1. Case study ANIMAL WELFARE Canine Aggression- The Importance in Veterinary Public Health

2. Epidemiology of the canine aggression towards children During 1995, 347 patients –mostly bitten by dogs- were attended (nearly one per day). Some of them presented severe lesions that required hospitalization and chirurgic treatment (ref.: Dr. Elias Jimenez F., Hospital Nacional de Niños, San José, Costa Rica)

3. Epidemiology of the canine aggression towards children Incidence Rate for Dog bite. Approx. 1 in 272 or 0.37% The main cause for wounds in children reportedly was during playing with dogs, followed by bites CountryBites Estimated population USA1,079,615 293,655,405 1 Canada119,514 32,507,874 2 1. US Census Bureau, Population Estimates, 2004 2. US Census Bureau, International Data Base, 2004

4. Anatomical sites of dog-bite injuries : 45.3% arms/hands 25.8% legs/feet 22.8% head/neck For children 4 years and under, 64.9% of injuries were located at the head/neck. For those 15 and older, 86.2% of injuries from dog attacks were to the extremities. (Statistical Sources: Nonfatal Dog Bite-Related Injuries Treated in Hospital Emergency Departments - United States, 2001).

5. Anatomical sites of dog-bite injuries : 45.3% arms/hands 25.8% legs/feet 22.8% head/neck For children aged 4 yrs or less, 64.9% of injuries were located at the head/neck. For those aged 15 yrs and older, 86.2% of injuries from dog attacks were at the lower portions of limbs. (Statistical Sources: Nonfatal Dog Bite-Related Injuries Treated in Hospital Emergency Departments - United States, 2001).

6. In 2001, 68 million of pet dogs were estimated in the United States. In 2001, an estimated 368,245 victims were treated for injuries related to dog bites. In 2001, children aged between 5-9 yrs had the highest dog-related injuries. In 2001, an estimated 42% of all dog bites (e.g. 154,625) occurred in children aged 14 or younger. Statistical Sources: Nonfatal Dog Bite-Related Injuries Treated in Hospital Emergency Departments - United States, 2001.

7. Types of dog-related injuries recorded in Emergency Rooms: 26.4% as "dog bite" 40.2% as "puncture" 24.7% as "laceration" 6.0% as "contusion/abrasion/ hematoma 1.5% as "cellulites/infection" 0.8% as "amputation/avulsion/crush" 0.4% as "fracture/dislocation" (Statistical Sources: Nonfatal Dog Bite-Related Injuries Treated in Hospital Emergency Departments - United States, 2001).

8. Context Emergency room of the Children National Hospital Carlos Saenz San José, Costa Rica

9. Background 7 years old child bitted in the lip and left arm by a dog belonging to a friend

10. A conflict has been established between the two families The animal was given all vaccination shots and it did not show any symptom of disease. It is not its first to bite people. The family decided to consult an specialist in animal behavior

11. Signalment Specie :Dog Name : Gringo Age : 18 Months Sex: Male (non-castrated) Weight: 14 Kg Raze : Cross breed (Cocker Spaniel-Golden Retriever) Color: Golden Observations: one eye missing

12. Complaint presented by the owners “Aggression towards children” “The dog licks its own legs constantly”

13. Pertinent History Some time before, the parents noted that the dog began to nip the children heels stronger than normal. The animal has pushed /leaned against the child on several occasions. The animal licks and bites the air and then for during long periods it bites its own legs. During the visit, Gringo positioned itself in between the veterinarian and the child (owner) and then it became very anxious, once the child started to run across the room.

14. The veterinarian has to perform a complete anamnesis. Has the dog shown aggressive behavior ? Not enough contact with children during the socialization period Evidence of aggression for protection of resourses Has the dog shown predatory behavior towards other animals ? ? ? ?

15. Physical Examination The dog was easy to examine. No abnormalities were detected on physical examination

16. 1. Like a Small Animal Veterinarian, do you think that the physical examination is enough when the issue is related to a behavioral problem? Questions 2. How do you differentiate between aggression caused by organic causes and aggression without organic causes ?

17. Laboratory tests T4 within the inferior range limit. TSH within the superior range limit. Urinalysis High Glutamine.

18. Diagnosis Inappropriate behavior associated with: Protective Aggression Fearful aggression (against unknown children) Attention-seeking behavior.

19. The veterinarian has to perform a: Risk Analysis “The canine aggression towards people is potentially a dangerous problem, and the veterinarian must decide if is right and safety correct it ” (Manteca, 2003)

20. Treatment Behavior modification Desensitization Anti-anxiety medication Amitriptyline Fluoxetine

21. Note: To follow-up the case the student may refer to the student guide. Also he should check the bibliography attached/provided. Case study developed by the SAPUVETNET II partners of the University of San Simon, Course of Veterinary Medicine and Zootechnics, Cochabamba (Bolivia) and National University of Costa Rica, school of Veterinary Medicine, Heredia (Costa Rica) contacts: Guillermo Parilla e-mail: guillermovet@hotmail.com; Jorge Quiros e-mail: jquiros@medvet.una.ac.crguillermovet@hotmail.com jquiros@medvet.una.ac.cr