DM4 Pt4-6 Psychotropic medication

Question 1

What are the main benefits of psychotropic medication in behavior modification for cats?

Answer 1

They relieve anxiety, lower emotional arousal, and support positive learning and responses to triggers.

Question 2

When might psychotropic medications be used as a cornerstone in treatment?

Answer 2

In chronic emotional disorders, when exposure to triggers is unavoidable, or when a cat has high sustained emotional arousal.

Question 3

Why is medication sometimes necessary for behavior treatment in cats?

Answer 3

To preserve safety, improve welfare, and support the human-cat bond, especially when other treatments have been unsuccessful.

Question 4

Why should psychotropic medication be part of a behavior modification plan?

Answer 4

Medications like TCAs and SSRIs enhance positive learning but are more effective alongside environmental and behavioral management.

Question 5

What medical evaluations are required before starting psychotropic medication?

Answer 5

Physical exams and biochemistry tests (e.g., liver and kidney function) to rule out medical causes and ensure safe medication use.

Question 6

What patient conditions are challenging to manage without medications?

Answer 6

Cognitive decline, severe anxieties, and repetitive behaviors.

Question 7

Why is informed client consent important when prescribing psychotropic medications?

Answer 7

Most medications are used “extra label” (not licensed for cats), making consent essential for off-label use.

Question 8

What are key factors to monitor during drug therapy for behavior modification?

Answer 8

Efficacy, physical health, caregiver support, and regular follow-up exams.

Question 9

Why may psychotropic medications be challenging for cats to take?

Answer 9

Cats often have low tolerance for chronic oral medications, which may cause distress.

Question 10

How long might it take to observe the effects of psychotropic medication?

Answer 10

Effects may take days to weeks, so managing expectations is important.

Question 11

What is a key consideration for long-term medication therapy in some cases?

Answer 11

Using the lowest effective dose, as in long-term management of urine spraying.

Question 12

Why might older cats or those with systemic issues be more vulnerable to medications?

Answer 12

They may be more susceptible to adverse effects due to age or coexisting health conditions.

Question 13

What factors influence the choice of medication for behavioral treatment in cats?

Answer 13

Behavioral diagnosis, cat’s health, environment, client goals, work schedules, and willingness to follow treatment.

Question 14

Who is responsible for prescribing behavior-related medications in cats?

Answer 14

The veterinary behaviorist or referring veterinarian, with input from the pet behavior counselor.

Question 15

Why should caregivers expect an extended treatment period for most behavioral medications?

Answer 15

Full behavioral changes may take weeks to months, with a minimum treatment period often between 4-9 months or longer.

Question 16

How quickly can initial effects of SSRIs like fluoxetine be seen in cats?

Answer 16

Initial effects may be seen within the first week, with full effects after 4-8 weeks.

Question 17

How long do the initial anti-anxiety effects of TCAs like amitriptyline or clomipramine take to appear?

Answer 17

Initial effects appear in 5-7 days, but more significant changes may take 4-6 weeks.

Question 18

What is a recommended approach after a problem behavior is resolved with medication?

Answer 18

Continue drug therapy for 1-4 months, then gradually reduce the dose while monitoring.

Question 19

Why should MAOIs like selegiline not be combined with SSRIs, TCAs, or SARIs?

Answer 19

Combining these can lead to serotonin syndrome, a potentially fatal condition.

Question 20

Which medications are used for situational anxiety, such as vet visits or car trips?

Answer 20

Benzodiazepines (alprazolam, oxazepam, lorazepam), gabapentin, and trazodone, which have rapid onset times.

Question 21

What is buspirone recommended for in inter-cat aggression cases?

Answer 21

For victims of aggression only, as it increases outgoing and assertive behaviors.

Question 22

What medication is recommended for nonspecific anxieties or psychogenic alopecia in cats?

Answer 22

Amitriptyline (TCA), with effects seen in 5-7 days.

Question 23

Which medication treats ritualistic behaviors associated with obsessive-compulsive disorder in cats?

Answer 23

Clomipramine (TCA), with initial effects in 5-7 days and full effect in 3-5 weeks.

Question 24

What SSRI is used for social phobias, anxieties, and urine marking related to social interactions?

Answer 24

Paroxetine, with full effects in 6-8 weeks, often used to increase social confidence.

Question 25

Which medication is used for generalized anxiety and impulse control aggression in cats?

Answer 25

Fluoxetine (Prozac), an SSRI with effects seen in 6-8 weeks, especially for aggression outbursts.

Question 26

What is selegiline used to treat in cats, and what is a key administration consideration?

Answer 26

Selegiline (an MAOI) is used for cognitive dysfunction and should be given in the morning, avoiding combinations with SSRIs, TCAs, or SARIs.

Question 27

What is gabapentin primarily used for in feline behavioral medicine?

Answer 27

To reduce anxiety and provide mild sedation in anticipation of stressful events, like veterinary visits.

Question 28

How does gabapentin work in the nervous system?

Answer 28

It inhibits the release of excitatory neurotransmitters, such as substance P, glutamate, and noradrenaline.

Question 29

Does gabapentin have an effect on GABA binding or re-uptake?

Answer 29

No, while gabapentin is structurally similar to GABA, it does not directly affect GABA binding, re-uptake, or degradation.

Question 30

What is the recommended timing and dosage of gabapentin before a vet visit?

Answer 30

Administer 50-100 mg per cat approximately 2 hours before the visit, with a possible loading dose 12 hours prior.

Question 31

What additional medication is gabapentin commonly combined with to manage situational anxiety in cats?

Answer 31

Trazodone, as it works with gabapentin to enhance the anxiolytic effect.

Question 32

What condition is gabapentin used for in feline hyperesthesia management?

Answer 32

It is used with a starting dose of 5 mg/kg bid, potentially increasing to 10 mg/kg bid as needed.

Question 33

Why should human gabapentin syrups not be used for cats?

Answer 33

They often contain xylitol, which is toxic to cats.

Question 34

What is pregabalin and how is it used as an alternative to gabapentin?

Answer 34

Pregabalin is used similarly for feline hyperesthesia, starting at 2.5 mg/kg bid and increasing to 5 mg/kg bid if needed.

Question 35

What is trazodone’s primary function in cats?

Answer 35

It acts as a serotonin agonist and reuptake inhibitor, reducing anxiety and aiding in situational stress like transport or vet exams.

Question 36

What is the recommended dose and timing for trazodone before a vet visit?

Answer 36

50-100 mg per cat (or 10 mg/kg) given 60-90 minutes before transport or 90-120 minutes before vet exams.

Question 37

What are some common side effects of trazodone in cats?

Answer 37

Sedation, weakness, restlessness, and vomiting.

Question 38

Why is trazodone suitable for cats with systemic disease?

Answer 38

It has minimal effects on the cardiovascular system, making it safer for cats with systemic health issues.

Question 39

What is complementary and alternative veterinary medicine (CAVM)?

Answer 39

A group of diverse treatments, often controversial, including acupuncture, homeopathy, herbal medicine, and physical therapies.

Question 40

What is the difference between complementary and alternative therapies?

Answer 40

Complementary therapies are used with conventional treatments to enhance results, while alternative therapies are used in place of conventional medicine.

Question 41

Why is CAVM considered controversial in veterinary medicine?

Answer 41

Many CAVM treatments lack scientific evidence from double-blinded, peer-reviewed trials, and some are scientifically debunked.

Question 42

What is an example of a complementary therapy with some scientific support?

Answer 42

Acupuncture and certain botanical preparations.

Question 43

What is a major risk of using alternative therapies in place of conventional treatment?

Answer 43

Delaying or replacing effective treatment, potentially compromising the patient’s welfare.

Question 44

Why can a “scatter gun” approach in CAVM be problematic?

Answer 44

Using multiple treatments at once makes it difficult to know which treatment is effective and can lead to unknown interactions.

Question 45

What is a potential downside if a caregiver places too much faith in CAVM?

Answer 45

Disappointment if CAVM does not help, possibly leading caregivers to “lose faith” in trying further treatments for their pet.

Question 46

What approach is recommended when addressing CAVM inquiries?

Answer 46

Provide balanced, evidence-based information and monitor the patient closely to ensure safety and efficacy.

Question 47

Give examples of behavior-related CAVM treatments.

Answer 47

Anti-anxiety wraps (e.g., Thundershirt™), pheromone therapy, alpha-casozepine, L-tryptophan, valerian, SAMe, CBD oil.

Question 48

What does the ethos “do no harm and may help” mean in the context of CAVM?

Answer 48

Some caregivers choose CAVM believing it will cause no harm and could provide additional support alongside conventional treatments.

Question 49

Why is patient monitoring essential when using CAVM in behavior management?

Answer 49

To observe any side effects, assess interactions with other treatments, and ensure the welfare of the patient.