Nicole Cottam a, Nicholas H. Dodman a, Alice A. Moon-Fanelli a & Gary J. Patronek b a Department of Clinical Science, Tufts Cummings

This article was downloaded by: [Dr Kenneth Shapiro] On: 09 June 2015, At: 07:26 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Journal of Applied Animal Welfare Science Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/haaw20 Comparison of Remote Versus In-Person Behavioral Consultation for Treatment of Canine Separation Anxiety Nicole Cottam a, Nicholas H. Dodman a, Alice A. Moon-Fanelli a & Gary J. Patronek b a Department of Clinical Science, Tufts Cummings School of Veterinary Medicine b Animal Rescue League of Boston, Boston, Massachusetts Published online: 25 Jan 2008. To cite this article: Nicole Cottam, Nicholas H. Dodman, Alice A. Moon-Fanelli & Gary J. Patronek (2008) Comparison of Remote Versus In-Person Behavioral Consultation for Treatment of Canine Separation Anxiety, Journal of Applied Animal Welfare Science, 11:1, 28-41, DOI: 10.1080/10888700701729148 To link to this article: http://dx.doi.org/10.1080/10888700701729148 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content ) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with

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JOURNAL OF APPLIED ANIMAL WELFARE SCIENCE, 11:28 41, 2008 Copyright Taylor & Francis Group, LLC ISSN: 1088-8705 print/1532-7604 online DOI: 10.1080/10888700701729148 Comparison of Remote Versus In-Person Behavioral Consultation for Treatment of Canine Separation Anxiety Nicole Cottam, Nicholas H. Dodman, and Alice A. Moon-Fanelli Department of Clinical Science Tufts Cummings School of Veterinary Medicine Gary J. Patronek Animal Rescue League of Boston Boston, Massachusetts To investigate the validity of remote consultation for treatment of canine separation anxiety, this study compared the efficacy of 2 types of behavioral services offered by Tufts Cummings School of Veterinary Medicine (TCSVM): (a) PetFax, a remote consultation service in which dog caregivers (owners) and a certified applied animal behaviorist correspond via fax or email and (b) in-person clinic consultation, which requires that owners bring their dogs to the Animal Behavior Clinic at TCSVM to consult with a board-certified veterinary behaviorist, a veterinary behavior resident, or a certified applied animal behaviorist. The study tested 4 variables for significant differences between PetFax users and clinic visitors: (a) pre- and posttreatment anxiety scores; (b) owner-reported improvement; (c) percentage of rehomed dogs, dogs relinquished or euthanized because of separation anxiety; and (d) clarity of communication with owners. The study found no significant differences between the groups. Difference scores and owner reports demonstrated substantial reduction in separation anxiety in both groups. Results indicate remote consultation is a valid way for behavioral professionals to share behavior modification advice with owners regarding canine separation anxiety. Correspondence should be sent to Nicole Cottam, Tufts Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536. Email: nicole.cottam@tufts.edu

CANINE SEPARATION ANXIETY 29 The number of healthy companion animals relinquished and euthanized in U.S. shelters is believed to be in the millions (Kass, New, Scarlett, & Salman, 2001) and could account for a third of all canine deaths (Patronek, Glickman, Beck, McCabe, & Ecker, 1996). The Regional Shelter Relinquishment Study found that behavioral problems were the most frequently given reasons for canine relinquishment (Salman et al., 1998). Salman et al. (2000) found that at least one behavioral reason was given for the relinquishment of 40% of the dogs in this study. Some caregivers (owners) of companion animals (pets) with behavior problems ask their veterinarians to euthanize their animals. Patronek and Dodman (1999) estimate U.S. veterinarians euthanize 224,000 pets each year for behavioral reasons. Thus, an extraordinary number of companion animals die each year as a result of behavior problems. Successful treatment of companion animal behavior problems might help decrease the number of pets who are relinquished and euthanized. However, veterinarians report they feel unsure about their ability to diagnose and treat such problems (Patronek & Dodman, 1999). This is not surprising because few U.S. veterinary schools offered courses in animal behavior before the 1990s. Stricklin (1983) surveyed deans of 29 North American veterinary schools and found that only 6 of 15 respondents had a mandatory, nonhuman animal behavior course as part of their curriculum. In 1993, the American Veterinary Medical Association demonstrated the importance of the veterinarian s role in addressing companion animal behavior problems by granting veterinary behavioral medicine specialty privilege. In 1991, the Animal Behavior Society began offering certification for veterinary and nonveterinary professionals interested in applying learning theory and ethological principles to resolve companion animal behavior problems. Among other rigorous academic and experiential requirements, recipients must have a doctorate or master s degree in the field of animal behavior to receive this certification. The issue of who is qualified to address animal behavior problems is controversial. Some feel that only those with medical degrees are qualified to diagnose behavior problems and suggest treatment options (Overall, 2006), making veterinarians the only professionals qualified to address companion animal behavior problems. Proponents of this view report that the proper role of nonveterinary behaviorists is to assist owners in implementing learning theory-associated treatment suggestions such as desensitization prescribed by the veterinarian. Opponents of this view point out that many veterinarians because of the lack of education about companion animal behavior problems as part of their veterinary education are not prepared to diagnose animal behavior problems and propose treatments. However, many will agree that a limited number of academically qualified experts are currently in the emerging field of applied companion animal behavior therapy. As a consequence, owners of pets with behavioral problems often do not

30 COTTAM, DODMAN, MOON-FANELLI, PATRONEK have direct access to professional behavior-specialty services. Telecommunications across the miles to address training and behavioral issues could help resolve the lack-of-access problem especially for those people living in rural, confined, underserved, or isolated populations. Although telecommunication is coming of age in human psychological research and practice (Leigh et al., 2000), the literature examining the validity of remote consultation in pet behavioral modification therapy is sparse. Hsu and Serpell (2003) looked at the value of in-depth history questionnaires in formulating behavioral diagnoses and found that diagnoses made from such questionnaires were accurate for seven different diagnostic categories. Accuracy was based on validation of the diagnosis by a behaviorist at a follow-up visit in a clinical setting. To our knowledge, only one prior study(dodman, Smith,& Holmes, 2005) directly measured the validity of remote consultation. This study found that fax-based consulting between owner and behaviorist was as effective as an in-clinic behavioral consultation for diagnosing and treating canine owner-directed aggression. The present study was conducted to evaluate whether remote consultation is valid for assessing and treating canine separation anxiety and exploring further the validity of remote behavioral consulting. Separation anxiety was chosen for the following reasons: 1. It is a prevalent problem that accounts for 5% to 40% of cases presented to behaviorists (Horwitz., 2000; Voith & Borchelt, 1996); 2. Veterinary literature has described it well as a discrete entity; 3. It is a serious ongoing welfare concern for affected dogs; and 4. It may lead to the breakdown of the human animal bond, relinquishment, abandonment, or euthanasia of the pet. METHODS Eligible participants consisted of clients with dogs who displayed signs of separation anxiety and utilized one of two behavioral services offered by Tufts Cummings School of Veterinary Medicine (TCSVM) between January 1998 and July 2005: 1. PetFax, a hospital-approved, remote, fax-based consultation service in which clients use an eight-page, in-depth questionnaire to describe their pets behavior problem to a certified applied animal behaviorist (see http://www.tufts.edu/vet/vet_common/pdf/petfax/request1.pdf) and 2. In-clinic consultation at the Animal Behavior Clinic (ABC) at TCSVM by an applied animal behaviorist, veterinary behaviorist, or a veterinary behavior resident (all Tufts-approved clinicians).

CANINE SEPARATION ANXIETY 31 Before their in-clinic appointment, owners filled in the same eight-page questionnaire that PetFax clients used to describe their dog s behavior and either brought it with them to the ABC or faxed/mailed/emailed it in ahead of time. PetFax Separation anxiety was confirmed from owners responses to specific questionnaire inquiries regarding their dog s behavior in four general situations: 1. While the owner was home with the dog, 2. When the owner was leaving the home, 3. When the owner was away (evidence of vocalization, destructive behavior, inappropriate elimination, inappetence), and 4. When the owner returned home. Within a few days, PetFax clients were sent a personalized, written report confirming the likelihood that separation anxiety accounted for their dog s behavior and, with suitable medical caveats and provisos, advising them how to modify and manage their dog s anxious behavior by the following: 1. Avoidance of the cycle of anxiety that occurs during the owner s departure and arrival, 2. Independence training at times when the owner is home, 3. Short-term planned departures, 4. Employment in the form of environmental enrichment while the owner is away, and 5. An increase in daily aerobic exercise. Handouts on separation anxiety its presentation and current treatments were also faxed to owners. Clients were made aware of adjunctive pharmacological treatments used by Tufts veterinary behavior staff to treat separation anxiety and advised to contact their local veterinarian to discuss the pharmacological and behavioral suggestions provided in the written PetFax consultation response. Follow-up phone calls between the client s local veterinarian and Tufts veterinary behaviorist to discuss medical concerns and pharmacological strategies are included as part of the PetFax service. Also included are follow-up phone calls between the owner and the certified applied animal behaviorist to discuss implementation of behavior modification techniques. The frequency of follow-up calls involving participants in this study was not tallied.

32 COTTAM, DODMAN, MOON-FANELLI, PATRONEK In-Clinic Consultation Clients who attended clinic consultations brought their dogs to the ABC at TCSVM for a 1.5- to 2-hr meeting with a Tufts-approved behavioral consultant who was a board certified veterinary behaviorist, a veterinary behavior resident, or a certified applied animal behaviorist. Clinic clients received personalized management and behavior modification recommendations to help address their dog s separation anxiety. As with the PetFax service, these recommendations included (a) avoidance of the cycle of anxiety that occurs during the owner s departure and arrival, (b) independence training at times when the owner is home, (c) short-term planned departures, (d) employment in the form of environmental enrichment while the owner is away, and (e) an increase in daily aerobic exercise. The veterinary behaviorist or veterinary behavior resident was available to address any medical or pharmacological needs for cases seen by the certified applied animal behaviorist. For instance, if a dog had any known or suspected medical problem that might be contributing to the anxiety, medical examination and relevant laboratory tests were performed by the veterinary behaviorist or veterinary behavior resident. If medication was deemed necessary or was requested by an owner, it was prescribed by the veterinary behaviorist or veterinary behavior resident. Data Collection Method: Before and After Scores Before scores used to quantify separation anxiety were obtained by generating a score from a checklist used to indicate the presence and severity of behaviors associated with separation anxiety at the time of the initial PetFax or in-clinic consultation (Table 1). Owners rated the severity of their dog s anxiety as mild, moderate, or severe in 13 situations. Many owners indicated that their dog s anxiety was mild to moderate or moderate to severe by placing a check on the column dividers. Thus the degree of a dog s anxious reaction in each of the 13 different situations was given a value as follows: No = 0, Mild = 1, Mild to Moderate = 1.5, Moderate = 2, Moderate to Severe = 2.5, and Severe = 3. The highest score possible for a dog is 39, which would be the result if the dog s behavior was described as severe in all 13 situations. If an owner failed to answer a question, that question was ignored when generating both the before and the after score. An after score was generated from the information received in a postal follow-up survey. Clients were given the opportunity to re-rate the severity of their dog s behavior in the same 13 situations. A difference score was generated by subtracting each dog s after score from the before score. In addition to re-rating the severity of their dog s separation anxiety via Table 1, owners were asked to report on their perception of the consultation process. Seven

CANINE SEPARATION ANXIETY 33 TABLE 1 Diagnostic Checklist Used for Separation Anxiety Behavior No Mild Moderate Severe Does your dog follow you around the house? Does your dog become anxious at the sound of car keys? Does your dog become anxious when you put on your coat or shoes? Does your dog become aggressive when you leave? Does your dog exhibit other problem behaviors as you prepare to leave? Does your dog bark or whine excessively within 30 minutes of your departure? After you leave does your dog s activity decrease? After you leave does your dog appear depressed? After you leave does your dog have a loss of appetite? Only in your absence does your dog destroy property? Only in your absence does your dog urinate or defecate in your home? Does your dog regularly have diarrhea, vomit, or lick excessively in your absence? Does your dog exhibit an excessive greeting on your return (jumping, hyperactivity, barking, more than 2 3 minutes)? multiple-choice questions with response options in the form of a 4- or 5- point Likert scale were posed: 1. Feelings toward the clarity of the questions asked by the behaviorist; 2. Owner-reported comprehension of the etiology of the behavior problem; 3. Clarity of the treatment options supplied; 4. Satisfaction with the amount of written information provided relevant to their dog s behavior problem; 5. Ability to remember advice; 6. Whether, and to what degree, the treatment options were implemented; and 7. The ease of implementing the behaviorist s suggestions. Owners were asked one limited-choice question regarding their perception of any change in their dog s anxious behavior ( > 75% improvement, up to 75% improvement, up to 50% improvement, up to 25% improvement, no improvement, or worse ). Owners were also asked if their dog had been euthanized, rehomed, or relinquished because of the dog s separation

34 COTTAM, DODMAN, MOON-FANELLI, PATRONEK anxiety and whether medication was used as part of their dog s treatment plan. A total of 201 owners were mailed a follow-up survey, a letter explaining the purpose of the study, and a self-addressed stamped envelope. The follow-up survey was pretested for clarity with one nonparticipant client who came to the ABC for an appointment. Appointment time constraints prevented the survey from being tested with more nonparticipant clients. Data Analysis The data were analyzed with SPSS 13.0 statistical software package. Frequency distributions were generated for the before and difference anxiety scores. These data were nonnormally distributed. The null hypothesis, that no differences existed between the two consultations groups in either the average difference score or before score, was tested using the nonparametric Mann Whitney t test for independent samples. The Mann Whitney t-test was also used to detect a difference in the difference scores of medication users and nonusers. Fisher s Exact test (2-sided) was used to test for a relationship between consultation type and the following: 1. Owner-reported percentage change in anxious behavior; 2. Rate of rehoming, relinquishment, or euthanasia due to separation anxiety; 3. Clients attitudes toward their consultation; and 4. Use of medication. Fisher s Exact test (2-sided) was also used to check for a relationship between use of medication and owner-reported percentage change in anxious behavior. Respondents RESULTS Eighteen of the 201 surveys sent were returned to TCSVM as address unknown. Of the 183 remaining surveys (66 PetFax and 117 clinic), 69 were returned. Twenty-eight surveys were returned from the PetFax group and 41 from the clinic group. The total response rate was 38% (42% PetFax and 35% clinic). The average number of months between the time of consultation and the date of response to the survey was 21.6 months (SD +/ 11.3). Sixty-five percent of clinic survey respondents were seen by a board certified veterinary behaviorist, 20% by a veterinary behavior resident, and 15% by the certified applied animal behaviorist.

CANINE SEPARATION ANXIETY 35 Change in Separation Anxiety Score No significant difference was found between the two consultation groups in the before score. The average before separation anxiety score for PetFax dogs was 17.3 (SD +/ 4.6, n = 25) and 16.9 (SD +/ 5.6, n = 37) for dogs brought to the clinic. No significant difference was found between the mean difference score of dogs treated via PetFax and those brought to our clinic. The average difference score for dogs treated via PetFax was 7.1 (SD +/ 6.0, n = 25), whereas the average difference score for dogs brought to the clinic was 6.6 (SD +/ 6.4, n = 37) Note: a positive difference score value reflects improvement in behavior. These changes represent a 41% improvement (7.1/17.3) for PetFax dogs and a 39 % improvement (6.6/16.9) for dogs brought to the clinic. Seven surveys were not used in the difference score analysis (3 PetFax, 4 in-clinic) because the owners either did not complete the posttreatment checklist (n = 5) or provided ambiguous responses to it (n = 2). Owner-Reported Change in Separation Anxiety The majority of clients in both consultation groups reported that their dog s separation anxiety improved. Figure 1 illustrates the number of owners in each consultation group who reported that their dog s separation anxiety got worse, did not improve, or got better by 25, 50, 75, or more than 75%. Twenty-one out of 27 (78%) PetFax clients and 34 out of 37 (92%) in-clinic clients reported that their dog s separation anxiety improved by 25, 50, 75, or more than 75%. No significant difference between owner-perceived behavior change and consultation method was detected. One PetFax owner did not respond to the survey question regarding improvement (the dog was relinquished due to separation anxiety). Three in-clinic owners failed to answer the improvement survey inquiry (dogs were rehomed or euthanized due to separation anxiety) and one owner s response was ambiguous and disregarded. Percentage of Dogs Euthanized, Relinquished, or Rehomed In addition, the relationship between method of consultation and decision about a dog s future relinquished, rehomed, or euthanized was examined. No statistical difference was found between the two groups. One of 27 PetFax dogs (3.7%) was relinquished to a shelter, and 3 of 41 in-clinic dogs (7.3%) were returned to the breeder, rehomed, or euthanized because of separation anxiety.

36 COTTAM, DODMAN, MOON-FANELLI, PATRONEK FIGURE 1 One other PetFax dog was euthanized, but the owner failed to indicate whether the dog was euthanized due to separation anxiety or for some other reason. Communication With Client Consultation type versus owner-reported change in separation anxiety. The following results summarize the outcome of seven survey inquiries made regarding the participants perception of the consultation process. No significant difference was found between consultation type and clarity of questions asked by the behaviorist. All respondents in the PetFax group and most in-clinic respondents (90%) indicated that the questions posed by the behaviorist during the consultation were either mostly clear or entirely clear. Clients were also asked, How well do you understand why your dog has a behavior problem? No difference between the two consultation groups was found. The majority of all clients (86%) responded that they mostly understood or completely understood why their dog had a behavior problem. Specifically, 89% of PetFax clients and 83% of in-clinic visitors mostly understood or completely understood why their dog had a behavior problem.

CANINE SEPARATION ANXIETY 37 The two consultation groups did not differ in the percentage of respondents who reported the instructions were clear or mostly clear. When asked, How clear was the behaviorist s advice?, the majority of owners (91%) in both groups answered mostly clear or entirely clear. No significant difference between the two consultation groups was found with regard to satisfaction with the written materials provided. Seventy-one percent of PetFax users and 60% of in-clinic visitors reported that that they received enough written material to help them understand and address their dog s separation anxiety. No difference between the two groups was found regarding owner ability to remember advice. Most of the clients in both groups (93%) remembered most or all of the suggestions offered by the behaviorist. Specifically, 93% PetFax clients and 90% of in-clinic visitors reported remembering most or all of the suggestions. Clients were asked whether they implemented the treatment suggestions and, if so, how many of the suggestions they implemented. The groups did not differ in the number of suggestions that they implemented. The majority (79%) of the clients in both groups reported having implemented most or all of the suggestions. More specifically, 78% of PetFax clients and 80% of in-clinic clients implemented most or all of the suggestions. One owner in the PetFax group and zero owners in the in-clinic group reported having implemented none of the treatment suggestions. Finally, clients were asked about the ease of implementing the suggestions of the behaviorists. No statistical difference between the two groups was found. Fifty-eight percent of PetFax users and 64% of clinic visitors reported that implementing the suggestions were easy most of the time or very easy. The remaining respondents (42% of PetFax users and 36% of clinic users) reported that implementing the advice was somewhat easy or not at all easy. Use of Medication Medications administered to dogs in this study included Prozac (fluoxetine), Clomicalm (clomipramine), Elavil (amitriptyline), Xanax (alprazolam), Inderal (propranolol), and melatonin. Sixty-two percent (16/26) of PetFax survey respondents used one or more of the aforementioned medications as part of their dogs treatment for separation anxiety versus 93% (37/39) of in-clinic survey respondents (p =.002). Though this study was mainly concerned with searching for any therapeutic differences as a result of consultation method, differences in whether use of medication affected improvement in these dogs separation anxiety was also evaluated, independent of consultation method. Medication was used as part of the treatment plan for 53 dogs from both consultation methods.

38 COTTAM, DODMAN, MOON-FANELLI, PATRONEK Owner-reported improvement information was available for 48 of the 53 medication users. Eighty-three percent of owners (40/48) who used medication as part of their dog s treatment plan reported improvement in their dog s separation anxiety, whereas 100% (12/12) of owners who did not use medication also reported improvement. In other words, owners who administered medication to their dogs were no more likely to report improvement in their dog s separation anxiety than owners who did not report using medication as part of their dogs behavior modification plan. Furthermore, when the mean difference scores were compared between medication users (6.6, SD +/ 6.5, n = 47) and nonusers (8.8, SD +/ 5.1, n = 12), no significant difference was found. DISCUSSION Although direct observation and standardized behavioral measurement of dogs with separation anxiety when alone, before and after treatment, would be the best way to measure behavioral improvement, before and after treatment scores based on owner observations are also informative and useful for general identification of behavioral change. In this study, a decrease in separation anxiety score by approximately 40% was found in both consultation groups. Although this level of improvement seems only moderate, it should be regarded as clinically significant if a high percentage of owners report improvement, which was true for both groups of clients (78% PetFax, 92% in-clinic). None of the owners of the four dogs who were relinquished to a shelter, rehomed, or euthanized responded to the question regarding owner-perceived percentage improvement in separation anxiety, nor did they re-rate their dog s anxiety via the checklist. Such owner nonresponse could lead to a slight exaggeration of the owner-reported percentage improvement and mean difference scores if these four dogs demonstrated no behavioral improvement at all. It is possible that the group of owners who completed this study did not represent all owners of dogs with separation anxiety who used PetFax or had an in-clinic appointment. It could be that satisfied, motivated clients were more likely to respond, leading to an overestimation of improvement. Alternatively, an underestimation of improvement could have been made if dissatisfied clients were more likely to respond. In addition, because the average number of months between the time of consultation and the date of response to the survey was 21.6 months, variation in owner perception of mild, moderate, and severe anxious behaviors over time may have positively or negatively affected the difference scores. Comparison of the level of improvement in separation anxiety with past findings is difficult because the quantitative anxiety-scoring method used in this study is unique; however, comparison of the owner-rated percentage improvement can be made. Our finding for percentages of overall improvement (78% PetFax, 92%

CANINE SEPARATION ANXIETY 39 in-clinic) are similar to the percentages of improvement reported elsewhere: 62% (Takeuchi, Houpt, & Scarlett, 2000), 67.9% (Takeuchi, Ogata, Houpt, & Scarlett, 2001), 81% (Blackwell, Casey, & Bradshaw, 2006), and 85% (King et al., 2000). Our overall euthanasia and rehoming rates due to separation anxiety were low ((PetFax euthanasia = 0%, rehoming rate = 3.7%; in-clinic euthanasia rate = 2.4%, rehoming rate = 4.9%) on the same order as Takeuchi et al., who reported a 12% euthanasia rate and 8% rehoming rate for dogs with separation anxiety. However, Takeuchi et al. (2000) did not specifically report whether the subjects were euthanized or rehomed as a result of separation anxiety. Although PetFax clients used medication to treat their dogs separation anxiety significantly less often than did clinic visitors, the two groups reported similar improvement scores. Owners who used medication as part of their dogs treatment plan were no more likely to report improvement than were owners who did not use medication. This finding corroborates Podberscek, Hsu, and Serpell s (1999) finding that typical signs of separation-related behavior problems were not significantly affected by treatment with clomipramine but were reduced with behavioral therapy alone. Blackwell et al. (2006) recently found that 12 weeks of nonpharmacological treatment for separation-related disorders was effective for reducing separation symptoms. It is also worth noting that Dodman, Smith, and Holmes (2005) found no difference in aggression-improvement scores between medication users and nonusers. There was no significant difference noted between the two consultation methods in clarity of questions, client comprehension of the dog s behavior problem, client understanding of behaviorist s instructions, satisfaction with written materials, owner ability to remember advice, number of implemented suggestions, or ease of implementing suggestions. It bears noting that the three behaviorists used the same assessment, behavior modification, management methods, and handouts whether the consultation was remote or in clinic. This might explain the lack of significant differences between the two services. CONCLUSION Behaviorists often consult with owners in person and observe the patient directly (in a clinical setting or by making house calls ); however, the patient s problem behavior is not always displayed during the appointment. Although observing the problem behavior directly is optimal (or via video surveillance), this cannot always be arranged. Consultants typically rely on descriptive information provided by owners when assessing the cause of the behavior problem and formulating a behavior modification plan. This study suggests that written/verbal communication without direct observation of the dog in the clinical setting is as effective as direct communication with a client and observation of the dog in a

40 COTTAM, DODMAN, MOON-FANELLI, PATRONEK clinical setting for assessing and managing canine separation anxiety. Direct observation of the behavior problem and in-person interviews are more desirable than remote consultation from the perspective of the owner and behaviorist; however, in-person consultations are not always feasible because of the low number, geographical location, and accessibility of qualified behaviorists. According to the Animal Behavior Society s Web site directory listing, there are only 49 certified applied animal behaviorists nationwide (http://www.animalbehavior.org/absappliedbehavior/caab-directory) and 39 board certified veterinary behaviorists in the United States (www.dacvb.org). Owners need a method to access accurate information from qualified professionals; remote consulting is a valid option for clients to garner valuable information. This study corroborates the results of Dodman et al. (2005) regarding remote consulting and lends credence to the observation that consulting via fax-based, written communication, with appropriate veterinary provisos, is a viable method of treating canine separation anxiety. Future research is needed to determine if remote consulting is valuable in the treatment of other canine and feline behavior problems. ACKNOWLEDGMENT This study was approved and conducted under the auspices of The Center for Animals and Public Policy, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536. REFERENCES Blackwell, E., Casey, R. A., & Bradshaw, J. W. S. (2006). Controlled trial of behavioral therapy for separation-related disorders in dogs. The Veterinary Record, 158, 551 554. Dodman, N. H., Smith, A., & Holmes, D. (2005). Comparison of the efficacy of remote vs. in-clinic behavioral consultation for treatment of canine owner-directed aggression. The Veterinary Record, 156, 168 170. Horwitz, D. F. (2000). Diagnosis and treatment of canine separation anxiety and the use of clomipramine hydrochloride (Clomicalm). Journal of the American Animal Hospital Association, 36, 107 109. Hsu, Y., & Serpell, J. A. (2003). Development and validation of a questionnaire for measuring behavior and temperament traits in pet dogs. Journal of the American Veterinary Medical Association (JAMA), 223, 1293 1300. Kass, P. H., New, J. C., Scarlett, J. M., & Salman, M. D. (2001). Understanding animal companion surplus in the United States: Relinquishment of nonadoptables to animal shelters for euthanasia. Journal of Applied Animal Welfare Science, 4, 237 248. King, J. N., Simpson, B. S., Overallm, K. L., Appleby, D., Pageat, P., Ross, C., et al. The CLOCSA (Clomipramine in Canine Separation Anxiety) Study Group. (2000). Treatment of separation anxi-

CANINE SEPARATION ANXIETY 41 ety in dogs with clomipramine: results from a prospective, randomized, double-blind, placebo-controlled, parallel-group, multicenter clinical trial. Applied Animal Behavior Science, 67, 255 275. Leigh, J., DeLeon, P. H., James, L. C., Folen, R., Earles, J., & Gedney, J. (2000). The coming age of telecommunications in psychological research and practice. American Psychologist, 55, 407 421. Overall, K. L. (2006). How do we obtain and disseminate accurate information? Journal of Veterinary Behavior, 1, 89 93. Patronek, G. J., & Dodman, N. H. (1999). Attitudes, procedures and delivery of behavior services by veterinarians in the small animal practice. Journal of the American Veterinary Medical Association (JAMA), 215, 1606 1611. Patronek, G. J., Glickman, L. T., Beck, A. M., McCabe, G. P., & Ecker, C. (1996). Risk factors for relinquishment of dogs to an animal shelter. Journal of the American Veterinary Medical Association (JAMA), 3, 572 581. Podberscek, A. L., Hsu, Y., & Serpell, J. A. (1999). Evaluation of clomipramine as an adjunct to behavioural therapy in the treatment of separation-related problems in dogs. Veterinary Record, 145, 365 369. Salman, M. D., Hutchinson, J. M., Ruch-Gallie, R., Kogan, L., New, J. C., Jr., Kass, P. H., et al. (2000). Behavioral reasons for relinquishment of dogs and cats to 12 shelters. Journal of Applied Animal Welfare Science, 3, 93 106. Salman, M. D., New, J. C., Scarlett, J. M., Kass, P. H., Hetts, S., & Ruch-Gallie, R. (1998). Human and animal factors related to the relinquishment of dogs and cats in 12 selected animal shelters in the USA. Journal of Applied Animal Welfare Science, 1, 207 226. Stricklin, W. R. (1983). A survey of animal behavior-related research and teaching activities in North American agricultural and veterinary medical colleges. International Journal for the Study of Animal Problems, 4, 279 283. Takeuchi, Y., Houpt, K. A., & Scarlett, J. M. (2000). Evaluation of treatments for separation anxiety in dogs. Journal of the American Veterinary Medical Association (JAMA), 217, 342 345. Takeuchi, Y., Ogata, N., Houpt, K. A., & Scarlett, J. M. (2001). Differences in background and outcome of three behavior problem of dogs. Applied Animal Behavior Science, 70, 297 308. Voith, V. L, & Borchelt, P. L. (1996). Readings in companion animal behavior. In V. L. Voith & P. L. Borchelt (Eds.), Separation anxiety in dogs (pp. 124 139). Trenton, NJ: Veterinary Learning Systems.