Lecture 11: The Behavioral history and exam Flashcards
what options are available for your treatment plan?
- behavior modification
- environmental managmeent
- medication
- surgery
behavior consultations
- gather info
- make a dx
- develop a tx plan
Important info to ask
- whats the problem?
- what factors exist in the environment that contribute to the problem?
- what factors exist in the environment that will be important to the resolution of the problem
- how motivated are the owners to resolve the problem?
collect info
- communication with persons familiar with animal
2. direct observation of animal
communication with client
client fills out stupid history form prior to the consult
direct interview at the time of the consult
advantages to client filling out history form prior to consult
- time efficient for practitioner
- client has time to think about questions and answers
disadvantages to client filling out history form prior to consult
- client may misinterpret questions and practitioner may not realize
- both client and practitioner may miss opportunities for digression into areas that are pertinent to understanding the case
advantages to direct interview during consult
- info is likely to come out in a conversational context unlike history form
- many opportunities for practitioner to explain and interpret questions; same for client
disadvantages of direct interview during the consult
- most time-consuming technique
- some clients will digress at length
- may need excellent interviewing skills to keep interview on track
blend of techniques
review history form
develop list of questions
shorter interview
history forms
- separate forms for different species and problems
OMG this is so stupid…
history forms for aggressive dogs
you will want detailed descriptions of as many incidents the owner can recall
history forms for feather picking birds
will want info about diet, sleep cycle, air purity, type of cage, etc.
history forms for dogs with separation anxiety
want info on what the dog does when its left alone and when it does it
categories of info (7)
signalment problem behavior current environment early history training/learning other problem behaviors medical history
signalment
breed, gender, age
all affect probabilities of diagnosis
problem behavior =
chief complaint
chief complaint: general description
client is most interested in talking about this
gives you info about what will be most important topics of discussion
chief complaint: specific description
need empirical info - based on or characterized by observation and experiment rather than theory
ask for multiple descriptions of multiple incidents
clients tend to use what type of info
subjective info
ex: “rex gets mad if he thinks I’m going to disturb his dinner…”
must find out what owner means by Rex gets “mad”
how do you determine behaviors from owner’s description?
clarify terms
ex: what does owner mean by “mad?”
diagnosis of aggression is VERY important. look for (3 things)
- postures
- motivation
- context
how common is unprovoked aggression?
VERY rare!
there is usually always a signal.
are problems of long duration easier or more difficult to resolve?
more difficult
problems of long duration are likely to have undergone what type of change?
progressive change
- these changes can reveal pertinent info
- inciting cause may no longer exist
appearance of problem
how often?
under what circumstances?
–> often logistical solutions are best
problems of long duration may have gone through _______?
several permutations
ask about previous treatments
what they have already attempted
what medications they have tried
develop a problem list
the pet may have problems the owner didn’t mention because they were considered:
- less important
- untreatable
things you want to identify in pets environment
other people and animals it interacts with
just shoot me now….
early history
- source of animal (stray, breeder, friend)
- age when obtained
- previous owners
significance of early history
may help owner understand contributing factors to current problem, improving compliance to protocol
direct exam
you have to do a physical exam on your patients. so do whatever you need to do to make sure you and your staff are safe
end of consult
discuss owner’s goals
treatment plan
demonstrate “appropriate” behavior
I’m so glad this is the END of this lecture!
