Top 5 behaviors every clinician should recognize

Is that dog really calm? On this episode of The Vet Blast Podcast, presented by dvm360, Ori Stollar, MSc, DVM, DACVB, joins host Adam Christman, DVM, MBA, to walk through the 5 stress signals in dogs and cats that are easy to miss—and easy to misread—in the exam room.

The pair digs into how to build a fast, useful behavioral history; when a "behavior problem" is actually pain, a urinary tract infection (UTI), or something else possible in disguise; plus Stoller's own case of a patient whose sudden lethargy turned out to be a slipped disc.

Below is a partial transcript, edited lightly for clarity.

Adam Christman, DVM, MBA: At what point would it be time for me, the primary care [practitioner], to refer to you, the behaviorist…? Maybe it's…severe separation anxiety [or] noise aversions, and I just can't get things under control. What does that look like?

Ori Stollar, MSc, DVM, DACVB: Whenever anyone feels that it's too much for them to treat. Let's say you already gave it a shot. You tried 1, 2, even several medications…[that] didn't really do too much, but you really believe that there's still something to be done—then yes, definitely refer those cases.

Anything that you know might not even be a complicated case. I do have other veterinarians refer cases to me that are not really difficult. They just prefer the specialists to do it, and it's OK. We're being paid to do it, so we don't care. I mean, whatever you send our way, we're going to take it….

Another thing would be situations where you have a concern about safety and even liability. Maybe not your own liability, but, say, it's a family that has babies or young kids in the house, and they have a dog that already bit people or has a very high…hunting drive, or something like that, and you don't really know how to address it in a safe way. Or you don't want to say something that you think might end up with the dog biting someone, and then they're going to blame you for it—and technically, in a way, you'll be liable for it.

We might not be able to do more than you, but because…our bread and butter, in a way, we deal with it a lot. We know how to say those things to the clients, and even sometimes tell them, “Look, we might be able to help you a little bit, but [this dog] is aggressive. There's always the chance that he's going to bite someone. These are the safety measures that you need to take.” Then we send the client the visit summary, we send the veterinarian the visit summary, and then you know everything is logged. So for safety reasons and for liability…I think everyone feels much more comfortable.

As far as the process itself, it's actually pretty easy. I guess it's different for different veterinarians or different behaviorists, but in most cases, I know that it would usually be just sending the patient or the client our way. We'll tell them the cost. We'll tell them how to fill [out] the questionnaire, and we'll set up the meeting and all of that. And we'll want the referring veterinarian to send us the medical records, like any blood work [or] history that might or might not be relevant. Because, as I mentioned, sometimes we might find something in the medical record that might indicate that the patient is experiencing pain, and it was overlooked. So it's good for us to have the full picture.

Christman: Yeah, and you know what? We just don't have the time, especially to dedicate [to] behavior. Just exactly to your point, you're doing a big medical history. You're spending a lot of time with the owner, giving them great recommendations. And when they're seeing the [general practitioner], it's like 20 [to] 30 minutes, and [you’re] usually trying to rule out the primary reasons, and then there's [probably] a recheck in another one.

That's what I love [about] working with you. I love working collaboratively because it is a teamwork-based approach, just exactly what you said…. Sometimes it can be challenging to get the pet owner on board with the “why” behind the referral. But yeah, [there's] so much information that we get from the behaviorists.