History

The behavior history determines the five “W’s” of the problem behavior: What? Where? When? Who (is present)? and Why? [4] A standardized, thorough behavior questionnaire insures collection of all significant information (examples on webpage). Inclusion of daily routines, family dynamics, environment, behavior frequencies and triggers help characterize the problem along with details on behavior modification/training attempted and its success [1, 4, 5]. The completed questionnaire reviewed before the behavior visit enables in-person consultation to be more productive and relevant to the behavior concerns (Web 23.1, sample questionnaires. Overall, Karen L, 2013 / with permission of Elsevier) [1, 4].

Observation

Direct observation of the patient’s personality and behavior occurs during the consultation or while viewing video recordings of the pet in the home environment, if safe to do so [1, 4]. Indirect observation occurs through descriptions of the pet from family members. Conclusions about the pet’s personality, motivation and mental state requires knowledge of species communicative body and facial postures [1, 4, 5]. Staff and owners must be familiar with species specific postures and expressions. (www.ZoomRoomOnline.com).

All stimuli and context (social and environmental) that trigger the behavior are determined [1, 4]. Owners may struggle to identify specific triggers if behaviors have advanced from episodic occurrences to more serious generalized patterns. In these situations, stimuli, or context causing increased intensity of the generalized behavior are determined [1].

Diagnosis

The complete behavior diagnosis is a descriptive phrase containing three components: the observed behavior, the behavior trigger(s) and the psychologic cause. For example, to determine the behavior diagnosis for “fear-based aggression toward children”; aggression is the observed behavior, children are the trigger stimulus and fear is the root cause. The observed behavior and trigger stimuli are gleaned from history and observation. The psychologic etiology is determined by satisfying criteria of a given psychologic behavior etiology (Table 23.1, Web 23.2). The three-part behavior diagnosis may not always be possible. The first component “observed behavior” is always known; however, the trigger stimuli and/or psychologic cause might remain unknown.

Medical Co-morbidities

Medical abnormalities can be primary, contributory, or occult causes of behavior problems requiring vigilance in treating known or suspected conventional diseases. Behavior issues are the only symptoms of some diseases such as cognitive dysfunction or pain [4]. Standard medical history, examination, and conventional database including at minimum a complete blood cell count, serum biochemistry profile, thyroid test, urinalysis, and survey radiographs are crucial to every behavior evaluation [1, 4].

Shen

Behavior abnormalities are considered a disturbance of the Shen (Spirit or Mind) [16]. Shen processes all incoming sensory and intuitive information and supervises the physical and mental reactions to that information [17]. Shen oversees and interprets the seven emotions (joy, anger, sadness, grief, fright, apprehension, worry) and regulates the five spirits (Hun, Po, Yi, Zhi, Shen) [18]. Signs of Shen Disturbance include abnormal behavior (e.g. restless, nervous, anxiety, insomnia, forgetful, hyperactivity, frightful, inability to focus) [16].

TCVM Patterns of Shen Disturbance

The Shen, though associated with the mind, is housed in the heart and requires nourishment from the heart Yin and blood to remain healthy [16]. The heart belongs to Fire and with imbalance is prone to excesses of heat, phlegm or fire, and deficiencies of blood, Yin and Qi [16]. Excess patterns result from heart heat/fire (hot foods, environmental factors, liver Qi stagnation) or non-substantial phlegm obstructing the heart orifice (secondary to heat, cold, damp, or spleen Qi deficiency) [16, 17]. Deficient patterns include heart blood, heart Qi, and/or heart Yin. Kidney Jing deficiency should be considered in behavior problems of young or senior patients as kidney Jing supports body fluids essential to manifest and anchor Shen. Mixed patterns result when excesses of fire, phlegm or liver Qi stagnation combine with depletion of blood, Yin or Qi (Table 23.2) [19].