In a snap! Veterinary behavior quickies

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In small animals, behavioral problems such as aggression and separation anxiety can be complex. Fortunately, solutions are available to improve these issues significantly in a relatively short time. We got the skinny on these “behavior quickies” from E'Lise Christensen, DVM, DACVB, who owns two practices: Behavior Vets of New York City and Behavior Vets of Colorado.

Behavioral wellness is evident, Dr. Christensen says, when the animal:

• Can handle being alone
• Is friendly
• Is housebroken
• Explores and manipulates its environment
• Quickly and completely adjusts to change
• Tolerates or ignores noise, storms and fireworks
• Demonstrates normal vocalization, licking and grooming patterns
• Enjoys veterinary visits and can undergo most wellness care without sedation.

Because behavioral problems are often very complex, Dr. Christensen recommends referring to a veterinary behaviorist for any behavioral case that a general practice veterinarian does not feel comfortable treating. “Be kind to yourself,” she advises, and acknowledge when a case is “out of your league.” Referrals can also be made when psychoactive medications are being considered for behavioral management. Of course, referral is a feasible option only when there is access to a veterinary behaviorist and the client accepts the referral.

Behavior quickies overview

Despite the complexities of behavioral cases, many affected pets can respond to treatment. Behavior quickies are fast-acting, general solutions to behavioral problems that can manage behavior proactively, meet owners' expectations for improvement and fulfill species-specific needs. Here are some examples.

Avoiding triggers. Removing a pet from the source of its behavioral problem can be effective. For example, if a dog is aggressive toward strangers in the home, its owner can teach the dog to be comfortable in a “safe zone,” such as a crate in a separate room. The dog can stay there happily when unfamiliar people visit.

Enrichment. Food puzzles are a great way to provide enrichment for pets. These puzzles can be as simple as food placed in a cardboard box for a pet to retrieve. For puppies that are being housetrained, food puzzles should be easy enough to complete without disrupting the housetraining schedule.

Structured interactions. Dr. Christensen notes that pet owners often interact with their pets in ways that are physically intrusive and bizarre to the pet (yes, pets find hugging and kissing a little odd). Structured interactions that allow for normal species-specific behavior can de-escalate behavioral problems. Teaching a dog an easy task, such as sitting, before allowing it to do anything it enjoys is an example of a structured interaction.

Reward-based training. This involves reinforcing positive behavior that cannot be performed simultaneously with the negative behavior. Repeatedly rewarding this positive behavior can quickly reduce behavioral problems. Punishment-based training, such as shock collars and choke collars, should be avoided because they don't treat the underlying problem; rather, they only address the sign of a problem. In addition, these devices damage the human-animal bond, decrease learning and increase the risk of aggressive and fearful behavior.

Pheromone therapy. Pheromones, such as Feliway and Adaptil, can help pets calm down and reduce problem behaviors.

Exercise. “Exercise can help improve behavioral problems but must be tailored to the individual pet,” Dr. Christensen says. Too much or too little exercise may not help. For example, if a dog has a naturally high energy level, too much exercise can simply get the dog more worked up.

Dr. Christensen notes that separation anxiety does not respond well to exercise alone because exercise does not address the panic. “True separation anxiety is a panic attack that triggers a fight-or-flight response,” she says, “so it doesn't matter [whether the pet is] tired from exercise. Many well-exercised dogs will still panic.”

Safety tools. Safety tools, such as body harnesses and basket muzzles, may be necessary for some pets. For a veterinarian who can choose only one safety tool and does not have time to explain behavior modification to a client, Dr. Christensen recommends a body harness. Body harnesses, such as the Freedom No Pull Harness and Balance Harness, should be fitted to allow a dog to move its shoulders freely, she advises. Dogs with aggressive behaviors can be taught to wear a basket muzzle happily in trigger situations.

Supplements. Both fast-acting supplements (e.g. Zentrol and Anxitane chewable tablets) and slower-acting supplements (e.g. Solliquin, Zylkene) are available to manage behavioral problems. However, Dr. Christensen cautions, supplements (especially OTC supplements and those intended for humans) are not necessarily safer than traditional drugs. In addition, some supplements may interact with traditional drugs. “At least consider the potential for drug interactions when combining supplement use with traditional behavior modification medications,” she advises.

Because supplements tend to work slowly in dogs, starting treatment with a supplement can increase the risk of reduced or slow efficacy, Dr. Christensen says. She notes that it is most ethical to treat anxiety with fast-acting medications to start, given that panic attacks associated with anxiety are harmful to the brain. However, for cases in which the speed of effect is not a concern, Dr. Christensen recommends a slow-acting and consistent medication such as fluoxetine (Reconcile-Novartis), clomipramine hydrochloride (Clomicalm-Elanco), or paroxetine rather than a supplement alone. Veterinary supplements (e.g. Solliquin, Anxitane, Zylkene) are often safe with a variety of medications and can improve treatment response. 

A client's comfort level with supplements can also influence whether they are part of the treatment plan for anxiety.

Medications. Fast-acting medications, particularly those that work in 20 to 90 minutes, provide the quickest relief for behavioral problems. Examples include benzodiazepines, clonidine, trazodone and gabapentin. Slower-acting medications include fluoxetine, clomipramine and selegiline.

“A benefit of fast-acting medications is that they can succeed or fail quickly,” Dr. Christensen says. “The quicker an adverse effect or a lack of response is observed, the quicker a veterinarian can make a new treatment plan.” She recommends administering a fast-acting medication during an office visit so the client can see the effects. Having the client observe a medication's positive effects on behavior can improve client compliance with the treatment plan.

Putting behavior quickies into practice

For general practice veterinarians incorporating behavior quickies into a treatment plan for behavioral problems, Dr. Christensen offers several pieces of advice.

Start with the same quickie for all cases. Dr. Christensen recommends that veterinarians with a favorite among the behavior quickie options start with that one for each case.

Don't undertreat. Undertreating a behavioral problem increases the likelihood of treatment failure. If a treatment fails, a pet owner may give up on addressing the problem and not come back for further treatment.

Address concerns about personality changes. Clients can be concerned that psychoactive medications will change their pet's personality. When used correctly, however, these medications will not cause negative personality changes in pets, Dr. Christensen says. If a negative personality change does occur, stopping the medication will likely reverse that change.

The concern about personality changes may stem from fear. Dr. Christensen recommends having an honest conversation with clients about their goals and fears regarding their pet's behavioral problems. Counseling the client and talking openly about the suffering that behavioral problems are causing are important, she says.

Encourage the clients to have fun. Owners of pets with behavioral problems often feel hopeless and at their wit's end with trying to manage the problem at home. They may also be afraid that the veterinarian is going to judge them. Encouraging clients to work as a team with the veterinarian to solve the behavioral problem can help the clients actually have fun and enjoy their relationship with their dog again, Dr. Christensen says.

Dr. Pendergrass received her DVM degree from the Virginia-Maryland College of Veterinary Medicine. Following veterinary school, she completed a postdoctoral fellowship at Emory University's Yerkes National Primate Research Center. Dr. Pendergrass is the founder and owner of JPen Communications, a medical communications company.