Using a case approach
All veterinary personnel should be able to use standardized behavior assessment tools and provide general guidance on managing canine and feline behavioral problems. A recommended case approach includes the following steps:
- Identify a behavioral problem during a preventive care appointment after the client either completes a brief screening questionnaire or requests help for a specific behavioral concern.
- Monitor the patient’s stress level as it enters the clinic and is moved to the exam room (see the section, ‘‘Minimizing the Patient’s Fear in the Veterinary Hospital’’).
- Provide client-education materials about common behavioral disorders, their prevention, and treatment.
- While the patient is in the exam room, review the behavioral history by asking general questions, such as the age of onset and progression of any behavioral problems and situations that trigger the problem behaviors. A risk assessment should be made, including the likelihood of injury to the pet and human handlers and any risk of relinquishment of the pet.
- Complete a comprehensive physical exam, including diagnostic testing.
- Make a list of problem behaviors and a presumptive diagnosis based on specific behavioral descriptions (e.g., a dog bites a child only in the presence of food).
- Develop a management plan designed to reduce stress in any clinical situation.
- Make a list of differential diagnoses based on the current literature and the existence of possible comorbidities.
- Advise clients to implement the first treatment step, avoidance and protection, immediately. For example, when a child is near food, restrict the dog’s access to the child. Conversely, restrict the child’s access to the dog when the dog is eating. That strategy avoids the manifestation of problem behavior and protects both the dog and child.
- Make a final diagnosis based on the overall analysis, consultations with veterinary behavior specialists, and reference materials.
- Devise a written treatment plan based on best practices.
- Follow up with the owner by phone or text.
- Schedule regular rechecks.