There are a lot of professionals who might come into your dog’s life — your veterinarian, certainly, and possibly a trainer, and perhaps a groomer, a pet-sitter, a dog-walker, and others.
That’s a lot of professional advice which could come your way. And some of it might — in fact, probably will — conflict. How is a pet owner to sort and filter the many pieces of information and misinformation coming her way?
And, most importantly for us professionals, how do we work together to give our clients the best information and therefore the best combined care?
(I don’t mean this to be controversial or insulting to any profession or professional — it’s really, honestly about playing to everyone’s individual strengths!)
This question came to a head for me as I was writing up recommendations for a client’s anxious dog. One option — not the first, but an item which had to be included as another route if our first plans didn’t work as well as hoped — was referral to a qualified veterinarian for diagnosis and probable prescription of behavioral drug therapy.
Recommending this is necessary more often than I’d like in my behavior career, and it often scares me — not because I’m opposed to using drugs when necessary, or opposed to working with vets, or opposed to sharing clients, or anything like that, but because there’s a risk that the suggestion might lead to an inappropriate treatment.
No, I’m not bashing vets! Hear me out.
I’ll use a case which is a few years old and impossible to identify. I’d been working with a family for a few weeks, with a young dog who shows signs of generalized anxiety. I observed that he just wasn’t making the progress he should and that he might need some medical help. I gave the family the contact information for an excellent behavioral vet clinic and told them that they would need a referral from their own vet to visit the specialist clinic, but that it would cost their vet nothing and was just a phone call or fax.
The client’s vet didn’t give the referral. The vet said that he could proscribe behavior drugs and they didn’t need a specialist. Or, it seems, a trainer (“the drugs will fix it”). The client called me to let me know that they had a new prescription (a drug which I’d heard from specialists wasn’t preferred for some types of cases) and their vet was taking care of it.
I was slightly miffed at being dismissed by this vet I didn’t know, yes, but even more I was worried for the client. But, in my area a non-DVM cannot legally discuss any diagnosis or prescription drug, so what I could say was very limited. “I know you have a fully-qualified veterinarian,” I said, “but behavioral medicine is very specialized and there’s a lot of new research to keep up with. Even if you don’t continue with me, I’d really urge you to see a vet who has a majority of professional experience in this field.”
But she assured me that the vet had assured her that he could handle it, and I wished her well.
About a week later she called back. The dog had bitten their child. Treated with a drug which reduced inhibitions, but not anxiety, and without training on reducing or managing anxiety, the dog’s behavior became dangerous. I was very upset — now a child had been injured, the previously mildly-fearful dog now had a bite record and a greater anxiety problem, and the family had been put through far more than ever should have been necessary, and for the sole reason that another professional had dismissed the importance and validity of behavioral medicine.
Vets & Trainers Together!
Is this an isolated incident? Unfortunately, no. And that’s not necessarily the vets’ fault, really. Yet it can lead to terrible results.
There is a vague perception that trainers don’t want to work with vets except to get training referrals and money, but that’s decidedly untrue. I have referred FOUR anxious dogs for veterinary evaluation in the last ten days. And as I wrestled with my worries in telling clients to talk to their general vets about behavior, I tweeted:
Attention, vets: trainers want to refer to you! We NEED vets to help w/ medical behavioral issues. But we need to trust you'll do right. 🙂
— Canines In Action (@CIA_k9s) December 5, 2011
Due to Twitter’s necessarily abrupt phrasing, that came out a little harsher than I’d meant (and I did follow it with an explanation that I meant partnership, not criticism). But immediately other trainers began retweeting, suggesting that in fact many trainers have similar worries.
I don’t mean at all to bash vets — far from it! A DVM has to cover a lot of ground — to be fair, I think we expect maybe too much of our vets, most of whom might treat cancer in a lizard and pyometra in a dog and diabetes in a cat within the space of an hour before going into emergency surgery on a hit-by-car victim. Not that they’re not up to it — the vast majority of vets do a great job! — but to then expect that they should also know the latest research on how sub-clinical hypothyroidism might affect behavior is a bit unfair. I mean, sub-clinical!
We’re not afraid to refer to specialists in dermatology, ophthalmology, etc. — why should a specialist in behavior be any different?
As I mentioned, I’m barred legally from discussing drugs and medical diagnoses — but also ethically. I’m not a vet, I never went to vet school, and I’m just not qualified to speak on that. When I do notice something which might be a medical issue in a client’s pet, I suggest that “you might ask your vet about X,” which brings it to their attention without pretending to diagnose anything.
And medical factors come into behavior cases more often than you might think — hip dysplasia causes a dog to be aggressively protective of his sore joints, or a urinary tract infection is affecting house-training. Trainers need vets to take care of these physical factors, and I never worry that the vet will resist treatment or downplay such an obvious physical component’s importance.
Behavior people have an advantage in that we only have to keep up with one focus! While trainers eat and breathe behavior stuff, vets usually have much more in the field demanding their attention and often just don’t have the schooling for some behavior cases. But as in the case above, they might also lack the schooling to recognize that they lack the schooling, and this is where things can get messy.
And so now I find myself occasionally wanting to refer a client for help I know they need, but fearing to be undermined by someone with the best of intentions but insufficient special expertise. And while I am always very, very careful to avoid criticizing their vet, I feel terrible having to explain the importance of seeing someone with a specialty in behavioral medicine.
(Note: there are definitely general-practice DVMs who do keep up with behavioral medicine! But obviously unless the vet tells clients and trainers that he’s emphasizing behavioral medicine, we can’t know, and skittish trainers will probably refer to a known behavioral specialist. Please, clients and interested vets, Do ask, Do tell!)
Bad Advice Can Come From Anywhere
I got into a similar topic on Twitter last week.
ACO told owner of fearful chi 2 grab dog & spray bitter apple in mouth when he bit. now dog is biting harder. WTH.
— debbie jacobs (@fearfuldogs) November 30, 2011
We understood — an animal control officer is an animal professional, and a pet owner might see one as a behavior authority. But an animal control officer has an entirely different role than that of a behavior expert. Their responsibility is to identify and remove dangerous dogs — not dogs at risk of becoming aggressive, which is a behavioral evaluation, but dogs fitting a legal description by previous legal incidents — or abused dogs. They’ve got a brutally tough job (and I’ve personally campaigned at city hall to give ours more authority and defense) which I do not envy at all, and it doesn’t include solving pet behavior problems.
@primitivedog i don't know ACO personally. probably loves dogs. and I really mean that
— debbie jacobs (@fearfuldogs) November 30, 2011
Again, the fact that someone isn’t qualified to offer good behavior advice or treatment doesn’t mean trainers or pet owners dislike or disapprove of them — it just means it’s not their field.
Groomers see a lot of dogs, and they take specialized courses in dealing with the coat and its many variations of tangled filth and ultra-stylized beauty. I, on the other hand, can barely do anything with my own hair and have an astounded respect for anyone who can clean up a muddy, badly-matted beast in a couple of hours. It’s just a matter of field of expertise.
@fearfuldogs Tough for upset pet owner to know backgrounds tho, when free (or paid!) advice offered. Wish more respected 100s hours put in.
— Canines In Action (@CIA_k9s) November 30, 2011
A good trainer can show you an accumulation of education and continued education, usually totaling hundreds of hours of formal education. Bad advice comes a variety of places, but one easy tip-off is, Is this person trained to be a trainer? Right off the top of my head, I’ve had clients cite the origins of their training practices from such dubious sources as:
- movies (“I saw a guy bite the dog’s ear in this film, and it worked.” I wish I were kidding.)
- TV, both reality and fiction (too many to count)
- people in line at the convenience store who have the same breed
- people in line at the convenience store who don’t have the same breed
- this guy who knows a guy in the police who handles a police dog (Handling a highly-trained working dog does not make one a trainer any more than driving a well-tuned car makes me a mechanic. Yes, there are many wonderful trainer-handlers and driver-mechanics out there, but the two aren’t necessarily the same.)
- the guy at the pet store
- the internet (so be sure and check my credentials before accepting any of this!)
- a professional trainer who became a professional trainer by reading a book and then printing cards (No kidding, I’ve known several professional trainers who not only had no behavior education at all, but some had no dogs, and a few didn’t even like dogs.)
- and of course, much much more
A good rule of thumb is, “Would I take, say, medical advice from this kind of source?” If the answer is no, or at least not without further research and verification, then it’s probably not a great source for behavior advice, either.
I’ve been thinking about what might block a vet or client from being comfortable with specialized behavioral medicine, and I have a few ideas.
It’s too expensive. I am less than two hours from what I’m comfortable calling one of the best animal behavior clinics in the world. A two-hour consult there is about the same cost as two hours of private training with me, and it includes both a behavioral specialist vet and a behavioral technician (who, at the time of this writing, holds the same certification and KPA faculty position I do). Not to sell myself short or anything, but it’s a pretty good deal.
It’s a greedy gimmick. I’ve heard a few people speculate that behavior medicine is a ruse to push prescription drugs and training services. This ignores the fact that usually, clients seeking specialized behavior help are already paying for training and perhaps drugs, and the specialist usually helps them to need less of both.
A general-practice DVM can handle it. Some can! But not necessarily all. While it’s perfectly true that any DVM can prescribe a behavior-modifying drug, as I said above, I think it’s a bit unfair to expect every vet to be aware of every behavior protocol out there on top of all the other practical information. As I tell clients, a lot of this research has only been reviewed and published in the last few years, so unless your vet makes a practice of reviewing new behavioral medicine, he might not be aware of it. That doesn’t make him a bad vet — it’s just a fact that no one can be a specialist in everything. A behavior vet, on the other hand, focuses on that field first, and so is more likely to be familiar with newer drugs and newer protocols.
That said, I would love for more general-practice DVMs to get involved with behavioral medicine! There’s a huge need for vets who can treat these cases appropriately and we’d welcome more!
I don’t want to drug my dog! That’s a very fair feeling, and I respect it. That said, if there’s a medical factor to the behavior — and brain chemistry is a medical factor — then it may need a medical solution. This is one of the jobs of the behavioral vet, to identify how much of the behavior is due to a medical cause and also the best way to address it.
The majority of the time, behavior drugs are used temporarily — they simply put the brain in a better state to receive and process the training (often, the same training we’ve already been doing, which let us see that the brain wasn’t working properly). The drugs aren’t needed permanently.
Likewise, drugs don’t install learning on their own! They only allow training to work better. This is why behavior drugs should be given in conjunction with good training, never instead of.
And good behavior drugs aren’t just tranquilizers, and the dog on appropriate medication and dosage won’t appear drugged. It won’t change his personality or take your dog away! and it certainly won’t “dope” him. See here for more info.
I don’t want to bring in another professional. Aw, man, professional jealousy is the worst. Fortunately, I don’t think it’s common — good trainers and good vets know that networking leads to better business all around. (After all, even someone visiting a specialist still needs an everyday vet or trainer!) Still, occasionally someone tries to resource-guard a client, and that’s sad.
Trainers muddy the waters and go where they shouldn’t. Sadly, this has happened. But it shouldn’t. No good trainer will allegedly diagnose a medical problem (even if it’s not illegal in his area) or discuss drug recommendations. In fact, there are classes on avoiding this professional no-no. And while it does happen, it isn’t the rule with good trainers, and vets shouldn’t be too worried about it.
Have you heard other reasons behavioral medicine isn’t used to advantage? Tell me in the comments!
The Way It Should Be
I talked with my mom about the possibility of her dog having a thyroid problem, based on physical and behavioral symptoms. (I know I said I’m normally very circumspect, but hey, it was my mom. And my final advice was still, Ask the vet about it.) Mom, having a decades-long comfortable relationship with the vet clinic, was likewise pretty open about what I’d suggested. The vet said she hadn’t heard anything about those behavioral symptoms being related to thyroid issues, but it was worth checking out. She went home and looked it up. And then she called my mom and said, “Yep, there’s studies out on this, and it might be the case.” And the test indeed showed hypothyroidism.
It works the other way ’round, too — a client asked her vet for behavioral help with her troubled dog, and the vet sent the client to a veterinary behavioral specialist. The behavior vet wrote up a diagnosis and training plan and referred the client to me for training “aftercare.” Everyone benefited, especially the client and dog.
This is a perfect synchronization of pet owner, vet, and trainer working together, each using our own fields (behavior, medical testing, and the accurate relay of information) to cooperatively solve a problem. Awesome. Now let’s do it everywhere.