Behavior Case Triage

Mar 8, 2017 / Practitioner Updates

behavior dogs

Guidelines to help practitioners assist clients with behavioral concerns

Behavioral problems in dogs and cats are a common cause of damage to the human-animal bond and pet relinquishment (1). While behavioral problems rarely develop overnight, pet owners may be reluctant to discuss their concerns with veterinary staff; when concerns are mentioned, owners may do so in passing or at the end of an appointment, leaving veterinary staff insufficient time to assess the pet’s behavior or provide knowledgeable advice to help the pet and client (2).

The following guidelines will help practitioners assist their clients with behavioral concerns.

Identify Behavioral Concerns

Few clients will discuss concerns about their pet’s behavior unless directly asked, so it is essential for practitioners to include discussion of behavior in every appointment. This can be done as part of standard history taking, using open-ended questions such as, “What concerns do you have about your pet’s behavior?”

Once a problem is identified, collect a minimum database including a physical examination, complete blood count, chemistry profile, and urinalysis as all behavior problems have medical differentials. Determining the progression of the problem will help to guide further evaluation.

  • Behavioral problems are chronically progressive as they result from learning. If a chronically progressive problem is identified, schedule a follow-up visit to review the behavior history and provide assistance.
  • Behavioral problems with an acute onset, especially in a mature or senior pet, are most likely due to a medical condition. The articles by Overall (3) and Frank (4) provide excellent lists of differential diagnoses for behavior problems to guide further evaluation.
  • Some patients present with medical conditions that may have underlying behavioral causes. Examples include foreign body ingestion, injuries from fighting with other animals, and injuries from escape attempts. If a patient presents with these conditions, further evaluation of the patient’s behavior is indicated.

Assess the Urgency and Type of Assistance Needed

Goals for the behavioral assessment include identifying problem behaviors that are within normal limits but problematic for the client, behavioral problems due to fear and anxiety and can be managed by the primary care veterinarian, and behavioral problems that require urgent assistance and referral to a veterinary behaviorist.

  • Conditioned, unwanted behaviors such as jumping up to greet or stealing food off of counters are normal behaviors that can be addressed with the help of a qualified trainer. Animal training is an unlicensed profession, so the skill and knowledge-base of trainers varies greatly. The American Veterinary Society of Animal Behavior provides excellent guidelines on how to choose a trainer:
  • Separation anxiety and noise aversions are common in the pet population and result from fear and anxiety. While qualified trainers may be able to provide support, veterinary involvement is required as many patients will require pharmaceutical or nutraceutical anxiolytics for effective treatment.
  • Behavioral problems resulting in injury to the patient or others, problems with multiple triggers, or problems that have resulted in the breakdown of the human-animal bond require urgent assistance and referral to a veterinary behaviorist.

Provide Assistance

Veterinary staff can offer immediate assistance for all levels of behavioral concerns. Immediate assistance can be provided by:

  • Showing empathy throughout the discussion with the client. Most clients will feel embarrassed by their pet’s behavior and may feel blamed or judged by others. Using empathy throughout the discussion will allow the practitioner to gather an accurate history and can promote treatment adherence (5).
  • Advising the client on management strategies to avoid triggers. Management is crucial in the treatment of all behavioral problems and will prevent continued rehearsal of the behavioral problem as well as reduce stress and anxiety.
  • Advising the client to discontinue punishment-based interventions. Responding to behavior problems through the use of punishment remains common practice by many pet owners and dog trainers (6). These interventions present significant welfare and safety concerns as they cause fear and anxiety and can result in owner-directed aggression (7). Training via positive reinforcement is recommended as it will teach the animal appropriate behaviors through the use of desirable consequences and can strengthen the human-animal bond.

Further levels of assistance may include behavior modification and treatment with pharmaceutical or nutraceutical anxiolytics. If the veterinarian is unsure how to proceed with treatment, referral to a veterinary behaviorist can be offered.

Veterinarians play an important role in the treatment of behavioral problems. By integrating behavior into every appointment, problems may be identified and treated early in their progression when they have the best prognosis for improvement and before they have degraded the human-animal bond.


Kwan JY, Bain MJ. 2013. Owner attachment and problem behaviors related to relinquishment and training techniques of dogs. J Appl Anim Welf Sci 16, 168–183. doi:10.1080/10888705.2013.768923

Martin KM, Martin D, Shaw JK. 2014. Small Animal Behavioral Triage. Vet Clin North Am Small Anim Pract 44, 379–399. doi:10.1016/j.cvsm.2014.01.004

Overall KL. 2003. Medical differentials with potential behavioral manifestations. Vet Clin North Am Small Anim Pract 33, 213–229.

Frank D. 2014. Recognizing behavioral signs of pain and disease. Vet Clin North Am Small Anim Pract 44, 507–524. doi:10.1016/j.cvsm.2014.01.002

Abood SK. 2007. Increasing adherence in practice: making your clients partners in care. Vet Clin North Am Small Anim Pract 37, 151–64. doi:10.1016/j.cvsm.2006.09.011

Rooney NJ, Cowan S. 2011. Training methods and owner-dog interactions: Links with dog behaviour and learning ability. Appl Anim Behav Sci 132, 169–177.

Herron ME, Shofer FS, Reisner IR. 2009. Survey of the use and outcome of confrontational and non-confrontational training methods in client-owned dogs showing undesired behaviors. Appl Anim Behav Sci 117, 47–54. doi:10.1016/j.applanim.2008.12.011

—Kelly Ballantyne, DACVB, Veterinary Behavior at Illinois