Behavior Problem or Medical Issue

Mac is a 4 year old male Bulldog who was having issues with increasing anxiety as well as reactivity towards other dogs.  His dedicated owners did many training classes with Mac but they could see that he was becoming increasingly anxious and reactive.  Finally, frustrated and upset, his owner was to the point of considering talking to her vet about possibly putting him on medication for the behavior issues.  She told me he was having issues with his skin and that he actually had welts on his body,  and asked me if I thought that the stress could be causing him to have skin problems.  I told her no, but that I thought that the skin problems could be causing the behavior problems.  She took him in and had extensive allergy testing done.  She is also working with a nutritionist who is creating a custom diet for Mac.  As his skin and allergy issues are getting resolved, his anxiety and reactivity is dramatically decreasing.  He is relaxed, comfortable and happy.

Jack, an adult male Pekingese, was found as a stray and then adopted by his owner so his history is unknown.  What they do know is that Jack is sweet and loving with all the members of his family.  Imagine their surprise when a family member reached down to pet Jack and was bitten by him.  Jacks owner asked me if I would help her with this behavior issue.  I asked if he had ever done anything like this before or if he had ever seemed uncomfortable with being touched in certain areas or was ever defensive in that way.  She said no, that it was very "out of the blue".  I recommended taking Jack to the vet for a full workup before we considered behavior modification for him as it sounded to me like he could be in pain.  She took him to the vet and it was discovered that he had a back problem and was experiencing pain.  He is on medication for his back pain and has had no further issues.

I come across situations like this all the time in which a dogs "behavior issues" are actually a health or medical issue.  Sometimes, like in Jacks case, his owners had no idea he was in pain.  Other times, like in Macs case, his owners knew he was dealing with a health issue and he was being treated for it, but they didnt know it could impact his behavior.

Most of the time, when consulting on a behavior case, there is a clear trigger or a history that gives me an idea of what may be going on with the dog to cause the behavior issues.  However, there are times when a problem seems to arise out of the blue, where there is no clear trigger, history or cause.  In these cases, it usually ends up being a medical problem.

This is not a complete list, by any means, but here are a few behavior issues that I see that tend to point to a medical problem.

• "Out of the blue" aggression or reactivity
• Sudden housebreaking issues in dogs that were previously housebroken
• Sudden growling/tension/aggression with other dogs in the home that they previously got along with well and had no issues with previous to this onset 
• Sudden aggression or reactivity when certain body parts are touched, particularly if the dog seemed okay with this type of handling in the past
• Dogs that "refuse" to sit (or sometimes lie down), but readily respond to other trained cues
• Anytime new behavior problems present at the same time as or shortly before or after a medical issue of any kind is discovered

"Out of the blue" aggression or reactivity

When a dog with absolutely no history of aggression suddenly reacts aggressively, this can be a red flag that there may be a medical issue going on.  When I work on cases like these, I collect a lot of history about the dog and I evaluate the dog myself.  Sometimes, as I collect the history, I will find that the dog actually does have a behavior issue and, in fact, did give many warning signals but they went unrecognized by the owner.  Other times, there was no indication that there was an issue previously and that is when I would be wanting to get the dogs veterinarian involved so that we could really make sure that the dog is checked over well to see if there is something going on medically.  I will talk with the owner to try and determine if we can  figure out what event, specifically triggered the aggression.  One thing that can be an indicator of a medical problem is if it was something that the owner has done many times before that should not cause that reaction, such as the owner pet the dogs back or lifted the dog onto her lap then it may lead me to believe that the dog is in pain or uncomfortable.

Sudden housebreaking issues

When someone contacts me and tells me that their seven year old dog, who has always been very good at house breaking has recently started urinating in the house and that they want to hire me for help with housebreaking, I am definitely going to recommend a vet check.  Generally, when a dog just starts having house breaking issues it is medical, not behavioral.  Not always, of course.  There are cases when significant changes in the home causes this, but more often than not, the problem is not behavioral.  I know of one little dog who was actually given away by her owners because they said she "couldnt be housebroken".  She was taken in by a friend of mine who works in a pet hospital and immediately had a urinalysis done on her.  By the time she got her she was actually urinating blood.  It turned out she had a raging urinary tract infection, that had gone on for a year, untreated, before they gave her away because she "wasnt trainable".

Sudden growling/tension/aggression with other dogs in the home

When two dogs have lived together for many years and have always gotten along and then one of them suddenly begins to be defensive or growly, this can be a medical problem.  When a dog is in pain, they will behave like we do when we are in pain.  They can be touchy, hypersensitive, they dont want to get bumped into and so they are much more defensive of their body than they may normally be.  I have seen this in dogs that are experiencing pain or are having issues with balance or are unsteady, as well as in dogs that are beginning to experience vision problems.

Sudden aggression or reactivity when certain body parts are touched

Some dogs that are sensitive or that have not been conditioned to having their body parts touched can be uncomfortable with gentle handling of their body.  They may be particularly touchy about their feet, ears or mouth, their back or some other part of their body.  If the dog just isnt used to it, we can desensitize the dog to being touched and handled.  However, if the didnt seem to mind it in the past, but suddenly stiffens or growls when touched in a certain area, he may have some pain or discomfort.  When my dear old, now deceased Dachshund, Slater was experiencing back pain, he did not growl or snap or act defensively, but when I would pick him up he would become visibly tense.  He was also increasingly less tolerant of the other dogs in the house when he was not feeling well.  Some dogs are so hypersensitive when they are in pain that even petting them could trigger a reaction.

Dogs that "refuse" to sit (or perform some other behavior) but are responsive to other requests

I generally see this with the sit.  A dog will not sit down when asked and so the owner immediately accuses the dog of being willful.  More than a few times, I have seen this be indicative of a problem with the dogs hips or rear assembly.  Just last night in class, I had a little dog who was having a hard time learning to sit.  As it turns out, she recently had surgery to correct a problem in her hip.  Many dogs that have pain when doing one behavior will happily respond to other requests, such as lie down because performing that behavior is not painful for them.

Behavior problems that present just before, just after or when a medical problem is discovered

Sometimes a dog will actually be being treated for a medical problem when a supposed behavior problem occurs.  If a behavior problem starts with a dog that we know has been dealing with a medical issue, including but certainly not limited to orthopedic problems, pain of any kind, allergies, ear infections, urinary problems, stomach problems, skin issues, thyroid problems, surgery of any kind, including spay/neuter than it is wise to consider that the cause could actually be the medical issue.  Additionally, if the dog is on any medication for a medical problem, this could also contribute to changes in behavior. 

Notice that most of "behavior issues" that end up actually being medical issues appear suddenly or "out of the blue".  The fact that the behavior is unusual or uncharacteristic for the dog displaying the behavior is many times a tell tale sign that it could be a medical problem.  Most of the time, once the dog is treated for the medical problem the behavior issue just goes away.  So, its definitely worth ruling out a health issue or medical problem requiring treatment before getting started on a lengthy behavior modification program that will not actually address the real issue with the dog.  

Finally, when we are trying to determine if there is a medical explanation behind a behavior issue it will be necessary that the dog have a very thorough veterinary check up that includes blood work, possible urinalysis and possible x-rays if pain is suspected.