Lecture 11: The Behavioral history and exam

Question 0

what options are available for your treatment plan?

Answer 0

1. behavior modification
2. environmental managmeent
3. medication
4. surgery

Question 1

behavior consultations

Answer 1

1. gather info
2. make a dx
3. develop a tx plan

Question 2

Important info to ask

Answer 2

1. whats the problem?
2. what factors exist in the environment that contribute to the problem?
3. what factors exist in the environment that will be important to the resolution of the problem
4. how motivated are the owners to resolve the problem?

Question 3

collect info

Answer 3

1. communication with persons familiar with animal

2. direct observation of animal

Question 4

communication with client

Answer 4

client fills out stupid history form prior to the consult

direct interview at the time of the consult

Question 5

advantages to client filling out history form prior to consult

Answer 5

• time efficient for practitioner

- client has time to think about questions and answers

Question 6

disadvantages to client filling out history form prior to consult

Answer 6

• 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

Question 7

advantages to direct interview during consult

Answer 7

• 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

Question 8

disadvantages of direct interview during the consult

Answer 8

• most time-consuming technique
• some clients will digress at length
• may need excellent interviewing skills to keep interview on track

Question 9

blend of techniques

Answer 9

review history form
develop list of questions
shorter interview

Question 10

history forms

Answer 10

• separate forms for different species and problems

OMG this is so stupid…

Question 11

history forms for aggressive dogs

Answer 11

you will want detailed descriptions of as many incidents the owner can recall

Question 12

history forms for feather picking birds

Answer 12

will want info about diet, sleep cycle, air purity, type of cage, etc.

Question 13

history forms for dogs with separation anxiety

Answer 13

want info on what the dog does when its left alone and when it does it

Question 14

categories of info (7)

Answer 14

signalment 
problem behavior
current environment
early history
training/learning
other problem behaviors
medical history

Question 15

signalment

Answer 15

breed, gender, age

all affect probabilities of diagnosis

Question 16

problem behavior =

Answer 16

chief complaint

Question 17

chief complaint: general description

Answer 17

client is most interested in talking about this

gives you info about what will be most important topics of discussion

Question 18

chief complaint: specific description

Answer 18

need empirical info - based on or characterized by observation and experiment rather than theory

ask for multiple descriptions of multiple incidents

Question 19

clients tend to use what type of info

Answer 19

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”

Question 20

how do you determine behaviors from owner’s description?

Answer 20

clarify terms

ex: what does owner mean by “mad?”

Question 21

diagnosis of aggression is VERY important. look for (3 things)

Answer 21

1. postures
2. motivation
3. context

Question 22

how common is unprovoked aggression?

Answer 22

VERY rare!

there is usually always a signal.

Question 23

are problems of long duration easier or more difficult to resolve?

Answer 23

more difficult

Question 24

problems of long duration are likely to have undergone what type of change?

Answer 24

progressive change - these changes can reveal pertinent info - inciting cause may no longer exist

Question 25

appearance of problem

Answer 25

how often? under what circumstances? --> often logistical solutions are best

Question 26

problems of long duration may have gone through _______?

Answer 26

several permutations

Question 27

ask about previous treatments

Answer 27

what they have already attempted | what medications they have tried

Question 28

develop a problem list

Answer 28

the pet may have problems the owner didn't mention because they were considered: - less important - untreatable

Question 29

things you want to identify in pets environment

Answer 29

other people and animals it interacts with just shoot me now....

Question 30

early history

Answer 30

- source of animal (stray, breeder, friend) - age when obtained - previous owners

Question 31

significance of early history

Answer 31

may help owner understand contributing factors to current problem, improving compliance to protocol

Question 32

direct exam

Answer 32

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

Question 33

end of consult

Answer 33

discuss owner's goals treatment plan demonstrate "appropriate" behavior I'm so glad this is the END of this lecture!