兽研1. 引言
尽管遛狗已被认为对人类心理、生理和社会福祉有益[1,2,3]，但探讨遛狗对犬本身益处的研究却极为稀少。这给兽医带来了挑战：他们难以向犬主提供有适当研究支持的、关于犬只（总体上以及具体个体患者）适宜遛行与运动量的可靠临床建议。尽管Rohlf及其同事（2012）发现，其调查中几乎所有受访者（犬主）都认为规律运动对犬的行为有益（99.1%）、能促进犬主与犬之间的关系（99.9%）并维持理想体重和体况（99.1%）[4]。已发现多种因素会影响犬的遛行量；例如，Westgarth等（2015）发现，饲养犬的数量（“多犬”）和家庭中的人数（“更多人”）均与每日遛狗呈负相关，而与犬的体型（中型犬，可能还有大型犬）呈正相关[5]。此外，若干与犬主—犬关系和犬行为相关的因素也与每日遛狗相关：因爱好而获得该犬、犬躺卧在家具上呈正相关；而犬躺在人腿上、对家庭成员低吼、与犬玩追逐游戏则均呈负相关[5]。迄今为止，关于遛行对犬影响的研究往往集中于不同条件下犬在遛行时如何与环境和社会刺激互动等问题。例如，Westgarth及其同事（2010）考察了宠物犬在遛行过程中与其他犬、人及环境互动的性质和频率，并评估了使用牵引绳对调节此类互动的作用[6]。Foltin和Ganslosser的研究（2021）发现，在林地环境中无绳遛行的犬在探索性运动模式上表现出很大差异，且行走距离比其主人更远[7]。公犬倾向于比母犬花费更多时间、在更远距离外远离主人[7]。讨论的这些性别差异的可能原因包括：据报道母犬在种间互动中与人更具社交性，因而更可能靠近其人类同伴；而公犬更大胆、更主动、更具探索性，因而更可能在更远距离外探索[7]。其他作者则关注遛行对特定犬亚群的价值；例如，Gunter等（2017）考察了鼓励遛狗对新领养犬退回收容所的影响，发现参与遛狗并未降低退回率[8]。他们还报告称，监护人的责任感、遛狗自我效能感以及对犬牵引行为的认知也不具有预测作用。尽管公众（尤其是犬主）和专业人士（兽医及相关人员）普遍认为遛狗有益于犬的生理和行为健康[7,9,10]，但似乎尚无专门针对遛行对犬的价值或不同遛行方案的相对价值的已发表研究。缺乏具体研究，兽医可能难以针对具有特定生理或行为需求的患者提供有科学依据的适宜运动建议。虽然兽医的职责是维护患者福利，但建议犬主调整遛行习惯可能很困难——尤其当犬主认为这些习惯对犬的生理和行为健康至关重要，而一般文献又无法用于解释和说理时。
运动与步行方案可能因多种原因而调整。Marcellin-Little等人（2005）研究了运动犬的康复与体能训练，结论是需进一步开展研究以确定非运动犬和运动犬所需的最佳运动量[11]。兽医治疗方案和行为问题的管理也可能需要调整步行常规。医学原因包括骨科手术后的康复[12]、损伤预防、骨关节炎的管理[13]，以及超重和肥胖犬的管理[14]。调整犬只步行的常见行为原因包括社交功能受损[15]和牵绳时的反应性[16]，因为避免高应激情境和减少问题行为重复演练的风险是治疗方案的基本内容。因此，可能需要减少步行量或改变遛狗方式[15,16,17,18]。兽医行为临床医生有时发现难以理解客户为何不愿实施此类建议，即使已解释这样做的原因且客户口头确认理解。如果主人无法实施和遵守兽医或行为学家的建议，那么行为改善进展有限是情理之中的。影响主人可能不遵守因行为问题而减少遛狗建议的因素，以及对这些建议的总体依从水平，在很大程度上仍不清楚。
医学领域将依从性定义为人类患者的行为（无论是服药、遵循饮食建议还是做出其他生活方式改变）与医学或健康建议相一致的程度[19]。在兽医领域，客户依从性是指客户能够实施兽医建议（医学、行为或其他健康相关建议）的程度。多项研究调查了可能影响客户信任、满意度进而影响对所给建议依从/遵从的因素（见Lamb等人2018年的综述）[20]。例如，兽医沟通技巧[21]，以及犬主人对初级保健知识的了解、学习兴趣、看法、对兽医在初级保健中角色的认知以及对兽医初级保健服务的满意度，均是影响对兽医建议信任度和建议满意度的因素[22]。因此，临床医生-客户关系显然很重要，采用以关系为中心的护理方法（其特征是兽医与客户之间的协作伙伴关系、提供明确建议以及有效沟通建议理由）的兽医能获得客户对其建议更高的依从性[23]。虽然以关系为中心的方法提供明确建议可能改善依从性，但并不能保证依从。了解影响主人决策及后续宠物相关行为的其他因素无疑有助于改善依从性。在人类领域，众所周知改变行为可能具有挑战性，找到有效的策略来实现改变也可能很困难，即使益处显而易见[24]。了解主人行动和行为受影响的途径，使兽医临床医生能够开始解决阻碍其建议实施的障碍。
计划行为/理性行动理论（Ajzen 1985；Ajzen 1991）[25,26]已成为研究人类行为最具影响力和最流行的概念框架之一（Ajzen 2002）[27]。该理论旨在预测人的意志性行为并增进对其心理决定因素的理解。该理论指出，人的决策和行为受三个因素影响：个人意向、态度（对某一行为的信念）和主观规范（对他人关于某一行为态度的信念）。个人感知的行为控制、自我效能和控制点（对特定行为控制力的信念）也构成该理论的一部分，并在预测目标导向行为中发挥作用。这些因素可能在主人关于如何及为何遛狗的信念、其行为是否受周围他人影响，以及更广泛地对其作为犬主人应有何种期望的认知中发挥作用。了解他们对改变行为的控制感，能进一步细化他们是否可能实施兽医建议的改变。
因此，本研究旨在调查主人为何可能不总是遵守兽医建议，以及什么影响他们关于遛狗的决策。我们假设主人关于遛狗的决策不仅受犬的行为或生理需求或兽医建议的影响，因此开展了一项调查以评估其他可能重要的因素。
2. 材料与方法
2.1. 调查与数据收集
一项在线调查（见补充调查S1）托管于JISC平台（2024年8月20日至2025年1月31日），通过电子邮件向兽医同行发送、社交媒体平台发布以及在兽医诊所张贴招募海报等方式，采用滚雪球抽样法在国际范围内分发。参与者须满足以下条件：目前养有犬只、年满18周岁、能够上网并同意参与。参与为自愿且匿名。参与者不获得任何报酬，并可随时退出。在填写问卷时，参与者被要求以其当前饲养的犬只为对象进行回答；若目前饲养多只犬，则以名字首字母排序最靠前的那只犬为关注对象。
收集了参与者的人口统计学数据，包括参与者的年龄和性别、家庭人口数及其年龄。关于住所的信息包括参与者所在国家、家庭中犬只总数、犬只是否有可进入的户外区域进行排泄和放松，以及住所位置（市中心、郊区、村庄、乡村等）。犬只的人口统计学数据包括犬只年龄、性别及绝育状态、品种、体型/体重，以及参与者目前是否遛犬。
随后要求参与者考虑影响其遛犬决策的因素。问卷条目的设计参考了Ajzen的计划行为理论/理性行为理论[25,26,27]。影响因素包括参与者认为其犬只的兽医、犬只的训练师、任何重要他人/朋友/家庭成员以及其社区对犬主遛犬的看法，以及参与者自身信念可能如何影响其遛犬方式或是否遛犬。参与者使用5点Likert量表对每个条目的同意程度进行评分，随后进行编码（1=非常不同意；2=不同意；3=既不同意也不反对；4=同意；5=非常同意）。
最后，呈现了四个假设情景，其中兽医对其犬只做出了某种疾病的诊断，并据此建议调整遛犬方式。具体如下：诊断为关节炎/退行性关节病后减少遛犬频率/缩短距离（因医学原因减少遛犬）；诊断为对遛犬时常见事物存在恐惧攻击行为后减少遛犬（因行为原因减少遛犬）；被告知犬只超重需要更频繁、更长时间地遛犬（因医学原因增加遛犬）；以及被告知为改善心理健康需要更频繁/更长时间地遛犬（因行为原因增加遛犬）。问题旨在揭示犬主对该建议的一些看法，包括在此评估下他们是否会信任该建议、实施该建议的难易程度，以及可能影响其落实该建议的其他因素。参与者使用5点Likert量表对其依从可能性进行评分，随后进行编码（1=非常不同意；2=不同意；3=既不同意也不反对；4=同意；5=非常同意）。
2.2. 数据分析
为控制回答的一致性，在因医学原因减少遛犬和因行为原因减少遛犬两个情景中，对“我发现很难遵从，因为这是我犬只排泄的方式”和“我发现很难遵从，因为这是我犬只唯一外出的时间”这两个条目回答不一致的参与者被剔除。
使用IBM SPSS（v29）进行数据分析。首先创建描述性汇总，然后初步使用Friedman检验进行双变量分析，评估四个情景之间依从性差异的显著性。
此后，基于因医学原因与因行为原因减少运动建议的依从可能性之差（医学评分减去行为评分），创建了一个新的因变量（medvsbehavpriority）。正值表示倾向于因医学原因而依从，负值表示倾向于因行为原因而依从；零表示无偏向。随后评估了该变量与影响其遛犬行为因素相关条目评分之间的双变量关联。这识别出在预测优先关注身体健康而非行为健康的偏向上可能重要的因素。然而，为了识别最重要的因素，我们随后在一系列广义线性模型中使用这些显著因素。为降低变量过度设定问题的风险，将同意程度评分量表重新分类为三点量表（非常同意和同意合并为一个类别，两个不同意级别同样合并）。然后采用向后模型构建程序生成最小充分模型（MAM）。当模型中仅剩显著变量时停止模型构建，并使用赤池信息准则（AIC）评估每个阶段的模型充分性。
鉴于初始双变量分析的结果，未进行等效分析来解释因医学原因与行为原因而增加运动量的可能性。
首先使用简单的双变量分析，未校正显著性阈值α设定为p = 0.05，因为在此类探索性发现研究中，在考虑值得进一步研究的潜在因素时，2型统计误差的影响比1型误差的影响更受关注（Perneger, 1998）[28]。随后的多变量分析旨在寻找最佳解释变量，从而提供对最佳预测因子的进一步见解，但不一定是最具生物学相关性的因素。
3. 结果
共提交了1590份完整回复。在应用基于厕所和室外一致性的筛选后（见上文），保留了1098份回复。所有分析均在该数据集上进行。
大多数参与者为女性，近一半（47.4%）的参与者年龄在35至54岁之间。参与者来自以下国家，按频率降序排列：美国（37.8%）、澳大利亚（25.1%）、英国（20.9%），其余16.2%来自其他国家。大多数参与者居住在郊区（53%）。主人人口统计学特征的完整详情见表1。
大多数参与者的犬只报告为2至7岁（58.8%），47%为雌性，53%为雄性，绝大多数报告已绝育（81%）。大多数犬只报告为超过21 kg的大型和巨型品种（54.9%），中型犬（11-20 kg）占29.8%，玩具/微型和小型犬（<10 kg）占群体的15.3%。大多数犬只报告可进入中小型（46.1%）和广阔（40.5%）的室外空间，其余的可进入非常小的室外空间（5.1%）或仅在主动监督下进入（8.3%）。受访者报告92%的犬只目前有散步。犬只人口统计学特征的完整详情见表2。
对于“我会遵从所有建议，因为我的兽医知道我犬只健康的最佳方案”这一陈述，85%的主人表示在假设诊断为关节炎/退行性关节病后，他们可能遵从兽医建议减少散步频率/缩短散步距离，相比之下，对于因散步中常见事物恐惧而表现出攻击性的情况，这一比例为63%。在基于犬只假设超重或心理健康建议增加散步/延长散步时间的场景中，82%同意或强烈同意遵从医学原因的兽医建议，而行为原因的比例为79%。
主人遵从因行为原因减少散步的兽医建议的可能性显著低于因医学原因（Q = 0.659，标准检验统计量11.959，p < 0.001）；且遵从因行为原因减少散步建议的可能性显著低于因医学原因增加散步（Q = −0.482，标准检验统计量−8.752，p < 0.001）或因行为原因增加散步（Q = −0.383，标准检验统计量−6.959，p < 0.001）。他们遵从因医学原因减少散步建议的可能性也显著高于因行为原因增加散步（Q = 0.276，标准检验统计量5.000，p < 0.001）和因医学原因增加散步（Q = 0.177，标准检验统计量3.207，p = 0.01）。他们遵从因医学原因与行为原因增加散步建议的可能性无统计学差异（Q = 0.099，标准检验统计量1.793，p = 0.437）（这些结果见补充表S1）。这些结果表明，主人最不可能遵从因行为原因减少散步的建议，最可能遵从因医学原因减少散步的建议。
以下变量在双变量分析中被发现具有显著性，并被考虑纳入MAM：“我不觉得我的兽医期望我遛狗”；“遛狗是我狗上厕所不可或缺的方式”；“遛狗是我日常生活的重要组成部分”；“遛狗是我狗唯一外出的机会”；“我很容易找到适合遛狗的对狗友好的步道和小路”；“我觉得我的狗对出去遛弯感到兴奋”；“我相信遛狗对我狗的身体健康很重要”；“我觉得遛狗对我自己的身体健康很重要”；“我觉得遛狗对我见朋友/家人/邻居很重要”；“我觉得我的家庭成员或‘重要他人’认为遛狗是作为狗主人负责任的事情”；“我觉得我所在的社区期望狗被定期遛”；“我觉得和我的狗一起散步对我自己的心理健康很重要”；“散步对我来说不是一项放松的活动”；“我不觉得遛狗对我狗与人的社交互动很重要”；“遛狗给了我重要的在自然中的‘优质时间’”；“散步给了我狗重要的在自然中的‘优质时间’”；“我觉得遛狗是我作为负责任的狗主人被期望做的事”；“我不期待和我的狗一起出去散步”；“我觉得家庭事务使我难以遛狗”；“我相信遛狗对我狗与其他狗的社交互动很重要”（见补充表S2）。
对于多变量分析，AIC在每个阶段持续下降，直到最终模型保留四个显著的 explanatory 变量（AIC 289.5）：我不觉得我的兽医期望我遛狗（Wald卡方 8.755，p = 0.013）；我相信遛狗对我狗的身体健康很重要（6.721，p = 0.035）；遛狗给了我重要的在自然中的“优质时间”（35.007，p < 0.001）；我不觉得遛狗对我狗与人的社交互动很重要（124.354，p < 0.001）。
4. 讨论
本研究的目的是更深入地了解为什么狗主人可能并不总是遵从兽医关于管理其狗行为的建议，以及特别是哪些因素影响他们遵从关于遛狗建议的决策。作者假设主人关于遛狗的决策受多种因素影响，而不一定是其狗的行为或生理需求，或兽医的建议。
我们的研究发现，狗主人对兽医建议的遵从在四个假设情景中有所不同。对于陈述“我会遵从所有建议，因为我的兽医知道我狗的健康最佳利益”：85%同意或强烈同意因医学原因减少遛狗，82%同意或强烈同意因医学原因增加遛狗，79%同意或强烈同意因行为原因增加遛狗，但只有63%同意或强烈同意因行为原因减少遛狗。主人在其狗被诊断为关节炎/退行性关节病后显著更可能遵从减少遛狗的建议；同样可能遵从因医学或行为原因增加遛狗的兽医建议；显著更不可能遵从因行为原因减少遛狗的建议。这表明本研究中接受调查的主人表现出优先考虑身体健康而非行为健康的偏向。MAM识别出四个因素，可能有助于深入了解主人做出违背兽医建议的选择时其决策的部分影响因素：主人对什么对其狗身体健康重要的信念、他们如何看待兽医对遛狗的期望、他们自己在自然中优质时间的需求，以及其狗与人社交互动的需求。
我们的发现得到了行为临床医生经验的支持，他们据轶事报告称客户似乎难以实施作为行为治疗计划一部分的减少遛狗的建议。狗主人报告称，即使在做出诊断并建议作为治疗计划一部分的具体调整后，他们也可能并不总是遵从关于遛狗的兽医建议。他们给出的原因多种多样，需要被理解，因为遛狗调整可能是有效行为治疗计划的重要组成部分[15,16,17,18]。如果主人无法实施这些策略并遵从兽医或行为学家的建议，那么可以合理预期行为改善的进展将受到限制。
对兽医建议的依从性受多种因素影响[29,30]。其中一些因素在临床医生的控制范围内，例如提供书面说明和视觉辅助材料、根据患者反应调整治疗方案，以及发送随访预约提醒[26]。然而，他们对其他一些因素的控制力可能较弱，尤其是那些影响个体决策和行为的因素。这些因素包括客户的意图、态度、主观规范、感知行为控制、自我效能感，以及针对特定行为的控制点[25,26,27]。了解这些因素将使临床医生能够解决并消除实施建议的潜在障碍。在医学领域，临床医生（尤其是那些涉及行为改变的临床医生）正试图向与建议保持一致性的概念迈进[31]。一致性强调临床医生与患者之间的共识；它考虑双方对特定治疗的看法；它包括对推荐治疗步骤的公开讨论、信息共享和对患者的支持，这对于那些接受长期治疗计划的患者尤为重要[31]。这是一个承认必须尊重患者观点的过程，即使他们做出的选择似乎与临床医生的观点相冲突[31]。将兽医临床医生转向与客户保持一致性的视角，可能有助于制定改善兽医患者治疗结果的治疗计划。因此，了解本研究中发现的这些原因，可以提高初级保健兽医、行为专家以及其他为犬主提供建议的人员的能力，与客户共同制定一致的治疗计划。
犬主对“我认为遛狗对我的犬的身体健康很重要”这一说法的回应（1098名受访者中仅有51人不同意或强烈不同意），以及对“我**不**觉得我的兽医期望我遛狗”这一说法的回应（1098名受访者中仅有158人同意或强烈同意），以及这些因素保留在MAM中的发现，表明这些信念——关于遛狗对犬身体健康的重要性——被犬主广泛持有。此外，这些结果表明这些信念可能被他们的兽医所强化。其他犬主的回应——遛狗以满足排泄需求、遛狗是犬唯一的外出时间、家中只有一只犬（1098名受访者中620人）、中型或大型犬（1098名受访者中928人）、遛狗为犬提供接触自然的机会——在双变量分析中均具有显著性——与这些关键解释因素相关，并且似乎与犬主关于照顾和关注犬身体需求的信念交织在一起。
此外，当考虑“我**不**觉得遛狗对我的犬与人的社交互动很重要”这一因素时（377人同意或强烈同意），该说法的反面，即我确实觉得遛狗对我的犬与人的社交互动很重要，表明大多数犬主也认为遛狗是满足犬这些社交需求的一种方式。这意味着人们认识到遛狗对犬的心理健康以及身体健康的潜在重要性。积极的情感体验、自主性的表达以及各种正常行为——包括与人、其他动物及其环境的互动——是被认可的福祉和积极福利的指标[32]。所有这些都可以通过适当的遛狗方案来满足。此外，当被要求考虑“遛狗给了我重要的在自然中的‘优质时间’”时，1098人中仅有69人不同意或强烈不同意。犬主可能持有遛狗对自己有益这一信念，或已从自己的医疗保健专业人员那里获得相关建议[1,2,3]。这可能立即给犬主带来问题，因为他们试图遵从为了自身健康而多遛狗的建议，这与兽医少遛狗的建议相冲突。此外，如果犬主认为遛狗也满足了犬在自然中享受“优质时间”的需求（1098人中仅有35人不同意或强烈不同意），这就构成了更大的认知障碍。Rohlf及其同事2012年报告称，犬主同意遛狗对犬的行为有益、促进人犬关系、并维持犬的理想体重和体况[4]。因此，与兽医少遛狗的建议相反，他们可能认为应该多遛狗以帮助改善犬的行为[7,8,10]，尤其是在缺乏具体相反理由的情况下。
此外，带犬散步可能原本就是犬主养犬的主要原因之一。Holland及其同事报告称，促进运动是想要养犬的常见原因，分别有48.2%的现有犬主和69.7%的潜在犬主表达了这一观点[33]。如果犬主被建议不要与犬进行某项活动，而该活动是养犬最重要的原因之一，那么遵从该建议显然会很困难。不遛狗的犬主可能会对他们原本以为会拥有的散步时光感到一种失落感。
当主人因行为方面的原因被建议减少遛狗时，他们内心所纠结的是：他们相信自己可能正在损害自己和爱犬的身体健康，并且相信自己的兽医期望他们遛狗，这可能与他们现在被告知不要这样做的建议产生内心冲突。除此之外，兽医可能并不愿意与主人充分探讨行为问题。尽管行为问题是被收容所犬猫安乐死的主要原因之一，但在一般执业的小动物兽医中，有40%并未将其列为四大福利问题之一[34]。半数受访者因自身行为学知识不足而不愿与客户讨论行为问题，80%的人认为自己所受的教育使他们在处理犬猫行为问题方面能力不足或极其不足[34]。如果合格的兽医都感到自己缺乏应对行为问题的能力，这或许在一定程度上解释了为什么行为问题在一般执业中可能未被足够频繁地讨论或处理，以及为什么它们是收容所安乐死的主要原因——收容所可能承受着这些诊断不足和治疗不足状况所带来的后果。考虑到一般执业兽医最可能是获得专业意见和建議的接触点，如果兽医普遍感到自己在该领域缺乏知识和技能，那么向犬主传播适当的行为知识和建议也会受到妨碍。如果行为问题不经常与主人讨论，那么主人可能倾向于优先重视身体健康问题。
兽医需要能够讨论身体健康与行为健康之间相互关联的本质，并理解主人对此的信念和观点。这些包括本研究阐明的信念。讨论需要以富有同情心和同理心的方式探讨遛狗对主人身心健康意味着什么，并促成旨在让兽医和主人共同寻找对主人和犬都可行的解决方案的讨论。需要帮助主人认识到，在身体健康与行为健康之间，他们并非面临“二选一”的决定，而是应鼓励一种视角，去思考“我还能做些什么来满足爱犬的身体健康需求，同时不损害其行为健康？”此外，了解对主人健康和福祉的潜在影响至关重要，以便在适当时解决主人对此的担忧。如果兽医能够识别潜在的信念并对其进行重构，他们可能帮助主人克服心理障碍，帮助确定实现相同目标的其他途径，从而更接近依从。这是一种有效策略，已被多个领域中问题复杂且需要人类行为改变的专业人士采用[35]。使用动机性访谈等咨询工具可能有助于促进这种方法，以实现更好的理解、制定和实施由主人参与制定的个性化计划[36]。
使围绕遛狗决策的这一复杂讨论更加复杂、并影响兽医做出循证建议能力的，是关于遛狗对犬的益处或风险已发表的材料非常少这一事实。作者未发现任何出版物为任何特定品种或年龄组的犬提供关于日常运动类型——或特定运动类型的频率、强度或持续时间——的直接循证建议，也未发现关于犬一般身体健康需求的相关建议。此外，作者未发现任何已发表的研究调查遛狗对犬行为健康的益处，尽管人们普遍认为遛狗对犬的行为有益[7,9,10]。这些是需要探索的研究领域，并将大大有助于支持兽医患者的治疗建议。
调查存在局限性，包括可能适用于本研究的参与偏倚、自我选择偏倚和应答偏倚。仅93名（8%）受访者报告目前不遛狗，且大部分犬为大型或巨型品种（54.9%）。这可能表明调查或许未能按比例覆盖人群中目前不遛狗的犬主或饲养小型犬的犬主。尽管已尽一切努力通过广泛分发渠道招募具有代表性的犬主样本（包括遛狗和不遛狗的犬主），并避免仅针对遛狗人群，但仍可能存在一定的抽样偏倚。控制犬体型存在实际挑战，因为某些品种或体型犬的受欢迎程度可能因国家和/或参与者所在地而存在显著差异。据作者所知，目前尚无全球性数据库描述当前犬品种或体型的受欢迎程度，从而无法根据体型明确当前具有代表性的种群比例。此外，还有一些因素无法在本研究中加以控制，如受访者的人格特质（总体上依从的可能性）、受访者既往与兽医的经历（正面或负面）、受访者管理有行为问题犬的经验、受访者当前兽医的人格特质和沟通风格（专制强硬型与权威协作型），这些可能是有价值的进一步研究方向。尽管如此，本研究已从多个国家、生活在各种环境和住房类型中的大量参与者中收集了数据。这表明这些问题并非局限于某一特定地点，而是影响作为广泛群体的犬主。此外，尽管存在这种变异性，某些影响因素仍然显现，提示它们在犬主决策中是强影响因素。本研究为解决动物行为问题治疗中这些复杂但具有临床相关性的因素提供了一个起点。进一步开展客观研究，探讨在犬实际（而非假设）被诊断患有内科或行为问题后客户的信念及其对兽医建议的依从性，可能提供更多临床数据并进一步阐明依从性模式。
5. 结论
本研究为实际实施与改变遛狗相关的兽医建议及依从性所面临的挑战提供了重要见解，尤其是在解决行为问题的背景下。改进兽医行为医学的本科和研究生培训将有助于行为问题被识别、处理和适当治疗。这反过来将提高兽医领域以及普通人群对解决行为问题重要性及其对动物福利关键影响的认识。更广泛而言，兽医需要意识到犬主的潜在信念会影响其决策能力和对治疗方案的依从性。这些信念可能复杂且相互交织。如果临床医生能够通过多种咨询技巧——例如动机性访谈和重构——识别并处理这些信念，他们可能改善客户与兽医的关系、人际沟通以及客户对治疗建议的依从性，最终改善犬及其主人的结局。
研究结果在兽医临床实践中的应用如下：客户具有可能影响其依从兽医治疗计划能力的潜在信念；
兽医需要意识到影响依从性的潜在信念并加以处理；
对于要求犬主减少遛狗的行为问题兽医治疗计划，犬主可能尤其难以依从；
兽医需要在兽医行为医学和咨询方面培养额外技能，以识别问题并制定考虑客户意见和动机的治疗计划；
建议的咨询技巧包括重构和动机性访谈；
未来工作可更具体地探索犬主信念，并制定基于证据的犬运动与遛狗标准建议，以及针对年龄、品种和内科疾病的调整方案。
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1. Introduction
While walking pet dogs has been associated with benefits for human mental, physical and social wellbeing [1,2,3], there is very little research examining the benefit of dog walking for dogs. This presents a challenge to veterinarians in providing sound clinical advice, backed by appropriate studies, to dog owners about appropriate walking and exercise for dogs in general, and individual patients in particular. This is despite Rohlf and colleagues’ (2012) finding that nearly all respondents (dog owners) to their survey believed that regular exercise is good for a dog’s behaviour (99.1%), promotes the relationship between an owner and their dog (99.9%) and maintains ideal weight and body condition (99.1%) [4]. Several factors have been found to influence the amount dogs are walked; for example, Westgarth et al. (2015) found that the number of dogs owned (“multiple”) and the number of people in the household (“more people”) were each negatively associated with daily walking, whereas there was a positive association with the size of the dog (medium and possibly large dogs) [5]. In addition, a number of factors relating to the dog–owner relationship and the dog’s behaviour were also associated with daily walking: having acquired the dog for a hobby, and the dog lying on furniture were positively associated; whereas the dog lying on laps, growling at household members, and playing chase games with the dog, were all negatively associated [5]. To date, the research on the impact of walking on dogs has tended to focus on issues such as how, under different conditions, dogs interact with their environment and social stimuli on walks. For example, Westgarth and colleagues (2010) examined the nature and frequency of interactions of pet dogs with other dogs, people and the environment whilst being walked, and assessed the effect of the use of a leash in modulating such interactions [6]. Foltin and Ganslosser’s study (2021) found that dogs walked off-lead in a wooded environment showed great variation in exploratory patterns of locomotion and travelled further than their owners [7]. Male dogs tended to spend more time and greater distances away from their owners than females did [7]. Potential reasons discussed for these sex differences included females reportedly being more social with humans in their interspecific interactions, hence being more likely to stay closer to their human companions, and males as being bolder, more proactive and explorative, hence being more likely to explore at greater distances [7]. Other authors have focused on the value of walking for specific subpopulations of dogs; for example, Gunter et al. (2017) examined the impact of encouraging dog walking on returns of newly adopted dogs to a shelter and found that participation in dog walking did not reduce return rates [8]. They also reported that the guardians’ sense of obligation, dog-walking self-efficacy, and perceptions about their dogs’ on-leash behaviours were also not predictive. Despite the widely held belief by the general public (dog owners in particular), and professionals (veterinary and allied), that walking dogs is beneficial for dogs’ physical and behavioural health [7,9,10], there appears to be no published research specifically focused on the value of walking for dogs, or the relative value of different walking regimens. Without specific studies, veterinarians may struggle to provide scientifically grounded advice regarding appropriate exercise for their patients with their particular physical or behavioural needs. While a veterinarian’s role is to advocate for patient welfare, advising owners to modify walking routines can be difficult—especially when owners believe these routines are essential for their dog’s physical and behavioural health, and when the general literature cannot be called upon for explanation and reasoning.
Exercise and walking regimes may be modified for several reasons. Marcellin-Little et al. (2005) investigated the rehabilitation and conditioning of sporting dogs and concluded that further research needs to be conducted to determine the optimal amount of exercise needed for both non-sporting and sporting dogs [11]. Veterinary treatment plans and the management of behavioural issues may also require modifications to walking routines. Medical reasons include rehabilitation after orthopaedic procedures [12], injury prevention, and the management of osteoarthritis [13], as well as the management of overweight and obese dogs [14]. Common behavioural reasons for modifying walks for dogs include impaired social functioning [15] and reactivity when on-leash [16], since avoiding situations of high stress and reducing the risk of rehearsal of problem behaviours are fundamental aspects of a treatment plan. As a result, walking less or modifying how dogs are walked may be required [15,16,17,18]. Veterinary behaviour clinicians sometimes find it challenging to understand why clients are reluctant to implement advice of this nature, even when the reasons for doing so have been explained, and the client verbally confirms their understanding. If owners cannot implement and comply with veterinary or behaviourist advice, it is reasonable to expect that progress towards behavioural improvement will be limited. The factors influencing why owners may not comply with advice to reduce dog walking for behavioural issues, and the overall level of compliance with these recommendations, are still largely unknown.
Compliance has been defined within the medical field as the extent to which a human patient’s behaviour (whether taking medications, following dietary advice, or making other lifestyle changes) coincides with medical or health advice [19]. In the veterinary field, client compliance is the extent to which a client is able to implement the veterinarian’s advice (medical, behavioural or otherwise health-related). Several studies have investigated factors that may influence client trust, satisfaction and thus compliance/adherence with the advice given (see Lamb et al. 2018 for a review) [20]. For example, veterinarian communication skills [21], and dog owners’ knowledge of primary health care, their interest in learning about it, their opinion on it, perceptions of their veterinarian’s role regarding primary health care and satisfaction with their veterinarian regarding primary health care, were all factors affecting trust in veterinary advice and satisfaction with that advice [22]. Thus, the clinician–client relationship is clearly important and veterinarians using a relationship-centred care approach (characterised as a collaborative partnership between a veterinarian and a client, the provision of clear recommendations, and effective communication of the rationale for the recommendations) achieve greater client adherence to the advice they offer [23]. Whilst providing clear recommendations in a relationship-centred approach are likely to improve compliance, they cannot guarantee it. Understanding other factors which affect owner decision-making and subsequent behaviours relating to their pets will undoubtedly help to improve compliance. In the human field, it is well-recognised that changing behaviours can be challenging, and finding effective strategies to bring about change can also be difficult, even when the benefits are evident [24]. Understanding ways in which owners’ actions and behaviours are influenced allows veterinary clinicians to begin to address obstacles which impair implementation of their advice.
The Theory of Planned Behavior/Reasoned Action (Ajzen 1985; Ajzen 1991) [25,26], has emerged as one of the most influential and popular conceptual frameworks for the study of human action (Ajzen 2002) [27]. The theory aims to predict volitional human behaviours and improve understanding of their psychological determinants. It states that human decision-making and behaviour are affected by three factors: the individual’s intentions, their attitudes (beliefs about a behaviour), and subjective norms (beliefs about others’ attitudes toward a behaviour). An individual’s perceived behavioural control, self-efficacy and locus of control (beliefs about their control over a particular behaviour) also form part of this theory and play a role in predicting goal-directed behaviours. These factors may play a role in owners’ beliefs about how and why they walk their dogs, whether their behaviours are influenced by others around them, and their perceptions of what is expected of them as dog owners more generally. Understanding their sense of control over modifying a behaviour gives additional nuance to whether they may or may not implement changes advised by their veterinarian.
Thus, the aim of this study was to investigate why owners may not always comply with veterinary advice, and what influences their decision-making with respect to dog walking. We hypothesised that owner decisions regarding dog walking are influenced by more than the dogs’ behaviour or physical needs, or the veterinarian’s recommendations, and so undertook a survey to evaluate what other factors may be important.
2. Materials and Methods
2.1. Survey and Data Collection
An online survey (see Supplementary Survey S1), hosted on JISC (20 August 2024—31 January 2025) was distributed internationally using snowball sampling through emails to veterinary colleagues, social media platforms, and recruitment posters displayed in veterinary clinics. Participants were required to currently own a dog, be at least 18 years of age, have internet access, and provide their consent to participate. Participation was voluntary and anonymous. Participants did not receive any remuneration and were able to opt out at any time. For the purposes of completing the questionnaire, they were asked to respond in relation to their current dog; if they currently owned more than one dog, they were to focus on the dog whose name came first alphabetically.
Participant demographic data was collected including the participant’s age and gender, the number of human household members, and their ages. Information about the home included the country in which the participant lived, the total number of dogs in the household, whether the dog had access to an outdoor area for toileting and relaxation, and the location of the home (city centre, suburb, village, rural, etc.). Dog demographic data included age of the dog, sex and neuter status, breed, size/weight and whether the participant currently walked their dog or not.
Participants were then asked to consider factors that have influenced their decisions about walking their dog. Ajzen’s Theory of Planned Behavior/Reasoned Action [25,26,27] was considered when designing the questionnaire statements. Factors included what participants believed their dog’s veterinarian, their dog’s trainer, any significant other/friends/family members, and their communities thought about dog owners walking their dogs, and how their own beliefs may influence how or whether they walked their dogs. Participants rated their agreement with each statement using 5-point Likert scales, which were later coded (1 = Strongly Disagree; 2 = Disagree; 3 = Neither Agree nor Disagree; 4 = Agree; 5 = Strongly Agree).
Finally, four hypothetical scenarios were presented in which a veterinarian had made a diagnosis of a condition in their dog and advised on the modification of their dog’s walks as a result. These were as follows: walking less frequently/shorter distances following a diagnosis of arthritis/degenerative joint disease (walking less for a medical reason); walking less following a diagnosis of fear aggression to something commonly encountered on walks (walking less for a behavioural reason); being advised the dog was overweight and needed to walk more often and for longer duration (walking more for a medical reason); and being advised that in order to improve mental well-being they were to walk more often/for a longer duration (walking more for a behavioural reason). Questions were aimed at uncovering some of the owners’ perceptions of whether they would trust this advice given the assessment, how easy or difficult it would be to implement the advice, and other factors that may influence their implementation of this advice. Participants rated their likelihood of compliance using 5-point Likert scales, which were later coded (1 = Strongly Disagree; 2 = Disagree; 3 = Neither Agree nor Disagree; 4 = Agree; 5 = Strongly Agree).
2.2. Data Analysis
In order to control for response consistency, those participants that responded differently for the statements “I would find it difficult to comply as this is the way my dog goes to the toilet” and “I would find it difficult to comply as it’s the only time my dog gets outside” within the two scenarios relating to walking less for a medical and walking less for a behavioural reason were removed.
Data were analysed using IBM SPSS (v29). Descriptive summaries were created, before the significance of differences in compliance between the four scenarios was assessed initially using bivariate analyses using a Friedman test.
After this, a new dependent variable (medvsbehavpriority) was then created based on the difference in likelihood to comply with a reduced exercise recommendation for a medical versus behavioural reason (medical rating minus behavioural rating). A positive value indicated a bias towards compliance for medical reasons, while a negative value indicated a bias towards compliance for behavioural reasons; zero indicated no bias. Bivariate associations between this variable and ratings of the statements relating to factors affecting their dog-walking behaviour were then evaluated. This identified potential factors of importance in predicting a bias towards prioritising physical over behavioural health. However, in order to identify the most important factors, we then used the significant factors in a series of generalised linear models. To reduce the risk of issues from the overspecification of variables, the agreement-rating scales were reclassified into a three-point scale (strongly agree and agree merged into a single category, and the same done for the two levels of disagreement). A backwards model-building procedure was then used to produce the Minimum Adequate Model (MAM). Model building stopped when there were only significant variables remaining in the model, with the Akaike Information Criterion (AIC) used to assess model adequacy at each stage.
Given the results from the initial bivariate analysis, an equivalent analysis was not undertaken for explaining the likelihood of increasing exercise in relation to a medical versus behavioural reason.
Simple bivariate analyses were used in the first instance, with an uncorrected significance threshold alpha set at p = 0.05, since in this type of exploratory discovery work the impact of a type 2 statistical error is of more concern than the impact of a type 1 error in the consideration of potential factors worthy of further consideration (Perneger, 1998) [28]. The subsequent multivariate analysis sought to find the best explanatory variables, and so provides further insight into the best predictors, but not necessarily the most biologically relevant factors.
3. Results
There were 1590 complete responses submitted. After applying the filter based on consistency relating to toilet and outside (see above), 1098 responses were retained. All analysis was performed on this data set.
The majority of participants were women, and nearly half (47.4%) of the participants were between the age of 35 and 54 years old. Participants were from the following countries, in descending order of frequency: United States of America (37.8%), Australia (25.1%), the United Kingdom (20.9%) and the remaining 16.2% from other countries. The majority of participants live in suburban areas (53%). Full details of owner demographics can be found in Table 1.
The majority of participants’ dogs were reported as being between 2 and 7 years old (58.8%), 47% were females and 53% were males, and the vast majority were reportedly neutered (81%). The majority of dogs were reported as being large and giant breeds over 21 kg (54.9%) with medium-sized dogs (11–20 kg) at 29.8% and toy/miniature and small dogs (<10 kg) comprising 15.3% of the population. The majority of dogs were reported to have access to small- to moderate-sized (46.1%) and extensive (40.5%) outdoor spaces, with the remainder having access to a very small outdoor space (5.1%) or access only under active supervision (8.3%). Respondents reported that 92% of the dogs were currently walked. Full details of dog demographics can be found in Table 2.
For the statement “I would comply with all the advice as my vet knows what is best for my dog’s health”, 85% of owners indicated that they were likely to comply with veterinary advice to walk their dog less frequently/for shorter distances following a hypothetical diagnosis of arthritis/degenerative joint disease, compared with 63% for demonstrating aggression due to fear of something commonly encountered on a walk. For the scenarios where owners were advised to walk more/for a longer duration following advice based on their dog being hypothetically overweight or for mental wellbeing, 82% agreed or strongly agreed to comply with veterinary advice for medical versus 79% for behavioural reasons.
Owners were significantly less likely to comply with veterinary advice to walk their dog less for a behavioural reason than for a medical reason (Q = 0.659, Std test stat 11.959, p < 0.001); and significantly less likely to comply with advice to walk less for a behavioural reason than to walk more for a medical (Q = −0.482, Std test stat −8.752, p < 0.001) or more for a behavioural reason (Q = −0.383, Std test stat −6.959 p < 0.001). They were also significantly more likely to comply with advice to walk their dog less for a medical reason than to walk their dog more for a behavioural reason (Q = 0.276, Std test stat 5.000 p < 0.001), and more for a medical reason (Q = 0.177, Std test stat 3.207, p = 0.01). There was no statistical difference in the likelihood of them complying with advice to walk their dog more for a medical versus a behavioural reason (Q = 0.099, Std test stat 1.793, p = 0.437) (see Supplementary Table S1 for these results). These results indicate that owners were least likely to comply with advice to walk less for a behavioural reason, and most likely to comply with advice to walk less for a medical reason.
The following variables were found to be significant in the bivariate analysis and were considered for inclusion in the MAM: ‘I do not feel that my vet expects me to walk my dog’; ‘Walking is integral to how my dog goes to the toilet’; ‘Walking my dog is an important part of my daily routine’; ‘Walking is the only time my dog gets outside’; ‘I have easy access to dog friendly walking tracks and paths for walking my dog’; ‘I feel that my dog gets excited to go for walks’; ‘I believe that walking my dog is important for my dog’s physical health’; ‘I feel that walking my dog is important for my own physical health’; ‘I feel that walking my dog is important for me to see friends/family/neighbours’; ‘I feel that members of my family or a “significant other” thinks that walking a dog is the responsible thing to do as a dog owner’; ‘I feel that the community I live in expects dogs to be walked regularly’; ‘I feel that walking with my dog is important for my own mental well-being’; ‘Walking is not a relaxing activity for me’; ‘I do not feel that walking my dog is important for my dog’s social interactions with people’; ‘Walking my dog gives me important “quality time” in nature’; ‘Walking gives my dog important “quality time” in nature’; ‘I feel that walking my dog is expected of me as a responsible dog owner’; ‘I do not look forward to going for walks with my dog’; ‘I feel that family commitments make it difficult to walk my dog’; ‘I believe that walking my dog is important for my dog’s social interactions with other dogs’ (see Supplementary Table S2).
For the multivariate analysis, AIC consistently dropped at each stage until a final model remained with four significant explanatory variables (AIC 289.5): I do NOT feel that my vet expects me to walk my dog (Wald Chi sq 8.755, p = 0.013); I believe that walking my dog is important for my dog’s physical health (6.721, p = 0.035); Walking my dog gives me important “quality time” in nature (35.007, p < 0.001); I do NOT feel that walking my dog is important for my dog’s social interactions with people (124.354, p < 0.001).
4. Discussion
The aim of this study was to understand more about why dog owners may not always comply with veterinary advice with respect to managing their dog’s behaviour, and what influences their decision-making with respect to complying with advice about dog walking, in particular. The authors hypothesised that owner decisions regarding dog walking are influenced by multiple factors, and not necessarily their dogs’ behaviour or physical needs, or their veterinarian’s recommendations.
Our study found that dog owners’ compliance with veterinary advice varied across the four hypothetical scenarios. For the statement “I would comply with all the advice as my vet knows what is best for my dog’s health”: 85% agreed or strongly agreed with walking less for a medical reason, 82% agreed or strongly agreed for walking more with a medical reason, and 79% agreed or strongly agreed with walking more for a behavioural reasons, but only 63% agreed or strongly agreed with walking less for a behavioural reason. Owners were significantly more likely to comply with advice to walk less after their dog received a diagnosis of arthritis/degenerative joint disease; as likely to comply with veterinary advice to walk more for a medical or behavioural reason; and significantly less likely to comply with advice to walk less for a behavioural reason. This indicates that owners surveyed in this study displayed a bias towards prioritising physical health over behavioural health. The MAM identified four factors that may provide insight into some of the influences on owners’ decision-making when they make choices contrary to advice given by their veterinarian: owners’ beliefs about what is important for their dog’s physical health, how they viewed their veterinarian’s expectations about walking their dog, their own need for quality time in nature, and their dog’s need for social interactions with people.
Our findings are supported by the experience of behaviour clinicians who anecdotally report that clients seem to struggle with implementing advice to reduce walking as part of a behaviour treatment plan. Dog owners reported that they may not always comply with veterinary advice on dog walking even after a diagnosis is made and specific modifications are advised as part of a treatment plan. The reasons that they give for this are multifactorial and need to be understood, as walking modifications may be an essential component of an effective behaviour treatment plan [15,16,17,18]. If owners are not able to implement these strategies and comply with veterinary or behaviourist advice, it is reasonable to expect that progress towards behavioural improvement will be limited.
Adherence to veterinary advice is influenced by a number of factors [29,30]. Some of these are within the clinician’s control such as providing written instructions and visual aids, adjusting therapy according to the patient’s response, and sending reminders for follow-up appointments [26]. However, they may have less control over others, particularly those affecting an individual’s decision-making and behaviour. These include clients’ intentions, attitudes, subjective norms, perceived behavioural control, self-efficacy, and locus of control regarding a particular behaviour [25,26,27]. Understanding these factors will enable the clinician to address and remove potential barriers to the implementation of advice. In the medical field, clinicians (especially those involved with behavioural change) are attempting to move towards the concept of concordance with advice [31]. Concordance emphasises an agreement between the clinician and the patient; it considers each other’s perspective on a particular treatment; and it includes open discussions on recommended treatment steps, information sharing and supporting patients, which is especially important for those on long-term treatment plans [31]. It is a process that acknowledges that patients’ views have to be respected even if they make choices that appear to be in conflict with the clinician’s views [31]. Shifting veterinary clinicians towards a perspective of concordance with clients may assist in developing treatment plans that improve treatment outcomes for veterinary patients. Thus, an awareness of reasons such as those found in this study can improve the ability of primary care veterinarians, behaviour specialists, and others advising dog owners, developing concordant treatment plans together with clients.
Owners’ responses to ‘I believe that walking my dog is important for my dog’s physical health’ (only 51 of 1098 respondents disagreed or strongly disagreed) and to ‘I do NOT feel that my vet expects me to walk my dog’ (only 158 of 1098 respondents agreed or strongly agreed), and the finding that these factors remained in the MAM, indicate that these beliefs—about the importance of walking for their dogs’ physical health—are widely held by owners. Additionally, they suggest that the beliefs may be reinforced by their veterinarians. Other owner responses—walking for toileting needs, dog’s only time outside being during walks, being a single dog in the household (620 of 1098 respondents), a medium or larger dog (928 of 1098 respondents), walking providing their dog access to nature, were all significant in the bivariate analysis—relate to these key explanatory factors and appear to be intertwined with the owner’s beliefs about taking care of and attending to their dog’s physical needs.
In addition, when considering the factor ‘I do NOT feel that walking my dog is important for my dog’s social interactions with people’ (377 agreed or strongly agreed), the reverse of this statement, I do feel that walking my dog is important for my dog’s social interactions with people, indicates that the majority of owners also feel that walking their dog is a way of meeting these social needs for their dog. This means that there is an acknowledgement of the potential importance of walking for the dogs’ mental wellbeing as well as physical health. Positive affective experiences, expression of agency, and a variety of normal behaviours—including interactions with people, other animals and their environment—are recognised indicators of wellbeing and positive welfare [32]. All these can be met through appropriate walking regimes. Add to this the fact that when asked to consider ‘Walking my dog gives me important “quality time” in nature’, only 69 of 1098 disagreed or strongly disagreed. Owners may have the belief or have received advice from their own health care professional about dog walking being good for them [1,2,3]. This could immediately raise problems for the owner in trying to comply with advice for their own health to walk the dog more, conflicting with their vet’s advice to walk the dog less. Furthermore, if owners believe that walking the dog also meets their dog’s need for “quality time” in nature (only 35 of 1098 disagreed or strongly disagreed), it presents an even greater cognitive block. Rohlf and colleagues 2012 reported that owners agreed that walking was good for their dog’s behaviour, promoted their relationship, and maintained their dog’s ideal weight and body condition [4]. So, contrary to their vet’s advice to walk less, they may believe they should walk more to help their dog’s behaviour [7,8,10], especially in the absence of specific reasoning to the contrary.
Additionally, taking a dog for a walk could have been one of the primary reasons an owner adopted a dog in the first place. Holland and colleagues report that facilitating exercise was a frequent reason for wanting to get a dog, as expressed by 48.2% and 69.7% of current and potential dog owners, respectively [33]. If owners are advised not to undertake an activity with their dog that was one of the most important reasons for acquiring it, complying with the advice will clearly be difficult. Owners who do not walk their dogs may feel a sense of loss concerning the walks they thought they would have.
What owners are then navigating, when advised to walk their dogs less for a behavioural reason, is their belief that they may be compromising their own and their dog’s physical health, and their belief that their veterinarian expects them to walk their dog, potentially creating in an internal conflict with the advice that they are now being told not to do so. Added to this is the fact that veterinarians may not be comfortable fully exploring behavioural concerns with owners. Despite behavioural problems being a leading reason for euthanasia in shelter dogs and cats, they were not recognised as one of the top four welfare problems by 40% of small animal veterinarians in general practice [34]. Half of the respondents were reluctant to discuss behaviour problems with clients because of deficiencies in their behaviour knowledge, and 80% felt that their education equipped them poorly or extremely poorly to deal with behaviour problems in dogs and cats [34]. If qualified veterinarians feel ill-equipped to deal with behavioural concerns, this may go some way to explaining why behavioural problems may not be discussed or addressed in general practice frequently enough, and why they are a leading reason for euthanasia in shelters that may bear the consequences of these underdiagnosed and undertreated conditions. Considering that the general practice veterinarian is the most likely contact point for informed opinion and advice, if veterinarians generally feel they lack knowledge and skill in this area, disseminating appropriate behavioural knowledge and advice to dog owners will also be impaired. If behaviour problems are not routinely discussed with owners, then there may be a tendency for the owners to prioritise the importance of physical health concerns.
Veterinarians need to be able to discuss the inter-related nature of physical and behavioural health and understand owners’ beliefs and perspectives regarding these. These include the beliefs elucidated by the current study. Discussions need to include a compassionate and empathetic exploration of what walking the dog means for the owner’s physical and mental wellbeing and enable a discussion aimed at the veterinarian and the owner together, finding a solution that works for both the owner and the dog. The owner needs to be helped to see that they are not being faced with an ‘either/or’ decision, when it comes to physical versus behavioural health, but rather encourage a perspective that considers ‘what else could I do to fulfill my dog’s physical health needs that doesn’t compromise its behavioural health?’ Additionally, understanding the potential implications for the owner’s health and wellbeing is essential so that owner’s concerns regarding this can be addressed, as appropriate. If veterinarians identify underlying beliefs and can reframe them, they may assist owners in overcoming mental barriers and help identify other means to achieve the same ends, moving closer to compliance. This is an effective strategy that has been employed by a variety of professionals in several fields where problems are complex and require human behavioural change [35]. This approach may be facilitated by using counselling tools such as motivational interviewing to bring about better understanding, development and implementation of a personalised plan that the owner is involved in developing [36].
Further compounding this complex discussion around dog walking decisions, and impacting veterinarians’ ability to make evidence-based recommendations, is the fact that there is very little material published on the benefits or risks of dog walking on the dog. The authors are unaware of any publications that provide direct evidence-based recommendations for types of daily exercise—or on the frequency, intensity or duration of particular types of exercise—for any particular breed or age group of dogs, or for the physical health requirements for dogs in general. Additionally, the authors are unaware of any published studies that have investigated the benefits of walking for dogs’ behavioural health, despite the widely held belief that walking is good for the dog’s behaviour [7,9,10]. These are areas of research that need to be explored and would go a long way in supporting recommendations for treatments for veterinary patients.
There are limitations associated with surveys, including potential participation, self-selection and response biases which may apply to this study. Only 93 (8%) of the respondents reported not currently walking their dogs, and a large proportion of the dogs were large or giant breeds (54.9%). This may indicate that the survey has perhaps not reached a proportionate number of dog owners in the population that do not currently walk their dogs, or those who own smaller dogs. Whilst every effort was made to recruit a representative sample of the dog-owner population (both those who did and did not walk their dogs) through broad distribution channels and avoiding those targeting only a dog-walking population, some sampling bias may still remain. Controlling for dog size presents practical challenges since the popularity of certain breeds or sizes of dogs may vary substantially depending on the country and/or participant location. As far as the authors are aware, there is no worldwide database describing the current popularity of breeds or sizes of dogs which could clarify a current representative population proportion according to size. There are also factors such as the respondent’s personality (how likely they are to comply in general), the respondent’s previous experiences with veterinarians (positive or negative), the respondent’s experience of managing a dog with a behavioural problem, the respondent’s current veterinarian’s personality and communication style (authoritarian and forceful versus authoritative and collaborative) which could not be controlled for in this study, and may be valuable avenues for further investigation. Nonetheless, this study has allowed the collection of data from a large number of participants in several countries who live in a variety of environments and housing types. This indicates that these issues are not isolated to one particular location, but affect dog owners as a broad population. Additionally, the fact that certain influences emerged despite this variability suggests that they are strong factors within owner decision-making. The study offers a starting point for addressing these complex but clinically relevant factors when treating animal behavioural problems. Further objective research into client beliefs and compliance with veterinary advice after a dog has actually, rather than hypothetically, been diagnosed with a medical or behavioural problem is likely to provide additional clinical data and further clarify patterns of compliance.
5. Conclusions
The study provides important insight into the challenges involved in the practical implementation of and compliance with veterinary advice relating to a change in dog walking, particularly in the light of addressing behavioural problems. Improvements in under- and post-graduate training in veterinary behavioural medicine will facilitate behavioural problems being recognised, addressed and treated appropriately. This in turn will raise awareness within the veterinary field, as well as the general population, of the importance of addressing behavioural problems and their critical impact on animals’ welfare. More broadly, veterinarians need to be aware that dog owners’ underlying beliefs affect their decision-making and capacity to comply with treatment plans. These beliefs may be complex and intertwined. If clinicians are able to identify and address beliefs with a variety of counselling skills—for example, motivational interviewing and reframing—they may improve client–veterinarian relationships, their interpersonal communication, and client compliance with treatment recommendations, ultimately improving outcomes for dogs and their owners.
Applications of findings to veterinary clinical practice are as follows:
Clients have underlying beliefs which may affect their ability to comply with veterinary treatment plans;
Veterinarians need to be aware of underlying beliefs affecting compliance to address them;
Owners may find it especially difficult to comply with veterinary treatment plans for a behavioural problem that specifies that an owner should walk their dog less;
Veterinarians need to develop additional skills in veterinary behavioural medicine and counselling to identify problems and develop treatment plans that take into account client input and motivation;
Suggested counselling skills include reframing and motivational interviewing;
Future work may explore owner beliefs more specifically and the development of evidenced-based standard recommendations for dog exercise and walking, as well as modifications for age, breed and medical conditions.