General practitioners often find behavioral cases a daunting challenge, so it is important to follow a logical process when formulating a treatment plan for cats with such presentations. The first step is making a behavioral diagnosis, or list of differential diagnoses, via collection of a comprehensive and accurate history. Taking a thorough behavioral history is arguably the most important part of dealing with animal behavioral issues.

Empathy underpins all counseling. Empathy is a skill that “creates a climate for acceptance, support, disclosure and a working alliance. It is crucial for the building of a trusting relationship.”1 Empathy includes being sensitive to the feelings of the client without making judgments. It requires respect and interest in the client and constructive honesty to enhance the cat–human bond. The veterinarian must remain sufficiently objective to make rational and well-informed decisions.

While it has been found that female veterinarians are more likely to make rapport building statements and to receive lifestyle–social information from clients,2 these skills are particularly important for all veterinarians when attending to behavior cases. Many of the basic counseling skills employed in various forms of psychological counseling are appropriate for history taking in a veterinary context. The need to develop rapport and understanding with the client is critical in both instances. These skills include the following:¹

The type, duration, and intensity of behavioral problems vary enormously. This chapter focuses on issues that require a behavioral consultation to be addressed appropriately. A good starting point for behavioral issues is a thorough physical examination and, generally speaking, a blood profile and urine test to help rule out medical issues that could be contributing to the behavioral problem and that may also have an impact on the treatment plan. One case study showed the importance of a full medical workup of a cat presenting with feline idiopathic cystitis that could be successfully controlled with behavioral therapy alone.3 It is not uncommon for there to be a crossover between medical and behavioral issues, with both needing to be addressed. The results of such investigations will form part of the collected history and are addressed elsewhere (see Chapter 3: Deciphering the Cat: The Medical History and Physical Examination).

It is not uncommon for clients to ask about behavioral concerns as part of a routine consultation. Alternatively, the veterinarian may become aware that behavioral advice is required to address the presenting complaint which the client may perceive as being a straightforward medical issue. In some cases, it is possible to cover the required advice as part of a standard consultation. However, in cases that are complex, it is necessary to schedule an extended behavior consultation.

Providing clients with a behavioral questionnaire indicates that you are concerned about the issue and relieves the pressure to give inadequate advice due to time constraints. It can be helpful to use an analogy when booking the behavior appointment, such as a comparison with a separate time being scheduled if their cat required surgery. A behavioral questionnaire allows clients time to consider and answer several questions about the cat before they arrive for the consultation. The completed questionnaire can be returned prior to the set consultation time if the veterinarian prefers to review the history and undertake any relevant research prior to the visit. That said, it is also important that the written history is reviewed at the face-to-face appointment to ensure there are no misunderstandings. Clients will also feel reassured if they can discuss the history and confirm the veterinarian appreciates their situation and goals for treatment.

Many clients will not have undertaken a behavioral consultation with their cat before. A cover sheet should be provided with the questionnaire to explain the likely duration of the consultation, topics that will be covered, and an estimate of cost to demystify the process.

A questionnaire not only provides structure for the veterinarian so that critical areas are covered but also helps clients see their cat’s issues more clearly. Encouraging input from all household members affords the best chance of obtaining an accurate history and identifying potential areas for disagreement that may need to be addressed. Several textbooks have behavioral history templates that can be modified according to the style and preferences of the attending veterinarian (Box 15.1). An example of a questionnaire for behavior problems is in Box 15.2.