Current Concepts

How to Keep Your Clients & Prevent Shelter Relinquishment

by Dr. Nicholas Dodman, BVMS, DACVB

When your clients lose their patience with their pet, you may lose your patients. In fact, behavioral issues account for 15 percent of veterinarians’ annual client loss. By incorporating elements of behavioral medicine into your practice, you can provide a great service to your clients, help save pets’ lives and help prevent professional “burnout.” It makes good business sense from several aspects.

Did you know that more puppies die from behavioral causes than infectious disease?

By incorporating behavior into your practice, you'll keep more clients--and save animals from shelters.

Did you also know that three times as many dogs die from behavioral causes as die from cancer? Between 40 and 90 percent of owners report behavioral issues with their pet. Each year, seven to eight million dogs and cats are surrendered to the nation’s shelters and pounds as owners are often all too quick to concede defeat. Almost 70 percent of these surrendered animals (4 million) cannot be placed and are euthanized. In fact, 25 percent of all pets born are euthanized before their second birthday. Three to four percent of cases seen in veterinary practice involve behavioral issues, and 20 percent of front office time is spent answering questions about behavior. Simply put, veterinarians can make a difference by being the resource for scientifically based advice about behavior beyond that of the local dog trainer.

Understanding a dog’s or cat’s behavior can also help with handling and restraint and may elucidate unreported behavioral problems. Behavioral problems can cause medical issues: for example, acral lick dermatitis in dogs or psychogenic alopecia in cats. The opposite is also true: medical problems can cause altered behavior.

Sometimes it can be quite difficult to distinguish between what is primarily medical and what is primarily behavioral. For example, tail chasing might be considered either or both, and dermatological problems sometimes have a behavioral component. Knowing more about behavior can help you educate your clients, create a better pet, make that pet easier to treat, strengthen the bond between the pet and the owner, and enhance the relationship that you have with the owner.

There are two ways that behavior can be brought into your practice. The first is what I refer to as the “general behavioral approach”, which means that behavior should be dealt with as needed during routine appointments. The second, which is not necessarily for everyone, is “specific behavioral counseling.” General behavioral advice should always be given at the time of first vaccination, when a new pet is brought to your practice or during annual wellness exams. It is important to ask relevant questions at these times and have the owners provide information relating to issues such as aggression, fears and phobias, compulsive disorders and house soiling. If you find out at a first puppy visit that a puppy is growling at its owners or nipping them, that is the best time for you to assist them in (excuse the pun) nipping the problem in the bud–not when the dog is two years old and much harder to turn around. Puppy issues to discuss include housebreaking, crate training, puppy classes, breed problems, socialization, growling or biting and submissive urination.

With kittens, too, there are certain issues that should be addressed at the first appointment, including whether the cat should be kept indoors, how many litter boxes are ideal, how to accommodate destructive scratching and how to assure proper socialization.

Behavioral counseling is not unlike other aspects of veterinary medicine. You have the owner fill in a thorough behavioral history form, perform a physical exam, make a list of problems and rule-outs, employ whatever diagnostic tests are appropriate, establish a diagnosis, recommend therapy and follow up with the client. Veterinary technicians can be very helpful in this process and are often keen to help with history taking or follow-up. As far as history taking is concerned, it is best to have a written form which the client fills in before the interview; this helps develop rapport with the client, assists in your understanding of the problem and saves time at the appointment.

Questions you might like to include are:

  • How would you describe the animal’s behavior?
  • What is its daily routine?
  • What is the composition of the household and the relationship between the pet and the family?
  • What is the owner’s attitude toward the pet, and how serious does he or she perceive the problem to be?

It is often not necessary to actually see the pet engaging in the behavior; however, videotape can be helpful in quantifying a behavior. Broad categories of behavior problems that you may wish to address include aggression, fear-related behaviors, compulsive behavior, inappropriate elimination, ingestive problems, sexual behavior, predatory behavior and hyperkinesis. With any behavior problem, it is particularly important to know exactly what the dog or cat does and when he or she does it. It is also important to know surrounding events, what triggers the behavior and what follows it. It is important to know when the problem first occurred, under what circumstances and what has already been tried by the owner.

Behavior-modification strategies include one or more of the following: a leadership program, desensitization, counter-conditioning, environmental modification, providing sufficient exercise, attending to the pet’s diet, ensuring clear communication between the owner and the pet, physical control of the dog by means of a head halter and lead and, if necessary, medication.  Alleviation of fear, environmental enrichment, clear communication, and mutual trust are all important if a pet is to be the best that he or she can be—one who is a joy to be with, responds appropriately and consistently, shares affection and is part of the family.

An owner’s adherence to your guidelines will vary from case to case. Here are some pointers to maximize effectiveness:

  • Never give an owner more than three things to do; they may get overwhelmed and do none of them.
  • Always repeat your understanding of the problem and give the problem a name.
  • Explain the treatment and ask whether the owner fully understands it, supply written discharge orders and handouts, charge for your service and request follow-up phone calls in one to two weeks and in a month.
  • Discuss the options,and give an honest prognosis for full or partial resolution.
  • Be realistic and give a time frame for results.

With all behavioral issues, it helps to intervene early and for owners to maintain elements of the behavioral modification plan into the future. Prevention is better than cure, but it’s not always possible; pets will sometimes turn up at your door who have come from puppy mills or pet stores and who have therefore been inadequately socialized and not acclimated to circumstances they’ll face throughout their lives.

Some of these cases can be challenging, but many can be turned around if the owners are prepared to make the commitment.