors, are over-represented in those relinquished to shelters.

2. What type of pet does the client want? Most advice is geared primarily towards cats and dogs, but some clients with limited mobility might do better with something like guinea pigs. Guinea pigs are very social, big enough to cuddle, and don't live as long as some small dogs. Oddly, people sometimes resist getting a pet because they do not want to have to worry what will happen if they die before their pet. In any case, pets should be provided for in wills. Clients who love birds that talk must realize that the best talkers are also among the longest-lived of the birds, and they tend to be the larger, more forceful psittiacines that can injure someone. Clients who want a Himalayan cat because of the way it looks, need a reality check: Himalayans only look great when hours of grooming occur. Also, cats are wonderful, but people who want small fuzzy dog-substitutes will be disappointed in a cat no matter how fabulous the individual. The debunking of myth is important: cats are not asocial, they do need attention. The time to deprive the client of the "romance" is before they get an inappropriate pet. Clients who seek information that is offered become realistic when allowed to make their own educated decisions.

3. What size of pet does they client want, and does this size mesh with what they can handle? Size of pet can affect client mobility (many hotels and rental units will take small, but not large pets), amount and type of exercise required, grooming needs (regardless of coat length bigger dogs take longer to groom than smaller), and the cost of maintaining a pet of that size. Larger animals are more expensive to feed and when they become ill the cost of medications increases. Finally, larger dogs produce larger amounts of feces - cleaning up after these dogs is not a subtle pursuit.

4. What activity level is suitable for the client's family? Activity levels can be associated with a dog's size (bigger, energetic dogs need more space than smaller, energetic ones), but is more directly related to the dog's age and the type of work for the breed selected. Younger animals are more energetic. Having a fenced yard is not a substitute for exercising a dog. The best exercise dogs can have involves social interaction with humans or another dog. Another dog that is evenly matched in size, age and energy level will really tire out its companion. Tired dogs are happy dogs and they have ecstatic people. Most dogs that are simply turned into a yard sit by the door after eliminating. At this point you may wish to encourage your clients to remember that hamsters are really good at entertaining themselves while you sleep.

5. What specific needs of the client is the pet expected to meet? People for whom silence is important might be ill served by the quintessentially cute Beagle puppy. People who wish to do little grooming and who are averse to fur on their furniture should not have long-haired cats. Dogs that are highly motivated to hunt have a different focus and may not meet the needs of a young child who needs to carry a pet around. Dogs that are highly motivated by scent can also be more difficult to housetrain if there are already household problems in that regard. There is no substitute for an honest self-assessment of client needs and expectations and common sense.

6. How important is the appearance of the pet to the client, and what effort can they invest in maintaining that appearance? Health can also be affected by a lack of grooming. If the clients can't or won't meet the pet's grooming needs, themselves, and can't or won't hire someone to do this, the pet will be ill-served by the clients. Clients need to closely examine what appearance really means to them.

7. If the pet is a baby when the client gets it, will they understand the behavioral changes that will occur with age and maturity? Puppies do not look as they will when adult, and data refute assertions that you can tell a puppy's future behavior and status based on how it behaves with its littermates. Temperament tests do not reflect or predict later adult behavior. Shelters, rescue organizations, and some breed groups can recommend dogs and cats with known behavioral propensities. Showdogs and cats retire and may be available for placement in a "pet" home, often for free if the client neuters the animal and meets the breeder's care conditions.

8. Does the client have a realistic impression of the cost of having the pet? Costs include medical care, food, toys, equipment, shelter, and fees for pet-sitters or boarding, if the clients travel. Again, this is another category in which pocket-pets like guinea pigs can really be wonderful.

If you start with the above you have the best chance of creating clients who have reasonable expectations and who are willing to invest the time to work with their pets to avoid the common behavioral problems and misteps. Also, these clients will come to you at the first sign of any behavioral concerns. How to handle those issues is covered in the companion piece, "Training your staff to handle behavior counseling, p. 16".

Suggested Reading

• Houpt KA, Honig SU, Reisner IL. Breaking the human-companion bond. J Am Vet Med Assoc 1996;208:1653-1659.

• Love M, Overall KL. Dogs and children: how anticipating relationships can help avoid disasters. J Am Vet Med Assoc 2001;219, 446-453.

• New JC, Jr. Salman MD, Scarlett JM, Kass PH, et al. Moving: Characteristics of dogs and cats and those relinquishing them to 12 U.S. animal shelters. JAAWS 1999;2:83-96.

• Overall KL. Clinical Behavioral Medicine for Small Animals. Mosby, St. Louis. 1997a.

• Overall KL. Early intervention and prevention of behavior problems: Step 2 - Routine screening for behavioral problems, Veterinary Forum August 2001: 42-46.

• Owens P. The Dog whisperer: A compassionate, noneviolent approach to dog training. Adams Media Corporation, Holbrook, MA, 1999.

• Salman MD, New JG Jr, Scarlett JM, Kass PH, et al. Human and animal factors related to the relinquishment of dogs and cats in selected animal shelters in the United States. JAAWS 1998;1:207-226.

• Salman MD, Hutchison J, Ruch-Gallie R, et al., Behavioral reasons for relinquishment of dogs and cats to 12 shelters. JAAWS 2000;3:93-106.

• Scarlett JM, Salman MD, New JG Jr, Kass PH. Reasons for relinquishment of companion animals in U.S. animal shelters: selected health and personal issues. JAAWS 1999;2:41-57.