14/15. Behaviour consults, and Fear and anxiety

Question 1

Behaviour Consult Flowchart

Answer 1

the complaint
>medical exam, lab tests
>trainer referral, or consult in clinic, or referral to behaviourist
>diagnosis
>prognosis
>treatment plan

> > owner education, modify environment, modify the pet

> follow up

Question 2

Options for referral for behaviour problem

Answer 2

• Board certified veterinary behaviorist (DACVB)
• Certified applied animal behaviorist (CAAB/ACAAB)
  > Clinical component not as extensive as for DACVB, not necessarily veterinarian
• Behaviour consultants & Trainers
  > Minor to moderate issues requiring regular assistance, but not for serious behaviour issues
  > Industry is not standardized
  > Some have advanced training – do your research

Question 3

how much time for initial behavioural consult?

Answer 3

1-2 hours

Question 4

what is fear

Answer 4

• Emotional response to a present or threatened danger

Question 5

what is anxiety

Answer 5

• Reaction to a prospective or imagined danger or uncertainty

Question 6

what is a phobia

Answer 6

• Marked, persistent, excessive fear of clearly discernable objects or situations

Question 7

Common fear-related behaviour problems

Answer 7

• Fear of people, places, objects, noises
• Generalized anxiety
• Separation anxiety

Question 8

General treatment recommendations for fear

Answer 8

Owner education:
* Identification of fear
* Remain calm, no excessive soothing to reduce anxiety transfer * Pet is not ‘bad’, just scared

Environmental management:
* Identify all problem stimuli, and avoid exposure outside of training
* Use barriers when necessary
* Use muzzle for potential aggression
* Use leash-head halters to improve control

Behaviour modification:
* No positive punishment
* Never appropriate with fear and anxiety
* General training for control and to build confidence
* Train for settle, watch and touch for use during training
* Desensitization and counterconditioning
* Ensure appropriate exercise and mental stimulation
* Medication – dependent on severity, ability to manage, level of anxiety * Allows for adjustment of threshold & increased learning ability

Question 9

good commands to teach to deal with fear

Answer 9

settle, watch, touch

Question 10

how to develop a plan for desensitization and counter conditioning

Answer 10

• Step 1 – Identify fear threshold and train client to identify signs
• Step 2 – Develop a clear gradient for exposure
• Intensity, duration, distance
• Step 3 – DS & CC using gradient
• Progress to next step when animal is calm
• Repeat and increase over multiple sessions

Question 11

types of behavioural meds

Answer 11

• Situational
  >eg. Benzodiazepines

Maintenance (daily)
* eg. Tricyclic antidepressants & SSRIs

Pheromones & homeopathics
* eg. DAP (Adaptil) for dogs

Question 12

how common are noise phobias

Answer 12

• 20-50% of owners report fear of noises

Question 13

noise phobias prognosis

Answer 13

• Good for specific noises, reduced for general sensitivity
• Chance of relapse is high without maintenance
• Thunderstorm phobia can be more than just noise, better resolution if treated before it becomes associated with other stimuli

Question 14

noise phobias treatment

Answer 14

• Owner education
  > Continued reinforcement is going to be necessary for maintenance
• Management
  > Try to prevent/reduce impact of exposure outside training
  » White noise, anxiolytics prior to expected event
  » Try distraction – play/treats beforehand
  > Limit potential for self-harm – safe, contained, dark
• Behaviour modification
  > DS & CC specifics
  > Medications for unpredictable exposure
  > Compression wraps may be helpful (eg. Thundershirt)

Question 15

Generalized anxiety associated with:

Answer 15

• Previous negative experience(s), generalized
• Inadequate socialization
• Cognitive decline
• Unavoidable stressors in environment

Question 16

generalized anxiety prognosis

Answer 16

• Good for improvement, but often poor for complete resolution * Key factor is level of socialization

Question 17

Generalized anxiety treatment

Answer 17

• Management
  > Triage concerns based on animal welfare and owner needs
  > Provide predictable routines, calm environments, stable social environment
• Behaviour modification
  > Teach settle, watch, touch exercises; preferably specific safe location
  > Develop detailed plans for DS & CC based on triage
  > Medications likely useful – clomipramine, fluoxetine

Question 18

what can reduce separation anxiety?

Answer 18

lots of social exposure

Question 19

behaviours associated with separation anxiety

Answer 19

• Destructive behaviours (often exits, owner items)
• Urination/defecation
• Vocalizations
• Repetitive locomotion/inactivity
• Escape attempts
• Self-injury
• Anorexia
• Excessive greetings at return

Question 20

risk factors for separation anxiety

Answer 20

• Single owner
• Neutered
• Rehomed animals
• Recent changes to home and family composition
• Lack of obedience training

Question 21

prognosis for separation anxiety

Answer 21

• Good for improvement, complete resolution may not be possible in severe cases
• May take weeks to months to resolve
• Setbacks due to extended time away/at home, changes in household routines

Question 22

separation anxiety treatment

Answer 22

Owner education
* Dispel anthropomorphic reasoning – response is due to fear/anxiety, not intended to ‘punish’ owner

management
* Safe environments to prevent destruction and self-injury
* During treatment avoid separation/reduce impact
* Situational meds for unavoidable separation
* Other care options
* Exercise and mental stimulation, especially before separation
* Crates not necessarily a good idea

behaviour modification
* Increase independence around the home
* Drugs, distraction and good things at separation
* People are calm during separation & greeting
* Identify extra triggers and treat separately
* Desensitization to departure cues
* DS & CC for departures
* Medications in combination with behaviour modification