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149 Cards in this Set

  • Front
  • Back

Barriers to treatment of behavior problems?

-- liability


-- owner compliance


-- confidence


-- knowledge


-- time


-- cost


-- fear

Consequences of not treating behavioral problems?

-- deterioration


-- problem patient


-- injury


-- pet welfare


-- euthanasia


-- liability


-- relinquishment


-- bad advice

What is the 5-Step Formula for treating behavioral problems?

1. ID and avoid triggers


2. Foundation Exercises


3. Products


4. Behavioral modification


5. Drug therapy

Why is it important to ID and avoid triggers?

-- safety of the pet, yourself, children


-- damaging to pet, property, human-animal bond


-- stop reinforcement

What is positive reinforcement? What is negative reinforcement?

-- positive reinforcement: reward given for a behavior


-- negative reinforcement: removal of an aversive stimulus

Damage control if unintentional exposure to trigger?

-- calmly, safely, quickly get below threshold/remove trigger/remove pet from trigger

Purpose of foundation exercises?

-- structure


-- predictability


-- redirection


>> less reactive pet


>> leadership

Four basic commands for foundation exercises?

-- sit/stay


-- watch me


-- go-to-spot


-- u-turn

What does 'nothing-in-life-for-free' mean?

-- make the dog work for everything


-- command/response/reward for everything of value to the pet

Common mistakes with foundation exercises?

-- owners try when triggers present


-- owners try to force compliance


-- owners use mediocre rewards


-- owners don't use target hand


-- owners expect too much too soon


-- owners only require command for food, not affection

Useful products for behavior modification (7)?

-- 4-6" leash


>> no retractable leash on aggressive animals


-- head collar (gentle leader)


>> easywalk harness for brachycephalics


-- muzzles


-- baby gates & crates


-- thundershirt


-- food puzzle toys


-- Dog Appeasing Pheromone (adaptil)

What is Dog Appeasing Pheromone (DAP)?

-- Adaptil


-- synthetic analogue of the pheromone from mammary glands of lactating bitches


>> calms puppies

Possible ways to modify behavior?

-- punishment


-- positive reinforcement


-- flooding


>> overwhelm animal with stimuli


>> don't know how they will respond


>> may make them worse


-- classical conditioning


-- operant conditioning


-- negative reinforcement

Recommended behavioral modification techniques?

-- desensitizaton


>> gradient exposure to stimulus


>> try to stay below threshold of eliciting unwanted behavior


>> reward for not doing this behavior


-- counter conditioning


>> amazing reward


>> pair stimulus to something the dog loves

Remember that drug therapy will not solve?

-- natural behaviors, like digging or herding

Steps for determining drug therapy?

1. Make behavioral diagnosis


2. determine if the patient/condition is a candidate for drug therapy


3. determine best drug for patient/condition


4. know drug risks/dangers/challenges


5. assess drug efficacy/termination of drug tx

FDA approved drug to treat canine separation anxiety?

-- clomipramine (clomicalm)

Another drug to treat canine separation anxiety?

-- fluoxetine (Reconcile)


>> dog generic no longer on the market


>> can use human formulation

Conditions that make patients candidates for drug therapy?

-- separation anxiety


-- anxiety related behaviors


-- aggression secondary to anxiety


-- impulsivity


-- compulsive behavior

How do you determine a patient is a good candidate for drug therapy?

-- PE


-- bloodwork: CBC/chem/T4

Amitriptyline has a ___ first-pass hepatic metabolism, so it should not be used in?

-- high first-pass hepatic metabolism


-- should not be used in patients with liver disease

For patients with liver disease, you should?

-- use a lower dose (50%)


-- consider drugs that don't have a conjugation phase (e.g. lorazepam, oxazepam)

Clomipramine (serotonergic) may cause iatrogenic hypothyroidism. T/F?

-- true

SSRIs affect cP450 how?

-- inhibit cP450


-- other drugs metabolized by cP450 should be adjusted downward

TCAs affect cP450 how?

-- enzyme substrate/inducer


-- other drugs that are metabolized by cP450 may be metabolized more rapidly

You should avoid serotonergic drugs if?

-- dog has a history of seizures

Serotonergic drugs?

-- fluoxetine


-- clomipramine


-- selegiline


-- trazodome


-- amitriptyline


-- paroxetine

Drugs to avoid if dog has cardiac disease?

-- amitriptyline


-- clomipramine

Event drugs are for what kind of stimulus?

-- identifiable


-- avoidable


-- uncommon

Event drugs include?

-- benzodiazepines


- atypical antidepressants


-- antihypertensives

Daily drugs are for what kind of stimulus?

-- unavoidable


-- common

Daily drugs include?

-- SSRIs


-- TCAs

Benzodiazepines have ___ half-lives, while SSRIs have ____ half-lives.

-- benzodiazepines: short half-lives


-- SSRIs: long half-lives

Benzodiazepines mechanism of action?

-- increase GABA (inhib. neurotransmitter)

Examples of benzodiazepines?

-- diazepam


-- alprazolam


-- clonazepam


-- clorazepate


-- lorazepam


-- oxazepam

Concerns about benzodiazepines?

-- addictive


-- not labeled for use in dogs


-- disinhibition of aggression


-- human abuse potential


-- paradoxical excitation/agitation (10%)


-- used PRN most often (4-6h duration)


-- slow withdrawal if used routinely for >2 wks


>> reduce dose 25% per week

Best benzodiazepine to use as event drug?

-- alprazolam


>> give 60 min prior to anxiety provoking event


>> 4-6 h effect

What is clonidine?

-- another event drug


-- anti-hypertensive agent (alpha 2 agonist)


-- reduce arousal


-- off-label use in dogs

Study looking at the use of clonidine in addition to daily drugs (SSRIs and TCAs) as an event drug in dogs with fear-based behavior programs showed that?

-- clonidine was effective for both groups of dogs (different types of behavior problems) in reducing the intensity of the dogs' negative reaction


-- adverse effects were minor

What is trazodone?

-- event drug or daily drug


-- serotonin antagonist and reuptake inhibitor


-- not labeled for use in dogs

Study for adjuntive use in treatment of canine anxiety disorders?

-- retrospective study


-- used in combo with other behavioral drugs


-- enhanced behavioral calming as both event and daily drug

What do SSRIs do?

slow reuptake of serotonin in the synaptic cleft

What do tricyclic antidepressants (TCAs) do?

block serotonin and norepinephrine transporters >> inc. conc. of 5-HT and NE in synaptic cleft

TCAs have more side effects than SSRIs. T/F?

-- true

What does serotonin effect?

-- anxiety


-- mood


-- appetite


-- sexual desire


-- impulsivity


-- treatment goals: reduced anxiety and impulsivity

Conditions with FDA approved drugs?

-- clomipramine (clomicalm)


>> canine separation anxiety when used in conjunction with a behavioral modification program




-- selegiline (anipryl)


>> canine cognitive dysfunction

Effects of amitriptyline? Drug class?

-- TCA


-- not very potent for serotonin


-- not a good choice for OCD


-- not a good choice for liver or cardiac dz


-- lots of sedation, esp. with cats


-- good if concurrent allergic skin disease


-- good if sedative effects desired

Effects of clomipramine? Drug class?

-- tricyclic antidepressant (TCA)


-- FDA approved for canine separation anxiety


-- significant serotonin effects

Clomipramine study for canine acral lick dermatitis?

-- retrospective study


-- 3 wks of drugs >> reduced licking


-- significant healing in 8/10 dogs during 6 mo period


-- 3/10 dogs weaned off drugs successfully

Clomipramine study on dominance-related aggression in dogs?

-- double blind, placebo controlled study


-- no difference between groups in dogs' response to aggression triggers


>> 30% placebo effect

Clomipramine study on treating anxiety and OCD in cats?

-- urine marking, over-grooming, excessive vocalization


-- 6 mo study duration


-- 10 cats improved/resolved behavior


-- 1 cat withdrawn due to side effects

SSRIs are less specific and less safe than TCAs. T/F?

FALSE


>> more specific than TCAs


>> excellent safety record


>> lack cardiac effects

Study on use of fluoxetine to treat dominance aggression in dogs?

-- single blinded, crossover study


-- 5 wks tx


-- significant reduction in aggression comparing week 1 to week 5


-- 8/9 owners reported overall dec. in aggression

Study on use of fluoxetine on urine spraying behavior in cats?

-- prosepective double-blind, placebo controlled


-- 8 wks tx


-- fluoxetine group went from 8.6 marks/wk to 0.4 marks/wk


-- placebo group showed no change

Effects of fluoxetine in treating canine compulsive disorder?

-- double-blind placebo controlled study


-- no behavioral modification prescribed


-- baseline 2 wks, 6 wks treatment


-- 50% fluoxetine dogs improved at 2 wks


-- 70% dogs improved by 6 wks

Waht is paroxetine? Effects?

-- SSRI


-- anticholinergic effect (constipation, dry mouth)

Sertraline is also what kind of drug?

-- SSRI

Best way to give psychotropic drugs?

-- oral deliver


-- most psychotropic drugs have rapid GI absorption


-- absorption rate/extent enhanced with food

Should you try giving psychotropic drugs transdermally?

--no!

Study on comparative bioavailability of transdermal vs. oral fluoxetine in healthy cats?

-- 12 purpose-bred research cats


-- half got oral, half got transdermal fluoxetine


-- no detectable plasma fluoxetine/norfluoxetine in transdermal group

Study on transdermal vs. oral administration of amitriptyline & buspirone?

-- 6 healthy adult cats


-- TD levels for buspirone below limit of detection


-- TD levels of amitriptyline could be detected but not quantified

Assessment of drug therapy? Why is this difficult? Helpful to do what? How long until behavior change?

-- difficult because avoiding over-threshold situations


-- concurrent therapy?


-- helpful to keep log of behavior


-- may take 4-8 wks to see changes

If pet behavior deteriorates on drug?

-- discontinue/change treatment

If pet behavior improves on drug? When should you discontinue? Relapse? Monitoring?

-- continue treatment until improvement has been stable for 2-3 mos


-- terminate treatment at that point


-- return to drug therapy if relapse occurs


-- PE , CBC/chem every 6-12 mos

If a dog is fear-aggressive, you should avoid?

-- benzodiazepines


-- disinhibition of aggression

What is the five-step formula?

1. ID and avoid triggers
2. Foundation Exercises
3. Products
4. Behavioral modification
5. Drug therapy

Incidence of dog-directed aggression/fear? Owned pets? Relinquishment?

-- owned pets: 24%


-- pets relinquished to shelters: 54%

Dog-aggression is ____.

-- reliable


-- 79% of dogs with dog-aggression were aggressive in >75% of all encounters with other dogs

Impact of dog-aggression on human-pet bond?

-- embarrassing


-- reduced exercise for dog


-- injury to owner and other dogs


-- relinquishment


-- euthanasia

Why is dog-aggression maintained?

negative reinforcement maintains behavior


>> dogs go away (pass by)

Why is veterinary exam critical for assessment of dog-aggression?

Rule out:

-- painful, arthritis


-- irritability due to low thyroid (inc. agitation)


-- sensory deficits


>> fear due to surprise, lack of knowledge

DDX for dog-aggression?

-- pain-related aggression


-- irritable aggression


-- sensory deficit


-- fear-related aggression


-- protective aggression (less common)


-- competitive aggression (owner has treats)


-- arousal


-- frustration

How to set realistic expectations for dog-aggressive dogs?

-- ID caregiver's goals


-- realistic goals: socially-acceptable dog


>> may not be Miss Congeniality

What is the trigger (step one: ID and avoid triggers)?

other dogs

Immediate goals of ID and avoiding triggers?

-- keep everyone safe


-- mitigate stress and ensure quality of life for all


-- get information: behavior, triggers, frequency


>> on walks, dog park, sizes of dogs?

Good questions to ask to get valuable information about dog behavior?

-- Describe what your dog does/looks like when he encounters another dog on walks.


-- What specific situations elicit the behavior?


-- Does the behavior happen once a month, once a week, once a day, or several times per day?


-- Is the dog ever calm in the context of trigger stimuli? (novelty issue?

Reducing the frequency/intensity of behavior via avoidance of triggers is easiest if?

-- simplest to address if pet has identifiable and avoidable triggers or low frequency

Strategy for identifying and avoiding triggering stimuli?

-- ID triggering stimuli


>> e.g. aggressive toward non-family dogs
>> starts 1 block away


-- quantify behavior problem


>> 2-5x per week, on walks


-- problem avoidance


>> walk at times/places with less traffic (dogs)


-- manage environment


>> keep dog away from problem area

Foundation exercises for dog-aggression?

-- target hand


-- sit


-- watch me


>> bring dog's attention to you


-- u-turn


>> get dog out of the situation

Products for dog-aggression?

-- head collar


>> better control/steering, prevents lunging


-- adaptil


-- thunder shirt


-- basket muzzle

Best behavior book to recommend to clients?

"Decoding Your Dog"


-- Debra Horowitz

Behavior modification plan?

-- desensitization


>> sit, watch me



-- counter-conditioning


>> give treats in proximity of other dog

Drug selection: there are no FDA approved drugs for dog-aggression. T/F?

-- true

Daily drugs for dog-aggression?

-- fluoxetine (SSRI)


-- paroxetine (SSRI)


-- sertraline (SSRI)




-- clomipramine (TCA)

Event drugs for dog-aggression?

-- trazodone


-- clonidine

Clomipramine is ONLY FDA approved for separation anxiety, not for socially inappropriate behaviors. T/F?

-- true!

Follow-up for dog-aggression treatment?

-- check in one week later


-- check in two weeks after that

___-___% of problem behaviors noted at relinquishment are consistent with separation anxiety.

-- 30-40%

When should you screen for separation anxiety?

routine health care appointment

Signs of separation anxiety?

When separated from attachment figure(s):


-- destruction


-- vocalization


-- house-soiling


-- panting


-- salivation


-- lick granuloma


-- anxiety

DDX for vocalization?

-- rxn to external stimuli


-- socially facilitated


-- play


-- fear induced


-- separation anxiety

DDX for destruction?

-- play


-- exploration


-- external stimulus (e.g. postman)


-- separation anxiety

DDX for house soiling?

-- lack/break in house training


-- LUTD, PU/PD


-- urine marking


-- excitement urination


-- separation anxiety

Great way to get a history of the dog's behavior?

-- video footage

Separation anxiety is characterized by?

-- cycles of distress/activity every 23-28 mins over the duration of absence

Dogs with separation anxiety: behavior signals? Important to remember?

-- 63% enthusiastically greeted owner


-- 70% responded to predeparture signs


-- 84% followed owner closely at home


-- 63% reacted to keys




>> lots of normal dogs do these things, too!

__-__% of dogs with separation anxiety have a noise phobia.

-- 8-50%

___ of dogs with noise phobia have separation anxiety.

-- 40%

Normal puppy behavior when left home alone? If you're not sure?

-- 75% of the time, puppies are passive


>> e.g. sleeping, calm


-- may have initial bout of anxiety upon departure, but then settle down


-- if you're not sure, videotape them

Things that have a positive correlation with separation anxiety?

-- source: humane society or pet store


-- males


-- more female humans in the home


-- single-owner household


-- social upheaval (marriage/divorce)


-- urban households


-- play within 30 min of return


-- pessimistic dogs?

Things that are not a risk factor for separation anxiety?

-- source: friends/family, breeder


-- age


-- adopting at <7 wks


-- other pets in home


-- spoiling behaviors

Predictive behaviors when left alone?

-- howling, scratching at door for >10s


-- barking/standing at door for >40s

Preventative steps for separation anxiety?

-- Be positive (puzzle toy or kong)


-- Only reward calm behavior


-- No drama (on arrival/departure)


-- Develop independence (inc. distance/duration of absence)


-- exercise/play on routine basis


-- Adaptil (DAP)

One should never punish a dog that has caused destruction out of anxiety. T/F?

-- true

Drugs for treatment of separation anxiety?

-- clomipramine (clomicalm) >> FDA approved


-- fluoxetine

What is the most common behavior problem with cats?

-- feline house soiling

___% of cats relinquished to animal shelters had daily or weekly incidents of house-soiling.

-- 23%

House-soiling is the most common problem post-adoption and most likely issue to prompt return to the shelter. T/F?

-- true!

Consequences of failure of treatment of feline house soiling?

-- relinquishment


-- banishment


-- euthanasia

What is shotgun therapy and why doesn't it work?

-- just trying things that might work like clavamox, prozac, feliway, and new litter


-- need to figure out the diagnosis first so that you can treat it appropriately!

What does periuria mean? Perichezia?

-- periuria: urinating around


-- perichezia: defecating around

DDX for feline house soiling?

-- marking (spraying)


-- toileting


-- medical reasons (UTI, GI dz, endocrinopathies, musculoskeletal dz, etc)

What should you rule out medically?

-- <1y: uroliths, anatomical abnormalities, developmental problems




-- 1-7y: feline idiopathic cystitis, uroliths, bacterial cystits uncommon




-- >8y: bacterial infections, renal disease, metabolic disease

Medical diagnostic tests?

-- PE


-- UA


-- rads, ultrasound

Behavioral periuria includes?

-- toileting


>> picking a new toilet spot




--marking


>> communication

If urine deposition is vertical, this indicates? Horizontal?

-- vertical: marking


-- horizontal: toileting or marking

If there is perichezia, this indicates?

-- toileting

If there is a substrate pattern, this indicates?

-- toileting

If the litterbox is not sufficient, this indicates?

-- toileting

Does volume differentiate between toileting and marking?

-- no

Feline social issues affect?

-- treatment plan (not diagnosis)

Study looking at fecal glucocorticoid metabolites in spraying and toileting cats?

-- fecal glucocorticoid metabolites higher in all cats from spraying households than from toileting households

Treatment for toileting?

-- offer best litterbox (ABCs)


-- Accessible
>> avoid: noisy or dark areas/dead ends/stairs


>> # cats + 1 = # litterboxes


>> uncovered


-- Big box


-- Cafeteria/Clay/Clumping/Carbon/Clean litter

Study of covered litterboxes vs. uncovered litterboxes?

-- covered boxes were not found to be a risk for house-soiling


-- some cats have individual preferences

Litterbox size study?

-- 74 cats, 43 homes, 4 wks


-- bigger litter box was used more frequently


>> more clean real estate

Which litter type do cats most prefer?

-- clumping clay

Litter preference study showed that cats preferred?

-- 12 cats split into two groups


-- Everclean clay based litter (clumping)


-- fine litter over coarse litter


-- clumping clay over silica


-- fresh step over feline pine

Which clumping clay litter do cats pick?

-- Fresh Step scoop


-- contains carbon >> odor absorbing

Study on cat preference for scent?

-- 18 cats


-- recorded response to scent for 30 s


-- scent was not significant for neutral or avoidance behavior


-- citrus scent was highest scoring for avoidance


-- control and bleach were the most preferred

Scented vs. unscented Fresh Step Litter study?

-- 4 colony rooms


-- ~8 cats per room


-- 4 overnight, 10h periods


-- no preference demonstrated

Study on best carpet cleaner to remove urine odor?

-- blinded human participants were asked to sniff each carpet square and score it


-- Febreze with Clenzaire was preferred product

Define "clean" litterbox.

-- scooped BID, changed monthly

Treatment for urine marking?

-- "DEFG"


-- Drugs (SSRIs)


-- Environment of Plenty (enrichment)


-- Feliway


-- Gonadectomy, Get rid of triggers

How do you get rid of triggers?

-- partial or full segregation from other cat(s)


-- put a bell on aggressive cat >> help avoid


-- block view of outdoors, remove cat attractants

What is Feliway?

-- facial pheromone, calming effect



Feliway spray study?

-- double blind, placebo controlled


-- baseline week + 4 wks tx


-- reduction in marking but did not completely resolve the problem

How do you provide an environment of plenty?

-- provide abundance of feline resources throughout home


-- sleeping perches (prefer fabric)


-- feeding sites


-- water sites


-- litterboxes


-- scratching posts


-- puzzle toys, boxes or bags


-- play: 5 min sessions, 3x per day

There are no FDA approved drugs for treatment of urine marking in cats. T/F?

-- true


>> all treatment is considered off-label

Study looking at use of fluoxetine for urine marking?

-- randomized, placebo-controlled double-blind


-- mean weekly rate of spray decreased significantly by week 2 and continued to decrease through weeks 7-8


-- fluoxetine decreased frequency of urine marking

Second fluoxetine study on urine marking looking at more than 8 wks of treatment?

-- treatment >8 wks revealed increasing efficacy in reduction of marking


-- return of marking after termination of fluoxetine occurred in most cats


-- clomipramine and fluoxetine had equivalent efficacy

Is transdermal dosing a good idea?

-- no!


-- oral, not aural

Most cats return to some level of urine marking after stopping meds. T/F?

-- true


-- second course of tx as effective as first course, though

Goal of feline house-soiling treatment?

-- practice best medicine, inc. treatment success


-- avoid shotgun therapy


-- establish definitive diagnosis


>> medical work up


-- offer a targeted treatment plan

Few spraying/toileting cats have a primary medical problem. T/F?

-- FALSE


-- many spraying/toileting cats have a primary medical problem

Features of toileting cat behavior?

-- horizontal deposition


-- +/- perichezia


-- substrate pattern (e.g. likes carpet)


-- litterbox less than ideal

Features of marking cat behavior?

-- vertical or horizontal deposition


-- no perichezia


-- no substrate pattern


-- litterbox acceptable

Targeted treatment for toileting?

Offer best box:


-- Accessible


-- Big


-- Clay clump/clean

Targeted treatment for urine marking?

Reduce need to communicate


-- drugs


-- environment of plenty


-- feliway


-- get rid of triggers/gonadectomy

Drugs for off-label treatment of urine marking in cats?

-- fluoxetine (SSRI)


-- clomipramine (TCA)