Hello, everybody. It's a great pleasure and a great honour, a huge honour to be here today with all of you in this amazing virtual congress. I would like to start thanking, to the organisation for the kind invitation to be here with all of you.

In these difficult moments with this pandemic, it's totally impossible to be face to face as I like with each person around the world, on the way that I. Usually, and used, but we need to face, this reality and finding a new way, to achieve everybody. And through this amazing congress, we can, create, a smaller world and be all together, joined.

So I hope that you enjoy, this behaviour stream. And I hope that, you, feel happy when seeing. This lecture.

So, my first lecture is about the relation of body and mind. It's very important to see, the, the impact that stress has on body and also, cases that look like behaviour, and at the end, they are not behaviour. So there is only one body.

So at the end of this lecture, my main goal is that all of you, start thinking together with me. That we cannot split the body in pieces and there is a huge relation between all between all the organic systems. So, but before going ahead, we must think about what is a behavioural problem because there are differences between a behavioural problem and the problematic behaviour, OK?

And this is related to the human perspective. In the human perspective, a behavioural problem is any specific behaviour that Bothers. And in fact, we need to count with the tolerance of the, the, the owners because it can vary a lot between people to people.

And I have several cases of people who, whose the tolerance were very, very huge, while others are completely out and, and, and they do not understand, and, problematic behaviour become a, behavioural problem. So what is important is that we understand that the majority of times that the behavioural problem comes to us, they are already in a level of tolerance, quite low. So, in fact, in fact, giving examples, I, I had one owner, whose, cat every single night during the last 4 years was spraying in the corner of her bed every single night.

Until one day. And you know when that day was, when she got a new boyfriend. And that was the moment that these behavioural problem became a huge problem that needed to be solved.

Another example could be, let's say, reactive dogs, dogs that can growl, bite, or show, stress signs. And these usually are not a problem until one day, . For instance, recently I saw a Labrador with, 7 or 7 or 8 years old, and for all his life he was reactive to several stimuli.

And in fact, when the owner got pregnant, this become a huge problem, and this was a reason for the consultation and the owners were ready to, to think about euthanasia. So it's very important to understand the tolerance of the owners. Obviously that's when we are speaking about a behavioural problem, we need to see the animal's perspective as well.

And this is really very important because when we see the animal perspective, we need, we will see a different approach. And this is, this is mandatory to understand the animal's perspective, OK? And this is the only way that we can treat and solve behaviour problems or problematic behaviours.

So what is a behaviour problem? A behavioural problem is an expression that covers many situations from scratching, for instance, to behaviours that can be related with organic or medical problems. And behavioural problems can be a cause and or a consequence of medical pathologies.

And I on proposed included brackets on medical because during the last years. We forgot that brain is part of medicine. That's why behavioural medicine should be included in, I would say as internal medicine, OK?

Because it's a medical approach exactly as other specialities. So, during the last years, we've put it the brain apart and we thought that behaviour problems were not medical, but in fact, they are, OK, as we're going to see. So there are many conditions, as I said at the beginning, that apparently they look like behavioural problems when in truth there are signs of other pathologies and we're going to see later on and it's very important to have a good relation.

With the GP because the generalist always have relevant information. So when we do receive a referral, we always need to have a very good relation with our colleague who sent this case. So when we look to these images, we can think immediately in psychogenic alopecia, for instance, acro dermatitis.

There are several names for this problem, but in fact, we can have two types of starting, two sources of this problem. So let's say that we start with ayoderma, OK? Let's let's say that We start with localised pyoderma in, in the paw or there is a pain, in the joints and the animals start leaking, OK?

And every time that that the animal is leaking, the owner, pays attention and say stop, don't do it. Don't do it. OK?

If we approach only the pain or if we approach only the dermatology, then, Then you solve the problem. The animal has learned, how to grab attention for, from the owner. So if you only treat the, the, the primary problem, the, the problem persists during the time, because every time the dog wants to grab attention, he starts leaking and the humidity, promotes the growth of bacteria, ringworms, and so on.

So you need to treat both dermatology. Brain. But let's say that it is the other way round.

And let's say that instead of this situation, we have, a dog that is living under a very stressful environment and, he starts, licking his paw, because licking grooming is a way to decrease the level of stress. When the animals is leaking, it's the same when we go to a massage. We start releasing end.

And we calm down. And the same is happening with dogs and cats when they are grooming, they are, decreasing their stress level. OK?

So let's say that, this animal is under a stressful environment and he starts, grooming and, over grooming. If we go and treat, only the behavioural problems, remember that when the animal once again is grooming and leaking, the Conditions of humidity are increased, which means that the, the, the conditions to bacteria overgrowth or other parasites or ringworms are also there. So we need to treat, both dermatology and the behavioural problem.

So the body is only one, and we need to treat and always remember, of integrating all specialties, which is very very important. So when we're making a diagnosis, a behavioural diagnostic protocol should always include the medical exam. But a medical diagnosis protocol should always consider the possibility of a behavioural problem as well.

And in fact, if we go back to our faculties, how many of us learned to include in our differential diagnosis, behavioural problems? But in fact, we need to include. Them.

It's very, very important to include, remember, the body is only one. We have also the effects on motivation. For instance, if the hungry increase, the priorities gradually change to activities that allow to obtain food.

So giving an example, if we have a medical, diabetic animal, we know that there are several changes in their motivation. And for instance, they have polydipsia and polyphagia and this means that they have a huge motivation to drink and to eat, which means that the animal can become defensive or more reactive regarding resources as foods. And for those that's already or have diabetes or, once, had the feeling of hungry.

I bet that all of you already had the feeling of hungry, we become more irritable. So imagine an animal that is always, feeling hungry. This makes the animal being more irritable and also, more tired.

OK? Which, which means that we need to understand in between lines of the behaviour shown by the animal. So it's very important to consider other pathologies.

And also the effect of pain. I'm not going to cover the effect of pain because my dear colleague, Doctor Sarai in her presentation is going to cover deeply pain. But remember that pain can change a lot the behaviour.

And usually, I say when we have a sudden behaviour change, it We should focus in another thing the part of the behaviour, OK? And we're going to see later on some cases which are not directly related with pain, but pain will influence as you'll see on Doctor his presentation. So, when we're doing a clinical approach, we need also to focus on the problem presentation and we usually I call this a functional approach to the pathology.

And it is something similar to what we already spoke about. We can have the same behaviour causing, being caused by different causes, different sources. So the same behaviour having Different causes and also the same cause or the same pathology can lead to different physical signs or different, behaviours in each patient.

We can have the same pathology in one animal, making him become, more reactive, for instance, or another animal, start, barking, another starts scratching more. So it really depends, . on, on the animal.

And we need to, to have this clear in our mind. So there is an interdimensionality, which means we cannot split the body. All systems are linked to forming only a only body.

And this is very important to understand. In fact, during the last years, we've been, speaking about specialties, and separating the body, and we know We know a lot about neurology. We know a lot about neurology and so on.

But in fact, all the body is one and all systems are linked and one change in one system can produce a change in another system. And this is very important to understand, OK? And, there are, individuals that find a way to openly manifest their anxiety behaviours.

But others don't. And those that don't find a way to manifest their anxiety, behaviours, their, behaviour problems are those that will develop psychomeic diseases. OK?

This is very well described in humans. Today, I'm going to bring, an approach, that we could think about for, the other animals as well, OK? So, if we go back to 2007, a study was published in the Journal of Norwegian Medical Association, and it says that during the evolution, together with the development periods of each species, which means, taking in consideration consideration the genetic, genetic predisposition and the Epigenetic effects.

Obviously that we always need to think about the vulnerability and resilience, which is something individual. So two animals in front of the same stimuli, one can develop a behavioural problem and the other can have nothing at all. And, and if we remember about, multi-dog households or Multi-cat households.

You see that in the same household, there is one cat that, that developed this, a certain behavioural problem, while the other doesn't. And this happens because of the vulnerability of these specific animal. In my, humble opinion, the environment has a huge impact on, the response.

Of the animal. So, what the animal learned with the environment, especially during your, childhood, it's very important to the future of the animal. So the environment where the animal, is growing and the the environment where the animal is living is very important for their responses.

So. In front of a specific event or in front of a specific stimulus, the animal wants to have a quick recover. And this is what the animal is willing because he cannot continue, continues during long periods of time, with stress.

So the animals, want to find a way to recover. However, there are some Animals, as I said, that they cannot find a way to recover. So those are the animals that would go to develop other problems, like, the well studied and well-known feline interstitial cystitis.

But there are also, gastroenterology problems. There are skin problems, respiratory problems, and also behavioural problems. OK?

So when we are evaluating the patient, we should always verify adequately all the animal's history, OK? It's very important to check all the animal's history and the environment that's, where the animal is living. At the same time, we need to see if, there are any physiological manifestations that can be linked with chronic stress situations as we're going.

To see, today. We know, as I already mentioned that stress and anxiety leads to problems in the bladder. I mentioned the feline interstitial cystitis and and in human beings, it is also well, studied, especially in women with depression, there is a high incidence of, interstitial cystitis as well.

In terms of He, obviously that we understand clearly that if we are living under a continuous, or chronic stress, environment, then, the development of hypertension can lead to many other synchchondrial diseases, but there are much more. So if we look to endocrinology, and the situation that I'm going to mention is Well studied in humans, but in veterinary world, it's not that much studied yet. So we know that in acute stress situations, there is a decrease on insulin and an increase of glucocorticos, namely cortisol, and cortisol, per se, will, will, increase the resistance to insulin.

So imagine that the Stressor, persists in the environment become becoming chronic, which means that the level of, of, of of cortisol increased, increasing the resistance to insulin, which is already decreased. So, so, there is a relation between stress and diabetes. And this, as I said, it's well studied in humans in, in.

In our world, it's not so well related. And I'm not saying that stress is causing diabetes, but we know that stress, can be a a risk a co-risk factor, of diabetes. And it's very important that we realise that stress has, has a serious impact in this, in, endocrinopathy, OK?

In terms of reproduction, we know that when the animal is stressed, starts releasing androphin, in order to, calm down and decrease the effects of stress. But the release of endorphin, inhibits, the LH production. And in cases of, males, LH is very important for the spermatozoa production.

So it's, stress can, can, can, can have a serious impact in reproduction. And that's why in the past, when we were assessing, the welfare, on, zoologic parts, on zoos, usually, we, assessed, for instance, the, the, newborns, the mentality, the numbers of new, babies arriving. Because it was a sign of, good welfare.

In fact, nowadays, we also know that, many animals, when they do not have nothing to do, and this is a situation of negative welfare, in this situation, they also can copulate and reproduce. OK? So, but it's, it's important to understand that there is a relation between, stress and low level of spermatozoa.

There, in, in, in situations of stress, there is also an increase of prolactin and prolactin, will inhibit the rep the reproductive heat. So, and this is another question mark that we haven't studied yet, but for me, I would put a question mark if there is, so this is only a hypothesis, if there is a relation between Beaches that have pseudo pregnancy. If there is a relation between the environment where they are living, if there are environment stressors, and this could be correlated with the occurrence of pseudo pregnancy as well.

So can stress be a co-risk factor of pseudo pregnancy, and this is a question mark that we need to think about as well. This was my PhD thesis, and in fact, this is about chronic kidney disease on cats. And, what I tried to, to, to, to check, was if there, there is an influence of the environment where the cats are living together with, the development of chronic kidney disease or control of chronic kidney disease.

And in fact, what is Happening. And I, I could spend here one hour speaking about my PhD or, 2 hours, but I'm not going to, to do it for you. But, let's, let's keep in mind, when we have, systemic hypertension, what is happening is there is, a different, input level and output level of blood in the kidneys.

And what is happening. Is that the inputs of, blood coming to the kidney, do the, constriction of the vessels coming out of the kidney. This constriction makes, that, the, the, the, the, the quantity of blood inside the kidney increase.

And in this situation, that these stasis, this congestion. Promotes, can be a first, step to the development of a glu marrow or nephritis. So am I saying that stress is directly causing, chronic kidney disease?

No. I'm just saying that we also need, because we know that chronic kidney disease is a multifactorial disease, and we need to start thinking about the hypothesis of including stress as a risk factor as well. When we move to gastroenterology, there are very interesting, details that we should always remember.

And the first is that bacteria and other microbiotes make serotonin. 90% of, of this serotonin is produced, in, in the gut. And that's why usually there, there is, the sentence all over the world saying that we are.

What we eat, because there is, a, a direct relation as we're going to see. And as you see, many of the neurotransmitters, are produced by the microbiots, OK? And there are 10 more, 10 times more micro micro oh, sorry.

Sometimes there are words difficult to say for a non-native English. There are 10 times more microbes in the human gut than Cells in the body. And this is important because we have identified the enteric nervous system.

And this enteric nervous system has more cells than the spinal cord. And there is a, a, a vagus nerve, and this vagus nerve connects the, the central nervous system and the enteric nervous system. But 90% of the information flows up from the gut directly to the brain, OK?

And this is very important, but the inner nervous system is, is not new. What is new is what we are learning about the relation of microbiota with the central nervous system. And what we are now studying and learning more and more every day is the impact of the microbiota, to with the behaviour and within the central nervous system with the brain.

But when speaking with about gastroenterology, we need to remember, that in human beings, once again, is very well described the stress ulcers. It's also described in some species in companion animals, it's not very well considered, OK? But not going deeply in physiology, but what is happening in situations of stress is that the, the high level of cortisol.

We create, immune depression, OK? And this immune depression can, leads to overgrowth of specific, let's call bad, bacteria or virus or parasites that could damage the, the, the, the different, layers of the, the stomach, OK? Or the guts.

But in fact, the, the, there is also In this situation, the decrease of prostaglandins, which are important to the recovery of these damages, OK? And also in stress situations, all together with those two factors in stress situations, there is a central vasoconstriction, sorry, there is a general vaso constriction because we need to have blood. The muscles to for our flight or fight response.

In fact, it is not a priority to the animal to continue with the digestion. So, in fact, there is a vasal constriction and the, the, the, decrease on the blood input to, the, the most of, the organs in, in, in, in the abdomen, namely the stomach. So altogether, the the conditions to the development of ultra.

Altogether in stress situations, the conditions are preparing the stomach to develop ulcers. At the same time, it can happen vomits and diarrhoea for all the situations that I already explained. But if you think about the fight or flight response, what will happen is that once again, the body needs to get ready to get away from the, that stimuli or to fight.

And in fact, it's not none. To, to have a good digestion. And the, the weight should be lower.

So the normal response and imagine yourself in a stress situation, if it is a very threatening moment or a scary, moment, some people got diarrhoea or vomits because it's also a way of, decreasing, our, weight and get your body ready to fight or fight. OK. But, in situations of colitis of stress, there is another problem which is the animal starts pooing, and defecating inside the house and this breaks the relation with the owner because the owner is also getting stressed with the situation and starts usually punishing the dog, which increases the stress and the the the situation increase, and becomes more negative in the animal perspective.

There can be also changes on appetites. So, and I'm not going deeply in physiology once again, but there can be changes in, any animals who, in certain situations, they can become, more analytic or decrease the appetite or animals that in situations of, of, certain acute stress. From time to time, they become, polyphagic.

Some of them can also be bulimic, because we see them eating more than normal, and then vomiting and then eating and then vomiting. OK? And these can be related, especially with, specific hormones.

One is the cortisol, and the other is the FSH, and the, these, both these hormone. Are very important to control the appetite and we need to understand, that depending on the stress type, there can be animals, having anorexia or decrease, of, appetite, and others who, have, who has, increase of appetite or even, let's say a bulimia. OK?

So what do we need to know? In fact, we need to know everything. Usually I say that in behaviour, medicine, we are very curious people, and we need to, to, to know everything about the the family where the animal is living and about the, the animal's environment.

So we need a good information and a good data intake. And this is very important. Usually, we do use specific questionnaires.

To help us not to lose any specific points. And we also need to do a complete physical examination, a physical, exam to assess pain, and we also need to do some laboratory analysis. Usually, those that I require before a behavioural situation.

So I asked to the GP to check in order. To rule out many other diseases that can be, conditions that are leading to behavioural changes. Usually, I recommend a full blood complete count.

I usually, check the liver and the kidney, OK? And also glycemia. It's very important to check the the sugar blood level, because as we saw, it can also lead to behavioural changes.

In Portugal, where, where I'm living, T4, and TC TSH is not, very cheap, it's quite expensive. So usually, I recommend to do T4 and TSH in senior dogs, or, in, in senior cats. But, if there are certain symptoms that makes, makes me think that there is a pos of having a thyroid problem, then I ask after my behavioural consultation.

There are some authors recommending adrenal cortical functions, but in this case, bear in mind if T4 and TESH is already, expensive, making adrenal cortical function is also quite expensive, and I'm not going to do this. In all my patients. OK.

So, when, when I have cases that, when I talk with the GP and we consider the, the, the hypothesis of adrenal cortical problem, adrenal cortical, pathology, then we would, promote and ask the owners to do it. And finally, cheap and give us very important information is the urine analysis, OK? So now that we saw the impact of stress in the body, now we're going to see, some cases, that looked like behaviour and were sent to, to, to, to to, to a behavioural consultation and as we're going to see, they were not behaviour only.

Behavioural, let's say, because we would need to treat both, specialities as you, you will see. In this situation, I'm going to split the body in pieces, OK? Because, it's, it's, it's a way to become more organised in my lecture.

However, we never know, if the animal coming has an orthopaedic problem or a neurologic . Problem. So, we need to, to once again remember that the body is only one, but only for a lecture is easier to organise this way, OK?

I also would like to say that to show videos of these cases, I would need the permission, the, the, the written, the, the signed consent. Of the owners to show you the, the videos and I don't have. So I'm going to describe the cases showing some photos, OK.

Obviously that's the part of the animal's name, obviously that's name of, of the owners are changed, OK, because I'm only using as an example. So let's starting by neurology. And the first case that I'm going to talk about is Joa.

Joka is a dachshund, a tackle, 3 years old, non-nutrient male, and he came for a consultation because he has already beaten all the family. So he came, according to the owners, to, to, because, he was aggressive, OK? And I, I hate the diagnosis of aggression.

So I, nowadays, I'm not, making a diagnosis of aggression because aggression is not a diagnosis in my opinion, OK? Aggression for me is a symptom, a symptom of something wrong in the emotions level. So if you do, if you are doing, an emotional approach, then you need to understand what is the emotion behind the aggression.

And then you're going to treat the emotion and not the aggression. It's the same as with diarrhoea. You're not going to treat diarrhoea.

Diarrhoea is a symptom of something wrong in the gut, and you're not going to treat the diarrhoea. You are going to treat what is causing diarrhoea. OK.

So, and the same with aggression. So, but during all the, the, the consultation, we understood that the, the dog's, posture was ambivalent. So, which means that there would be, fear, anxious behind these, behavioural manifestation.

And in his History, there was incorrect socialisation, inconsistency of the rules because the animal, passed, the major part of the day with the grannies, let's say, and then, dad or mom pick, pick his, pick him up and, take him home. Where the rules even in his own, own. We're different from the, the male owner, the female owner, and the daughter.

OK? So the, there were lots of inconsistency in the rules, which I usually say it's not a problem in, a normal behavioural dog, but in a, in an anxious, dog, it's very important to have consistency of rules. I would say it's important.

In all dogs, but the majority of dogs, they can cope with inconsistency, and they can learn and adapt themselves to each rule of, from each owner. However, in anxious animals, inconsistency can lead to more and more stress and can increase the problem. OK?

So. We started the behavioural modification, directed to fear, emotion, and also learned, something that in the past we called fear aggression and learned aggression. OK.

Nowadays, I would say that we, we, what we have, we have done was an emotional modification plan to treat anger. Anxiety and to treat fear, OK? And this was our main goal.

We suggested some anxiolytic drugs and painkillers as well, but the owner, was not happy with, anxiolytic drugs, so they didn't accept, at this moment. It's very, very important to understand, and I don't know, in each of your. Countries how it happens, but here in Portugal, it happens that some owners, they come already with the idea in mind that I'm going to prescribe a drug that solves the behavioural problem, and I always say that there are no miracle pills and there are other owners that they are more resistant to the prescription of anxulic drugs, and this was the Case of dishonour.

So one month after, the, the dog was much better, less attacks, much self, much better self-control, and he was always improving during the following month. So during one year, the animals was, the animal was fully normal, but one year after, he, has bitten again. OK?

And before this Episode, the owners, because after one year working with our rehabilitator and with us, the owners were already understanding the body language and they understood that the dogs are manifesting in fear again in specific situations that lead him to grow. So now, what do we need to know? What do we need to do now?

Well, we could ask to the crystal ball, yeah, but no, we are scientists, so we are not going to check the crystal ball. We are going to review the case and look since the beginning and remember about the breach. So what are the medical problems, that can be a source of a sudden return, return of this behavioural manifestation?

Indeed, indeed. You are absolutely right because I'm reading your mind and you're absolutely right. In fact, I asked to the neurology college to check, this animal, and, the first step was doing an X-ray and there, there was a shrink of the, the indisc in vertebra disc.

And in the myelography, there was also some changes, slight changes that allowed the the colleagues not to go ahead with a surgery. So, the animal started with medication. The animal started, with acupuncture.

The owner was very happy to, to do acupuncture. However, one year more it looks like a cycle, one year more, the animal was totally under control, but one year after the animal has bitten again. So what are we going to do?

Once again, we are going to review everything, every, so we are going to review the case as if it is a new case and reviewing and asking for more videos. Videos is something videos are very important, . It's a very important part of the behavioural consultation.

So I ask lots of videos, OK? So, and reviewing the case once again, as it is a new case. And in the videos recorded when the owners did the zoom, what we noticed in certain moments was a.

One leap in the, in the, in the, in the higher lip, we could see, a shaking, OK? And our, presumptive diagnosis is, was psychomotor epilepsy. To do a final diagnosis, we would need to do, to go through an EEG, which, and even.

Doing, an EEG, it, it would be very important to, to, to find the focal seizure. And in this situation, those, seizures were very rare. And in fact, what we did were, was the therapeutics, diagnosis and we starting, starting anti-convulsion.

Medication together with, with the anxiolytic drugs and we kept this animal under control until nowadays and the owners got divorced and there were major changes in this dog's life and he was living without any other signs for the rest of his life, OK? So, moving to another case, Beauty, she's a cat, one year old non-neutral female, and she came for consultation because of sudden quick runs around the house without any explanation and sometimes together with very high vocalisation. The medical history has nothing to mention, but in fact, this cat was living in a poor environment.

So on the films, we noticed that. In fact, the vocalisations were very high and total totally uncontrolled vocalisation, and there was a sound of a bell. And my opinion is that the bell should always be avoided because the sound of the bell can create behavioural changes in certain cats.

So, bells are not recommended. Apart from that, she was, a white cat, with different eye colours, and we know by genetics that there is a possibility of a deafness. And how much did the noise or the vibration of the bell could, influencing these animals' behaviour.

So our treatment was promoting environmental enrichment. Once again, I, I am keeping in my presentations, the frequent names that you're going to see in the literature, but, as I mentioned, most of, the behaviourists are replacing the word aggression or aggressive by other words and not to. Labelling an animal and in terms of environmental enrichment nowadays, as, Doctor Serra is, also, mentioned in, her books, we are replacing by, environmental optimisation or, as other authors are also saying, environmental management because.

When we speak about enriching, it looks like luxury. And in fact, we are not going to, enrich the animals, but giving the minimum, for them to have quality of life. OK?

So I kept in my presentation what you're going to, to, to, to, to see in the majority of the literature, but it's important to make these notes. Parts, so we optimised our environment and we asked the owners to take off the bell. And in fact one month after only with the optimisation of the environment and taking the bell out there there was a drastic reduction of these behaviours.

So happy owner, happy vet. OK. However, About one year after this cat was euthanized, and the reason for this euthanasia was that suddenly she she started with seizures.

OK. She started with seizures. She went to, a urgents.

She made, the CT and it was diagnosed a meningioma. And the meningioma was not, very easy, in a very easy location for surgery. At that time, it was not very.

To have insurance, and, it was not possible to, to, to, to, to, to, to, to make a proper treatment and, the owners together with the colleagues decided for an euthanasia. So could it be possible that the meningioma was already there one year after? I don't know, but, once again, a sudden change of behaviour can be related with, other pathologies.

So bear in mind. Case three is Jones. Jones is a bull terrier, male, 10 month.

Very young, the dog with circling and tail chasing. This dog was from, a student of mine, and the student was very open, to behaviour. And, booked immediately a behavioural consultation.

So once again, we start, the owner was very, very, very happy with clicker training. He loved clicker training, so, so we started to, to, to, to emotional modification plan plan using clicker training and also, optimising the, the environment where the puppy, was living because there was a lack of stimulation and we recommending dog apiing pheromone also. To promote the positive emotions.

One month after, there were few improvements, and as it was, a young terrier, once again, we sent to neurology and, the neurology, diagnosed with called the equinna syndrome, which is a lumboscar stenosis, which leads to, compression and pain and can be responsible for this behavioural manifestation. So, moving on to orthopathy, I'm bringing boss. Boss is a, a German shepherd, non-neutral male, 6 years old, and he was champion, champion of obedience.

He was the proud of his owner. He was like a robot, you know, the type of dog that does everything that the owner ask. And the owner was very proud of all the, all, all the championships that he.

One, but he came to a consultation because the aggression manifestation was escalating. He started by drawing and currently, he was already snapping the air. OK.

So in the aggression manifestation assessment questionnaire, we observed that the growling started mainly when the owner asked him to. Stand up. For instance, when he was laying down, the owner asked him to stand up or when the, on, when he was laying in the sofa and the owner asked, come down.

So standing up, coming down, standing up, coming down. And after this manifestation also increased during the training sessions when he was asked to sit, sit. So laying down, standing up and sit.

So, escalating aggression was a gradual and decreasing gradually, but we have something here in common, the movement, OK? And this lead me to ask for orthopaedic, orthopaedic colleague to see this case. And in fact, the Hip X-ray showed a hip dysplasia.

OK. So once again, this dog was showing behavioural changes when in fact behind these behavioural changes, we had a hip dysplasia. Are we only going to treat the hip dysplasia?

No, we're going to, to treat the hip dysplasia, but also the behavioural problem because in fact, The dog has already learned to use specific behaviours and we need to work with this behavioural manifestation as well. Case 5, Shura. Shura in Portuguese means crying or crier.

He's a busted hounds, 7 years old, non-neutral male, and he came for consultation because of a psychogenic alopecia. And the lesions were localised on the flank and on the back. OK?

So, having this in mind, the first step that, I always do. When I have a psychogenic alopecia, is asking for, a full, a full complete dermatology, exam. And, the dermatology, dermatological exam was OK.

So due to the breed and the location of the lesions, it was made an X-ray and the X-ray was not conclusive. So, the, the colleagues suggested other exams. And There it comes.

Another hernia, this hernia. In fact, what happens in these situations is that, Shura, was leaking the flank and the back because of a neuropathic, pain. OK?

I'm not going to, to, to go deep in types of pain because is going to speak about that. But in fact, the, in situations of neuropathic pain, the animal starts, for instance, leaking in another area in order to decrease the feeling of pain. OK?

There is a decrea release of endorphins that also are important to control pain. Dermatology. Bob, Bob, is a male, non-neutered, 6 years old.

He came also for consultation because of circling and tail chasing. In his history, we found intermittent reinforcement by the owners among other issues, but in the physical exam, we, found this tail. What's, immediately made me, remember my school time and, the, the rat tail.

OK. So in this situation, even being 6 years old, I asked for, other exams and I asked for checking thyroid. And in fact, the T4 was decreased, the TSA.

The age was increased. So the dog was treat, was diagnosed with a hypothyroidism. And in situation, in this situation, we're going to treat the hypothyroidism, but also the behavioural problem because the dog has already learned how to grab attention from the owner.

So we need to treat the behavioural situation as well. Moving to ophthalmology. Let's start by Galgu.

Galgu, is, a weed male, non-neutered, 4 years old, and he came for consultation because he was presenting fly catching. So, trying to catch imaginator flies that doesn't exist. In fact, in his, .

Living environment, we noticed that he, passes long periods during the day at the canal where he was not very well stimulated, to say, not stimulated at all. OK. So, but in situations of, fly catching or other, related to all with ophthalmology, I always ask, and this is the good, reason to You have, a team, of colleagues that you can trust and you can, ask for a second opinion.

And I asked this, animal to be seen by the ophthalmologist from my faculty. And in fact, it was, diagnosed a subluxation of lens. OK.

So, in fact, it was not, a behavioural problem, but an organic problem. Case 8, William. William is a Siamese neuter 12 years old, and he came for a consultation because suddenly he became reactive or aggressive toward the owners, OK?

And the reason was suddenly he became aggressive toward the owners. So sudden, sudden, sudden makes, makes us think about an organic problem, OK. But we always need to start by the blood checkup, checkup and everything was OK.

There were no findings of pain that justify the sudden starting of this behaviour, but Remember that cats are very subtle and very good in hiding, his pain signs, for instance, OK? So very important to have this bear in mind. But even so, we didn't find something, so we diagnosed two negative emotions that could be frustration.

Fear related with the, the presence of the owners, something in the environment that the cats start associating and once again, there are many owners in Portugal very that love clicker training and we planned with our rehabilitator a behaviour, a behavioural. Modification plan or emotional behavioural, emotional modification plan, with clicker training, making a desensitisation, contraconditioning, working a lot with the owners. The owners were very happy to do it.

They didn't want any medications by now. 15 days after few or none improvements, and even there were sudden attacks without any previous signs. So we kept the treatment and we suggested again to start anxiolytic medication, but the owners were not into that.

One month after the second follow-up, the attacks increased. But in this follow-up, we noticed that the, the, the cat was giving us more clear signs of a higher anx anxiety level. So it leads us to think about the hypothesis, open hypothesis of pain, OK?

But something else that we noticed was that the pupil was always dilated. We Few or non size changes. So in these situations, even with the light, obviously that the pupil could be dilated due to the stress condition in the consultation room.

However, there were none or few size changes. So, once again, I asked the ophthalmologist to check this animal. And this cat was with a glaucoma.

And the glaucoma was causing him lots of pain. So, in fact, this animal was not simply under a behavioural problem. He was in pain once again with the glaucoma.

So we would need to treat this glaucoma and the behaviour because he was already using some learned behaviours. Moving to urinary and reproduction system, starting by this case, which is Pinto and Branco. In Portuguese, pintage means spots and brau means white, and you can guess why.

They are two cats from the same litter. They are neutered means 4 years old, and they came to consultation because, suddenly 2 weeks ago, they started to fight. In each other's and this was the reason for the consultation.

Obviously that 4 years old could be a good, a good reason for, the starting, of, of, of conflicts between them. There could be, some tension in the household before and now with 4 years old, they started, increasing their tension and, fights started. So we required complimentary exams and in fact, what we found that was that in the urine analysis of one of the cats, he was with strovitis and immaturia.

OK. So once again, the pain could be the cause of the problems starting, but at this moment, especially in cats, we are. Going to treat the bladder, but also the behavioural problem.

Cats are very subtle, and, doctor is, is, is going to speak to you, to you about, intercate tension, and you're going to see many, many interesting, and important, details that you need to focus on in interca tensions. Lassie, Lassie is a female, non-neutral dog with 5 years old. And I highlight again, non-neutrid dog, OK?

And you're going to understand why. So, in terms of clinical history, there, there, there were no changes, no. Nothing to to report.

And the reason for consultation was that the, she became more anxious and started to growl to the owner every time that the owners approached her when she was laying down in her bed and she was staying longer periods of time in her bed. So first time to, to see is the blood exam results and everything was OK except in the blood cells account that reveal a slightly coytosis, nothing very serious. So what else can we do?

So we can ask to our dear colleagues from USA or from Australia, Dr. Ivan Anino or Doctor Chris Brown, to give us a hand, OK? And jokes apart.

They are, very nice people. They are very good professionals. and I'm just putting here to make a Joke, OK?

But, they are very nice people, and very good professionals. OK? Jokes apart, what we need to do is review the history and make more questions.

And there is one question that we always need to ask. And this is, something that I always Check, with my students is that if they are asking the correct questions, and in this case, the, the, the, the question for jackpot, as I usually say, is when was the last hit? And the answer was very interesting.

She has been in heat for several following times. And these make a new light for our diagnosis. So we asked a ultrasounds and the ultrasounds showed the uterus distention with content, so there was a pyometer and after the surgery, everything become too normal.

So the border between behavioural problems and with medical or non-medical reasons is everyday thinner and thinner. So, once again, remember that when you're doing a behavioural protocol of diagnosis, you should always include the medical exam. And when you're doing a medical protocol of diagnosis, you should always Consider the possibility of a behavioural problem.

And this is very, very important to all of us. When we are assessing an animal, we need to make a full history intake of the behavioural and also collect information about the info environment where the animal is living. Have clearly in mind that chronic stress can result in a specific problem, but can also contribute to the occurrence of several others, OK?

And this is very important. So stress management is important in in every species including ourselves and as we know, as health professionals, we are in the top of the causes . We are in the top of the professionals with higher levels of depression, burnouts, suicides, and we need to protect ourselves.

And thanks to, to, to, to the virtual congress because there will be also lectures in this field and these very important to each one of us to protect ourselves. So, but the first step is to understand that we We are not well, and we need support. However, asking to the, colleague next to you if he's all right, because behind a smile, sometimes there is, a serious problem, that the person is hiding and a negative emotion behind a smiling person.

OK. So remember the importance of taking care of you and taking care of the others. Thanks once again, and I hope you've enjoyed.

You can find me on the social media, on the Facebook, on the Instagram, and I'm very happy to have virtual friends, despite the fact I prefer real friends. But at this moment in this world, the, the social, these social media is becoming very common way to, increase the connection. So thank you very much and hope that you've enjoyed.