Page 229 - WSAVA2017
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WSVA7-0458
BEHAVIOR
APPROACH TO SEPARATION ANXIETY IN PRIMARY CARE
L. Radosta1
1Florida Veterinary Behavior Service, Veterinarian, West Palm Beach, USA
SEPARATION RELATED DISORDERS IN DOGS. A PRACTICAL APPROACH TO TREATMENT IN PRIMARY CARE.
Lisa Radosta DVM, DACVB Florida Veterinary Behavior Service 3421 Forest Hill Blvd
West Palm Beach, FL 33406 www.flvetbehavior.com info@flvetbehavior.com Introduction
Separation related disorders are common in dogs in the United States. Diagnoses and treatment in primary care is most effective when broken up into multiple, shorter appointments. Just as with medical appointments in which the technician takes the animal to another location to draw blood or administer treatments, the technician is an integral part of the efficient and effective management of behavior cases. This paper addresses the format through which separation anxiety cases can be diagnosed and treated effectively and efficiently I primary care practice.
Separation related disorders involve a physiologic response to the stress of isolation or separation from one or both of the owners. Some patients may only respond to the owners departure with a stress response when left completely alone, remaining calm if any person is home, even an unfamiliar one. Other patients will react to the movement of one particular owner throughout the house with no clear signs that the owner is actually departing.
The signs include: hypersalivation, urination, defecation, vomiting, panting, self mutilation, destruction, attempts to escape, aggression, pacing, vocalization, immobilization, injury, and vocalization. Dogs with separation related disorders are often hyperattached to one or both owners, showing increased greeting and following behavior. As mentioned above, dogs can exhibit signs of separation anxiety when there is a virtual absence (i.e., owner
in another room), most commonly the signs will be exhibited when the owner has departed. The signs of separation related disorders can look very similar to other behavioral disorders such as storm phobia, noise phobia,
canine cognitive dysfunction, inappropriate elimination, attention seeking behavior, normal territorial behavior, frustration related destruction and confinement anxiety. In addition, medical diseases which cause diarrhea, polyuria and/or polydypsia can cause elimination when the owner is not home leading to in incorrect diagnosis of separation anxiety. Because there is a physiologic component to this disorder, medical diagnoses can contribute and other behavior disorders can present similarly, it is imperative that the veterinarian interview the client and examine the patient to make the diagnosis. The best way to make an accurate diagnosis is through a detailed history obtained through a history form
and interview and a video of the pet’s behavior when
the owner departs. Once the diagnosis is made, the treatment plan can be laid out and the technician can be utilized to teach the owner how to implement the plan.
Just as in any discipline, there are basic tools necessary to treat behavior problems. A questionnaire and handouts are necessary to efficiently collect history and explain the treatment plan. Just as with dermatology and internal medicine cases, the veterinarian can rely heavily on the technicians in the practice to help gather an accurate history and communicate the treatment plan to the clients.
First appointment
The focus of the first appointment is medical work up, diagnosis, and emergency treatment. Collecting history is more efficient with a one-page history form filled out while the client waits in the lobby. This way, the history taken in the examination room can be more targeted. A one-page questionnaire intended for use by primary care veterinarians is available on the Veterinarians page at the following website: www.flvetbehavior.com. A complete physical examination is warranted with any ancillary tests indicated as necessary from the physical examination results. Most separation related disorders will need
some sort of medical treatment in the form of either supplements or medications so screening labwork (CBC, serum chemistry, T4, fT4, U/A) is often indicated at the first appointment. When the history has been taken and the diagnosis made, emergency treatment intended to stabilize the patient should be instituted.
Emergency treatments take the form of environmental changes, avoidance and pharmaceutical therapy.
When deciding to institute pharmacologic therapy, the veterinary should consider 7 basic questions: 1) Is the environment conducive for a positive outcome? 2) What is the animal’s latency to arousal? 3) Is the animal’s quality of life affected? 4) Is the animal at risk? 5) Is the behavior predictable? 6) Is the behavior mild, moderate or severe? 7) Are there concurrent diagnoses which
An Urban Experience
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