Integrative Management of Abnormal Small Animal Behavior

Integrative Management of Abnormal Small Animal Behavior

Cynthia McDowell


Inappropriate behaviors in pets have serious physical, emotional, and monetary consequences. Studies estimate 40% of pet dogs and cats in the United States exhibit problem behaviors constituting the number one and two reasons for relinquishment to shelters, respectively [13]. Commonly reported behaviors in both include aggression, destructiveness, inappropriate elimination, and compulsive disorders; with dogs additionally reporting anxiety and unruliness [2].

Veterinarians are key to behavior wellness programs. Every veterinary visit should screen common issues such as abnormalities associated with elimination, sleep, eating, and vocalization along with human/animal interactions (e.g. mouthiness, growling, biting, property destruction) [1, 2, 4, 5]. Behavior specific questions alert caregivers to early symptoms which can be more easily treated and prevent adverse outcomes that threaten the human animal bond [1, 4]. The primary care veterinarian bears ethical responsibility to provide diagnostic and treatment options, offer the inclusion of a veterinary behavior specialist and maintain oversight of these patients. Goals to stabilize the patient, prevent disease progression, and resolve the abnormality are paramount [1]. The integrative veterinarian is in a unique position to triangulate behavioral and conventional treatment with complimentary therapies, such as traditional Chinese veterinary medicine (TCVM) to expand treatment options and improve patient outcomes [615].

Integrative Medicine Diagnostic Approach



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].


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. (

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].


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.

Table 23.1  Common behavior terminology, phenotype, and definition [1]. Overall, Karen L, 2013 / with permission of Elsevier.

Behavior etiology Behavior phenotype Definition
Various Aggression Action(s) that reduces the freedom or fitness of another such as a growl, lunge, snap, nip, bite, tense body posture, or facial expression. (Expanded web table containing 12 aggression trigger/etiology categories)
Anxiety Various State of heightened monitoring with increased vigilance/scanning and sympathetic arousal in the absence of stimuli
Fear Various Response to stimuli characterized by withdrawal, passive and active avoidance, and sympathetic arousal
Phobia Various Profound, non-graded, extreme, often per-acute exaggerated fear response to a consistent stimuli manifest as intense, active avoidance/escape
Various Compulsive and repetitive behaviors Inappropriate repetitive, stereotypic motor, locomotor, grooming, ingestive, or hallucinogenic behaviors
For more information readers are directed to the expanded version (Web 23.2. Overall, Karen L, 2013 / with permission of Elsevier) containing additional behavior etiologies and phenotypes: Overactivity, Hyperactivity, Hyper-reactivity, Inappropriate Elimination, Nuisance Behavior, Geriatric Behavior, Abnormal Cognition

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].

Traditional Chinese Veterinary Medicine (TCVM)


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].

Table 23.2  Shen Disturbance TCVM Patterns, clinical signs, acupuncture, and Chinese herbal medicine treatments [7].

TCVM pattern Clinical signs Acupuncture points and Chinese herbal medicine
Phlegm/fire flaring upward

Tongue: red or deep red

Coating: yellow or thick yellow and dry coating

Pulse: surging, rapid

GV-14, Tai-yang, Er-jian, Wei-jian, ST-44, HT-9, PC-9, An-shen, Da-feng-men, HT-7, PC-6, ST-40, SI-3, LIV-3, LIV-2

Zhen Xin Sana

Fire with Yin deficiency

Tongue: red or deep red, with cracked lines

Coating: none to scant or peeled off and dry

Pulse: thready, fast, and weak

HT-7, BL-15, An-shen, Da-feng-men, KID-3, BL-23, SP-6

Er Yin Jiana

Heart Qi deficiency

Tongue: pale and wet

Coating: white

Pulse: weak or irregular

An-shen, Da-feng-men, HT-7, PC-6, CV-17, BL-14, BL-15, BL-43, BL-44

Heart Qi Tonica

Heart Yin/blood deficiency

Dry skin or dandruff

Tongue: red or pale, with crack lines

Coating: none to scant or peeled off and dry

Pulse: thready, weak

An-shen, Da-feng-men, HT-7, PC-6, BL-14, BL-15, BL-44, BL-43, BL-17, SP-10, KID-3, SP-6

Shen Calmera

a Dr Xie’s Jing Tang Herbal Inc, Ocala, FL USA.

Integrative Treatment


Successful treatment of a behavior problem depends upon clear communication that creates owner compliance. The owner must understand the behavior and that oral treatments are tools to facilitate success with the behavior modification exercises that create healthy brain synapses and healthy behaviors. The clinician must understand an owner’s goals of treatment, objectively triage the patient, and give a reasonable prognosis [4, 20].

If the behavior presents a danger to other animals or people, the trigger is unidentified/uncontrollable or the owner is considering relinquishment of the animal; then immediate measures must provide safe management of the pet, perhaps even short-term hospitalization [20]. Sadly, if the owner is unable or unwilling to manage the pet creating safety or quality of life concerns, euthanasia may be the most humane option.

In all cases, whether mild or extreme, recommendations for behavior problems must be well-documented, reviewed verbally, provided in written form, and include judicious patient follow-up [20]. Long-term and intermediate goals established at the onset of treatment include benchmarks of improvement as well as an endpoint. A notebook of progress sheets for quick entry journaling of daily treatments and behavior scores will aid owner compliance and give the clinician a tool to follow at-home progress (Web 23.3 – daily progress sheet).

Medical Treatment of Co-morbidities

Treatment of co-morbid disease, whether TCVM or conventional, is crucial in resolving behavior problems. Even seemingly unrelated medical issues cause a stress response contributory to behavior imbalances [4

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jul 30, 2023 | Posted by in ANIMAL RADIOLOGY | Comments Off on Integrative Management of Abnormal Small Animal Behavior

Full access? Get Clinical Tree

Get Clinical Tree app for offline access