Just Ask the Expert: What constitutes a diagnosis of separation anxiety?

Dr. Tynes welcome behavior questions from veterinarians and veterinary technicians.

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Q. One of my patients is an 18-month-old spayed female Labrador mix that was in a shelter from 8 weeks of age until adopted.

A single owner adopted the dog, and it initially seemed fine. The owner works intermittent days that sometimes last as long as 12 hours. When the neighbors were around and the dog was home by itself, they would greet it and pet it through the fence a couple of times a day. But when the neighbors moved, the dog was left home alone on those long days with no interaction, and it began exhibiting separation anxiety-type behaviors.

GETTY IMAGES/CREATIVE CROP

The dog digs at, chews, and climbs on the fence in an attempt to get out. If placed in a crate, even for only a couple hours, it chews and digs at the crate. If given free access to come in and out of the house, it still tries to get out of the fence or comes inside and chews on furniture and other items.

The dog can be left in a car while the owner shops without exhibiting destructive behavior. When the owner visited family members who also have a dog for two weeks, the dog was fine to be left in that home with the other dog, sometimes for as long as two or three hours, without exhibiting destructive or escapist behaviors. Even if the dog was put in a separate room and the resident dog was allowed to roam freely while the family was gone, the dog in question did not exhibit any destructive behavior.

The dog does chew on things left within reach, such as shoes and plastic pill bottles, whether alone or while people are home. And the dog has never urinated, defecated, or deliberately caused self-injury when left alone. But the owner is concerned the dog will hurt itself simply by trying to climb the fence, etc.

Does this dog have true separation anxiety? The owner would like to keep the dog but can't have the dog continually trying to escape or be destructive. What options are there for this owner to keep the dog or for the dog to go to a better-fitting family?

A. The history described here demonstrates how challenging it can be to accurately diagnose separation anxiety, or separation-related distress, as some prefer to call it. The most common behaviors associated with separation anxiety are destruction, housesoiling, and vocalization. However, what is important to note here is that these are the behaviors reported by owners most commonly primarily because they cause a problem for the owners—vocalization often leads to complaints from neighbors, and destructive behaviors and housesoiling can lead to expensive home repairs.

Dr. Valarie V. Tynes

The more easily missed (and often ignored) signs that a dog is distressed by separation from an owner—pacing, panting, salivating heavily, trembling, and whining—are often the earliest signs displayed by a dog with separation anxiety. Some dogs even begin displaying these signs when they see their owners preparing for departure, and most dogs with separation anxiety continue exhibiting these signs for 15 minutes to an hour after their owners depart.

To accurately diagnose separation anxiety, signs of distress associated with the owner's real or perceived absence from the dog must be present. Not all dogs with separation anxiety exhibit vocalization, destruction, and housesoiling; some only exhibit one or two of these signs. What is necessary are signs of anxiety or distress, and the best way to determine if these are present is to have the owner set up a video camera to videotape the dog for the 30 minutes to an hour after the owner leaves.

Other rule outs

In addition, always remember to rule out other causes (including behavioral and medical) of destruction, housesoiling, and vocalization. For example, if a dog is housesoiling, confirm that the dog is truly housetrained and that housesoiling never occurs in the owner's presence. You should also confirm that the dog does not have any medical conditions that might lead to housesoiling. If accidents do occur in the owner's presence, review housetraining protocols with the owner and make sure the dog's housetraining improves before considering a diagnosis of separation anxiety.

Destruction of household items can occur as an element of play and exploratory behavior in many dogs, even one of this age. In fact, I would be most careful to rule this out in a dog such as the one described here in which the history suggests that the dog may not be receiving adequate physical and mental stimulation or appropriate supervision. The fact that the dog exhibits some destructive chewing behavior even when the owner is present suggests that a lack of stimulation could be at least part of the problem.

Some dogs exhibit destructive behavior because other fearful or exciting stimuli may be present when the owner leaves. For example, dogs with thunderstorm phobias or other sound phobias may exhibit the type of destructive escape behavior that you describe if those stimuli occur while the owners are gone. However, if this is the case, the dog should also exhibit similar signs when the owner is present as well, but it should be noted that many dogs with fears and phobias may be somewhat less distressed when their owners are present and be extremely distressed when they are alone during the scary events.

Dogs that become excited or aggressively aroused about the presence of passing dogs, wildlife, or strange people may also exhibit destructive behavior around doors or windows in the home, where they often sit and watch people and animals pass by. Again, this type of behavior should be displayed when the owner is present as well, so a good behavioral history will help you to rule out these other causes of destructive behaviors.

Finally, many behaviorists recognize an additional diagnosis called barrier frustration in which a dog is simply distressed by confinement. Affected dogs may become extremely destructive in their attempts to escape confinement, regardless of whether their owners are present. These dogs are likely still experiencing severe distress, but in these cases treatment involves teaching the dogs to tolerate confinement as opposed to teaching them to tolerate being separated from their owners.

Differing degrees of separation anxiety

Behaviorists have differing opinions on subclassifications of separation anxiety. In my experience, individual dogs exhibit different degrees of separation anxiety. In the most severe cases, a dog's distress is present whenever its owner (or the person to whom it is most attached) is absent. However, many dogs with what could be considered a milder degree of separation anxiety are OK as long as some individual is present. And some dogs are OK as long as they have a canine companion present.

Unfortunately, I find this last category to be uncommon and, thus, am hesitant to suggest that people acquire a second dog to help the dog that has separation anxiety. The fact that the dog described here was less distressed when in the other home with another dog may have had as much to do with being in a novel environment as being with the other dog. While some dogs begin displaying their separation anxiety immediately in any environment, in other dogs it appears to develop after a period of time in a particular environment.

Why the distress?

No one fully understands what predisposes dogs to developing separation anxiety. Some dogs with separation anxiety display signs of hyperattachment, while other dogs simply appear to be unable to cope with being alone. There is a great deal of variation in the presenting signs and histories of dogs with separation anxiety. However, once a dog has developed separation anxiety, the repeated experience of being left alone while suffering great emotional distress leads to a steady worsening of the distress over time.

Essentially, these dogs begin associating their distress with the place they are left and the state of being alone. This explains why some dogs that experience separation anxiety while being confined to a kennel may become extremely phobic of the kennel and actually harm themselves severely in an attempt to get out of the kennel.

It also probably explains why some dogs with separation anxiety are fine when left in the car. The car is a completely novel environment, and because it is rare for a dog to be left alone in a car for four to eight hours, some of them will not show distress when left alone in the car. This is not the case with all dogs, however, so do not encourage owners of dogs with separation anxiety to begin leaving their dogs in the car rather than at home without a thorough discussion of the dogs' history and behavior and the pros and cons of leaving a dog alone in the car.

Thoughts on treatment

Treatment of separation anxiety is rarely easy; it requires patience, persistence, and dedication on the owner's part. It is a condition that can often be managed even when it cannot be completely cured. And it is likely to be more easily treated if help is sought as soon after the appearance of clinical signs as possible, since the condition is likely to worsen with time.

Ultimately, separation anxiety is a treatable condition, but to treat it successfully, you must begin with an accurate diagnosis, usually confirmed by a videotape demonstrating signs of anxiety or distress when the dog is left alone.

Rehoming a dog with separation anxiety is always an option, but in my experience it is a rare person who has the luxury of never leaving home without his or her dog. Even rehoming should not be considered without a treatment plan in place for treating the problem, whether it is separation anxiety, barrier frustration, or a case of a dog that is being understimulated and underexercised.

Valarie V. Tynes, DVM, DACVB

Premier Veterinary Behavior Consulting

Sweetwater, Texas