Ethical dilemmas and legal issues in veterinary behavior cases (Proceedings)

Veterinary behavior 

• That branch of veterinary medicine which deals with the prevention, diagnosis and treatment of behavior problems in non-human animals.

Clients often have questions about animal behavior and behavior problems.

• They expect their veterinarian to provide them with accurate, useful information.

• There are a lot of pop-culture myths about animal behavior and self-professed experts in behavior who give out a lot of misinformation.

• Just as you should get an appropriate, scientific education in anatomy and surgery before doing surgery, you should get an appropriate and science-based education in applied animal behavior before giving behavioral advice.

• Several million dogs and cats are euthanized or abandoned each year due to unacceptable behavior.

• Often, these behavior problems could have been treated or prevented.

• Each year, in the United States alone

• Several million people are bitten

• 20+ people are killed by dogs

Dog problem

• Also a people problem

• Owner kept saying “Don't shoot my dog!” while people were trying to stop two dogs that were mauling this girl.

• Strange relationship between some people and dogs in U.S.

• Dogs are “mans best friend”. Dogs love us without judging us. Dogs save our lives. Dogs are cuddly and sweet, loving and heroic. Dogs are Lassie.

• Any dog may bite, maul or kill someone.  After all, they're dogs.

• Because of 1, we must accept two as an inevitable part of having such wonderful pets.

Consequence?

• The consequences of this attitude, and the presence of the attitude, often come out during criminal and/or civil legal proceedings following a dog attack.

• Owners commonly blame victim for walking past, reaching toward, or even just being near their dog.

Societal norms?

• Any good behaviorist can figure out what “provoked”, i.e. caused, the dog to bite.

• As a society, we must decide what is and is not an acceptable provocation for dogs living among us.

General practice

• First contact by pet owners confronted by behavior problems

• Presented with a chief complaint

• Diagnose

• Decide on an appropriate treatment plan

Behavior Problems vs. Training

• Veterinary Behaviorists may use certain training techniques in the treatment of certain problems, especially with dogs. However, training is only one part of a comprehensive treatment plan.

• School teachers and Psychiatrists do not do the same thing!!!!

• Practice of veterinary medicine:

• To diagnose, treat, correct, change, relieve or prevent animal disease, deformity, defect, injury, or other physical or mental conditions; including the prescription or administration of any drug, medicine, biologic,…or to render advice or recommendation with regard to any of the above.

• Model Practice Act, AVMA

Psychoactive medications

• Medications that produce changes in behavior and/or motivation

• Most use of psychoactive medications in veterinary medicine is extra-label.

• ONLY exceptions are

• Anipryl® for Canine Cognitive Dysfunction

• Clomicalm™ for Canine Separation Anxiety

• Reconcile™ for Canine Separation Anxiety

Animal medicinal drug use clarification act (amduca 1994)

• Requirements for extra-label use

• Valid client/veterinarian/patient relationship

• Behavioral history MUST be taken

• For any chief complaint which is behavioral in nature you must do an appropriate and adequate medical and behavioral evaluation to justify coming to a diagnosis.

• Just because the owner or the dog trainer says the dog has dominance aggression (or any other diagnosis) it does not mean that the dog does have dominance aggression.  It may have fear aggression, hip dysplasia, be inadequately exercised, not have been appropriately trained to not jump up on people, or a variety of other problems instead.

Veterinarian has established a diagnosis

• Not the dog trainer

• Not the veterinary technician who has an interest in behavior

• Not the “behaviorist” who is not a veterinarian, even if they have some kind of certification

• Not the owner who saw on 20/20 last night that Prozac cures thunderphobia

Must be a specific rationale, and its use is accepted under current medical conditions.

• Keep up with the literature

• This is a rapidly advancing field

• Extra-label usage

• Inform client of the extra-label status of the drug.

• If necessary, explain to the client what extra-label means.

• Inform the client of known side-effects.

• Signed informed consent statement.

The buck stops here

• While the veterinarian can obtain valuable information and assistance from

• Veterinary Technicians who are educated and experienced in techniques of treating animal behavior

• PhD's who focus on domestic and applied animal behavior

• Ethical trainers who use humane training techniques

• The veterinarian is legally and ethically responsible for all decisions regarding treatment of a given case.

When to refer to a specialist?

• Anytime the case is so complex or presents such dangers that you feel uncomfortable attempting to pursue diagnosis and treatment yourself, with or without correspondence with a specialist, or if the patient is not responding to treatment as expected.

• Particularly consider referral in cases of serious aggression.

Euthanasia: aggressive dogs

• Attitude of the owner

• Presence of vulnerable individuals in the household

• Size of the Dog

• Type of Aggression

• Intensity of the Aggression

• Special logistical issues for preventing bites

• ACVB

• American College of Veterinary Behaviorists

• Recognized by the AVMA in 1993

• All listed in the AVMA directory and on www.dacvb.org

• One year general internship or equivalent

• 2-3 year conforming residency

• additional pre-requisites for two year residency

• non-conforming residency option exists

• learning and effort must be equivalent to a conforming residency