I love you too much: Helping dogs with separation anxiety (Proceedings)

History and causes

Separation anxiety is a normal reaction to being abandoned starting as puppies. Most dogs are desensitized to separations as they mature.

As with most problems, separation anxiety exists on a spectrum, as a problem behavior ranges from mild to severe.

Symptoms range from mild to severe.  Mild signs may be ignored by the owner if they do not know what they mean.  Such signs include drooling, inappetance, pacing, and whining. The owners usually seek help when the signs become severe.  Such additional signs are barking, howling, destruction (usually around entryways/windows, or of owners' personal objects), inappropriate elimination, and/or escape.

These signs only occur when the owner is not present.  It may occur when all people are gone, or just when the owner that the dog is most attached to is gone. Usually signs occur within the first few minutes of the owner's departure, and can occur cyclically throughout the day.  It can also happen if the owner is out of sight of the dog.

These signs can also occur as manifestations of other problems; the main diagnostic feature is that these signs occur only when the owner is gone.  Sometimes owners give excessive attention to the dog prior to departures and upon returning which may enhance the contrast between the owner being at home and away.

Treatment

Differentiate separation anxiety from other types of anxieties (noise phobia), barrier aggression/frustration, attention-seeking, confinement anxiety, lack of stimulation, inappropriate elimination, urine marking, cognitive dysfunction. Almost essential to diagnosis is videorecord the animal when the owner is completely gone. Options are webcams, cell phone, or digital camera videocameras. 

May have to set up different situations, different locations, with and without other household dog(s), different times of day, etc.

Counsel the owners on the problem. The dog is not doing these behaviors “out of spite” or because “he's mad that we left him.” This is panic and the animal is in distress.  It is a difficult problem for a lot of owners to handle, but they can work through it.

Have the owners implement a command-response manner of interacting, so that the dog has a more stable relationship with its owner.  It also helps stabilize its anxiety.

It is important to eliminate the anxiety that the dog feels when it is left every day. If at all possible, have one of the owners take him to work with them, find a doggy day care in their area, board the dog at your clinic, or have the dog spend the day at a friend's house.  The reason behind this is so the dog doesn't continue to panic in their house, continually relearning these reactions and behaviors there. 

Begin implementing “independence exercises”. Choose a place, such as a special mat, which will be used for this part of the program. Put the dog on the mat and have him stay, giving him a long-lasting yummy food treat that he only gets when the owner is separated from him. Start out with a short period of time and a short distance away. This could be as short as 2?3 seconds and 2 steps away if necessary. Then release him/her. Gradually increase the length of time the dog stays on the mat, up until about 15 minutes or so. The owners also need to increase the distance they move from their dog during the stay.

Eventually they will be able to move into another room while the dog is staying on the mat. If they can't go to the bathroom by themselves, they can't leave the house. Start with just a second or two, then increase the time away, and gradually they should close the door behind them. Once that is accomplished, they can work toward stepping out of the house while the dog stays. They should start getting closer to the door, touching the door, jingling the handle, opening the door, etc., etc.

They should move the mat around to different areas of the house and even outside when they want to work with the dog there. When the dog is on the mat for a longer period of time, they should give him a toy smeared with peanut butter or other long-lasting treats. This makes it pleasurable to be on this mat. Take this toy treat away when the down?stay session is over.

When the owners start getting ready to go outside do not initially use a food treat, as it can become a cue for the dog. When the dog starts to become more comfortable with departures, reintroduce food treats. Progress on departures will be slow at first, increasing by only very gradual steps: 1,2,1,2,3,2,1,4,2,5--minutes. Later the steps will be much greater after the dog can be left alone for 30 minutes (e.g., 30, 45, 15, 60, 45, 30, 60, 75--minutes).

The owners should downplay their departures and returns. Actually ignore the dog completely for 15 minutes before they leave, and until the dog is gradually more relaxed after they return home. This is hard for most people to do, because the dog is so happy (and frantic!!) to see them.   The dog may try even harder to get their attention when they first start to do this, but have them try to preoccupy their time with something else when they first arrive home, so that they aren't as likely to give in to the demands for attention.

If there is a big difference between the amount of attention that they give the dog on the weekends and the weekdays, try to minimize this difference, so that there is not such a stark contrast between the two.

Another component of the behavior modification program involves desensitizing the dog to departure cues, such as the owners putting on their shoes, picking up their keys, etc. Often this is not effective, as the dog knows when the owner is really leaving. If owners are willing to try this part of the plan, on the days they are not leaving (at least at their regular time), they should go through their whole normal weekday morning routine, but don't leave the house. This should make the dog less sensitive to the departure activities, so that the dog will learn not to associate them with them leaving it alone. However, most dogs know for certain when owners are leaving or not, so don't focus so much on this part of the plan.

Medications

Antianxiety medications are often necessary to facilitate behavior modification. 

Serotonin enhancers

Only one drug remains licensed to treat separation anxiety…Clomicalm ® (clomipramine), a tricyclic antidepressant (TCA). Dose: 2-4 mg/kg/day, once or divided BID.

Other medications that are frequently utilized are those in the SSRI (selective serotonin reuptake inhibitor) family. Such are fluoxetine (1-2 mg/kg once daily), sertraline (1-3 mg/kg once daily), and paroxetine (1-2 mg/kg once daily).

Both clomipramine and fluoxetine have demonstrated benefit based on placebo-controlled studies.

Benzodiazepines

While SSRI's or TCA's can take up to 4-6 weeks to see the full effect, we may also medicate the animal in the interim with a benzodiazepine. Such are alprazolam (0.05-0.1 mg/kg, up to TID) and diazepam (0.5-2 mg/kg, up to TID).

Pheromone

Dog Appeasing Pheromone (DAP/Adaptil®) has been shown in placebo-controlled trials to have some benefit in decreasing anxiety in some dogs.

Other medications

Clonidine and trazodone have shown benefit for some dogs in decreasing anxiety based on open-labeled and retrospective trials.