Last in a two-part series: Counter-conditioning crucial when dogs fear inappropriately

Last month (p. 20S) this column introduced the case of a 5-year-old rescued German Shepherd that became fearful.

In the first of the two-part series, the history and diagnosis were addressed.This month, the focus is on treatment. As you may recall, this dog was diagnosedwith:

* attention-seeking behavior which was really only slightly out-of-context.

* fear aggression, primarily to other dogs

* protective and territorial aggression that was mostly in-context,but could spiral into inappropriate, possibly dangerous behavior if notappropriately directed.

* food-related aggression

In need of medication?

The client asked if I thought the dog needed medication. Given this dog'shistory, I felt it was a toss-up in the drug department. Anti-anxiety medicationboth speeds the learning of any behavior modification and aborts behaviorsthat interfere with it.

In this case, although side effects from the commonly used anti-anxietymedications are rare, I felt that monitoring might be a big issue for theclient and worsen her anxiety. We discussed this and she said that she woulduse drugs if I thought the dog would be better for it, but that she alsoworried - often irrationally - about medication. We discussed both the low-techtricyclic antidepressants (TCAs) (amitriptyline) and the newer selectiveserotonin re-uptake inhibitors (SSRIs) like sertraline (Zoloft) and fluoxetine(Prozac).

In the end, we decided to try the behavior modification without the medication,and if the dog wasn't noticeably calmer within a month, we'd start meds.The client was happy with this, especially since she felt that she had notbeen allowed to ask adequately about her concerns when she'd previouslyconsulted a specialist.

Modification steps

Behavior modification, meanwhile, was to include:

* The client was to ask the dog to sit quietly for everythinghe wanted and to relax while doing so; in fact, I taught the client, usingmy dog, Flash's example, to reward the dog whenever he took a deep breath(Protocol for Deference).

* The client knew exactly the types of circumstances that upsether and the dog. If she could teach the dog to sit and not react to increasinglymore upsetting circumstances in the house, she could eventually desensitizehim to things outside the house, and then counter-condition him to experiencesin which he was reactive using food treats.

We practiced some of this and if I was there, the client's judgment wasflawless. When I wasn't there, her e-mails spoke of painful uncertainty.Two trainers in the past had told her she was stupid. The damage they didto this client and any dog she'll ever have is almost unspeakable.

* If either the client or the dog was becoming anxious or distressedin any circumstance, they were given permission to leave it. Since the dogwas going to be wearing a Gentle Leader for all walks, this was easy toaccomplish; all they had to do was turn around in the opposite direction.

* If the client could identify another calm dog, the dogs couldtake walks together so that the patient could relieve her of the burdenof eternal vigilance by taking his cues, in part, from the other dog.

* The dog sitter was instructed to also reinforce relaxed behaviorsand was asked to do both aerobic exercise with the dog and slow massage.

* The client was instructed to ignore her neighbor who wouldbark back at her dog anytime the dog barked at him. In fact, I recommendedthat since the probability of improving the neighbor's behavior was low,she should expect the worse, and then reward her dog for any instantaneousquiet associated with the request to "look" and then get him outof the situation.

The client had two re-exams with Flash and me. Each time the dog wasmarkedly improved, and even more effusive and "normal" in hisplay with Flash. During the last visit, he tackled Flash quite roughly.Flash's response was to walk away and not play with the dog again untilhe was sitting and quiet. Then Flash solicited him for a walk, not a tumble.

Pain memory

Also at the last re-exam the client asked me to cut the dog's toenails.They were long, but I was very concerned about the dog not having a badexperience. Apparently the inability to address the dog's nail care wasa great stressor for the client. When she had consulted the previous specialistshe'd been told that the dog would have to be muzzled and knocked out. Theclient works in a lab and is well aware of the dangers of anesthesia, andthis prospect terrified her.

So, with the client holding the leash which was attached to the headcollar, we took the dog outside, where there was more for him to watch,and with him just standing - and me not touching his paw or leg - I wasable to clip three nails before he noticed.

When he did notice, he snapped and backed up.

Clearly, this is a dog that has had a lot of forelimb pain and who hadbeen manhandled. So, we stopped. In my experience, manicures are seldomreal medical emergencies. I sent the client home with the instructions towork with her dog sitter as we had done and take on one nail a day. A fewweeks later she was frantic, because they had only been able to trim onenail. Her veterinarian was afraid of the dog. Did I know any veterinarianwho would treat him gently and work with her for routine care? Yes, I did,and I provided two names. Less than a week later she and the dog sitterhad trimmed most of the dog's toenails themselves.

What lessons are in this case history?

First, once the client was no longer constrained to feel that she hadto cut the dog's nails, which compounded her worry about abuse and manhandlingwhen it was eventually done, she was able to do so, because she had a wayout, if needed.

Second, we manhandle way too many dogs. I am a big fan of drive-through/parkinglot vaccinations with a 27-gauge needle for fractious or fearful dogs, examinationsthat take place in segments when you sit in a chair talking to the client,and toenail clippings that take just the tips that are touching the groundand allow the dog to be playing with a toy at the same time.

Dogs are not born struggling with and fearing veterinarians; we teachthem that.

Third, this dog had never really learned to play or to interact withdogs normally. He'd been locked in a cage well through social maturity.Accordingly, his actions were way too strange for all but the calmest, mostnormal dogs. His play with Flash was truly too rough, out-of-context andbizarre for most dogs, so Flash taught him how to play using the same skillsthat allows him to teach puppies.

Fourth, everyone worries about big dogs, especially if they are GermanShepherds. And when this dog growls or lunges, everyone is on alert. Askyourself whether this dog's behaviors are relatively "normal"given his history.

For a dog that was so abused (imagine having your limbs run over andthen being thrown in a cage for being too stupid to get out of the way ofthe tractor), his aggressions were relatively mild.

Boils down to

All of this dog's inappropriate behaviors were about uncertainty andanxiety. A clear, humane rule structure that gives him some degree of predictabilityhas made a huge difference in this dog's life, and he will continue to improve.

Fifth, puppy mills are nightmare places for dogs.

Sixth, people matter. This client had been given so much bad advice,and had been told it was her fault and that she was stupid so often, thather concern was that she would ruin the dog. This client is insecure anda chronic worrier, and this annoys people she consults. That's the beautyof e-mail; she can worry and I can answer when I have time without rewardingthe worrying.

Both client and patient are doing well. She's happier; the dog has friends,and she worked up the courage to tell her neighbor that she wanted him tostop growling and barking at her dog.