Proceeding of the LAVC Latin American Veterinary Conference Oct , 2010 Lima, Peru

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Close this window to return to IVIS www.ivis.org Proceeding of the LAVC Latin American Veterinary Conference Oct. 25-27, 2010 Lima, Peru Next LAVC Conference: Oct. 24-26, 2011 Lima, Peru Reprinted in the IVIS website with the permission of the LAVC http://www.ivis.org/

Separation Anxiety in Dogs & Cats Terry Marie Curtis DVM, MS, DACVB College of Veterinary Medicine University of Florida (352) 294-4397 curtist@ufl.edu Dogs may experience distress and engage in problem behaviors related to the absence, or perceived absence of family members. Common manifestations of Separation Anxiety (SA) in dogs include destruction of objects (pillows, carpets, doors, window sills, crates, etc.) with or without self-injury (usually in an attempt to escape), excessive vocalization, inappropriate elimination (urination and/or defecation), and excess salivation. For most dogs with SA, these behaviors occur within 5-30 minutes after the departure of the owner. An important question to ask when taking the behavioral history is: What is the shortest time you have been gone and returned to find the problem behavior? Dogs with SA often act with great excitement upon owner return: jumping, running around and vocalization. While many dogs without separation issues may act in this manner, dogs with SA engage in these behaviors for a long time. Not all dogs with SA are triggered by all departures. They may react to unscheduled departures only, work-related departures only, or any departure. Some dogs may be okay as long as they re not alone, while others are alright only if their primary attachment figure is present. The onset of SA is variable. Some dogs exhibit these behaviors in puppy hood. Changes in the household may trigger separation issues such as a different schedule, a recent move, addition or deletion of family members, etc. Often post-boarding or post-vacation may trigger SA. The most common and most erroneous misconceptions that owners have is that their dog is being spiteful, ungrateful, and/or angry at being left alone. They will often say that their dog knows that it did something wrong. This is NOT the case and it is imperative that owners understand that SA is a distress response specifically related to being separated from social group members. These animals are in panicked distress, not angry. The dog s apparent knowing it did something wrong behavior can be explained, however. In cases where there is destruction and/or inappropriate elimination, the dog is often punished by an angry and frustrated owner. The dog is aware of the owner s anger and of the urine, feces, and destruction. The dog DOES NOT associate the punishment with the act of creating the mess, but the dog DOES associate the punishment with the combined presence of the owner and the mess. So, when these conditions are met: Owner + Mess, the dog will act to appease crouching down with tail between its legs. Owners mistake this behavior for knowledge of an inappropriate act, and believe that the dog is guilty or sorry. These misconceptions can hinder treatment and are counterproductive for a healthy human-animal bond. Also, inappropriate punishment may result in fear-motivated and defensive aggression. Videotaping is a great diagnostic tool. It allows the owner to see exactly what the dog is doing. They can see the panic. It helps to explain to the owner what is going on, and it is useful in monitoring the effect and extent of treatment. Diagnosis of Separation Anxiety involves the history of one or more of the distress behaviors occurring in the owner s absence and/or excessive excitement behavior when the owner returns. There may or may not be evidence of a strong attachment to the owner. Also, if these behaviors occur when the owner is with the dog, then other differentials must be considered. For example, destruction can be an element of play or exploratory behavior. It can occur in the

course of territorial displays at windows and doors, and can also occur during phobic episodes related to noises or storms. Excessive vocalization can be in response to provoking stimuli outside, social facilitation with other dogs, part of a territorial display, or part of play behavior. Inappropriate elimination can be indicative of incomplete house training or urine marking. It can also be a sign of a medical problem or cognitive decline. Knowing when the behavior occurs, again using a videotape, can help to rule out these other differentials. The goal of treatment is to teach the pet how to be calm and relaxed during the owner s absence. It involves changes in pet-owner interactions, changes in leaving and return protocols, decreasing the anxiety associated with owner departure, teaching the pet how to be left alone, environmental changes and management, and sometimes the use of psychotropic medication. Changes in Pet-Owner Interactions The goal here is to facilitate the dog becoming more independent and less anxious. It involves ignoring attention-seeking behavior and rewarding the dog for being calm and relaxed. This behavioral therapy is vital to the treatment of separation anxiety. Changes in Leaving and Return Protocols In an attempt to decrease the level of anxiety that these dogs exhibit prior to owner departure, it is recommended that the owner ignore the dog 15-30 minutes prior to leaving. Upon return, they are to greet the dog softly and quietly, and attend to the dog ONLY when it is calm and quiet. Decreasing the Anxiety Associated with Departure This involves changing the predictive value of pre-departure cues and re-teaching the dog that the routine no longer predicts departure. This is accomplished through habituation, counter-conditioning and desensitization. Habituation is a decrease in response as a consequence of repeated exposure to a stimulus. The goal is to disassociate the predeparture cues from the actual departure. Examples include picking up keys, putting on shoes, packing briefcase, etc. Using the picking up keys as an example, through habituation, the owner picks up the keys the dog alerts, becomes anxious, and comes to the owner; the owner ignores the dog and goes about routine the owner does not leave the house. Consequently, the dog learns that the keys mean nothing. This is done with all of the predeparture cues so that they no longer predict departure, no longer lead to an anxious response, and become less important to dog and easier to ignore. With Counter- Conditioning a response is elicited that is behaviorally and physiologically incompatible with another response. A dog cannot be anxious and relaxed at the same time. In the case of SA, the dog is rewarded for relaxation and the technique is used to decrease the response of the dog to departure cues. For example, the dog is taught to sit/stay near an exit. If the dog is calm and relaxed, it is rewarded with a yummy treat. This process is usually used in combination with desensitization. In Desensitization, the dog is exposed to a low-level anxiety-causing stimulus. This low-level anxiety response can be easily interrupted and diverted. Gradually the intensity of the stimulus is increased, ideally without eliciting the anxious response. In the example of the owner getting closer to the door, eventually the owner steps outside the door, but returns quickly. As the dog learns the task, the owner can increase the time away. Teaching the Dog to be Left Alone at Home This involves the implementation of graduated planned departures GPDs, which use short absences to desensitize the dog to the owner leaving and being gone. Prior to this part of the treatment, the dog must have already been habituated to departure cues and desensitized to approaches to the door, etc.

GPDs are like REAL departures with two exceptions: 1) Initially the absences are very short, and 2) As the owner departs, he/she leaves a new and consistent safety cue or signal for the dog. Classical conditioning is used such that a neutral stimulus is paired with a conditioned stimulus and results in a conditioned response. In this case, the neutral stimulus, NS = owner departure. The conditioned stimulus, CS = safety cue. And the conditioned response, CR = good behavior, feeling relaxed. The safety cue can be auditory (bell), visual (a towel or rug that is put down just prior to departure), or a combination of auditory, visual, and olfactory such as spraying a can of potpourri. Environmental Changes and Management Suggestions include: increased play and exercise, Doggie Day Care, gradual conditioning to crate (can be good with some dogs, disastrous with others ), mixing up departure cues, masking departure with noise while dog is busy with toy in another room, use of the Anxiety Wrap (see www.anxietywrap.com), and use of the Gentle Leader head collar to help decrease the dog s overall level of anxiety. This collar is used on walks and during DS&CC; it is NOT to be left on the dog when unattended. Pharmacological Intervention Keeping in mind that the goal is for the dog to not experience anxiety, use of a daily maintenance medication along with a fast-acting, short-duration medication may be warranted. Clomicalm (clomipramine) is a tricyclic antidepressant and Reconcile is a selective serotonin reuptake inhibitor both of which have been FDAapproved for use in dogs with separation anxiety. Both provide the long-term maintenance treatment, and will help to decrease the dog s overall level of anxiety. Clomicalm is administered at 1-2mg/kg BID. It is available in 20, 40, and 80mg tablets. Reconcile comes in 8, 16, 32, and 64mg tablets and is labeled at the dose of 1-2mg every 24 hours. Xanax (alprazolam) is a fast-acting benzodiazepine which is given 30-60 minutes prior to departure. It is administered at the dose of 0.02 0.05mg/kg, increasing the dose, as needed, due to tolerance. It is available in 0.25, 0.5, 1.0, 2.0mg tablets. Valium (diazepam) is a longer acting benzodiazepine and can be effective for 6-8 hours. It is dosed at 0.5 2mg/kg. As with alprazolam, start at a low dose and work up, if necessary. Another benzodiazepine option is Klonopin (clonazepam) the longest-acting of the three. The dose for clonazepam is 0.05 0.2mg/kg and lasts 8-12 hours. None of the benzodiazepines are approved for use in dogs, so the client must give consent in writing. The benzodiazepine can be given along with Clomicalm and Reconcile but the two FDA-approved medications for Separation Anxiety Clomicalm and Reconcile should NEVER be given together. There is another anxiolytic medication that can be given alone or along with both the maintenance and/or as needed benzodiazepines: trazodone. For detailed information about the use of trazodone in dogs with Separation Anxiety, please refer to the complete article in JAVMA December 15, 2008, Volume 233, Number 12 pp. 1902-1907. The dog should be weaned off of all medications slowly when the time comes to do so. Voo-Doo DAP (Dog Appeasing Pheromone) is reported to Mimic the properties of the natural pheromones of the lactating female. It may help to decrease the dog s overall level of anxiety and comes in a diffuser, collar, and spray. Another dog may work However, the dog with SA may be attached to one particular human, in which case the presence of another dog won t help. There is also the risk of the new dog getting Separation Anxiety. Separation Anxiety in Cats - There has been one retrospective study done (Schwartz, 2002) looking at 136 medical records of cats that displayed typical Separation Anxiety behaviors. 75% urinated on owner s bed. Other manifestations of SA in the cat include psychogenic

grooming and destructiveness. Treatment with Alprazolam (Xanax ) can be effective as follows: 0.125 0.25mg/cat q 4-6 h 2-3 days prior to owner departure Wean off over 3 days after owner return