Chrissy 0:00
Welcome to The Dogs of our lives. Podcast with me. Chrissy Messick, this is where traditional training transforms into true connection and understanding with our dogs. As a certified dog trainer, behavior consultant and interspecies communicator with a background in high level sports medicine, I bring a unique functional approach to understanding our dogs by integrating body, mind, heart and soul, join us for insights, stories and practical wisdom that will help you prevent problems before they start and build a deeper bond with your animal companion. Before we get into today's episode, let me ask you a question, how well do you actually know your dog? Why not take my quiz to find out? You can find the link in the show notes. Now let's dig in. Today. I have the pleasure of talking with Dr Stacy Jones, who has been a small animal veterinarian for more than 20 years. She's not only a wonderful veterinarian, but a wonderful person as well. She currently works at the veterinary behavior center in Boulder, Colorado, and is involved in lap of love, which is a veterinary hospice and in home euthanasia service, which we recently had to use for a mutual client. And I'm telling you, it takes someone special who can do this and make it as peaceful a transition as possible for the whole family. In today's episode, we spend a lot of time discussing the role of medications in the behavior plan, how they work, and dispelling myths on this topic, we also address the importance of the human family being a part of the veterinary visits to create safety for the dog and peace of mind for the humans. Another important topic we discuss is the role of the human family with dogs that are showing unwanted behaviors, so this means the humans bandwidth, expectations, etc, and what part that plays in the big picture. I feel this is such a compassionate episode for both the humans and dogs living with them. I'd love to hear your thoughts about our discussion. Hello, Stacy or Dr. Stacy Jones, I should say,
Stacy 1:56
please call me Stacy. Hello, Chrissy.
Chrissy 2:00
Thank you so much for being on here. I'm really excited to talk to you today, because I feel like the information that you have to share, and Dr Fagan and the whole veterinary behavior center is just really important information to get out to people to understand and we know each other, because we we work together. We we collaborate together, as with Team dogs. You know, you see some of my clients, and we collaborate and work together. And so that's how we know each other. It's been how many years? Jeez.
Stacy 2:33
Well, this is my fifth year at the vet behavior center, yep. So it seems like we've, we've been working together a long time, and I'm so appreciative to have this opportunity, and also just to get to know you on a very different in a very different way.
Speaker 1 2:49
Yes, we have a lot of fun conversations, I think. Okay, so do you just want to tell us a little bit about yourself, where you live, what you do, and the current dogs in your life? Sure,
Stacy 3:00
so. I am a Colorado native. I grew up in Colorado. I had the pleasure of attending Colorado State University for veterinary school. I did a one year internship in emergency medicine in Boston, and I had a special interest in anesthesia from the time that I was in veterinary school, I thought I was gonna go back and do an anesthesia residency, and then when my husband and I were coming home from Boston, we were expecting our first daughter. Yeah, we just decided to switch gears. So I became a general practitioner at a local clinic, and I ended up being there for 16 years, which was lovely. And my primary interests in that practice were actually Greyhound so I had a opportunity to do some research in in Greyhound anesthesia. So kind of two loves coming together. There a life threatening problem that greyhounds have under anesthesia, where their potassium rises and they can have, they can have cardiac arrest. So that was a really different experience than I expected. I didn't know I was going to have a research opportunity in general practice, but it was. It was really meaningful. The Greyhound clients and all of my the Greyhound community was just a really important part of my life through that. And then I also had kind of a side interest in helping fearful pets receive veterinary care. And so that's actually kind of how I got connected with Dr Fagan, because right before COVID, I had shadowed Dr Fauci a few times, and we had discussed the opportunity to maybe come and work for her practice. And so I made the leap and joined the vet behavior center, literally two weeks before COVID lockdown, and then suddenly, so suddenly, we were doing telemedicine. Because, my goodness at all, the you know, curbside practice that had been instituted where clients couldn't come inside with their pet. Because it was just never going to work for our patient population that was mostly experiencing anxiety, or, you know, such significant anxiety that there was aggression, so there was no way that they could just come inside with us without their guardians. And so we actually,
Stacy 5:21
you tell him, puppy.
Stacy 5:24
Oh, hilarious. Okay,
Stacy 5:25
do you want to leave a little click clack of the nails too? I know. Well, who was that? By the way, that
Stacy 5:31
was my son, Brady, who's 17. Oh,
Stacy 5:34
the the dog was, oh no. The dogs were
Stacy 5:38
dozer, who's 10, and tank, who is about eight, yeah, so mixed bead dogs that are that came into my life after we lost our greyhound. Um, that's who I have at home right now. That was part of the question. I have two horses and two dogs and seven chickens and a turtle and a cat.
Chrissy 6:01
You have a farm.
Stacy 6:03
I feel very lucky. Yeah, no, I
Chrissy 6:06
love it. Okay, yeah, so you've been at the veterinary behavior center now for five years. You said, right, yeah, this
Stacy 6:12
is going to be my fifth year. There's different ways to practice behavior as a veterinarian, you can certainly have a special interest in behavior and incorporate it into everyday practice, which is, you know what a lot of people do there is the track to become a veterinary behaviorist, so a specialist in in behavior. So just like there's oncologists and who are cancer specialists or surgeons that are Orthopedic Specialists, their veterinary psychiatry and behavior is its own specialty. So Dr Ariel Fagan is one of the board certified veterinary behaviorists in Colorado, and she had actually offered me residency, although I wasn't that wasn't necessarily the track that I was interested in, although we do have residents at our practice now who are doing extra training to become specialists, but there was a an interesting model that had been started by some other veterinary behaviorists that basically mentored general practitioners and gave them intense learning in the field of veterinary behavior and psychiatry in order to increase the amount of service that they're able to provide, and it's been a really beautiful model for our practice. I feel so thankful that I was offered that opportunity, because I work with an amazing team of people, and I continue to grow my expertise over time, but I don't, I didn't have to decide that I wanted to be a veterinary behavior specialist. Yeah,
Chrissy 7:51
yeah. So I know Colorado, state is, I think, the Top program in the country, or something like that, right? I'm
Stacy 7:58
not sure where it is right now. I think when I was there, which was like 22 years ago, coming on 22 years ago, I think it was the number two. Back then, we had a program through our community practice that was targeted towards behavior, and currently there's not a veterinary behaviorist, so a diplomat in veterinary behavior, so a specialist. There's not there's not one at Colorado State University right now. So they actually Dr Paco. My understanding is Chris Paco comes in from out of state to do lecturing and have a curriculum up there. So I don't know very much about it, but my understanding from having students through our practice and kind of hearing through the grapevine that it's been a very meaningful addition to students education as they're finishing up veterinary school. I know that there are differing levels of education that veterinarians are provided in veterinary school, and there's not a lot of veterinary behaviorists in North America. I think that the number is around 100 right now, yeah. And so, you know, we have two in Colorado and but they also serve all the neighboring states, right like, you know, New Mexico and Arizona, you know, Utah and Montana and Kansas and, you know, you know, all the neighboring states around us. So there's a high need for this service, and just not a lot of people that are providing it. And so the people that are in academia are certainly very valued in passing that education on to students and then people in private practice. I mean, I don't know how it is everywhere, but like the veterinary behavior center often has students or people that are interested in behavior coming through our practice to shadow. Yeah, that's
Chrissy 9:46
awesome. Yeah, super important. This just kind of popped up in my head, and you don't have to answer this if you don't want to, because maybe it's controversial, but you know, whenever I come with my clients to their appointments. You guys, we're all in there in the same room. You know, the humans come in with their dogs, and the room set up for safety. You know, there's lots of space and that kind of thing. My question is to you, so many veterinary clinics don't have the human come back with them. I just think it's super important, because a lot of times a dog is will be stressed, they take the dog in the back, and a lot of times, you know, it looks like the dog is doing well, but in reality, the dog is just like frozen and kind of shut down, and so they're not really expressing their true selves. And so just, what are your thoughts on that? Yeah, it's a
Stacy 10:44
really, it's a really important question, and I think something that I've been exploring for many, many years, I actually had. So just a side note, both my kids, but have been at the Children's Hospital Colorado, and at Children's, they have basically a philosophy that's called family centered care, where they allow families, they encourage families to stay with their small patients. You know, child patients even very extreme things. So like one of my mentors in family centered care, worked in the emergency department, and she told me that they would often have families present during even CPR, because they wanted families to be able to know that they they did everything possible and to have transparency. You know, also just children gain, you know, comfort by being present with their parents or their families or their you know, their guardians, people that they trust, right? And it makes it less stressful for everyone to try to help with even small procedures, like blood draws as an example, yeah, my lens that I've kind of looked at veterinary medicine through has been tainted, not tainted, but tinted, let's say, tinted by that experience of having, especially like when my son had heart surgery at Children's and, you know, we were able to stay with him through everything except for the surgery itself. You know, at that time, we had to go home at night and come back in the morning. They now they have the ability to have family stay there. So that's a side way of kind of saying that when I was in general practice, it I was always advocating for families to stay with their pets. And then what I recognized over time is that it was easier to coach people, you know, like you could say out loud, oh, you know, there's yawning and oh, he's licking his lips and oh, he's just closed his mouth and he's, you know, his ears went back, his tail is low, like we can see that he's really feeling scared about this experience. And, you know, trying to help people understand what their animal was going through, so that it would be easier to make recommendations on ways to decrease the anxiety of delivering the care that they needed, if that was adding some extra medication support or some sedation for a procedure or coming back on a different day with a different plan, it just made it easier for people to understand why we were making those recommendations. And we definitely saw what we call behavioral inhibition, which is basically what you're describing, right? When animals lose their social support by being removed from their preferred people, their outward behavior can change, so like if they were barking at the vet in the exam room, and the veterinarian takes them to the treatment area away from their guardians, the barking might stop and they might shut down or freeze their outward behavior, but it doesn't mean that they feel any differently inside and for us, I was actually a more dangerous situation, because you could get tricked into thinking that the patient was actually feeling comfortable, but they were just about ready to explode. And so, you know, an unwanted or unexpected, in quotes, unexpected bites could come from that kind of situation. And so, I mean, there are still times where it happens or it has to happen. And sometimes we have very, you know, just open discussions with people about, you know, if, if behavioral and efficient is going to be utilized as a strategy, then at least we talk about it openly. Okay, this is actually what's happening. It doesn't mean that they're actually more comfortable, right? And so I don't know, in the big picture over time, if, if the goal is for patients to be able to have a say in kind of what's happening to them and their own experience in the clinic setting, and if they're not able to cope, then we as veterinarians can give them other ways of being assisted through through anxiety and pain medication support. Then, you know, I don't think we have to rely on some of the strategies that have been kind of standard over you. Over the course of time, yeah,
Chrissy 15:01
yeah. And I just think the more the human Guardian understands body language, it can see how their dog is feeling. It's super helpful for them to know kind of where they're stress level that their dog is in those situations. So how would you how would you suggest that someone advocate for their dog, like, if the Clinic says, No, we don't allow the humans to come back with the dog or to be in with the dog. What? What recommendation would you say? You know that would be helpful for someone to advocate for their dog? Yeah. I mean,
Stacy 15:34
I think it's always worth asking, right, being clear at the beginning, most of the time. Obviously, the patient population that you and I work with are typically patients that have fearful experiences in unfamiliar settings, and especially in places where you know they've been poked with needles and things have happened in the past, right? So most of our patient population, we are encouraging people to have open discussions with their primary care doctors about the lowest stress, or, you know, least stressful, way to facilitate veterinary care. Many of the practitioners in our area, in our community, have been very amenable to making adjustments when they know kind of what is helping and what what works. So, you know, a lot of times we practice things at the veterinary behavior center in the clinic setting, and then we kind of try to transfer it over to the primary care setting to make it, you know, kind of generalized to other contexts, right? I mean, I definitely still see some situations where primary care veterinarians just they feel uncomfortable with a handling plan, or they might not have the ability to navigate it just due to time or space or help, you know, assistance. And so in those cases, sometimes we just have discussions like, well, do we need to come up with a different way for that that pet to receive this particular part of the veterinary care plan, like a medical as an example? I mean, one of the interesting things that I learned about this particular concept is in when I was in general practice, is that there would be times where, if a pet was taken to the treatment area and the Guardian didn't get to stay with the pet, that the Guardian would be kind of wondering what happened back there, like making a, you know, a narrative in their mind about what was going on. You know, it's really hard to express really what was going on without having the person having been present. In most cases, I think it is just actually a lot more accurate for clients to be able to witness what's actually going on and being able to have for them to be able to have a say. You know, if there's some things that are really urgent things, and if they're an absolute need, then certainly sedation can just occur, right, right,
Chrissy 18:04
right, yeah, yeah, yeah. I think that's really good. I think the important takeaways from that is, ahead of time, communicate, you know, what's the intention you know, and communicate what you would like to do as you know, to advocate for your dog and just have a discussion beforehand. I think that's super important. Yeah,
Stacy 18:24
even having an appointment to discuss a low stress handling plan can actually be really effective, right? Most of the time, primary care teams are very open to making adjustments, but in the moment, if they didn't have time planned for that particular way of navigating an appointment. It really is unfair to ask if you communicate with them ahead of time and say, this is kind of what my my patient or my pet has experienced in the past. This is kind of what I would like to try you give the scheduling team time to make space available for that to happen, then it's a lot different conversation than trying to jam it in, in a, you know, in a little, little time appointment where people are already, you know, time stretched Right, right, yeah,
Chrissy 19:17
yeah, that's cool, yeah. That's a good I like that idea. Okay, so we're gonna just go back a little bit in time. Can you tell us about your childhood, growing up, and anything during that time where you learned values, beliefs, or anything that shaped your thoughts and feelings and attitudes towards animals, and then has that changed over the years? Let's
Stacy 19:39
see. Well, I was very lucky to have parents and godparents who gifted me the ability to grow up with horses. So my godfather gave me a horse when I was very young, and my dad did some maintenance at some land at some neighbor's house, and we were able to. Keep him there while I was growing up. And so that was a really magical experience to grow up with, with a horse. My parents also. We had family dogs. And so I think one of the things that I recognized about animals early on was just their ability to be fully present with you and their non judgment of anything that was going on. You know, you can say anything to them. You can express, you know, how you're feeling to them, and they there's no judgment there. Um, which is, which is beautiful.
Chrissy 20:32
Just look at you. They just look at you with those eyes.
Stacy 20:35
I know, which is so beautiful, which I've always kind of secretly wanted, if I if I could go back in time and, like, do something different, I wonder if I would have done, like, therapy work with dogs, because I love, like, the reading programs that they have where they bring dogs in to read with, you know, for kids to read to dogs because they're non judgmental, right? Being present and being non judgmental have been values that I've kind of carried forward and tried to utilize, actually, with humans. When I care for animals that are cared for by humans, like caring for people is actually such a big part of what we do in veterinary medicine, and maybe it doesn't it's under recognized, but people who are in this field, just like, I know you understand so much of it is like being able to be compassionate and helpful to humans as well. And I think just as time has gone on, the behavior community has really introduced me to some really beautiful additional values, like being able to have autonomy and agency, basically control, having a say in what's happening to you, and having a say in your own outcome, and being able to communicate whether you do or don't want to participate in something. And it does seem like that concept is kind of opening up over time with with our work with animals, but it's really important, right, that organisms be able to have a say in what's happening to them. So yeah, those, those values, I think, have served me well, and I'm lucky to work in a community of people that also have the same values. Yeah,
Chrissy 22:19
working with you, you definitely care for the human and the dog or cat or whatever animal is there. So I know you are very passionate about both of those. It's just so funny because there's this misconception about, I don't know about veterinarians, but a lot of people think that dog trainers just work with dogs, and it's if you're going to be a good dog trainer or behavior consultant or behaviorist, you have to know how to work with humans as well, because that's who you're helping as well as the dog.
Stacy 22:57
No, I think it's a really important one in actually having a series of discussions at the veterinary behavior Center recently, specifically, one of our our leaders, Bridget Chesney, was talking about, you know, how we we ask a lot of these animals with regard to the amount that they have, not that they have to, but the amount that we're requesting that they change their behavior and granted, we're setting their environment up for success or trying to right. We're trying to make it easier for them to make the decisions that we would rather them make, instead of the undesired behavior. And we're helping them medically, and we're teaching them those skills, right? But we are asking them to change something that has been functional for them, you know? And it's a big ask for some of these types of behaviors that we that we deal with, and we were discussing about like, well, well, we're also asking a lot of what the Guardians, pet guardians, have to do. They have to change a lot of the ways that they have been behaving and the things that they have been doing for and sometimes the way that they've been thinking about something for a long time. And so it's, it's kind of multifaceted behavior change, right? Like, on numerous different levels, yeah.
Chrissy 24:24
So many like the mindset, the emotions, the skills, oh, just so much. All right. So have there been any dogs in your life that have influenced you personally and or professionally, and has that changed your approach to work or life, yes. Yes. Next question,
Stacy 24:46
I'm making a bet that if you asked anyone who's working in behavior, animal behavior, that there's probably some animal behind the curtain that yes, that has opened. Just a whole new way of looking at things, right? Yeah, so I was a veterinarian for a long time, probably halfway through my career. This is my 22nd year coming on my 22nd year. So I was probably halfway through my career when I was gifted a young rescue dog and and she was lovely, and she also came to us at a time where I had young children. She had a lot of fearful behavior around noises and fast movement so many everyday things were hard for her. She had difficulty being left alone or being separated from her preferred people. She had trouble, kind of remaining calm in her safe area when she was by herself, she was eliminating inside, despite having the skill to use the dog door and have a functional backyard that she loved running around in, but just was not a toileting outside anyway, like there was a Day where she when my son was holding her collar to prevent her from escaping out the gate, and she put him in the face. And it was that was, it was just like a series of difficult conditions that added up to us recognizing that there was a major gap between what she needed and what we needed. So there's just a mismatch right between the environment and what was going to make her feel the most safe. I mean, I tried all sorts of stuff. I was reading, I was I'm, gosh, I'm a veterinarian. I should have these skills, right? But I just wasn't able to maintain her in our home in a way that made sense for her or for us, really, and that was a massive shame spiral for me, and I was embarrassed because this rescue group that I had worked so closely with, you know, I had to tell them that I couldn't keep her and we had to find a new home within the rescue organization, Which ended up working out beautifully, but it gave me so much compassion for the kinds of things that people actually experience, like not being able to leave your house because your pet is so distressed, or trying to help pets eliminate outside, even though they are skilled at it, but don't always choose to right, and just how much anxiety can be disruptive to a pet's quality of life. And I learned a ton from her, and I'm very thankful for having had the experience now, and it's actually what kind of got me interested in helping fearful pets in the veterinary clinic. So it really shaped the way things went for me, but it was a personally devastating time in my life. Yeah, what about you? Did you? Do you have a,
Stacy 27:50
probably a couple dogs?
Chrissy 27:53
One was we had two boxers before Kevin and I, my husband, we first got married. We're like, let's get dogs so we can practice being parents. So we got one boxer. Did everything wrong. We got him from breeders, and that's a whole other podcast episode. But did everything wrong with the first with Zoe, our first boxer, starting with, you know, finding a good breeder. And then our second boxer, who we got, I think maybe six months later or a year later, we did much better. We learned, but Zoe, our first boxer, looking back, man like right from the get go, separation stuff, medical issues, you know, fear, all these things. So got to the point where I started kind of, what do I do here? Like, we, we're pretty savvy, you know, people and that kind of stuff. So I started researching and went down the road of, we did use an electric collar, and did that for probably three weeks, I was like, This is dumb. Like, this doesn't make any sense to me. She looks like she's scared, you know. And I didn't even know anything about dog, anything like, I just had no idea. But it didn't feel right to me, and so I just stopped using it, and then found the Humane Society, and then kind of learned from there. And so just all of her issues kind of helped guide me toward a humane way of learning and teaching and working with dogs. So that was one, and they both lived till like 11 and 13. And then Zoe, she always had some issues we were working through, but she taught me so much as well. And then, not too long ago, I think it's been, like five years ago, we adopted a english bulldog who came from a hoarding situation. He had issues as well. And we worked through so many of them, but there was one, you know, any sound? He would attack. So when we turn on the blender, we had to take him outside. And it got to the point where my youngest daughter, she opened a book and turned a page, and he jumped up and grabbed her arm, and I was like, Oh, I just cannot do this. And so, you know, we all cried super hard because we loved him, but we decided that we had to re home him because we had seven year olds running in and out of the house and all these kinds of things. So finally, I interviewed people through the Humane Society. I just they knew me, so we just did that foster to adopt thing. Finally, three months later, I found the perfect couple for him, older couple, really quiet home. They had had English Bulldogs before, so they adopted him, and we still visited him two years later. And they also found that he had an impacted tail, which was causing him some issues as well. So that was a really interesting medical thing that we hadn't found, that they had found because they had worked with Bulldogs so much, it felt terrible, but it was the right thing to do, and it ended up being the right thing for that couple. You know, they said he saved their lives like it was just so it, even though it was super hard, it was the best thing for all of us. So dogs, they teach us so much.
Stacy 31:25
My gosh, they do. And I mean, it is so interesting to look back, right and just say, Oh, if I had known then what I know now, right? Like things would be different. But that just gives us even more compassion, I think, for what families are going through, because they're just starting, just like we were just starting. And, but also just like the, I don't know, the theme of being able to say, Okay, is there a major mismatch between what the pet and what the family and what the environment need are able to offer and and being able to have a, I don't know an open conversation about that, I think we get, oh, there's grief, right? And you take an animal into your home and it's not what you thought was life was going to feel like it's significantly impacting your ability to have safety in your home, or to be able to leave or feel comfortable. So many of our shared patients, right? Their lives are really small, their family, their humans, lives are very small, and it can feel isolating for them. They might not feel like anyone else understands, even though I wish I could connect them all together and say, you have this huge community of people that are undergoing the same situation at the same time, and you just don't even know it, you know? But which I think you you have a group, right?
Chrissy 32:49
A support group, yeah, yeah, we're actually talking tonight, but I have a small little support group, you know? We talk, we share our successes, we share our challenges, we share skills, we share tips with each other. I'll talk about a topic for a short amount of time, so it's a really supportive space, and we have fun together, and we laugh and cry and, you know, they find it super helpful. So yeah,
Stacy 33:18
when you recognize that you're not the only one right that you're not alone and that other people understand, not necessarily your exact situation, but they understand what it can feel like to have a good portion of your life, or sometimes a lot of your life revolve around an animal's behavior needs you know, which I think is why you And I enjoy this work so much, is that there really is a lot of opportunity to help, right? We can teach animals to have different skills to cope with things that they didn't weren't able to cope with before. We can teach them to feel differently about the way that they feel about things that are hard. We can, gosh, the safety and management piece, right? Just even if all you did was set the environment up differently and change the way that you the situations that you put the animal in, and try to set things up for success and avoid them practicing the undesired behavior, if that's all you did, you'd still have a lot of opportunity to make some headway. And then if we layer in the medical pieces right, making sure there's not hidden contributing factors like pain, like you're just talking about, or itching, or GI discomfort, or neurological or hormone imbalances, or, you know, Any number of physical or physiological contributing factors that decrease pets ability to cope with stress or to engage in the behavior as as us as the clinical sign of the problem, right? If the behavior, sometimes behavior is the only thing that has changed that we let, lets us know that a pets painful for an example. Example, right? And so many of the pets that come in, that we work with, that that we see in our in our practice, have have hidden pain. And so, yeah, if we can address those medical needs, and then help from a psychiatry standpoint, you know, that is something that I've really, really found valuable, and it's mind blowing how much medication can help some patients, and it's also mind blowing how fearful our public is about utilizing medications. And I know I was, you know I was, did you feel worried about using medications with your animals when you were very first starting? Well,
Chrissy 35:41
it's funny, because we never ended up doing that, but getting into dog training and actually working with clients, I think I was lucky, because I learned just through education, like formal education, when I started, you know, getting my certification in dog training, behavior consulting, I guess from a consumer point of view, I just didn't really understand what it did and how it worked. And, you know, you have the idea that, Oh, it's gonna make my dog, it's gonna change your personality, or it's gonna make him like sleep all day. And so I just didn't, I didn't really have any thoughts about it, because my background is in sports medicine as well, so I had that reference point. But, you know, as with dogs, learning about it with my clients, I think I got to the point where, well, I know, I got to the point where understanding how it works and seeing how much it helps clients. I mean, I have to counsel clients on that, with that all the time. And so I guess, from my point of view, coming from the sports medicine world, knowing medication has its place, because we would have to refer athletes, the athletes that I worked with, we would have, we would refer some of them to see the psychologist, and maybe they would need medication for that. And so I guess I had that viewpoint that I already subconsciously knew, from a dog, dog perspective, how it worked. There are so many myths out there about psychiatry and drugs with dogs. And so I think, well, we'll talk about that in a minute, about, you know the medication is and how that works, and just talk about the reality of it, the truth of it, instead of all these myths that are swirling around. But I guess that's my experience of learning about it, yeah,
Stacy 37:35
and I think it's, I mean, it certainly was mine, with humans that I love and my own animals, you know, like when, when we had that puppy, I didn't I was a veterinarian, and I didn't really know how to utilize psychiatry medication in a way that would have been safe and functional for her. That's why I'm so thankful for the veterinary behavior center, and Dr Fagan, and then all of the continuing education that's available for veterinarians these days from the specialty community that passes on that information. You know, it's really, it can be really life changing, or, in some cases, life saving, for some, for some pets, you know. So did you want to put a pin in that for a minute? Or do you want to talk about it right now? About
Chrissy 38:22
it right now? Yeah, I'll get to that in a couple questions. But people are probably sick of me talking about this. But with punishment type training or aversive type training, the prong collars, the shot collars, those kind of things. So when these dogs get to you, you know, a lot of stuff has been tried, and people are like, just use the shot collar or prong collar that fixes it. What I just want to say about that is it might look like it's fixing it, like from the outside, but internally, the dog is emotionally just a mess, like emotionally upset, like you said, there could be an underlying medical issue, medical pain, Gi, allergy stuff. So then, on top of all this internal stuff that the poor dog is dealing with, they're they're dealing with this external pain, and then the trust goes away with the human guardian. And a lot of people that use these training methods say, Oh, it's just like a tap on the shoulder, or Oh, it's just a way to communicate. And, you know, I strong, strongly disagree, because people are like, Why do you need to go this route of like, you know, the families are struggling, and it's emotionally exhausting for everyone, and it's, it's humane treatment, you know, humane treatment of a dog that can't verbally say, I don't feel good, or my stomach hurts, you know? And so that's why you guys are so important, is because you have the skills to get to the root of the problem instead of just treating a. Symptom. You know what I mean. So for the most part, by the time clients get to you, they've tried many things and they're frustrated or stressed out. So where are your referrals coming from? First of all, and then by the time these people get to you, what are you seeing with the dog and the human?
Stacy 40:16
Yeah, so that's some complex questions, I know. Well, let me just back up a little bit. We discussed how difficult unwanted behaviors can be for people and how it can decrease people's ability to cope, right? And so you could still have an understanding or compassion towards people who feel so distraught or they need to have the behavior change so quickly that they would chalk their own dog or that they might put on a collar that pinches you know they just they don't have the information right that helps them know that although that might shut down or change that outward behavior in the moment, it absolutely can change the way that the animal communicates, like they might learn it's not okay to communicate that they're uncomfortable by as an example, growling or or barking, right? So their outward behavior might be shut down, but you're right, the internal experience is unchanged, or maybe worse, because if they're already feeling worried about a situation, like they're anxious or fearful, and then you add that aversive into the environment and their experience, then yeah, they're going to have more anxiety. And definitely we see all the time in our practice where those that we call that inappropriate methodology, although it can work to shut down our behavior, it it isn't the long term answer, it often makes things significantly worse. And so it is true that families often reach for veterinary behaviorist services or veterinary behaviorist led teams later in the process than I wish they did. That's like if your dog had cancer, and the last person that you consulted with was an oncologist, right? We have so many ways to help, and like the very first I think about Susan Friedman's hierarchy of intervention, and you know, the very first exit on the highway is making sure that basic physical needs are met and that they're medically Okay. Families often have tried a ton of different things by the time they see us. Sometimes it's it's fast like sometimes there's very skilled positive reinforcement trainers that are able to detect that they've had kind of a plateau with where they're able to get or that they can see the dog's body language that is just very significantly impacted in the environment and refer really quick. And so we have a ton of families that come to us that way, and then we have a lot of families that come that have just tried everything, including, like, they just spent $5,000 on board and train with shock collar. And you know, they're out, they're not any further, you know, off and so, or maybe worse. So, yeah, I we see a ton of dogs, mostly dogs, but with some cats, Dr Fagan and Dr Feldman in our practice. See, you know, all species. I just see dogs and cats, but you know, mostly anxiety or fear related behaviors, to the point of fear related aggression. We see patients who have fearful behavior in separation from their preferred people or being alone. So you know, separation anxiety or isolation, anxiety or difficulty with noises, thunder, you know, repetitive behaviors, elimination in the house, like those kinds of things, our best chance for actually achieving a functional outcome is on the very first intervention. If we see someone early on when a dog is our cat is doing an undesired behavior like we have actually a pretty good chance of helping pretty quickly. But when they've been practicing that behavior, rehearsing it over and over and over again, and it's really solidified in their repertoire of things that they can choose to do, it makes it a lot harder to to shift, although it's still possible. And I'd say even despite the significant level of severity of behaviors that we treat in our practice, we have a really high chance of coming to a functional outcome for most of those families, in collaboration with, you know, highly skilled trainers, positive reinforcement trainers and primary care teams and sometimes specialty care teams, and working together as a group, I think we're often just limited by where people are on their trajectory. Right behavior changes, a process that takes time, and sometimes people are just tapped out, you know, where they're financially. Really limited because they've tried a lot of other things, or there's different ways people feel in the house, someone wants to keep going, someone doesn't want to keep going, right? And so there's all sorts of layers of complexity, but the psychiatry toolbox is actually and the teaching new skills toolbox is actually really broad, right? And we can keep trying and keep adjusting over time. I mean, I was really worried when I joined the veterinary behavior center, thinking that there was going to be a lot of outcomes that were undesired, you know, and not not successful in the way that we think of maintaining an animal and in their home and a healthy and comfortable way, but that doesn't happen very often, and but when it does, it's we're here, all of us, right? You, all of us are here to and as a community, to have that those discussions. And so I don't consider those failures. I still consider those being things that can help people navigate really difficult situations. Man, I'm not trying to think of where your question started today. No, I think you answered
Chrissy 46:06
I think you answered it. No. And I just want to say, unless you've been in this situation, you can't understand it there, then that's another thing. There's a lot of judgment. There can be a lot of judgment from people that haven't been in this situation, so unless you've been in this situation, it's hard to understand, yeah, there
Stacy 46:25
can be a lot of judgment from the behavior community in general, right? Yeah, it's super complex stuff. It definitely is a lot more there's a lot more resources that are available now than when I first started, right like veterinary social workers as an example, and groups like yours that are, you know, meeting and having support networks for people, even on Facebook, although I'm not on social media, but my understanding is that there's ways for people to recognize that they're not alone. Yeah, yeah.
Chrissy 47:20
And so, I know, you know, we've talked about medications and how that can be an integral, integral part of the treatment plan. So can you dispel some myths and taboos surrounding this topic? Yeah,
Stacy 47:32
gosh, when I was a young veterinarian, and we didn't have a veterinary behaviorist in our area, and we were, you know, we kind of had a handful of things that we were schooled on, you know, we would absolutely try them, and many times they could be helpful, but sometimes we just didn't know how to adjust the doses, or when to adjust the doses, or, you know, how to counsel people on, you know, what to do if you actually saw a side effect. And so I recognize that in my young, the young part of my career as a general practitioner, you know, sometimes I would have patients on medication for long periods of time, and it wasn't actually helping. You're like, so that's one thing that I Gosh, I'm so appreciative of the mentorship from Dr Fagan. So big picture stuff, we only use medication if it's actually helpful, and we we only use medicine if it's not causing set undesired side effects. And almost always, like, I can't think of a single situation that I've had in my career where, like, if a if a side effect of a medication came up when we stopped the medication that that side effect went away, but it does. It is possible, but it's super rare. Typically, when we use medication, we use them in kind of two ways. One, fast acting medication that I kick in in an hour or two, that can last a number of hours, or up to six to eight hours, or some of them up to eight to 12 hours, but we just give them in anticipation of a stressful event, like before fireworks, before veterinary clinics, right? And those medications, sometimes we use them in combination with each other, sometimes they're just kind of little prequel to getting to the clinic and getting sedated for a bigger need, right? But there, the goal is for them to decrease anxiety during stressful events. And those medications can be a little bit more sedating at the doses that we use, sometimes, sometimes not in for a very short period of time, if a pet is feeling a little bit more sleepy than normal, and it also is associated with anxiety reduction. Then we have a conversation with the client like, would that be acceptable? But we never want patients to feel like that every day, you know. So when we use daily maintenance medications that are typically more serotonin focused or other neurotransmitter focused. We don't want them to feel like they're sleepy or they're sedated or tranquilized. We don't want their personality to be any different, except for just the things that are hard turned down. We want them to be playful and engaged and like, do all their normal stuff, you know, and if they're not, that is a very clear change point for us, like we're always on the balls of our feet ready, like, if we see something we don't like, we're gonna make an adjustment, because we don't want patients to continue to feel that way. I think if I had known that early in my career, it would have been a lot more helpful to help people understand, you know what we're really after? I think so many people land in in our clinic and think we're going to try to tranquilize their dog and right? Maybe, maybe they do need some extra help for certain types of situations like that visits, but we don't want them to feel that way every day, um, almost always the daily serotonin focused medications that are maintenance type medicines, those guys can take four to six weeks to even see if they're going to start to help, but almost always, if there's going to be an undesired side effect, it happens fast, like usually in the first three to five days, so we'll often know right away if there's something we clearly don't Like about one of those medications, but sometimes it could take a little bit of time for us to figure out what the actual benefit is going to be. So there are situations where we'll start a daily maintenance type medication, and we know that it's a long term investment. So in the meantime, we'll also start a fast acting medication plan to help within an hour or two, and, you know, last a portion of the day, sometimes giving it twice a day or three times a day while we're waiting for that foundational medication to kind of see what we're able to get from it. And then we fade the fast acting one off. We will sometimes use what we call those are called Bridgers. They're the ability to kind of get in there and try to get some relief going while we're waiting for the daily maintenance medication to, you know, to assess it. Yeah,
Chrissy 52:07
the medicines that you're using, they're, they're not meant to, like, make your dog drowsy or change their personality or anything like that, unless, like you said, it's intentional for the vet and you know that to sedate that kind of thing, but it's just taking the edge off and helping the dogs be able to cope better and to when you're using that in conjunction with training and teaching and behavior change, you're not going to just use it by itself. You want to. You want to use everything you have at your hands to help dog, you know, learn new skills and feel better. It
Stacy 52:46
is one part of a comprehensive treatment plan, right? We would never use medication as the only therapy, and we would never use medication just to put dogs in the same exact situation that you know, that is already too hard for them, but they don't yet have the skills for
Chrissy 53:02
right? That's a huge, I think that's a huge thing that people it's good for people to understand is that you're not going to give a dog medication just so they can go to a pub and hang out,
Stacy 53:15
right? Like that's so not what
Stacy 53:19
it's layered on top. It's layered on top of the foundational management plan, like that antecedent arrangement. How do you arrange the environment? How do you set up their interactions so they're not in situations that are too hard, so that they don't practice undesired behaviors? Right? If you don't have that base and that safety plan isn't in place, then anything that you layer on top of it isn't going to be nearly as successful and and when we think about the success of medication like we're hoping, that the portion of the treatment plan that is held up by medication is doing at least 20 to 30% of the heavy lifting, right? If it's not helping that much, then we're gonna keep making adjustments until we find the right brain match. We're not gonna leave patients in an ineffective plan. And sometimes we have a lot of success, and I'm sure you do too, where people have they're very good at managing the environment, and they're very good at making sure that the patient has their medication support, and maybe they don't have the time to teach a lot of new skills, and in some situations, that's okay, but everyone's freedoms and their world can kind of continue to grow, and their ability to be in the world can grow when we teach new skills. But there's always a discussion on like, what is realistic expectations for this patient? Like, you know, what do we have to change our expectations to be able to actually be more successful? Stressful in the medication plan, some dogs really should never be sitting on a brewery patio, right? So, yes, yeah, yeah. But I mean, as far as the success of the medicine, the categories of things that we think about are, does it decrease the intensity and the frequency of the behavior. Can they get back to baseline faster? Can they recover something happens? Can they can they recover quicker? Is there a little bit more time before the undesired behavior happens, like where the Guardian could recognize that their body language is changing, or redirect them ask them to do something else? Can they be a better learner? You know, if they feel less worried, can they learn better? And then, just generally, like, most of the timing when we're talking about this, it's usually anxiety associated, right? Like, it's a silent form of suffering. And so if patients feel more comfortable in their own body and in the world, then that's a success too. Sometimes medication is really, really helpful. Like, I've had patients who come back and say 80% improved with the medication. It doesn't happen all the time. Like, we feel really excited when we get 30% but I am increasingly thankful for the psychiatry toolbox as part of an overall treatment
Stacy 56:22
plan. Yeah, you know, it's super sad. People
Stacy 56:25
might push it off until the last minute, because it really should be used early and upfront and then faded later when, yeah, right. I
Chrissy 56:34
think people just don't know. Like, I didn't know, you know. And so I think this is why this is so important we're talking about this right now to educate people about this? Yeah, I would say too. As a trainer and behavior consultant, I will do a lot of referrals to you guys, when I working with a client, and we've gotten to the point where we're like, 70% better, and I'm like, I think there's something else going here, going on here, or we've hit a plateau, you know, it might be a good next step to go, you know, visit Stacy. But also, I think another myth that I would like to dispel is, I think a lot of people think that you as veterinary veterinarians and veterinary behaviors, if you're prescribing medication, you get a kickback, or you're making money off that, and so I can you talk about that? Yeah, veterinarians
Stacy 57:26
manage who provides the prescriptions in very different ways. You know, some veterinary clinics carry their own prescriptions so that clients don't have to pay to have it shipped to them via an online veterinary pharmacy that is highly reputable or that they don't have to drive to a human pharmacy to pick it up. So veterinarians do use in clinic pharmacies to help families, you know, with the financial investment and then also just the ease of obtaining medications. But as an example, I mean, I want to say I worked at the veterinary behavior center for maybe three years before we had our own pharmacy. Like we always just prescribed it out to human pharmacies or reputable online veterinary pharmacies, and that's so we wrote the prescription. We had someone else fill it, and like we never had, if there was no financial benefit to us, we have, over time, started carrying some medication so that people can just walk out the door with it and try it right away. So many of our patients have very, very urgent needs, and even the barrier to, like, drive to a pharmacy and wait to get it picked up could be hard for people. You know, it's one extra thing someone has to do. So we've chosen to have our own pharmacy that we have tried to make very cost effective and equitable to other pharmacies that families would get medication from. But it is not, it's definitely not a money making part of our practice. Yeah, yeah, yeah. I mean, we, we think about it, just our ability to hold space for difficult conversations, and our ability to be skilled at what we do, and to care for people and pets and, you know, in a very comprehensive way like, that's, that's how we make a living, and not on selling medication. Yes,
Chrissy 59:22
yeah. I just wanted to talk about that because that is brought up so much that I see and definitely not. The hilarious
Stacy 59:30
thing is that most of the psychiatry medications that veterinarians have access to are actually human medications. There's not a dog formulation or cat formulation. There's very few psychiatry medications are actually formulated for and branded and, you know, basically provided as a brand name veterinary product. So almost all the things that we actually use are human medications that we just have. We're very skilled at using where there's a lot of evidence. Behind it, and a lot of practice, but a lot of the stuff that we use just actually is prescribed through human pharmacies. Yeah,
Chrissy 1:00:06
yeah, okay, well, we talked a lot about medications,
Stacy 1:00:11
which I think is super
Stacy 1:00:13
important, yeah. I mean, I'd say it's maybe one of the main reasons people put off seeing a veterinary behaviorist led team. Is that they're worried about the medication conversation? I mean, yeah, I mean, some of it, I think, might be access, like just, is there a veterinary behaviors led team in their area? Is there a long wait? You know, what's the emotional and bandwidth and time and financial investment like those are barriers too. But I would say, think people are scared of using medication, and I hope we can help them, over time, understand that we're here. We feel the same way about the medication that they do. We don't want harm to come, and we only want it to be beneficial. Yeah,
Chrissy 1:00:58
you know another thing that you know, might be a barrier as well as I've worked with clients who have worked with their primary care, you know, veterinarian and their dog has been on medication, but it hasn't helped. And so their thought is like, well, I don't it's not helping. So that's not an avenue that we're going to go down. But I just want to clarify that that's what's very unique about the veterinary behavior center is you guys have the skills and the nuance to work with medications, to help them work for dogs that are really struggling. Yeah,
Stacy 1:01:36
as a general practitioner, I would often have placed a pet on, like, as if we were doing a daily medication, and if it wasn't working, I would have either stopped it or just continued it long term. Like I didn't have a lot of other options or ideas because I didn't have that knowledge base at that time in my career. So when I see dogs come in and they've been on as an example Prozac for three years, and it's not helping. And in fact, their appetite is reduced like i There's no judgment for me around that situation. But man, we are here to move the needle a lot faster, because if we hit a side effect, we're changing lanes. If we aren't getting any benefit, we're changing lanes, like we're we're not going to linger in a plan that isn't actually helpful. And the toolbox is huge, like, it's huge of things that we can try. And sometimes it's very, very targeted. There's different chemical benefits, like side benefits for some of our psychiatry medication, and sometimes, will very purposefully match a patient with a certain medication option as a trial, because they have numerous things going on, you know. So yeah, this the nuance of psychiatry and veterinary medicine is, I hope, going to be continued to grow as a skill set for young veterinarians coming up, and I think that that is possible. And also just because something hasn't helped doesn't mean that medication can't be an important part of a treatment plan. And you know, veterinary behaviorist led team are the best places to kind of lean into for those types of conversations.
Chrissy 1:03:22
Yeah, we could talk forever about this.
Stacy 1:03:26
Yeah, we, we can, but I, I'm one of the reasons that I was feeling very appreciative of the opportunity to come on to this was the ability to have this particular conversation. Because I think it is the thing that is maybe the most misunderstood about veterinary behavior is the medication piece and what part it plays. Yeah,
Chrissy 1:03:47
you know, for me, I'm, I'm a pretty holistic, I'm holistic approach, and so I'm all for natural type, working with the natural, I guess, approach. And, you know, doing that kind of thing, and I've done that before, but there are times when that's not enough. You need more. You know, you need to look more at, you know, silent pain, or, you know, GI issues and stuff that you've said. But also, I'm all for a natural approach and that kind of thing and the CBD and stuff. But sometimes you just need, you need something that's going to be much more stronger, I guess, you know, and effective. Of
Stacy 1:04:28
course, the patient population that we take care of is typically significantly impacted, you know. So a lot of people have come to us after trying a lot of different strategies, including supplements or CBD, and they're still struggling. You know, we always think about like, is there a nutritional or a dietary component that could be a helpful part of the plan? And we do use supplements in our practice that have you know academic information behind. Them, but almost always, our patients, like just a supplement isn't really going to be the thing that does a lot of the heavy lifting. We usually are layering those things in on top of a psychiatry medication plan for most of our kiddos, and then as we taper psychiatry medications off after patients have been behaviorally stable, if that's appropriate, then sometimes supplements can be a really nice, you know, tool for that process. You know, CBD, I've practiced my whole life in Colorado. So, you know, I have a lot of families that have tried it, and I definitely see increasing amounts of valuable information coming in. There's, there's actually a lot of data in the veterinary field about CBD, and some really excellent academics looking into it right now, I'd say we have some information on most of our information, probably on pain and some upcoming information on use for behavior. We don't typically use it as a first line in our practice. We do have families that utilize it. If we're going to have people use any supplement, we are always talking to people about the fact that that whole the arena of supplements is just not regulated, and so products may have in there what they say they do, or they may have other things in there that are undesired, that they don't know about. So if people are going to use supplements, we want to be recommending particular products at particular doses with particular instructions. So there's still prescribed medications, even if they're, you know, not actually prescription. So whole topic in and of itself,
Chrissy 1:06:48
another one. But I just wanted to bring that up. The approach is very multifaceted, and it's not, it's not just, let's throw medication at this dog, you know? I mean,
Stacy 1:06:57
when you think about, you use the world word holistic, and I don't know, I mean, I think that has many different, yeah, meanings to people, but when I think about the word holistic for our practice, it makes sense to me that we we utilize all sorts of different strategies to create functional change and relief for people, and so a holistic approach is looking at the environment and the family system and the internal conditions of that patient, like their medical needs, and the external conditions with interactions and the way that the environment we talked about that. But then also, I don't necessarily think that medication is not holistic. There's helping animals feel better in their own skin, even if it is a molecule that is derived by a process that makes medication like it still can make them feel better. It still could have a positive impact, and I'm not saying that we don't think about that it could have a negative impact. We're always talking to people about the possible side effects and what to do if we see something we don't like, but those are really more rare.
Chrissy 1:08:12
Yeah, yeah. So is there anything that's weighing on your mind, or any negative wisdom that you would like to share with our audience?
Stacy 1:08:20
I think I would like to kind of sign off with the message that veterinary behaviorist led teams are here to help at any point, but we're certainly a lot more effective when people reach out early, just even meeting the team and having a conversation. Can I think a lot of time alleviate a lot of this, the worry and questions that people have about a lot of the things that we've talked about, but their own pets, individual needs and their own pets, individual kind of treatment plan, we try really hard to help people feel empowered very early in the plan. And so my hope would be that if people just got into the office and met folks that do what we do, that a lot of their questions could actually be answered. And I just want to also just say thank you to you for this opportunity, and I have so enjoyed the training community that I have got a chance to work with through the veterinary behavior center. I love our Nerd herds on Friday where where trainers from all over the area come and we we gather to talk about papers and concepts and patience, and it's just such a collaborative experience, working with highly skilled trainers like you and highly skilled veterinarians that are, you know, on the front lines in general practice every day, doing really difficult stuff, and then specialty teams, you know. So I, I feel, I just feel so great, grateful. Yeah, and. So I guess if people have an interest in if they're in Colorado and want to check our center out, we have a website, the veterinary behavior center.com our team is able to field questions, and we have some really cool stuff coming down the pipeline with some different courses. And so yeah, super excited to meet your listeners. Yay.
Stacy 1:10:23
Thank you so much for being
Chrissy 1:10:26
on and yeah, I just want to say thank you, because I know you're so busy and your schedules just you know you guys are super busy all the time. So thank you for taking the time to educate and talk about things, the hard things, and just being transparent about so much stuff, and I really appreciate collaborating with you and everybody else at the veterinary behavior center and and just talking about nerdy stuff.
Stacy 1:10:53
Well, yeah, I think if the community keeps it up like we can really start to help people with important information that is valuable in their their own situations, right? Keep doing what you're doing. Chrissy and I'll catch you at Nerd Herd.
Stacy 1:11:10
All right, thanks. Stacy, alrighty, bye. Thank
Chrissy 1:11:13
you for joining us today. I hope you discovered a valuable nugget you can implement right away with your dog. If you enjoyed the episode, please follow rate and share with fellow dog lovers who might benefit. Don't forget to take our How well do you know your dog quiz? You'll find the link in the show notes until next week. Happy tales you.
