Behavioral elements are the most important of the factors because the characteristics of the behavior problem determine how
important the other factors will be in the resolution of the issue.
An educated decision regarding a pet's life cannot be made without a thorough description of the problem behavior. What is
the problem? What is the frequency and intensity of the behavior? Identifying the predictability of the problem is essential.
Owners often report that a problem behavior is unpredictable, but with careful questioning, you can often determine that the
problem is highly predictable in relation to when it will occur and what triggers it. When the behavior will not occur may
be less predictable, but this information is equally important. Does the behavior pose a danger to people or other animals?
Is the animal self-injurious? Determine how many triggers there are for the behavior and, in the case of aggression, how many
targets—these are not always the same. For example, a dog may exhibit aggressive behavior in response to loud noises, such
as lawn equipment, garbage trucks, or motorcycles. The dog may direct its aggression only toward these items or may redirect
onto nearby animals, people, or objects.23,24 The targets may be specific (e.g. only one particular dog or person) or may be more random (whatever or whomever happens to be nearby).
Bite threshold and inhibition
With respect to aggressive animals, two important factors to note are the bite threshold (how easily is the animal triggered
to use its mouth?) and bite inhibition (when the animal does bite, how severe is the injury?). Animals that show frequent
aggression but do little to no damage are often much better candidates for rehabilitation than animals that bite infrequently
but do considerable damage when they do bite. In general, the animal's next bite is likely to be similar in severity to the
previous bites. An animal that consistently injures its target severely enough for emergency treatment poses a greater risk,
in part, because owners consider these situations more concerning.25
It is not necessarily true that a dog's bite severity will escalate over time. The bite severity depends in part on the animal's
bite socialization (did the animal have the opportunity to learn mouth control when it was young?), the animal's physiologic
status, and the behavior of the victim (did the victim pull away and, thus, inadvertently increase the severity of the injury?).
Additionally, the context of the episode is important in assessing the future risk and predictability of injury. The degree
of apparent provocation in relation to the severity of the resultant injury may also help determine the extent of behavioral
pathology. For example, a history of prolonged, multiple bite attacks in response to a seemingly innocuous interaction such
as looking at a resting dog while walking past it supports the diagnosis of what some authors label impulse control aggression.26,27 In my experience, the animal's age may influence the bite threshold. Similar to people, adolescent animals often exhibit
higher levels of impulsivity and reactivity.28,29
It is a fallacy that once an animal bites, it will always bite again. There are numerous case examples of dogs or cats that
have bitten once and then never again. The predictability of the aggression and the level of warning the animal shows before
escalating to biting should also be evaluated and considered when making a prognosis—a predictable and prolonged warning phase
generally portends a better potential for therapy.
SPECIFICS FOR THE APPOINTMENT
Take a complete and thorough history. Physically examine and interact with the animal as much as safety allows. Evaluate the
owner's relationship with the animal and how the owner and the pet interact with each other. List the favorable and unfavorable
prognostic factors (see Treat or euthanize? Putting it all together: Prognostic indicators).
If a client is unsure whether he or she can implement a plan but does not want to euthanize the animal, set a finite treatment
goal. Have the client dedicate two to four weeks to the program. At the end of that period, evaluate the situation. How hard
was it for the client to implement the necessary safety management steps? How much time was the client able to spend on the
training exercises? How stressful was it for the client to live within the bounds of the program? Does the client feel he
or she could maintain that intervention long term? Was there any change in the animal's behavior during that time? Was it
better or worse or some of both? The answers to these questions will help the client to decide whether to push on for another
set time frame or to stop the program and euthanize the pet.
Give clients permission to elect euthanasia without judgment, especially in cases in which the patient poses an injurious
risk to other animals and people. Take into consideration the patient's welfare as well. Animals that are showing frequent
anxiety or aggression are living highly stressful lives.