Triaging behavior: should you refer clients to a Trainer or a Behavior Vet?

Written by Chiara Perri and Dr Dennis Wormald,
Last updated March, 2023

As you may have noticed, there are a large number of dogs needing help with their behavior at the moment. These issues can range from anxiety, arousal issues, resource guarding, reactivity towards dogs, people or children, fear aggression, and more. However, as a vet, it can be confusing to know which cases can be managed by you, and which ones really need referral. This triaging of behavior cases can seem overwhelming, as behavior training is not well taught in vet school. However, as with any disease a dog can get, triaging the severity of a case is a very important skill for the GP vet to have. This can be hard as not all behavior issues present themselves in a clinic consult room, and some clients are not great at explaining or defining the issues they see. Once a case has been triaged, the most severe cases need to go straight to a Behavior Vet, while the others can go straight to a dog Trainer.

The roles of Behavior Vets and Trainers
It is essential to have a clear understanding of the roles of Trainers and Behavior Vets, to work properly with the referral system. The most severe cases, and cases that need medications or aren't responding, need to go directly to a Behavior Veterinarian. Not all Behavior Vets are specialists, and the vets who are behavior specialists should be strongly recommended for the most serious of cases.

The role of the dog Trainer is to work on behavior modification, providing clients with strategies to improve the situation at home or during walks. They can also provide valuable information regarding body language, thresholds, motivating factors, reinforcement rates and values, etc. Trainers can also do a home visit to put in place a safety management plan while waiting for the Behavior Vet to see the client. They can also provide bite risk assessment if dealing with reactivity towards people or dogs and implement plans to help reactive dogs remain neutral in the presence of other dogs. Trainers collaborate with the Behavior Vet, sending updates and reports each time they see the client. They can provide input on the level of improvements, how medications are impacting the behavior problems and continue to monitor and adjust training strategies along the way.

When should a case be referred to a Trainer vs a Behavior Vet?
It is important to note that Trainers cannot start their role until the dog is stable, the client has a good understanding of the diagnosis, and the client is prepared to put in the required effort to achieve a good outcome. In many cases, the dog also needs to be on a complicated schedule of medications to stabilize them to a point where the Trainer can help.

Herein lies a problem. In many cases, vets may unknowingly refer a case to a dog Trainer, when they are not yet able to help the patient. These dogs require the services of a Behavior Veterinarian, but the client has the expectation the Trainer is supposed to fix their issues. While good Trainers will try to help the client understand that they need to see a Behavior Vet in this situation, it can cause problems. The client can become confused, frustrated, disillusioned, give up, or even become angry to be told one thing by the vet and then another by the Trainer.

Although there is easy way to explain how a vet should triage a behavior case, we have provided a list below of common presentations that we recommend a direct referral to the Behavior Vet before the Trainer becomes involved:

• Any display of aggression towards their own handler, other people, other dogs or children.
• Any display of aggression in a home where children live (but not necessarily directed at the children).
• Any bite history in that the dog has already offended (this would be for a bite of any grade towards a human, child or dog).
• Anxiety where the dog is highly distressed at home and possibly a threat to itself.
• Any compulsive behavior (fly chasing, tail chasing, shadow chasing, circling, ritualized pacing, self-mutilation).

Should the GP vet medicate the case before involving a Behavior Vet?
Yes, especially if there is a long wait to see the Behavior Vet, or the problem seems managable. In this case some kind of behavior medication may need to be prescribed by you, but don't forget that it must be accompanied by some advice on behavior modification. If there is uncertainty regarding what the behavior issue is, it is recommended to hold off medicating until the dog has seen the Behavior Vet or been assessed by a behavior Trainer who can get more detail about the issue. Many clients think the Behavior Vet will be quite expensive, but they often do not know the fee is not just for the initial consultation but also a tailored plan for the individual, protocols for ongoing management, ongoing support for a period (up to 12 weeks post consultation depending on the vet), and it is this support that is most beneficial when starting on the medication and behavior modification journey. Getting behavior medications right is different for each patient, and the Behavior Vet is an expert and guiding them through this. Behavior medications are not like antibiotics, where you can just prescribe and forget about the case, clients often need a lot of guidance as the dog starts to respond. GP vets don’t have the time, knowledge or experience to provide this service to clients, and this is why the success of behavior medications in patients that see a Behavior Vet is much higher.

We hope this information has been helpful in understanding the roles of Trainers and Behavior Vets. If there are any other behavior issues not mentioned, Trainers can certainly assist with them as the first port of call. If they still feel that the dog would benefit from seeing a Behavior Vet, or something has changed in the nature of the behavior problem, they can certainly refer themselves. We understand it isn't easy being the GP vet stuck with the behavior case, so thank you for doing your best to help them.