Welcome to this special episode of Chattering with
iCatCare sponsored by Orion.
I'm Yaiza Gomes Mejias, iCatCares Veterinary Community Coordinator and I'm
hosting this episode today with Laura Watson, our Cat Welfare Coordinator.
Today we are joined by one of the leading voices in veterinary
behavioural medicines, Dr Sarah Heath, with decades of clinical experience,
Sarah has redefined how we understand the emotional lives of our cats.
We will explore how behavioural medicine is no longer a niche interest, but a
vital integrative discipline that touches every corner of any veterinary practice.
So would you like to start with the questions, Laura?
I can indeed.
So the Heath Model redefines how we think about emotional health in animals.
Can you explain its core principles and how they translate
into clinical decision making?
So the Heath Model, it's really about comprehensive veterinary healthcare.
So the idea that healthcare has got these three elements to it, one element
to that is emotional health, which I guess the Heath Model started with the
sink analogy, thinking about how to explain emotional health to caregivers.
The first part of your question was about what are the core principles of
the emotional part of the Heath Model?
And certainly I think the thing that differentiates it from other ways
of understanding is that it really talks about that integration between
emotional capacity, emotional input, and emotional drainage leading to arousal.
So not just thinking about emotions as valence or whether they're
engaging positive or protective, but also about that state of arousal.
How much emotional of whatever type is this animal dealing with
at the time, and how is that influencing behavioural output?
The core of the emotional part of the Heath Model is the sink
analogy and the idea of this interplay between those factors.
So knowing some history to know a bit about their potential sink
size, their capacity for emotion, thinking about their bias emotionally.
So are they more engaging or more protective?
And thinking about their drainage ability, how well do they cope?
How resilient are they from an emotional health point of view, which results
in the residue in the sink as we talk about it in the sink analogy,
but basically that state of arousal.
So that's really the concept of emotional health, but the Heath Model
in its entirety is far more than that.
So it's all also about comprehensive veterinary healthcare.
The physical, emotional, and cognitive together.
Cognitive health can be looked at as the way we think, learn, and remember.
All the time when you're having experiences, there is an
element of cognition, there's an element of memory formation.
There's also an element of learning to use a different, more applicable,
more successful behavioural response.
behaviour is just an output, not a diagnosis.
These elements create a behaviour, which is what we see the animal doing, but
that response also becomes learned.
How do they think about what they're doing?
How do they remember what they're doing?
How do they decide a good response in the future?
There's a term emotional intelligence where cognition meets emotion and where
you make decisions about how you respond to those emotional responses, and
that's really important when we think about a cat in a clinic because they
will have certain emotional responses.
What they do about those has quite an impact on their welfare, but also
on the welfare of the veterinary staff, the perception of the
caregiver of how that visit has gone, and therefore the potential to
have subsequent visits, et cetera.
So we are affecting the cognition of the human animals involved as well.
But that cat will be learning something and if we can teach them that they
can succeed in dealing with these protective emotions by using things
like avoidance, by staying in their carrier, being partially hidden by
a towel, and feeling that they are successful in using avoidance, we lower
the potential for them to use repulsion because repulsion is not needed.
But it doesn't mean if an animal's using repulsion, it is more or less unhappy or
threatened that an animal using avoidance or is inhibited and doing nothing.
They're just alternative strategies to deal with emotion
and influence through cognition.
If they are successful, they're more likely then to be put into
that behavioural repertoire for that individual for the future
through cognitive processes.
Brilliant.
Fantastic.
I remember the first time I heard you talking about the sink.
That was the moment where I really understood emotional resilience.
In your experience, what are some of the most overlooked behavioural
signs that actually point to underlying physical health issues?
So we talk about flare up in cats in relation to things like cystitis or things
like skin disease or the flu signs where we have a pattern of a disease process
in a physical sense that sometimes is quiescent, sometimes may appear to be
treated, but then raises its head again.
And that to me is a big sign that says, let's consider what are
the other components of health?
Is emotion involved?
Is cognition involved?
They will always be involved, but to what extent is it involved?
To what extent do we have to address that in order to get a full
resolution of the physical signs?
I don't think it's one particular disease process, but more the
pattern of how it presents in terms of this quiescent flare up history.
That would be a big red flag for me.
The other is when your experienced veterinary surgeon finds a case baffling.
I think that's another signal for me that you need to also consider the other
dimensions of the health triad, because that can be a complicating factor.
So you've got your physical health condition, but if there's emotional
compromise involved, cognitive compromise involved as well to a significant
level that may actually make that physical disease much more difficult
to really pinpoint and get to the
bottom of.
So I would always see that as a red flag.
The third thing would be response to treatment.
If I've made a good diagnosis as a general practitioner, and I know
that this is a case I deal with a lot and I know this condition
well, and I know how to treat it.
And yet I'm not getting the resolution I expect or not in the speed of efficacy
or the retention of that efficacy, which brings us back to flareups.
If something doesn't fit your normal pattern, I would then go, have we looked
at the other parts of health enough?
Are they contributing more than we thought?
Should we revisit that?
So those would be my flags.
Rather than looking at specific conditions, a general practitioner
might think, hang on, maybe we need to think comprehensive healthcare
approach here and look at the relative contributions from all three domains.
How can general practitioners begin incorporating behavioural assessments
into routine exams, considering our limitations in time and training?
So this is where I hope the sink analogy does help and also the tree analogy,
that's also part the Heath Model, because what I'm hoping is that general
practitioners will realise that what they can do in that very short time is
a very first point emotional assessment.
A bit like in your 10 minutes of a consult, you don't investigate
physical health entirely.
You gather some basic information about its physical health in that
10 minutes, and if you need more, you're gonna have that animal in
and do other tests, but you don't do a full write down to everything
clinical examination from a physical health point of view in 10 minutes.
It's impossible.
We wouldn't expect you to do that from an emotional point of view either.
So what is the equivalent of taking a temperature and having a look in
its mouth and auscultating its heart?
Basically it's to look for signs of two things, emotional bias and arousal level.
So arousal level talked about as being synonymous in the sink with
the amount of water in the sink.
Look for signs of displacement behaviours.
Those displacement behaviours, this sink is very full, this
animal's got a lot of emotion.
So are they yawning?
Cats also do yawn, not as extensively as dogs do.
For cats, more thrashing tails, they do lick their lips.
So those behaviours that are grooming without intent.
So that's spontaneous, quick grooming type behaviour that's
often displacement related.
So we are looking for those signs that the sink is very full.
Now for cats, that could be because they often get a lot of input
from coming in the car, being in a carrier, being in a strange place.
Arousal may be contextual rather than as inherent, but it's a guide that
this animal does have quite a lot of emotion to deal with at the moment.
That means that it's unlikely to make very rational decisions.
Think about yourself when you're full of emotion and how bad
your decision making can be.
This animal is probably on the back foot in terms of making good decisions,
and that's therefore a bit of a warning sign that we're gonna have to be careful
handling this individual because it hasn't got much capacity to deal with the next
input and do something sensible with it.
So that's a really useful thing to have ascertained in your 30 seconds as it
walks through the door, or you see it come out of the carrier, or you lift the
carrier lid and leave it in its carrier, and you are looking for those signs.
The bias that's about is this animal more pessimistic or optimistic?
We talk about the inflow from those different emotions, so the engaging
emotion represented in the Heath Model sink analogy by the cold tap
and then the hot tap representing the protective emotions and what we are
looking for is which is predominant because they are not in isolation.
Engaging in protective emotions are not an either or.
It's like the health triad.
It's not, which is it?
It's what's the relative contribution from each.
It's the same with emotion, which is the predominant input
in this cat at the moment?
If engaging emotion is predominant, the animal will show engaging
behavioural responses, they'll want to interact, to explore or be interested.
Those behaviours will be the predominant signs.
You know, you've got an animal getting input from its engaging emotions.
As long as that's coupled with low arousal, you've probably
got a good consult on your hands.
But remember, you could have engagement, but a high level of
arousal and still have a problem.
Whenever you put into a full sink, you still get a flood, so doesn't matter.
So look at the two together.
That's why arousal's so important.
The protective side, do I think this animal's more protective in its responses?
Thinking about the four elements of the tree analogy, the four
different responses from protection, is this animal trying to repel me,
trying to avoid inhibiting itself?
The cat's appeasement behaviour plays a role, and one of the
difficulties with cats is differentiating between appeasement
interaction and engaging interaction.
But once you've looked at those responses, you've got an idea of pessimistic
cat with a high state of arousal.
Now I want to know, is that purely contextual?
Does that only happen here?
Or is that something caregivers see in other contexts as well?
So I would have just maybe three different contexts that you ask about.
Let's see, what, how does your cat respond when visitors come to the house?
How does your cat respond when you show it affection?
You've got a familiar and an unfamiliar person.
And then other than coming to the vet practice, do you ever take your cat
anywhere else, cattery, et cetera?
How do they react to that, for example?
So you just get some scenarios, though you can test out that bias and that
arousal in another context and see, does that sound like it's actually something
that's seen in other contexts as well?
Because if that's the case, I've got a pessimistic, high arousal
cat who shows that in a lot of various contexts, I've got more
likelihood it could be a significant factor in this animal's health.
You've now queued it up.
You haven't got a diagnosis.
You don't know if there is emotional illness or just emotional compromise,
and those two things are very different.
But you'd have some idea of, am I gonna think about emotional
contribution for this individual, or am I concentrating on physical health.
At the moment, I've done a quick emotional assessment.
I'm reckoning this animal is actually engagingly biased,
pretty low level of arousal.
I'm not seeing signs that emotional compromise are likely to be a
big factor in this cat's life.
I'll concentrate on my physical health diagnosis.
Or am I going, no, I think this could be a major factor in this condition.
I'll treat the physical health and then decide whether I ask a
veterinary nurse to take that further.
That might be the first step, not referral, but get another member of the
team to spend a little bit longer asking more questions and then make a decision.
Am I going to need to refer out for that behavioural medicine approach, the
emotional and cognitive health input or am I gonna be able to do that in-house?
That's fascinating and it's so important.
We usually tend to make notes about the barriers we find to approach the
animal, but we don't add many words that refer to the actual animal's
perspective of the situation.
So I think words there are very useful.
Thank you for that.
Yeah.
Love a word.
I loved something that I heard you say in one of your lectures, Sarah, once a
few years back, listen with your eyes.
It was profound.
You don't have to do much with the actual cat, just watch the cat in front of you
and it really shaped my nurse consults going forward because I was like,
actually, I don't need to touch the cat.
I don't need to do anything.
Just have a little conversation with the owner, watch the cat, does it come
out of its carrier and yeah, I'm ready, I love this environment and allorubbing
on everything, or are they hiding in their carrier underneath the blanket?
Because it just instantly gives you that idea of what emotional bias,
like you say, that cat is sitting at, which can then help shape your
consult because what's priority to actually get done in that consult?
Interesting what you just said, Laura.
We'll just pick up on something you just said then.
So that is, absolutely, that this emotional assessment in its barest
sense, if you like, in getting it right back down to the minimal,
can actually be done in seconds.
The more you do them, the more easier and the quicker you will do those, the quicker
you'll get a feeling for that emotional bias and that arousal level in that
individual as they come into the practice.
With cats, I mentioned earlier about appeasement and said that
one of the difficulties with cats and appeasement I think is our
understanding isn't quite there yet.
We are still grappling with this concept of how it works in cats, but I personally
believe, this is a personal belief and not saying I've done any studies yet
to really determine where this fits.
But I see that allogrooming and allorubbing, yes, there's affiliative
behaviours in a feline sense, but because I believe them to be appeasement
to behaviours, I think they actually come from a point of uncertainty.
The difference being appeasement is gathering information through
engagement, finding out about it and telling it about you.
And the reason, therefore, I believe we see that in cats who are considering
themselves to be part of a social group, the only individual they exchange
information with, rather than just take it from, would be an individual that
they trusted to some extent because otherwise it's too dangerous as a prey
animal and as a solitary survivor, you put yourself in too much danger.
Whereas if you're a dog, horse or a person, it makes perfect sense because
you're socially obligate, that the value of social contact is always going to be
there and therefore it might be better to engage with this thing I'm worried about.
It shows more input from engagement, but the protective emotion is still there.
Appeasement comes from protection.
Engagement comes from engaging emotions.
When cats go up to another cat or a person and rub and and do that, my belief on that
is that it tells me that I've got both engaging and protective emotion present.
Not that they are 100% engaging, is that protective emotion of a worrying
degree is a different question because appeasement inhibition repulsion
avoidance are absolutely normal when justified, absolutely normal.
Nothing abnormal about using any of those responses if justified by the
emotion and the context that you are in.
So that animal who shows engagement is a cat, isn't a cat who lives in this context
and then shows some appeasing behaviour.
Yes, I would believe there is an element there of protective emotion,
but probably within normality and not something to worry about, but there is
a bit of a, or there has been a little bit of a tendency to create this image
of some emotions as being negative and bad, and we should get rid of them.
That worries me because these are very important emotions.
The fear anxiety system is hugely important and in our animals in a
consulting room should be present because it is not a normal place to be.
If we see that animal showing that sort of behaviour that I would say is
okay, yes, that animal has got levels of fear, anxiety, but they are normal.
They are things that are protecting it from making a mistake and doing
something stupid and letting itself be too open because it's a cat and
it has to protect itself, but it's actually got enough engagement
that it is going to use appeasement rather than inhibition or avoidance.
It's going to want to find out more proactively from you.
Amazing.
And it helps us learn, doesn't it?
Because it helps us gauge what's normal for that individual
in front of us, isn't it?
And react accordingly.
If it didn't have that fear and anxiety there, then we wouldn't
know when not to go too far.
It's their way of communicating with us, 'No, I've had enough, this needs to
stop here', so it's really interesting.
Fantastic.
So many of the cat caregivers views on behaviour can be seen as
training issues rather than medical concerns or normal species typical
behaviours as problem behaviours.
How can veterinary teams reshape that narrative?
Yeah.
So we're back to this differentiation between behaviour
and behavioural medicine.
And so you are absolutely right that many of the behaviour outputs that
caregivers find difficult are things that are incompatible with living as a human.
That's a problem when you take any species into a domestic environment,
these animals are not humans.
This ideal existence that we perceive from a human perspective is not necessarily
going to be the ideal perceived existence for them, and that is automatically
going to cause some miscommunication.
And it's all about education.
It's all about understanding what the species is that you take on.
I share concerns with many people about the horrors of images on
YouTube and TikTok skewing perception of what these animals are.
And then we have inappropriate breeding, which is leading to morphologies,
which are not compatible with being a cat in the normal sense of the word, a
species specific normal, if you like.
Dan O'Neill at the RVC, he talks about innate health and talks about health
being something that is needed to allow you to be what you are meant to be.
Whether you're a cow, cat, or a human.
We need innate health.
We need a health that allows us to be what we are supposed to be.
One of the problems with any domestic animal, and then we could
get into a ethical debate on pet caregiving, but we won't but that's
another topic for another day.
But we need to remember that as human animals, we are making a decision to
take another species, whatever that species is, we are talking about cats,
but whatever species into an environment which is not their chosen environment.
If we're gonna do that, we have to be willing to compromise.
We have to be willing to understand what is absolutely
essential for that individual to be a cat and what is optional.
The essential stuff must be provided.
In the Heath Model we talk about environmental
optimisation, not enrichment.
Environmental enrichment is different.
It is a thing, but it's the addition of things that are not
necessary, but nice to have.
The five pillars from iCatCare and from the guidelines are fundamental needs.
They are not enrichment.
When we were doing those guidelines a long time ago now, we sat and had
that debate about what they would be called, and they are called
environmental needs for a reason that they are a need, they're not an option.
So I think getting that across, that if you want to live with another species,
I think this is an education piece across the board for the veterinary
profession, not just in the cat world, but if you want to live with another
species, and I would highly advocate that we do, we benefit enormously from it.
But we can only do that if they benefit too.
If it's only for our benefit, then I don't believe we should be doing it.
It has to be beneficial and I feel that about assistance animals and
animals doing anything to further and increase the quality of life
of human animals, I'm all for it.
As long as the individual involved is also benefiting.
If it's at the detriment of their health and welfare, then
I don't think it's acceptable.
No, I completely agree.
A veterinary team could do so much to help.
The big part of my job in practice as well was supporting cat caregivers,
and how many times did I email those environmental needs to caregivers and
discuss them with them and put them in the kitten packs and put them on social media
and little nuggets of information used.
Like you said, social media can be used for such a negative, so let's,
in practice use it as a positive tool that we can actually educate with our
caregivers so that they know what they need to provide their cats with as well.
And be very careful about the images we use on veterinary
practice social media sites.
I see terrible imagery used and used on cat social media platforms by
individuals who are very experienced in physical health treatment for feline
patients, but the imagery that's shown and used on their platforms is really
detrimental because it's showing protective emotional bias without
that being talked about, recognised, even spoken about, and even sometimes
talked about in the opposite way.
Look at how lovely and happy this cat is, when actually the signs that we're seeing
on that is of a cat that's clearly in protective emotional bias and struggling.
We have to be really careful as a profession about imagery.
Yes, inappropriate breeding and morphologies, but also emotionally.
It is really important that we get that message out there, that they show these
behaviours because they're unhappy.
How do you envision veterinary nurses contributing more actively to behavioural
medicine in everyday practice?
What makes them particularly well suited to supporting the emotional
health of their feline patients?
Love veterinary nurses, advocate the use of the word the veterinary
team, veterinary professionals.
We are a team.
One can't operate without the other and as far as caregivers are concerned,
nurses are traditionally thought of as potentially more approachable
people that they can talk to.
I think nurses sadly do not have any more time than vets have, but they do
have some communication skill differences with, compared with a lot of veterinary
surgeons, although they are now better, much better trained vets in communication
skills at undergraduate levels.
But caregivers often perceive that the vet doesn't have time to talk about it.
As I say the vet nurse is just as time pressured, but their perception is very
different from the caregivers themselves.
So I think there's a window there of opportunity and that also, I think this
is an area where we can really, as a profession, give this message to the
world that it is a veterinary team.
That a vet nurse and a vet have equal contribution to make to a veterinary
practice by doing dual consults, having a nurse in the room with you, but having
the nurse in there at the beginning because they may actually be using their
eyes to do that emotional assessment.
And then the vet saying, I'm going to leave you now with my colleagues capable
hands, who will just take some of those little things we've talked about a
little bit further and decide whether or not to arrange another appointment.
And then they go into another consulting room and start another consultation.
But the nurse has been introduced as a co-professional, as someone
who's on a equally important for this cat's welfare, and therefore
the caregiver sees it as a team.
So it's important the vet is talking about behavioural medicine, emotions,
et cetera, but it may be the vet nurse who then takes that step further and
does more than that initial assessment.
But I'm also a massive advocate of vet consults, but I know that time
pressures and other pressures have meant that isn't always the case.
But I do believe that is how we should be seen by the client that we're a team.
There's two people involved in this.
There's the vet and nurse contributing different but equally important things.
We did that in our practice and it worked really well.
So just as an example, like with our diabetic patients, the vet would
do the spiel on the, this is what you medically need to treat the cat
with, but then they'd do the same.
We're gonna leave you with Laura, for example.
She's gonna go through everything else, how to teach the owner to actually inject
the cat and that's just as stressful.
And then how they might need to adapt the home environment as well.
It's such a big change for them, isn't it?
And what to spot for.
And I used to really love that.
And like you say, it comes a lot when that veterinary professional,
when that vet does speak highly of you and they do see you because
then the owner sees you as an equal.
There's not that kind of hierarchy there.
It's then you are seen as just as valuable to that cat's journey.
So one of the things that Ilona Rodan, who many of you will know, very dear friend
and colleague, and I remember talking to her about cat friendly practice, right
way back over a decade ago now, isn't it?
When we started talking about these things.
Her saying that one of the things she'd found in her cat only practice
in the States was that not moving the cats from one place to another
is hugely beneficial for them.
So she got her nurses to come into the consult room to take bloods and
do that with the caregiver present.
And that not only was that very beneficial for the cat because the cat
didn't transition, and that's, we know that to be very important for them.
But also she said the value caregivers placed on nurses shot up and their respect
for them as professionals changed because they saw vet nurses taking blood samples.
They saw vet nurses doing what vet nurses do all the time,
but often behind closed doors.
The caregiver only sees the vet in the consult room, they never meet the
vet nurse apart from one discharge maybe where they're just handing them
over, they don't see those skills.
Bringing the nurse into the room, taking samples and doing blood pressure
measurements, doing things like without moving the cat, beneficial for
the cat, but also hugely beneficial for increasing the recognition of
veterinary nurses.
So I think that's also an important part of cat friendly approaches.
Do you have a standout case where you remember a nurse's positive
impact in the clinical outcome or communication with a caregiver?
I think that's probably difficult for me at specialist level because that, it's
not the same scenario, but I do know from teaching veterinary nurses a lot about
the fact that they often have input, particularly in observational skills,
and pick up on things that through no fault their own the vets are, have got
their head thinking about something else.
Maybe they're doing an otoscope examination and don't notice the cat
shows a behavioural change or is finding it hard to maintain a sit posture to get
that look down the ear, and therefore the vet nurse brings in that extra bit
listening with their eyes and giving that information and feeding it back.
So I think there are countless examples of where that has been the case, where
vet nurses notice something, maybe heard something a caregiver said, that
has led that individual to actually have their behaviour investigated
because the caregiver hasn't actually come out and said it outright.
It's just something that has come in a much more subtle way through a comment
or through a, an action, comment from the caregiver or an action of the pet.
For clinics looking to utilise their registered veterinary nurse, what
first steps would you recommend for building behavioural responsibilities
into their daily routines?
I think we have this idea that emotional assessment is something
we should be doing on a daily basis.
We are getting better, aren't we, at pain scoring.
That's really good.
But we are still not very good emotional scoring or emotional assessment of
an animal in the veterinary context.
Vet nurses can be really good at doing, so again, in a consult room if the
vets are not feeling overly confident about doing emotional assessments try
having your vet nurse in with you for a while, into a series of consults, and
see what did they pick up using those emotional values of arousal and bias
and what have they seen in that consult.
See how much additional information you get from nurses standing,
watching, and taking in information.
Progress that into emotional assessment of our hospitalised patients and also
thinking about that recurrence, I talked about the flags at the beginning of
what about a physical health case makes me think that the contribution from
emotional dimensions may be significant.
If that happens, and as a vet, you go, 'God, this is the third time
I've seen this cat with cystitis.
I'm gonna make an appointment for you to see the nurse because that is
a red flag that tells us that other domains of health may be involved.
I want to investigate that further.' I hope we talk about it in those terms.
We don't say it could be stress because caregivers become
defensive, upset, worried.
Talking about it in a way that could be perceived as being negative because of
some of the misunderstandings about what stress actually is, which we probably
haven't got time to go into today.
But if we talk in terms of health domains and the vet says, 'I've noticed this
is the third time we've seen fluffy for cystitis, a little concerned because
there are other dimensions to health.
I've talked to you about what's happening with the bladder.
Sometimes there can be an interplay with emotions and with the way the animal
thinks or what their memories they've got, and those things can impact as well
and it's all about their health and so really the best person for me to pass
you to now is the vet nurse because I want her to expand on our clinical
examination as a clinical assessment.'
It's a clinical exam.
It's health.
That's what you are looking at, rather than talking about it as a behaviour
problem or stress, that word is so difficult because it's rarely defined.
It has two aspects to it.
There's physiological and psychological stress, and we very rarely define
which one we're talking about.
We talk about it as if it's an emotion, which it isn't.
It gets lumped in with fear and anxiety, which it's not.
It's given bad press, which it's not.
So stress, none of us would be alive if there wasn't such a thing as
psychological and physiological stress.
It keeps you alive.
There's a lot of misperception and caregiver defence around that word,
they're worried about that word because it makes them feel like
they must have done something wrong.
If their cat is stressed, 'oh my God, that must be my fault.
That must be something wrong with, I must have done something' instead of thinking
about it as having some compromise in its emotional health systems.
Which is, could be an illness as well.
It isn't always, often it's not, often it's a reactive emotional compromise
that's, that is related to environments and needs, but it can be an illness.
I see nurses as helping to keep it as behavioural medicine.
And yes, if it's just a behavioural change which is purely cognitive,
then what you need then is training.
We think more of that in the dog world because with cats we have a
different perception of training.
In the behavioural world, we prefer the word education to training because
training is literally about a response being put into a particular context and
that can be important and is important for dogs in a challenging domestic world.
Education is relevant to any species to live in a world that's not their own.
So they need to learn and be educated to be able to do that.
But getting that differentiation between education and behavioural medicine, I
think nurses are fundamental to that.
And talking about education, if you had to choose a few changes in veterinary
education and practice to better integrate behavioural medicine into mainstream
care, which ones would you choose?
I really want to see behavioural medicine as a day one skill.
That's been my sort of professional life ambition, to get to the point where it's
recognised that it's not a, an added extra, and that behavioural medicine
is a veterinary discipline, different from behaviour counselling, behavioural
medicine is something different, and it's a veterinary discipline.
So it should be fundamentally central to veterinary undergraduate education,
veterinary nursing education.
Not an optional extra, not something that's added on, but something that's
absolutely fundamental from first year, when we teach them in first year as
veterinary students about husbandry and about ethology, that we actually talk
about it in terms of behavioural medicine, not just in terms of pure ethology or
et cetera, but actually talking about it as part of what creates health.
And that's actually, go back to the oath, that issue of the health and
welfare of the animals committed to my care shall be my prime concern.
I didn't say the physical health, I said the health and that to me is absolutely
fundamental to what we need to change in the veterinary profession, that health
is seen as a comprehensive thing, which is why in the Heath Model we talk about
comprehensive veterinary healthcare.
Thank you for your valuable insight on the behavioural medicine in, in modern
veterinary care and for reminding us that health isn't just physical,
but has a lot of other components.