SYSTEMS THINKING IN DOG BEHAVIOUR MEDICATION – A Framework to Improve Prescribing Precision in Complex Canine Behaviour Cases

Executive Summary:

In canine care, behavioural medication decisions are often based on symptom recall rather than structured system analysis. This paper proposes that effective pharmacological planning requires a systems dynamics approach: analysing behavioural feedback loops, tracking change over time, and applying defined clinical thresholds. Caregivers are repositioned as active participants in the system, equipped to contribute meaningful data through structured observation and pattern recognition. Medication is presented as a valuable clinical tool — appropriate when system-informed indicators demonstrate that regulatory change is not occurring despite targeted relational and environmental input. Medication alters system feedback pathways. Without first mapping the structure and timing of behavioural feedback loops, pharmacological input risks reinforcing instability rather than supporting regulatory recovery.

Five minimum conditions for responsible use are introduced, grounded in lived clinical cases where disrupted sleep, persistent autonomic dysregulation, and failure in sensory engagement reveal system inertia. By focusing on time delays, reinforcing behaviours, and system feedback rather than surface symptoms, the paper introduces a repeatable, model-based logic grounded in systems dynamics for clinical decision-making. It calls for a clinical evolution beyond “pro-medication” or “anti-medication” positions, advocating instead for clarity before, during, and after pharmacological intervention — ensuring that decisions are guided by system realities rather than professional habit or urgency. Key terms are defined in Appendix A.Author’s bio: see page 49

Abstract

Veterinary behavioural medicine is undergoing a significant shift. Although psychopharmacology has become more accessible and frequently utilized, its application often remains reactive, inconsistent, and lacking the systematic approach required for complex behavioural cases [1]. The assumption that a diagnosis alone justifies medication must be questioned—particularly within a system that often encourages early prescribing yet seldom incorporates structured follow-up.

A more effective approach integrates a systems-thinking model for behavioural medication decisions, prioritizing three key elements: the dog’s neurobiology, caregiver involvement, and measurable behavioural indicators. Instead of rigid protocols, this model emphasizes adaptable decision-making principles. It advocates for shared responsibility between veterinarians and owners, precise timing in medication use, and strategic clarity—transforming medication from a temporary fix into a carefully aligned tool that works in harmony with the dog’s physiology.

This perspective challenges the current norms, urging a re-evaluation of when and how behavioural medication is prescribed. The goal is to ensure it genuinely supports lasting behavioural change rather than serving as an automatic or isolated intervention. By refining prescribing practices, veterinary professionals can better align medication with long-term behavioural outcomes.

Introduction: Building the Missing Framework for Safe and Strategic Medication Use

Behavioral pharmacology has transitioned from a treatment of last resort to a commonly recommended intervention in canine medicine. This shift reflects both growing recognition of psychopharmacology’s potential and mounting pressures on caregivers and practitioners to deliver rapid solutions. However, as prescribing practices expand, clinical decision-making frameworks have failed to evolve with the same rigor.

Yet despite growing demand, clinical guidance has not kept pace. Presented is a systems-based framework for medication decisions—one that brings clarity, structure, and repeatability to a field currently shaped by urgency, assumption and compression of time.

The protocols established by Overall, K. and others [2-4] advocated medication only after exhausting non-pharmacological approaches. Recent veterinary behavioral medicine literature continues to emphasize thorough emotional and behavioral assessment before medication [5].

However, these protocols provide inadequate guidance as prescribing increases without consistent decision-making frameworks or follow-up systems. A structured systems thinking model that reorients clinical reasoning from symptom-driven urgency to model-informed intervention clarity is needed.

The model places observable behaviour, neurobiological understanding, and caregiver participation at the centre of treatment planning. It proposes that medication decisions must be more than clinical shortcuts or reactive measures. Decisions must be made with insight, structure, and accountability — before, during, and after the prescription is written. This requires both measurable indicators and system-informed roles.

The intent of this paper is to provoke dialogue, elevate expectations, and strengthen clinical reasoning. Its aim is to enrich current practice by offering a repeatable, model-based framework for evidence-informed decision-making. It affirms that pharmacological interventions can be necessary, urgent, and effective — and insists they are most powerful when embedded within a system of clear behavioural data, caregiver accountability, and structured oversight.

Chapter One: The Normalisation of Behaviour Medication

Psychoactive medications are no longer taboo in dog care. They’re marketed, normalised, and often suggested early — sometimes within the first consult. The justification is often urgency. Urgency can obscure clarity, freezing the behaviour in the moment rather than allowing feedback loops to reveal system patterns.

Historically, medication was reserved for the most severe cases — introduced only after structured behavioural interventions had failed. Clinicians like Overall [2,5,6], advocated for a cautious, evidence-informed path, where pharmacological support was embedded within broader behavioural strategies. But today, the starting point has shifted — and so must our standards.

A recent UK study found that 0.4% of dogs were prescribed drugs for undesirable behaviours, with breed variations in prescribing patterns [7].  While the data appears minor, the study supports the shift in veterinary medicine to increasingly pathologizing canine behavior, prioritizing pharmacological solutions over behavioral modification or acceptance of natural behavioral variation. This shift may stem from pressure on veterinarians for quick fixes, owner demand for immediate relief, and growing recognition of the neurobiological underpinnings of behavior. 

The study also reveals breed-based disparities in prescribing patterns, with Toy Poodles, Tibetan Terriers, and Shih-Tzus disproportionately receiving behavioral medications—suggesting that breed-related behavioral stereotypes may further drive the pathologization of natural behavioral variations. This reinforces the broader shift toward pharmacological solutions over behavioral modification, particularly in breeds perceived as 'high-maintenance' or prone to anxiety.

When behavior is framed as static pathology rather than an emergent system response, two risks dominate: (1) premature medication that bypasses adaptive solutions, and (2) misdiagnosis of protective behaviors as disorders. These are compounded by system-level effects—feedback suppression (masking observable signals) and diagnostic drift (normalizing medication for breed-typical traits). The study’s findings on breed-based prescribing (e.g., Tibetan Terriers’ 2.7x higher odds of drug therapy) exemplify how diagnostic drift can entrench pharmacological intervention as a default, rather than a last resort.

In clinical practice, I work with dogs who present with severe behaviours — aggression, reactivity, chronic shutdown — often after multiple prior interventions have failed. The turning point was not the addition of medication –it was the correction of the system. We applied human-led co-regulation, mapped systemic dynamics, and searched for what I term the ‘White Pathway’[1] — those fleeting moments when a dog pauses, hesitates, or seeks relational feedback before tipping into full reactivity. This is not calm, nor shutdown. It is the nervous system in a state of flux — unstable, but reachable — where co-regulation and behavioural redirection are still possible. This missing “state of flux” has been detailed elsewhere [8], but it remains foundational: it is here that impulse control first becomes accessible. From this baseline, we structured intervention around clear neurobiological mapping, dynamic feedback loops, and relational system input.

Across hundreds of cases, this systems-first model has achieved a documented 98% success rate[2], based on a systems-based clinical model grounded in CNSS domains, caregiver-led tracking, and successful completion of an intensive therapeutic and educational program. Medication, where used, was introduced only after system-level dysfunction was confirmed and where pharmacological support became necessary to stabilise biological processes already in active change.

Chapter Two: Clearing the Fog

Before medication enters the conversation, five distortions must be cleared.

Five System-Level Failures That Distort Medication Decisions

1. Emotional urgency collapses time

Meaning, it introduces time distortions into the feedback system, shortening observational loops and driving reactive intervention before system stability can be assessed. Without sufficient delay periods, behaviour is mistaken for static disorder rather than dynamic system output, undermining the identification of emerging stability patterns.

When medication is introduced through fear, guilt, or professional discomfort, the system loses its ability to wait, observe, and understand behaviour as it unfolds. The caregiver is rushed, the prescriber is rushed. The behaviour is frozen in the moment. And the feedback loops needed for meaningful change are bypassed entirely [9-11]

2. Immediate action overrides reflection

Quick interventions may unintentionally suppress the system’s adaptive signalling, reducing opportunities to assess emerging behavioural regulation [9-10]. Medication, then, becomes a response to professional uncertainty, not the dog’s needs [11].

3. Misreading traits as disorders rewrites the system’s narrative

Sensory preferences, developmental changes, or temperament-based expressions are framed as chronic dysfunction [10]. This alters how the entire system responds to the dog. Instead of adaptation, the system locks into pathology — often for life [9-11].

4. Poor timing shifts the locus of change away from the caregiver

When medication is offered before co-regulation has been attempted, the caregiver is removed as an agent of change [10] and systems change in behaviour must be led [12]. The system starts to orbit around the prescription, not the relationship [9]. Future interventions become harder to measure, and harder to believe in [11].

5. Silence is mistaken for success

Behavioural quiet is often rewarded — but without understanding whether the nervous system has stabilised or shut down [10]. When medication masks signs of stress, the system falsely concludes the problem is solved, even as dysregulation continues beneath the surface [9,11].

Chapter Three: What’s Happening Inside

Consider a dog presenting with separation anxiety: is the behavior a 'disorder' to suppress, or an adaptive signal of unmet needs in its relational environment? This distinction is critical when evaluating pharmacological interventions

Before examining how behavioral medication decisions are made, we must first define the system they act upon: the dog’s internal behavioral architecture, where behavior emerges from dynamic feedback loops [30] integrating physiology, environment, and learning. Recognizing these nonlinear patterns shifts our clinical practice from symptom management to system-level interpretation–where behaviors serve as both diagnostic signals and intervention targets. These principles align with neurobiological [53] and ecological models of animal behavior [54]. To operationalize this systems view, we must first unpack the neurobiological substrate of behavior.

Reading Behaviour from the Inside Out

To understand behavioural medication, we must identify which components of a dog’s internal system are active.  The central nervous system (CNS)–governed by physical structures and biochemical pathways–drives behaviour through neuronal communication[13,14].  Dysfunction in these processes often manifest as behavioural symptoms [14], which medications may alleviate, exacerbate, or alter by modulating neuronal activity [14,15].

To simplify this, one could say, neurons communicate via electrical signals and neurotransmitters. When a neuron fires, it releases chemicals into synaptic space, where they may:

1.     Bind to receptor neighboring neurons,

2.     Diffuse to nearby cells, or

3.     Feedback to regulate the original neuron’s activity [16]

Behavioural drugs intervene by either binding to these receptors or blocking the reuptake of neurotransmitters, thereby altering brain chemistry and consequently, behaviour [7,18,19].

This level of neurobiological detail is challenging for dog trainers and behaviours and caregivers–yet, foundational for responsible for pharmacological decisions. My interpretive model addresses the gap by distilling these mechanisms into an accessible point of entry, enabling informed collaboration and a common.

The Four-Agent Neurobehavioral Model[3]

This framework identifies four core neurobiological systems governing canine behavior, each with distinct functions and observable signatures. The model enables precision observation—differentiating adaptive responses from pathological dysregulation—and intervention guidance to determine when medication supports or disrupts system self-regulation.

By identifying which agent is active, we can discern whether behavior represents a communication signal (e.g., fear-based aggression as Tom's protective response) or a system failure (e.g., chronic hyperarousal from Reggie's stuck survival state).

The Agents

1.     Reggie (Autonomic Nervous System)

Role: Survival responses via sympathetic (fight/flight mobilization), ventral parasympathetic (social engagement), and dorsal parasympathetic (shutdown/freeze) pathways [10,19].

Signs of Dysregulation:

•       Hyperarousal: Pacing, panting, muscle tension

•       Hypoarousal: Lethargy, dissociation [10,19]

Key Insights:

•       Medication may dampen symptoms (e.g., pacing), but safety requires co-regulation and environmental stability [19]

•       First-line interventions: Co-regulation, predictable routines, sensory load reduction [10]

2. Tom (Limbic Threat System)

Role: Threat detection and emotional memory formation (amygdala-driven) [19,21].

Signs of Dysregulation:

Explosive reactivity to perceived threats (often mislabeled as "disobedience") [19]

Key Insights:

Early medication risks cementing fear memories by blocking new learning [19]

Priority: Graded exposure to rewrite threat associations before or alongside pharmacotherapy

3. Viv (Vestibular-Spatial System)

Role: Balance and anxiety modulation via brainstem-limbic pathways [22–25].

Signs of Dysregulation:

•       Circling, restlessness, spatial disorientation

Key Insight:

•       Requires rhythmic movement (e.g., structured walks)—not drugs—to recalibrate

4. Conrad (Prefrontal Regulation)

Role: Impulse control and adaptation [26–28]; inhibited by Tom/Reggie dominance [29].

Signs of Dysregulation:

•       Impulsivity, inability to settle

Key Insights:

•       Medicate only if Conrad is beginning to reappear (not chronically offline)

•       Medication should be paired with Neurobalance Wheel strategies (impulse control, cognitive flexibility) [55]

•       Contraindicated in chronic stress without environmental support

Model Synthesis

Dynamic Interaction: Agents interact via feedback loops (e.g., Tom's dominance suppresses Conrad) [30]

Intervention Logic: Medicate only when the target system is identified (e.g., SSRIs for Tom's hypervigilance) and minimum environmental supports are in place (per caregiver capacity)

Avoid medication when signals are adaptive (e.g., Reggie's arousal during real threats)

Empirical Alignment:  Maps to established neuroanatomy [30] while addressing clinical realities

These simplified agents correspond to known neurobiological structures. Reggie maps to the autonomic nervous system (parasympathetic, sympathetic), Tom to the amygdala and limbic threat processing, Viv to the vestibular system influencing sensory stability, and Conrad to the prefrontal cortex managing inhibition and planning [30].

Together, these internal agents operate within dynamic feedback loops that regulate the dog’s behavioural system [30]. Their activation and dominance are not static traits, but responsive outputs shaped by relational environments, sensory inputs, and internal physiological states over time. Recognising these patterns enables a systems-based understanding of behaviour, positioning each agent’s influence as both an indicator of current system conditions and a guide for intervention decisions.

Timing Matters. So Does Interpretation.

A dog’s behavioral struggles reflect internal system strain. Clustering symptoms (e.g., pacing + reactivity) reveals which agent is dominant—and whether the dog is overwhelmed or seeking regulation.

Our job is to slow the reading, widen the lens, and ask:

•       Who’s active here — Reggie, Tom, Viv, or Conrad?

•       Is this system overwhelmed, or reaching?

•       Is the behaviour seeking safety, or trying to control the moment?

•       Has the system been given a chance to adapt – or has it been repeatedly interrupted?

This is not guesswork. This is clinical interpretation. And it’s essential to achieving not just short-term quiet, but long-term behavioural change.

As Donella Meadows wrote, “Changing the behavior of a system requires changing its structure.”

Chapter Four: Reframing First-Line Thinking

Contemporary protocols in veterinary behavioural medicine already require thorough behavioural and medical assessments, including history-taking, diagnosis, and consideration of environmental and relational factors before prescribing psychoactive drugs. Yet critical gaps remain, especially given the increased normalisation of medication use in behavioural cases [31].

As Overall (2001) states:

“Rational pharmacological therapy requires complete medical and behavioural histories, requisite laboratory work, complete client understanding and compliance, and an honest and ongoing dialogue between the client and veterinarian that includes frequent follow-ups and re-examinations.”

Yet perspectives on medication’s role vary. As Summerfield (2016) argues:

“In my opinion, medication should be considered as a first-line treatment option for the vast majority of dogs with true behaviour problems.” – Summerfield J, 2016. [32,33]

While this reflects growing recognition of behaviour’s physiological roots, modern cases reveal gaps in how medication is applied. A key shortfall is the treatment of behaviour as a static symptom, rather than a dynamic product of interacting systems—including the autonomic nervous system (stress responses), limbic system (emotions), and prefrontal cortex (decision-making). Behavioural symptoms should be understood as signals of underlying neurobiological regulation—particularly involving the autonomic nervous system (ANS) which governs stress responses, limbic system, vestibular system, and prefrontal cortex. Without tracking these systems longitudinally (e.g., through sleep quality, stress recovery, or social engagement), medication decisions risk being made in partial view.

The caregiver functions as a critical structural component within the behavioural system, exerting continuous influence over the dog’s stress regulation and emotional trajectory. In most prescribing practices, this element is insufficiently modelled and clinical protocols under-emphasised the caregiver’s role. Today, we recognise that the caregiver is not simply a reporter of symptoms, but a structural actor. Their interactions directly shape the dog’s stress responses, emotional stability, and ability to adapt.  From a system dynamics perspective, the caregiver’s behaviour and the shared environmental context must be included in medication decisions. Without these feedback relationships, medication may suppress symptoms temporarily but fail to address systemic dysregulation. The caregiver must therefore be positioned as a structural actor across all phases of pharmacological intervention: pre-prescription, active dosing, and post-stabilisation.

To address these gaps, we propose a system-informed protocol that integrates neurobiological tracking, caregiver dynamics, and structured feedback loops.

A Three-Step Protocol for System-Informed Medication Use

Step 1: The consideration of behavioural medication—whether raised by the veterinarian, or caregiver—should initiate a pause, not a prescription. This is the point at which the case must shift from symptom management to systems understanding. Structured mapping of neurobiological and environmental inputs must occur. Are we seeing behavioural indicators that may reflect a neurochemical basis—and have relational, environmental, and developmental contributors been sufficiently explored?

Step 2: Once behavioural indicators support pharmacological intervention—such as patterns of chronic stress, inhibited cognitive function, or failure to progress despite caregiver effort—a treatment strategy must be co-developed. This strategy must also confirm that sources of physical pain, underlying illness, and breed-specific genetic needs have been assessed and ruled out. The plan includes defining medication goals, selecting behavioural and environmental supports, specifying caregiver actions, and outlining measurable short-term indicators.

Step 3: A feedback loop must be established using the same data that supported the initial decision. Caregivers, guided by the behaviourist, track indicators such as changes in sleep, co-regulation signals, autonomic regulation, and emotional recovery. These are not post-hoc impressions; they are the mechanism for clinical recalibration.

This feedback loop is operationalized through structured tracking of both quantifiable and interactional evidence (Figure 1), ensuring medication efficacy is evaluated systemically. Figure 1 maps the clinical decision pathway from caregiver-tracked indicators (left) through behaviorist 

analysis (center) to veterinary intervention (right), with iterative feedback arrows.

Figure 1: Clinical feedback loop integrating Quantifiable Indicators (e.g., White Pathway moments) and Interactional Evidence (HLCPM-based caregiver-dog dynamics) to evaluate medication efficacy.

Rather than relying solely on lab results, effective monitoring should track measurable indicators of regulatory health—such as sleep quality, stress recovery times, and social engagement—to assess medication impacts over time. Beyond context, these reflect internal shifts before and after medication.

Effective prescribing must account for the system surrounding the dog, caregiver, home, routine and historical stressors – and how these interact under structured interventions.

This is where the behaviourist’s role becomes central. Serving as a bridge between veterinarian and caregiver, the behaviourist delivers trained behavioural insight, instructs on structured data collection, and helps analyse observable indicators. This triadic collaboration ensures that decisions are not made in isolation, but within a functional behavioural system.

This paper introduces a framework that includes: 1. Neurobiological system tracking (ANS, limbic, vestibular, prefrontal) through structured indicators; 2. Clustering behavioural symptoms and tagging them with probable neurotransmitter activity to clarify how medication functions as a targeted input within regulatory systems; 3. Structured tracking before medication introduction, and repeated post-intervention to guide and assess its effects.

These clusters do not serve diagnostic purposes. Rather, they support clinical reasoning by suggesting which neurochemical systems (e.g., serotonergic, noradrenergic, dopaminergic) may be overactive, underactive, or dysregulated. This guides medication selection not by behaviour alone, but by interpreting behavioural systems as expressions of neurobiological state.

The assumption that medication can begin based on symptom alignment with diagnostic categories—and continue indefinitely without ongoing structural evaluation—has created a clinical environment where initiation is clear but continuation is unstructured.

Protocols must now evolve to reflect behaviour as emergent, systems-based, and relational—not solely pathology-driven [33]. This requires longitudinal tracking, a structured feedback model to guide medication use, and clear criteria for when pharmacological support remains necessary.

This represents a shift in framework rather than a judgement of current practitioners. Protocols developed for earlier contexts may no longer fully support today’s complex behavioural cases. Medication is being used without a repeatable system that includes caregiver input, neurobiological markers, and observable changes in regulation. What’s missing is a map–for knowing when to prescribe, what to prescribe, and how to evaluate the outcome.

This paper expands—not rejects—the role of medication. It challenges us to ensure that what we treat is not urgency or ambiguity, but structural dysregulation. The caregiver becomes central, supported by a behavioural modification system, tracking core indicators that provide the clarity needed.

It also recognises the pressure veterinarians face: high caseloads, limited time, and urgent caregiver demands. In this context, prescribing can feel like the only immediate path. But this protocol introduces a modest shift—asking that when medication is considered (but not urgently required), caregivers provide structured behavioural data.

This builds on existing precedent. Caregivers already prepare dogs for medical handling through training. Extending that preparation to behavioural cases—expecting co-regulation work and structured observation—is not a radical ask. It is a continuation of what good care already demands: dogs do better when humans prepare them.

While pharmacological intervention is sometimes urgent and entirely appropriate, urgency must not displace structure. This framework accounts for critical cases — but insists that even urgent decisions be revisited through feedback.  Medication becomes most effective not when it is fast, but when it is embedded in a feedback-informed system—tracked, co-supported, and revisable based on system-level behavioural indicators

To implement this protocol, medication decisions must be grounded in two complementary evidence types:

Two Forms of Behavioural Evidence Informing Medication Decisions

1.     Quantifiable System Indicators

Directly observable behavioural or physiological patterns over time, typically gathered by caregivers:

• Hours of deep-quality sleep

• Recovery time post-stress

• Guidance-seeking moments

• Orientation shifts

• Digestive changes

• White Pathway moments (fleeting pauses where the dog seeks relational feedback before reactivity [8])

These indicators reflect the system’s natural state—showing regulatory health outside direct intervention.

2. Interactional Evidence

Structured analysis of caregiver-dog dynamics using the Human-Led Canine Paralanguage Method (HLCPM), a communication model assessing:

·       Paralanguage Cues (tone, posture, rhythm, and emotional signalling 

·       Relational scaffolding (behaviourist-evaluated support structures)

·       Routine-based behavioural stability 

Data sources:

·       Video recordings of interactions

·       HLCPM session notes

·       Caregiver engagement quality ratings

This evidence evaluates whether the system (caregiver + environment) effectively promotes the dog’s regulation.

Together, these evidence types support ethically sound, system-informed medication decisions. They account for both internal state and external support dynamics. This ensures that medication is not used to mask unmet needs, but rather to support recovery when those needs are actively being addressed.

This three-step protocol embeds pharmacological decisions in a repeatable structure of observation, intervention, and review. Medication becomes a strategic input, used in rhythm with the dog’s internal system.

Pharmacological intervention is sometimes urgent and entirely appropriate. This framework honours that reality. What it challenges is the idea that speed alone equals effectiveness. Medication becomes most powerful when introduced with system clarity, supported by caregiver input, and evaluated in context. This is not hesitation—it is precision.

With the protocol established, we turn now to the foundational question: what must be in place for a pharmacological decision to be considered valid, timely, and effective?

The next question is not how—but whether—to prescribe. What constitutes a clinically sound foundation for pharmacological use?

Chapter Five: Raising the Clinical Floor: Standardizing Behavioral Evidence in Veterinary Practice

Having established the neurobiological and systemic principles governing behavior, we now operationalize these insights into clinical decision-making. The following framework transforms theory into actionable steps. Current veterinary guidance prioritizes 'clinical judgment' but rarely defines what evidence must be required to justify pharmacological intervention. While Overall (2001) and de Assis et al. (2020) advance diagnostic rigor, neither specifies how to evaluate behavioral evidence pre-prescription or assess medication efficacy longitudinally.This gap perpetuates reliance on anecdote—a stark contrast to physical medicine, where interventions follow objective diagnostics. In behavior cases, we alter neurochemistry based on recall and interpretation, not structured data.

We propose a clinical upgrade: make standardised behavioural data collection the minimum requirement for prescribing—transforming theory into actionable clinical steps

This shift positions the behaviorist as the architect of evidence—equipping caregivers to track markers like sleep patterns, recovery time, and White Pathway moments over 3–4 weeks. These indicators reveal regulatory capacity and sensory integration, forming a baseline for intervention.Post-prescription, the same data measures impact. If indicators stagnate, the system—not just dosage—is reassessed. For instance, if a dog’s stress recovery time remains prolonged despite medication, the treatment plan might integrate additional co-regulation training or environmental adjustments. The prescription is no longer the decision; it is one component within a larger clinical feedback loop.

Clinicians often rely on caregiver descriptions, which lack diagnostic rigor. In physical health, we rely on observable samples and diagnostics before intervention. Behavioural systems require equivalent rigour—structured, observable data—prior to altering neurochemistry. Yet with behaviour, we still rely on anecdote, recall, and interpretation. And we do so before altering brain chemistry.

Medication, in this framework, is no longer a reaction. It is a data-driven intervention. It earns its place not by urgency or pressure, but by demonstrating impact against a clearly defined set of behavioural criteria.

Only with this foundation can systems-based frameworks operate ethically. Medication earns its place not by urgency, but by demonstrably shifting measurable outcomes. With this foundation in place, we now turn to the operational framework that translates systems thinking into clinical action. The following chapter introduces five conditions that must be met before medication is considered—ensuring interventions align not just with symptoms, but with the dog’s neurobiological state and systemic readiness.

Chapter Six: The Systems-Based Medication Framework

Medication may be helpful. But not first and not without context.

The dog’s autonomic nervous system (ANS)—referred to here as ‘Reggie’ (the dog’s ANS)—operates through four distinct pathways, each reflecting a physiological and behavioral state:

·       Red: Reactive, hyper-alert, or aggressive.

·       Blue: Collapsed, withdrawn, or shut down.

·       White: Uncertain, checking for input (a reachable state for co-regulation).

·       Green: Socially engaged and learning-ready.

These pathways, aligned with polyvagal theory [34], help clinicians and caregivers identify where the dog’s system is ‘stuck’—and whether medication might help it shift

These pathways inform five systemic conditions that must be met before considering medication—ensuring interventions align with the dog’s neurobiological state.

This framework is grounded in the Canine Neurobiological Systems Science (CNSS) model, which integrates systems thinking and behavioral neuroscience (see Figure 2). Figure 2 depicts the CNSS model's modular architecture, showing how systems thinking principles inform behavioral intervention protocols.*

Figure 2. Illustrates the structural components of the Canine Neurobiological Systems Science (CNSS) framework as applied to behavioural medication decisions. It highlights CNSS’s modular architecture—models, tools, protocols, and methodology—and its integration of informing science domains, demonstrating an innovative systems-based approach to canine behaviour care.

Five Conditions That Must Be Met Before Medication Is Considered

In addition five conditions present as a sub-framework, to be met before medication is considered. Not as rules, but as systems checkpoints. Without them, the wrong input can disrupt what the system is still trying to resolve. These five minimum conditions operate as a dynamic system stability assessment — measuring readiness for pharmacological intervention based on functional system patterns, not procedural assumptions.

1. Observation Before Intervention

• A 3–4 week structured observation period (tracking sleep, recovery time, White Pathway moments) must precede medication unless the dog is in immediate danger [35, 36].

• Video/journal evidence is required to detect patterns invisible in isolated consults [49–51].

2. Pathway-Driven Decisions

• Medication must align with the dog’s autonomic state (Red/Blue/White/Green) [8, 37–39].

• White Pathway moments indicate reachability; their absence may justify medication to reduce suffering [10, 40, 41].

3. Caregiver Engagement & Environmental Stability

• Medication requires an actively engaged caregiver and predictable routines [42, 43].

• Without relational co-regulation, medication risks masking unmet needs.

4. Feedback-Informed Prescribing

•       Medication is a system input, not a standalone solution. Its impact must be evaluated through:

o   Longitudinal tracking of quantifiable indicators (sleep, stress recovery).

o   Structured feedback loops (video/journal data) to distinguish true regulation from symptom suppression [51].

5.     Medical Rule-Out:

• Confirm no undiagnosed pain or illness contributes to behavioral dysregulation through veterinary examination and lab work [31]. Medication should never replace medical diagnostics.

Having established the neurobiological and systemic principles governing behavior, we now operationalize these insights into clinical decision-making. The following framework transforms theory into actionable steps.

Limitations and Practical Considerations

• Urgent cases may require provisional medication with concurrent tracking.

• Caregiver-led tracking (guided by frameworks) can substitute when behaviorists are unavailable.

Although ideal conditions are not always attainable, clarity, systems insight, and structured behavioural oversight must remain the foundation of all clinical decisions. In the cases presented, outcome data reflects structured involvement through medication stabilisation and post-stabilisation behavioural restructuring, with longer-term follow-up based on caregiver engagement

Note on Systems Foundations:

The clinical recommendations outlined in this paper are underpinned by the Canine Neurobiological Systems Science (CNSS) framework. CNSS integrates principles from systems thinking (e.g. Senge’s Systems Thinking [11], Meadows’ Systems Thinking [9], Jay Forrester, Systems Dynamics [55]) and behavioural neuroscience (Porges’ Polyvagal theory [10], Sapolsky’s Neurobiology [19], Delahooke’s Developmental Pscyhology [39]) to conceptualise behaviour as an emergent property of interacting neurological and relational systems.

Developed through structured clinical application across 147 complex canine behaviour cases, CNSS was validated through dynamic systems tracking and outcome measures focused on systemic regulation rather than symptom suppression. With a documented 98% program success rate based on structured engagement, behavioural improvements, and longitudinal caregiver reporting, CNSS provides the systems-based clinical foundation from which medication timing, planning, and intervention decisions are derived.

The following cases illustrate how this structured approach to pharmacological decision-making plays out in practice.

Chapter Seven: Case Examples[4]

The following cases illustrate how the systems-based framework guides medication decisions. Each demonstrates the critical role of tracking neurobiological indicators (e.g., sleep, recovery time) and caregiver engagement in achieving lasting change.

Systems-Based Case Summary - Harry:

Harry, a six-year-old mixed-breed rescue, presented with chronic hypervigilance, impulsive defensive behaviours, and behavioural regression—reflecting a system locked in sustained threat activation. Fluoxetine was continued based on underlying system dysfunctions (Generalised Anxiety Disorder and Fear-Related Reactivity), not surface-level behaviours. Early pharmacological response was partial but plateaued, constrained by limited caregiver capacity to support regulation. An extended intervention phase focused on developing caregiver responsiveness to behavioural cues, which gradually stabilised relational feedback. Dosage adjustment was then introduced as a system leverage point, yielding measurable improvements. Behaviour modification centred on restoring safety and flexibility through structured routines, environmental predictability, and targeted co-regulation. Ongoing tracking confirmed medication effectiveness and clarified the need for continued behavioural re-patterning within an increasingly responsive system.

Hx: Rescue, mixed breed, neutered male, 6 years. Adopted at 1 year. Prescribed Fluoxetine/Trazodone for regression. Historical hip fracture prior to adoption	Sx & Clusters: NA – Noradrenaline, DA – Dopamine, Glu – Glutamate, GABA – Gamma-Aminobutyric Acid, 5-HT – Serotonin, OXT – Oxytocin Threat - NA, DA, Glu: Hypervigilance*, Hyperalertness, Startle* Processing - Glu, GABA: Noise/Vibration Sensitivity, Car Fear*, Startle* Safety - 5-HT, DA, OXT: Generalised Anxiety, Car Fear*, Hypervigilance* Impulse Control - 5-HT, DA: Resource Guarding, Predatory Aggression * Indicates overlap across clusters
Psychoactive Metrics: DIAS - Dog Impulsivity Assessment Scale3 : All normal; reliability limited by caregiver stress and emotional inconsistency. CFQ - Canine Frustration Questionnaire4 : Barrier frustration/perseverance – very high All other dimensions - normal	BModx: Threat System: Avoidance strategies, relaxation, calming cues Processing System: Visual DS/CC, HLCPM, reinforcement precision Impulse Control: Canine signal recognition, trigger management Trauma Memory: Outdoor engagement walking Safety System: Daily tracking, relational scaffolding
Notes: Fluoxetine was initially prescribed based on surface behaviours, without symptom cluster analysis or indicator tracking; renewals occurred without structured reassessment. Continued use was based on partial past effectiveness; dosage was later increased following behavioural regression. Presenting behaviours were mislabelled as separation anxiety, though the pattern reflected uncertainty anxiety rooted in early trauma, environmental instability, and inconsistent caregiver routines. Caregiver stress, lack of behavioural education, and difficulty interpreting distress signals limited system support during the early phases of treatment. The behavioural plan prioritised systemic stability, with dosage adjustment introduced only after caregiver responsiveness improved. Caregiver-related reporting variability was noted and accounted for in tracking interpretation.

Systems-Based Case Summary - Gabby:

Gabby, a fifteen-month-old mixed breed (Golden Retriever, Border Collie, German Shepherd), presented with persistent hypervigilance, sensory flooding, and impaired emotional recovery — consistent with dominant Red Pathway activation and absence of White Pathway hesitation. Medication planning centred on system dysfunctions (Generalised Anxiety Disorder and Fear-Related Reactivity), not isolated surface fear behaviours. Fluoxetine was recommended as the first-line intervention, with Clomipramine identified as a secondary option if SSRI intolerance emerged. Pre-medication tracking demonstrated persistent Red Pathway dominance and sleep fragmentation, but also indicated a system attempting regulation, with isolated moments of relational engagement, for example, we detected rare but critical White Pathway moments, confirming system reachability. This supported pharmacological intervention as a stabilising tool within a structured behavioural plan.  Post-medication tracking confirmed increased White Pathway occurrences (momentary pause, orientation), followed by deeper sleep, emotional retention, and emerging access to the Green Pathway, supporting medication continuation and system-directed behavioural re-patterning.

Hx: Mixed breed (Golden Retriever, Border Collie, German Shepherd), female, spayed, 15 months. Adopted at 9 weeks from a farm setting. Early digestive issues resolved. Sleep deprivation (~10 hrs/day). No medication at intake. Positive reinforcement training background.	Sx & Clusters: NA – Noradrenaline, DA – Dopamine, Glu – Glutamate, GABA – Gamma-Aminobutyric Acid, 5-HT – Serotonin, OXT – Oxytocin Threat - NA, DA, Glu: Hypervigilance*, high startle reflex*, persistent environmental scanning* Processing - Glu, GABA: Sleep deprivation*, sensory flooding indoors* Safety- 5-HT, DA, OXT: Timid behaviour*, low recovery resilience*, impaired memory consolidation* Impulse Control - 5-HT, DA: Barrier frustration, leash pulling, low frustration tolerance * Indicates overlap across clusters
Psychoactive Metrics: DIAS3 : High impulsivity overall; poor behavioural regulation; high aggression/response to novelty scores CFQ4 : Barrier frustration very high; general frustration high; coping mechanisms inconsistent Tracking Data: Sleep insufficient; repetitive eruption patterns during guest arrivals indoors	BModx: Threat System: Structured avoidance/recovery, HLCPM (Human-led Canine Paralanguage Method) relational scaffolding, relaxation protocol5 Processing System: Sensory-Based Positive Experiences and Balance Exercises (SPE&BE)6, low-stimulation exposure Impulse Control, Trauma Memory and Safety System: Impulse-control exercises, dog-signal interpretation training
Notes: Medication recommendation (Fluoxetine, SSRI) based on dominant system dysfunctions (GAD and FRR) rather than surface fear-reactivity. Secondary pharmacological plan (Clomipramine, TCA) identified based on potential serotonin transport inefficiencies if SSRI poorly tolerated. Sleep deprivation, emotional fragility, and working-line genetic traits contributed to persistent neurobiological instability. Early barn isolation and relational neglect implicated in chronic emotional dysregulation and poor system buffering. Behaviour modification plan structured around targeted system repair (threat regulation, sensory processing, emotional resilience). Initial tracking data confirmed persistent sensory flooding and sleep deprivation, supporting pharmacological stabilisation. Ongoing tracking on medication showed improved deep sleep, emotional retention, and learning consolidation, supporting continued medication use.

Systems-Based Case Summary - Finn:

Finn, a five-year-old Havanese mix rescued from a feral background, presented with chronic separation anxiety, compulsive eruption behaviours, and persistent hypervigilance — indicating prolonged Red Pathway dominance and intermittent Blue Pathway collapse. Medication planning targeted underlying system dysfunctions (compulsion, emotional safety breakdown), not surface reactivity, leading to Clomipramine selection with monitored escalation. Behaviour modification focused on systemic re-stabilisation through safety signalling and relational repair, rather than symptom suppression. Tracking data prior to medication showed partial system improvements, indicating supporting system feasibility. This included early White Pathway emergence during caregiver interactions, marked by momentary hesitation and relational referencing.  Post-medication data confirmed sustained Green Pathway access (learning, rest, and flexible engagement). Medication was withdrawn after two years with no reported relapse. While formal tracking concluded at 8 weeks post-integration (per protocol), caregiver competency—developed through our lifetime support model—sustained stability. This aligns with our goal: medication as a temporary scaffold for system-level change.

Hx: Havanese mix, neutered male, ~5 years. Rescued from Egypt (feral early life, overcrowded shelter). History of torment by children. Chronic separation anxiety and compulsive behaviours at intake. Rare prior use of Trazodone (limited success). Homed with current caregiver at 5 years.	Sx & Clusters: NA – Noradrenaline, DA – Dopamine, Glu – Glutamate, GABA – Gamma-Aminobutyric Acid, 5-HT – Serotonin, OXT – Oxytocin Threat - NA, DA, Glu: Hypervigilance indoors/outdoors*, compulsive aggression*, obsessive fear responses* Processing - Glu, GABA: Sensory flooding, poor recovery post-trigger Safety - 5-HT, DA, OXT: Severe distrust, absence of secure relational signalling* Impulse Control - 5-HT, DA: Barrier frustration, leash pulling, low frustration tolerance, compulsive vocalisation*, compulsive pacing* * Indicates overlap across clusters
Psychoactive Metrics: DIAS3 : Overall impulsivity normal; behavioural regulation high; aggression/novelty response high CFQ4 : General frustration high; barrier frustration/perseverance abnormal. Tracking Data: Daily logs documented eruption intensity, recovery lags, sleep consistency (12–15 hrs); self-play and self-grooming improvements noted post-Bmod-intervention but core eruption patterns persisted without pharmacological support.	BModx: Threat System: Structured avoidance/recovery, HLCPM relational scaffolding Processing System: Noise and visual desensitisation and counter-conditioning Impulse Control and Trauma Memory: Impulse-control exercises, dog-signal interpretation training Safety System: Impulse-control exercises, relaxation protocol5
Notes: - Medication planning grounded in compulsive symptom clusters and separation anxiety dominance, not surface reactivity alone.  - Clomipramine selected to target serotonergic and noradrenergic pathways with gradual dose escalation monitoring. - Early trauma history (feral upbringing, abuse by children) contributed to impaired threat regulation and emotional safety systems.  - Behaviour modification focused on structural recalibration, enabling long-term behavioural adaptation rather than immediate symptom reduction - Tracking data indicated partial improvements in self-regulation domains prior to medication decision, but persistent system instabilities reinforcing the need for medication introduction. - Continued tracking post-medication showed system stabilisation; notified medication successfully withdrawn after two years without relapse of core system dysfunctions.

Systems-Based Synthesis of Case Outcomes

Across the cases of Harry, Gabby, and Finn, a shared system pattern emerged: behavioural volatility persisted when intervention was directed at symptoms rather than the structure producing them. Medication introduced in response to system feedback — including time-series behavioural indicators, relational mapping, and pathway-specific neurobiological insight — functioned as a stabilising input. It shifted the system’s regulatory trajectory rather than masking its outputs.

In Harry’s case, sustained deficits in relational orientation and delayed recovery from affective events signalled unresolved instability. Medication served not as a solution to observable behaviour, but as an input supporting a system unable to reorganise through relational or environmental means alone.

Gabby’s dysregulation, expressed through disrupted sleep cycles and sensory saturation, pointed to a system overwhelmed by unmanaged input. Medication, paired with structural adjustments to her sensory environment, enabled a partial return to regulation.

Finn’s case illustrated delayed feedback: early surface improvements in behaviour masked persistent compulsive loops. Once these were tracked longitudinally, pharmacological input was introduced not to override them, but to create space for structural recalibration. Over time, this allowed for successful withdrawal of the medication, once indicators showed system-level recovery.

These cases reveal five principles for systems-based medication use:

1.     Track First

• Observable indicators (sleep, recovery time, White Pathway moments) reveal dysregulation before symptoms escalate.

• Standard protocol: 3–4 weeks pre-medication tracking + 6–8 weeks post-medication integration monitoring.

2.     Match Pathways

• Medication aligns with the dog’s autonomic state:

  • Red/Blue: Pharmacological support to reduce suffering.

  • White/Green: Behavioral interventions to reinforce stability.

3.     Partner with Caregivers

• Medication efficacy depends on:

• Caregiver consistency in co-regulation.

• Environmental predictability.

• Lifetime support model ensures sustained gains post-medication.

4.     Plan the Exit

• Successful withdrawal requires:

• Short-term tracking confirmation (6–8 weeks post-integration).

• Caregiver competency to maintain stability independently.

• Finn’s case: Withdrawal succeeded due to caregiver skill development, despite limited long-term tracking.

5.     Medication as a Scaffold

• A temporary tool to create space for system-level change—not a permanent solution.

• "The goal is not to medicate, but to recalibrate."

This framework redefines medication from a reactive measure to a strategic, time-bound input. As demonstrated by Harry, Gabby, and Finn, lasting change emerges when pharmacological support is embedded within a system of tracking, caregiver partnership, and pathway-specific behavioral repair. The cases also highlight a critical insight: medication withdrawal succeeds when short-term data and long-term caregiver capacity converge—even when formal tracking cannot span years.

Observable gains aligned with restoration of autonomic flexibility, increased co-regulatory signals, and reactivation of pathways linked to safety and engagement. Medication, in this context, was not a reaction — it was an informed system adjustment, guided by evidence, timing, and structural clarity.

The Systems Imperative in Canine Behavioural Health

Behavioural care stands at a crossroads. For decades, we’ve treated symptoms; now, we’re learning to read them—as dynamic signals from living systems seeking equilibrium. This paper hasn’t merely proposed protocols—it has revealed a fundamental truth: what we call “problem behaviour” is often the system’s best attempt to self-regulate under unsustainable conditions. 

Emerging Paradigm

Three recognitions are reshaping our field:

1.      Medication as Feedback Modifier

Psychoactive drugs don’t “fix” dogs—they alter the system’s communication pathways. Used without understanding these dynamics, we risk silencing vital signals. Used wisely, they create windows for systemic change.

2.      The Collaborative Ecosystem

When caregivers track patterns, veterinarians interpret neurobiological states, and behaviourists map feedback loops, something remarkable happens: the dog’s behaviour becomes legible—not as pathology, but as the system’s current dialect.

3.      Success Beyond Suppression

The metrics that matter shift:

•       From “reduced barking” to restored exploratory curiosity

•       From “compliance” to increased White Pathway moments

•       From “management” to system resilience

The Invitation

This isn’t about imposing rules—it’s about extending an invitation to:

·       See Differently

Observe behaviour as the system’s language—where pacing might be Reggie’s plea for safety, and reactivity Tom’s exhausted alarm.

·       Partner Differently

Let caregivers’ observations illuminate what labs cannot. Let behaviourists’ feedback-loop analyses guide pharmacological timing. Let veterinarians’ neurobiological expertise anchor the team.

·       Measure Differently

Celebrate when tracking reveals a dog’s first self-initiated recovery—not just when symptoms fade under chemical suppression.

The future belongs to clinics that embrace this complexity—where medication decisions emerge from the system’s own storytelling, where every professional cultivates dual literacy in neurobiology and systems dynamics, and where “treatment” means creating conditions for the system to heal itself.

This is the frontier: not better behaviour modification, but true behavioural medicine. The dogs are waiting. The science is ready. The question is no longer if we’ll make this shift—but how boldly we’ll lead it.

Acknowledgment:

With gratitude to the dogs and caregivers whose clinical cases informed this work. Their willingness to share their experiences has contributed to advancing clarity, compassion, and systemic insight in behavioural medicine. All names have been changed to respect client confidentiality.

I also wish to acknowledge the foundational contributions of Dr. Karen Overall and other pioneers in veterinary behavioural medicine, whose frameworks established many of the principles upon which this paper builds. While this work introduces a systems-informed model that extends beyond current protocols, it does so with respect for those whose clinical insights continue to shape the field.

Appendix A: Glossary of Key Terms

5-HT – Serotonin: A neurotransmitter linked to mood regulation, emotional resilience, and impulse control.

ANS – Autonomic Nervous System: Governs involuntary physiological functions such as heart rate, respiration, digestion, and arousal.

Blue Pathway – A neurobiological state representing collapse or freeze; associated with parasympathetic dorsal vagal dominance.

Caregiver – The primary human responsible for the dog's day-to-day care and co-regulation support.

CFQ – Canine Frustration Questionnaire: A tool used to assess a dog’s frustration tendencies across contexts.

CNSS – Canine Neurobiological Systems Science: A framework integrating systems thinking and behavioural neuroscience to understand and intervene in complex canine behaviour cases.

Conrad – Represents the prefrontal cortex in the CNSS model, responsible for executive function, behavioural inhibition, and adaptive decision-making.

DA – Dopamine: A neurotransmitter involved in reward, motivation, and behavioural regulation.

DIAS – Dog Impulsivity Assessment Scale: A psychometric tool to measure impulsivity traits in dogs.

GABA – Gamma-Aminobutyric Acid: A neurotransmitter that inhibits neural activity, promoting calm and reducing anxiety.

Glu – Glutamate: The primary excitatory neurotransmitter in the brain, involved in learning and sensory processing.

Green Pathway – A neurobiological state of calm engagement, social interaction, learning, and environmental safety.

HLCPM – Human-Led Canine Paralanguage Method: A communication model based on tone, posture, and relational signalling used to support co-regulation.

Medication Feedback Loop – The use of pre- and post-medication behavioural data to assess the efficacy and appropriateness of psychoactive treatment.

OXT – Oxytocin: A hormone and neuropeptide associated with bonding, trust, and relational safety.

Red Pathway – A neurobiological state representing heightened arousal, reactivity, or defensive aggression, typically associated with sympathetic activation.

Reggie – Represents the autonomic nervous system (ANS) in the CNSS model; regulates physiological stress responses.

SPE&BE – Sensory-based Positive Experiences and Balance Exercises: Intervention tools designed to regulate sensory input and promote physiological calm.

Symptom Cluster – A grouping of behaviours thought to relate to underlying neurochemical dysfunction.

Tom – Represents the limbic system (especially the amygdala) in the CNSS model; responsible for threat detection and emotional memory.

Tracking Indicators – Structured behavioural observations collected by caregivers (e.g., sleep quality, orientation, recovery time) used to guide clinical decisions.

Vestibular System – A neurobiological system governing balance, spatial orientation, and anxiety modulation.

Viv – Represents the vestibular-spatial system in the CNSS model; linked to sensory processing, movement, and anxiety regulation.

White Pathway – A transitional neurobiological state marked by hesitation, checking, or relational referencing, indicating the dog is reachable and co-regulation is possible.

List of Figures:

1.     Smith S. Clinical Feedback Loop for System-Informed Medication Use. In: Medication and the Missing System: Rethinking Psychoactive Use in Dog Behaviour Care. 2025.

2.     Smith S. CNSS Framework: Applied to Pharmacological Decision-Making. Internal framework illustration. (2025)

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Author’s Bio:

Sparky Smith, MSST (Haines Centre for Strategic Management in partnership with University of San Diego), ISCP.Dip.Canine.Prac. (International School of Canine Psychology), MCMA, SSBB, is a Canine Psychologist and systems thinking specialist. Her innovative application of MIT Sloan’s Systems Thinking tools to canine behaviour cases was adopted as a teaching exemplar for cross-disciplinary methodology. With 20+ years of cross-sector systems expertise, she developed the Canine Neurobiological Systems Science (CNSS) framework, achieving a 98% success rate in complex behavioural cases through neurobiological tracking and caregiver-system integration. Founder of Dog Parentology, her work bridges strategic systems analysis and applied behavioural neuroscience.

Publishes under the professional name Sparky Smith. Legal name: Susan Smith.

ORCID ID: 0009-0006-8265-7488

EMAIL: Sparky@Dogparentology.com

Author AI Use Disclosure:

The author used generative AI technology (ChatGPT by OpenAI) solely to assist in improving the readability and structure of the manuscript. All substantive content, including data analysis, clinical interpretation, and conclusions, were generated and reviewed entirely by the author. The author retains full responsibility for the integrity and accuracy of the work.

[1] The White Pathway (see Appendix A for glossary of key terms (e.g., White Pathway, CNSS)) is one of four neurobiological states defined in the Canine Neurobiological Systems Science (CNSS) model (see Figure 2). It represents a moment of uncertainty in which the dog remains reachable—open to co-regulation and input. Its presence signals regulatory flexibility; its absence may support medication to reduce distress. The four pathways form the basis for five systemic conditions guiding pharmacological decisions. The others include Red (threat), Blue (collapse), and Green (engagement). This are further defined in Ch. 6.

[2] Success was defined as completion of a structured behavioural program grounded in the CNSS framework. Each case included a full psychological assessment, an individually tailored plan, twelve private therapy sessions, and guided learning based on systems thinking and behavioural science. Caregivers actively participated by submitting videos, tracking patterns, and completing applied learning tasks. Success required three outcomes: caregiver-reported behavioural improvement, completion of the program with demonstrated ability to apply core strategies, and confidence in managing future behavioural issues across the dog’s life. All interventions addressed brain function, relationships, routines, and environment as interacting systems.

2 I first introduced this model in the context of canine surrender prevention, demonstrating how misinterpreting these internal systems often contributes to relational breakdown and, ultimately, the loss of the dog [20].

[4] The term ‘clusters’ refers to ‘symptom clustering’. It is important to note that symptom clustering is not a diagnostic endpoint, but a pattern-based tool used to interpret behavioural data in relation to probable neurochemical activity. Within CNSS, clustering enables professionals to form cautious hypotheses about neurotransmitter involvement — particularly when paired with system tracking data and caregiver-led observations.