Treat or euthanize? Helping owners make critical decisions regarding pets with behavior problems - Veterinary Medicine
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Treat or euthanize? Helping owners make critical decisions regarding pets with behavior problems
Owners of these pets come to you to help them make a crucial decision. To be better prepared, here are the critical factors you and the owner should consider, as well as concrete steps you can take in reaching a decision.


VETERINARY MEDICINE


BEHAVIORAL FACTORS

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.


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Source: VETERINARY MEDICINE,
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