Handling separation anxiety spikes when life changes

Assisi Animal Health / Calmer Canine

Anxiety, in its multiple miserable manifestations, is a growing reality for everybody during the COVID-19 pandemic. No one, especially our pets, knows what is coming next. As many of us return to the office, some dogs are not adapting well. They are getting frantic; many are destructive and house soiling. Nearly all are wildly exuberant when their owner finally returns to save them from their overwhelming angst. Separation anxiety is a serious drag on the well-being of pets and their owners. Help from veterinary professionals is sorely needed.

These are big problems. The American Veterinary Medical Association reported in 2018 that 20% of dogs in the United States have separation anxiety,¹ slightly more than the number of canine otitis cases. However, many dogs with separation anxiety never receive a diagnosis or treatment.

Prepandemic, many dogs that paced, licked their lips and yawned, repeatedly got up and lay down, or repeatedly checked the windows had kept their subclinical hysteria a well-guarded secret. Only the dog knew. Work-from-home orders of the past 20 months felt like a godsend to them. As pet owners return to the office, some dogs are exceeding their threshold for panic.

Pharmaceutical anxiolytics have been a mainstay of treatment. Now we have something new and, in some ways, better. Calmer Canine from Assisi Animal Health, a targeted pulsed electromagnetic field device (tPEMF), is effective, simple for at-home use, and safe.

Calmer Canine works by sending microcurrents of pulsed electromagnetic signals targeting the amygdala, the fear center in the brain. Its specific waveform works at the cellular level by controlling the activity of the microglial cells that are responsible for commanding the activities of other cells. tPEMF signals enhance the binding of calcium to calmodulin, promoting the production and release of nitric oxide (NO). NO inhibits proinflammatory cytokines (eg, IL-6) and increases anti-inflammatory cytokines (eg, BDNF). NO also induces production of endorphins, serotonin, and dopamine. The net effect is a reduction in neuroinflammation and a rebalancing of the overactive, anxious brain. These tPEMF signals were developed by a team of veterinarians and neurobiologists.

These are challenging cases; there are no quick fixes. Niwako Ogata, BVSc, PhD, DACVB, points out that “any benefit of living with a dog can quickly diminish when pet dogs engage in undesirable behaviors that damage the human-animal bond. These dogs often end up relinquished and may or may not find a new home.”² Our clients are desperate for help, many of them unaware that veterinarians can make the difference.

General veterinary practice is busier and higher stress than ever. When I am feeling pushed, I can sometimes improve my mood by reaching a little beyond the presenting complaint. If I ask, “How is Kita doing with your new work schedule?” the answer can set me up to help more than my patient. Clients bond closely to a doctor who also improves their lives.

Kita is a real dog, a 2-year-old, spayed female pit bull mix. Her separation anxiety was severe. When her owners started getting ready for work in the morning, she would pace and follow them from room to room. She barked and whined as they left the house, and she then urinated, defecated, and pulled at the doors and carpet while home alone.

Kita’s owners then tried to protect their home from daily damage by confining Kita to a crate. Struggling against mounting panic, Kita broke free, leading to the use of zip ties to secure the door. Videos of dogs with that crushing feeling of being trapped make it clear what a big mistake this is. Kita’s owners did the right thing next—they asked their veterinarian for help.

Kita’s doctor prescribed fluoxetine (Prozac), a good first-choice anxiolytic, but they missed the chance to recommend alternative treatments, behavior modification, and management changes. Kita’s anxiety did improve somewhat, but her owners’ fear became an obstacle. They worried about the safety of psychotropic medications and decided to stop. They reported that Kita quickly reverted back to her high degree of separation anxiety. “Kita was perfect in every way, but it was like a completely different dog once we left the house,” they noted. That’s when their veterinarian suggested Calmer Canine.

“Within 2 weeks Kita went from whining for hours after we left to immediately going into her kennel and falling asleep. She was more comfortable around the house; she began to readily eat in the mornings. (Before we had to coax her when she saw that we were about to leave.) She stopped following us from room to room. The treatments were so easy to do, even without the wrap (although that did make it even easier). We could not believe that something so easy made such a difference!” the owners reported.

Home run? We get a few of those in behavior medicine, but in daily practice it is a tailored treatment plan that yields the best results. This doesn’t have to be difficult.

A recent, not-yet-published trial with 40 dogs has been completed with video results showing positive improvement in the treated dogs.³ In the open trial pilot study, 9 dogs with separation anxiety were treated with a pulsed electromagnetic fields device placed on the head twice daily for 15 minutes for 6 weeks. Their owners completed questionnaires on days 0, 7, 14, 28, and 42 and took videos of their dogs when they were home alone on days 0, 28, and 42. On days 28 and 42, all 9 dogs demonstrated a reduction in overall anxiety scores, with 5 dogs showing resolution of clinical signs on day 42. Although a caregiver placebo effect cannot be ruled out, this would not be expected to affect the video results.

The halo-shaped Calmer Canine that made such a difference for Kita is lightweight and causes no sensation during the twice daily, 15-minute treatments. The optional vest is a comfortable fabric collar and chest wrap that holds the battery-powered Calmer Canine in place behind the dog’s head. My clients have their dogs sit next to them at breakfast and again in the evening while they read or watch television. A standard treatment course takes 4 to 6 weeks.

Calmer Canine can take the place of medications but well-chosen psychotropics are often helpful. Fluoxetine (0.5-1.5 mg/kg once per day) or clomipramine (Anafranil; 2-4 mg/kg twice per day) are primary/ everyday anxiolytics. As an adjunct, trazodone (1-5 mg/kg twice per day or as needed) can be given 1 to 2 hours prior to departures. Clonazepam (Klonopin; 0.1-1 mg/kg; duration 6-8 hours) has been a valuable add-on in some cases. Acepromazine alone is not considered useful because it sedates but does little to control anxiety. In treatment-resistant cases, antianxiety medications can be safely used along with the Calmer Canine.

These pets need every bit of safe treatment possible. Adaptil Calm pheromone diffusers promote a calm emotional state. Videos have shown that relaxing music, such as “Through a Dog’s Ear,” played when the dog is home alone further reduces agitation.

Improvement should never be considered permanent. Even dogs that advance by leaps and bounds may never be far from losing their grip and tearing the window blinds into tiny shadows of their former selves. Noise phobia, commonly comorbid with separation anxiety, also may upset whatever tenuous control has been achieved.

Dogs need to channel their inner savage. Dogs are genetically programmed to forage for survival, not gorge from a bowl and then do nothing the rest of the day. Rather than tossing a treat into the living room on their way out the door, owners can require their dogs to extract all their sustenance from food-dispensing toys and puzzles. Dropping these treasures as the owner departs, with zero fanfare, and then silently retrieving them as they return makes it clear that being alone means it’s time to survive—just like a real dog.

Behavior modification has an important place in reminding an anxious dog that being alone really isn’t catastrophic. Owners can desensitize their dog to predeparture cues by occasionally and gently handling keys and touching their briefcase or purse—never triggering their dog’s anxiety. Independence training and graduated absences have helped many abandon their overattachment, but it takes real dedication to commit to these time-consuming and repetitive exercises.

A thorough physical exam and laboratory work-up, including a fecal test and urinalysis, are essential to identifying every factor that may affect a behaviorally disordered pet. Joint or dental pain, pruritus, lower urinary tract infection, and gastrointestinal discomfort are all possible contributors to anxiety and elimination behaviors. Best results come with thorough treatment.

Calmer Canine treatments significantly reduced Kita’s anxiety. She became comfortable staying in her fenced yard and made no attempts to escape. Her family reported “she remains placid for 12+ hours” while they are at work. Life is good.

Conclusion

Veterinarians are full of good intentions, but we must be realistic. Dispensing
quick advice on correcting a $1000-a-day sheetrock demolition habit won’t put a dent in a dog’s separation anxiety. A thorough 1- to 2-hour behavior consultation will set these pets and their owners on the path to a better life. Make this a win-win-win. Charge for your time and expertise.

Veterinary professionals can easily incorporate Calmer Canine into their practices and make it easy for clients to use this valuable treatment at home. If we’re ready with a strategy of how we can help a distressed dog behave better, more of our clients will get on board and share our commitment.

References

1. Kahler SC. Separation anxiety calls for specific diagnosis, treatment. American Veterinary Medicine Association. August 29, 2018. Accessed October 28, 2021. www.avma.org/javma-news/2018-09-15/ separation-anxiety-calls-specific-diagnosis-treatment

2. Ogata N. Separation anxiety in dogs: what progress has been made in our understanding of the most common behavioral problems in dogs? J Vet Behav. 2016;16:18-35. doi:10.1016/j.jveb.2016.02.005

3. Gruen ME, Griffith E, Korman J. Calmer Canine research: a pilot study test. Assisi Animal Health. Accessed October 28, 2021. https://assisianimalhealth. com/calmer-canine-research/