How To Work Behavior Into Your Practice

Educate your clients about how to prevent and deal with behavioral problems as part of an overall wellness management program.


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Educating clients can help prevent the holocaust of animals surrendered to shelters.

A few years ago, I had the distinct honor of being introduced to my ex-Prime Minister, the now recently deceased Right Honorable Lady Margaret Thatcher.
 
The president of Tufts University introduced me to her saying, "This is Dr. Dodman.  He’s an animal behaviorist working at our veterinary school.” Lady Thatcher shook my hand and looked heavenward as she said with a sigh, "Ah yes, behavior, that’s what it’s all about really, isn’t it?” 

She was completely correct. 

Our clients are endeared to their pets because of the way they behave and the opposite is also true; that pets’ misbehavior leads to great frustration and, all too often, the pet’s surrender. 

It is our job as veterinarians to make sure that our clients are educated about how to prevent and deal with behavioral problems as part of an overall wellness management program if pets are to have a home for life. 

I am reminded of the Clomicalm slogan: "If your clients lose their patience, you lose your patients.” 
How true that is. It has been estimated that unacceptable pet behavior accounts for approximately 15 percent of annual client loss for vets as frustrated clients give up on their pets. About 4 million dogs are surrendered to shelters and pounds annually, many because of behavior problems, and 2.2 million of these dogs are euthanized. 

Put that in the context of 9 million puppies born each year and it is a sizable problem.
 
Another troubling statistic is that three times as many dogs die as a result of behavior problems as die from cancer—and no one would argue that cancer is a minor league problem. In addition, more dogs die from behavioral causes than from all infectious diseases together—and the figures are equally tragic for cats. 

Education Benefits
Bearing in mind this ongoing travesty, it is our duty as vets to provide timely behavioral advice in an attempt to reduce this annual holocaust. 

Educating your clients about pet behavior has several advantages. First of all, it creates a better pet and it makes that pet easier for you to treat. Secondly, it strengthens the bond between the pet and the owner and helps ensure that the pet stays with that owner. Thirdly, it enhances the relationship between the owner and veterinarian to have their veterinarian answer common questions about their pets’ behavior.
 
You don’t need to be a behavioral specialist to offer appropriate advice.
 
Practicing veterinarians can help their clients better understand their pet’s behavior in two ways. One is general behavior counseling, addressed during each appointment. A few pertinent questions can help address potential problems at an early stage, making developing problems easier to correct. The second approach, which may not be for everyone, is specific behavior counseling when troubling behavior problems already exist. 

With general behavior counseling, it is especially important to dispense the correct preventive advice at the time of first vaccination of puppies or on a client’s first visit. Behavior should also be addressed at annual wellness examinations by asking relevant questions or perhaps having owners fill out a specific form. 

New Owners
New puppy owners should be advised about issues such as housetraining, the use (and abuse) of crates, when to engage in puppy classes (early is the answer), specific breed tendencies, socialization, how to deal with growling, biting and submissive urination.

New kitten owners should be advised about the indoor versus outdoor issue, appropriate litter box arrangements, how to deal with furniture scratching, socialization of kittens, and general kitten behavior (what to expect). 

To expedite the transmission of advice, it is helpful to supply handouts, which should be concise and not overwhelming for the client. If issues arise later, it is helpful to employ behavioral questionnaires to elicit information about aggression, fear, phobias, compulsive disorders, and so on.

Outreach
For veterinarians who wish to embark on behavioral counseling, the process is much the same as a regular exam, involving history taking, physical examination of the patient and appropriate blood work to rule out underlying issues. 

Based on the behavior that the pet is exhibiting, a problem list can be compiled to assist in arriving at a presumptive behavioral diagnosis. Following that, behavior modification therapy can be initiated along conventional lines supplemented by handouts describing the techniques and, of course, follow–up is always needed.

The broad categories of behavioral problems that will be seen include aggression, fear-related problems like separation anxiety and thunderstorm phobia, compulsive behaviors, inappropriate elimination, ingestive behavior problems, and sometimes predatory behavior or hyperkinesis. 

Details Count
In questioning owners about any of these problems, you need to know exactly what the dog or cat is doing (not the owners’ interpretation of the behavior). You also need to know when the pet engages in the behavior.

Does it occur with the owner present or absent, how many times a day does it occur and how long do incidents last? It is also helpful to know what precedes their behavior and what follows it. Other questions that are relevant are when did the problem first arise and under what circumstances, and what has been tried in the past to address it. 

Details are important.

For example, one Labrador patient of mine continuously barked at his owners when they were on the telephone or having a conversation. This problem was driving them crazy. I asked them how they dealt with it and they said they put the dog outside in their truck just to get him out of the way and as a time out. When I asked them how the dog felt about that, they said he loved it so, in fact, they were rewarding the behavior and not curtailing it. Strict attention withdrawal for barking resolved this problem in a matter of a couple of weeks.

Strategies
Behavior modification strategies are not that numerous nor difficult to learn or engage. They include what I call a leadership program (originally called learn to earn), desensitization and counterconditioning, positive or negative reinforcement, and environmental modification. 

These are supplemented by giving appropriate amounts of exercise, a healthy diet, and clear communication between owner and the pet. For dogs, physical control via a device such as the head halter and, last but not least, medication is sometimes necessary.

Owner compliance can sometimes be a problem. 

It helps to give the problem a name (the behavior diagnosis) to be clear about your understanding of the problem, carefully explain the treatment program and give a time frame for likely results as well as an honest estimate of what degree of improvement owners can expect. 

Some problems, like litter box problems in a cat, meet with almost 100 percent success. Other problems, like canine fear aggression, can be alleviated and controlled but will never entirely disappear. 

Whatever the problem, it is helpful to supply handouts and discharge orders.

Charge for Your Time
Believe it or not, charging for your time dispensing behavior advice increases owner compliance.

Follow-up calls in one to two weeks and after a month or so are helpful to keep people on track.
 
For any veterinarians not interested in behavioral counseling, properly trained staff can often help point clients in the right direction, especially with training. 

Alternatively, the client can be referred to a veterinary behavioral specialist. 

Doing nothing is not an option if the human/companion animal bond is to be preserved and the pet is to remain in the home. 

Numerous resources are available to help veterinarians in their behavioral quest including the new book "Decoding Your Dog,” written by my colleagues in the American College of Veterinary Behaviorists, and the Tufts book, "Puppy’s First Steps.”

Numerous online resources are available, too, including websites such as Petplace.com.
 
The age of vets helping prevent and deal with animal behavior problems has dawned and I would strongly encourage all vets to incorporate aspects of behavioral medicine into their practice. 

An author and researcher, Dr. Dodman is a professor at Cummings School of Veterinary Medicine at Tufts University and is founder of Tufts’ Animal Behavior Clinic.

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