Introduction

The role of the veterinary nurse in the management of behaviour problems is important. One essential role that the veterinary nurse can play is keeping track of dogs with behaviour problems by contacting owners on a regular basis to monitor progress. Veterinary nurses also play a crucial role in providing support for clients. This can be done via follow-up phone calls or in-house assessments using prepared checklists.

As one of the first people the pet sees when they enter a veterinary hospital, nurses can also help identify animals that are anxious. They can let the veterinarian know what they have observed in the waiting room as well as in the kennel area and this helps identify which pets may need to be referred because of their behaviour. Additionally owners may tell veterinary nurses about their dog's behaviour and not the veterinarian so it is important that veterinary nurses pass on this information.

As some dogs need medication to assist with their behavioural issues the veterinary nurse needs to have an understanding of why medication may be prescribed, and the effects and potential side effects of psychotropic medication so that they can assist owners that may have simple queries or concerns. All discussions about medication should be noted in the patient files and veterinarians need to be made aware of these discussions. All serious side effects should be referred to the veterinarian.

Medication should always be prescribed in conjunction with a behaviour-modification programme and it is rarely used alone as a treatment option. Medication is not a silver bullet or quick fix, and owners need to have realistic expectations; veterinary nurses can help emphasise this to owners.

Dog Behaviour

In general, when dogs exhibit unwanted behaviours they fall into two categories. They can be normal dogs doing behaviours that we don't like, such as jumping up on people. These dogs have poor manners and need training to help them learn good manners. We need to give them guidance about the behaviours we want them to perform and then reward them when they get it right. So we might teach them to sit rather than jumping up on people or lie quietly on a mat rather than get under our feet when we are cooking dinner. These behaviours are usually classified as problem behaviours. Teaching basic good manners can be very helpful for these dogs.

The other reason that many dogs exhibit unwanted behaviour is that they have a physiological abnormality such as an anxiety disorder. Anxiety is caused in part by a problem with how the brain functions and processes information and it is a medical problem - just as diabetes is caused by a problem with how the pancreas functions and processes sugar. Anxiety can arise from feeling uncertain about what is going to happen next. Anxious pets have trouble predicting the outcomes of events and perceive many normal events as threatening. Even when the outcome of an event is pleasant they are often so anxious they cannot take in that information. Anxious pets do not cope with changes, however small those changes may appear to us. So anxious dogs exhibit unwanted behaviours because they can't help it. It is estimated that about 20% of the canine population have a mental health disorder such as an anxiety disorder, which is not dissimilar from the figures quoted for the human population. Although teaching manners may be helpful it will not be enough for these dogs as they have an underlying medical condition.

Treatment / Management of Behaviour Problems

Dogs with behaviour problems such as anxiety disorders need a carefully implemented treatment plan. This plan involves three key areas - the 3 M plan: environmental Management, behaviour Modification, and Medication.

Environmental management involves changing the way dogs interact with the world so that they do not have an opportunity to 'practise' the undesirable behaviour. Every time they have an opportunity to express any unacceptable behaviour it is more likely they will do it again. This is particularly important for fearful and anxious dogs as managing their environment helps keep them in a calm and less anxious state. This too gives them the best opportunity for learning new information. Another example of environmental management would be to provide the dog with a safe, secure environment such as a crate for times the dog is anxious.

Behaviour modification involves using specific techniques such as desensitisation and counter-conditioning as well as relaxation exercises to help them to cope with their fear and anxiety. This fear and anxiety learning is much more difficult than task learning and requires lots of repetition. For example dogs that are frightened of people may still be scared even though they receive lots and lots of treats. They often need to meet a person many times before they become comfortable with that person. If done incorrectly, it is easy to make the problem significantly worse. Additionally if they are anxious it is harder for them to remember that the last meeting they had with a person was non-threatening.

Medication is usually prescribed in two ways - situational (or short-term use) and long-term use. For example, situational medication might be prescribed for dogs with firework phobias for the owners to give about 1–2 hours before the expected event. They are not designed to sedate the dog but just to decrease the anxiety at that time. An example would be the use of a benzodiazepine such as diazepam (Valium®). Many dogs with behaviour problems have anxiety disorders and may need medication for at least 8–12 months and some of them may need medication for the rest of their lives. This is to help the chemical messengers (neurotransmitters) in the brain improve the way the brain functions. Examples of these long-term use medications are the tricyclic antidepressants such as clomipramine (Clomicalm®) and the selective serotonin re-uptake inhibitors such as fluoxetine (Reconcile®).

Before starting long-term medication a complete physical examination, blood work (including haematology and biochemistry) and urinalysis is necessary. This is because the medication is metabolised by the liver and eliminated by the kidneys and we need to know what the baseline is and establish that these internal organs are functioning normally. If long-term medication is necessary then the blood tests should be repeated every 6–12 months. Medication should never be stopped suddenly. It should always be weaned off gradually under veterinary supervision.

Many dogs also benefit from the use of the synthetic pheromone analogues such as dog appeasement pheromone (Adaptil®). This is available as a room diffuser, spray and collar. Although side effects have not been reported some owners may still have concerns. Owners also need to be informed of how to use each product correctly so that maximum benefit is achieved. Incorrect usage can be one reason for apparent treatment failure.

Conclusion

By using a combination of environmental management, behaviour modification and medication the fastest, longest lasting and most successful results are achieved. The role of the veterinary nurse is crucial in the management of behaviour problems so that the outcome for the dog and the client is successful and the welfare of the dog is not compromised.

References

1.  Landsberg G, Hunthausen W, Ackerman L. Handbook of Behaviour Problems of the Dog and Cat. Oxford: Butterworth Heinemann, 2003.

2.  Ley J, Kerr K, Seksel K, et al. Results on the use of dog appeasement pheromone (DAP) collars in a selection of Australian dogs with anxiety disorders. Journal of Veterinary Behavior: Clinical Applications and Research 2010;5:45–46.

3.  Overall KL. Clinical Behavioral Medicine for Small Animals. St Louis: Mosby, 1997.

4.  Seksel K. Behaviour-modifying drugs. In: Maddison J, Page S, Church D, eds. Small Animal Clinical Pharmacology. 2nd ed. London: WB Saunders, 2008; 126–147.

5.  Sheppard G, Mills DS. Evaluation of dog-appeasing pheromone as a potential treatment for dogs fearful of fireworks. The Veterinary Record 2003;432–436.