Avoidance and management of stress related dx Flashcards
Revision - what are the two main emotional systems?
- Desire seeking, social play, lust, care
- Fear/ anxiety, frustration, panic grief, pain
What common problems areas associated with EH and PH interplay?
- GI
- Skin problems
- Eyes/ areas
- Oral dx
- Cardioresp
- Obesity
- Urogenital
Pain can be things …?
Physiological, inflammatory and neuropthic
What is chronic pain associated with ?
Depressive-like symptoms
What happens with continued and prolonged stress?
may disturb the HPA axis to such an extent that
the negative feedback mechanisms are disrupted; the adaptive responses of the
HPA axis may then become maladaptive.
Low levels of serotonin …= ?
Found to be relevant in increased pain sensitivity
How to take a bhvr history?
» Done while taking medical history.
» Look for incidents or events that could be related to the behaviour change/clinical signs.
» Best map it in a timeline.
» Use specific terminology to describe behaviour/ findings not anthropomorphic terminologies
What can commonly be emotional disorders manifesting as physical disorders ?
»Urinary disorders – Feline Idiopathic
Cystitis, Feline urological syndrome
»Gastrointestinal disorders – IBD,
stomatitis, gingivitis, gut stasis
(rabbits/rodents), constipation
»Neurological type disorder- Feline
Hyperesthesia Syndrome (FHS)
»Obesity
FIC - Describe
- neurohormonal abnormality complex
- Tx aimed to dec central noradrenergic drive important in reducing signs of FIC
C/S of FIC?
- Change in bhvr, inappropriate urination, excessive grooming, vocalisation
What problems with FIC?
- Genetics
- Rearing
- Husbandry
- Emotional conflict
- Confidence
- Self confidence
- Environment
Environmental optimising strategies?
» Prey preference
» Scratching preference
» Safe space – rest space, hunting space
» Feeding – location, space, routine,
» Water – location, amount
» Resource spacing
» Litter tray – substrate, location, numbers, type
Behaviour modification ?
» Reduce conflict
» Avoid change in lifestyle.
» Positive association – training for health
» Increase confidence – seize punitive tx, praise small wins
Drug/pheromone Therapy ?
- Inc self confidene
- Inc feeling of a safe space
Analgesia
Feline hyperesthesia syndrome C/S?
dilated pupils ; sudden excitaiton, biting tail, vocalisation,
General info for feline hyperesthesia syndrome?
- Disorder poor pathophysiology
- Must rule out other conditions
- Often brought in as a neurological problem
Differentials for Feline hyperesthesia syndrome?
- Derm
- Bhvr
- Orthopaedic
- Neurological brain tumours
What to do for feline hyperesthesia syndrome?
- Optimising environment
- Address emotional arousal
- Provide safe space to rest and hide
- Pain management
Describe GI disorders
- Prolonged/acute stress affect GI through different mechanisms eg microbiome, permeability, inflammatory response
- Inc Sympathetic NS and lack of cortisol inhibition can lead to inc tissue permeability
Bhvr signs of GIT ?
Change in defecation pattern , stool consistently, feeding eg conpulsive eating, PICA
Risk factors to Obesity associated with negative or conflicted emotional states
- Poor diet & feeding
- Social stress
- Lifestyle
- Owner’s behaviour
- Co-existing health problems
- Genetics & Gender
Diagnosis of Obesity (Bhvr motivated) ?
- Behaviour history
- Videos/ Photo
- Rule out other conditions eg DM, Hypothyroidism
- Emotional motivation – F/A?
- Eating pattern- compulsive, PICA
Tx & Management for Obesity?
- Change feeding pattern – slow feeder, puzzle, scatter
- Reduce emotional conflict
- Pain management
- Safe feeding space
- Establish normal feeding pattern eg predatory feeding in cats
- Treat emotional disorder - drugs/pheromone/ nutraceuticals
Physical disorders contributing to emotional conditions ?
- Epilepsy
- Pseudopregnancy
How does epilepsy contribute to emotional conditions?
- Fear/ Anxiety
- Aggressive bhvr
- Abnormal perception
How does pseudopregnancy contribute to emotional conditions?
- Anxiety/ Frustration
- Emotional conflict
- Guarding
- Restless
- Building nest / ‘hoarding’
What Tx principles ?
- Nutritional (for physical condition)
- Nutraceutical (target neuroT e.G. L-tryptophan, L-theanine
- Medication - target neuroT (onset 3-5 wks ; fluoxetine, alprazolam
- Bhvr modification
What medication can be used in bhvr medicine?
- Serotonin - serotonergic neurons in brains, high % absorbed in the gut. Regulates, sleep, appetite, mood. Serotonin Specific Re-uptake Inhibitor - SSRIs require tx for min 6-8 weeks
What two serotonin inhibitors can we use?
- Tricyclic antidepresants (TCAs) eg clomipramine and Amitriptyline inc concentration of both Serotonin and NE in synapse
- Serotonin antagonist reuptake inhibtor (SARI) e.g. Trazadone
What to BEWARE of wirh SSRI, MAOI & TCAs use?
Serotonin Syndrome - tremors, muscle fasciculations, seizure, agitation
Dopamine - use?
Important for +ve salience, memory and reward. Inc in response to rewards like food, water. Monoamine Oxidase (MOA) inhibitors (Selegiline) used to manage cognitive dysfunction
Describe Norepinephrine use?
noradrenergic systems play a role to regulate moods, arousal, CVS
function (vasoconstriction/increase blood pressure). Eg; selective alpha2receptor agonist
(Clonidine, Xylazine, Medetomidine)
Describe ACh
inhibition of enzyme, prolongs ACh half life, enhance cholinergic
transmission. Associated with learning, memory, muscle movement.
GABA use?
primary inhibitory NT in the brain
-
Benzodiazepines ( Diazepam, Alprazolam, Clonazepam) used for sedation,
muscle relaxation, anxiety reduced. Has retrograde amnesic properties.
-
Benzodiazepines ( Diazepam, Alprazolam, Clonazepam) used for sedation,
-
Imepitoin (Pexion) was developed as anticonvulsant is partial agonist of
benzodiazepines of GABA. Licensed for use in dogs for fear/anxiety.
-
Imepitoin (Pexion) was developed as anticonvulsant is partial agonist of
Prevent escalation of problem?
- client education about bhvr interplay with Physical dx
- Discuss probable bhvr change associated with condition
- Treat early or use neutraceuticals if expecting emotional stress
- Bhvr mods should always be introduced when treating condition
