Veterinary Referral Form Animal Behaviour Case

EMERG/INTRO

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Summary behaviour assessment:&#13;&#10;&#13;&#10;The behaviour was assessed in the home in order to establish cause, and to assess treatment options. These will include management and prevention of risk, and desensitisation and counter-conditioning using controlled exposures where appropriate.&#13;&#10;&#13;&#10;At times when the problem behavours are not evident, {dogsName} is a contented and very-well cared for family pet with dedicated owners who have spent considerable time investing in training.&#13;&#10;&#13;&#10;{dogsName} shows XXXX behaviour including &#13;&#10;&#13;&#10;At other times {dogsName} will avoid situations, will remove themselves upstairs or will pace back and forth from one room to another as they attempt to investigate from a safer distance. This is likely to be a conflict behind wanting to engage and investigate, but anxiety that this may become overwhelming.&#13;&#10;&#13;&#10;{dogsName} is visually very sensitive to movement both at close range as well as to certain sounds when at home and when out.&#13;&#10;&#13;&#10;{dogsName} reacts towards certain dogs when on walks by XXXXXXX. This can occur at a considerable distance away and occasionally with some specific dogs, when {dogsName} can detect their presence via scent/sound. If their owner attempts to redirect them at this point they may snap at their owner when they are very agitated, in redirection rather than this being a specifically targeted response.&#13;&#10;&#13;&#10;This behaviour is motivated as a defensive, distance-creating response where {dogsName}  is unsure about or is predicting that the 'threat' (as they see) it is too close or likely to approach. They react as an attempt to repel the threat and if this 'threat' persists they will experience frustration as they attempt to ensure that the threat does not continue to approach/moves away/remains at a distance. It is likely to be influenced by their sensitivity to sounds and movements. &#13;&#10;&#13;&#10;{dogsName} has also XXXXX&#13;&#10;&#13;&#10;{dogsName} reacts towards XXXXXX&#13;&#10;&#13;&#10;This behaviour is most likely a predatory/chase impulse, reinforced by their sensitivity to sound and movement.&#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10;As {dogsName} is of considerable size this can make walks more difficult, but {dogsName} is relaxed at other times and will spend their daytimes resting at home.&#13;&#10;&#13;&#10;{dogsName} is well trained, well socialised and has an excellent quality of life.&#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10;The unwanted behaviour is motivated by an attempt to repel what {dogsName} sees as an approaching problem or threat to his comfort and safety. {dogsName} also shows a history of well-managed resource-guarding behaviours and places high value on food and some items, but will play ball without any signs of adverse response.&#13;&#10;&#13;&#10;It is likely that this predisposition is a contributing factor to some of the defensive behaviours, along with frustration that warning signals are not heeded.&#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10;This leads to a state of overwhelm and conflicted behaviour as {dogsName} would like to stay near the family but is also anxious about the children approaching/passing, even though they may not be intending to touch him, and this can occur at around 10 feet away.&#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10; &#13;&#10;&#13;&#10;Risk: There is no bite history at present.&#13;&#10;&#13;&#10;Risk of escalation/generalisation/sensitisation: There is a risk of escalation if the current situation is not treated.&#13;&#10;&#13;&#10;Risk of recurrence: There is a risk that {dogsName} will always display similar behaviours in similar circumstances, even with behaviour intervention.&#13;&#10;&#13;&#10;Risk to the dog: There is a risk to {dogsName} as they are at times unable to avoid &#13;&#10;&#13;&#10;XXXXX&#13;&#10;&#13;&#10;simply because they are all part of normal family life and environment.&#13;&#10;&#13;&#10;Risk to people:&#13;&#10;&#13;&#10;Risk to other animals:

Owner Name

First NameLast Name

Owner Surname

Owner Phone No:

Owner Email:

example@example.com

Owner Address

Street Address

Street Address Line 2

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Please note that clients based out of our local area, and/or with dogs aggressive to visitors, and/or due to Covid-19 safety advice, will be seen remotely. These measures are for the safety and welfare of staff, client and pet.

Pet's name

SPECIES

Pet’s Breed:

Pet’s Age:

Gender:

Neutered:

Date behaviour problem first evident

Date seen for emergency consultation

Date

Is the pet insured? If so, with whom?

Date seen for main consultation

Date

Details of Behaviour Problem(s)

Vet address full:

Karen Wild, CCAB Certificated Clinical Animal Behaviourist

Veterinary Referral Form for Animal Behaviour Case

Pet Owner Details

Pet Details

Veterinary Practice details

Further Medical History