Why do you need a vet referral for help with a behaviour issue?

This is a question we often get asked by prospective clients and it’s a really good question. Why would your vet need to be involved when your dog is barking at other dogs on walks? Or they’re scared of fireworks/chase shadows/show aggressive behaviour towards owner? They are behavioural issues aren’t they? The short answer is… it’s complicated!

Medical problems are often involved in behavioural issues

In fact, in some veterinary behaviour clinics, up to 80% of their cases have been estimated to have a painful medical condition, which is either directly causing, or at least exacerbating the issue. In such cases - effectively managing any pain or treating the medical problem can hugely improve or even resolve the behavioural issue. At Companion Minds, we are are not veterinarians, so it is important we work alongside our patients vets by combing our behavioural expertise with their medical expertise.

OUCH! That noise Hurt!

To make the link a bit clearer, let’s use an example of pain related noise sensitivities. Consider a middle-older aged dog who has has been comfortable and relaxed around fireworks for 5 years, and then suddenly (or so it seems) firework period comes round and the dog is terrified. Perhaps the dog has also been ‘slowing down on walks’, or been more ‘grumpy’ in the evenings. These are all indications the animal may be in some degree of pain, even if it isn’t immediately obvious (i.e. no obvious lameness). However, pain comes in all different sorts - acute, chronic, low severity, high severity, and it might even fluctuate. I’m sure these are all aspects that most of us can relate to from periods of our lives when we have suffered from pain. If the animal is a bit sore, think about what happens when they hear loud noises like fireworks: instead of startling and recovering instantly, that normal startle response and associated sudden tensing of the body actually physically hurts them. The dog then makes a connection that the loud noise = pain and therefore becomes very worried by the noise itself. In such cases, even if the pain is managed medically by your vet (possibly also with other professionals like physios or hydrotherapists), there may still be some underlying anxiety due to the animal having learnt to expect pain. This is where our behavioural modification protocols can then be effective in changing the animal’s perception of the fireworks. You can see that if we tried addressing the response to fireworks from a behavioural only perspective,  when the animal was still in pain, our progress is likely to be extremely limited. 

This is just one example, there are lots out there! A great, free to access paper (that isn’t too heavy in its scientific jargon!) has recently come out by the wonderful Professor Daniel Mills (who taught both me and Tom on the Lincoln Masters course) and colleagues, which lays out various cases of problematic behaviours such as aggressive behaviour, changes in performance, house-soiling, separation related issues, and a few others- and how there was a medical component contributing to the animals behaviour (Mills et al. 2020, Pain and Problem Behavior in Cats and Dogs, Animals 10(2), 318: https://doi.org/10.3390/ani10020318).

A referral from a vet can…

-       Open up of the channels of communication between your vet and ourselves as professionals. We get to spend many hours with the animals at our consultations and may see things which we think requires medical expertise, in which case, we would communicate and ask your referring vet about this who can then see the animal to investigate further if they feel it’s needed.

-       Allows us access to the animals’ medical records. This means we can be aware of any medical problems present that might effect what we do in behaviour modification e.g. if a dog has painful hips we don’t want to incorporate jumping or lots of sitting into a behaviour plan. It also allows us to do things such as to put together timelines, correlating behaviour changes with precise dates of medical problems, which can help us work out what might be going on.

-       Makes your vet aware of the behavioural issue and that the animal may need further support from them at some point. 

-       Ensures the animals has had a recent health check, so any immediately apparent physical illness can be addressed by your vet before any behavioural treatment begins. That is, your vet can essentially ‘sign off’ that there is either no immediate medical concern, or at least no medical reason not to, proceed with behaviour assessment and treatment.

So hopefully now you can see why having a vet involved is super important. We are NOT vets, and therefore cannot diagnose or treat medical conditions. We have however been trained to identify when we think an animal might be in pain or when we think an animal might need the additional medical expertise of a veterinarian. Therefore our relationship with your vet is paramount to ensuring the best possible outcome for both you and your animal- and therefore an important ethical and welfare aspect to our process.

Behavioural indicators of possible involvement of pain: 

Below are some ‘red flags’ of possible involvement of pain in a behaviour problem. These are often signs we gather in a behaviour history that we think need to be reported back to your vet. This list is not exhaustive, but just an example of common signs:

-       Sudden onset of the behaviour problem

-       The behaviour is worse during or after episodes of exercise

-       The behaviour is worse in the evenings 

-       ‘Jekyll and Hyde’ type personality (and/or a change in personality)

-       The animal doesn’t seem to enjoy exercise, or stops a lot/lays down on walks.

-       The animal is described as lethargic, low energy, and doesn’t play a lot.

-       The animal is defensive when approached (to people or other animals), particularly if resting or asleep.

-       The animal avoids being touched or handled in a particular area or in a particular way (e.g. avoids a harness being put on, or moves their back end away when being brushed).

- The particular form of aggressive behaviour can sometimes be indicative

- We might think the animal is making some odd movements and will film this (with owner permission!) to send to your vet for their opinion.

- Maybe there just isn’t a very good behavioural explanation, so we have to consider whether there is something physical going on instead.

We also work alongside your vet to feedback progress in your dogs behaviour. This may help them manage the medical component, if present, which they would be overseeing.

Behavioural problems are quite often a really complicated interplay between natural tendencies (personality), learned associations and experiences on the animals’ part, and their physical health. To get the best possible outcomes, often all areas need to be addressed- without one or the other addressed, progress may be limited, which is why we work on vet referral only. 

If you have any concerns about your animals behaviour, please don’t hesitate to contact us to enquire about the clinical behaviour service we offer. We also advise you speak to your vet about the behaviour problem, and you can also discuss with them seeking the help of an appropriately qualified Clinical Animal Behaviourist or Veterinary Behaviourist (these can be found at the following link: https://abtc.org.uk/practitioners/)