Dear Georgina,
I enjoyed the recent article about desensitisation and counter-conditioning in the October issue of The Veterinary Nurse (6(7): 402–9), but some of my colleagues who work as behaviourists were a little surprised by the inference that the RVCS only viewed those accredited by the Association for the Study of Animal Behaviour (ASAB) as Certified Clinical Animal Behaviourists (CCAB) as currently accepted to deal with behaviour problems.
It was the impression of my colleagues that veterinary surgeons are free to refer to behaviourists of their choice and are not limited or restricted to those with particular qualifications or training. But, as professionals, it would be important for vets to be satisfied that the individual is competent and has adequate and appropriate qualifications to carry out this work. Therefore could you please clarify the intended meaning of your article in regard to who veterinary surgeons should refer clients to when their pets display behaviour problems.
Kind regards
Graham Thompson MSc CCAB
In response,
Dear Graham,
Thank you for contacting The Veterinary Nurse and giving me the opportunity to respond to your query. You will have noted that the article is written in a veterinary nursing journal to advise veterinary nurses regarding the potential complexity of the underlying conditions motivating behaviours, the modification of which may involve desensitisation and counter-conditioning. The article specifically neglects to become involved with advice regarding to whom a practice should refer behaviour cases (although it mentions the ASAB list of accredited clinical animal behaviourists, APBC members and the ABTC register in ‘Further Advice’).
Sadly, as had occurred with the veterinary nursing profession, the ‘behaviour’ profession has been unregulated. Although BSAVA and other organisations are working closely with the ABTC, who have developed a register of practitioners fulfilling mutually acceptable requirements, veterinary surgeons remain free to refer behaviour cases to whoever they wish. There are, of course, insurance and liability issues to consider in association with following professional guidelines to refer to a ‘suitable’ professional, but otherwise the selection is left to the veterinary surgeon's individual preference. As this historical problem had no relevance to the nature of the article, I did not mention it.
The reference to behaviour clinicians in the early part of the article was with relevance to reminding nurses of their particularly delicate position regarding the Veterinary Surgeon's Act. Although the RCVS does not give specific guidance to their members regarding behaviour referrals, it does recognise both diplomates of the European College of Animal Welfare and Behavioural Medicine and ASAB accredited veterinary surgeons as specialists in behaviour, allowing them to use the associated post nominals between that of their first degree and their membership. By extension of this argument, it is my opinion that there must also be recognition of the competencies of other ASAB CCABs, who are assessed on exactly the same criteria as the veterinary surgeons. The relevant criteria can be found both on the ASAB website and that of the ABTC. However, as these are the minimum accredited criteria accepted as required of veterinary surgeons specialising in the detection and treatment of companion animals requiring desensitisation and counterconditioning regimens, veterinary nurses should be aiming to attain a similar level of competency if they also wish to become involved in such work.
I hope that the above goes some way towards explaining the point that was touched upon, but not further developed, within the article. As mentioned, I did not even embark upon a discussion regarding the qualifications of the behaviourists to whom the veterinary team should refer as this is a matter for the individual veterinary practitioner and had no relevance to the points that I was attempting to make to the nursing readership.
Yours sincerely,
Claire Hargrave MSc BSc(Hons) CSci CChem MRSC CCAB
I read the very useful article on Lyme Disease in The Veternary Nurse (6(7): 380–7) and felt that perhaps the disease risks were under estimated with the poster reading that there is no risks to humans of transmission from dogs. Lyme disease is a serious life threatening zoonosis and the possibility of transmission via the ticks on a dog to humans is regarded as low but I would have thought higher than zero.
Many thanks
Richard Armour BVMS MRCVS
In response,
Dear Richard,
There has to date not been a single confirmed case of transmission from dogs to people and indeed, numerous studies have looked for a correlation between dog ownership and incidence of human disease, as well as dog ownership as a risk factor for Lyme disease in people and found none (Eng et al., 1988; Cimmino and Fumarola, 1989; Goosens et al., 2001). This is despite infection in people increasing year on year. This is because dogs pose no direct transmission risk, most of the ticks on dogs will be attached at any given time and only 2.3% of ticks on dogs have been found to be infected. Many risk factors have been demonstrated for Lyme disease in people such as wild mushroom picking, outdoor recreational sports, walking in rural areas etc but not dog ownership and so at the moment it can be concluded that pets represent a risk of transmission to people which is close to, or actually zero. Either way, the vital take home message is that people who walk with their pets in rural areas, should check themselves and their dogs daily and carefully remove any ticks found. This will greatly reduce the risks of disease transmission.
Ian Wright BVMS BSc MSc MRCVS