The Veterinary Journal 192 (2012) 272–278

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The Veterinary Journal

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Review

Maximising canine welfare in veterinary practice and research: A review

James W. Yeates ⇑Department of Clinical Veterinary Science, University of Bristol, Langford House, Stock Lane, Langford, Bristol BS40 5DU, UK

a r t i c l e i n f o a b s t r a c t

Article history:Accepted 27 October 2011

Keywords:Animal welfareBENCHHospitalisationIatrogenic harmsVeterinary research

1090-0233/$ - see front matter � 2011 Elsevier Ltd. Adoi:10.1016/j.tvjl.2011.10.024

⇑ Tel.: +44 7717773808.E-mail address: James.Yeates@bristol.ac.uk

1 See: http://www.legislation.gov.uk/ukpga/2006/45

This article looks at the existing evidence-base by which veterinary surgeons can make welfare-focusedtreatment choices. Narrative and structured reviews were conducted. Papers were categorised underheadings based on (1) themes in the UK Animal Welfare Act (AWA 2006) – behaviour, environment,nutrition, company and health; (2) iatrogenic harm induced by treatment; (3) decision-making methods,and (4) the subjects’ context (e.g. home versus laboratory).

There is more information available about ‘overt’ problems (e.g. acute disease), than ‘covert’ issues (e.g.chronic pain, lack of company and obesity). Forty of 109 papers covered pain, suffering, injury and disease,compared to 69 across four other themes in the AWA. Twelve papers were identified as focusing on wel-fare assessment and clinical decision-making. Veterinary surgeons should consider each of the five welfarethemes described in the AWA in both veterinary practice and in determining veterinary research priorities.

� 2011 Elsevier Ltd. All rights reserved.

Introduction combinations of ([dog], [canine] OR [companion animal]) AND

Veterinary surgeons have a duty to ensure their patients’ wel-fare. In the UK, this duty is regulated by the Animal Welfare Act2006,1 which places on those responsible for an animal a responsi-bility to take reasonable steps to ensure that the needs of that animalare met to the extent required by good practice.

Fulfilling this responsibility requires veterinary surgeons (1) tohave sufficient awareness of the major problems affecting dogsthat they can address; (2) to be aware of the possible harm thatveterinary treatment can cause through avoidable errors (e.g. mis-diagnosis), inevitable risks (e.g. drug reactions) or unavoidabletreatment effects (e.g. surgical incisions) that might be termed ‘iat-rogenic welfare compromises’; and (3) to make accurate treatmentdecisions so as to maximise the opportunities provided and mini-mise potential iatrogenic welfare compromises.

Achieving these aims requires an appropriate evidence base, ap-plied in suitable frameworks and reviewed in a format that is use-ful. This article reviews the available original research on dogwelfare. For veterinary surgeons, it examines how to identify andachieve improvements in canine patients’ welfare in practice. Forveterinary researchers, it identifies areas requiring further workand methods of prioritising and achieving research goals.

Literature identification and characterisation

The literature was identified by keyword search of the PubMed,Web of Science and Google Scholar databases, using keyword

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/contents.

([welfare], [quality of life], [quality-of-life], [stress], [pain], [fear],[suffering], [neglect⁄] OR [harms]) and using the keywords ([veter-inary] OR [animal]) AND ([ethics OR decision-making]).

Further candidate search keywords were identified throughinformal discussions with a group of experts (12 veterinary sur-geons and four animal welfare researchers) about welfare compro-mises that affect individual dogs. These prompted searches in theabove databases using further keyword combinations. These key-word searches were not in combination with the above keywords.Additional articles were identified by examining papers’ citationsvia a ‘snowballing’ method. Literature was deemed relevant if it re-lated to the description of a welfare-related condition, a way a con-dition could be identified, a method of resolution or an approach todecision-making.

In the first structured part of the study, papers were identifiedand included if they met the criteria of being peer-reviewed andoriginal papers or published doctoral theses. Papers were excludedif they were not immediately relevant to pet dogs in the homeenvironment, i.e. if they needed to be translated or extrapolatedto the pet context from another species (e.g. rats) or context (e.g.rescue kennel environments). Laboratory-based experimentalstudies were included where the laboratory setting was for meth-odological ease e.g. to control variables or facilitate observation.Papers were not excluded based on any judgement of the qualityof the evidence they contained.

Each paper was then categorised into themes, as shown inTable 1. Papers dealing with multiple themes were counted in mul-tiple categories as appropriate. Each paper that covered specificopportunities to address welfare needs was codified into themesin terms of the need to which their subject area corresponded in

Table 1Framework for narrative assessment of welfare issues.

Main theme Subthemes

Opportunities to address welfare needsdescribed in UK Animal Welfare Act2006

Need to be protected from pain,suffering, injury and diseaseNeed for a suitable dietNeed for a suitableenvironmentNeed to be housed with, orapart from, other animalsNeed to be able to exhibitnormal behaviour

Iatrogenic welfare compromises Iatrogenic pain, injury anddiseaseOther iatrogenic welfarecompromises

Decision-making methods Identifying opportunities toimprove welfareImproving welfareMinimising iatrogenic welfarecompromisesBalancing harms and benefits

J.W. Yeates / The Veterinary Journal 192 (2012) 272–278 273

general. This was firstly based on the five welfare needs describedin the Animal Welfare Act, namely, (1) the need to be protectedfrom pain, suffering, injury and disease; (2) the need for a suitablediet; (3) the need for a suitable environment; (4) the need to behoused with, or apart from, other animals; and (5) the need to ex-hibit normal behaviour patterns. Secondary codification was basedon the aetiological or therapeutic steps they covered, specifically(1) the nature or causes of the problem; (2) identification or assess-ment; (3) treatment; or (4) compliance.

Papers dealing with multiple needs or steps were counted inmultiple themes as appropriate. The total frequencies of papersconcerned with each theme were calculated. This was repeatedfor those papers that covered iatrogenic harms, with needs con-flated into two themes: (1) pain, injury and disease, and (2) otheriatrogenic welfare compromises. Papers covering multiple themeswere included in the total frequencies of papers in each of thosethemes as appropriate.

Articles that dealt with decision-making methods were classi-fied into four themes, based on the aim of the process they de-scribed (i.e. what they help the veterinary surgeon to do). Thesewere (1) identifying opportunities to improve welfare; (2) improv-ing patients’ welfare; (3) minimising iatrogenic harms; and (4) bal-ancing harms and benefits. These themes were devised throughprocess mapping of the steps involved in clinical treatment. Again,the total frequencies of papers concerned with each themes werecalculated, with papers dealing with multiple processes countedin multiple themes as appropriate.

In the second part of the structured study, all original peer-re-viewed papers were classified according to the context of the re-search subjects, namely, (1) natural environment; (2) homeenvironment; (3) working dogs; (4) laboratory environment; (5)research/shelter kennels; and (5) veterinary practices. ‘Naturalenvironment’ included stray or free-roaming domestic dogs.‘Working dogs’ included military animals, Pets as Therapy dogs2

and guide dogs. Comparative papers were counted in multiplethemes. The totals for each theme were calculated.

For narrative analysis (descriptive results sections below), find-ings were collated into the themes as for the first study. A descrip-tive review was produced, citing especially salient or recentexamples of identified research. Through the narrative study, par-ticular issues where research is lacking (as indicated by a relativelack of relevant papers identified through appropriate keywordsearches) were identified.

2 See: http://www.petsastherapy.org/.

A total of 391 documents were identified, of which 270 paperswere considered relevant. An extended reference list of relevantpeer-reviewed papers is included in Electronic SupplementaryMaterial (Appendix 1).

In the first study, 104 papers were identified as specifically cov-ering a need for pet dogs, with pain, injury and disease being thetheme most commonly covered (Table 2). Thirty-three papersinvestigated iatrogenic harms, with iatrogenic pain, injury and dis-ease being the theme most commonly covered (Table 3). In the sec-ond structured study, 74 papers were identified as specificallydealing with one or more context (Table 4). Some papers specifi-cally looked at dogs in the home environment, but more papersconcerned dogs in rescue kennels and laboratory setting. Severalpapers considered the veterinary context, of which most lookedat postoperative welfare.

Opportunities to address welfare needs described in UK AnimalWelfare Act 2006

Need to be protected from pain, suffering, injury and disease

Pathologies cause pain or feelings of illness such as nausea, pru-ritus and malaise. Treating these conditions is a central element ofveterinary practice and research, by cure, palliation or prevention.For example, recent research has focused on diseases associatedwith genetic components (Ott, 1996; Cruz et al., 2008). Veterinarysurgeons may help prevent conditions by assisting in breeding re-gimes to reduce the prevalence of phenotypes associated withmonogenetic and autosomal recessive alleles (Patterson, 2000;Obermauer and Sampson, 2001) and some polygenic conditions(Swenson et al., 1997; Willis, 1997) and by contributing to epide-miological data on breed-related conditions (Higgins and Nicholas,2008). Indeed, a recent Special Issue of The Veterinary Journal hasbeen devoted to the question (see Wade and Nicholas, in press).

Need for a suitable diet

Inappropriate diets can lead to hunger, thirst, malnutrition,dehydration and obesity. Obesity may be reduced or preventedby increased exercise and dietary changes (German et al., 2007)and the findings of Hughes et al. (1989), Hetts et al. (1992) andPrescott et al. (2004) suggest that dogs’ exercise levels, like theirdiet, may depend on human involvement. Unfortunately, manyowners appear to walk their dogs for no or ‘little’ time (Kobeltet al., 2003). Veterinary surgeons can advise changes in dietaryor exercise regimes, and veterinary research is beginning to inves-tigate methods for overcoming barriers to achieving owner life-style changes (German, 2006).

Need for a suitable environment

Dogs’ welfare can be compromised by their environment, e.g. bylack of space (Beerda et al., 1999), noise and other disturbances(McCobb et al., 2001; Sherman and Mills, 2008), unpredictability(Burrows et al., 2008), or lack of routine (Meers et al., 2004). Whileresearch has focused on kennelling, harmful environments com-monly occur in home situations, e.g. in ‘puppy crates’ (Houptet al., 2007) and these are less well researched.

Veterinary surgeons may also prevent welfare problems byreducing future relinquishment to shelters (Patronek et al., 1996;Scarlett et al., 2002). Multiple studies have suggested that manydogs are relinquished due to behavioural problems (Patroneket al., 1996; Overall, 1997), so welfare may be improved by helpingto solve or prevent problem behaviour (Scarlett et al., 2002). Otherresearch suggests that generating realistic expectations may im-

Table 3Numbers of papers accessed dealing with iatrogenic welfare compromises for petdogs (total n = 33).

Iatrogenic pain,injury and disease

Other iatrogenicwelfarecompromises

Balancingharms andbenefits

Nature andcauses

10 16 –

Identificationandassessment

3 2 –

Treatment 7 2 5Compliance 2 0 0

Table 4Numbers of papers accessed dealing with specific class/context ofdogs (total n = 74).

Class/context Number of papers

Natural environment 2Home environment 16Working dogs 8Laboratory environment 10Rescue/shelter kennels 23Veterinary practices 15

Table 2Numbers of papers accessed specifically dealing with each need for pet dogs (totaln = 104).

Pain,injury anddisease

Diet Environment Company Behaviour

Nature and causes 23 3 8 12 20Identification and

assessment3 3 1 2 2

Treatment 12 2 6 4 3Compliance 2 2 0 0 1

274 J.W. Yeates / The Veterinary Journal 192 (2012) 272–278

prove owners’ attachment (Serpell, 1996) and reduce relinquish-ment to shelters (New et al., 2000). Veterinarians are in a good po-sition to give advice about breed-related medical costs andlifestyle-compatibility (Marder and Duxbury, 2008), and future re-search may investigate how to encourage owners to seek pre-pur-chase veterinary advice when it could be more effective. Otherways to decrease relinquishment may include microchipping,which facilitates reuniting strays with their owners, and neutering,which may decrease overpopulation and may be related to a de-creased risk of relinquishment (New, 2000). Veterinary practicescan advocate routine microchipping and neutering, e.g. by dis-counting prices.

Need to be housed with, or apart from, other animals

One report suggests that four in five dogs are kept singly (Kobeltet al., 2003) although dogs appear to be a gregarious species(Macdonald and Carr, 1995; Palestrini et al., 2005). Consequently,single-housing can restrict social behaviours (Hubrecht et al.,1992; Mertens and Unshelm, 1996) and lead to signs of stress ina kennel environment (Hubrecht, 1993). Isolation at home can sim-ilarly restrict social behaviours and can lead to clinical signs suchas vomiting/diarrhoea (Takeuchi et al., 2001) and repetitive behav-iours (Borchelt and Voith, 1982; Luescher et al., 1991), which canbe suggestive of distress, anxiety or boredom (Appleby and Pluij-makers, 2003).

Several studies have suggested that the presence or absence ofhuman company can affect domestic dogs’ welfare (e.g. Gácsi et al.,

2001; Prato-Pevide et al., 2003). It can be a source of positive inter-actions (Rooney and Bradshaw, 2002); on the other hand, somedogs show stress when isolated (Bradshaw et al., 2002; Fallaniet al., 2007) and ‘hyper-attached’ dogs appear especially stressedwhen separated from their usual carer (King et al., 2000). Indeed,human and canine company may represent separate motivations(Rooney et al., 2000) or needs (Odendaal and Meintjes, 2003),and human company may be equally or more important than ca-nine company (Rooney and Bradshaw, 2002) or a suitable environ-ment (Taylor and Mills, 2007). Conversely, company is potentiallyhazardous, with risks of pain, injury, fear or transmissible diseasessuch as methicillin-resistant Staphylococcus aureus (Cefai et al.,1994), and these hazards should be appropriately managed.

Veterinary surgeons can provide useful advice about behav-ioural needs, transmissible diseases and aggression. They can pro-mote proactive interventions such as puppy socialisation tominimise later problems (Zulch, 2010), and enrichments such ascompany or obedience training, which may reduce separation-related behaviours (Clark and Boyer, 1993; Blackwell et al.,2008). Veterinarians can also counsel against behaviours that rein-force aggression or ‘hyper-attachment’ (Clark and Boyer, 1993;Takeuchi et al., 2001) and help to assess and manage risks ofchanges such as increased company, so that owners do not exces-sively forfeit opportunities to improve their dogs’ welfare becauseof concern for potential dangers.

Need to be able to exhibit normal behaviour patterns

The performance of abnormal behaviours such as stereotypicbehaviours, or the non-performance of normal behaviours suchas play behaviour or environmental interactions, may suggest wel-fare problems (Beerda et al., 1997). There may be underlying wel-fare problems such as chronic pain, malaise, depression or anxiety.Alternatively, normal behaviours may be frustrated, for example byfear of ‘disciplinary’ measures or by a lack of a resource or space(Hetts et al., 1992; Taylor and Mills, 2007).

The concept of ‘normal behaviour’ is problematic. ‘Normal’should not be taken to mean ‘common’, since many problembehaviours are prevalent in certain populations (Kobelt et al.,2003; Houpt et al., 2007). Nor should ‘normal’ be taken to mean‘acceptable’ or ‘desirable’, since many undesirable behaviours actu-ally represent normal, adaptive responses (Overall, 2001). Forexample, inappropriate hunting, barking or play might be undesir-able for the owner, but can be enjoyable for the dog (Yeates andMain, 2008). Conversely, some activities that are acceptable forthe owner, such as attention-seeking behaviours, may be copingmechanisms for an underlying problem (Hiby et al., 2006; Rooneyet al., 2007). In addition, normal behaviours may vary for differentcontexts and for individual dogs with different ages, breeds andpersonalities (Svartberg et al., 2005). Assessment should take intoaccount these differing conceptualisations of normality, and not fo-cus on one comparison. For example, when assessing the welfare ofan aging bulldog, veterinary surgeons should combine compari-sons to other geriatric bulldogs, to elderly dogs of other breedsand to younger dogs. More research is needed to understand whatconstitutes normal behaviour for dogs and how to identify andclassify normal and abnormal behavioural repertoires.

A working or operational definition of normal behaviour cannevertheless help researchers to investigate the risk factors forthe absence of normal behaviours or the presence of abnormalbehaviours, and to generate hypotheses concerning the underlyingmotivational and welfare states. Veterinary surgeons may thentreat the underlying causes, for example by behaviour modificationprogrammes or pharmacological therapies, e.g. anti-anxiety drugssuch as tricyclic antidepressants (e.g. clomipramine), serotonin-re-uptake-inhibitors (e.g. fluoxetine), monoamine oxidase

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inhibitors (e.g. selegiline) and benzodiazepines (e.g. alprazolam)(Podberscek et al., 1999; King et al., 2000; Crowell-Davis et al.,2003) or pheromones (e.g. Levine et al., 2007).

Training methods used by owners can also compromise welfare(Blackwell et al., 2008; Herron et al., 2009). Aversive training meth-ods can cause negative mental states. Treatments based on positivereinforcement can be harmful if misapplied, and may lead to hy-per-attachment or abnormal attention-seeking behaviours. Inap-propriate methods of behavioural modification may also lead tofurther problem behaviours.

Iatrogenic welfare compromises

The opportunities to provide veterinary treatment come withrisks of causing harm, both due to misuse or errors and when ther-apies are used appropriately. Visiting the veterinary practice canincrease dogs’ cortisol levels (Van Vonderen et al., 1998), heartrates and blood pressure (Kallet et al., 1997) and many dogs show‘vet-fear’, i.e. fear-related behaviours within a veterinary practice,which may increase with subsequent visits (Döring et al., 2009).Fear-related behaviour may increase with restraint (Rosado et al.,2009) or punishment (Blackwell et al., 2008; Herron et al., 2009).Hospitalisation may increase heart rate (Väisänen et al., 2005)and cortisol levels (Van Vonderen et al., 1998), even within30 min of kennelling (Siracusa et al., 2008).

Surgery may cause pain, suffering and injury. For example, neu-tering may lead to post-operative pain-related behaviours andstress responses (Devitt et al., 2005). Neutering without suitableadvice on diet and exercise may also increase the risk of obesity(Houpt et al., 1979). Medical treatments may also cause harm.For example, the ‘symptomatic’ reduction of behavioural responsesto noise using acetyl promazine may increase fear (Sherman andMills, 2008). It would be beneficial for all areas of veterinaryscience to measure both conventional clinical parameters andwelfare-based measures, in order to identify possible welfareside-effects of treatments. This is occurring within clinical behav-ioural research, which provides a useful precedent for research inother areas.

Veterinary surgeons may harm individual animals by perpetu-ating welfare compromises. In some cases, medication may perpet-uate problems that might have been otherwise self-limiting. Forexample, immunosuppressant medication may reduce the animal’sability to eliminate an infection. Perhaps more commonly, veteri-nary treatment may perpetuate welfare compromises throughkeeping an animal alive. Veterinarians may also perpetuate exist-ing welfare problems for other animals. Breed-related conditionsmay be perpetuated by surgeries such as repairing genetic herniasor caesarean section without neutering (Robbins and Mullens,1994) which improve the welfare of the individual patient. Moreepidemiological modelling research could investigate the extentto which veterinary refusals to provide treatment could improvebreed welfare standards.

Decision-making methods

Identifying opportunities to improve welfare

Some issues may be easily identified by both the owner and theveterinarian, because either the cause or their clinical signs arereadily apparent. These ‘overt’ problems may include injuries,obesity and substantial postoperative pain, pruritus or anxiety. Inseveral cases, more reliable methods of scoring such issues arebeing validated, e.g. for pain (see, for example, Holton et al.,2001; Wiseman-Orr et al., 2004) and pruritus (e.g. Ahlstromet al., 2009; Favrot et al., 2010). Other relatively overt issues have

had relatively little study, such as vet-fear and peri-operativedistress.

Some issues are harder to identify because they are under-presented by owners, who may be aware or unaware of the prob-lem. For example, Bradshaw et al. (2002) suggested that only 3% ofowners whose dogs showed separation-related behaviours hadpresented this issue to their veterinary surgeon. Veterinary re-search can elucidate reasons for non-presentation (e.g. that ownersare relatively unconcerned with non-problem behaviours; Shoreet al., 2008) and develop methods to encourage owners to identifyand present concerns about their dog’s welfare. In some cases,owners may present issues that are ignored by the veterinarianwho either fails to recognise the problem, or who does not considerit to be of significance. In other cases, overt issues are ignored byboth parties, such as conspecific company, which is known bythe owner and easily determined by the veterinary surgeonthrough clinical records or direct questioning.

More ‘covert’ issues are harder to identify, including some casesof chronic pain, long-term anxiety and lack of company. Investiga-tion and validation of overall quality-of-life screening tools (e.g.Wojciechowska and Hewson, 2005; Mullan and Main, 2007), con-sultation frameworks (Yeates and Main, 2009) and owner-basedparticipatory tools (Yeates and Main, 2011a) is an active area ofveterinary research, which aims to help veterinary surgeons toidentify these issues.

Improving veterinary patient welfare

After recognising opportunities, veterinary surgeons need torealise them. Treatments need validation based on welfareimprovements. This validation could combine traditional clinicalmeasures with ‘welfare assessment’, as in the recent QUEST study(Oyama, 2008).

Achieving welfare-based treatment goals often depends on theclient and there is an increasing amount of research on improvingcommunication skills in veterinary practice and on developingdrugs that are more easily administered or longer-acting. But moreresearch is needed on how to encourage owners to effect majorlifestyle changes, such as neutering their dog, increasing its exer-cise level, seeking pre-purchase advice or consenting toeuthanasia.

There are also intra-practice and inter-practice barriers toachieving welfare outcomes, such as pressure from owners or col-leagues (Yeates and Main, 2011b). More work is needed to identifythe best methods of tailoring welfare assessment to individualpractices and of coordinating veterinary surgeons and to prioritisethe most important welfare issues.

Minimising iatrogenic welfare compromises

There are many ways in which veterinary surgeons can refineprocedures to minimise welfare harms, most obviously throughcareful choice of medicine or surgical technique and analgesia(Tranquilli et al., 2007).

Behavioural research suggests that canine patients’ vet-fearmay be reduced by desensitisation (Simpson, 1997), avoiding rep-rimands (Cowan, 2007) and positive experiences (Lindsay, 2005).For example, dogs can be gradually and positively trained to accepta muzzle at home (Rooney et al., 2009). More generally, there is aneed for veterinarians to exchange information about how to min-imise harms via in-practice research and case-studies.

Balancing harms and benefits

There is a lack of research on ways to help owners and veteri-nary surgeons to weigh up the benefits and harms of treatment,

Table 6Criteria for prioritising welfare issues.

CriterionIntensity of the problemDuration of the problem

276 J.W. Yeates / The Veterinary Journal 192 (2012) 272–278

e.g. by developing welfare-focused best practices from meta-analyses or systematic reviews to synthesise research, or by adapt-ing the concept of quality-adjusted life years. Other researchshould identify how these best practices can be most effectivelydisseminated.

Table 7Candidate areas for future research priorities suggested by this review.

Research theme Specific areas of focus

Need to be protected from pain,suffering, injury and disease

Relations of disease with otherwelfare issuesPalliative careProphylactic treatmentsEpidemiology of breed-relatedconditions

Need for a suitable diet Owner lifestyle changes to tackleobesity

Need for a suitable environment Welfare implications of homeenvironmentsLong-term causes of relinquishmentOwner presentation of behaviourproblems

Need to be housed with, or apartfrom, other animals

Effects of single vs. multiple housingin home environmentsInappropriate human–animalinteractions

Need to be able to exhibit normalbehaviour patterns

Identifying normal canine behaviourInter-individual variations in dogs’behaviourNegative effects of training methods

Iatrogenic welfare compromises Welfare effects of visiting veterinarypracticesWelfare effects of hospitalisationWelfare effects of medication,including anaesthesiaVeterinary strategies to reducebreed-related conditions

Decision-making methods Identifying non-health-relatedwelfare issuesCorrelates between clinical and otherwelfare parametersVeterinary communication skillsEncouraging owners to effectlifestyle changesIn-practice barriers to achievingwelfare outcomes

Incidence and prevalence of the problemUrgency with which a solution is requiredAbility of the veterinary profession to prevent, reduce or eliminate the effects

of the problemCost-effectiveness of reducing or eliminating the effects of the problemEffects on non-patient animalsIndirect effects on owners and practice

Suggestions for further work

Scientists and clinical researchers need to continue expandingthe evidence-base by which to determine best practice. Manyovert, presented and iatrogenic issues have large bodies of litera-ture devoted to them which constituted the largest number of pa-pers identified, despite the expectation that the inclusion criteriain the search engines may have excluded many papers on specificdiseases and injuries.

The amount of identified research that investigated dog welfarein rescue shelters and laboratory contexts appeared disproportion-ate to the actual numbers of dogs in each environment. For exam-ple in the UK, 5604 dogs were used in licensed scientificprocedures in 2006 (Home Office, 2007), while a report suggestedthat there are 10.5 million dogs living as pets (Murray et al., 2010).This disproportion may have been an artefactual effect of theexclusion criteria used in the literature search. For example, manypapers on ‘phobias’ or separation-related behaviours were notpeer-reviewed or were deemed not to be context-specific.

Alternatively, the results may reflect a real disproportion of theamount of research devoted to certain topics possibly due to thepractical differences of researching dogs in home environments,which are a more diffuse and diverse population (CAWC, 2006).It may instead be due to a belief that pets are likely to be relativelywell looked after (e.g. compared to farm animals). Or it may be dueto politico-legal concerns about enforcing matters traditionallyconsidered to be aspects of citizens’ private lives. The dispropor-tion may also reflect (at least in part) a lack of funding; researchin laboratory and kennel environments is often funded by specificbodies, such as the NC3Rs and re-homing charities.

While many welfare issues are the responsibility of owners, fail-ure to address irresponsible pet ownership risks welfare problemsfor patients and subsequent criticism of the veterinary profession,which should widen its remit further to include priorities not tra-ditionally seen as ‘veterinary science’ and include discussionsabout all five welfare needs (see Table 5).

Helping owners to improve their animal’s welfare may involvemore in-depth discussions with owners and more inter-disciplin-ary work, for example with sociologists and anthrozoologists. Suchwork should involve deciding what exactly is meant by certain ter-minology. Veterinary surgeons’ terminology can differ from that oflay-people or other disciplines, which can be problematic for cli-

Table 5‘BENCH’ candidate areas for discussing dog welfare in veterinary consultations.

Discussiontheme

Specific areas of focus

Behaviour Need to be able to exhibit normalbehaviour

Training; play; exercise

Environment Need for a suitable environment Improved beddingMental stimulation fromsurroundings

Nutrition Need for a suitable diet Owner lifestyle changesto tackle obesityOwner interaction toprovide human company

Company Need to be housed with, or apartfrom, other animals

Conspecific companyCompany from otherspecies

Health Need to be protected from pain,suffering, injury and disease

Preventing diseaseTreating disease

Coordinating veterinary surgeons.Disseminating best practiceResearch prioritisation

ent-clinician communication. It also provides a difficulty in com-municating research (and for this review, prevented moredetailed categorisations into specific topics). Similarly, there isconfusion and vagueness in many welfare-relevant terms used inveterinary research. To achieve better communication within vet-erinary practice, and better dissemination of best practice, it wouldbe beneficial if researchers as well as veterinary surgeons woulddefine the terms they use so that readers and clients would knowwhether these agreed with their own or not.

For optimally beneficial research funding, there is a need for ba-sic research to set priorities to direct research into the areas it canprovide most welfare benefits, using pre-set criteria (e.g. Table 6).This review aimed to use such criteria to set priorities. Unfortu-

J.W. Yeates / The Veterinary Journal 192 (2012) 272–278 277

nately, sufficient evidence does not exist and highlights the needfor data not only to direct veterinary practice, but also to direct vet-erinary science. Veterinary surgeons, especially in first opinionpractice, could contribute to this data, by assisting surveys, allow-ing ‘data-mining’ from clinical records databases, or by performingin-practice research on welfare topics (see Table 7).

Conclusions

If the veterinary profession wishes to take on responsibility foranimal welfare then veterinary surgeons need to ensure they con-sider all aspects of patients’ welfare, and not only issues of pain, in-jury and disease. Practitioners should provide treatments onlywhen the risks of harm outweigh the expected benefits and shouldalso ensure they identify opportunities to improve welfare, forexample, by screening (or ‘benchmarking’) patients’ welfare usingthe five welfare needs described in this paper and to fulfil thoseopportunities by providing adequate advice and encouraging ade-quate compliance. Researchers should proportionately consider allwelfare issues, not just presented, overt and iatrogenic harms. Re-search strategies, and budgets, could be distributed across the fivewelfare needs in the UK Animal Welfare Act 2006 – in all countries.Given the data currently available, research might expand work onwidespread covert issues and methods of achieving welfare out-comes including areas suggested in this review.

Conflicts of interest statement

None of the authors of this paper has a financial or personalrelationship with other people or organisations that could inappro-priately influence or bias the content of the paper.

Acknowledgements

The authors wish to thank the participants who helped to iden-tify issues; Drs. David Main and Siobhan Mullan for comments onthe paper or specific sections; and BSAVA Petsavers and RSPCABristol for funding the position during which the research wasdone. The funders had no involvement with the study design, col-lection, analysis or interpretation of data; manuscript writing or inthe decision to submit the manuscript for publication. The authorwishes particularly to thank the anonymous reviewers for somevery helpful indicators and suggestions, some of which have beenincorporated in the article.

Appendix A. Supplementary material

Supplementary data associated with this article can be found, inthe online version, at doi:10.1016/j.tvjl.2011.10.024.

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