Behavioral History Taking Skills...

Copyright ABA, Inc., 2009. All rights reserved. May NOT be reproduced in whole or in part forANY reason for distribution to other than telecourse participants.

Behavioral History Taking Skills TelecourseSuzanne Hetts, Ph.D., CAAB and Daniel Q. Estep, Ph.D., CAAB

Animal Behavior Associates, Inc.www.AnimalBehaviorAssocaiates.com

[email protected]

REASONS FOR TAKING A BEHAVIORAL HISTORY –

1. Analyze the cause/motivation of a behavior problemThe manifestations of behavior problems–housesoiling, barking, destructiveness –

can all have a variety of causes and a behavior modification plan won’t be effectiveunless it targets the “cause” or motivation. Destructive behavior for example can benormal puppy/young dog behavior, result from attempts to escape the house or yard (inturn motivated by a variety of possible reasons), be due to separation anxiety, or be theresult of some sort of noise phobia. How will you be able to determine which? Thebehavioral history is your main tool.

2. Assist with diagnosing a medical condition.Only veterinarians can diagnose disease or illness. Often the first sign a pet is

sick is a change in behavior so having very detailed, specific information about the natureof the behavior change may provide key information about a disease or illness. Non –veterinarians can assist veterinarians by passing along information about what appears tobe abnormal behavior.

3. Solve a training problem.Perhaps your usual training methods for basic “obedience” aren’t working. You

may need more information to determine why. There may be something the ownershaven’t told you that is contributing to the problem.

http://www.animalbehaviorassocaiates.com/


WHAT TO INCLUDE IN A BEHAVIOR HISTORY

1. Signalment –Species, Breed, Age, Sex, S/N status, Name

2. Early HistoryWhere acquired, at what ageSocialization History

Experiences during sensitive periodHealth status

Serious illnesses?Puppy classes

Techniques usedBehaviors taughtPuppy’s response

Other trainingHousetrainingCrate training

3. Current EnvironmentPhysical environmentFamily composition

PeoplePetsTypes of relationships – friendly, fights, fear? etc.

Daily routineInside, outsideFeeding routineWhere spends time – day, nightPlay, exercise, toys, gamesIf still in crate regularly – why?

Current trainingClasses past puppy classesSpecialty training – agility, tracking, conformationIn-home trainers?Owner has done all of training without help?Methods and equipmentType of discipline used and for what behaviorsWhat behaviors does dog know and how reliable?

Sit, down, stay, etc.

4. Current medical statusMedicationRegular veterinary care (should be veterinary referral)Any health problems?


5. Any other behavior concerns (not the one they called about)What does your dog do that you wished he wouldn’t?What does your dog do that you don’t like?Noise phobiasAnything else you would consider a problem?

6. Primary behavior issue (why you are there)Have owners describe most recent incident

Paint you a mental pictureBody posturesSequences of behavior

How did owners/others respond to the behavior?What did the dog do in response?Repeat

When and whereNOT when and where (when/ where behavior doesn’t occur)

How / why did this bout of behavior endEstablish a time line

Second most recent incidentThird, fourth, etc.

Separate question – when did this behavior start? How long has it been going on?Answer to this question may not be congruent with the first incident theyremember - something to explore and clarify

What have owners done to try to change the behaviorHow has dog responded to these effortsProgression of problem

Gotten worse, stayed the same, gotten better, something else?

Evaluating HypothesesLet’s say a client contacts you because they’ve received complaints from their neighborsand animal control that their dog is barking too much when they aren’t home. Youshould do your homework and come up with a list of possible reasons for this prior tomeeting with the owners. Possibilities would include

Separation anxietyNoise phobia – of what??Other fear – hot air balloonsFrustration – trying to get to children playing across the streetTerritorial defense – “aggressive” barkingPlay – fence running with the dog next door, chasing squirrels“boredom” – care/attention seeking

Make a list of questions under each category that would provide you with the informationyou need to discriminate among these possibilities. “Pet Behavior Protocols” providesthese question lists. Maybe the owners don’t have the information you need. How canthey go about getting it? Perhaps some information fits one cause, but answers to otherquestions better fit another one. What additional information would help? How can you


get it? It’s possible that a behavior has multiple causes, that there are actually multipleproblems, and /or that the factors that started a behavior problem aren’t the same onesthat are maintaining it.

The owners’ answers to questions will strongly influence what specific questions you askand the direction the history takes.

Discovering NuggetsAsk for the same information in different ways. See the example above about obtaining atime line and then asking separate questions – When did the behavior start? How longhas it been going on? Determine if the answers are consistent. It’s not uncommon thatanswers to these questions will not initially agree. If they aren’t, then ask morequestions.

e.g. “This started right after the baby was born”. But when you are trying toindependently establish a time line you find out this isn’t true.

Avoid buying into owner’s interpretations. It is not uncommon for owner’s to makeconnections/associations where there aren’t any and to also miss others that are relevant.

“My dog has separation anxiety”.“It’s because he’s trying to be ‘alpha’”.“He knows better but he does it anyway”.

Be nice, but persistent about pinning down what dog actually did or is doing, includingbody postures. Some owners will immediately start with interpretations (“He was justignoring me”) or will continue to be vague (“He doesn’t like that”, “I can’t get him to doit”, “He just goes crazy”). You must press them into providing details (“I called him tocome to me and he chased the squirrel instead”. “When the visitor reached to pet himFido took a step back, then lunged forward and growled. I think Fido was staring right athim with his ears up but his tail was down”).

When to Administer a Behavior HistorySome behavior consultants prefer to have the owner complete a questionnaire ahead oftime, others want to start the consult with history taking, while some prefer acombination. If the behavior involves aggression, at the least, you or an assistant or staffmember should have sufficient information about the dog’s behavior to know what to do,or not to do, to keep you safe when you first encounter the dog. What do you want toavoid doing? Do you want the dog on leash, outside or in another room when you firstenter the home?


Communication Skills and Styles

Talking to people about their pets’ behavior problems has some elements in commonwith crisis intervention work. Strong emotions are often involved from either the ownersor you or both. One of the principles of crisis intervention training is that the “helper”must address the client’s emotions before being able to impart more objectiveinformation about the problem at hand.

Granted, pet professionals are NOT mental health professionals and should not getinvolved in clients’ marital disagreements, discipline problems with their children, orpersonal emotional issues. However, it’s undeniable that these subjects often arise whentalking about pets, because pets are family members and are part of family dynamics.These family issues often influence clients’ ability to follow through with training andbehavior modification recommendations.

You may need to acknowledge these issues without trying to solve them. For example ifa husband and wife have different perceptions of the pet’s problem, different levels ofdesire to work with the pet, or different opinions about training, your job is not toimprove their marital communication.

However you may need to acknowledge the “elephant in the room” by saying somethinglike:

“I can see you have different opinions about Fido (acknowledging). It’s prettycommon for families to disagree about their pet’s problem (normalizing). I canunderstand your frustration Bob (validating, establishing rapport), and I also agree withSally that -------. My recommendation for Fido is -------. I would suggest that you try totalk with one another to reach some sort of workable compromise as to how you aregoing to proceed with Fido.” It’s not your job to get involved with their personalcommunication process.

Another tactic is to make a prediction about what the influence of family issues on thedog’s behavior. You might say for example: “Unless you can find a way to stop Timmyfrom teasing Fido, I don’t think we can stop Fido from biting him”. You might state thatit needs to be a “house rule” that pulling Fido’s ears can’t be acceptable, and offer somealternative, concrete ways that Timmy could interact with Fido so that new patterns couldbe established. However, getting involved in how the adults discipline or control Timmyis not your job. You’ve already let the adults know not to expect their dog to get betterunless they make changes with their child. They need to decide how to do that.

Useful Communication and Interpersonal SkillsThe techniques we’ll discuss are basic techniques that are often taught to para-professional helpers who are not mental health professionals. With a little bit of practice,you will be able to comfortably and successfully use them.


AcknowledgingAcknowledging means validating the truth or existence of something. In our context, itmeans verbally recognizing or admitting the existence of yours or your clients’ emotions.If your client is crying because her (we’ll say she because it’s just a fact that women aremore likely to cry!) dog bit her child, if you ignore that emotional display and try to pressforward with the behavioral history, it will compromise the quality of information youacquire.

While it’s not your job to explore all that might be behind your client’s reaction (and itcould be many things!), you will establish a better rapport and be more successful if youacknowledge, rather than ignore the emotion. You might say something like “I can seehow upset you are” or “I can understand why this is so upsetting for you”.

You can do the same thing if you feel yourself becoming sad, mad, or defensive. If youare so upset that you can’t continue in a cordial manner, you may need to acknowledgeyour own emotional reaction. Perhaps saying something like “I know you were doingyour best, but I get upset when I hear about dogs being thrown and pinned to the floorbecause I know there are more effective ways to deal with problems that don’t put you oryour dog at risk”.

NormalizingNormalizing means putting emotions into context. You might say something like“Anyone would be just as upset as you are if their dog had done that severe damage totheir house”. Or “If my dog had done that, I’d be upset and frustrated too”.

Self-DisclosureWith this technique you use a personal example to let clients know you – or others -havebeen in similar situations and they aren’t alone. “When my dog was a puppy she tore upthe last picture I had of my grandparents before they died. I thought I could never forgiveher, but I eventually did”.

You want to set some limits on this however. You don’t want to get so involved relatingyour own personal experiences that the conversation becomes about you, not about theclient.

Controlling the ConversationWhile you need to deal with the emotional content of conversations that is getting in theway of your client being able to give and process information, these communication skillshave a tendency to encourage people to open up about all kinds of things. If theconversation is getting off track, you need to be able to get it back on. Here are somephrases you can use to do so:

“What you are saying is important information that we might need later, but rightnow I need you to tell me more about--------”

“I can understand how emotional this is for you, but for me to best help you weneed to talk about-----”


“I’ve enjoyed hearing your stories about -----, but what’s more important rightnow is for you to tell me about----”.

“It’s obvious that’s a really important topic for you, but it’s more important forme right not to be able to talk about-----”

You could even be more direct with some clients and say “I love chatting with you, butsince you are paying me for my time, I really don’t want to waste your money, so weshould get back to talking about------”.

Active ListeningS – Squarely faceO – Open postureL – Leaning slightly forwardE – Eye contactR – Relaxed posture

Active listening also includes behaving in ways that make it clear you are payingattention and listening. Rather than just writing on your papers, you might need to nodyour head that you’ve heard, say “yes”, “uh-huh”, “got it”, or something that doesn’tinterrupt your client but lets them know you are actively engaged in hearing what theyhave to say.

Tone of VoiceYou probably already know it’s not just what you say but how you say it. Be carefulwith your tone of voice, and try to keep it neutral.

Your Communication StyleSimply said, you must develop your own. Some people can make great use of humor,while with others it falls flat. Be yourself, and do what you feel comfortable with.

Your Own “Stuff”It’s important to keep in mind your end goals when you work with clients. Some clientattitudes, communication styles, and behaviors can be quite annoying or frustrating. Ifyou allow these to “get to you” and become angry, impatient or defensive, you won’t getvery far in accomplishing your end goals (which we assume are to help the pet and thefamily). You may need to “vent” after the consultation but you will need to find a way tomanage your own emotional reactions, not take things personally, and recognize youcannot “save the world” or have everyone behave and believe the way you do.


ANIMAL BEHAVIOR ASSOCIATES, INC.BEHAVIOR RECORD

Location: Tel IC IH OTH Dx:__________________________Date:________________ Time:______ to_______ By:_____________________Person Interviewed:______________ Others Present:__________________________Presenting Problem: Why are you here?______________________________________________________________________________________________________________What are your goals?_____________________________________________________________________________________________________________________________Animal’s History:Age obtained________ Previous homes? Y/N _________________________________Where obtained? Friend, Breeder, Pet Store, Shelter, Stray, Other__________________________________________________________________________________________Why was pet obtained? Companionship, protection, breeding, show, other___________________________________________________________________________________Sire/Dam/Littermate Behavior _______________________________________________________________________________________________________________________Have you owned this kind of pet before? Y/N __________________________________Home Environment:Area where you live? Urban_____ Small town/Suburban______ Rural______Pet’s home environment: Single house, attached house/condo, duplex, efficiency/studioapt., 1-2 bedrm. Apt., 3+ bedrm. Apt., mobile home, farm, other _________________No yard, patio/courtyard, small yard, large yard, large acreage, no fence, privacyfence, chain/wire fence, other fence, electronic fence____________________________Doggie door into house, garage, barn? Y/N ___________________________________Pet runs free in the neighborhood? Y/N When? How often?_______________________Household changes since pet acquired? Marriage, divorce, birth, death, personcame/left, pet came/left, birth, death, household moves __________________________________________________________________________________________________Percent time your pet is indoors______ outdoors______Describe a typical 24 hour day for your pet? Where sleeps, when/where fed, wherekept when owners home and gone, when walked, when play, when with other people,animals, when alone._______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Do you take/leave your pet in the car? How often and how does she do?____________________________________________________________________________________Food and FeedingWhat do you feed your pet? Dry, Canned ______________________________________How often do you feed your pet? Ad lib, 1X, 2X, 3X, Other _______________________Who feeds your pet? ______________________________________________________What treats do you feed your pet? Most preferred? Dog treats, human food, other________________________________________________________________________________________________________________________________________________


Observations/Additional Questions:

Play and ExerciseWhat toys does your pet play with? Most preferred?______________________________________________________________________________________________________Games your pet plays? Most preferred? People, other pets?_______________________________________________________________________________________________How long are play period and how often?______________________________________Is pet crated, in an outdoor run or on a chain?_______________________________________________________________________________________________________What kinds of exercise does your pet get? Walks, runs, games, other. _______________How often and for how long are exercises?_____________________________________________________________________________________________________________Family members / People with whom the pet regularly interacts:Name Sex Age Relationship Kind of interactions(Friendly, Playful,

Aloof, Fearful, Threatening, Unruly)_______________________________________________________________________________________________________________________________________________________________________________________________________________________Other family pets / animals with whom the pet regularly interacts:Name Species Sex Age Related ? Lives with pet? Kind of Interactions_______________________________________________________________________________________________________________________________________________________________________________________________________________________Interactions with other people? Friendly, playful, aloof, shy, fearful, aggressive, unruly.(To men, women, children, infants)___________________________________________________________________________________________________________________________________________________________________________________________Interactions with conspecifics?_______________________________________________________________________________________________________________________________________________________________________________________________Interactions with other species (domestic, wild animals)?_________________________________________________________________________________________________________________________________________________________________________How is your pet at the veterinarian, groomer, boarding, shows/competitions? Friendly,playful, aloof, shy, fearful, threatening. ________________________________________________________________________________________________________________Housetraining:How was this animal housetrained and when? Was it easy to housetrain? ____________________________________________________________________________________Discipline: Discipline used for other than major complaint and what works ___________


________________________________________________________________________________________________________________________________________________


Obedience Training:No training, owner home-trained, already trained when acquired, group obedienceclasses, in-home trainer, other.____________________________________Commands pet knows: Sit – Good, OK, Erratic; Down – G, OK, E; Stay – G, OK, E;Come – G, OK, E; Heel – G,OK, E; Fetch – G,OK, E; Drop It – G, OK, E;Others _________________________________________________________________Other Problems: fears, ago, destructive, food related, elimination, vocalizing, unruly

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What medical problems has your pet had? Any surgeries or medications? Any currentmedications? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PROBLEM DESCRIPTION

Describe the problem as it now occurs________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Age at onset?________Describe the first incident you remember. When, where, who was present, whatanimal did, what people did. How you responded to the incident. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


________________________________________________________________________________________________________________________________________________


_____________________________________________________________________Has the behavior changed since it first occurred? Change in frequency, duration,intensity, different locations or circumstances? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe the last incident of the problem.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe the second to last incident._________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Describe other incidents or conditions._______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Frequency of the problem. Daily, weekly, monthly? Is it consistent orerratic?________________________________________________________________________________________________________________________________________________________When /Where it occurs?___________________________________________________


________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


________________________________________________________________________Are there social or environmental correlates of the problem? Pet moved, change inschedule, family moved, visitors, diet change, traumatic event, injury/illness.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What has been done thus far to address the problem? Discipline, confine, obedience?Made it better, made it worse?_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________How has the pet responded to the corrections?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Observations of animal or other information. Behavior to interviewer, to owner, toother people, to other animals ( Friendly, playful, aloof, shy, fearful, threatening, unruly).________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Departures: What do you normally do and how does the pet respond?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Returns: What is done and how pet responds.___________________________________


________________________________________________________________________________________________________________________________________________

Petbehaviorproblems.com8-A Camellia Place Lexington, Massachusetts 02420

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CANINE BEHAVIORAL HISTORY

Please fill out this form to the best of your ability. The more information you are able toprovide, the easier it is to correctly diagnose your dog’s behavior problem and provideyou with the proper individualized treatment plan. All of your answers are confidential.

YOUR INFORMATIONS

Enter Your Name:

Your e-mail Address:

Your Telephone Number:

How were you referred to us?

YOUR VETERINARIAN

First Name: Last Name:

Hospital Name:

Address:

City: State: Zip:

Telephone: Fax:

E-mail:

YOUR DOG

1. What is your dog's name?

2. What is the breed (or mix of breeds) of your dog?

3. What type of coat does your dog have (short, long, curly, wiry etc)?

4. What color is your dog?

5. Is your dog a male or female?


6. How old is your dog?

7. How much does your dog weigh?

8. Is your dog neutered (spayed or altered)?

9. If yes, how old was your dog when he/she was neutered?

10. Why did you neuter your dog?

11. Where did you get your dog?

12. How old was your dog when you obtained him/her?

13. How long have you owned your dog?

14. Why did you choose this kind (breed) of dog?

15. Why did you choose your individual dog?

16. Does your dog have any medical problems?

17. If yes, please list what they are?

18. When did they occur?

19. Is your dog being treated for any medical problem at this time?

20. If yes, is your dog on any medication?

21. Do you know anything about your dog's parents or relatives?

22. If yes, did they have any medical problems? What were they?

23. Did they have any behavioral problems? What were they?

YOUR HOUSEHOLD

1. Please list all of the people who live in your house with your dog and their ages.

2. Have you owned pets before? If yes, what kind?

3. When did you own the other pets?

4. Did you grow up with pets? If yes, what kind?

5. Did any of your other pets have behavior problems? If yes, what kind?

6. What happened to your other pets?

7. Please list all of the animals who live in your house: (Name, species (dog, cat, etc.), breed,

sex, neuter status, age, when obtained, where obtained from)

8. What kind of home do you have? (house, apartment, town house)

9. How big is your home?

10. Is your dog allowed in all parts of your house? If not, where is your dog allowed?


PERSONAL DOG CARE

1. What do you feed your dog? (canned, dry, combination, table scraps)

2. What brand of food do you feed?

3. When do you feed your dog? (if meals, times/day, if free choice how often the bowl is filled)

4. Who feeds your dog?

5. Does your dog get treats? (If yes, what kind, how often, and when)

6. Do you feed your dog from the table?

7. Does your dog beg for food?

8. Where does your dog sleep at night?

9. Where does your dog stay when you are not at home?

10. Is your dog allowed on the furniture?

MANAGEMENT

1. How many hours does your pet spend outside?

2. When and where outside does your dog run loose?

3. Do you have a yard? If yes, is it fenced?

4. If yes, what kind of fence do you have?

5. How tall is the fence?

6. Is your pet tied outside?

7. If yes, what kind of tie-out?

8. Do you walk your pet on a leash? If yes, how many times per day?

9. How long is each walk?

10. If you walk your dog, what kind of walking device do you use?

11.Does your dog pull on the leash?

12. Does your dog receive regular exercise?

13. If yes, what kind? How many times per day or week?

14. How long is each session?

15. Do you play with your dog?

16. If yes, how do you play with your dog? (Ball, Frisbee, Wrestle, etc.)


17. How many times per day or week?

18. How long is each session?

OBEDIENCE TRAINING

1. Has your dog received any formal obedience training?

2. If yes, why did you decide to obedience train your dog?

3. If yes, did you go to group classes? Or did you have private sessions with your trainer?

4. How many lessons did you and your dog attend?

5. Which family members went to the training classes?

6. How did your dog do in the classes?

7. What commands does your dog know?

8. Will he/she do these commands if you do not have a food treat?

9. Did you like your trainer? If yes, what is the name of your trainer?

10. Where is he/she located?

11. What is his/her telephone number?

12. Did your trainer recommend food as rewards during training?

13. Did your trainer recommend that you use a choke chain, pinch collar or head collar?

14. If you are using a head collar, what brand?

15. Did your trainer recommend that you use a shock collar? If yes, when were you told

to shock your dog?

16. Did your trainer recommend Clicker training?

17. If you didn't take your dog to formal obedience classes, did you teach your dog

commands? If yes, which commands?

18. Will your dog do these commands if you do not have food treats?

19. Have you ever taken another dog to obedience classes?

20. Does your dog have any AKC or UKC titles? (Champion, CD, AD etc.)

THE PROBLEM

1. What is your dog doing that is problem to you?

2. Does your dog have any other behavior problems?


3. What happened that made you decide to seek help?

4. When was it?

5. What happened before the incident?

6. How did you respond after the incident?

7. How did your dog respond?

THE HISTORY/DEVELOPMENT OF THE PROBLEM AND CORRECTIONSATTEMPTED

1. How long have you and your dog had this problem?

2. When was the first time you noticed that your dog had the problem?

3. How old was your dog when you noticed that your dog had this problem?

4. Describe in detail the very first episode of the problem.

5. When was it?

6. What time of day?

7. What happened before?

8. What did you do after it occurred?

9. What did your dog do after the incident?

10. Describe in detail another early episode of the problem.

11. When was it? What time of day?


13. What did you do after it occurred?

14. What did your dog do?

15. Tell us everything that you have done to try to correct the problem you are having.

"Include the dates of all attempted corrections, how long you tried and how your dog

responded" (no better, somewhat better, much better).

16. Has your dog been on any medications for the behavior problem? If yes, what types?When? For how long?

DETAILED DESCRIPTIONS OF RECENT INCIDENTS

Describe in detail the most recent episode of the problem:




3. What did you do after the episode?


Describe in detail the next to last episode of the problem:



7. What did you do after the incident?


Describe in detail the third to last episode of the problem:



11. What did you do after the incident?


13. How often does the problem occur? (times per day, per week, per month)

14. Does the problem happen more often now than when it started? If yes, please

describe.

15. Was the increase gradual or sudden?

16. Is the problem worse in severity/intensity since it started? If yes, please describe.

17. How often do your dog's other problems occur? (times per day, week or month)Please list

problem and frequency

18. Does the problem happen more often that when it started? If yes, please describe.

19. Was the increase gradual or sudden?

20. Is the problem worse in severity/intensity since it started? If yes, please describe.

24 HOUR DAY

Where does your dog sleep at night?

Starting with when both of you get up:Please indicate when you feed your dog, who feeds your dog, when you play with your dog, who plays with your dog, when you petyour dog, when your dog interacts with other animals, when your dog urinates and defecates, when your dog is left alone, when yourdog goes outside, when you are likely find evidence of the behavior problem.


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AGGRESSION SCREEN

1. Has your dog ever bitten a person?

2. If yes, did the bite break the skin?

3. If yes, was the bite reported?


4. If yes, was your dog quarantined?

5. If yes, did the bite require medical treatment?

6. If yes, what kind? (for example, tetanus shot, antibiotics, stitches)

7. Has your dog ever bitten another animal?

8. If yes, what kind of animal?

9. If yes, did the bite break the skin?

10. If yes, was the bite reported?

11. If yes, was your dog quarantined?

12. If yes, did the bite require medical treatment?

13. If yes, what kind? (for example veterinary visit, antibiotics, stitches)

Describe what your dog does if you do the following things? (Please indicate if you oryour family have never done these things. We are especially interested if your dog showshis/her teeth, growls, barks, snaps or bites. But also if your dog doesn't care.)

1. Pet your dog while he/she is eating dog food.

2. Touch your dog's bowl while he/she is eating dog food.

3. Pet your dog while he/she is eating delicious food in the bowl (table scraps):

4. Touch your dog's bowl while he/she is eating delicious food:

5. Pet your dog while he/she is eating a real meat bone:

6. Touch the real meat bone:

7. Pet your dog while he/she is eating a rawhide or pig's ear:

8. Touch the rawhide or pig's ear.

9. Try to take away a stolen piece of food (for example from the table or counter):

10. Try to take away a stolen non-food item (for example piece of clothing):

11. Try to take away your dog's favorite toy:

12. Reach for a piece of food which has fallen from a table or counter:

13. Pet your dog while he/she is sleeping:

14. Move your dog while he/she is sleeping:

15. Pet your dog while he/she is resting in a comfortable place (couch):

16. Move your dog while he/she is resting in a comfortable place (couch):

17. Approach your dog while he/she is in the crate (cage):


18. You hold your dog back if he/she tries to run out the door:

19. Pull on your dog's collar:

20. Pull on your dog's collar while he/she is barking at something at the door:

21. Lift your dog:

22. Untangle your dog (as in the leash):

23. Put your dog's collar on:

24. Take your dog's collar off:

25. Put your dog's leash on:

26. Take your dog's leash off:

27. Put your dog's harness on:

28. Take your dog's harness off:

29. Put your dog's coat/sweater on:

30. Take your dog's coat/sweater off:

31. Brush your dog:

32. Trim your dog's nails:

33. Towel dry your dog when wet:

34. Wipe your dog's feet:

35. Wipe your dog's face, eyes or mouth:

36. Put medication in your dog's ears:

37. Put medication in your dog's eyes:

38. Cause a little pain (take a tick off or step on your dog's foot or tail):

39. Pet your dog:

40. Hug your dog:

41. Reach over your dog while lying down:

42. Push your dog into a sit:

43. Push/pull your dog to lie down:

44. If your dog is resting with one person and another person approaches. (indicate who the

people are):

45. When two family members hug:

46. When you reprimand your dog in a loud voice:

47. When you reprimand your dog by raising a hand or shaking a finger:


48. When you hold your dog's muzzle:

49. When you shake your dog by the skin on the back of the neck:

50. When you hit your dog (where do you hit your dog?):

51. When you jerk on your dog's leash:

52. When you stare at your dog:

53. When your veterinarian examines your dog:

54. When your veterinarian restrains your dog:

55. When your veterinarian gives your dog a shot:

56. When a groomer grooms your dog:

57. When a stranger walks past your home or yard:

58. When a stranger enters your home or yard:

59. When a stranger walks past your car:

60. When a stranger enters your car:

61. When a stranger approaches you on a walk:

62. When a stranger pets your dog on a walk:

63. When a service person fills your car with gas:

64. When you go to a toll booth:

65. When your dog sees unfamiliar children:

66. When your dog is approached by unfamiliar children:

67. When you are approached by unfamiliar children:

68. When your dog is petted by unfamiliar children:

69. When your dog sees unfamiliar dogs:

70. When your dog is approached by unfamiliar dogs:

71. When an unfamiliar dog enters your home:

72. When an unfamiliar dog enters your yard:

73. When a jogger runs past your dog:

74. When a roller blader skates past your dog:

75. When a skateboarder skates past your dog:

ATTACHMENT


On a scale of 1 to 10, How serious is each problem to you and to each family member? (1being not at all serious and 10 being the most serious):

1. Main problem:

2. Other problems:

Have you considered getting rid of your dog? Why have you not done so? (this question

does not mean we are recommending this)

Have you considered putting your dog to sleep? (this question does not mean we are

recommending this) Why have you not done so?

Copyright 1999-2003, Petbehaviorproblems.com

BEHAVIOR HISTORY • CANINE

210 Newman Springs Road, Red Bank, NJ 07701 • Telephone 732-747-3383 • Fax 732-747-3385 • www.rbvh.net

Date

TRACY L. KROLL, DVM FEES

Practice Limited to Behavior Canine Behavioral Consultation • $350.00210 Newman Springs Road • Appointments are approximately 1-1/2 hours longRed Bank, NJ 07701 • Fee includes six months of follow-up with email Telephone 732-747-3383 and telephone calls. Fax 732-747-3385 • Re-check Fee • [email protected]

CLIENT INFORMATION

Name

Spouse/Secondary Name (if applicable)

Mailing Address

City State Zip

Home Telephone ( ) Business Telephone ( )

Cell Phone ( ) E-mail Address

PATIENT INFORMATION

Name Breed & Color

Age Sex Male Intact Male Neutered Female Intact Female Spayed

PRIMARY CARE VETERINARIAN INFORMATION (If you have been referred, the following information must be provided)

Name Hospital

Address

City State Zip

Telephone ( ) Fax ( )

REASON FOR TODAY’S VISIT

Main behavior problem or complaint

Additional problems in order of importance to you

Age of onset Has the problem changed since onset?

Frequency of each problem

1


210 Newman Springs Road, Red Bank, NJ 07701 • Telephone 732-747-3383 • Fax 732-747-3385 • www.rbvh.net 2

Please describe the most recent incident or an example of a typical incident

Have you sought previous help for this problem? If so, where and what was suggested?

How do you discipline your dog for this problem or other behaviors?

Please list all people, including yourself in the home. Include ages, gender, and how long you are away from home

on weekdays:

Please list all animals in the home including patient. Indicate the order in which they came into the home, ages,

breed, and sexual status:

What is dog’s relationship to others in the home (friendly, aggressive, hostile, fearful, etc.)

What describes your home environment? Check all that apply.

City/town Apartment

Suburbs Duplex

Rural Townhouse/condo

Single family home Other

Has there been any move since the dog entered family? How many times?

Where did you get this dog?

Breeder - referral Newspaper Friend SPCA Pet store

Why did you decide to get a dog?

Did you choose this breed specifically? If yes, why this particular breed?

If known, how many littermates? Males Females

Why did you choose this dog over the others?

Have you owned dogs before? Yes No

How old was your dog when you adopted him/her?



What was your dog’s behavior when you first adopted him/her?

Did you meet your dog’s parents? If so, describe their behavior:

Did your dog have previous owners?

If yes, why was the dog given up?

At what age was your pet spayed/neutered? (if dog is not intact)

If your dog is intact, has he/she ever been bred?

Are you planning to breed in future?

Feeding schedule: Please list type of food, brand name, dry vs. moist, amount, meal times, who feeds, and

location of food:

What is your dog’s favorite treat?

How much structured exercise does your dog get daily? What type of exercise?

How does your dog behave with familiar visitors?

How does your dog behave with unfamiliar visitors?

How does your dog react to children?

Has your dog attended obedience class?



What percent of the time will your dog do the following for each member of the household?

Sit

Stay

Down

Come

Heel (don’t pull)

Any tricks?

Does your dog show in breed, obedience, or agility?

Does your dog do any of the following? Check all that apply.

Jump on people without permission

Paw at you or at others for attention

Lick you

Mount people; if yes, whom?

Mount other animals or objects

Bark at you; if yes, when?

If excessive barking is a problem, please describe what situations lead to it

How would you describe your dog’s energy level?

Does your dog jump onto furniture, beds, etc?

Is your dog on any medication for this or any other reason?

Past medical problems (if there are any problems, present or past that required medical attention, please have

your veterinarian fax or mail me a copy of the treatment history)

Date of last rabies vaccination

Was this a one year or three year vaccine?

Which of the following statements bests describes your current situation:

I am here out of curiosity, but the problem is not serious.

I would like to help the problem, but it is not serious.

The problem is serious, but if it remains unchanged, that is okay.

The problem is very serious, and I want to change it, but I will keep my dog regardless of the outcome.

The problem is very serious, and if I can not improve the situation, I will euthanize my dog or give him/her up.

5

What do you hope to get from this consultation? (Please list 2 or 3 goals that are most important to you)


210 Newman Springs Road, Red Bank, NJ 07701 • Telephone 732-747-3383 • Fax 732-747-3385 • www.rbvh.net

FOR AGGRESSION CASES ONLY

Has your dog bitten people?

Total number of bites

Number of bites that have broken skin

What parts of the body has the dog bitten and how severe were the injuries?

Total number of aggressive incidents (growling, snapping, lunging, biting)

Describe a typical episode

If your dog is placed in that situation 10 times, how many of those times will aggression be seen?

Who is/are the target(s) of aggression?

How old was your dog when he/she growled at a person for the first time? What was the circumstance?

How old was your dog when he/she bit or snapped at a person for the first time? What was the circumstance?

5



Please answer yes or no to the following:

Episodes appear unprovoked Yes No

Dog is abruptly docile after an episode Yes No

Dog appears sorry or licks after an episode Yes No

Dog appears disoriented after an episode Yes No

Episodes are associated with a glazed or absent expression Yes No

I can usually tell what will set my dog off Yes No

Attacks happen suddenly and surprise me Yes No

The aggressive behavior is new and uncharacteristic Yes No

Thank you for taking the time to complete this history form. The information you provide helps me to get

to know your dog and case prior to consultation, so we can focus on your goals and treatment during our

time together.

Please note that behavior appointments are seen at the RBVH Rehabilitation Center located at

210 Newman Springs Road, Red Bank, New Jersey, located approximately one mile from our main

building in Tinton Falls.

All bills must be paid when services are rendered. We accept all major credit cards including Care Credit.

Personal checks are welcome when accompanied by a driver’s license. We do not bill. If you have any questions

regarding your payment today, please discuss it with a receptionist before seeing the doctor. Thank you.

©2008 RBVHBEH-02


References and Further Reading

Hetts, S. 1999. Pet Behavior Protocols: What To Say, What To Do, When To Refer.Lakewood, CO: AAHA Press, Chapt. 6, Response Protocol for Behavior Problems, pp.81- 88.

Hetts, S. 1999. Pet Behavior Protocols: What To Say, What To Do, When To Refer.Lakewood, CO: AAHA Press, Chapt. 2, Communication Skills, pp. 17-26.

Overall, K.L. 1997. Clinical Behavioral Medicine For Small Animals. St. Louis, MO:Mosby-YearBook, Chapt. 5. Taking the Behavioral History, pp. 77- 87, Appendix A,Client Questionnaires, pp.393-407.

Voith, V.L. & Borchelt, P.L. 1996. History taking and interviewing. In Voith, V.L. andBorchelt, P.L. (Eds.) Readings in Companion Animal Behavior. Trenton, NJ:Veterinary Learning Systems, pp.42-47.

Voith, V.L. 1996. Interview forms. In Voith, V.L. and Borchelt, P.L. (Eds.) Readings inCompanion Animal Behavior. Trenton, NJ: Veterinary Learning Systems, pp.48-53.

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