2013年9月17日星期二

Advocating for the Anxious Dog

Working on behavior cases such as aggression and anxiety can be incredibly rewarding. There’s nothing like watching the bond between a dog and owner deepen as both learn to trust one another and work cooperatively together. Seeing a fearful dog blossom or an anxious dog learn to relax always gives me goosebumps.


Working with behavior cases can also be incredibly frustrating and devastating at times, and nowhere is that more likely than when the subject of anxiety medications comes up. This is probably the biggest area (other than the dangers of punishment) where I meet client resistance and misconceptions. Perfectly reasonable people become perfectly unreasonable when I bring up the topic of seeing a veterinarian or veterinary behaviorist to discuss medicating their dog. This has to stop, for the dogs’ sakes.


Imagine that your dog is diagnosed with hypothyroidism. This means that his thyroid gland is not working as well as it should, and because of this physical problem he is suffering from a range of symptoms (possibly lethargy, weight gain or loss, poor temperature regulation, and skin/coat issues, to name a few). The vet prescribes daily medication to regulate his thyroid levels. Would you refuse to give him this medication?


Now, let’s say your dog is diagnosed with diabetes. His body can no longer regulate his blood sugar levels, and due to this physical problem he’s suffering from a range of symptoms, including excessive drinking, excessive urination, increased appetite, and weight loss. The vet prescribes insulin injections to regulate his blood sugar levels. Would you refuse to give him his insulin shots?


What if your dog is diagnosed with anxiety? His brain chemistry is imbalanced due to too little serotonin. Due to this physical problem he’s suffering from a range of symptoms such as hypervigilance, trouble sleeping restfully, irritability, and reassurance-seeking behaviors. Your vet prescribes a Selective Serotonin Re-uptake Inhibitor (SSRI) to increase the amount of serotonin in his brain. Would you refuse to give him this medication?


Here’s the thing: anxiety is often a physical issue. The brain is an organ. As such, it can develop abnormally (in utero or due to early experiences), suffer from physical trauma, or malfunction. There is a delicate chemical balance that can sometimes, due to genetics or environment, get disrupted. We know that the brain of a dog who was given a supportive, enriched environment as a puppy is physically different from the brain of a dog kept in a sterile environment or exposed to traumatic or neglectful stimuli during development. We know that the brains of anxious or aggressive animals are observably different from those of normal animals. This is not news. This is a fact that has been proven time and time again through rigorous scientific study.


We treat other physical problems with a combination of lifestyle changes (management) and medication. Severe anxiety that impacts a dog’s quality of life needs to be treated the same way. Not treating an anxious dog due to your personal misconceptions about anxiety medications is just as neglectful as not treating your dog’s diabetes or hypothyroidism. We may treat a severe heart arrhythmia by giving a dog beta blockers and limiting strenuous physical activity. Severe clinical anxiety is best treated with both medications and behavior modification. One or the other given separately just doesn’t cut it in many cases.


So why are so many people resistant to using anxiety medication for their dogs?


There’s a large cultural bias against anxiety. Because the symptoms are less quantifiable than, say, a kidney problem, it’s harder to definitively diagnose anxiety. There is still a large portion of the population who seem to believe that anxiety does not really exist. This is sad and harmful (not to mention ignorant).


The brain has an amazing capacity to heal itself and return to homeostasis, which I think also causes some resistance to meds. It’s true, there are many cases where dogs really don’t need medication and just behavior modification alone will fix the problem. Through learning, new neural pathways can be created and the problem behavior may resolve. This is why I rarely recommend anxiety medications as the first step when working with behavior cases. However, this is one issue where undermedication is much more likely than overmedication. Many general practice veterinarians do not feel comfortable prescribing anxiety medication, and between this and client resistance, I see more dogs suffering for years before they get the help they need than I see dogs who don’t need medication and are prescribed it anyway.


The bottom line is this: not every case needs anxiety medication. In fact, the majority of cases don’t. However, some cases legitimately do. In these cases, refusing to consider medication is as cruel and neglectful as refusing to give pain medication to a dog with severe hip dysplasia. If your dog’s quality of life is impacted by severe anxiety or aggression, you owe it to her to help her. You owe it to her to consult with a board certified veterinary behaviorist about whether medication may make her more comfortable.


You are your dog’s voice. Advocate for her. Do not make her suffer because of your misconceptions.

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