Vet referral to behaviourist

lisa701

We have a 7 month old puppy which has been showing signs of separation anxiety for a few months. Despite all our attempts to avoid this, its still occurred and now we are looking to get it sorted.

I've got the details of a behaviourist who will be able to work with us but their policy is we need a referral from our vet - and thats where we have hit a brick wall and I need some advice.

On speaking to our vet he was a bit, well funny with us. He suggested that despite referring animals to these particular people before there were others, and possibly drug treatments which can be offered. To go any further we need to make an appointment to have him fully checked over (although its only been a month since he was last seen) and they will then discuss the options. I felt like I was being told they will choose who they refer our pup to and I don't get much say in the matter. I certainly don't feel there is a need for drugs, I mean would you give drugs to a child who gets upset when you leave him in nursery or school? I was just made to feel like they will make a decision and I have no say in the matter which has really upset me.

The cost of the referral consulation will be £55, and if we are referred to who I think they will choose the costs are in the £100's per half hour!!! Thats much more than the people we had considered going to, which I will point out we have been to before for basic training so feel comfortable with them and they know our pup.

Any advice would be greatly appreciated before I go ahead with the £55 bill for nothing.

Thanks

Fire_Fox

If your pet insurance will pay for the behaviourist the vet appointment should be part of that, minus the excess. IMO it's responsible and professional for the vet to ask you more questions, check the puppy over and run through your options before referral, just as your GP would for you. If your behaviourist has equivalent qualifications to the vet's preferred one then you should be able to insist upon that.

A puppy with separation anxiety is not necessarily the same as a child getting a bit upset at being left at nursery, one is a disorder of mental health. We do medicate children for certain mental health and behavioural conditions, therapy is not always sufficient.

krlyr

Firstly, is pup insured? Many insurers will cover behavioural costs to a degree (mine offer £2-300 I think, if I remember rightly) so cost may not be too much of an issue - though there'll be an excess.

Secondly, I don't disagree that a full checkup is the first step. Defeats the point of a veterinary referall if they don't look into things in a bit more detail, if nothing else! A good behaviourist will not want to proceed with behavioural modification or recommend medications if there is any doubt whether the dog is in full, good health.
Just to show how important it is, I was dealing with separation anxiety with my own dog this year - I had assumed it was triggered by the house move last Christmas as the barking started just after that. Making changes to the routine, doing some 'leave alone' training, using various OTC calmative products etc. helped but we got into a loop of one step forward, two steps back. I was beginning to consider medication - I don't think it's something to rule out completely but it wasn't my first choice either (though bear in mind that medication is much more effective used in conjunction with behavioural modification - perhaps find the stats to quote at your vet as a reason you want to see the behaviourist before trying medication). Medication can help to take the edge off the issue and help the dog be in a better state of mind to learn to be left alone, it's not quite comparable to a child who's upset about going to nursery because a child would usually settle in within a few days/weeks, but true separation anxiety in dogs can go on for a lifetime - so medication provides that window of calmer, more rational behaviour to modify the dog's feelings on being left.
Anyway, before going down that route, I asked for a thorough blood test to be done, including her thyroid function - the thyroid affects a lot of things, physically and behaviourally. Turns out her results were borderline low and since treating her with artificial thyroid hormones, she has improved 200% - not just behaviourally but little things physically I hadn't particularly noticed or chalked up to a medical condition, like slight weight gain (assumed I was just feeding her too much when leaving her Kongs for when she was alone - but I continue to feed her the same amount now yet she has lost those extra lbs and toned up nicely on her meds), less energy etc.
Had I just gone down the behavioural route without further investigation, it could have been a constant uphill battle to deal with her anxiety because of this undiagnosed, untreated medical cause for it.

Do remember, however, that you are the client. If you want to use a particular behaviourist, ask your vet why they won't refer you there. Do they have a bad reputation, or does the vet just get commission from using the place they recommend?
Also remember that there is no law against going to a different veterinary practice if you're unhappy with how your current one acts. You could even continue to use both - e.g. keep your current one for emergencies if it's more convenient but attend another for this issue. Just make sure that each practice is aware of any medication or treatment that the other prescribe, so there's no risk of combining two medications or treatments that don't go together.

However, a really good book on separation anxiety that I would recommend is Nicole Wilde's "Please don't leave me!" - it covers behavioural options as well as medications.

lisa701

Thanks for your replies.

Pup does calm down after a short time if left with someone he knows such as my parents, but if we leave him on his own he will either cry for a while then go to his bed or completely destroy the place despite toys, kongs, leaving tv on etc. Even if we just open the door to put something in the bin he gets upset and acts in the same way as if we are leaving him alone.

I can understand the need for a check up, I'm just upset at the tone the vet took with me, almost talking down to me suggesting we follow his plan and we have little say in the matter. At the end of the day they may be experts but the pup is still our pet and we should have some say in what course of treatment we follow.

Medication is not my first choice, and having watched people being medicated for mental health issues for several years in my job I don't feel its always the best course of treatment, often just masking the underlying issues and never actually curing them.

I do have pet insurance, but know that a large vet bill for treatment will mean my premiums will more than double next year and probably make it unaffordable hence the reason why I'm concerned about the cost of treatment offered by the vet. Also the person they are likely to refer us to is not local, and we then need to take into account the cost of travel & time off work to get to the person as these will not be covered by insurance - none of this would not be an issue with our chosen person.

I'm just going to go along to the assessment and see what they say - if I don't like it I will consider getting a second opinion.

krlyr

Is he barking or howling? Soiling indoors? Pacing, panting, chasing his tail? If you haven't already, I would set up a webcam and watch his behaviour when left.
Separation issues can happen without it being fullblown separation anxiety and it may not need as extreme a treatment if it's just mild separation issues. Not that it would harm to get a good behaviourist in, but might save you a few pennies to buy something like the Nicole Wilde book and have a really good bash at tackling it yourself. What methods have you been using so far?

Have you tried any of the calmative products on the market? DAP/Adaptil? Calmex? Zylkene? A Thundershirt? Magnesium supplements, valerian supplements, Rescue Remedy drops? Kiki's anxiety was pretty severe (barking nearly constantly when left, chewing at exits, spinning in circles, etc) and some of the products did help take the edge of it and may be even more effective in a milder case with no physical cause.

lisa701

He mainly whines if left alone. He will pace between the door and the window assume so he can see if someone is returning, but then he disapears off to his bed. However, the whines can go on for a good half hour which isnt good for either the dog or my neighbours.

On one occassion he did chew the wooden blinds, but he hasnt shown any interest in them since. Think he was doing his usual pacing between the window and door and as the blinds had been left down and were blocking his view he had a nibble at them.

If we leave him in the car (e.g. to nip into a shop) he whines for a bit, if I stand near the car he will scratch at the door & window to get out, but once I've walked out of sight he calms down and when I return he is usually fast asleep or just looking around.