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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 |
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Consequences of not treating behavioral problems? |
-- deterioration -- problem patient -- injury -- pet welfare -- euthanasia -- liability -- relinquishment -- bad advice |
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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 |
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Why is it important to ID and avoid triggers? |
-- safety of the pet, yourself, children -- damaging to pet, property, human-animal bond -- stop reinforcement |
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What is positive reinforcement? What is negative reinforcement? |
-- positive reinforcement: reward given for a behavior -- negative reinforcement: removal of an aversive stimulus |
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Damage control if unintentional exposure to trigger? |
-- calmly, safely, quickly get below threshold/remove trigger/remove pet from trigger |
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Purpose of foundation exercises? |
-- structure -- predictability -- redirection >> less reactive pet >> leadership |
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Four basic commands for foundation exercises? |
-- sit/stay -- watch me -- go-to-spot -- u-turn |
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What does 'nothing-in-life-for-free' mean? |
-- make the dog work for everything -- command/response/reward for everything of value to the pet |
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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 |
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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) |
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What is Dog Appeasing Pheromone (DAP)? |
-- Adaptil -- synthetic analogue of the pheromone from mammary glands of lactating bitches >> calms puppies |
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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 |
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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 |
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Remember that drug therapy will not solve? |
-- natural behaviors, like digging or herding |
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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 |
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FDA approved drug to treat canine separation anxiety? |
-- clomipramine (clomicalm) |
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Another drug to treat canine separation anxiety? |
-- fluoxetine (Reconcile) >> dog generic no longer on the market >> can use human formulation |
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Conditions that make patients candidates for drug therapy? |
-- separation anxiety -- anxiety related behaviors -- aggression secondary to anxiety -- impulsivity -- compulsive behavior |
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How do you determine a patient is a good candidate for drug therapy? |
-- PE -- bloodwork: CBC/chem/T4 |
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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 |
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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) |
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Clomipramine (serotonergic) may cause iatrogenic hypothyroidism. T/F? |
-- true |
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SSRIs affect cP450 how? |
-- inhibit cP450 -- other drugs metabolized by cP450 should be adjusted downward |
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TCAs affect cP450 how? |
-- enzyme substrate/inducer -- other drugs that are metabolized by cP450 may be metabolized more rapidly |
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You should avoid serotonergic drugs if? |
-- dog has a history of seizures |
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Serotonergic drugs? |
-- fluoxetine -- clomipramine -- selegiline -- trazodome -- amitriptyline -- paroxetine |
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Drugs to avoid if dog has cardiac disease? |
-- amitriptyline -- clomipramine |
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Event drugs are for what kind of stimulus? |
-- identifiable -- avoidable -- uncommon |
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Event drugs include? |
-- benzodiazepines - atypical antidepressants -- antihypertensives |
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Daily drugs are for what kind of stimulus? |
-- unavoidable -- common |
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Daily drugs include? |
-- SSRIs -- TCAs |
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Benzodiazepines have ___ half-lives, while SSRIs have ____ half-lives. |
-- benzodiazepines: short half-lives -- SSRIs: long half-lives |
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Benzodiazepines mechanism of action? |
-- increase GABA (inhib. neurotransmitter) |
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Examples of benzodiazepines? |
-- diazepam -- alprazolam -- clonazepam -- clorazepate -- lorazepam -- oxazepam |
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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 |
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Best benzodiazepine to use as event drug? |
-- alprazolam >> give 60 min prior to anxiety provoking event >> 4-6 h effect |
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What is clonidine? |
-- another event drug -- anti-hypertensive agent (alpha 2 agonist) -- reduce arousal -- off-label use in dogs |
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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 |
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What is trazodone? |
-- event drug or daily drug -- serotonin antagonist and reuptake inhibitor -- not labeled for use in dogs |
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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 |
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What do SSRIs do? |
slow reuptake of serotonin in the synaptic cleft |
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What do tricyclic antidepressants (TCAs) do? |
block serotonin and norepinephrine transporters >> inc. conc. of 5-HT and NE in synaptic cleft |
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TCAs have more side effects than SSRIs. T/F? |
-- true |
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What does serotonin effect? |
-- anxiety -- mood -- appetite -- sexual desire -- impulsivity -- treatment goals: reduced anxiety and impulsivity |
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Conditions with FDA approved drugs? |
-- clomipramine (clomicalm) >> canine separation anxiety when used in conjunction with a behavioral modification program -- selegiline (anipryl) >> canine cognitive dysfunction |
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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 |
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Effects of clomipramine? Drug class? |
-- tricyclic antidepressant (TCA) -- FDA approved for canine separation anxiety -- significant serotonin effects |
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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 |
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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 |
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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 |
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SSRIs are less specific and less safe than TCAs. T/F? |
FALSE >> more specific than TCAs >> excellent safety record >> lack cardiac effects |
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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 |
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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 |
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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 |
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Waht is paroxetine? Effects? |
-- SSRI -- anticholinergic effect (constipation, dry mouth) |
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Sertraline is also what kind of drug? |
-- SSRI |
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Best way to give psychotropic drugs? |
-- oral deliver -- most psychotropic drugs have rapid GI absorption -- absorption rate/extent enhanced with food |
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Should you try giving psychotropic drugs transdermally? |
--no! |
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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 |
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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 |
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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 |
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If pet behavior deteriorates on drug? |
-- discontinue/change treatment |
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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 |
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If a dog is fear-aggressive, you should avoid? |
-- benzodiazepines -- disinhibition of aggression |
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What is the five-step formula? |
1. ID and avoid triggers
2. Foundation Exercises 3. Products 4. Behavioral modification 5. Drug therapy |
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Incidence of dog-directed aggression/fear? Owned pets? Relinquishment? |
-- owned pets: 24% -- pets relinquished to shelters: 54% |
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Dog-aggression is ____. |
-- reliable -- 79% of dogs with dog-aggression were aggressive in >75% of all encounters with other dogs |
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Impact of dog-aggression on human-pet bond? |
-- embarrassing -- reduced exercise for dog -- injury to owner and other dogs -- relinquishment -- euthanasia |
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Why is dog-aggression maintained? |
negative reinforcement maintains behavior >> dogs go away (pass by) |
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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 |
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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 |
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How to set realistic expectations for dog-aggressive dogs? |
-- ID caregiver's goals -- realistic goals: socially-acceptable dog >> may not be Miss Congeniality |
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What is the trigger (step one: ID and avoid triggers)? |
other dogs |
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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? |
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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? |
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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 |
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Strategy for identifying and avoiding triggering stimuli? |
-- ID triggering stimuli >> e.g. aggressive toward non-family dogs -- 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 |
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Foundation exercises for dog-aggression? |
-- target hand -- sit -- watch me >> bring dog's attention to you -- u-turn >> get dog out of the situation |
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Products for dog-aggression? |
-- head collar >> better control/steering, prevents lunging -- adaptil -- thunder shirt -- basket muzzle |
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Best behavior book to recommend to clients? |
"Decoding Your Dog" -- Debra Horowitz |
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Behavior modification plan? |
-- desensitization >> sit, watch me
>> give treats in proximity of other dog |
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Drug selection: there are no FDA approved drugs for dog-aggression. T/F? |
-- true |
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Daily drugs for dog-aggression? |
-- fluoxetine (SSRI) -- paroxetine (SSRI) -- sertraline (SSRI) -- clomipramine (TCA) |
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Event drugs for dog-aggression? |
-- trazodone -- clonidine |
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Clomipramine is ONLY FDA approved for separation anxiety, not for socially inappropriate behaviors. T/F? |
-- true! |
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Follow-up for dog-aggression treatment? |
-- check in one week later -- check in two weeks after that |
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___-___% of problem behaviors noted at relinquishment are consistent with separation anxiety. |
-- 30-40% |
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When should you screen for separation anxiety? |
routine health care appointment |
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Signs of separation anxiety? |
When separated from attachment figure(s): -- destruction -- vocalization -- house-soiling -- panting -- salivation -- lick granuloma -- anxiety |
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DDX for vocalization? |
-- rxn to external stimuli -- socially facilitated -- play -- fear induced -- separation anxiety |
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DDX for destruction? |
-- play -- exploration -- external stimulus (e.g. postman) -- separation anxiety |
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DDX for house soiling? |
-- lack/break in house training -- LUTD, PU/PD -- urine marking -- excitement urination -- separation anxiety |
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Great way to get a history of the dog's behavior? |
-- video footage |
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Separation anxiety is characterized by? |
-- cycles of distress/activity every 23-28 mins over the duration of absence |
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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! |
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__-__% of dogs with separation anxiety have a noise phobia. |
-- 8-50% |
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___ of dogs with noise phobia have separation anxiety. |
-- 40% |
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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 |
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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? |
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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 |
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Predictive behaviors when left alone? |
-- howling, scratching at door for >10s -- barking/standing at door for >40s |
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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) |
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One should never punish a dog that has caused destruction out of anxiety. T/F? |
-- true |
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Drugs for treatment of separation anxiety? |
-- clomipramine (clomicalm) >> FDA approved -- fluoxetine |
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What is the most common behavior problem with cats? |
-- feline house soiling |
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___% of cats relinquished to animal shelters had daily or weekly incidents of house-soiling. |
-- 23% |
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House-soiling is the most common problem post-adoption and most likely issue to prompt return to the shelter. T/F? |
-- true! |
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Consequences of failure of treatment of feline house soiling? |
-- relinquishment -- banishment -- euthanasia |
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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! |
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What does periuria mean? Perichezia? |
-- periuria: urinating around -- perichezia: defecating around |
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DDX for feline house soiling? |
-- marking (spraying) -- toileting -- medical reasons (UTI, GI dz, endocrinopathies, musculoskeletal dz, etc) |
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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 |
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Medical diagnostic tests? |
-- PE -- UA -- rads, ultrasound |
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Behavioral periuria includes? |
-- toileting >> picking a new toilet spot --marking >> communication |
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If urine deposition is vertical, this indicates? Horizontal? |
-- vertical: marking -- horizontal: toileting or marking |
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If there is perichezia, this indicates? |
-- toileting |
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If there is a substrate pattern, this indicates? |
-- toileting |
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If the litterbox is not sufficient, this indicates? |
-- toileting |
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Does volume differentiate between toileting and marking? |
-- no |
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Feline social issues affect? |
-- treatment plan (not diagnosis) |
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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 |
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Treatment for toileting? |
-- offer best litterbox (ABCs) -- Accessible >> # cats + 1 = # litterboxes >> uncovered -- Big box -- Cafeteria/Clay/Clumping/Carbon/Clean litter |
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Study of covered litterboxes vs. uncovered litterboxes? |
-- covered boxes were not found to be a risk for house-soiling -- some cats have individual preferences |
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Litterbox size study? |
-- 74 cats, 43 homes, 4 wks -- bigger litter box was used more frequently >> more clean real estate |
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Which litter type do cats most prefer? |
-- clumping clay |
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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 |
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Which clumping clay litter do cats pick? |
-- Fresh Step scoop -- contains carbon >> odor absorbing |
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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 |
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Scented vs. unscented Fresh Step Litter study? |
-- 4 colony rooms -- ~8 cats per room -- 4 overnight, 10h periods -- no preference demonstrated |
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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 |
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Define "clean" litterbox. |
-- scooped BID, changed monthly |
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Treatment for urine marking? |
-- "DEFG" -- Drugs (SSRIs) -- Environment of Plenty (enrichment) -- Feliway -- Gonadectomy, Get rid of triggers |
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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 |
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What is Feliway? |
-- facial pheromone, calming effect |
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Feliway spray study? |
-- double blind, placebo controlled -- baseline week + 4 wks tx -- reduction in marking but did not completely resolve the problem |
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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 |
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There are no FDA approved drugs for treatment of urine marking in cats. T/F? |
-- true >> all treatment is considered off-label |
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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 |
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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 |
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Is transdermal dosing a good idea? |
-- no! -- oral, not aural |
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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 |
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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 |
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Few spraying/toileting cats have a primary medical problem. T/F? |
-- FALSE -- many spraying/toileting cats have a primary medical problem |
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Features of toileting cat behavior? |
-- horizontal deposition -- +/- perichezia -- substrate pattern (e.g. likes carpet) -- litterbox less than ideal |
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Features of marking cat behavior? |
-- vertical or horizontal deposition -- no perichezia -- no substrate pattern -- litterbox acceptable |
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Targeted treatment for toileting? |
Offer best box: -- Accessible -- Big -- Clay clump/clean |
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Targeted treatment for urine marking? |
Reduce need to communicate -- drugs -- environment of plenty -- feliway -- get rid of triggers/gonadectomy |
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Drugs for off-label treatment of urine marking in cats? |
-- fluoxetine (SSRI) -- clomipramine (TCA) |