Commentary

Veterinary behaviorists should be the first,

not the last, resort for optimal patient care
Colleen S. Koch dvm, dacvb From Lincoln Land Animal Clinic Ltd, 1150 Tendick St, Jacksonville, IL 62650; and the
University of Missouri Veterinary Health Center, 1092 Wentzville Pkwy, Wentzville,
MO 63385.
Address correspondence to Dr. Koch ([email protected]).

C onsultation with a veterinary behaviorist is of-

ten the final stop prior to euthanasia for many
owners of dogs, cats, horses, parrots, and other pets
Experts have been advocating the inclusion of
animal behavior courses in the veterinary curriculum
since at least 1975,7,8 and the human-animal bond was
with behavior problems. In many instances, owners an important topic of discussion during conferences in
are tired and spent, both emotionally and financially, the 1970s and 1980s.9 In a 2004 study,10 veterinarians
before finding their way to a veterinary behaviorist in private practice classified behavior in the “need-to-
and are looking for reassurance that their pet is not know” category for new graduates.10 A 1988 survey
as bad as everyone claims it to be or that euthanasia by McKeown and Leuscher11 found that 42% of dog
or rehoming is really their only option. owners and 47% of cat owners had concerns about the
Most animals relinquished to an animal shelter behavior of their pets, and behavior concerns are the
because of a behavior problem have been seen by a most common cause for animals to be relinquished to
veterinarian in the previous year.1 Although veteri- a shelter.1,2,12 By contrast, Gazzano et al13 demonstrated
narians should ask about behavior at every patient that owners of puppies taken from the dam before 8
and client contact, this does not always happen.2,3 weeks of age who were provided behavior advice dur-
And, even when owners raise concerns about be- ing their puppy’s first veterinary visit reported less ag-
havior during appointments, those concerns are gression and fewer behavior disorders than owners in
rarely adequately addressed.3 Perhaps veterinarians the control group who did not receive behavior advice.
do not feel comfortable addressing behavior issues The ongoing problem appears to be that many
because they were not exposed to them in veteri- veterinarians graduate without an understanding of
nary school.2,4 Regardless, the lack of attention to body language, learning theory, and animal behavior.
behavior issues can lead to a cascade of problems Without education, many are unable to differentiate
including poor welfare for the owner and pet, relin- between a behavior problem and a training problem
quishment or euthanasia of the pet, and compassion and lack the ability to treat either appropriately.14 How
fatigue, loss of patients,5 and decreased income for many veterinarians, for example, are taught how to
the veterinarian. This depressing downward cycle house train a puppy, teach a puppy not to jump on
needs to stop. people, or train a cat how to use a litter box? Simply
Asking clients about behavior problems during understanding the difference between a fearful pet
appointments can be difficult for veterinarians. Time and a normal pet and having the ability to educate
is always limited, and discussions regarding other owners on an appropriate plan of action can benefit
services and products, such as bloodwork or para- everyone: the owner, the veterinarian, and the pet.
siticides, may take precedence. Certain indicators, Veterinary behaviorists are often used as the last
such as a dog wearing a prong, choke, or electronic resort for behavior problems for a variety of reasons.
(shock) collar or the need for application of a muzzle First, most veterinarians have been involved with ani-
during the examination, may suggest that a pet has mals in some way prior to entering veterinary school
behavior issues the owner is trying to address or that and may have had exposure to training techniques.
the owner is unaware of the implications of using Unfortunately, they may not have been exposed to
these devices. As veterinarians, we have a duty to ed- the best techniques for any animal but especially fear-
ucate clients on appropriate ways to handle behavior ful and anxious animals and often are expected to
and training problems, or at least know when and to just “get it done” during appointments. Often, this
whom to refer these clients. The addition of behav- leads to the use of force and restraint—grasping a cat
ior services in clinical practice helps to preserve or by the scruff of the neck, holding a dog down, hob-
maintain the human-animal bond, resulting in better bling a horse, or toweling a parrot—and this attitude
care, improved quality of life, and increased aware- is often conveyed to clients. Instead, it is our respon-
ness and use of other specialists.6 sibility to educate clients in humane and appropriate

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ways to handle animals, even if these methods may one considers that behavioral disorders are one of the
take a little more time initially. leading causes of death in animals.12 In addition, most
Second, there is a shortage of veterinary behav- veterinary schools do not include animal behavior
iorists and a growing number of animal trainers who courses in their core curriculum.17,18 This gap in train-
claim to be behaviorists. In addition, dog trainers who ing and resulting lack of understanding of normal ver-
use primarily positive punishment outnumber those sus abnormal behavioral development leaves many
who use positive reinforcement. Although punish- general practitioners without the necessary tools to
ment, compulsion, and corrective training methods identify patients that may need help and, too often,
can lead to perceived improvement in some animals, leads to an unfortunate “wait and see” approach to
the underlying motivation for the behavior is not ad- fearful young animals.
dressed and is simply suppressed. This also reflects Behavior issues are treatable medical conditions
the need for veterinarians to be able to distinguish and in many ways are the equivalent of psychiatric ill-
behavior problems from training concerns. nesses in humans. Although there may not be a cure
To complicate matters further, several popular for many behavioral problems, there are certainly a
television shows have placed the spotlight on uncre- variety of treatments available that can improve the
dentialed and unlicensed individuals who claim to quality of life of patients and their relationship with
be behaviorists. This has created a misconception their owners. Without appropriate treatment, how-
of what behavior specialists do and has often pro- ever, these patients and their owners will struggle
moted unacceptable and inhumane techniques that as the human-animal bond erodes, leading to relin-
may result in increased fear, anxiety, and aggression. quishment to a shelter. Courses on animal behavior
According to the AVMA, “the terms ‘specialist’ and and learning theory should be an integral part of
‘board-certified’ are used interchangeably to des- the veterinary school core curriculum and not just
ignate the same thing. The AVMA, and many state offered as elective opportunities.7,17,18 Even subtle
veterinary practice acts, limit the use of the term changes in animal behavior without an identifiable
‘specialist’ to those individuals who have been board- cause often motivate owners to seek veterinary care.
certified by one of the AVMA Recognized Veterinary Because behavior issues are prompting contact with
Specialty Organizations.”15 To become a behavior spe- our patients, behavior should not be viewed as an af-
cialist, an individual must complete veterinary school terthought but as an integral part of veterinary prac-
and a residency program in veterinary behavior, must tice. Behavior should be integrated into every course
publish results of a research study in a peer-reviewed in the veterinary curriculum, from basic medicine
journal, write multiple case reports, and pass an ex- courses to clinical applications during rotations.
tensive examination covering all aspects of the field. Many veterinary students do not feel prepared to
By contrast, animal trainers and groomers, dog walk- handle behavior issues at the time of graduation,19 sug-
ers, pet sitters, and related professionals do not re- gesting that they are not being given the necessary tools
quire credentialing and do not have a licensing board to identify and treat behavior problems. This deficit in
to hold them accountable for their knowledge or ac- knowledge is unacceptable. As pets continue to play a
tions. These individuals may hold certificates attest- larger and larger role in the family, owners will begin to
ing to their education, but no entity ensures that they demand expert treatment of behavior problems. Pup-
are using safe and humane techniques. pies and kittens that are fearful do not outgrow this
The practice of medicine does not offer guaran- problem.20 It is our responsibility as veterinarians to
tees. Veterinary behaviorists determine the underlying educate clients as to what a veterinary behaviorist can
motivations of behavioral problems and treat them. offer and why seeking the help of a veterinary behav-
As may be the case for other areas of medicine, be- iorist should be considered the standard of care.
havioral medicine may require lifelong medication in Behavior disorders are not uncommon. When
addition to systematic behavior modification and man- owners seek help for a behavior issue, they should be
agement. The quick fixes and lifetime guarantees of- directed to a veterinary behaviorist first, not last. If
fered by trainers and uncredentialed behaviorists are appropriate, the veterinary behaviorist can, in turn,
often illusory, and unless the underlying motivation is direct clients to qualified trainers who understand
addressed, the unwanted behavior will continue to re- learning theory and use positive reinforcement. Early
surface. Unfortunately, each time it does, the problem intervention in this manner has the potential to ad-
will often become more difficult to treat. Veterinary dress problems while they can still be corrected and
behaviorists cannot guarantee resolution of behavioral can prevent clients from suffering financially and emo-
concerns, and a dog that is sent to a boarding facility tionally. Rather than as a last resort, patients should be
for training is not permanently reprogrammed. Each directed to a veterinary behaviorist as a first resort in
day is a learning opportunity for every animal, and be- keeping with the highest standards of medical care.
havior modification requires consistent and persistent
lifelong training that owners must provide. References
Currently, there are fewer than 80 diplomates of 1. Scarlett JM, Salman MD, New JG, et al. The role of veterinary
the American College of Veterinary Behaviorists in practitioners in reducing dog and cat relinquishments and
North America.16 This is far too few, especially when euthanasias. J Am Vet Med Assoc 2002;220:306–311.

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2. Patronek GJ, Dodman NH. Attitudes, procedures, and de- behaviorists’ advice given to puppy owners. J Vet Behav
livery of behavior services by veterinarians in small animal 2008;3:125–133.
practice. J Am Vet Med Assoc 1999;215:1606–1611. 14. Strickler BG. Helping pet owners change pet behaviors: an
3. Roshier AL, Mcbride EA. Canine behaviour problems: discus- overview of the science. Vet Clin North Am Small Anim
sions between veterinarians and dog owners during annual Pract 2018;48:419–431.
booster consultations. Vet Rec 2013;172:235. 15. AVMA. ABVS FAQs. Available at: www.avma.org/Professional
4. Roshier AL, Mcbride EA. Veterinarians’ perceptions of behav- Development/Education/Specialties/Documents/ABVS%20
iour support in small-animal practice. Vet Rec 2013;172:267. FAQs.pdf. Accessed Jul 23, 2018.
5. Kim RW, Patterson G, Nahar VK, et al. Toward an evidence- 16. AVMA. Market research statistics: veterinary specialists
based approach to stress management for veterinarians and 2017. Available at: www.avma.org/KB/Resources/Statistics/
veterinary students. J Am Vet Med Assoc 2017;251:1002–1004. Pages/Market-research-statistics-Veterinary-specialists.aspx.
6. Herron ME, Lord LK. Use of and satisfaction of pet owners with Accessed Jul 23, 2018.
a clinical behavior service in a companion animal specialty re- 17. Juarbe-Diaz SV. Behavioral medicine opportunities in North
ferral practice. J Am Vet Med Assoc 2012;241:1463–1466. American colleges of veterinary medicine: a status report.
7. Houpt KA. Animal behavior as a subject for veterinary stu- J Vet Behav 2008;3:4–11.
dents. Cornell Vet 1976;66:73–81. 18. Shivley CB, Garry FB, Kogan LR, et al. Survey of animal wel-
8. Beaver BV. The role of veterinary colleges in addressing fare, animal behavior, and animal ethics courses in the curri-
the surplus dog and cat population. J Am Vet Med Assoc cula of AVMA Council on Education–accredited veterinary col-
1991;198:1241–1243. leges and schools. J Am Vet Med Assoc 2016;248:1165–1170.
9. Hines LM. Historical perspectives on the human-animal 19. Calder CD, Albright JD, Koch C. Evaluating graduating vet-
bond. Am Behav Sci 2003;47:7–15. erinary students’ perception of preparedness in clinical vet-
10. Greenfield CL, Johnson AL, Schaeffer DJ. Frequency of use erinary behavior for “day-1” of practice and the factors which
of various procedures, skills, and areas of knowledge among influence that perception: a questionnaire-based survey.
veterinarians in private small animal exclusive or predomi- J Vet Behav 2017;20:116–120.
nant practice and proficiency expected of new veterinary 20. Godbout M, Frank D. Persistence of puppy behaviors and
school graduates. J Am Vet Med Assoc 2004;224:1780–1787. signs of anxiety during adulthood. J Vet Behav 2011;6:92.
11. McKeown D, Luescher UA. A case for companion animal be-
havior. Can Vet J 1988;29:74–75.
12. Salman MD, Hutchison JM, Ruch-Gallie R, et al. Behavioral For all commentaries, views expressed are those of the au-
reasons for relinquishment of dogs and cats to 12 shelters. thors and do not necessarily reflect the official policy of the
J Appl Anim Welf Sci 2000;3:93–106. AVMA. This year marks the 25th anniversary of recognition of
13. Gazzano A, Mariti C, Alvares S, et al. The prevention of the American College of Veterinary Behaviorists by the AVMA.
undesirable behaviors in dogs: effectiveness of veterinary

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