Introduction

A person will often adopt a domestic animal as a response to a psychological need, such as the desire for a companion, but more often than not a future owner will focus on acquiring an animal that best meets their own needs without always considering the animal’s requirements. In an ideal world an owner might seek advice from a veterinarian on the best method of raising a pet and how to optimize the animal-human relationship before adopting an animal, but this rarely happens. This failure to consider the compatibility between the owner’s lifestyle, the reasons for acquiring the animal, and the animal’s needs can all impact on whether or not the type of management adopted is appropriate, putting both the animal’s well-being and the success of the relationship at risk.

One of the aspects where the owner’s conduct is often insufficient to meet an animal’s basic requirements is feeding. Most domestic animals rely almost exclusively on their owners for their dietary needs to be met, yet clinicians often note that many clients seem unaware that the dietary requirements of animals can differ widely, and that even the differences between canine and feline nutrition are not appreciated. An owner who is misinformed, careless or ignorant will tend to treat their animal in an unplanned and simplistic manner, offering and imposing anthropomorphic behavior in various situations including feeding. The animal thus becomes the victim of the owner’s inappropriate behavior, with consequences that can sometimes be critical and/or pathological, as when it becomes overweight or obese.

Professional intervention

Where this situation cannot be prevented by the provision of adequate information, then intervention by a professional is essential to correct the animal’s diet. However, this is not simply a case of selecting the appropriate food to encourage weight loss or maintenance of a correct weight. Nutritionists have noted that a weight-control diet alone will not in itself always achieve the required outcome in a domestic situation which is often quite different from the environment where the product was successfully developed and tested 1. The reason for this is the relationship that has been established between the animal and the owner; when considering the intervention required to correct the way in which meals are provided, and to avoid food being used inappropriately, it is essential that neither the human-animal bond nor the way in which the owner is handled should be underestimated.

Correctly managing food makes it easier to manage the animal in general, because the owner can communicate clearly and consistently with their pet so that the animal is more motivated and obedient. It is therefore vital to clearly explain even trivial instructions – such as the number and times for meals – so that the amount fed at each meal is controlled and to avoid food being given “out of hours”. The owner may otherwise offer the pet extra food, perhaps during their own meals (Figure 1) or in an attempt to prevent unwanted behavior on the part of the animal (e.g., to stop incessant barking by a dog or meowing by a cat).

In addition to the actual feeding of the animal, physical exercise has an important role to play. This is easy to achieve with dogs with their daily walk, although the amount of exercise must be based on the dog’s size. For cats, physical exercise can be encouraged by providing toys that release food if they are moved by the animal (Figure 2), or by hiding food in places that the cat must reach by climbing. These factors also link with an animal’s ethological requirements (which include displaying exploratory and/or predatory behavior, and intra- and inter-specific social contact) and allows the owner to share pleasant activities with their pet.

 

Clinician/owner relationship

However, for the veterinarian’s instructions to achieve the desired result it is important to establish that whoever feeds the animal has not only understood the information correctly, but that the instructions are faithfully adhered to. There is no guarantee that either oral or written instructions will be effectively applied; as with the human situation, only a minority of owners follow treatment instructions properly, with compliance gradually becoming less strict as time passes.

Perhaps more than any other medical discipline, it is essential for the veterinary clinician to establish a good relationship with the owner to ensure that instructions issued are effective. The owner is the animal’s “tutor”; the instructions will therefore only have a good outcome if the correct behavior is adopted by the owner. The veterinarian must therefore understand that the relationship between the clinician and the owner is both an integral and a critical aspect for the dietary instructions to be successful. It is not necessary to transform the clinician into a psychologist, but it is essential to understand the mechanisms that govern human relations and communication management.

It is vital to pay close attention to the initial contact between the owner and the clinic, or rather the owner and the first member of staff who meets him or her. Remember that it is not only animals that display an “instinct for survival”; people do so as well. Primitive behavior patterns, such as territory marking, are commonly seen in dogs and cats, but advanced social and cultural codes developed over thousands of years means that humans do not necessarily exhibit their own primitive behavior characteristics, at least not overtly; the signs are now usually masked. But put simply, the basic element of any living species is the principle of survival, and when two people meet for the first time, there are certain questions that are asked on a subconscious level: will the other person be a friend or an enemy, will they support me or fight me, will they be able to answer to my needs or will the threat remain?

An immediate response is required, and what is commonly referred to as the “4 x 20” principle is applied. These are four critical elements (with a common factor of 20) that are initiated – mainly on a subconscious level – when two people meet for the first time to quickly assess if the speaker is a “friend or enemy”; this process allows the individual to adopt the necessary behavior for survival.

The elements are as follows:

• Everything that happens in the first 20 seconds
• The first 20 words spoken
• The first 20 movements by the speaker
• The expressions shown within the 20 cm diameter of the other person’s face

Therefore the person responsible for the initial contact with every new client must be aware of this phenomenon and must ensure that they adopt the most welcoming attitude possible (Figure 3); this will help convince the owner that every member of the staff is a friend able to respond to their needs. The required characteristics are an attentive, welcoming manner with a pleasant attitude and an ability to listen; in other words, behavior that will establish a climate of respect and trust. People will assess the environment and equipment available in a veterinary clinic but also assess its trust and professional credibility. It should be remembered that even if the clinic has a highly professional image, all that is needed is a couple of incorrect behavioral patterns to change the client’s concept from friend to enemy and lose the loyalty that has been established with time and effort.

Once the first stage has been completed, certain factors which govern interactions between people need to be kept in mind; this is especially true with the relationship between the clinician and the owner. As in all relationships, where the roles are not equal, whoever has the main role (in this case the clinician) must manage the relationship with the other party (the owner), by using dialog almost as if it were an instrument. The main communication method should therefore be assertive, using a clear, friendly, calm voice with open gestures and direct eye contact (Figure 4); the speaker should have an upright, relaxed and receptive posture with a facial expression that shows involvement and compassion. Only in critical situations should a passive and/or managerial communication style be employed; these two methods may be useful in dealing with a difficult individual, such as an owner who is aggressive, nervous, inattentive, presumptuous, skeptical or uncooperative, but it is essential to understand and master these communication styles in order to make them actual tools of persuasion or guidance. If one has not fully mastered all the communication styles, it is better to maintain an assertive relationship and involve the other party with prompting questions to establish co-operation by proposing alternatives. Owners usually have the information that will allow a clinician to gather a proper case history, but for reasons that may not be evident, this is not always provided; rather the owners tend to give details that are tainted by their perspective on reality.

Dealing with overweight pets

It is also important to note that it is not unusual to find that an overweight or obese animal has an owner (or family members) who are also overweight, reflecting the consequences of their own incorrect eating habits (Figure 5). Obviously these poor eating habits on the part of the owner can also have consequences for the animal; in fact, the sharing of specific circumstances can provide an element of satisfaction for humans in a positive situation, but in negative situations sharing specific circumstances brings less sense of responsibility, guilt and shame. Therefore if both pet and owner are overweight or obese, then the human may actually perceive the situation as positive, or at least to be less negative or critical than others might see it. Interestingly, it is very easy to find media or internet pictures of overweight and/or obese owners with their animals which often convey a positive, sympathetic image, despite the fact that society recognizes that obesity can lead to serious health issues.

When dealing with an owner who is feeding their animal incorrectly (and especially when the owner or family members are also overweight), effective communication is essential, both as a tool for diagnosis and to convince the owner to apply the relevant treatment. Dialog should not be based on asking open questions (e.g., “when and what do you feed your dog?”), but rather by using paired alternatives to restrict the field and identify the owner’s behavior (e.g., “do you feed your dog at set times, or is there always food in the bowl?” “Does the animal always eat alone, or with you and the family?”). By communicating in this way the clinician can make the owner understand that there are different feeding behaviors, some of which can then be emphasized as negative. The objective of this form of communication is to allow the owners to discover the way in which they conduct themselves in relation to the animal; they can understand that they themselves are the ones generating incorrect circumstances which may create the problem and/or not support the solution.

Once the owner has provided answers, it is worthwhile checking the exact situation by using phrases such as: “Did I understand correctly that ..., can I confirm then that you feed your…, given what you’ve told me, it would seem that..., etc.” Reviewing the information has certain advantages, as it can create an alliance with the owner and make them the instigator in understanding the problem, as well as giving them the opportunity to analyze it from a different perspective (via the suggested alternatives). It also consolidates the relationship between the clinician and the owner, because the summary communicates the intention of checking that the problem has been understood, and consequently the clinician's wish to have a full understanding of the situation; in other words, it reinforces the concept of professionalism and that the clinician is a friend taking care of the problem.

If an owner, realizing that their overweight or obese pet has a severe problem, approaches a clinician to request help, they will probably follow the instructions given. On the other hand, if the owner does not appreciate that their pet has a potentially dangerous condition, and it is the clinician who points out the problem and advises on what should be done, the instructions will not always be willingly adhered to.

Strategic language

It is in these situations that language takes on a strategic significance for the dietary instructions to be successful. Like human behavior, managing the feeding of animals is triggered by motivation, by wanting to achieve objectives, by trying to find a sense of well-being, by principles, by the wish to experience pleasure, etc. Good sense, logical reasoning and sound instructions from a professional are not always enough to change behavior. Very often it is necessary to arouse feelings, emotions and sentiments in people to generate the motivation required to implement changes in their behavior; sometimes the “subconscious” needs to be triggered to promote change. The subconscious may be defined as that part of a person which is not rational and cognizant, but generates “feelings” that often guide our actions (e.g., when faced with a certain situation, someone may say: “I don’t know why but I just felt like acting in this way…, I acted instinctively but it seemed for the best…”). It may be necessary to facilitate these subconscious choices when dealing with the owner of an obese animal; for example the use of metaphors, anecdotes and homilies (i.e., language that generates feelings) can be an effective way of prompting these sensations and will allow the listener to perceive certain behavior patterns as either favorable or unfavorable (see box below).

Social rules

To make the instructions effective, the owner therefore needs to be convinced. It is worth knowing some of the main social rules that can persuade people to do something; if used correctly, they make it easier for the clinician to convince the owner that a set of instructions should be implemented for the animal’s well-being.

• Liking. People actually prefer saying yes to someone they know and appreciate. We will like a certain person for various reasons – for example, they may have a pleasing appearance, we may have a shared affinity with them (e.g., how they do certain things, how they dress, etc.), they may pay us compliments, or we may belong to a common group (e.g., a sports club or community). It is therefore important to pay careful attention to the “4 x 20 mechanism” in order to establish a positive and likable relationship; this includes trying to identify the other party’s interests and complimenting them on this when necessary.
  
  

• Reciprocity. This rule states that one person tries to repay what another person has offered them. A tactic that is often used is to do someone a favor or give them something, even if it is not asked for, and then request that it be reciprocated at a later stage. For example, the clinician could apply this rule by simply offering a small item for the animal to play with, while asking that the instructions are followed (“I have made a “gift” of this toy because it will get your animal to exercise more”), thus committing the owner to complying with the rule of reciprocity.
  
  

• Concessions. Another way of offering something to the owner can be to “increase” the level of the request, and then agreeing on a concession; for example, one could ask the owner to exercise their pet for at least an hour three times a day, and then allow them an initial period whereby they only have to exercise the pet for perhaps 45 minutes twice a day.
  
  

• Social confirmation. Most people think it is important to see what others say or do when deciding how they themselves should believe or behave; in other words, it is difficult to avoid the “power of others”. So when communicating with the owner the clinician can use phrases such as “these things I’ve just mentioned have been proven scientifically” or “people who have implemented this method have always had good results”(Figure 6).
  
  

 

• Commitment and consistency. People are more open to accepting further requests – even if these are more onerous than the original instructions – as long as any new request is consistent with the initial objective. So in this case, once the clinician has proposed a course of action and the client has committed to it, additional requests can be made at follow-up consultations, with the veterinarian emphasizing that these new tasks are still consistent with the original goal.
  
  

• Authority. People have a strong tendency to obey authority. Remember that aspects which influence obedience to authority include titles, clothing and status symbols that correspond to the type of authority being exercised. It is important therefore for the owner to immediately perceive that both their chosen clinic and clinician have all the necessary elements that convey authority – for example, the veterinary surgeon should be dressed neatly and appropriately ( Figure 7), the reception area should have a neat appearance, and the staff’s professional qualifications should be displayed prominently.
  
  

Conclusion

When dealing with an animal that is overweight or critically obese, the clinician must manage the relationship with the client carefully to ensure effective intervention, since the outcome for the patient will essentially depend on how the owner responds. The clinician may need to help the client recognize that obesity is a major problem, especially if the owner and/or family members have the same problem. To do this, the clinician must remember the importance of initiating a positive impression within the first few seconds of meeting each and every owner; if done carefully, this will generate the empathy needed to create a genial relationship whilst still allowing the clinician to maintain authority. Both verbal and non-verbal communication must be used carefully; the clinician should ask prompting questions and offer alternative answers which will allow the owner to recognize if they are feeding their animal incorrectly, and encourage them to find the solution to the problem. To persuade the owner, social rules and professional authority can be useful, and the clinician must always be aware that communication takes on special importance when it comes to compliance; if the owner is not persuaded, the instructions may not be correctly applied. Even though this may seem difficult at times, it is worth remembering the words of Seneca, the ancient Roman philosopher; “We do not confront adversities because they are difficult, instead they are difficult when we do not confront them”.

 

Further reading

• Watzlawick P, Beavin JH, Jackson DD. Pragmatics of human communication. New York, Norton 1967.
• Watzlawick P, Weakland JH, Fisch R. Change. Rome, Astrolabio 1974.
• Nardone G, Salvini A. Il dialogo strategico. Milan, Ponte alle Grazie 2004.
• Cialdini RB. Influence: The Psychology of Persuasion, New York, Morrow and Co. 1984.
• Horwitz D, Mills D, Heath S (eds). BSAVA Manual of Canine and FelineBehavioural Medicine. Gloucester, BSAVA 2002.
• Askew HR. Treatment of behavior problems in dogs and cats; a guide for thesmall animal veterinarian. (2^nd ed.) Oxford, Blackwell Publishing 2003.
• Vilanova XM. Etología Clínica Veterinaria. Barcelona, Multimédica 2003.
• Halsberghe C, Heath S, Iracka J, et al. A behavioural approach to canine obesity. Vet Focus – Special Edition Royal Canin 2008.
• Yaguiyan-Colliard L, Diez M, German A, et al. Tackling obesity in cats. Vet Focus – Special Edition Royal Canin 2008.
• Béata C, Bowen J, Fatjó J, et al. How to detect and manage anxiety in the cat. Vet Focus – Special Edition Royal Canin 2009.
• Linder D, Mueller M. Pet obesity management: Beyond nutrition (2014). Veterinary Clinics of North America – Small Animal Practice.