Small Animal Veterinary Psychiatry

Sagi Denenberg, Sagi Denenberg

• Éditeur: CAB International
• Année: 2020
• ISBN:
  9781786394576
• Sujet: Médecine
• Sous-sujet: Médecine vétérinaire

Problem behaviours are often the result of how an animal thinks and feels, genetics and environmental influences. Steering away from just description diagnoses and focusing instead on emotional and cognitive causes, this book provides a practical approach to diagnosing, treating, and managing behaviour pathologies in dogs and cats. Beginning by addressing cases in the first opinion practice, this book then considers physical disorders that may lead to or exacerbate abnormal behavior. From there, the focus shifts to mental and emotional health, from an assessment of normal behavior and giving juveniles an optimal start in life, to diagnosing mental and emotional disorders, addressing emotions such as anxiety and frustration, and how to manage these issues - by modifying behavior, managing the animal's environment, training, and, when necessary, the use of medications. The second half of the book then addresses owner concerns, including management problems, aggression, affective disorder, elimination disorder, abnormal and repetitive behaviours and ageing-related problems.With an emphasis on helping first line veterinarians identify common presentations and offer help to owners, this book: - Addresses both normal and abnormal behaviour in cats and dogs from an emotion and cognition perspective;- Provides behaviour modification protocols, and drug doses and indications;- Includes handouts to be used both within the practice and with clients to help the veterinary surgeon manage the case.Written by international experts, the book translates their insights and experience into approaches taken in behavioural medicine. Also including the most up-to-date drugs, it is an important resource for both small animal veterinarians and students of veterinary medicine or animal behaviour.

1 Addressing Mental and Emotional Health in the Veterinary Practice

ALISON BLAXTER¹, ALEX DARVILL² AND SAGI DENENBERG^3,4*

¹Bristol Vet School, University of Bristol, Bristol, UK; ²ACD Projects Ltd, Newmarket, Suffolk, UK; ³Langford Vets, University of Bristol, Langford, UK; ⁴North Toronto Veterinary Behaviour Specialty Clinic, Toronto, Canada

*Corresponding author:[email protected]

© CAB International 2021. Small Animal Veterinary Psychiatry (ed. S. Denenberg) DOI: 10.1079/9781786394552.0001

1.1Introduction

Behaviour problems in dogs and cats are among the leading reasons for relinquishment and euthanasia. Given that the behaviour of the dog or cat is the main reason for the human–animal bond, any behaviour changes ultimately will affect this bond.

It is critical to understand that the behaviour we see is the result of mental and emotional, and biological (physiological) drives (Panksepp, 2016). Therefore, when addressing ‘behaviour problems’ we must realize that there are several possibilities under this umbrella term. These include psychiatric disorder (e.g. mental and emotional), excessive presentations of normal behaviours (e.g. excessive vocalization, scratching, certain aspects of house soiling, and jumping), and physiological and physical conditions (e.g. pain, gastrointestinal and neurological conditions). The term ‘behaviour problems’ may not be accurate; we can change behaviours; however, if we do not change the underlying motivation, a new problem will arise later.

To address this range of possibilities, the clinician must first know what is the normal (i.e. biological) behaviour of cats (see Chapter 4) and dogs (see Chapter 5). If the behaviour of the patient is truly excessive or abnormal, the clinician should first rule out physical conditions such as dermatological, neurological or metabolic diseases (see Chapter 2) or pain (see Chapter 3).

The next step is to establish a diagnosis (see Chapter 7). Then we must manage the problem(s) using behaviour modification tools that are based on teaching the animal alternative behaviours or changing its motivation (see Chapter 8). Finally, in some cases, especially where a true pathology exists, the use of psychiatric medications is necessary (see Chapter 9).

1.1.1Addressing owners’ concerns

The process of addressing these problems can be complex. When an owner presents a dog or a cat with ‘behaviour problems’ the clinician must first determine if the behaviour in question is truly a problem the patient is presenting or an owner’s subjective assessment. The latter, while it may not be a ‘true’ problem, is nevertheless an important aspect. Owners may not be aware of what is normal, and, in fact, only see what is common. For example, many dogs excessively follow their owners around the house and, as a result, do not sleep well. Owners may not be aware that this behaviour represents an abnormality, as this behaviour is common.

1.1.1.1Subjective?

Often, owners will present a dog or a cat with an undesired behaviour that is not a true pathology (see Chapter 10). It is as important to manage these problems, and to help owners, as it is to manage true pathologies. At the end of the day, it is the owner that takes the patient home and must be happy with it. All too often, owners relinquish their pets due to conditions that other owners may see as normal, or they cope well. For example, a barking dog may not be a concern for the owner until they have a new baby at home who cannot sleep well.

1.1.1.2Helping owners

Patients do not arrive at us on their own; owners bring them when they have concerns about them. Aside from helping patients, we must help the owners. It may be frustrating at times to address certain cases when we feel that the owner should have come earlier, or should have managed the problem differently (e.g. without punishment). However, we should not be quick to pass judgement on owners. Owners try helping their pets in most cases, even when, in hindsight, they have chosen the wrong approach.

In most cases, it suffices to review the timeline of the problem. Owners are often reactive; they only try to intervene once the problem has started. Infrequently, owners are proactive. Therefore, even when owners use punishment, they do so after the problem has started. We may criticize owners for aggravating a situation, but not always for creating it.

Also, most owners feel guilty for using these techniques or not doing something appropriately. We must avoid the tendency to blame them; giving them a ‘guilt trip’ is not helpful for them or any of the involved parties. Owners are not more likely to be active if they feel guilty. We must foster a partnership with owners through trust, education, encouragement and honesty (even when we disagree with their approach).

1.1.2Whole-practice approach

Addressing behavioural problems, especially those with underlying psychiatric disorders, is time-consuming and may not always be possible during routine visits to the practice. Therefore, involving more staff members, questionnaires and follow-up appointments is necessary.

It is important to recognize that often owners will not discuss their pet’s behaviours with veterinarians as they either think that veterinarians are not knowledgeable about the behaviour of animals or they are concerned about the recommendations. Therefore, veterinarians must not only ask, they must also inform owners that they can and want to help. Questionnaires and handouts are a useful method to inform owners about the service and care the veterinarian can provide.

1.1.2.1Questionnaires

Questionnaires are good screening tools to use in the practice. While waiting at the practice, owners can fill in a questionnaire (see Handouts A1 – GP Questionnaire – Cat; and A2 – GP Questionnaire – Dog). Questionnaires should be designed to be simple to fill in and read. The veterinarian can quickly read the questionnaire as the owner enters the room and then review any concerns with the owner. These questionnaires should then be filed in the patient’s file.

Questionnaires should be adjusted to the patient’s age because its needs and behaviours change as it moves from one age group to the next. Time should be allotted through each routine visit to review the patient’s behaviour.

1.1.2.2Handouts

Following discussions with owners about their pet’s behaviours, we must provide them with information. At times, a referral is necessary. However, even when owners decide not to pursue referral we should attempt to help them. Providing handouts helps, as we can give them concise information while maintaining a routine visits schedule. For more information on available resources see Handout A11.

1.1.2.3Routine visits

Patients’ needs should be assessed during each routine visit. Just as you would evaluate the patient’s physical health, you should also evaluate its mental and emotional health.

Puppy visits should include discussions on socialization, training, identifying concerns and pathologies, and addressing emerging concerns. Starting correctly with puppies and kittens may alleviate future problems and prevent relinquishment or euthanasia (see Chapter 6).

Adult and ageing patients (see Chapter 16) should also be screened during routine visits. Their behaviour may have changed as well, especially since the juvenile state. Many, if not most, problems arise as the patient reaches social maturity and develops into an adult animal (see Chapter 6).

1.1.2.4Veterinarians

The role of the veterinarian is to diagnose and prescribe a treatment for these problems. Aside from ruling out any physical disorder that contributes to the development and maintenance of the problem, veterinarians can offer information on its management.

Once physical disorder is ruled out (see Chapters 2 and 3), the first step is to ensure that the problem is not progressing. This can be achieved through the prevention of triggers, implementing safety, and environmental management.

Safety is not just for possible victims of aggression; it is also for the patient itself. Not only might the patient suffer injuries in a possible fight (when aggression is the presentation) but it may also self-inflict injuries in some cases of compulsive behaviours, trying to escape different situations or running after the owner. A known side-effect of psychiatric disorder is euthanasia.

When we attempt to manage psychiatric disorder in the first-opinion practice, time is a concern. We may need to schedule a follow-up appointment to address and manage the problem more thoroughly. Another option is to appoint a staff member who can address owners’ concerns, offer basic training and management advice. The veterinarian can supervise the management and prescribe medications when necessary.

Veterinarians who seek more knowledge and training can pursue continuing education, seminars, online training, university degrees and clinical specialization.

1.1.2.5Nurses

Nu...