ADVANCES IN THE DIAGNOSIS AND TREATMENT OF NOISE PHOBIAS IN COMPANION ANIMALS

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A V N E IN THE DA N SS AND TREATMENT DACS IGOI OF N I E P O I S IN C M A I N A I A S OS H BA O P NO NM L
Heiblum, M.
Veterinary Hospital Universidad Nacional Autonoma de Mexico Private Practice in small animal behavior moisesheiblum@yahoo.com
Although it is a part of normal behavior, it is important Fear Response determine if the fear is adaptive or pathological which can Fear response is a complex physiological response involving several areas in the brain. This response is accompanied byidentified within the context in which it is produced. activation of the neuro-endocrine and autonomic components "Normalfear versus phobia" of the central nervous system, stimulation of the hypothalamicpituitary-cortico-adrenal axis, liberating stress hormones To experience fear w e attacked by an animal is normal, w hn and exhibiting certain somatic signs that increase survival lightening strikes a near-by tree is also normal, but to experie probabilities in the animal (1,2). These include defense fear w e the sky darkens may be considered a phobia. It can hn behavior increased blood pressure heart rate respiratory said that phobias are exaggerated fear responses as indicated frequency, glucose metabolism, and accompanied by a the danger level of the stimulus generating t e (2). hm decreased perception of pain hair bristling pupil dilation Possible Causes and diagnosis salivation urination and defecation, and evacuation of the anal slands Fear also s e s to be involved in altering the activity Genetic factors, traumatic events, early socialization em of certain neurotransmitters such a serotonin adrenalin deficit, associative learning, by either classic or instrumenta s noradrenalin and GABA These neurotransmitters therefore conditioning. become important targets for medicines (3) The diagnosis of noise phobias is mostly clear; the causin stimulus is usually loud and recognizable and the owner is Fear: capable of identifying its occurrence by the animal's behavi (2). The prognosis varies and depends on the animal itself, t Fear is a definite emotional state like a feeling of apprehension or anguish before a specific danger or imminent threat. It mayduration of the phobia, the success infindinga controllable a be considered as a normal adaptive behavior (1). It is a basic,efficient stimulus for systematic desensitization and counterinstinctive behavior that allows an animal to survive by makingconditioning (SD-CC), and the ability to control the intensity the stimulus during treatment. it ready for either fight or flight. Treatment may be divided into three mechanisms: Phobia: 1. This refers to an exaggerated response to fear that presents Modifying the environment: This consists of controllin the environment whenever possible; having control of itself chronically and intensely before a certain stimulus (1). animal; providing a secure place where the animal feels Phobias can be categorized as: and protected, and avoiding exposure to the stimulus exce during specific treatment sessions. • Specific phobias towards a specific and identifiable stimulus or stimuli such as the fear of firecrackers. 2. Modifying the behavior: This consists of several procedu with the objective of diminishing the animal's perception • Generalized phobias towards m n stimuli, sometimes ay danger or threat generated by the stimuli, while avoidi difficult to identify, for example, the fear of people, other unconscious strengthening of attention-seeking behavior animals and objects. like jumping on its master's lap, seeking constant physi • Situational phobias these stimuli occur under specific contact, whining, barking, hiding, attempts to escape, and identifiable situations or conditions, such as fear of a employed by the animal to feel safer. In general, these veterinarian or of car travel. procedures require making changes in the relationship a in the way the owner communicates with the animal. Noise phobias S m of these procedures involve: oe These phobias are commonly found in dogs and in a third of • Identifying causal stimuli the cases are so severe that owners look for professional help • Identifying the tolerance threshold or gradient of because the animal shows intense discomfort. 3 4
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ISRAEL JOURNAL OF VETERINARY MEDICINE
exposure to the causal stimulus without a s o of Diazepam, Clorazepate hw fear Occasionally combining TCA's and BDZ's is useful. • Avoid rewarding the animal if it s o s fear hw Alternative medicine may be applied: In order to establish the gradient of exposure and utilize D.A.P., acupuncture, homeopathy (3). systematic desensitization and counter-conditioning (SDCC) as a therapeutic tool, one may utilize, depending on Prevention the causal stimulus, audiocassettes, videocassettes, special Early exposure to a variety of stimuli within the h m effects recordings or exposure to the real stimulus at a environment and habituation during sensitive periods, u a have distance (1,2). proven to be useful. It is important that the animal be retrained with rewards in a controlled situation while recourse to obedience c m a dDevelopment of the phobia: o mns such as "sit" or "down" may b c m very useful, not only eo e because they provide us with additional control over the Previous traumatic experiences, such as lightning strikin a animal, but because they may be used as a vehicle to obtain nearby tree may trigger the development of a phobia. Th m r easily a physiologically relaxed state (1), which is include a hurricane or tornado and accumulated traumas s oe exactly w a we are looking for. The rewards must be highlyas frequent and very strong storms in the area. ht attractive so that they change the animal's perception of the We may say that a dog is storm phobic when the symptom stimulus through associative learning. exhibits are disproportionately more intense than the stimul provoking them (5).For example, symptoms that occur a s During DS-CC we m s search for an optimal level for the ut exposure, expose the animal to a very low intensity of thea response to harmless stimuli such as rain or dark clou stimulus (one the animal is capable of tolerating withoutAn important factor to consider is that an animal with sto phobi showing signs of fear or anxiety, reward calmed behaviors, as is subjected to a high degree of suffering. and increase very gradually the intensity of the stimulus A variety of types of phobias according to the intensity until it reaches levels close to those that originally causedsigns are discernable: (2) a fear response. If at any time the animal s o s signs of fear hw ye : or anxiety, it is imperative that we reduce the stimulus and • T p 1 hiding, staying close to its master, wandering, mo then proceed m r gradually. oe • Type 2: hiding, staying close to its master, wandering moaning, agitation, trembling, vocalizations Another technique of behavior modification is flooding. This technique is not very commendable as the subject • Type 3: stronger attempts to hide, staying close to its requires being exposed to the causal stimulus at its real master, and attempts to escape, wandering, trembling intensity until the animal becomes used to it and can relax. vatio The technique may be counterproductive, as the fear may be hypersalin, or n, agitation, vocalizations, urination, defecatio anal gland evacuation. reinforced if the animal is not able to get used to the stimulus intensity and the stimulus is withdrawn before habituation According to the severity of the signs, ten signs are commo or the animal may escape stimulus exposure before the fearobserved, and the scale varies from 0 to 5 (LIkert scale) w subsides. This technique implies a high degree of risk as represents the absence of signs and 5 the highest intens 0 the animal may harm itself, or others, while under a m cshown. (2) uh altered emotional state (1). The sg s to o s r e are: in b ev Punishment m s n t be applied for it only provokes a • Destructivity ut o higher state of anxiety. Maintaining the animal calm is an Elimination important part of the treatment. If the level of anxiety or • excitement is high, the animal immediately responds to • Salivation the threatening stimulus and new learning doesn't occur.• Vocalization However, if the level of anxiety or excitement is reduced • Hiding by using behavior modification techniques, medication or a• Wandering combination, new learning may then occur. • Agitation 3. Du te t e t r g r am n: • Staying close to owner • Trembling Tricyclic antidepressants (TCA's): Clomipramine, Amitriptiline, Imipramine • Self-mutilation Selective inhibitors of serotonin recapture (SSRI's): A s oe of a total of 30 points or m r in the scale is considered cr oe Fluoxetin, Paroxetin, and Fluvoxamin a s v r c s that u d u t dy requires medical treatment. (2,3) e ee a e n o be l Benzodiazepines (BDZ's): Alprazolam, Te t e t is simple for mild or m d r t cases: bring the r am n o eae VOLUME 63 (2) 2008
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i d os d rn the som the dog my f e at es wt the pee cs of n o r ui g t r , a e l ae ih rsne difficult to pe e t e p s r to r a stimuli and, on m i r v n x o ue e l the o n r po i e a p c of r f g s c as a l r e c nan r aoicei n , the si uu a p as w e the o n r is a s n. w e, r v d l e eu e uh a ag o t i e, p cso s ca e tm l s p e r hn we be t of f r iue a co e, or the like. unt r , l s t S r s hv mn cmoet to w i h the dog rs o d to s v r l phobia in cats t m ae ay o pnn o s h c ep n s eStorm ea of t e , t u mk g its te t e t so mc mr c m l ae . T ee is no r a o to as m t a t i d e n o c r H h m h s ai n ra n m uh o o pc t d e i hr e s n su e h t hs o s ' c u. o t c t r gse a dfee t r s o s . T e g n r ly t n to as e i t r if r n e p n e h y e ea e d Drug treatment of storm phobias: a r d ci n of t er activity l v l - hdn or e e se pn e u to hi e e i i g vn l e i g B s m dc to : B f r the r i y s a o b gn , or at l a t i t r r t d as i p ra t sg s of sr s or a xey T a e e i ai n eoe an e s n e i s ebe nepee s m ot n i n te s nit. at the b gn i g of the s a o , for the r m i d r of the s a o , do not e hbt the d sr ci e sg s t a d g h v . W e e i nn es n e a e n es n xii e tu tv i n h t o s a e h due to ca sc c n ii nn it is p s i l t a the dog s o s f aw e r t r s hm he d e n find a yhn " b om l l s i o dto i g o sbe h t h w eo n r eun o e r os ' t nt i g anr a e e to l wi t n iy som . (1) v n o -ne st t r s t eeoe the c n ii n g e u n tc d u r p re and is hrf r o dto o s n oi e , ne ot d d g o e (2, 5). i n sd a The m s c m o l u e m dc to s are: ot o m n s d e i ai n y Co i r mn (1.5 - 3.0 m / g t i e per day) or Fu x tn l mpa i e gk , wc l o ei e (1.0 - 1.5 m / g o c per day) gk , n e Q i ka tn ansiolitic m dc to t a mk it e se for tReferences: uc - ci g e i ai n h t ae a i r he dog to get t r u h the som ho g tr : 1. H i l m M m m r s de eoo i clinica en el p ro ebu , e oi a t l ga er ao i o a o d c to o tn a N M 0 2 p Apa oa (0.1 - 0.5 m / g q 6-8 h); D z p m (0.25 - 2.0 g t , d l m d de e u ai n c ni u U A 2 0 l rz lm gk i ea a m / g q 6-8 h) gk 2. U i est of Georgia, c ni un e u ai n c us s nv r iy o tn i g d c to o r e N v m e 2001 U d t on da n ss and te t e t oe br p ae r am n Du te t e t m s a a s be a c m a i d by b h voa s a a i a b h vo po l mg o i r g r am n ut l y w co pn e e a i r l m l nm l e a i r r be is . m dfc to and e vr n e t l m dfc to w ee i dc t d o ii ai n n io m na o ii ai n h r n i ae . 3. U i est of G oga c ni un e u ai n c us s M nv r iy e r i , o tn i g d c to o r e 1999 P y h p am c l g and te t e t of p o i s i sc o hr ao y o r am n hb a Desensitization and counter-conditioning d g and c t os as T e e are ef ci e if the dog s o s sg s of a xey or f a L d eg G: M., u t a s n W. & A k r a , L. 2 0 hs fe tv hw i n n i t e 4. a s r n u , e d rn an "artificial som . It r q ie b i g a l to mng Hnd b r ,of b hH uhpoe m , of thecdogm n cat ( 0 ui g t r " e ur s en be aae a b o n ok e ai r rb s vo l e and the v ro s c m o e t of the som if the dog r s o d to a ai u o p n ns tr ep n s 5.e Overall, K.A: Clinical b h voa m dcn for s a e ai rl e ii e ml specific si uu . For e a pe do not b gn wt t u d r if th tm l s xm l, e i ih h n e a i as St L us M s y ( 9 7. nm l . o i o b 1 9 ) dog f as rain. B gn wt the l a t t r ae i g si uu s c er e i ih e s he t nn tm l s u h as lg t rain, f lo e by m r i t n e rain; m d r t t u d r ih o wd oe ne s o eae h n e, f lo e by m r i t n e t u d r or a c m i ai n of stimuli, o wd oe ne s h n e; o bn to ec t r . (2,4) t eea Due to the f c t a s m d g r s o d o l to s e ii a t h t o e o s e p n ny p cfc stimuli, r c r i g a local som has po e to be u eu for SDe odn tr r vn sf l CC s m tm s (2, 5) o ei e . It is b s to c n u t DS-CC d rn the dry s a o , as the et o d c ui g es n g a is t a "ideally" the dog will n v r e p re c f a (3, 5). ol ht e e x ei n e e r T u we can p rom ga u l e p s r and a odn the risk of hs ef r r d a x o ue viig the dog s d e l fn i g itself ep sd to a hg -ne st som u d n i dn y x oe i hi t n iy t r , and t eeoe l o i g e eyhn t a had b e g i e d rn h r f r o sn v r t i g h t e n an d ui g t ea y hrp. It is e u ly i p ra t to c a g the m n e in w i h we q a m ot n hn e a nr h c c m u i ae wt the dog. Not c motn d rn the som o m n t ih c o f ri g ui g tr , r w r c l and r l x d b h vo, do not p ns if the dog digs, e ad am ea e e a i r u ih hides, m a s etc. on, The v t rn ra m s t l a o t r a e p cai n b f r eei ai n ut ak b u e l x e t to s eoe the te t e t w i h is u u ly difficult to r s l e totally. r am n h c sa e ov Ef ci e e s i ce s s wt te t e t tm , and a o t all the fe tv n s n r a e ih r am n i e l s m p te t s o i po e e t at o g t e may h v r l p e ai ns h w m r v m n, lh u h h y a e ea s s d rn s v r som . ui g e ee t r s S v r som pe e t a ge t c ae g b c u e t e h v e ee t r s r s n r a h l n e e a s h y a e m li l c m o e t , the d g g n r ly m nf s i t n e utpe o p n ns o s e ea a ie t ne s r s o s s it is difficult to find artificial stimuli for DS-CC, it ep ne, 36
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