Sarah Heath, BVSc, DECAWBM (BM), CCAB, MRCVS, European Veterinary Specialist in Behavioural Medicine (Companion Animals)
Behavioural problems are a common reason for pet owners to approach their veterinary practice for advice and yet it is still relatively uncommon for practices to offer a full behavioural medicine service for their feline patients. While it is understandable that many practices do not choose to pursue behavioural medicine as a referral level option, it is important to point out that behaviour is relevant to general practice on a daily basis. Whether it is in terms of considering feline responses when handling them in the clinic, investigating feline stress as a contributory factor in internal medicine cases or discussing specific behavioural problems with worried owners, veterinary practices are involved in advising about behaviour topics and influencing the way in which owners think about their pet's behaviour. As a result it is essential that veterinary nurses have some basic understanding of feline behaviour and ensure that the advice that is given to cat owners is in the best interests of the patient as well as the client.
Understand the Normal
Behaviour is no different from any other branch of veterinary medicine and in order to understand the abnormal it is important to understand the normal. This is particularly important in a feline context since cats have a very different social structure from humans and this fundamentally influences the way in which they behave.
Veterinary practices have a high level of contact with owners of kittens and are held in a position of trust. Advice from the practice is often valued highly by new owners and there is a huge responsibility to get new owners off to the right start! There is also a wonderful opportunity to educate new cat owners about normal cat behaviour and to explain the importance of catering for their natural behavioural responses within a domestic environment. Timely advice in this area can significantly decrease the occurrence of problems such as indoor toileting and feline obesity. One of the biggest challenges in feline preventative behavioural medicine relates to multi-cat households and neighbourhoods. Advice about the ways in which feline stress can be minimised in these contexts will be an important factor in the prevention of problems such as indoor marking and inter-cat tension.
Incorporate Behaviour into Everyday Practice
The veterinary practice is a potentially threatening environment for many pets and in many cases their natural species specific behaviour does not prepare them for dealing with it. An appropriate understanding of how animals learn combined with an understanding of feline ethology is therefore essential in order to avoid stressful encounters for pets and practice staff alike. Working on a basis of prevention being better than cure is highly appropriate in the field of feline behaviour and learning to read body language signals and take appropriate action early are keys to success in feline nursing.
Consider the Interplay Between Disease and Behaviour
Behaviour and disease are inextricably linked and the influence works in both directions. Evidence from human medicine suggests that the presence of disease affects mental health and it also suggests that mental health issues can be a risk factor when considering disease. The interplay between physical disability and mental health has largely been ignored in a veterinary context and when treating physical disease the consideration of underlying changes in emotional state may be more relevant than has been considered to date. A full medical work up and a chronological history, which maps behavioural change onto physical health, can be very important in ensuring that links between disease and behaviour are not missed. In feline medicine good examples of the interplay between behaviour and disease include dermatological problems, lower urinary tract disease and infectious diseases.
Use Medication and Pheromone Therapy Based on Diagnosis
Drug therapy and pheromone therapy both have a role to play in behavioural medicine but only ever after an accurate diagnosis has been made and only as an adjunct to, and not a substitute for, behavioural therapy.
When considering the use of drugs in cats it is important to consider the practical aspects of administering the medication. The aim of medication is to enable the animal to benefit more thoroughly from behavioural therapy and it is therefore important to ensure that the stress of administration of the drug is not going to outweigh any benefit that might be achieved. Medications in liquid form often allow more accurate dosing as well as ease of administration and these options should be investigated. Before medication begins it is important to have a complete medical and behavioural history together with the results of a full medical and behavioural examination. In some cases it is also prudent to carry out haematology and biochemistry screening and monitoring of cardiac, hepatic and renal function in order to rule out any potential medical causes for the behaviour or any physical contraindications for the use of the psychoactive medication.
Pheromone therapy is a very useful adjunct to behavioural therapy in cases where anxiety and lack of security are relevant, such as multi-cat household tension and indoor marking problems. In addition the application of pheromone therapy in a prophylactic sense should not be overlooked and the installation of Feliway should be considered when there is a need to increase security for new cats or for cats following a house move or a change in family circumstances.
Refer Early and Appropriately
Behaviour is complicated by learning and the longer that the behaviour has been present the more complex it will become. It is therefore better to investigate behavioural issues as soon as possible and refer if necessary.
There are many people offering behavioural services and some of them are not what they seem to be. It is therefore important for veterinary practices to check qualifications carefully and to make sure that the people are working on a motivational and not a symptomatic approach. In the field of feline behaviour it is also important to make sure that the person has experience in cat behaviour and is not simply transposing canine information into a feline context.
Behaviour is a vital aspect of veterinary medicine and needs to be incorporated into everyday general practice. The veterinary profession has a huge responsibility to work toward preventing behaviour problems but when behaviour becomes problematic it is best to refer early and appropriately. For feline behaviour problems it is essential to consider the ways in which normal feline behaviour may be being compromised within the domestic environment. Many of the behaviours which cat owners report as being problematic are perfectly normal, if inappropriate. It is therefore important that we do not simply reach for the drugs and pheromones without a thorough behavioural workup.