Chapter 7 All of the conditions discussed in this chapter are or can become pathological. For dogs whose problematic behaviors involve elimination, the elimination behaviors may be the result of management practices or may be normal behaviors displayed in contexts clients find undesirable. The manner in which these problematic behaviors are addressed before veterinary intervention is sought can create anxiety (see Box 2-1 for a listing of non-specific signs of anxiety). Because of this and the risk of co-morbidity, concerns about elimination behaviors are addressed at the end of this chapter. Diagnostic Criteria and Description: • True fear involves responses to stimuli (social or physical) that are characterized by withdrawal and passive and active avoidance behaviors associated with the sympathetic branch of the autonomic nervous system (Hydbring-Sandberg et al., 2004) and in the absence of any aggressive behavior. • Fear and anxiety have signs that overlap. Some non-specific signs, such as lowering of the back, shaking, and trembling, can be characteristic of both fear and anxiety. • Truly fearful dogs lower their entire bodies, necks, head, ears, and tails and appear to fold into their limbs (Galac and Knol, 1997). Anxious dogs do not do this and exhibit a wide range of stances. • The physiological signs of fear and anxiety probably differ at some very refined level, and the neurochemistries of each are probably very different in a way that is not addressed by the relatively non-specific medications we commonly use (see Table 10-5 for a summary of the complexity of the distribution of subtypes of serotonin receptors). • Refinements in qualification and quantification of the observable behaviors will hopefully parallel these differences. • True fear always involves avoidance, with an apparent intent to decrease the probability of social interaction. This is in contrast to anxiety, where avoidance is not the first choice. Dogs who are driven primarily by anxiety may put themselves into a social system, although it makes them uncomfortable and worried. • Specific behavioral responses may include (Fig. 7-1): Fig. 7-1 Two border collies from the same household. Notice the merle dog is calm and watching the photographer. The black collie is backed into a corner, tail tucked, back hunched, head lowered a bit, gaze averted, and her lips and nose dripping. The black collie has true fear; the merle collie is normal. • tucking of neck, head, tail, and all limbs, Fig. 7-2 The same collie in Figure 7-1 when she was not permitted to go into a corner. She turned her back on the humans, tensed her body, pulled her ears back and down, flush with her head, and hunched over a bit. • hiding (even if the only hiding possible is by curling into oneself, averted eyes, et cetera), • urination and defecation in extreme cases, • dander may become apparent and fur/feet may feel damp, and • for puppies, small breed dogs when fearful appear to vocalize more frequently at the veterinary clinic than large breed dogs, but both pant (Godbout et al., 2007). • Endocrinopathies, including Cushing’s disease and hypothyroidism, can result in many of the same signs, but the pattern is usually different. • There are periodic vogues for treating fear and a variety of anxiety-related conditions with thyroxine because the non-specific behavioral signs can occur with hypothyroidism. See the discussion in Chapter 6 on thyroidal involvement in aggression. • Any infectious or toxic agent that can affect the nervous system could potentially cause many of these non-specific signs, but the pattern is different. Fear can be insidious in the way that it is characteristic of infectious/toxic conditions, but a dog’s behaviors are not usually dependent on the social or environmental context if he has a toxic or infectious condition. Etiology, Epidemiology, and Risk Groups: • There appear to be two main groups of fearful dogs: • dogs who develop/display fear as very young puppies (5 to 8 weeks of age) and • dogs who become increasingly fearful as they move through social maturity (1 to 3 years of age) • For both groups of dogs, there appear to be sporadic and heritable forms, although the data are poor. • For very young puppies (5 to 8 weeks of age), fear can be due to lack of exposure or a heritable version of fear that appears to render the dogs averse to approaches of and interactions with strangers. • These dogs may freeze when faced with unfamiliar humans, and if not completely problematic as puppies, they worsen as they move through social maturity. • These dogs have consistent behavioral and physiological responses to unfamiliar people. • These dogs are usually quite good with other dogs. • Many lines of purpose-bred dogs have dogs who respond this way. Such behaviors may have been selected for during the process of trying to produce “tractable” laboratory dogs. • This condition can be detected at the first veterinary visits. When tested using a series of behavioral provocations that are part of routine care, these puppies withdraw and become quiet, although they may pant (Godbout et al., 2007). • If protected, these dogs can live a good life as pets, but people have to understand that they are likely never to be outgoing. • For dogs who begin to show fear during social maturity or for dogs who worsen during this time, clients will often express concerns that they ignored about some behavior during puppyhood. • Dogs can become fearful with time, but when this happens, the fear is not usually global, and identification of stimulus/stimuli that trigger the response will help in the process of treating it. Common Myths That Can Get in the Way of Treatment or Diagnosis: • Being “shy” is fine if the dog is not actively unhappy or suffering a decrement in his quality of life (QoL), but these concerns need to be assessed. Being more or less outgoing are variants of normal. Quivering in fear, salivating, and hiding when approached by non-threatening strangers are not normal behaviors. • This is “normal” in this breed. • Although some breeds do—deliberately or accidentally—select for pathologies, no one wants a breed to exhibit a pathological behavior where the dog suffers. If all other members of the family are like this—and this can and does happen—the client needs to seek a veterinary geneticist who will work with a behavioral specialist to counsel the client. • These dogs do not “grow out” of their fear. In fact, their fear worsens with time. Clients especially notice the profound changes that occur at social maturity, yet the dog is easiest to treat and responds best if treated as early as possible. Clients should be given some objective criteria (e.g., behavioral tasks that can be videotaped) by which to evaluate young dogs or puppies for whom there is a concern. If the vet and the client cannot measure improvement over a few weeks to months and with increased humane exposure to target situations, treatment should be started. Commonly Asked Client Questions: • Not completely, but with some protection and good treatment, these dogs can look like they are normal and be happier. • Are drugs needed for the rest of his life? • If medication is helping, and if the medication is causing no untoward side effects, treatment may be for life because this may be what the dog needs. Emphasis must be on QoL. • Could we have prevented this? • We do not know because while we know some forms of fear appear to be heritable, we do not know at what level or mechanism the pathology resides. • Too much early exposure may make the dog worse. • These dogs likely would benefit from extremely early treatment with medication and truly humane behavior modification. In fact, the earlier, the better. • Should we have known this would happen? • Clients need to know what questions to ask and what behaviors to observe. When adopting a rescue or shelter dog, we attribute much to his or her current condition/surroundings and past trauma. It’s possible that the fear contributed to relinquishment. • If clients are buying a dog from a breeder, they need to ask specifically about fears, anxieties, phobias, and genetic patterns, and they need to see other dogs in the line and speak to as many people as possible who have those dogs. If clients do all of this and can detect no hint of problems, either everyone thinks that the pathology is “normal” or this is truly rare. • People often engage in behaviors that scare dogs and most dogs are recoverable. Fearful dogs, by definition, are not recoverable easily. If people subjected a dog to a set of behaviors they knew to be causal of fear for that dog or if they did not intervene when they saw this happen, they are to blame. • Most people are misinformed or uninformed. This is sad and may make them feel terrible, but intent matters, so they are not really to blame. • Once clients know what the problem is and that there is help available, they become responsible for that dog. If they continue to put the dog in untenable conditions (from the dog’s perspective) or refuse to give it appropriate care, the balance of blame shifts in their direction. • A more useful focus is assigning responsible roles for everyone in the dog’s anticipated improvement. • Part of the management of this condition involves screening for it at every single veterinary visit. • Dogs with this condition should be protected from stimuli known to trigger it until they are engaged in an active behavior modification plan, combined with pharmacological treatment to facilitate the behavior modifications. • Behavior modification is essential. • Medication/dietary intervention: • Supplements containing omega-3 fatty acids and other polyunsaturated fatty acids (PUFAs) may have a beneficial effect on fearful behaviors by preventing damage to neurons that could inhibit the ability to recover from a fearful event. • Available nutriceuticals (alpha-casozepine [Zylkene], l-theanine [Anxitane], Calmex, and Harmonese) may benefit fearful dogs because they all have some effect on γ-aminobutyric acid and promote calmer behaviors through inhibition. Some of these may also have neuroprotectant effects (see Chapter 10). • Royal Canin’s CALM diet contains alpha-casozepine, and studies to date have shown very mild but potentially promising effects on behavioral indicators of stress (Kato et al., 2012; Palestrini et al., 2010). • In all but the mildest circumstances, medication may be warranted because: • Medications that may help come from the following classes of drugs: • Miscellaneous interventions: • Protection is undervalued as a treatment strategy, although people recognize its value as a coping strategy. Risk assessment is essential here. When nothing good is likely to come from the interaction, it’s not necessary (e.g., the dog is not bleeding uncontrollably) and/or the clients will not have the patience or time to guide the dog through the interaction or experience in a way that could benefit the dog, avoiding the fearful situation will protect the dog from becoming worse and making more molecular changes at the neuronal level that will help him to be more reactive. • “Protocol for Generalized Discharge Instructions for Dogs with Behavioral Concerns” • “Protocol for Teaching Your Dog to Take a Deep Breath and Use Other Biofeedback Methods as Part of Relaxation” • “Protocol for Relaxation: Behavior Modification Tier 1” • “Tier 2: Protocol for Desensitizing and Counter-Conditioning a Dog or Cat from Approaches from Unfamiliar Animals, Including Humans” • “Protocol for Understanding and Treating Dogs with Fear/Fearful Aggression” • “Protocol for Treating Fearful Behavior in Cats and Dogs” • People become worried and scared when their dog is fearful and may delay seeking help in the hopes that the dog “will grow out of it.” Truly fearful dogs do not “grow out of it,” and the risks must be frequently and clearly explained because the earlier these dogs are treated, the more normal they become. When deciding whether to use medication on a very young dog, minimize the cost of error, which is that the dog will worsen, and consider early use of medication in combination with true behavior modification (not just training or obedience training). • None of us are perfect, and no dog needs to be perfect. Clients who can adequately protect dogs from the objects of their fear may choose protection as a strategy, but they need to ensure that they can continuously implement the protection over a decade or more. Few clients have stable enough lives to guarantee this approach. • There are lines within breeds where all or most of the dogs exhibit some form of fear. Genetic counseling can help breeders to make choices that can alter this pattern. • Noise reactivity may enhance the risk for some types of fears and anxieties. Whether this is the case for true fear is currently unknown. • Dogs who are fearful may be difficult to assess medically, especially for pain. The sympathetic response to fear will mask a number of non-specific signs of physical ailments and may ultimately worsen pain. If the dog is painful after the fearful event, chances are he was painful before it. Medication and rehabilitative therapy to alleviate the pain should be considered, especially because nociceptive perception and anxiety become neurochemically associated centrally. Diagnostic Criteria and Description: • Consistent exhibition of increased autonomic hyperactivity and hyper-reactivity, increased motor activity, and increased vigilance and scanning that interferes with a normal range of social interaction in the absolute absence of any specific provocative stimuli. • This diagnosis is characterized by a heightened monitoring and attentiveness to environmental and social stimuli, which is accompanied by increased autonomic arousal (e.g., panting, increased heart rate and respiratory rates, mydriasis) when stimuli are present. • These dogs are often identified by some combination of the following behaviors: • constant monitoring of the social and physical environment manifest as increased locomotion, attentiveness, vigilance, and scanning, • easy distractibility manifest as lack of focus or what clients often call an inability to concentrate or pay attention, • hyper-reactivity involving a lower threshold for reacting, an out-of-context reaction, and a reaction that continues after the stimulus is gone, • physical and physiological signs of increased autonomic arousal, including dilated pupils, increased respiratory rate, increased heart rate, and near constant pacing once aroused, • sporadic or persistent diarrhea (this may be the most under-appreciated sign of this condition), and • weight loss, which clients may not appreciate, associated with increased activity. • Specific behavioral responses to stimuli can include pacing, barking, whining, and lunging, all of which are triggered at levels below which most dogs react and which persist for longer periods of time than would be true for normal dogs. • The form of the specific behavioral response may be affected by breed. For example, some border collies with GAD may exhibit parts of herding sequences or complete herding behavior (in the absence of true herding targets) as one of their manifestations of GAD. • Most “normal” dogs will habituate to the triggers that provoke the vigilance and scanning and autonomic hyper-reactivity and hyperactivity that occurs in GAD. • The signs of GAD are sufficiently non-specific that they can be associated with pain, cardiac disease, or endocrinopathies. • True hyperactivity may be a concern, but the attentiveness and monitoring that are characteristic of GAD are lacking. • In elderly dogs, cognitive dysfunction (CD) can share signs with GAD, and GAD may be a sequela to changes involved in early CD and/or “normal” aging in which visual and auditory capabilities change suddenly. • Inflammatory bowel disease/irritable bowel syndrome (IBD/IBS) is an often diagnosed but seldom verified condition. Any dog with IBD/IBS should undergo a complete behavioral history and evaluation. If IBD/IBS is not confirmed but the behavioral history is informative, the diarrhea may be a non-specific sign of heightened reactivity and autonomic arousal. Etiology, Epidemiology, and Risk Groups: • As with most behavioral conditions, GAD becomes most apparent as dogs pass through social maturity, suggesting that shifts in neurochemistry and/or regional brain activity are contributory. • There are no population-level data about prevalence and risk. • GAD may run in family lines, but there are no conclusive data. • GAD is often co-morbid with other anxiety-related conditions, especially noise reactivity/phobia. • Diagnoses involving aggression (e.g., true inter-dog aggression, impulse-control aggression) are often secondary to GAD. • In such circumstances, treating GAD often sufficiently raises the threshold for the aggression, allowing it to resolve. • Clients and vets should be aware of co-morbidity and ask whether the reactivity leads to the concomitant anxiety disorder, or whether the anxiety would remain were the reactivity lessened. • Attention-seeking behavior must be a diagnostic rule out because some dogs can learn that they can encourage non-stop attention by constantly moving and engaging in similar behaviors. • Dogs with attention-seeking behavior do not engage in the behaviors when they are alone; dogs with GAD engage in them regardless of the presence of the clients or anyone else. • Other dogs in the household appear to know that these dogs are abnormal and may avoid them when they are very reactive. If the client has another dog, the comparison of the behaviors of the two dogs can be dramatic and informative. Common Myths That Can Get in the Way of Treatment or Diagnosis: • This breed is very vigilant. • There is adaptive, in-context vigilance and vigilance that occurs regardless of the context. If the dog exhibits the latter, a diagnosis of GAD should be considered. • The dog will outgrow this behavior—he is so active just because he is young. • Normal activity has peaks and troughs. Dogs with GAD react profoundly to any perceived stimulus and instantly become aroused and distressed. Affected dogs would interrupt play with other young dogs if a new stimulus was sensed. • Clients should be encouraged to monitor such subtle differences in behavior early. Affected dogs will not outgrow the behavior with time but instead will learn to become more reactive and distressed, and react more quickly. Commonly Asked Client Questions: • Is this the result of the dog’s diet? • Diet is an unlikely cause of an anxiety disorder, although if the dog has any food-related allergies these could contribute to making the dog more reactive. • Is this the result of vaccinating the dog? • There is no evidence that vaccinations can cause any anxiety-related condition in healthy animals. Repeated trips to the vet, regardless of the reason, can be viewed by the dog as a series of frightening experiences (see earlier discussion on fear/fearful behavior). • Does this mean the dog is not getting enough exercise? • Controlling exposure of triggers that elicit the most extreme responses may help to keep the dog’s responses in a more manageable range. Curtains/drapes may help for dogs who respond to movement. Crating or gating the dog away from windows, doorways, letterboxes, et cetera, may help him not to react and so modulate the extent to which he becomes vigilant. • Clients have usually yelled at or reprimanded these dogs frequently. Yelling and reprimands don’t work, and the risk is that dogs learn to tune out most of the client’s requests. Teaching the client to talk to and interact with the dog only when the dog is sitting still and is quiet and attentive is a challenge but necessary if the client is to expand the extent of time in which the dog can focus on anything. • Clients should avoid as many circumstances as possible that trigger or worsen the behaviors. This may mean that the dogs have to stop going in the car or to the dog park, but such deprivations will be temporary, and the activities can be slowly resumed as the dog improves. • Clients and trainers often find it extremely hard to work with behavior modification in dogs with GAD. The lack of focus and willingness to pay attention and the hyper-reactivity and distress are challenges. For dogs who are unable to work with basic behavior modification until they begin to respond to medication, simply teaching the dog to sit quietly, look at the client, and take a deep breath—even if the dog must get up after each iteration of this exercise—will lay the foundation for using improved communication for helping the dog as the medication renders him less reactive. • The protocols for deference, relaxation, and deep breathing all will help, and all are necessary, but complete engagement in these may not be possible until the dog has begun to respond to medication. • Medication/dietary intervention: • There is some weak evidence that extremely high protein levels may render some dogs more reactive if these dogs are not working hard physically. If the dog is eating a very high-protein diet (>25%), lowering the protein may help the dog improve. • Medication is usually the key first step in allowing the dog to be less vigilant, less distressed, and more attentive to the client and other dogs about whether there are legitimate reasons for arousal. • Medications to which these dogs best respond include: • As these dogs improve, clients note that they begin to gain weight despite the same diet. Clients can be instructed to watch for weight gain as a sign that the dog is no longer patrolling so much as part of his need to be hypervigilant. • Clients may also note that if there are multiple dogs in the house, all dogs seem calmer and may play more as the GAD resolves or is controlled. • Some clients in desperation may have tried severe control techniques, including extensive and inappropriate crating, which usually makes the dog worse including non-jumping harnesses, which may injure active dogs; and electric shock to stop the dog. None of these are likely to be effective, but their discussion or use can be a gauge of the extent to which these dogs are disrupting the household. • For dogs who are always monitoring the auditory environment, white noise may help, as may headphones (e.g., Muttmuffs) or ear plugs if the dogs will wear them. • At first, the presence of other dogs is unlikely to help because these patients are too reactive and worried to focus on them. As affected dogs begin to improve, they may play more and become more able to use non-reactive dogs as models for calmer behaviors and sensors for true risk. • “Protocol for Generalized Discharge Instructions for Dogs with Behavioral Concerns” • “Protocol for Teaching Your Dog to Take a Deep Breath and Use Other Biofeedback Methods as Part of Relaxation” • “Protocol for Relaxation: Behavior Modification Tier 1” • “Protocol for Preventing and Treating Attention-Seeking Behavior” • “Protocol for Understanding and Treating Dogs with Noise and Storm Phobias” • “Protocol for Understanding and Treating Generalized Anxiety Disorder (GAD)” • “Protocol for Using Behavioral Medication Successfully” • “Generalized Guidelines for Using Alprazolam for Noise and Storm Phobias, Panic and Severe Distress”
Abnormal Canine Behaviors and Behavioral Pathologies Not Primarily Involving Pathological Aggression
Fear/Fearful Behavior
When examined using the same techniques at 18 months of age, the same dogs are fearful as young adults (Godbout and Frank, 2011).
Veterinarians see dogs at a very young age, and given the data from Godbout et al. (2007), dogs at early risk for this condition are recognizable at all ages.
TCAs (amitriptyline, nortriptyline, clomipramine) may help dogs to be less anxious and more outgoing as they modulate neurochemical activity. Broad-spectrum TCAs affect many norepinephrine/noradrenaline (NE/NA) and 5-hydroxytryptamine (5-HT) receptors and so may address a variety of neurochemical variants of fear. If the fearful response involves any ritualistic components, clomipramine may be the first drug of choice.
Generalized Anxiety/Generalized Anxiety Disorder (GAD)
Dogs who are less reactive may do a better job of attending to and understanding other dogs or people because they can relax and process the signals. Dogs with primary diagnoses involving aggression may not be able to read, process, plan, or act on the signals of others, regardless of whether they can take the time to observe and monitor them.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
