The Bitey End of the Dog
A podcast dedicated to helping dogs with aggression issues. Michael Shikashio CDBC chats with experts from around the world on the topic of aggression in dogs!
The Bitey End of the Dog
Beyond Training: The Medical Side of Aggression with Dr. Maggie O'Brian
In this fascinating conversation with Dr. Maggie O'Brian, one of North Carolina's few board-certified veterinary behaviorists, we have an enlightening discussion about the clinical side of animal behavior.
Dr. O'Brian takes us through the reality of treating complex behavior cases, where the line between medical and behavioral issues often blurs. She shares surprising insights about pain as an underlying factor in aggression, including the eye-opening statistic that 25% of dogs under four already have arthritis, and how addressing physical discomfort can sometimes completely transform a dog's behavior. One memorable case involved a Golden Retriever whose severe resource guarding disappeared entirely after pain treatment, leading the owners to exclaim, "We didn't know she had a personality!"
Whether you're a pet professional or simply trying to understand your own dog's puzzling behavior, this episode offers a compelling look at the intersection of medicine, behavior, and the powerful human-animal bond. Check out Dr. O'Brian's practice at Southeast Animal Behavior and Training, or explore their virtual options for nationwide consultation.
https://www.southeastanimalbehavior.vet/meet-the-team
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In this episode I sit down with Dr Maggie O'Brien, who is one of North Carolina's few board-certified veterinary behaviorists, to explore what day-to-day looks like in a clinical behavior practice. From navigating complex medication cases to supporting overwhelmed caregivers, maggie brings a wealth of insight into the evolving field of veterinary behavior. Maggie brings a wealth of insight into the evolving field of veterinary behavior. We dive into emerging treatments, the growing recognition of pain as a root cause in behavior cases and the nuanced conversations that come with helping both pets and their people. If you've ever wondered what a comprehensive, medically informed approach to behavior looks like, this conversation offers an inside look into the heart of that work. And before we jump into today's episode, a quick heads up If you're looking to learn more about helping dogs with aggression issues, head on over to aggressivedogcom, because we've got something for everyone. For pet pros, there's the Aggression and Dogs Master Course, which is the most comprehensive course available on aggression anywhere in the world, and it's packed with expert insights and CEUs. For dog guardians, check out Real Life Solutions, a practical course for everyday challenges like leash reactivity, resource guarding and dog-to-dog aggression. And if you want full access to expert webinars, live mentor sessions and exclusive discounts, the Ultimate Access Membership is just $29.95 a month. You'll also find info on the 2025 Aggression and Dogs Conference happening in Charlotte this September. That's all at aggressivedogcom. Check it out after the show.
Speaker 1:Hey everyone, welcome back to the Bitey End of the Dog. This week, we have a veterinary behaviorist with us, and you know how we love our veterinary behaviorists. On this show, dr Maggie O'Brien is joining us and we're going to be diving into a lot of different topics. When I was talking to Maggie before the show, I was like I have a wishlist of questions and topics I want to dive into and she's like, yeah, sure, no problem, so I'm excited to have Maggie here. Welcome to the show.
Speaker 2:Yes, thank you so much for having me.
Speaker 1:So just to give the listeners a little bit about what you do on Daily Retune, I've given everybody your background in terms of your academic degrees and all the letters after your name, but tell us a little bit more about like a day in the life of your practice and what you're focusing on now.
Speaker 2:Yes, so I am primarily in the clinical world, meaning I work with patients on a day-to-day basis. So we have a standalone practice in Charlotte, North Carolina, where we see dogs and cats for behavioral concerns. So it's myself and I have a wonderful resident and we have a wonderful team including some trainers and support staff and things like that. So on a day to day we just see dogs and cats for their behavior concerns and then we also have a virtual branch so we work with a lot of patients all over the country through video calls and things like that, so we're also able to help, again, dogs and cats with behavior concerns all over.
Speaker 1:Amazing and the difference here between you and some of my other veterinary behavior guests is that you are just straight on all clinically. You're working with patients, because I know a lot of veterinary behaviors are also doing research. They're teaching at universities, seeing some caseload, but your caseload must be massive because that's what you're focusing on strictly correct.
Speaker 2:Yes, so we see. I mean it depends on kind of how many rechecks we see in a day versus new appointments, but typically we'll see anywhere from like three new appointments and then three rechecks a day, or sometimes the ratio is different from that, but it is just all patients all day, which is very fun. That's why I got into this. I just like working with people and helping individual animals.
Speaker 1:Yeah, that's interesting because that was a question I was going to ask you. So what made you lean in that direction? So you were like I just don't want to do any research, I want to stay out of the universities and I just want to be in there with the patients, or was there something else?
Speaker 2:I think some people really thrive and love academia. I was never wildly drawn to the academic world or academia world, I should say Very obviously drawn to the academic world, but I just always got into this to help specific dogs and cats and their families, and so that's just what I find most rewarding. So that's what I've honed in on.
Speaker 1:That's fantastic, and you know I'm going to pick your brain about so many different aspects of cases. So, but first, is there anything kind of new and exciting? In the veterinary behavior world? We always get lots of really great insights, especially again from the academics, but also those in practice and finding new insights with meds or different protocols. What's top of mind for you? Anything kind of new and exciting that might be coming across the trainers' desks at some point?
Speaker 2:I think there's always a lot of things that people are thinking about or are coming up more and more commonly. Certainly they've been around forever. But things like being concerned about pain as a component in the cases we see and kind of what pain options we have for dogs how much does that play into their behavior or in cats' behavior? There's a lot more I would say inventiveness with how we can sedate certain dogs in a veterinary setting if they are very fractious, fearful in that setting. So that's been really fun more recently to work very hands-on with trainers and get plans together to get these dogs seen in a vet clinic that maybe haven't been seen in years. So that's been exciting. Recently there's some cool research coming out about caregiver burden, specifically pertaining to behavior cases. So how stressful is it to have a dog with behavior concerns or have a cat with behavior concerns for the owner, for the people working with the owners? So there's always lots of new stuff and exciting things.
Speaker 1:You're speaking my language, because actually I've kind of seen the same phenomenon in the behavior, consulting, training side of things with regard to pain, as well as the caregiver side of things. But the many more people, including dog guardians, pet guardians, are becoming aware of pain, I don't know kind of where that really like. We started to see that shift. I think it's been a little bit of a concerted effort from lots of different organizations from the veterinary side, the fear-free community, the trainer side, social media and some trainers pushing things out there.
Speaker 1:Canine arthritis management out in the UK. There's a lot of great resources helping educate the masses and a lot of people reference Dr Danny Mills' study on the pain and underlying medical issues, the high prevalence of it, right. So yeah, I'm very excited to see that and, on that note, we could talk about some of the pain meds, maybe as especially as of late, so Labrella being one of them as being controversial and something we could talk about. But let's dive into that side of things for a second. It's just pain meds, what you would typically recommend, pain trials like. There's a lot of new stuff to kind of wrap our heads around.
Speaker 2:Yeah, and it's such a prevalent problem that we'll see in our patient population and whether they come in, the owners are very aware that their pet is painful but more often there's not an awareness that the dog might be in pain or the cat might be in pain and that contributes to a lot of behavior problems. Just not as directly as the cat is limping, the dog is limping. It's more. The dog is touch sensitive or they're having out of character behavior at an age we wouldn't anticipate or they're having aggressive behavior at a younger age than we would anticipate.
Speaker 2:So whenever dogs don't quite follow the rules, we want to be specifically concerned about pain and obviously it should always be on our radar. But as far as treatment options and kind of what we do when we suspect that a dog might be painful, we always try to get them to consult with or kind of go back to primary care and consider working dogs up to the best of our ability for physical issues or cats up. I keep leaving our cats out but trying to work them up physically. A lot of times it's super helpful to even if we're really suspicious of pain or if they did initial things that indicate that the pet might be painful, we really try to onboard another specialist, such as a rehab veterinarian or neuro or ortho, depending on what the problems are, but really trying to have a team approach. And then really nice, now that there's so many treatment options for pain, just kind of an ever-expanding pool for us too.
Speaker 1:Could you talk about the prevalence of any particular issues, pain issues, are you seeing an increase in anything arthritis or any other trends when it comes to that, especially in the US with the dogs, and maybe you could talk about breeds in that regard?
Speaker 2:Yeah. So I don't know if there's an increase in prevalence, but there's certainly an increase in awareness, I would say, of dogs that are painful. So NC State had a study where I think it was 25, 20 to 25% of dogs under four have arthritis. So we're just learning to not focus on. This dog is 10, we should think about arthritis If a dog is two. It should be at least on our radar of. Is there possibly a medical component, such as pain, playing a role in this dog's behavior?
Speaker 1:I wonder how much of that has to do with breeding and structural characteristics. Do you know if this study was looking at that by any chance?
Speaker 2:That one was a mix of breeds. I don't think they pulled out any specific one and that was, I believe, more like people that work at NC State or are associated with it and volunteer their animals for it. But there's certainly you know, certain breeds that were going to be automatically. Oh, do there's? Certainly you know certain breeds that we're going to be automatically. Oh, do you have this? You know you're a German Shepherd. Do you have back pain? You're a golden retriever. Do you have hip issues? So we certainly have more breed predispositions towards certain issues that we want to be aware of, but we also don't want to. Oh, you're not a golden, so your hips are fine. You know. We don't want to be approaching things that way either.
Speaker 1:Yeah, yeah. So talk to us about Labrella now. That's made the rounds on social media lately and people are concerned and what is your insight there?
Speaker 2:Yeah, so Labrella is still fairly new. It came out in 2023, I believe and so it is an anti-nerve growth factor. So nerve growth factor plays a role with arthritis and inflammation and then, obviously, further down the line, pain awareness. So it's been in the UK for a little bit longer than in the US. It has shown to be very, very helpful for dogs. Certainly, clinically, we have many cases that have a significant difference, I would say, in outcome based on being treated with labrella.
Speaker 2:There are side effects that are being reported. So increased drinking, increased urination is now, I believe, officially on the label for it. And then there's some kind of mounting concerns about neurologic issues. It's just very difficult to say at this point if it is a kind of a causative issue. You know, do they get really comfy and active and then they do something to their back, that's, you know, because they were so much more comfortable and they were more active than they had been in a really long time or is there kind of a more concerning connection there? And it's just so early that it's hard to say.
Speaker 2:And I think it's tough because the population that's being treated are primarily senior pets. Senior pets are going to have a higher likelihood of developing scarier things. So how much is that associated? So I think it's an exciting addition to our ability to help. So I think it's an exciting addition to our ability to help. Ironically, in the behavior world, it's an injection once a month. So we see these dogs where it's like man, we'd love to try Labrella on you. But realistically, without onboarding a team to help, how do we get monthly injections into this dog in a realistic way?
Speaker 1:So yeah, yeah, how do you navigate conversations with your patients, your patients, caregivers, in terms of let's use LaBella as an example, or maybe when the benzo dies? I mean, they read something and they're like, oh no, that's like terrible. And it's especially something like this, where we don't the data is getting there, but we don't have anything robust or anything that's definitive. There's concerns about it, right, and so maybe that caregiver is concerned. At the end they say well, dr O'Brien, I don't know, I heard about this and then, and you know that that particular med, whether it's for behavior or pain or anything, is going to be probably the best option for that dog. How do you convince that type of concern?
Speaker 2:So we try to never talk someone necessarily into a treatment that they are very hesitant to pursue, whether it's an anti-anxiety medication or if it's something that's strictly pain management. So if there's true like I'm really scared of this, I don't want to do it, then it's kind of a full stop. We'll explore other options. Of a full stop, we'll explore other options. If it's more just that they have questions about it, then we'll kind of talk more about prevalence. You know, with behavior meds the incidence of side effects would be typically insanely low. So is your dog going to be this? You know one out of how many that has a weird side effect, potentially, but it's just so low that typically the main focus is pros versus cons and in the majority of cases the potential pros are going to vastly outweigh the potential cons. And that's true of any medication that any of us ever take. You know when they whisper the side effects at the end of your ads, you know, and really fast.
Speaker 1:Yes, five times speed, yes. So, speaking of the caregiver side, you know we have caregiver burden and I imagine so many of your conversations are considering that side of the equation. So we're talking about, you know, a person navigating. Do I give my dog this med and possibly they could be impacted by this particular side effect or this issue or this disinhibition or something I'm reading about or something somebody told me about, and then, at the same time, if it's a profound aggression issue with a longstanding history, there's also obviously the ramifications for that. So talk us through some of the things you've learned over the years when it comes to difficult conversations like that with patients, and you know some tips and tricks that may be helpful for the rest of the listeners in general, but also the trainers and consultants listening in.
Speaker 2:In terms of them being concerned about meds or just their stress level over behavior problems.
Speaker 1:It's kind of a broad question. I didn't give you any specifics there, but. I'm kind of looking for your insights in the human side of your consulting. What has been some of your biggest takeaways over the years? Like wow, I used to have this problem with convincing a person to do this or having that difficult conversation about potential outcomes or how a med can be important. So it's a general sort of broad question about, like anything that, any insights you might have that you've learned when it comes to talking to the humans.
Speaker 2:Yes. So we do put our kind of therapy hat on every, you know, fairly frequently and some weeks feel like that's, you know, a heavier part of our job than any other part of our job. But I would say that I try to outline our overall goals for patient care. So we want the dog to be happy enough with the plan we're laying out, or the cat to be happy enough with the plan we're laying out. We want the plan to be feasible for the owner.
Speaker 2:So I tell people, you know, if this plan takes over two hours of every single one of your days, it's not an appropriate plan.
Speaker 2:So we need to figure out something that works for that individual. And then the biggest thing, because we deal with so much aggression, is that we need the owner to feel safe enough with the situation that we're living with. So they need to feel safe enough for themselves, for the pets around them, for the community around that pet. So I tell people, on any of those three things, if we're not feeling like we're hitting you know where we need to then we do need to have a bigger discussion about does this obviously? Does it mean we change the plan? Does this bring up bigger questions for you about? Are we going to be able to keep this pet in the home? If we can't keep the pet in the home, what are our options there? Because that's a whole nother conversation. So I try to just lay out those main goals and then emphasize hey, if we're not hitting these things, you need to let me know so we can kind of regroup.
Speaker 1:I love that. You've kind of, in a way, you've learned like a system of navigating conversations, right? So you get to a certain stage in a conversation, you kind of know where it might go. And that's tough because you have limited time in a consult, right, you're not going to spend eight hours getting to know every single detail about this person as well as their case, so you have to be really efficient in that time.
Speaker 2:Yes, and luckily we do have people fill out a lot of paperwork ahead of time. And then it does include questions like have you considered rehoming? Have you considered euthanasia for this behavior problem? So having that helps navigate the conversation because sometimes on paper I'll think, well, this might be a behavior euthanasia discussion case, and they put no. Think, well, this might be a behavior euthanasia discussion case, and they put no, no, not even interested. So I know, hey, we're going into this with a plan of how to make things better.
Speaker 2:Sometimes you'll see cases where it's like, yeah, we're really at the end of the road here and we know, okay, we need to talk about that on a bigger picture during the appointment. I think the trickiest appointments are the ones where we see a case that feels more potentially dangerous or more serious than the owner is really aware, particularly like in a young dog with you know, if you see a nine month old that's starting to growl at everybody, or if you see if we're starting to see things where it's like this is going to be a really challenging case. These are people that are going to have a young kid in the next couple of years. Those conversations are a little more challenging because you just know you're going to bum them out. It's not the right word, but it is.
Speaker 1:You're going to kind of you know.
Speaker 2:Give them news that they maybe aren't anticipating about how difficult things can be with some of those guys.
Speaker 1:That's got to be really difficult too is having a. It's inevitable, right? We're going to have some periods of our career. We're going to have a higher percentage of those kinds of conversations. So what do you do in those times when it's like, oh gosh, it's one bad I'm not going to say bad, I'm going to say difficult conversation, one right after the other, where you're having to help the client see the reality of their situation. What do you do to kind of help yourself with that reality?
Speaker 2:of their situation. What do you do to kind of help yourself with that? I generally don't mind I mean I don't obviously don't enjoy making people feel kind of bringing up issues that they may not have been aware of. But I enjoy the aspect of, you know, being able to be empathetic and say, hey, I know this is not what you anticipated when you acquired this dog you had, this was going to be your brewery dog, you were going to go on group hikes, you know, and we need to adjust what our goals are overall with this pet. So I think I enjoy helping people in that regard, even though they're tougher conversations. So I don't necessarily feel like they you know I carry them home or things like that Cause I do genuinely enjoy helping people with those conversations. That might just be my own weird, unique thing, but so yeah, yeah, no it's.
Speaker 1:It's definitely not for the faint of heart when you have to have that many it's, it can make for a tough week or a tough month sometimes, right yeah, and luckily the you know, the really heavy ones are not not wildly common.
Speaker 2:and I try to tell people like we're not doomsday prepping here, we just want to be aware. You know, as your dog gets older, if you notice new things, if you see escalation, we need to be aware of that and this is what we're here to do to help. And so I think always ending with you know, this is these are all the things we're going to do to try to improve the situation and get things in a better spot. So I try to always have a level of optimism, you know, as much as it allows.
Speaker 1:Yeah, yeah. So just to back up a second. So you have this. Really, this sounds like a nice intake form or a way of getting some information. Does that contain elements of, like, a caregiver burden score? I think it's a CBI or that particular tool. I'm seeing that used more in the veterinary field. Is that something that you find could be helpful or is that something you use?
Speaker 2:So we do not, and there's been conversations about whether we should include things like that. Obviously, we are not human mental health professionals, so I never want to dip my toe in an area where it doesn't belong, and so I think just personally part of my potential concern there is okay. Well, if they come back with this form that says they're really struggling, I'm not the right person to talk to you about if you have serious mental health concerns. So I think that's been a little bit on the mind is are we opening the door for people to feel like we're the appropriate person to reach out for, for care?
Speaker 1:Interesting point. Yeah, it's almost like you need to add another disclaimer there with a little checkbox.
Speaker 2:You know yeah like if you're struggling. And the nice thing is, social work and veterinary care has definitely expanded and just resources for people that are living with pets with behavior problems have wildly expanded. So we have resources now where we can say, hey, this is really hard, this situation is really hard. Here are all these excellent resources that can provide help and we're here to help too, but there's people that that's their main is to support the human side of things.
Speaker 1:Yes, I'm really happy to see that aspect of it coming into the field for not only veterinary social workers but also for professionals to help pet parents know kind of how to navigate the after or even the during of a difficult situation. So I'm really happy to see that of a difficult situation. So I'm really happy to see that. I know Valerie Bogey as well as Marlene LeBurge are a couple that I've brought in for various aspects of the aggression space to talk about their expertise in that and it's good to see that because it's so badly needed right.
Speaker 1:For both sides, for both the patients as well as us as professionals. So, yeah, Okay, I know what kind of this is what happens to me. I have so many questions that come up as we're talking that I tend to jump around a little bit. But I want to jump back a little bit on the meds topic and get your opinion on, since we're talking about questions from caregivers and you know which meds should I use and what is all this information swirling around on social media? But let's talk about over-the-counter or things that people can get without a prescription. So CBDs or pheromones, those kind of products. What are your thoughts and opinions on those type of recommendations?
Speaker 2:Yeah, so there's a fairly big nutraceutical world in veterinary behavior, just behavior in general. So nutraceuticals would be your pheromones, your supplements like zilkene and all of those options that are available over the counter for people. Cbd is certainly one of those options that people will reach for. The jury is still a little bit out in terms of the dosing for CBD and can you find a safe dose to help with behavior. There's more information available with CBD in the pain world, in the seizure world.
Speaker 2:So clinically I would say, when we have patients that are taking CBD, it's typically because their rehab veterinarian recommended it, for pain is the primary reason we ever have pets on it. I do think I have a slightly unfair view of the nutraceutical world because usually by the time that we see cases it's like I've tried that, I've tried, we've done that, so they've usually failed. A lot of those things that are likely very, you know, could be very useful in a certain population, I just don't find it as applicable to the majority of the population that we see. We certainly reach for them, not infrequently, but more often we're discussing prescription medications.
Speaker 1:I'm gonna answer, or respond to this one carefully. So I get the same question a lot as a trainer or consultant and of course the right answer is ask your veterinarian or a vet behaviorist. But in terms of anecdotal experience, similar. They've tried, but when they, by the time they come to me, they've tried all these over-the-counter things and these different products or gadgets or whatever, and of course they haven't worked with us. They wouldn't be coming to see either one of us. So you know you tend to get a different opinion of those products when you're in a particular seat, so totally understandable. In a particular seat, so totally understandable. Well, in that regard, do you see any of those particularly being effective for aggression cases or having sort of a higher percentage of efficacy with aggression cases? Anything exciting you?
Speaker 2:For the nutraceutical world, or just the?
Speaker 1:Just nutraceuticals. We can get into the other meds definitely.
Speaker 2:I would say none of the nutraceuticals wildly excite me for aggression at this point and maybe that again is an unfair opinion of them. When you talk about non-prescription, non-behavior prescription, the most exciting outcomes could be management of pain and how much that improves their behavior. So how much of this problem is not a baseline anxiety problem, how much this is pain, and so I get very excited about that aspect because it's really rewarding and almost sad in hindsight like, oh my gosh, this whole, you know this whole thing was pain.
Speaker 1:um, yeah, yeah, yeah, yeah.
Speaker 1:And some odd cases too yes sometimes you get like that placebo effect where they plug something in or it's like a spray type of product, the olfactory factor involved and the client actually, for whatever reason, they think it's working, so they tend to calm themselves. So with the dog, the precursor cues that a person would give with their own anxiety or their concerns or tension start to dissipate, which then the dog's like well, okay, things are good now. So it looks like it's working, sometimes when it's actually not, which is totally fine though.
Speaker 2:Yes, yeah, yeah, placebo effect is very, very real, obviously in humans, then absolutely in humans' perception of their pets, because that's a whole nother layer of kind of making judgment calls. But all those kind of fall under. For me they're not going to hurt, they may help, and so there are certainly things that are absolutely worth trying, and you'll get people that feel like they're game changers, and that's a wonderful thing.
Speaker 1:Absolutely. Now, there are a few that you always want. Well, with any of them, we want to inform our veterinarian or vet behaviorists what they're taking, but there are some that can interact with other meds, correct?
Speaker 2:Yes, so CBD in particular can interact with some of the anti-anxiety medications. So it has some overlap, for instance, with how it's metabolized, with how fluoxetine is metabolized. Fluoxetine's a very common medication in the behavior realm, and then CBD tends to be a very common one that people will do over the counter. So it is very, very important to let your vet know what your dog is taking so they can kind of screen. For, oh, do we have anything here where we may not want to have both those things going at the same time?
Speaker 1:What's a potential side effect or outcome?
Speaker 2:So theoretically you can increase the levels of one because of the way that it's metabolized through the liver, so it can change the level of the drug. Clinically we don't know how much that actually is a risk for that pet, but we just know that they use similar pathways to kind of get through.
Speaker 1:Is serotonin syndrome a risk with over-the-counter or nutraceuticals in combination with one of those, or is that more when we're looking at prescribed meds?
Speaker 2:In theory it could be, because some of the supplements are precursors for serotonin. Clinically, I would say we have very small levels of concern with combining those things, but it is always good to be fully aware of, because if we're getting creative with medications and we're starting to play with multiple things that increase serotonin that might make us well, it's just to be overly cautious. Let's get that supplement off the table if we're getting more creative on our end as well. So we definitely like to know everything that people are giving their pet.
Speaker 1:Yes. So on the topic of meds, since we're there, let's talk about prescribed meds and what Maggie likes to use or what's common, because and it's a question I ask every vet and every babysitter comes on the show because I'm always curious what's the latest? But the standard answer there is no latest. Like we have what we're using, and there's been tweaks. But one of the things that the trainers will say well, like, what about trazodone and gabapentin? It's like they're being used so often in the cases they see, usually in the combination with fluoxetine or one of the TCAs. But so give us your overall pitch on meds first and then we can get into the individual ones, maybe a little bit more.
Speaker 2:Yeah, so elevator pitch on meds first and then we can get into the individual ones, maybe a little bit more. Yeah, so elevator pitch on meds is broadly for behavior. There's two big categories. You've got your fast acting as needed medications. So classically those get used prior to stressful events. So we tell people, just like some people don't like to public speak or some people are very terrified of getting on an airplane, there's medications that you can give dogs in anticipation of something that you know is going to stress them out. Those drugs tend to have big, wide dose ranges. The lower the dose usually the less side effects, but also the less efficacy potentially. And then the higher the dose, the potential more side effects, but also potentially they're more helpful. So if you have a once in a blue moon stressor and the dog is totally zonked out on that, those as needed meds. If it's rare and it gets us through it, then we'll deal with the sedation side of things.
Speaker 2:Those medications would include things like trazodone and gabapentin and clonidine and kind of all the benzos, all of those categories. They can be used daily, kind of in contrast to using them just as needed. The only issue potentially with using them daily for anxiety alone is that you get this dog or cat that feels better, then they feel worse, then they feel better and then they feel worse. So you get a lot of seesawing. And then you also get like this ride or die if they're really helpful on when the doses are due. So people will be like, oh my gosh, it's six o'clock, can I please give Clonidine? Like they're just desperate for the next dose of it. So the other categories are long-lasting daily. So those are typically pulled from antidepressants in people and you are trying to get the baseline level of anxiety, reactivity, you know, poor impulse control, whatever it is. You're trying to target to a lower baseline every day, but not change their personality and their goofiness and their joy, because those are all things we want, obviously.
Speaker 1:Absolutely. So let's do this. Let's take a quick break to hear a word from our sponsors, and then I want to dive much deeper into the bedside of things. So we'll be right back. Thanks for tuning in. I've got something really special just for podcast listeners. To celebrate the sixth annual Aggression and Dogs conference, I'm offering a limited time bundle deal that includes the Aggression and Dogs Master Course plus over 30 expert-led webinars on topics like how to break up a dog fight, dog-to-child directed aggression, fear-based aggression, dog-to-cat issues, genetics and behavior, resource guarding, dog-to-dog aggression and so much more. You'll learn from some of the most respected experts in our field, including Suzanne Clothier, dr Christina Spaulding, grisha Stewart, laura Monaco, torelli, trish McMillan and Dr Tim Lewis, just to name a few. You'll also get access to live group mentor sessions with me and join a Facebook community of over 2,000 professionals all working with aggression cases. The total value of this bundle is over $3,000, but you get everything the full master course, 30 plus webinars, live mentorship and community access for just $595. Only 50 bundles are available and this offer expires on October 31st 2025 or when they sell out, whichever comes first. Just head to the show notes and click on the link for the Aggression in Dogs Master Course and webinar bundle to grab your spot.
Speaker 1:All right, we've been talking with Dr Maggie O'Brien and we've been talking about a lot of different things, but I'm gonna do the deep dive into meds now and talk about types of aggression cases and which meds would potentially be the most appropriate. Now, of course, each case is unique. Each case is individual. So I'm asking you to kind of speak generally, which I know is not the easiest thing when it comes to meds. But with your classic fear-based aggression, you know you have dogs that are just fearful of particular stimuli. They go out in the world and they're having a tough time. So you could do the situational meds, where it's just like you're going to hike today and we got to get you out, but we also want to take the edge off. So that might be a situational med. And then you're looking at the antidepressant class. Those are the SSRIs or.
Speaker 1:TCA class drug in which to help treat the fear. So we're talking more, not just a dog that's afraid of garbage cans. Once in a while it's. We're thinking of dogs that just have a tough time outside, not completely learned helplessness, but just you know. Picture that kind of dog. What are you looking at there for meds typically?
Speaker 2:There's a lot of individual variations, so I tell people we do have certain meds that we might reach for with certain presentations, and this can vary too amongst veterinary behaviors in terms of what your first choices are for things. Typically if we are seeing an aggressive case where the pet may have poor impulse control, like the owners can't see the problem coming until it's happening, so it's like I didn't even know they were upset and they bit somebody. Where we really want impulse control, fluoxetine still tends to be my first choice for that when you're strictly trying to treat an impulsive or aggressive dog or cat. Potentially there are other things, like if the pet has we call them like Eeyore dogs, so if they're just like I just don't know if today's going to be any good Right, and the lamp moved four inches to the right, so the living room's probably off for the day, and you know just. If they're more fearful and withdrawn, I typically lean towards something like Sertraline or Zoloft, which has slightly more effect on dopamine and dopamine can be involved with motivation and rewards, so sometimes that'll bring them out of their shell more.
Speaker 2:If we have a dog that has complete ants in their pants, like I'm in the room for 90 minutes and I'm just exhausted, having watched this dog be active, like they're on the table, and then they're over there and what's in the window? And I heard a small sound over there. If they're very, very busy bodied, that might make us lean towards Clomacom or Clomipramine, which is a tricyclic antidepressant. There's more impact on norepinephrine, which plays a role in that hyper arousal vigilance. You know, on the go, on, the go, on the go.
Speaker 2:So there are certain things that you know. I joke with the assistant. I can say like I heard the dog asking for Clomacom through the hall because you can just hear their tippy taps for 90 minutes straight. So there are certain things that might lean us towards one or the other. But I tell people like your dog might look perfect on paper for something like Zoloft and then we're going to find out two months from now that Venlafaxine was the ticket all along. So we have guidance and it can certainly help, but we're always ready to shift gears if clinically we're not getting the outcome we want.
Speaker 1:So it sounds like when deciding on the appropriate med, what you feel is the best for the case. You're looking more like a personality profile versus a contextual type of aggression or behavior issue.
Speaker 2:Yes, yes, I would agree with that. So it's more just what's your overall like? Are you more timid? Are you more fearful? Are you zero to 60? Are you constantly on the go, as opposed to conflict? Aggression gets this problem, or you know. So it's more based on personality than specific diagnosis.
Speaker 1:I would say the dogs that are, if I was to describe the personality profile here, just a dog that is not showing signs of fear, what they might have labeled like conflict control aggression years ago or even dominance aggression years and years before that, but the dog that is proactively, sometimes using teeth to gain access to resources or to control the people in their environment. So we're not seeing the fear signatures. We're seeing hard stares, agonistic puckers, high flagging tail, straight spine alignment. So just, I'm going to come over here and make you get off the couch to the other dog or to the person, and so they're not responding to necessarily thwarting off a threat. They might be competing for resources, but they might be saying, okay, I'm going to proactively say you need to go there, you need to go there, which is not a common case, but would you be looking at meds for that kind of case?
Speaker 2:Yes, and typically and again, it would depend on the whole pet, but I typically on what you just described, fluoxetine would still be top of mind for that. Interesting, Interesting, and do you see a lot of those kinds of cases, or is that much for our few between and monitor everything? When we see dogs for resource issues within the house with another dog, it's more often that they are more insecure and oh, the couch is over there and the dog's near my mom and they do present in a more anxious, concerned manner than a cool, calm, collected everything around. This is mine.
Speaker 1:Yeah, kind of speaking of that personality. Let's talk about maladaptive behaviors and let's just use a Border Collie, since we're just talking about a dog that wants everything to be in its place. What do you typically go to if you have a dog that's presenting maladaptive, hurting or chasing the people out of the well, trying to keep the people in the home? They're just trying to leave or get up to go to the bathroom. They're biting at their calves because it's a lack of enrichment. So we determine okay, this dog's just not getting its needs met. Do you kind of look at, let's try to meet the needs first, or do you say this dog has gotten to the stage of well, we should probably separate this out a little bit. We can get into compulsive stuff, where the dog's starting to chase shadows and lights, or we're just seeing it manifest in a different way. The dog's just hurting people in the home, but it's hurting people. It's like putting teeth on skin now and it's getting very common, happens on a daily basis. What would you think of the med profile there?
Speaker 2:Generally we would. Still, I don't necessarily approach things wildly stepwise, so I tell people if it's, yes, this dog is under enriched, they have GI issues. They likely do have some level of anxiety or impulse control or meds could help. I like to be in a position where six weeks after we've met with them we're like we're doing better. I don't know exactly which one of these is helping, but we're doing better. I am so much more excited to be in that position than super stepwise. And then it's you know, eight weeks later we're like well, we kind of talked about the GI stuff. Let's start treatment for that or start looking into that. And two, I think the potential problem with being very stepwise is that a lot of these guys might need they need more enrichment, they need training or behavior modification, they need meds. So if you do it super stepwise, it could look like, well, the training's failing. Well, the training would have gone great if they were on medication and could focus for a second. So I don't know that I actually answered your question.
Speaker 1:No, it totally does, because it makes me think about the juggling of all of these potential balls of what could work. So why hold off one especially? And we could talk about the dynamic of how some people feel it takes forever to get a veterinary behavior appointment and all those dynamics like and the interest of time. So that's one additional layer of these cases is the client time, their commitment level, their patience level and something we have to consider and we say, okay, yeah, we could just do no meds for eight weeks, but then what? Now we've just spent eight weeks. Now we have another six weeks for the meds to take hold. So you bring up a lot of really salient points for this conversation. It's not just that. Let's just try one thing at a time, so it's incremental, right.
Speaker 2:Yeah, yeah. And, like you said, the we have this beautiful plan in mind. Well, it doesn't mean anything if the client can't realistically implement it. So that is definitely a really big factor we have to consider and try to encourage honesty from the. I was talking to Dr Nick Dodman and Vivian Zatola on another episode the other day and we'd gone as a topic of partial seizures, and dogs that are the classic.
Speaker 1:you know, I'm just sitting there, I'm going to attack you or the blanket next to me, or I'm going to staring off. My pupils get dilated and I just start biting whatever's nearby. So not full-blown seizures, but partial seizures, that one of the things that can happen is aggression, so high levels of aggression sometimes. So in that regard, of course, you might be working with a veterinary, neurologist, or and those are the cases where we're saying, okay, we've got a lot of balls, we're juggling here, right, so can you talk us through a little bit in another day in the life of Dr O'Brien working with other professionals? So let's say, you see a patient like that. You're gonna be like okay, we need to refer to this person, and so how is that done and is that easy for you, or is it hard to get the clients to commit?
Speaker 2:to that, that we see that are not purely behavioral. Where we do feel like there's something else you know again, pain being the most likely case there but pain, neurologic issues, gastrointestinal issues, allergies where it just feels like, okay, this medical issue is not being fully met, we either need to talk with primary care about addressing this or, if it feels like it needs a specialist, then kind of onboarding the specialist. That would be indicated in that case, because if dogs don't feel good, it absolutely affects the way they perceive the world, it affects their behavior. So it's. It can be really challenging to make improvements in a dog that does not physically feel well. So it's emphasizing the importance of that and, I think, trying to appeal to the owner's empathy side of it's.
Speaker 2:We just want your dog or cat to feel better, and it can be really challenging because a lot of this is expensive If they don't have pet insurance. They came to see us and I'm telling them they got to see another specialist too, and so it. It is difficult and luckily primary care veterinarians are phenomenal and wear 10,000 different hats. So if they can't see a specialist, you know it's well, we'll talk to your primary care about what they can do to help, and so it's just kind of onboarding to the level that the owner is able, and then obviously trainers and things are hugely important and part of what we always try to onboard and involve as part of the team. And that's just another conversation about emphasizing how important that is and trying to relay that.
Speaker 1:Yeah, and that's just like the human medical field. How often there is a lot of questions and confusion who to talk to, what's going to get covered? So, in regards to your practice, now, each you know I've chatted with a lot of different veterinary behaviors and that the system or the flow of how a patient moves through that process can be different depending on whether it's through university or through private practice or through just somebody in a satellite office. So for you, the patient we've already learned fills out this lovely intake form. You get to learn about them and learn about their wishes. And it sounds like we were chatting before the show.
Speaker 1:You only have about a two-week wait list, which is fantastic in the veterinary behavior world, and it's a misconception I like to clear up on the show too, because the general theme is like oh, it's going to take six months on average for any veterinary behaviors, and that's not true. Some, yes, but there's plenty of availability depending on which practice you reach out to, and yours being one of them. So they fill out this form. They wait the two weeks they get horse being one of them. So they fill out this form. They wait the two weeks. They get in to see you. You meet with them. So what is the next step in the process? Maybe we can use that partial seizure disorder dog as an example. Like you see the dog, you hear the history. What's next for them?
Speaker 2:So in that case it would obviously be trying to get them to go see a neurologist. Those cases, at least in my experience or not, those are pretty rare presentations and we'll get more often people saying like I think this dog is having seizures or you know REM sleep disorders and things, and then, because there's no identifiable trigger, and then you ask, when do you see ground? It's like it's when I pet him when he's sleeping or when I pull him off the furniture and you're like well, those are identifiable triggers identifiable triggers.
Speaker 2:So but if that case were to present, it would be, yes, trying to onboard neurology potentially if, like, let's say what, they're not willing to see neurology, you know, do you speak with their primary care? Do we start doing anti-convulsant trials and things like that. We always encourage a lot of follow-up. So I try to get people to email me at least once a week with how things are going for our follow-up window until we see them for a recheck appointment. I tell people like it'd be great if we could meet for one hour.
Speaker 2:Your dog or cat goes home and you never have another problem a day in your life. That is just not how behavior cases go typically. So we're going to need to zigzag somewhere along the way. So I try to make that clear from the jump, that part of this plan we're going to need to adjust based on your dog's response or your cat's response. So we try to encourage a lot of follow-up and then we'll also try to get the ball rolling if we do feel like other people are indicated to kind of hop along the team. So if I think neurology is indicated, then we'll submit a referral for them. That means that neurology department is going to reach out to that client. So trying to provide, you know, as few roadblocks as possible and get them the help they need without putting all of the work on the owner, can be, I think, helpful as well.
Speaker 1:And the outside professionals that you refer to. Do you have like a local practice or a veterinary hospital nearby or attached to so I'm not attached.
Speaker 2:We're standalone behavior building but we definitely have a relationship with, you know, the ortho people in the area and the internists and the opto people. So it's a small enough community where you kind of know, you know, and we've got the neurologist that will let us send them videos of gates and rehab people who will give me opinions on whether things should be referred and to what department, and so having that community is really very helpful. With the virtual world it's a little more of kind of just researching okay, this is their zip code, let's see who's in the area that would be best for them or talking to their primary care about hey, who's your go-to ortho person? Because I'd like this patient to go see that person.
Speaker 1:Yes, and something earlier you said too, really just shows the insight you have onto the human side of consulting, which is making sure you tell the patients we're going to be doing some zigzagging, possibly here, and just so you're prepared for that. I find that that's what experienced consultants learn to say. They start to answer questions before they're asked right so they sense what the questions might be coming and they kind of help the clients understand. I think it's so important, especially in aggression cases, that the clients are made aware that, hey, we're going to try our best, but we're probably going to have to change course maybe a few times, because it's rare for those cases to go perfectly and everything we try the first time is going to go well. So, in that regard, for trainers and consultants that might have the same conversations, you have a couple trainers on staff that you have to help with the cases. Do you also have a network of trainers you refer to in the area?
Speaker 2:Yes. So we have all the people that we really like and I do tell people like we have a list and I say I'm sure there's excellent trainers who, for whatever reason, I'm just not aware of and aren't on the list. If they're not on this list and you're really interested in working with them, please let me know who they are so we can do a little bit of vetting. But if people come in already working with a professional that we like and uses the methodology is the primary thing we're obviously concerned about then that's really helpful because it's oh, they come in with a B-Mod plan, they come in with environmental adjustments, and so it makes our lives significantly easier because they have that really good background.
Speaker 2:So then it's you know, we talk to the pet parent and then send all the info typically to them and then the trainer behavior consultant just gets CC'd on all of our communication. So it's usually like a hey team fluffy email that goes on between everybody, so everyone can kind of be on the same page. And then regionally we definitely have, since our trainers don't obviously travel hours to get to people we see a ton of people from the Triangle area. So I have trainers I really, really love in the Triangle area in North Carolina, so it's nice to get to know specific people and be able to vouch and be like, oh no, this person's incredible, go work with them.
Speaker 1:What's the furthest? Somebody's come to see you.
Speaker 2:Four hours, I believe is the furthest. Yeah, we had someone from Georgia come at some point. Yeah, okay.
Speaker 1:Maybe we'll get somebody to fly in now that they're listening to the podcast.
Speaker 2:Now, when people call and they're like, oh, it's four hours, we say we have a virtual option and people are like, yes, I will do that instead. So.
Speaker 1:Is that in-state only, or can you do anywhere in the US for the virtual option?
Speaker 2:That is national so.
Speaker 1:Wonderful, Wonderful that was. Was that also changed during the pandemic? I know that was a kind of a weird thing for veterinarians before that.
Speaker 2:So more research came out about virtual behavior consulting, I believe secondary to the pandemic. I was in residency for the pandemic so we didn't open until obviously there's ongoing things. But we didn't open until kind of the worst of it was through and we could do in-person appointments. Our side of the virtual stuff really just came from being aware that there's large portions of the US that do not have a veterinary behaviorist and so just trying to increase access to care for those people.
Speaker 1:Yeah, when I heard about virtual consults with VBs, I was like the best thing ever just happened. So needed.
Speaker 1:And I'm so happy that that happened. It's such a great resource for people that don't have that access in their area. So so just to back up a little bit on the trainer consultant role so you have your trainers and staff, you have trainers that you work with. So the role of the trainer and the vet behaviors do you typically write the plans and then the trainer helps to implement them, or is it sort of you see what the trainer consultant's doing and you say this is good, or do you give advice or what's the strategy there?
Speaker 2:kind of lay out. These are the main goals, and I would say as a veterinary behaviorist, I'm typically going to lean more on like these are the environmental changes. This is management. So I don't get into details necessarily of like these are the nuts and bolts of how you teach a dog to go to a place. If they're on the couch and they don't want to move, I do throw a cheerio on the ground to get your dog to move and that's kind of you know.
Speaker 2:Those are more the management tools, because we're really trying to like put out the fire in certain situations and just quickly get to a better relationship. But then I say, hey, there's a lot of great ways we can navigate. Yes, your dog can get an excellent recall, your dog can run to a spot on cue. We can teach pattern games and all this stuff that we can do with your pet. But it is going to go much better if you are under the guidance of a wonderful trainer that's in person, helping you in real time. And so then it is sending them like, hey, these are our main goals, but we're, because they see a unique side, right, they go to the house, they absolutely zigzag based on what they're seeing, and so it's not like. You must follow this guidance.
Speaker 1:Yeah, I think those roles are confusing sometimes for some guardians. They're not sure oh wait, is that behavior? So it's going to be coming to my home to teach my dog to sit in the kitchen, or is it? Is it a trainer? And it can get a little muddy sometimes. I think even trainers have some not knowing which path to go. And I've heard this comment like I'm just I'm afraid to talk to them, like just reach out to them. They all talk, right, they just you know, and it's like this sometimes strange, like I don't know, like there's a wall up between the veterinary behavior community and the training community. But it shouldn't be like that. Right, it's just we're all working together to help the dogs and cats in our care, and so do you have any insights there as far as you kind of laid out what you do? But do you think what can we do as a community to help each other, like connect more?
Speaker 2:Yeah, I would just say we're love when people come in with trainers on board. We love when people reach out about cases that they think might be warranting referral. Or if people come in with a really good trainer, then we're like, oh heck, yeah, again, this makes our life easier. So, yes, I would never want someone to feel like I can't reach out because we I mean, it's so much better when they are working with someone like that, and it's very uncommon to get referred by someone that we would then look and say, oh, we got to change a lot about what we're doing with this pet from a training perspective. Those styles of training and things just don't. We don't get a lot of referrals from, you know, shot collar camp trainers. It's just that's not the style that ends up on our door typically.
Speaker 1:Sure, yeah, which is yeah, it kind of works out for you in some ways?
Speaker 2:Yeah, cause that might be a little more awkward.
Speaker 1:Yes, yeah, yeah. It's always hard. I'm sure you having it, and same thing for trainers if their client's seeing a veterinarian that might be giving advice that is not part of their plan. That's a tough side of things to navigate, but if you guys get a chance, go listen to the episode with Dr Chris Pockel and we you know how to mend those issues or those relationships as well. Okay, so in the last five or 10 minutes here I'd love to hear maybe about an advanced case now. So we have a lot of dog pros and veterinarians and people that are working behavior cases in the listenership here. So walk us through maybe a case or two, something just top of mind, some advanced case, some unique insight or discovery or something that went really well for you and your practice.
Speaker 2:We had a very recent one that I think from a team perspective was fun, where the pet came in for fear aggression of unfamiliar people, but also one of the big issues was really challenging to see at the vet and had kind of been either pulled through a door for rabies injections or put in a squeeze cage, so really like last resort handling techniques.
Speaker 2:So we had I've worked with this family for a long time and we've gotten so much better on leash reactivity and people coming in the house but the vet visits were still not going well and despite medications and things like that.
Speaker 2:But we finally were able to convince the pet parent to onboard a trainer in their area because they were not local to Charlotte and work on injection training, which I think is such a cool area. So we call it the squish and boop, which is from Ohio State where I did my training, but just training a dog to be, you know, cooperative care world, being very willing, participant in not sneak attacking and so being very in on the game of how to do injections. And so still, you know, again, it's expectations, but the goal was not, yeah, let's get this dog examined and vaccinated wide awake, but it was like we've got to make injections doable for this pet. So we worked they worked really hard with the trainer and then the trainer was able to go with because the primary care was like heck, yeah, whoever wants to help. So the trainer came day of the visit and we were able to get her a much less stressful sedated exam earlier this week, which is super exciting.
Speaker 1:Yes, such a big hurdle for some of my clients too is just getting to that. But to get the basics done, you know the dog can't be handled Sometimes. That and the game changing aspect of it when it finally gets done and seeing like the relief on the person's face and you know, and if it's done in the most efficient way and most caring way for the dog, the kind of relief the dog gets to like oh that wasn't so bad.
Speaker 1:most caring way for the dog, the kind of relief the dog gets to like. Oh, that wasn't so bad. I had Tabitha Kusara, who's a LVT and does a lot in the handling side of things, just gave a wonderful webinar on handling cats and dogs that can experience these issues. And it's one of the misconceptions I think, especially on the trainer side, that I've seen is we have lots of lovely cooperative care techniques and when we're doing it on video it looks perfect at home.
Speaker 1:So we get these lovely chin rests, the dog's all happy food's involved, but we have to remember that's not going to look perfect in the veterinary environment, especially if you haven't practiced there and practicing there as much as you need to. To have a completely visit that's showing no signs of stress at all is next to near impossible most of the time. So it's just something I like to mention because we have, we see again, social media influencing us like the perfect situations all the time, but it doesn't look like that. The goal is decreasing the intensity and frequency of distress for the dog and making sure they feel safe as possible, but still getting what we need to get done as caretakers Right.
Speaker 2:And I think part of like that case was they put an immense amount of work into it. So this was not like they worked on it for two weeks and then we started working on this months ago. So yes, with cooperative care and veterinary handling, if you want to go down this path, it is going to be time intensive typically, so trying to set expectations for that.
Speaker 1:Can you tell us about another case where maybe you've had a high degree of aggression either high bite level, multiple bite injuries, something unpredictable, sort of a difficult aggression case where you've seen success, and what'd you do to make that happen?
Speaker 2:So we see just so many aggressive cases. That could be most relevant.
Speaker 1:Something that surprised you, maybe that, like I wasn't expecting that to happen, because this dog is like really you didn't think it was a good prognosis, but it turned out. Maybe.
Speaker 2:I would say one of the more surprising ones and I hate to keep bringing things back to physical issues, but one of the, I would say, quick fix, surprising cases that I've had in recent memory. I saw a golden retriever. That was about two, no obvious gait abnormalities, but I saw her for resource guarding, but kind of abnormal resource guarding. These people weren't trying to take rawhides from the dog, they were trying to pick up pieces of fluff from across a room but would traverse a room, bite the owner very severe aggression for triggers that we would consider benign. So that dog came in but when she was in the appointment she was just very dull and she was a golden retriever. She was a very dull dog. She just like she didn't wag her tail, she just laid in the corner, she wasn't frenetic, she was just very dull and her gait looked okay.
Speaker 2:But we had them do videos of going up and down a flight of stairs and you know, walking up and down a hallway at home where she's in her normal environment, getting up from laying down, and then you could see in that she had intermittent bunny hopping. You could just see she had more of a hard time than she should have. And again. I'm aware there's different feelings about Labrella, but we recommended let's try Labrella for a couple months. We at the same time did fluoxetine and did a lot of management things for the resource guarding and she had other aggression things towards the owners.
Speaker 2:And then, long story short, she is strictly on Labrella. She is not on any anti-anxiety medications she has. They sent me a video of her having. They said we didn't know she had a personality. They're not usually that easy of fixes where it's pain only, but that was a cool. I was like, oh my gosh, that poor dog, you know, but it was so. Its whole problem was just it was so painful and Labrella ended up being the ticket for that dog, which was really cool full and labrella ended up being the ticket for that dog, which is really cool.
Speaker 1:It's kind of bittersweet in a way when you, when the pain meds kick in and as you see such profound changes, but at the same time you're like the poor dog was suffering from that for so long and then just trying to express to the world you know, hey, I don't feel well here and finally something's done. That's definitely seen a fair share of cases and the interesting thing too I don't know if you had a case like this is sometimes the context in which the pain events have happened that have been been exacerbated by something. So I've had some. A case shared with me. There's dog had spine issues in the neck area and was, um, the previous trainer.
Speaker 1:I tried to address resource guarding of the food ball using a knee collar and and it was around the food bowl. So guess where the dog started attacking the people? And it wasn't the classic guarding case of I approach your food bowl, it's you're approaching with a food bowl, which doesn't make a lot of sense to people, like wait a minute, I have the resource, I'm bringing you something good, and then you're attacking me. And it's hard sometimes for people to put their mind around as well. It sounds like resource guarding. It seems like it's the food, but it's really not. It's the context of I could be in pain when you bring that food bowl out and then, once the pain is resolved, the behavior completely changes and dissipates. So it's actually not a resource guarding thing. In the general sense it might start out, but the major exacerbating factor was pain, yeah, and it's kind of whenever they don't follow patterns that we anticipate.
Speaker 2:There is this question of like, what are we missing here? You know why it's just when it's a weird presentation, it automatically rings like either something off in the environment or something is off with the dog, and just what piece are we missing? Cause it's not a normal, you know normal presentation.
Speaker 1:I love those kinds of cases. I don't like seeing the dogs tonight, but I love problem solving those kind of yeah, they're very interesting, yeah, yeah. So, in this regard, if you have one takeaway message for everybody, as a vet behaviorist, what would it be? Just your like thing. I wish everybody out there knew this. When it comes to helping dogs, what would it be?
Speaker 2:I think in general we would love to see pets as soon as possible if they are starting to notice issues.
Speaker 2:So I would love if people brought it up to their veterinarians that they had concerns about behavior and then they could kind of get pointed in the right direction, either from a training perspective or a veterinary behavior perspective. But we tend to select for very last resort scenarios where it can be sad. I guess is the right word to kind of look at a history and say, man, if we could have seen you three years ago we really could have had a different outcome than what we're dealing with now. So we always wish we can see cases as soon as they're starting to see issues, because you can have such a different outcome and just helping them get the right resources as soon as possible, as opposed to you know, potentially doing things that may accidentally, by no fault of the owner they're just they're trying their best but you know potentially do things that might push us in the other direction for a couple of years and then we kind of get on board.
Speaker 1:So yes, I 100% concur with that thought. I wish people would come to see the professionals much earlier than letting it escalate or spiral out of control, or the emotions and so many other things that can happen if you wait. So, maggie, this has been wonderful. Where can people find you or learn more about you and anything you're up to, and where do you want to send people to if you have anything going on?
Speaker 2:Yeah, so I am in Charlotte, north Carolina, so we have Southeast Animal Behavior and Training for anyone in the North Carolina-esque area and then we also have virtual veterinary behavior medicine. So that's our virtual option for folks that may not have a veterinary behaviorist available to them locally. We have that for anyone in the country. On that service, we do typically monthly race approved CEs for anyone. The credit for CE is available for, you know, rvts and DVMs, but anyone's able to join those and we just go over a behavior topic every month. So I think we already did January, but February's will be inappropriate elimination in cats. So those are obviously virtual and then, yeah, that's kind of what we're up to and then just live in a clinical life, you know.
Speaker 1:Wonderful. Maggie, thanks so much for coming on the show. I learned so much. I wish I could have you on for the rest of the day, but I wish you well in the future and I hope to see you again.
Speaker 2:Yeah, thank you so much for having me. This is very fun.
Speaker 1:What an absolute pleasure it was chatting with Maggie and hearing how she's helping dogs and their people navigate even the most complex behavior cases with empathy, science and a truly collaborative spirit. Her insights into medication, pain and the emotional toll on caregivers offer a valuable perspective for anyone working in this field. And if you're ready to go deeper into understanding and helping dogs with aggression, visit aggressivedogcom. Whether you're a professional or a dedicated dog guardian, you'll find everything from the Aggression in Dogs Master Course, which is the most comprehensive program of its kind, to expert-led webinars, informative articles and the Aggression and Dogs Conference happening from September 26th to the 28th 2025 in Charlotte, north Carolina, with both in-person and virtual options. And don't forget to check out our Help for Dogs with Aggression bonus episodes, which are solo shows where I walk you through real world strategies for issues like resource guarding, fear-based aggression, territorial behavior and more. Just hit, subscribe or head to the show notes for more info. Thanks for listening in and, as always, stay well, my friends, friends, friends world.