Prevention & Early Intervention of Behaviour Problems as Part of Routine Care
Karen L. Overall, MA, VMD, PhD, DACVB
Center for Neurobiology and Behavior, Psychiatry Department, School of Medicine, University of Pennsylvania
Philadelphia, PA, USA

The most common reasons pets are lost from the average veterinary practice in the USA, Australia, and Canada, countries for which adequate data exist and have been published, 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 over $20,000 USD per year in lost income. If the practice sells toys, supplies, leashes, and training services the financial losses are more substantial. How can we stop 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 a one of your clients asked 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 ½ h 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.

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 what 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 insure that your staff has the requisite training. Such training can be obtained through CE opportunities provided by veterinary associations, technicians' training programs, and the Association of Pet Dog Trainers (APDT), in the USA.

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 enquiring 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 # 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, a loose-leaf bound set of copies of articles, handouts, CE notes, et cetera that you, personally, have found useful, organized by topic, and a set of handouts that you--yourself--are comfortable with distributing to and discussing with the client.

5.  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.

6.  You can, either alone or in collaboration with other veterinarians in the area, host pet open-houses. 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.

7.  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 put your name and practice information on this 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. Such screens will take the client minutes to complete if they have no complaints, and will give them a venue by which they can communicate to their veterinarian concerns that they are having. These tools also provide the client with a venue in which they can raise issues that they may not even have known were problematic. The most valuable facet of this screening tool is that it provides a written chronology of the dog's behavior, along with attendant changes throughout life, while providing a forum for a dialog.

At every visit veterinarians should emphasize the need for good manners and for shaping and rewarding excellent behaviors. At the first visit all pets--cats and dogs--should be taught to sit for a food treat when requested. Simply learning to sit on request and for all attention (food, walks, love, leash or harness placement, grooming, tick removal, teeth cleaning) will: (1) treat and prevent many behavioral problems, (2) teach the pet that the client signals clearly about what the client wants and then addresses the pet's needs, and (3) teaches the pet that the client is reliable and trustworthy. These are the keys to a great relationship with a pet.

All cats and dogs should also be fitted for harnesses or head collars (or loose flat buckle collars if they already walk without struggle on a lead) at their first visit, and they should not be allowed to leave until the client understands how to teach the pet to enjoy walking without a struggle. Then, the clients need to go home and practice, practice, practice.

If the patients have behavioral concerns, these concerns absolutely must be addressed as early in the development of the problem as is possible. This is not an option if veterinarians do not routinely query clients about their pets' behaviors. It is worth noting that new data demonstrate that the average amount of time that a dog with a behavioral problem is maintained in the household before being relinquished is 4 months. Behavioral problems are true veterinary emergencies.

Common complaints or concerns leading to
relinquishment for dogs

Common complaints or concerns leading to
relinquishment for cats

1.  Pregnancy--emphasize early neutering and spaying for health reasons, and for some behavioral concerns (e.g., marking) for male dogs

2.  Breaking from, loss of, or incomplete housetraining

3.  Poor leash behavior--dragging and jumping

4.  Jumping on strangers

5.  Barking

6.  Fighting with other dogs

7.  Destruction

8.  Aggression: growling, snarling, lunging, biting

9.  Mouthing, nipping (and this could even be in play....)

10.  Too active (or too little exercise, given the breed or individual)

11.  To timely to groom or walk

12.  Roaming, escape behaviors, and jumping fences

1.  Pregnancy--emphasize early neutering and spaying for health and behavioral reasons including fighting, spraying, and marking

2.  Eliminating outside litter box

3.  Spraying or non-spraying marking

4.  Destruction--often associated with normal clawing associated with sheath removal or marking

5.  Roaming

6.  Fighting with other cats

7.  Shedding or vomiting hair and plants

8.  Nocturnal activity

9.  Too active and vocal

10.  Swatting, scratching, and biting

11.  Eating fabrics and plants

Demonstrations to occur at first visit for dogs and cats; those particularly applicable to puppies & kittens*

1.  "Sit" for a treat

2.  Examine ears--this is particularly important to teach dogs of breeds prone to ear infections

3.  Examine and trim nails

4.  Examine and brush teeth

5.  Massage and tick/lump search

6.  "Wait" for a treat [* older dogs & cats can have "stay" emphasized]

7.  "Come" for a treat

8.  Fitting of head collar or harness and reward for walking calmly in it [* if done for pups will prevent problems]

9.  Appropriate play between humans and dogs / cats [* using toys--not hands where the dog could be scared or hurt]

10.  Appropriate play between dogs and dogs or cats and cats [* puppy & kitten play groups, size and age appropriate play]

11.  Appropriate chewing toys [* good rawhides, Planet toys, dental ropes, Nyla- Bones, etc]

12.  Appropriate play [* balls, frisbees, et cetera, and the correct way to play tug]

13.  Appropriate corrections-say "no" firmly and walk away, withdrawing attention

14.  The difference between physical punishment, abuse, and appropriate "corrections"

15.  The benefits of using primarily reward structures instead of punitive ones

16.  The recommended exercise needs and types for dogs of the patient's size, breed, and temperament

17.  Appropriate grooming needs, tools, and schedules; included here is dispensing a flea comb and teaching the clients how to conduct a flea patrol

References

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

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

3.  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.

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

5.  Owens P. The Dog whisperer: A compassionate, non-violent approach to dog training. Adams Media Corporation, Holbrook, MA, 1999.

6.  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.

7.  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.

8.  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.

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

10. Seksel K. Puppy Socialization Classes. Vet Clin NA: Sm Anim Pract 1998;27:465-477.

11. Seksel K. Kitten Kindy® video with information booklet and leaflets, Malcolm Hunt productions, Sydney Australia: Australian Small Animal Veterinary Association, 1998.

12. Seksel K. Training your cat. Flemington, Melbourne, Australia: Hyland House, 2001.

13. Weston D. The Gentle Modern Guide to Dog Training, Howell Book House, NY, 1990.

Newsletters

1.  Association of Pet Dog Trainers [APDT]; 66 Morris Avenue, #2A, Springfield, NJ 07081 USA; 1.800.738.3647; www.apdt.com

2.  The Whole Dog Journal, PO Box 420235, Palm coast, FL 32142-0235 USA; 1.800.829.9165; wholedogjl@palmcoastd.com; www.whole-dog-journal.com

Products

1.  Premier Pet Products (manufacturer of The Gentle Leader®), 406 Branchway Rd., Richmond, VA 23236 USA; 1.888.640.8840; www.gentleleader.com

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Karen L. Overall, MA, VMD, PhD, DACVB
Center for Neurobiology and Behavior, Psychiatry Department
School of Medicine, University of Pennsylvania
Philadelphia, PA, USA


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