This chapter covers
How to demonstrate behaviour principles during routine consultations
The use of obedience as an emotional stabiliser
How to ensure puppy or training class lessons transfer to the consulting room
The puppy vaccination
Peri-operative behaviour counselling
For the most part during a consultation, we give advice on what clients should do to care for their pet. This may be regarding general routine care, such as diet, grooming and worming, or more specifically about the condition being treated at the time, such as bathing an abscess or redressing a wound, how many times a day tablets need to be administered or when they need to come back for a check-up. We do this without necessarily demonstrating exactly what they should do every step of the way–although personally I always gave a demonstration of how to apply ear ointment.
Following manufacturers’ instructions to count the number of drops to dispense, I found, was worse than useless. It guaranteed that in order to ensure the correct number of drops, the nozzle had to be outside the ear. The said ointment got nowhere near the vertical and horizontal canals where it needed to be and was more likely to be found spattered all over kitchen cupboards after vigorous head shaking. Hence there resulted many apparently intractable cases of otitis externa, a particular beef of mine.
Interestingly, the advertisement accompanying the recent launch of a single-dose topical treatment for otitis externa for application during consultation only cites ‘solving the owner compliance challenge’ as a distinct advantage of this new preparation. It also states that ‘it’s easy to underestimate how challenging owners find treating their dog at home. Even the most well meaning, committed owners may struggle but won’t necessarily admit this to their vet’. In other words, have small animal vets ever been fully cognisant of the difficulties both owner and pet face at home?
In any vet-client relationship, there are concomitant expectations. The expectation of the vet is that the clients should do as they have been told, and of the client that they must try to follow their vets’ instructions to the letter. (Would that it were true, do I hear you mutter?)
These assumptions cannot be made when it comes to the handling of a pet dog. The word ‘handling’ might even be better replaced with ‘communication with’ their pet. ‘Handling’ means just what it says on the tin – the dog must have some form of ‘hands on’ restraint in order to get a particular job done. Communication, on the other hand, is so much more important. It implies that owners must inform the patient of what they are about to do and what the dog is expected to tolerate during examination in order to prepare the dog in advance for what is about to happen. A dog is far better able to cope with events when there is already a known strategy in place as to what to do. So often, even the sight of a bottle of ear drops triggers a rapid departure from the room. It is therefore incumbent on the attending veterinary surgeon to ensure that whatever a dog’s chosen coping strategy happens to be, it is convenient for the vet and comfortable for the patient.
What bodily position will be better for the dog to adopt – standing, sitting or lying down? Which part of the body needs to be touched? What result has the dog been led to expect when having a paw lifted or ear touched? One can talk about correctly applying the principles of learning and what pressures can be brought to bear to ensure a dog complies with requirements until one is proverbially blue in the face. But nothing is more valuable than actually showing, by your own practical approach, how to do it. Not a word need necessarily be spoken, or the word ‘behaviour’ even mentioned: simply ‘do as I do’ demonstration is enough.
This is not just for one’s own satisfaction in successfully completing a consultation without a struggle and without further frightening a recalcitrant patient. It will also have far-reaching effects on how the dog is dealt with in the wider world. While clients may not do as they are told, they are susceptible to copying what they have seen. This is particularly true of children. If they observe a parent shouting at or dragging a dog off the forbidden sofa, this is how they may try to it themselves, thereby creating a serious risk of being bitten. The same is true for veterinary surgeons as role models. If the vet forcibly restrains a dog, or alternatively asks a couple of nurses in to do it for them, this may be deemed acceptable and to be emulated by the client.
How much better therefore to show how a dog can learn to tolerate veterinary attention by gaining something the animal wants, or alternatively being rid of what it does not want, as a direct result of such tolerance?
From puppy class to consulting room
First of all, what a puppy learns in a ‘party’ or class must extend beyond the remit of the veterinary nurse or trainer and enter into every aspect of the veterinary premises, including most importantly the consulting room. If puppies were ‘fine’ in class but not so fine once they’ve reached their first birthday, then the lessons taught early on have not been sufficiently rehearsed in all the contexts in which a dog is expected to succeed. Particular attention must be paid to those behaviours which best allow veterinary handling and examination, namely, the sit, the stand, the down and the roll-over. Although taught as obedience exercises in class and possibly in a client’s sitting-room, they are generally very ill-rehearsed, if at all, in the veterinary consulting room. It is therefore imperative that vets are also involved in the puppy training process, if only out of a sense of self-preservation. For a particular behaviour to be deemed worth doing, then there must always be both anticipated and tangible rewarding payback for the dog, wherever the puppy happens to be. There is little point in giving a food treat for an obedient sit in a puppy party only for a sit in the consulting room to result in a painful injection. A young dog’s newly formed trust in veterinary aspects of the world can thus be completely demolished.
The puppy vaccination
The young puppy’s first visit to the surgery is the most crucial and attitude forming that it will ever experience. It is essential that this visit is made as pleasant and as educational as possible, however long it takes. Lessons learned now may be remembered for the rest of the dog’s life – for better or for worse. If handled well, the adult dog may forgive a multitude of sins as previous pleasant memories help protect against future unpleasantness. If handled badly, a dog readily prepared to bite when threatened is created, at any time in the future and in any similar context. The majority of the available consultation time should be spent ensuring that the puppy not only enjoys himself but begins to learn the behaviours that will be the most convenient all round for the rest of his life. There are very few puppies who will not eat in the consulting room at this stage in their veterinary careers if tasty food is both offered ‘for free’ and given as rewards for suitable behaviour. It is essential that this is carried out before anything unpleasant has happened to them. Trying to ‘make friends’ after the puppy has been made upset is far harder to do and may be impossible. Do not therefore be misled into thinking ‘let’s get the nasty stuff over and done with as quickly as possible’. Extra time spent now is an investment in your relationship with the growing dog which will reap huge dividends in years to come.
It is arguable that discussions regarding worming, diet and neutering should be left to a competent veterinary nurse while the veterinary surgeon’s time is better spent teaching the puppy to sit on the consulting room table, using food as a lure. By contrast, the most important lesson a puppy must not learn is that being held firmly predicts pain and discomfort. I firmly believe that it is the accompanying enforced restraint which adult dogs come to object to rather than the injection itself. To avoid this unfortunate association being made, the moment the injection is given, the puppy must be let go and allowed to eat offered food. Evidence of success are smiling owners and a puppy who sits willingly on the table when presented for his second vaccination.
Reinforce ‘sit’ on consulting room table with food.
Hands off and give food at same time as injection administered.