Early training is key for the socialisation of puppies and kittens. This article looks at recent research on puppy and kitten socialisation, neutering and training methods, as well as how clinics and owners can improve the pet's experience of clinic visits.
Puppy socialisation
The peak socialisation period for puppies is between 6 and 12 weeks of age. This is the key period where new sounds, smells, sights and experiences all combine to inform the young dog what is to be deemed ‘safe’ as they grow up (Cazeaux, 2021; Landsberg et al, 2023). While research needs to be continued, although some behavioural traits have genetic roots (Puurunen et al, 2020), these inherited traits are affected by a puppy's early experiences.
Excellent breeders will discuss this with owners, and will ensure that from birth the litter has been gently and carefully exposed to other pets, well-behaved children, noises, such as the doorbell and washing machine, as well as a variety of people and environments such as grass, carpets and shiny surfaces, in a positive manner (Williams, 2023). These positive experiences must continue when the puppy has the stressful task of fitting into their new home, hopefully before they reach the end of their socialisation period at 12 weeks, to allow this safe exposure to novel stimuli to continue.
Habituation is the decreasing reaction to a stimuli until it becomes deemed neutral. Habituation to novel stimuli at this age does not just confirm to dogs that the specific noise heard is ‘safe’, but gives an increased tolerance of novel stimuli throughout a dog's life (Hargrave, 2020). Continuing these exercises leads to puppies who startle less easily, are bolder and more inquisitive and have more persistent problem-solving skills (Stolzlechner et al, 2022), whereas a lack of these normal behaviours, as seen in laboratory dogs, may cause increased fearfulness, attention and attachment behaviours, as well as unusual behaviours (Lopresti-Goodman and Bensmiller, 2022). If unaddressed, this could contribute to inappropriate behaviours expressed throughout the dog's life. Unfortunately, inappropriate behaviours are the most common reason for dog relinquishment or euthanasia (Puurunen et al, 2020).
Socialisation at an early age, breed and size all impact the likelihood of a dog exhibiting fear directed at another dog, as do training classes, levels of exercise and if the dog has lived in an urban environment. In one study by Puurunen et al (2020) it was unclear if the dogs deemed well-socialised as puppies overlapped with those receiving more training and exercise as adult dogs. Fear directed at strangers was more multifactorial, but included family unit size and weaning age, as well as socialisation, breed, training classes, level of exercise and urban living (Puurunen et al, 2020). This shows how much more robust research is needed on the influencing factors on behaviour to help reduce the incidence of unwanted and inappropriate behaviours exhibited by dogs, and the importance of early client education.
Sensible boundaries and a reliable routine of safety help to make a dog feel more comfortable and secure (Stagg, 2022). This predictability, alongside some level of control over their environment, such as a way to escape noxious stimuli, leads to a calmer puppy with lower stress levels, which supports training receptiveness and inquisitive behaviours normal and natural for a dog (Williams, 2023).
Adolescence and neutering in puppies and dogs
To confuse matters, during adolescence, between 7–14 months of age, when many owners will be considering neutering to prevent unwanted pregnancies, or to tackle unwanted behaviours, puppies experience a secondary ‘fear’ period (Landsberg et al, 2023). During this time, a surge of hormones can cause a tendency towards independence, impulsivity, emotional and frustrated behaviours, but also create a period where they are sensitive to negative situations and anxieties where the dog was once confident, or at least inquisitive (White, 2023).
There is no evidence that neutering will positively impact an anxious dog, if anything, oestrogen and testosterone can both increase social confidence, so their removal may increase anxiety (Puurunen et al, 2020; White, 2023). There is also the question that if neutering is performed during the fearful adolescent period, and the situation is not handled in a positive manner, this negative experience may exacerbate the loss of the hormones by creating a sensitivity to a previously neutral or positive stimuli, which was not present before the surgery, such as the clinic, car journey or staff (White, 2023). Breed-specific neutering data from Hart et al (2020) helps advise when is appropriate, according to known risk factors such as urinary incontinence, cancers and joint disorders, on when to neuter according to breed and gender. Some breeds have recommendations from this data to neuter from 6, 12 or 24 months (Hart et al, 2020), while other breeds are recommended to leave entire unless neutering is for another medical reason, although this study does not consider cancer or joint disorders beyond 5.5 years of age, testicular or prostate cancers. There has additionally been a consideration for the potentially longer lifespan of neutered dogs, and the overestimation of the incidence of mammary tumours associated with entire females (Hart and Hart, 2021).
This data is of course to be considered along with the specific situational fear or behaviours of the dog seen in the clinic, who may benefit from a behavioural consult before considering the surgery (White, 2023).
Training methods in puppies and dogs
Training should be entirely fear-free or reward-based (Emmerson, 2023), and discussions about training methods should be open and engaging to avoid clients unknowingly following poor advice and outdated methods; unfortunately 20% of owners still report the use of aversive training methods (Oxley et al, 2022). Ideally, the clinic should know who to advise referral to, for routine puppy or training classes, or for further stimulation classes such as flyball or agility, as well as behavioural concerns.
It is vital that normal handling exercises are completed from a young age. This includes grooming, nail trimming, tooth brushing, lifting onto tables and basic commands such as sit, stay and lie down. This helps these activities to induce less anxiety and be non-novel when required as an adult dog (Hargrave, 2020; Stolzlechner et al, 2022).
Behavioural extinction is a common phenomenon when behaviour reinforcement is no longer provided, so the animal fails to perform the behaviour requested (Emmerson, 2023). For this reason, rewards given during training should be given consistently, every time the task is performed, until the behaviour is reliable in a variety of environments, then on a variable ratio schedule (Emmerson, 2023). This ensures the dog is never sure if or when a reward will be received, so has adequate motivation to perform the task.
Sensitisation is the increased reaction to a stimuli which may have been previously neutral. A sensitisation period can occur as the reverse of habituation. This may occur when for a long period of time the dog has been suddenly away from vehicular traffic, for example, during the COVID-19 pandemic, when reduced outdoor noises may have allowed the loss of well-established competencies in robust and confident pets (Hargrave, 2021). This may result in an increase of the novel nature of stimuli the pet was once confident around, and may require reward-based and fear-free habituation, as was completed as a puppy.
Valence and arousal are both driving forces for an animal's ability to perform behaviours and training exercises. Valence is how pleasant or unpleasant the situation or stimuli is to the pet (White, 2023). A poor valence stimuli may exhibit such avoidance responses that the pet is unable to listen to the owner, and may escalate behaviours up the aggression ladder (Figure 1), while a very high valence stimuli encourages an animal to approach or interact (White, 2023). Arousal is the level of energy or enthusiasm the animal has (White, 2023). An animal with excessively high arousal will be unable to concentrate or focus on the task at hand, and would likely benefit from some calm time, or a reduction in stimuli before an acceptable outcome can be reached (Emmerson, 2023). An animal with excessively low arousal would be too disinterested or lethargic to complete a task, and may need some assistance and motivation to show willingness (White, 2023).
The ladder of aggression is a term to describe the increasing stages of fear and anxiety behaviours displayed if a dog feels their reaction to the stimuli is not gaining them the control or escape from the situation. It starts with dog appeasement and anxiety behaviours such as lip licking, whale eye, crouching, low posture and ears back, and these may all be missed quite easily, and can lead to the dog escalating the ladder of aggression (Williams, 2023). An animal who is a passive coper of stress may be frozen in fear, rather than outwardly aggressive; they may be easier to handle, but this will ultimately still lead to an escalation of aggression, and a worsening of fear response in the future (White, 2023).
Fear stacking is where multiple stimuli, which would usually elicit a small, possibly negligible negative response, may be compounded to elicit an amplified response, or an excessive level of arousal. This could be, for example, at a clinic visit if the dog experiences strangers, a change in routine, a disliked mode of transport, a clinic environment with possibly previous negative experiences, loud noises of other dogs and unfamiliar smells of both other dogs and cleaning chemicals, while being in pain, which may lead to the dog being unusually anxious or reactive (White, 2023).
Medical behaviour changes cannot be underrepresented. In any case where behaviour is seen to be inappropriate or having changed recently, consideration should always be made to giving a full health screening before embarking on behavioural consultation (White, 2023), especially those which have no external trigger. These cases should always be considered a health-related condition until veterinary advice has been sought (White, 2023). Pain specifically has been indicated as the underlying cause in up to 80% of behavioural referrals (Mills et al, 2020). Anxiety regarding resources, sudden movement, handling, other dogs, scavenging, licking surfaces excessively, fly biting, prayer position, destructive behaviours, stone eating and self mutilation can indicate systemic conditions, such as endocrine disease, or local conditions, such as muscular or skeletal problems, dental, ear or gastrointestinal pain, neurological dysfunction, abdominal pain or skin disease (Hargrave, 2019a).
Dogs at the clinic
To encourage a healthy and happy visit to the clinic, there are lots that both owners and the clinic themselves can do. Ideally the dog should be transported to the clinic in a way that reduces stress (Goddard, 2023). If they are high energy, the owner should consider walking them, or if they relax in the car then driving might be best. If they are fearful of buses then avoiding public transport would be beneficial; although understandably using the least stressful mode of transport may not always be possible (Stagg, 2022).
Dogs should be on appropriately secure leads, with harnesses or muzzles if required, which may entail muzzle training for safety, calming products such as pheromone, aromatherapy or milk derivative products. These should ideally be used in the days before a routine visit, depending on the medication or nutraceutical (Goddard, 2023). If possible, owners should be encouraged to have visits to the clinic where no treatment is performed, for habitualisation with the environment or simple tasks such as weighing on the scales. Ideally this should be done from a young age in a reward-based manner (Riemer et al, 2021; Stagg, 2022), and may help dogs become familiar with specific staff members and the clinic environment.
Clients should avoid being excessively early and causing fear stacking by providing too much stimuli prior to their appointment. Dogs should generally be discouraged from mixing in the clinic; obviously some pets may be unwell, but additionally some may be in pain and prone to unusual or unpredictable behaviours, or anxious and prone to quickly escalating the ladder of aggression if they feel a lack of control (Stagg, 2022; Goddard, 2023). Noise levels in the reception area should be kept relatively low to avoid excessive arousal or negative valence, and owners should be encouraged to be mindful of their own behaviour, and that of any children they bring with them, to ensure they are not compounding the anxiety of the dog through their frustrated tone, tense body language and stress levels (Goddard, 2023).
Handling and examination should be done gently and without force where possible to reduce further fear stacking and the hyperalgesia associated with high anxiety levels (Warnes, 2022). Owner behaviour should not be underrepresented in the clinic, as owner presence during the consultation has the potential to reassure and give confidence to an anxious dog, although further study is required to consider the negative effects of anxious behaviours of owners in these scenarios (Stellato et al, 2020).
Stellato et al (2021) found both fearful and aggressive behaviours in dogs in the veterinary clinic were more likely to occur when previously fearful or aggressive behaviour had been seen in other situations and, as a result of previous early experiences, stressful veterinary visits and owners’ prior experiences. This is supported by another study which discussed potential demographic-related causation of fear in veterinary clinics and found this to be insignificant, whereas the environment, and human–animal interactions, were the significant influencing factor (Edwards et al, 2019). When considering the methods used to combat an existing fear or anxiety-inducing environment, counter conditioning, relaxation training and anxiolytic medications were found to be the most effective, as opposed to the use of nutraceuticals, environment change and an increase in pet–owner interactions (Riemer, 2020).
Anxiolytics in dogs
Medical anxiolytics can be considered in cases where fear is severe or aggression is likely. One review (Erickson et al, 2021) of dexmedetomidine, alprazolam and trazodone found dexmedetomidine oral transmucosal has a similar effect to that of injectable, and at sub-sedatory doses exhibited fewer fearful indicators. Alprazolam reduces anxiety when combined with clomipramine during phobic events, which is sustained and transferred to future similar phobic events. Unfortunately, alprazolam can also cause sedation, disinhibition and paradoxical excitement. Trazodone is effective at calming dogs in novel or provocative situations, as well as during hospitalisation, although when used double-blind the anxiolytic effect was indistinguishable from the sedation, therefore this drug is used as extra label rather than as first line. Gabapentin has no therapeutic dose in dogs as an anxiolytic, and this subject requires robust study (Erickson et al, 2021).
Kitten socialisation
Kittens similarly have a peak socialisation period at 6–12 weeks of age, and need to experience the same range of sounds, smells, sights and experiences as puppies to become well-rounded and confident pets (Cazeaux, 2021; Emmerson, 2023) (Figure 2). Depending on the nature of the kitten, and its household, if this period is neglected, a kitten may grow to be fearful of contact, for example, if too much rough-housing is allowed from small children. This can lead to aggression and a cat who behaves excessively solitarily in nature, or resents contact. Conversely, being raised away from other kittens or cats, in the case of orphaned or hand reared kittens, can lead to adult cats who display behaviours or traits not typically cat-like, or who particularly struggle with cat–cat interactions (Cazeaux, 2021).
Adolescence and neutering in cats
A cat's ‘fear’ period extends from this socialisation period right through their lives, meaning that any and all interactions have the ability to suddenly create a fearful or anxious situation, when before the cat would tolerate the situation quite happily (Cazeaux, 2021; Emmerson, 2023). This can particularly be the case if a cat becomes unwell, and requires hospitalisation. If the clinic does not have separate dog and cat wards, or the cat is handled roughly, for example, the owner may find that it can be particularly reluctant with vet visits, car journeys, the carrier, or even restraint in the future (Landsberg et al, 2023).
Studies considering owner perspectives of neutering have found the majority of the public is supportive of routine neutering in order to prevent unwanted offspring and reproductive diseases: this is more evident when considering cat owners (Wongsaengchan and McKeegan, 2019) and additionally this has been shown to reduce cat–cat conflict (Amat and Manteca, 2019). There is limited research on the effect of cat–human conflict and behavioural disorders in cats related to neutering, although feline lower urinary tract disease is more prevalent in neutered males (International Cat Care, 2018).
Training methods in cats
The majority of cats’ instinctive behaviours are indicative of their largely solitary and predatory nature (Amat and Manteca, 2019). For this reason, many multi-cat households, or homes with young children, may find some behaviours challenging, although they usually have either a natural or stress-related motivation (Williams, 2023). This includes scratching furniture or carpets, waking owners for food, attacking quick movements and bringing home wildlife, which all relate to the cat's protection of resources, home environment and provision of food (Amat and Manteca, 2019; Hargrave, 2019b).
Gentle encouragement to play can be provided through enrichment, chase and puzzle feeding, and predatory games involving fluffy toys with rewards through high value food items (Cazeaux, 2021). Laser pointers and using hands to tease or play should be avoided as they create predatory behaviour without reward, leading to frustration (Amat and Manteca, 2019). As cats are naturally territorial, ensuring that there are enough food bowls, water access, litter trays, scratching posts and hiding places to reduce the time they spend in compulsory space-sharing activities can reduce stress in multi-cat households (Emmerson, 2023).
Normal handling exercises, such as those encouraged in puppies should also be completed with kittens. These include grooming, nail trimming and lifting onto tables. Although not commonly done, basic commands such as sit, stay and lie down can be taught to cats just the same as with puppies (Williams, 2023), which can be reinforced successfully with clicker training (Grant and Warrior, 2019; Emmerson, 2023). However, if the cat is stressed, these are less likely to be remembered or complied with in a clinical setting as a result of fear stacking (Emmerson, 2023).
Flat ears, tight whiskers, slow tail flick and eyes large with dilated pupils can all be misunderstood behavioural signals that a cat is feeling overwhelmed or uncomfortable in a situation, and lead to escalation of the ladder of aggression, ultimately leading to hissing, clawing or biting (Goddard, 2023; Williams, 2023). Again, as with dogs, some cats may be passive copers of stress, who choose to freeze or hide rather than actively protect themselves. These cats may be easier to handle in this state but will still be experiencing extreme stress and should be handled using fear-free and cat-friendly methods (White, 2023). Inappropriate behaviours from cats, usually caused by stress, redirected aggression or misdirected predatory behaviour, is a major driver to reduction of the animal–owner bond. Similar to when the human–animal bond breaks down in dogs, these behaviours can often lead to relinquishment or euthanasia (Amat and Manteca, 2019). Redirected aggression can be difficult to identify, but in many cases may have a health-related source, and for this reason any changes in behaviour, such as an increase in aggression or reduced tolerance of previously neutral stimuli, should have a veterinary assessment (Amat and Manteca, 2019).
Cats at the clinic
To prepare cats for a clinic visit there are lots of things both the owner and the clinic can do to reduce the stress of the situation. Carrier training at home can teach the cat the carrier is a safe place, and avoid aversion behaviours when they see the carrier (Goddard, 2023). Using an appropriate carrier with ventilation and both top and side openings is ideal, as well as having the ability to lightly cover this carrier, to reduce stimuli and allow the cat to hide. Using calming products such as pheromones and milk derivative products before the visit, ideally starting several days before, can be helpful. Ensuring, where possible, cats are booked at quieter times to avoid excessive road traffic, wait times and busy reception areas, will reduce the time the cat has to spend in the unusual environment.
Having a cat-specific waiting area is the gold standard for being feline-friendly, this should be away from dogs and with an elevated cat carrier stand for owners to use. Additionally, having cat-only wards ensures hospitalised cats have reduced stress and appropriate facilities where they cannot see other cats who may be present (Goddard, 2023). Very anxious pets may benefit from anxiolytic medications prescribed by the veterinary surgeon (see below). Bringing the cat in regularly for non-treatment visits, such as weight checks and for cuddles will help the cat associate the clinic positively, although it will depend on the time constraints of the clinic. Feline-friendly techniques should be used during handling of the cat (Riemer et al, 2021; Goddard, 2023), and owners should be discouraged from dragging or tipping the cat out of his/her box. Often, allowing the cat to stay still, and lifting the lid off the box is much less stressful (Goddard, 2023).
Anxiolytics in cats
Some cats benefit from anxiolytics, either for use during stressful periods or long term. Use of gabapentin has been correlated with lower stress indicators in cats. Sedation and anxiety relief were not differentiated in cats using trazodone, although stress indicators were deemed lower than controls, the recovery from the sedation effect may be considerable (Erickson et al, 2021). As benzodiazepines cause behavioural disinhibition, they should be avoided as they increase the likelihood of an aggressive reaction, and also they interfere with the learning process. Use of nutraceuticals or pheromones may be beneficial; however, robust peer reviewed studies are lacking (Amat and Manteca, 2019). Alprazolam can be used on an asneeded basis, while medications such as azapirone and clomipramine take 4 weeks to exhibit their full effects. Selective serotonin reuptake inhibitors should be avoided if serotonergic medications are given. GABA-A agonists can be also used, but take time to have an effect (Denenberg and Dubé, 2018).
Conclusions
While research and knowledge on behaviour modification techniques and neutering have advanced, it is important to keep clinical recommendations up to date according to these data, in order to truly practice evidence-based medicine. Involving the behavioural and physical health of the patient in consultations and diagnosis can ensure that symptoms are not misrepresented. Managing client expectation and understanding of their pet's needs and normal behaviours from the earliest contact is key to enabling a healthy and trusting bond with the clinic where animal welfare is prioritised. This includes challenging behavioural cases requiring referral and medical anxiolytic management if appropriate. Behavioural science is an area where registered veterinary nurses can specialise, and allows an area of empowerment and delegation within the team, with cohesive relationships between clients, veterinary professionals and para-professionals.
KEY POINTS
- Positive reinforcement training should be encouraged in all behaviour cases, with negative or punishment-based methods discouraged.
- Key socialisation periods for puppies and kittens should be the ideal time for habitualisation to novel stimuli, but the impact of fear periods on training and behaviou should also be considered.
- Neutering young animals should be considered from a whole-patient approach, with appreciation for the benefit and cost to both physical health and behavioural consequences.
- Anxiolytics come in many formats and can be useful for animals receiving training or behavioural modification, going through stressful circumstances, or during clinic visits and hospitalisation periods.