Difference between revisions of "Behavioural Consultation and History Taking"

Revision as of 20:22, 9 June 2014

Introduction

The majority of behavioural cases presented in veterinary practice are related to normal feline behaviour. However, it is essential to consider that some alterations in behaviour can also be concomitant with the simultaneous presence of clinical disease. In cats specifically, links between lower urinary tract disease (FLUTD) and soiling indoors stress the necessity for a full physical and clinical examination before any type of behavioural therapy is implemented. It is also crucial to remember that pathologies may cause continuing behavioural problems even when the illness has been clinically resolved.

Other examples of conditions which can cause alterations in feline behaviour include:

Diabetes mellitus: cats initially presented for a lapse in house training
Hyperthyroidism: aggression to both or either other cats or owners

As well as behavioural expressions of physical disease, behavioural symptoms can result as a outcome of shifts in neurochemical equilibriums in the CNS. Additionally, high levels of stress can cause alterations in behavioural, physiologic and immune responses. Alterations in the hypothalamic-pituitary axis have been linked to stress as well as effects on levels of dopamine, serotonin, noradrenaline and prolactin. In animals, stress is a contributing factor to gastrointestinal disturbances, skin conditions, feline interstitial cystitis as well as compulsive disorders and increased fear responses.

History Taking

As with other areas of veterinary practice, a thorough history is paramount. In a behavioural context history taking must be especially thorough and can be a very long process. Initially, it must be determined what the issue is from the client’s perspective and what they are expecting as a solution. It is important to collect information about the cat’s environment and not centre solely on the presenting behaviour. The history should also cover the medical background of the cat, the upbringing of the animal, current lifestyle and information about the specific problem which is of concern.

Key points in a behavioural history should cover:

Clinical history
Any current drugs being administered
Any former behavioural therapy as well as corrective measures being implemented and their effectiveness.
The animal’s disposition
Breeding and early upbringing
Current lifestyle - environment and housing
Relationship between pet and owner
The rate of occurrence of problem behaviour and its predictability
A thorough description of the issue, along with information about time and age of onset, duration of episodes, frequency and development including any alterations in pattern.
The owners response to the issue

Considering what happens before and after the problem behaviour is also important as this can often provide a clue to the stimulus. In addition videos or visits to the animals normal environment may be useful.

Social Structure within the Home

Example of a diagram illustrating the relationships between cats within the same household

If more than one cat resides within the same home, it is important to establish their relationship. An interactive diagram is ideal, similar to the one in the image. Record the friendly and aggressive behaviours between individuals:

Friendly: e.g. grooming, rubbing against, tail-up greeting
Aggressive: e.g. chasing, growling, hissing, spitting, fighting

It is possible to have no affiliative behaviour at all between a whole group of cats, or a to find that there is a single outsider. Factions often require their own resources so that they can coexist without competition.

House Layout

Draw a diagram of the house to show where the cats have food, water, litter trays and cat flap. Also mark on this where urine or faeces have been found and which cat left them, if relevant. This is particularly important in cases of housesoiling but is useful in other cases too as it helps to establish the appropriate allocation of resources.

References

Heath, S. Chapter 5, Common Feline Behavioural Problems – Feline Medicine and Therapeutics.
Merck Veterinary Manual (10th Edition) - Behaviour

@@ Line 1: / Line 1: @@
 ==Introduction==
-[[File:Cat relationships example.jpg|350px|thumb|right|Fig. 1: Example of a diagram illustrating the relationships between cats within the same household]]
+The majority of behavioural cases presented in veterinary practice are related to [[Normal Feline Behaviour|normal feline behaviour]]. However, it is essential to consider that some alterations in behaviour can also be concomitant with the simultaneous presence of clinical disease. In cats specifically, links between lower urinary tract disease (FLUTD) and [[Housesoiling - Cat|soiling indoors]] stress the necessity for a full physical and clinical examination before any type of behavioural therapy is implemented. It is also crucial to remember that pathologies may cause continuing behavioural problems even when the illness has been clinically resolved.
-[[File:Houseplan 2.jpg|thumb|right|350px|Fig.2: Example of a house plan diagram]]
-The majority of behavioural cases presented in veterinary practice are related to [[Normal Feline Behaviour|normal feline behaviour]] that is expressed in an inappropriate or undesirable manner. Investigation of feline behavioural cases therefore requires a detailed understanding of the physical and social conditions that underlie the problem.
-==Physical Health==
+Other examples of conditions which can cause alterations in feline behaviour include:
-It is important to be aware that health problems are a common causal or underlying factor in behavioural problems in cats. For example, lower urinary tract disease (FLUTD) and [[Housesoiling - Cat|housesoiling]] and indoor urine marking are commonly linked. A full physical and clinical examination should be completed before any type of behavioural therapy is implemented. Behavioural changes may precede clinical signs, and also persist after an illness is apparently resolved.
+*[[Diabetes Mellitus|Diabetes mellitus]]: cats initially presented for a lapse in house training
+*[[Hyperthyroidism]]: [[Feline Aggression|aggression]] to both or either other cats or owners
-The main ways in which health problems can affect behaviour include:
+As well as behavioural expressions of physical disease, behavioural symptoms can result as a outcome of shifts in neurochemical equilibriums in the CNS.
-*'''Altered motivation''': Polyphagia and polydipsia ([[Diabetes Mellitus|e.g. due to diabetes mellitus]] or [[hyperthyroidism]]) can lead to competition over resources, pain can cause increased defensive behaviour.
+Additionally, high levels of [[Feline Fear and Stress|stress]] can cause alterations in behavioural, physiologic and immune responses. Alterations in the hypothalamic-pituitary axis have been linked to stress as well as effects on levels of dopamine, serotonin, noradrenaline and prolactin. In animals, stress is a contributing factor to [[:Category:Alimentary Diseases - Cat|gastrointestinal disturbances]], [[:Category:Dermatological Diseases - Cat|skin conditions]], feline interstitial [[Cystitis|cystitis]] as well as [[Feline Compulsive Disorders|compulsive disorders]] and increased [[Feline Fear Overview#Signs of Fear|fear responses]].
-*'''Altered perception or cognition''': Decreased awareness of signalling can lead to interaction conflicts (e.g. visual impairment), and cognitive dysfunction can lead to confusion, anxiety and irritability. Focal epilepsy can produce confusion, sensory disturbances and mood changes.
-*'''General response to illness''': Inflammatory cytokines activate a pattern of decreased activity, social withdrawal and avoidance that is called sickness behaviour (due to the effect of inflammatory cystokines).
-Additionally, high levels of [[Feline Fear and Stress|stress]] can cause alterations in behavioural, physiological and immune responses. Stress-linked alterations in the hypothalamic-pituitary axis may be linked to effects on levels of dopamine, serotonin, noradrenaline and prolactin. In animals, stress is a contributing factor to [[:Category:Alimentary Diseases - Cat|gastrointestinal disturbances]], [[:Category:Dermatological Diseases - Cat|skin conditions]], feline interstitial [[Cystitis|cystitis]] as well as [[Feline Compulsive Disorders|compulsive disorders]] and increased [[Feline Fear Overview#Signs of Fear|fear responses]].
 ==History Taking==
-Detailed history taking is the most important aspect of reaching a diagnosis in behavioural medicine.
+As with other areas of veterinary practice, a thorough history is paramount. In a behavioural context history taking must be especially thorough and can be a very long process. Initially, it must be determined what the issue is from the client’s perspective and what they are expecting as a solution. It is important to collect information about the cat’s environment and not centre solely on the presenting behaviour. The history should also cover the medical background of the cat, the upbringing of the animal, current lifestyle and information about the specific problem which is of concern.
-This should include information about:
-*The problem from the client's perspective and their expectations of treatment.
-*Individual cats (origin, development, influential experiences, personality traits, history of sociability with other cats and people, current and past health, current and past drug treatments).
-*The physical environment (including resource availability and distribution, opportunities to perform normal behaviour and avoidance and escape responses).
-*Important changes; for example the introduction of a cat, arrival of a new baby, house move, building work, or a change of owner employment/health.
-*The social environment (relationship with other resident cats, people and other animals).
-*The relationship with the owner.
-*Methods of treatment already used by the owner (including punishment).
-*The owner's level of knowledge of normal feline behaviour.
-*Detailed description of specific events (including context, triggering events/stimuli, and the individual's response).
+Key points in a behavioural history should cover:
+*Clinical history
+*Any current drugs being administered
+*Any former behavioural therapy as well as corrective measures being implemented and their effectiveness.
+*The animal’s disposition
+*Breeding and early upbringing
+*Current lifestyle - environment and housing
+*Relationship between pet and owner
+*The rate of occurrence of problem behaviour and its predictability
+*A thorough description of the issue, along with information about time and age of onset, duration of episodes, frequency and development including any alterations in pattern.
+*The owners response to the issue
-It is also often helpful to place key information onto a timeline, as this can make it easier to visualise the connnection between events in the cat's life.
+Considering what happens before and after the problem behaviour is also important as this can often provide a clue to the stimulus. In addition videos or visits to the animals normal environment may be useful.
-Prognosis is considerably affected by owner expectation; it may not be possible to achieve complete harmony between a group of cats, but if this is the only acceptable outcome for an owner then the prognosis will be poor.
-Historical information and observation may be supplemented with videos or visits to the animals normal environment.
-==Social Structure within the Home==
+===Social Structure within the Home===
+[[File:Cat relationships example.jpg|350px|thumb|right|Example of a diagram illustrating the relationships between cats within the same household]]
-If more than one cat resides within the same home, it is important to establish their relationship. An interaction, similar to the one in figure 1., can be used to show the pattern of interaction between cats. During the consultation, the clinician questions the owner about a range of affiliative and aggressive behaviours, and annotates the diagram.
+If more than one cat resides within the same home, it is important to establish their relationship. An interactive diagram is ideal, similar to the one in the image. Record the friendly and aggressive behaviours between individuals:
 * Friendly: e.g. grooming, rubbing against, tail-up greeting
 * Aggressive: e.g. chasing, growling, hissing, spitting, fighting
-It is possible to have no [[Feline Communication Behaviour#Affiliative Behaviour|affiliative behaviour]] at all between members of a group of cats, or a to find that there is a a cohesive group with single outsider. [[Feline Social Behaviour#Social Structure|Factions]] are also often found to exist with a household. Understanding the social relationships between cats provides a basis for resource distribution, reduce inter-cat conflict and and finding ways to re-integrate the group.
+It is possible to have no [[Feline Communication Behaviour#Affiliative Behaviour|affiliative behaviour]] at all between a whole group of cats, or a to find that there is a single outsider. [[Feline Social Behaviour#Social Structure|Factions]] often require their own resources so that they can coexist without competition.
-==Resource Availability and Distribution==
-The correct distribution and availability of resources is critical to preventing and treating inter-cat conflict. Information should be collected that enables the clinician to identify sources of stress, such as competition for food.
 ===House Layout===
-Draw a diagram of the house to show where the cats have food, water, [[Cat Latrines|litter trays]] and cat flaps (similar to the image in figure 2.). Also mark on this where urine or faeces have been found and which cat left them, if relevant. This is particularly important in cases of [[Feline Housesoiling|housesoiling]] but is useful in other cases too as it helps to establish the appropriate allocation of resources. This layout can be supplemented with images.
+Draw a diagram of the house to show where the cats have food, water, litter trays and cat flap. Also mark on this where urine or faeces have been found and which cat left them, if relevant. This is particularly important in cases of [[Feline Housesoiling|housesoiling]] but is useful in other cases too as it helps to establish the appropriate allocation of resources.
-===Feeding===
-Food is the resource that is at the centre of most conflict between resident cats.
-*Food type (wet, dry etc)
-*Access type (ad-lib, meal fed, on demand, simulated foraging)
-*Number of locations
-The preference is for ad-lib access in more than one location with food being available at all times, ideally using simulated foraging (activity feeding).
-===Latrine Sites===
-Cats show strong latrine preferences, and information should be collected to identify any problems with latrine provision:
-*Litter type
-*Litter depth
-*Type of tray (size, covered/uncovered)
-*Location (and level of privacy afforded by this location)
-*Number of litter trays
-*Presence of latrine locations in the garden
-The preference is for mineral based, unscented litter filled to a depth of 2-3cm. Faeces should be removed daily, along with significant urine contamination. Separate latrines should be provided for urine and faeces, and the formula generally quoted for the optimum number of trays is 1 per cat plus 1. Latrines should be in locations that offer the cat privacy, and should be well away from feeding and resting areas.
-===Environmental Quality===
-Cats need opportunities to perform normal behaviours, and to be able to avoid, or withdraw from, social contact. This means that owners should provide opportunities for play, climbing and resting in the home. The requirement for a stimulating environment is increased if cats do not have outdoor access.
-The outdoor environment should provide opportunities to explore, leave scent marks, hide and shelter. It should also provide latrine sites and be planted to provide cover for the cat whilst moving around the garden (shrubs, tree etc). Gardens that encourage insects are also likely to be more stimulating for cats, since insects form part of the cat's diet and are a potential hunting stimulus.
-===Outdoor Access===
-*Access level/frequency: none, free access, permissive, on demand, etc.
-*Access type: e.g. cat door, window.
-*Access security: e.g. insecure cat door, security coded cat door.
-The preference is for free access through a secure, coded cat door that does not permit non-resident cats to enter the home. Free access is important to cats, as it enables them to scent mark and avoid contact with other neighbourhood cats with which they may share outdoor space.
-More detailed information is then obtained depending on the main problem:
-* [[Housesoiling - Cat#Behavioural Assessment|Housesoiling]]
 ==References==
-*Heath, S. Chapter 5, Common Feline Behavioural Problems – Feline Medicine and Therapeutics. 2004 British Small Animal Veterinary Association.
+*Heath, S. Chapter 5, Common Feline Behavioural Problems – Feline Medicine and Therapeutics.
-*Merck Veterinary Manual (10th Edition) - [http://www.merckmanuals.com/vet/behavior.html Behaviour]. 2011 The Merck Publishing Group.
+*Merck Veterinary Manual (10th Edition) - [http://www.merckmanuals.com/vet/behavior.html Behaviour]
-<br><br>
-{{Jon Bowen reviewed
-|date=September 9, 2014
-}}
-{{Ceva}}
+{{unfinished}}
-{{OpenPages}}
+[[Category:To Do - Behaviour GGP]]
-[[Category:Feline Problem Behaviour]]