Say the phrase “human-animal bond” and some practitioners will think about pets visiting patients in nursing homes, while others will think of animals in the classroom or of their own efforts to help a distraught owner cope with the loss of a beloved pet. Although all of the above are valid examples, they give the impression that the bond between owner and animal functions as a unique phenomenon rather than as a critical component that needs to be considered in every client interaction.

Just the thought of adding anything, let alone “Address bond-related issues,” to the already jam-packed examination procedure causes most private practitioners to roll their eyes heavenward, usually because they are thinking of the bond more emotionally than objectively. This response isn't particularly surprising, because the media and even a fair amount of the professional literature presents it that way; mention the bond to a group of professed animal-lovers and it won't be long before someone says something about unconditional love. However, while such representations of the bond may generate positive public relations, such a narrowly defined view won't help practitioners who find their relationships with their clients floundering because they don't understand the relationships that exist between those clients and their animals.

Does this mean that veterinarians must pry into the private lives of clients and their pets or question the herdsman about his most intimate feelings for his cows? Not at all. However, it does mean that they need to replace any unconditional love-based or otherwise romanticized definitions of the bond with a more practical realization that almost all human relationships with animals are conditional. Whether acknowledged or not, most people do place limits on their relationship with animals, and the bulk of these fall into 1 of 4 basic categories: time, financial, physical, and emotional.

Admittedly, we might smugly pronounce that people with such limits shouldn't have animals. But, then, what would we say about all those bond studies that prove that the more limited our lives, the greater our need for the benefits of animal interaction? Perhaps wildlife biologists can dismiss the role of the human-animal bond so easily, but surely not private practitioners who depend on such human-animal relationships for their livelihood.

In this and subsequent articles, how each of the above limits can undermine the treatment process and what can be done to prevent this from happening will be explored.

No busy practitioner questions that time can be a very scarce commodity. “If each day only had 10 more hours, I might get done everything that I need to do,” laments Dr. McIntyre. However, if she doesn't also take into account any time limits that her clients may have, she may inadvertently cause problems for them and their animals. For example, suppose Mr. Gorey lives alone with his golden retriever, Bonnie. He leaves for work at 7:00 a.m. and does not arrive home until 6:00 p.m. at the earliest. What is the likelihood of his medicating or otherwise treating his dog 3 times daily?

Working owners given more rigid instructions to treat their animal every 8 hours face an even more daunting task. Who can work a full-time job and treat an animal every 8 hours? Even food animal clients may experience this problem, as more of them seek outside employment to make ends meet. The same social forces that leave more and more people without supporting family and friends to care for them if they get ill also affect their animals.

Mr. Gorey gives Bonnie her first dose of medication just before he races out the door to work. While at work, he worries about possible side-effects that could occur in his absence: maybe he should have treated her sooner or delayed the treatment until after he got home. After a grueling day at work, further complicated by his worries about his pet, he rushes home. After assuring himself that no evidence of any negative side-effects exist, he medicates Bonnie again. Later, as he sits on the couch with her and watches television, he senses himself nodding off and faces another dilemma: should he give her the third treatment only 3 hours after the second, or should he risk missing it altogether because he fell asleep? If he misses that last treatment, should he double up on the one he gives right before he goes to work the next morning? What if that increased amount creates problems while he's gone?

These and other questions with no answers plague clients with time limits throughout the treatment process, even when treatments are needed only twice, or even once, a day. With luck, the random schedules on which some animals receive treatment won't delay the healing process or undermine the relationship between owner and animal and client and veterinarian, or both. However, the erratic approach can lead to 3 other problems. First, it may cause some clients to question whether the prescribed treatment schedule was even necessary in the first place. Second, it may cause them to use a similarly haphazard approach with a less forgiving ailment or treatment. Third, less than optimum treatment schedules caused by owner time limits may contribute to the growing problem posed by drug-resistant organisms.

Suppose Bonnie's problem does not resolve by the end of the 10-day treatment. Now Mr. Gorey has another dilemma: should he contact Dr. McIntyre or not? What he does depends on his relationship with both his dog and his veterinarian. If Bonnie appears sufficiently improved, if not totally better, and if Mr. Gorey once overheard the veterinarian rant, “Well, if people really care about their animals, they'll do what I tell them!” he might feel reluctant to disclose his own less-than-prefect behavior and risk alienating her. Under those circumstances, he may find it less troublesome to hope that Bonnie can complete the healing process on her own.

If, on the other hand, Mr. Gorey believes that Bonnie needs additional treatment, he will contact his veterinarian. Now he faces yet another dilemma: Should he tell her the truth or lie? If his desire not to alienate Dr. McIntyre exceeds his concern for his animal, he may bend the truth a bit. Rather than admitting that Bonnie didn't get the medication as directed, he tells Dr. McIntyre that Bonnie appears much better, but that she's not yet quite back to normal. However, if he does this, Dr. McIntyre could very likely prescribe yet another course of the same treatment, thereby, unwittingly, dooming owner and animal to that same frustrating sequence again.

In a third variation on this theme, Mr. Gorey feels sufficiently concerned about Bonnie's health that he opts to tell Dr. McIntyre the truth. In this situation, how he does it may also have lasting effects on his relationship with the veterinarian as well as on his animal's health. For example, he might hang his head in shame or otherwise grovel, which may lead him to resent the animal, or the veterinarian who put him in this position, or both. Or he may go on the defensive: “What dream world do you live in where people can do what you ask?” he shouts at Dr. McIntyre. “I'd like to see you have my job and do what you expect me to do!”

At this point, Dr. McIntyre will probably make her own contribution to the negative emotions already swirling about this treatment process.

“Why didn't he just tell me at the beginning that he didn't have the time to do what I asked?” asks a thoroughly confused and frustrated Dr. McIntyre. “I just wanted Bonnie to get better and prescribed the best treatment I knew to do that!”

Dr. McIntyre makes a valid point, but some clients don't feel comfortable questioning their veterinarian's treatment program. Perhaps they don't want to take up the clinician's time or they feel intimidated by the veterinarian for some reason. A surprising number of clients also don't realize that other options may exist.

Given the soap operatic qualities of these scenarios, the solution to problems related to client time limits is one that will arise time and time again throughout this series: Deal with them before you finalize any treatment program. Don't waste your own valuable time cleaning up the fall-out caused by incompatible owner and treatment schedules. Instead of just handing Mr. Gorey the medication and repeating the directions accompanying it, Dr. McIntyre should add, “Is this something you can do? If not, there are other options we can use.” In such a way, the veterinarian acknowledges that her client may have needs that preclude him doing what she wants and, also, that she is willing to find some other way for him to treat his animal successfully, if necessary.

By expressing these simple sentiments, Dr. McIntyre not only prevents all the time-related nightmares that may undermine the human-animal and client-practitioner relationships, she presents herself as a knowledgeable professional who cares as much about her clients as she does about her patients. For many clients, that duel concern is the difference between a good veterinarian and a great one.