The behavioral history: what do you need to know? (Proceedings)

Behavioral practice requires 

• Gather information

• Make a diagnosis

• Develop a treatment plan

• Behavior modification

• Environmental Management

• Medication

• Surgery

• What do you need to learn?

• What is the problem?

• Why has the owner contacted you in the first place?

• However, what prompted the contact may or may not turn out to be the major problem.

• What factors in the environment contribute to the existence of the problem?

• Presence of children

• Many pets in the household

• Owners let dog run loose

What factors in the environment may be important to the resolution of the problem?

• Can the pet be kept separate from the children?

• Can the owners put up a fence?

• How motivated are the owners to resolve the problem? (How much time, effort and money are they willing to put into treatment?)

Collection of Information

• Communicate with persons familiar with the animal

• Direct observation of the animal

• Client fills out history form

• Direct interview

Client fills out form

• Advantage

• Time efficient for practitioner

• Client has leisure to think about answers, especially if filled out at home in advance

• Client fills out form

• Disadvantage

• Client may misinterpret questions and practitioner may not realize this as reviews answers

• May miss opportunities for digressions into areas that are pertinent to understanding the case

Direct interview

• Advantage

• Information is likely to come out in conversational context that will not come out during written context.

• Many opportunities for practitioner to explain and interpret questions as history is collected

• Disadvantage

• Most time-consuming technique

• Some clients will digress at length

• May need excellent interviewing skills to keep interview “on topic”

Blend

• Review history form that client has filled out

• Develop list of questions that arise out of initial answers

• Short interview

• Using blended technique in general practice

• During routine exam you are told, “Doc, my pet does X”

• You quickly determine that there is not a five-minute answer to the question

Give history form to take home and fill out

• May also give diary sheets to be filling out until returns

• Make appointment to return for longer behavioral consult

Separate history forms for different species/problems

• Have a generic history form, by species

• Have problem-specific forms for the problems that are commonly presented to your practice and that you are comfortable working with

Signalment

• Breed, Gender, Age

• All affect probabilities of specific diagnoses

• Dominance motivated aggression more probable with young males than old females

• Cognitive Dysfunction more likely a cause of loss of housetraining in a 13 year old than in a 4 year old

• Aggressively “herding” people occurs in herding breeds, not toy breeds

Chief complaint

• When did the problem begin?

• When does the problem behavior occur?

• Has there been a change in the frequency or appearance of the problem?

• What has been done so far to correct the problem?

• Are there other problems?

• General description

• Client is most interested in talking about this

• Gives you information about what will be the most important topics of discussion

• Specific description

• You need empirical information

• Ask for specific description of multiple incidents, beginning with the most recent.

Clarify terms

• Aggression

• Spraying

• Urinating

• Fear

Description of an incident of aggression

• Who was present?

• What was the victim doing immediately prior to the incident?

• What were other individuals doing immediately prior to the incident?

• Exactly what did the animal do?

• What happened immediately after the incident?

• Body posture/Communication?

• Ears?

• Tail?

• Eye stare?

• Crouch/Stand?

Spraying vs. Urinating

• “My cat jumps up on the couch, squats down, then sprays all over the cushion.”

• “My cats urinates all over the wall and the chair legs.”

When did the problem begin?

• As a general rule, problems of long duration will be more difficult to resolve than problems of recent onset.

• Problems of long duration are likely to have undergone progressive change.  These changes may reveal pertinent information.

• When does the problem behavior occur?

• How often does the behavior occur?

• You need to know the current rate in order to assess whether the animal is improving or getting worse.

• Under what circumstances does the behavior occur?

• Can the circumstances be avoided?

• Does specific treatment of those circumstances need to be conducted?

• Has there been a change in the frequency or appearance of the problem?

• Problems of long duration may have gone through several permutations. 

• Environmental changes occurring at the same time may be significant

• If it is getting worse or better, there must be a reason. 

• What has been done so far to correct the problem?

• Has the client already attempted treatments you might recommend?

• If so, with what success?

• Have they attempted the treatment accurately?

• What medications have previously been prescribed by other veterinarians?

• What were the results?

• Side-effects in this animal?

• Are there any other behavior problems?

• Develop a problem list

• The pet may have other problems which the owner didn't mention because they considered them

• less important or untreatable

• Prioritize long lists

• Sometimes owners depart the UGA behavior service with a different top priority than the one they came in for

• There are time constraints on the owner addressing problems

• Treatment for one problem may be in conflict with treatment for a different problem

• Current Environment

• Humans

• Other animals

• Housing and Management

What persons are in the animal's environment

• Who does the animal routinely interact with?

• What is the relationship between the animal and the various individuals it routinely interacts with?

• What are the people's schedules?

• Has there been a change?

What other animals are in the environment?

• Species

• Gender

• Age

• Relationship with the animal with the problem?

Housing and Management

• Is there a fenced-in back yard?

• How is the animal exercised?

• Where is the animal kept during various times of the day?

• Where are the litterboxes kept?

• How often is the litter cleaned?

• Where is the animal fed?

Early history

• Source of Animal?

• Stray?

• Breeder?

• Friend gave up pet?

• Age when obtained?

• Previous owners?

• Any information about behavior at former household?

• Why was pet given up?

Early history

• Not likely to help current treatment, but may help owner understanding and thereby improve owner motivation and compliance with treatment protocol.

• If a dog has a history of abandonment, the owner may better accept that its destructiveness is due to anxiety/arousal when left alone, and not due to “spite”

Training and learning

• How was the pet house-trained/litterbox trained?

• Dogs-Has the pet been taught basic obedience?  How?  How well does it obey commands now?

• Dogs and Cats-Has the pet been taught any special commands or tricks?

• Other Behaviors

• Sexual

• Mounting?

• Ever bred?

• Maternal

• Had puppies/kittens?

• Grooming

• Pet's response?

• Medical

• Illness, injuries or elective surgery around the time the problem began?

• Previously diagnosed chronic medical problems?

• Previous or current medication for the behavior problem?

Observations during interview

• Where does the animal go?

• Body posture/Communication by pet?

• To Veterinarian/Technician

• To Owner/Family

• Owner's lap?

• Under/behind chair?

• Investigates curiously?

• Keeps walking towards you? (with tail up and direct eye stare?)

Direct exam by veterinarian?

• Carefully consider what you have learned from the owner and from observation of the pet's behavior during the interview.

• Is it safe to conduct any kind of direct examination?

• Will it be useful?

• Direct exam by veterinarian?

• Eye stare?

• Have the owner hold the leash

• Learning?

• Demonstrate pet's ability to learn