Dr. Karen Overall shows how to effectively use support staff to oversee behavior counseling within a practice.
The most common killer of pet dogs and cats are behavioral problems. Recently published data support the contention that behavioral concerns - whether they involve simple management-related issues, misconceptions about what constitutes normal behaviors or true behavioral pathologies are responsible for the elective death or placement of more pets than is any other veterinary condition.
Table 1: Common behavioral concerns or problems that should be reviewed for dog and cat clients
Common behavioral concerns for which dogs and cats are most often relinquished are discusses in Table 1. Demonstrations of lessons that should be discussed and demonstrated at the first visit for puppies and kittens, and adult dogs and cats are discussed in Table 2.
At every visit, veterinarians should emphasize the need for good manners and for shaping and rewarding excellent behaviors. At the first visit, all pets - cats and dogs - should be taught to sit for a food treat when requested. Simply learning to sit on request and for all attention (food, walks, love, leash or harness placement, grooming, tick removal, teeth cleaning) will:
All cats and dogs should also be fitted for harnesses or head collars (or loose flat buckle collars if they already walk without struggle on a lead) at their first visit, and they should not be allowed to leave until the client understands how to teach the pet to enjoy walking without a struggle. Then, the client needs to go home and practice, practice, practice.
This type of information cannot be conveyed in a 20-minute appointment, and veterinarians should plan accordingly, either adjusting their schedules or using their staff. Behavioral intervention is truly a case of deciding whether you want to pay now or later.
If the patients have behavioral concerns, they concerns absolutely must be addressed as early in the development of the problem as possible. This is not an option if veterinarians do not routinely query clients about their pets' behaviors. It is worth noting that new data demonstrate that the average amount of time that a dog with a behavioral problem is maintained in the household before being relinquished is four months. Behavioral problems are true veterinary emergencies. If the practitioner is not comfortable with dispensing behavioral advice, the following are options.
Table 2: Activities that should be demonstrated to the client at the first visit and then practiced daily by them
1. Refer to a specialist. The only specialists in veterinary behavioral medicine are members/diplomates of the American College of Veterinary Behaviorists (DACVB). Currently, there are only 30 boarded specialists in behavioral medicine, but the number is growing.
2. If there is not a specialist in your area, you may still be able to work with one. Contact a diplomate of the specialty college and ask if they will consult with you - not the client - through a formalized fax or e-mail consultation service. In this case, you remain the veterinarian of record and all correspondence about the patient will go to you from the specialist, not to the client.
3. Contact an applied animal behaviorist. Most people certified by the Animal Behavior Society are not veterinarians (although some are), but instead have a master's or Ph.D. degree in a behavioral field. To be certified, they must produce credentials supporting their training. While these individuals are not specialists and legally cannot diagnose and prescribe medication, they can be extremely helpful in teaching you and your client about the development of the pet's problems and suggest behavioral and environmental interventions.
4. Contact the American Veterinary Society of Animal Behavior (AVSAB) and ask if there is a veterinarian with an interest in behavior in your area. Their current membership directory contains the names and contact information for more than 400 veterinarians with this interest, and notes which individuals are boarded specialists, which are certified by the Animal Behavior Society as applied animal behaviorists, and which members will see clients whose pets have behavioral problems. While most members are not specialists, many will see behavior cases and sometimes consult with specialists. Furthermore, even the non-specialists may have attended a large number of more continuing education courses in behavior, and so have access to the most up-to-date information. Look for professionals who are honest about their training and credentials and ask on what resources they rely when they need help.
5. Become a member of AVSAB. Get the education and training. Your practice will gain financially, you will gain intellectually, and your clients will be so grateful that all of you will benefit in immeasurable ways from the experience.
6. Subscribe to newsletters that address behavioral concerns. Most of these are written for the dog owner, but the information in them is unlikely to be stuff that you learned in veterinary school. Two newsletters with lots of emphasis on preventing and treating undesirable behaviors are the Association of Pet Dog Trainers' (APDT) Newsletter and The Whole Dog Journal. These are inexpensive and you'd be surprised how much you can learn in the bathroom.
If you become sufficiently comfortable with taking a behavioral history, working through diagnostic algorithms and making treatment recommendations involving medication, you may still either not feel comfortable with making recommendations involving behavior modification. You may also feel that you don't have the time in your practice to do this. That's fine, because now the APDT has a program that certifies dog trainers. To become certified, the individual must pass a rigorous exam that focuses on learning theory, its application in changing behaviors, and on modification techniques that are humane, rather than abusive. Because individuals who pass the exam are now certified, the organization has a way to encourage and enforce the humane aspects of dog training. This should be welcome news for veterinarians and clients, alike, whose concerns about abusive and scary techniques did not receive adequate attention until recently. These certified trainers may run dog training centers or classes, consult on an individual basis, or work with veterinarians within their practices. Depending on client volume and needs, it may be and smart for five or six practices to co-operate and hire a certified trainer on a full-time to work with exclusively with their clients. Such work could involve classes, specific interventions or routine puppy training.
Veterinary technicians are often underappreciated and used. There are now two techninican groups for those interested in behavioral medicine:. The Veterinary Technician Animal Behavior Society, Inc. (VTABS) accepts full memberships from technicians that are certified, registered and licensed and those that are not. The Society of Veterinary Behavior Technicians (SVBT) restricts full membership to those technicians who are certified, registered or licensed, but has a non-voting membership category for others. The logic of this is understandable:. SVBT's goal is to become the third certified specialty (after ICU/Critical Care and Anesthesia) in veterinary technology. Both groups have newsletters and either conduct or alert their members to continuing education opportunities. Veterinarians should encourage their technicians to become active in this field and provide them with the resources to gain knowledge through continuing education that would not have been available to them during their training. Furthermore, many technicians are interested in dog training, having a licensed technician who is also an APDT-certified dog trainer and who belongs to a group seeking specialty status would be a boon to any practice.