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 (lincolnlandac@yahoo.com).
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
with behavior problems. In many instances, owners
are tired and spent, both emotionally and financially,
before finding their way to a veterinary behaviorist
and are looking for reassurance that their pet is not
as bad as everyone claims it to be or that euthanasia
or rehoming is really their only option.
Most animals relinquished to an animal shelter
because of a behavior problem have been seen by a
veterinarian in the previous year.1 Although veteri-
narians should ask about behavior at every patient
and client contact, this does not always happen.2,3
And, even when owners raise concerns about be-
havior during appointments, those concerns are
rarely adequately addressed.3 Perhaps veterinarians
do not feel comfortable addressing behavior issues
because they were not exposed to them in veteri-
nary school.2,4 Regardless, the lack of attention to
behavior issues can lead to a cascade of problems
including poor welfare for the owner and pet, relin-
quishment or euthanasia of the pet, and compassion
fatigue, loss of patients,5 and decreased income for
the veterinarian. This depressing downward cycle
needs to stop.
Asking clients about behavior problems during
appointments can be difficult for veterinarians. Time
is always limited, and discussions regarding other
services and products, such as bloodwork or para-
siticides, may take precedence. Certain indicators,
such as a dog wearing a prong, choke, or electronic
(shock) collar or the need for application of a muzzle
during the examination, may suggest that a pet has
behavior issues the owner is trying to address or that
the owner is unaware of the implications of using
these devices. As veterinarians, we have a duty to ed-
ucate clients on appropriate ways to handle behavior
and training problems, or at least know when and to
whom to refer these clients. The addition of behav-
ior services in clinical practice helps to preserve or
maintain the human-animal bond, resulting in better
care, improved quality of life, and increased aware-
ness and use of other specialists.6
1110 JAVMA | NOV 1, 2018 | VOL 253 | NO. 9
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
an important topic of discussion during conferences in
the 1970s and 1980s.9 In a 2004 study,10 veterinarians
in private practice classified behavior in the “need-to-
know” category for new graduates.10 A 1988 survey
by McKeown and Leuscher11 found that 42% of dog
owners and 47% of cat owners had concerns about the
behavior of their pets, and behavior concerns are the
most common cause for animals to be relinquished to
a shelter.1,2,12 By contrast, Gazzano et al13 demonstrated
that owners of puppies taken from the dam before 8
weeks of age who were provided behavior advice dur-
ing their puppy’s first veterinary visit reported less ag-
gression and fewer behavior disorders than owners in
the control group who did not receive behavior advice.
The ongoing problem appears to be that many
veterinarians graduate without an understanding of
body language, learning theory, and animal behavior.
Without education, many are unable to differentiate
between a behavior problem and a training problem
and lack the ability to treat either appropriately.14 How
many veterinarians, for example, are taught how to
house train a puppy, teach a puppy not to jump on
people, or train a cat how to use a litter box? Simply
understanding the difference between a fearful pet
and a normal pet and having the ability to educate
owners on an appropriate plan of action can benefit
everyone: the owner, the veterinarian, and the pet.
Veterinary behaviorists are often used as the last
resort for behavior problems for a variety of reasons.
First, most veterinarians have been involved with ani-
mals in some way prior to entering veterinary school
and may have had exposure to training techniques.
Unfortunately, they may not have been exposed to
the best techniques for any animal but especially fear-
ful and anxious animals and often are expected to
just “get it done” during appointments. Often, this
leads to the use of force and restraint—grasping a cat
by the scruff of the neck, holding a dog down, hob-
bling a horse, or toweling a parrot—and this attitude
is often conveyed to clients. Instead, it is our respon-
sibility to educate clients in humane and appropriate
ways to handle animals, even if these methods may
take a little more time initially.
Second, there is a shortage of veterinary behav-
iorists and a growing number of animal trainers who
claim to be behaviorists. In addition, dog trainers who
use primarily positive punishment outnumber those
who use positive reinforcement. Although punish-
ment, compulsion, and corrective training methods
can lead to perceived improvement in some animals,
the underlying motivation for the behavior is not ad-
dressed and is simply suppressed. This also reflects
the need for veterinarians to be able to distinguish
behavior problems from training concerns.
To complicate matters further, several popular
television shows have placed the spotlight on uncre-
dentialed and unlicensed individuals who claim to
be behaviorists. This has created a misconception
of what behavior specialists do and has often pro-
moted unacceptable and inhumane techniques that
may result in increased fear, anxiety, and aggression.
According to the AVMA, “the terms ‘specialist’ and
‘board-certified’ are used interchangeably to des-
ignate the same thing. The AVMA, and many state
veterinary practice acts, limit the use of the term
‘specialist’ to those individuals who have been board-
certified by one of the AVMA Recognized Veterinary
Specialty Organizations.”15 To become a behavior spe-
cialist, an individual must complete veterinary school
and a residency program in veterinary behavior, must
publish results of a research study in a peer-reviewed
journal, write multiple case reports, and pass an ex-
tensive examination covering all aspects of the field.
By contrast, animal trainers and groomers, dog walk-
ers, pet sitters, and related professionals do not re-
quire credentialing and do not have a licensing board
to hold them accountable for their knowledge or ac-
tions. These individuals may hold certificates attest-
ing to their education, but no entity ensures that they
are using safe and humane techniques.
The practice of medicine does not offer guaran-
tees. Veterinary behaviorists determine the underlying
motivations of behavioral problems and treat them.
As may be the case for other areas of medicine, be-
havioral medicine may require lifelong medication in
addition to systematic behavior modification and man-
agement. The quick fixes and lifetime guarantees of-
fered by trainers and uncredentialed behaviorists are
often illusory, and unless the underlying motivation is
addressed, the unwanted behavior will continue to re-
surface. Unfortunately, each time it does, the problem
will often become more difficult to treat. Veterinary
behaviorists cannot guarantee resolution of behavioral
concerns, and a dog that is sent to a boarding facility
for training is not permanently reprogrammed. Each
day is a learning opportunity for every animal, and be-
havior modification requires consistent and persistent
lifelong training that owners must provide.
Currently, there are fewer than 80 diplomates of
the American College of Veterinary Behaviorists in
North America.16 This is far too few, especially when
JAVMA | NOV 1, 2018 | VOL 253 | NO. 9 1111
one considers that behavioral disorders are one of the
leading causes of death in animals.12 In addition, most
veterinary schools do not include animal behavior
courses in their core curriculum.17,18 This gap in train-
ing and resulting lack of understanding of normal ver-
sus abnormal behavioral development leaves many
general practitioners without the necessary tools to
identify patients that may need help and, too often,
leads to an unfortunate “wait and see” approach to
fearful young animals.
Behavior issues are treatable medical conditions
and in many ways are the equivalent of psychiatric ill-
nesses in humans. Although there may not be a cure
for many behavioral problems, there are certainly a
variety of treatments available that can improve the
quality of life of patients and their relationship with
their owners. Without appropriate treatment, how-
ever, these patients and their owners will struggle
as the human-animal bond erodes, leading to relin-
quishment to a shelter. Courses on animal behavior
and learning theory should be an integral part of
the veterinary school core curriculum and not just
offered as elective opportunities.7,17,18 Even subtle
changes in animal behavior without an identifiable
cause often motivate owners to seek veterinary care.
Because behavior issues are prompting contact with
our patients, behavior should not be viewed as an af-
terthought but as an integral part of veterinary prac-
tice. Behavior should be integrated into every course
in the veterinary curriculum, from basic medicine
courses to clinical applications during rotations.
Many veterinary students do not feel prepared to
handle behavior issues at the time of graduation,19 sug-
gesting that they are not being given the necessary tools
to identify and treat behavior problems. This deficit in
knowledge is unacceptable. As pets continue to play a
larger and larger role in the family, owners will begin to
demand expert treatment of behavior problems. Pup-
pies and kittens that are fearful do not outgrow this
problem.20 It is our responsibility as veterinarians to
educate clients as to what a veterinary behaviorist can
offer and why seeking the help of a veterinary behav-
iorist should be considered the standard of care.
Behavior disorders are not uncommon. When
owners seek help for a behavior issue, they should be
directed to a veterinary behaviorist first, not last. If
appropriate, the veterinary behaviorist can, in turn,
direct clients to qualified trainers who understand
learning theory and use positive reinforcement. Early
intervention in this manner has the potential to ad-
dress problems while they can still be corrected and
can prevent clients from suffering financially and emo-
tionally. Rather than as a last resort, patients should be
directed to a veterinary behaviorist as a first resort in
keeping with the highest standards of medical care.
References
1. Scarlett JM, Salman MD, New JG, et al. The role of veterinary
practitioners in reducing dog and cat relinquishments and
euthanasias. J Am Vet Med Assoc 2002;220:306–311.
2. Patronek GJ, Dodman NH. Attitudes, procedures, and de-
livery of behavior services by veterinarians in small animal
practice. J Am Vet Med Assoc 1999;215:1606–1611.
3. Roshier AL, Mcbride EA. Canine behaviour problems: discus-
sions between veterinarians and dog owners during annual
booster consultations. Vet Rec 2013;172:235.
4. Roshier AL, Mcbride EA. Veterinarians’ perceptions of behav-
iour support in small-animal practice. Vet Rec 2013;172:267.
5. Kim RW, Patterson G, Nahar VK, et al. Toward an evidence-
based approach to stress management for veterinarians and
veterinary students. J Am Vet Med Assoc 2017;251:1002–1004.
6. Herron ME, Lord LK. Use of and satisfaction of pet owners with
a clinical behavior service in a companion animal specialty re-
ferral practice. J Am Vet Med Assoc 2012;241:1463–1466.
7. Houpt KA. Animal behavior as a subject for veterinary stu-
dents. Cornell Vet 1976;66:73–81.
8. Beaver BV. The role of veterinary colleges in addressing
the surplus dog and cat population. J Am Vet Med Assoc
1991;198:1241–1243.
9. Hines LM. Historical perspectives on the human-animal
bond. Am Behav Sci 2003;47:7–15.
10. Greenfield CL, Johnson AL, Schaeffer DJ. Frequency of use
of various procedures, skills, and areas of knowledge among
veterinarians in private small animal exclusive or predomi-
nant practice and proficiency expected of new veterinary
school graduates. J Am Vet Med Assoc 2004;224:1780–1787.
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
reasons for relinquishment of dogs and cats to 12 shelters.
J Appl Anim Welf Sci 2000;3:93–106.
13. Gazzano A, Mariti C, Alvares S, et al. The prevention of
undesirable behaviors in dogs: effectiveness of veterinary
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behaviorists’ advice given to puppy owners. J Vet Behav
2008;3:125–133.
14. Strickler BG. Helping pet owners change pet behaviors: an
overview of the science. Vet Clin North Am Small Anim
Pract 2018;48:419–431.
15. AVMA. ABVS FAQs. Available at: www.avma.org/Professional
Development/Education/Specialties/Documents/ABVS%20
FAQs.pdf. Accessed Jul 23, 2018.
16. AVMA. Market research statistics: veterinary specialists
2017. Available at: www.avma.org/KB/Resources/Statistics/
Pages/Market-research-statistics-Veterinary-specialists.aspx.
Accessed Jul 23, 2018.
17. Juarbe-Diaz SV. Behavioral medicine opportunities in North
American colleges of veterinary medicine: a status report.
J Vet Behav 2008;3:4–11.
18. Shivley CB, Garry FB, Kogan LR, et al. Survey of animal wel-
fare, animal behavior, and animal ethics courses in the curri-
cula of AVMA Council on Education–accredited veterinary col-
leges and schools. J Am Vet Med Assoc 2016;248:1165–1170.
19. Calder CD, Albright JD, Koch C. Evaluating graduating vet-
erinary students’ perception of preparedness in clinical vet-
erinary behavior for “day-1” of practice and the factors which
influence that perception: a questionnaire-based survey.
J Vet Behav 2017;20:116–120.
20. Godbout M, Frank D. Persistence of puppy behaviors and
signs of anxiety during adulthood. J Vet Behav 2011;6:92.
For all commentaries, views expressed are those of the au-
thors and do not necessarily reflect the official policy of the
AVMA. This year marks the 25th anniversary of recognition of
the American College of Veterinary Behaviorists by the AVMA.
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