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Veterinarians have long relied on the "Big Five" vital signs: temperature, pulse, respiration, pain score, and body condition score. However, a growing body of evidence suggests that behavior should be considered the sixth vital sign.

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Historically, veterinary restraint was based on dominance and physical force. "Hold the dog down" was common parlance. Today, thanks to behavioral science, we know that learned fear (fear memory) causes chronic stress, immunosuppression, and dangerous defensive aggression. Veterinarians have long relied on the "Big Five"

: Provide a written schedule of feeding times, exact portions, and exercise requirements Progressive . : Provide a written schedule of feeding times,