{"id":12965,"date":"2017-04-30T18:22:07","date_gmt":"2017-04-30T18:22:07","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=12965"},"modified":"2022-02-12T16:15:08","modified_gmt":"2022-02-12T16:15:08","slug":"separation-related-disorders-differences-dogs-cats","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/behavior\/separation-related-disorders-differences-dogs-cats\/","title":{"rendered":"Separation-Related Disorders and the Differences Between Dogs and Cats"},"content":{"rendered":"<p>Separation-related disorders<sup>1<\/sup> are characterized by physiologic and emotional distress occurring only when the patient anticipates or experiences an actual or virtual (e.g., person present but not accessible) absence from a person with whom the pet is socially bonded.<\/p>\n<p>Separation-related disorders are well recognized in dogs, but they are less understood in cats because of a lack of representation in the literature.<sup>2,3<\/sup> Prevalence in dogs presented to a behavior specialist ranges from 14% to 50%<sup>4\u20137<\/sup> compared with 19% in cats.<sup>2<\/sup> These disorders are probably underreported in cats.<\/p>\n<p>Symptoms of a separation-related disorder can include destructive acts, such as destroying household objects, chewing furniture, and frantic scratching at door frames and window sills.<\/p>\n<h2>Signalment and Predispositions<\/h2>\n<p>Clinical signs in cats and dogs may develop at any age, in any breed, and in either sex. There is evidence that 55% of affected dogs exhibit clinical signs before 3 years of age<sup>8<\/sup> and that cats older than 7 years may be predisposed.<sup>2<\/sup> Known predisposing factors in dogs include neutering,<sup>9<\/sup> absence of obedience training,<sup>8\u201310<\/sup> and adoption from a shelter or rescue or being a found stray.<sup>8,9,11<\/sup> Predisposing factors in both dogs and cats include daily extended periods of time without the owner, change in schedule or family makeup, and single-owner households.<sup>3,9<\/sup> There may also be a hereditary predisposition in both dogs and cats.<sup>3,12<\/sup><\/p>\n<h2>Clinical Signs<\/h2>\n<p>Onset of clinical signs in dogs and cats may occur with life events, lifestyle changes, or development of medical or other behavioral disorders (<strong>Box 1<\/strong>).<sup>3,13,14<\/sup><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box01.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-full wp-image-12968 aligncenter\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box01.jpg\" alt=\"\" width=\"631\" height=\"312\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box01.jpg 631w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box01-300x148.jpg 300w\" sizes=\"(max-width: 631px) 100vw, 631px\" \/><\/a><\/p>\n<p>Dogs with separation-related disorders can be divided into three classes: A, B, and C.<sup>1<\/sup> Dogs in class A may show initial signs in puppyhood and display hyperattachment<sup>1<\/sup> to one person by following them and soliciting attention and physical interaction.<sup>1,3,9,13,16,17<\/sup> Dogs in class B display signs triggered by a change in schedule or lifestyle or by aging and often show distress only when left completely alone.<sup>1,14<\/sup> Dogs in class C show clinical signs after a fearful experience and do not show hyperattachment.<sup>1<\/sup><\/p>\n<p>Clinical signs in both cats and dogs may start in anticipation of the owner\u2019s departure.<sup>2,3,16 <\/sup>Dogs may exhibit aggression in an apparent attempt to keep the owner from departing<sup>3,8,12<\/sup> or appear apathetic and withdrawn. Some dogs avoid participating in morning routines.<sup>8<\/sup> Particular signs reported in cats include urination on the owner\u2019s bed and destruction; these signs are more common among males than females.<sup>2,3<\/sup><\/p>\n<h2>Diagnosis<\/h2>\n<h3>Step 1: Collect a Targeted History<\/h3>\n<p>Even in affected dogs, as few as 13% of owners may seek assistance.<sup>17<\/sup> A simple behavior questionnaire with questions such as \u201cHas your pet urinated or defecated in your house since your last visit?\u201d or \u201cDoes your pet act differently as you get ready for work?\u201d can decrease the time invested in the examination room. Signs of anxiety with departure cues strongly support a diagnosis of separation anxiety.<sup>13<\/sup> Behaviors that indicate<sup>13<\/sup> a diagnosis other than separation anxiety are those that:<\/p>\n<ul>\n<li>\u0097Do not occur consistently and exclusively with departures<\/li>\n<li>\u0097Occur only in conjunction with other environmental events (eg, storms)<\/li>\n<li>\u0097Occur only when the pet is confined<\/li>\n<\/ul>\n<h3>Step 2: Perform a Physical Examination and Appropriate Diagnostic Testing<\/h3>\n<p>Complete a full examination. In dogs, monitor for caudal wear of the canines, a marker of crate chewing.<sup>14<\/sup> Complete blood count, blood chemistry, urinalysis, and thyroid testing should be performed to screen for underlying medical causes of the clinical signs and serve as a baseline before medication use.<sup>8,13<\/sup> Conditions that can cause discomfort or pain can present similarly to anxiety.<sup>18<\/sup> Depending on clinical presentation, initial diagnostics, and examination findings, additional diagnostics may be warranted.<\/p>\n<h3>Step 3: Rule Out Behavioral Contributors or Differentials<\/h3>\n<p>As many as 30% to 60% of dogs have comorbid noise and storm phobias.<sup>9,15,19<\/sup> Confinement distress could be the sole cause of anxiety or a very large contributor.<sup>3,8,13<\/sup> Testing the dog\u2019s distress level with confinement when the owners are present<sup>13<\/sup> and no confinement when the owners are not present can rule this out. Other diagnostic differentials to consider are listed in <strong>Box 2<\/strong>.<\/p>\n<p>Video recording is helpful<sup>13<\/sup> because many signs are \u201csilent,\u201d with no evidence of the behavior upon the owner\u2019s return. In addition, video can confirm the diagnosis, provide a baseline, have treatment implications, and help monitor for treatment success. There are many ways to inexpensively record video, including smartphones, apps, and home security systems.<\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box02.jpg\"><img decoding=\"async\" class=\"size-full wp-image-12969 aligncenter\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box02.jpg\" alt=\"\" width=\"726\" height=\"398\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box02.jpg 726w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2017\/04\/T1705F03Box02-300x164.jpg 300w\" sizes=\"(max-width: 726px) 100vw, 726px\" \/><\/a><\/p>\n<h2>Treatment<\/h2>\n<h3>Step 1: Educate<\/h3>\n<p>Owners may have preconceived ideas of the cause of their pet\u2019s disorder. The owner should understand that his or her pet is not acting this way out of spite or anger; that the owner didn\u2019t cause the behavior by loving the pet too much, spoiling it, or not being dominant; and that the pet is not bored and getting another pet will not help.<sup>1,9,13<\/sup><\/p>\n<h3>Step 2: Avoid and Manage Distress Immediately<\/h3>\n<p>As quickly as possible, put into place strategies and treatments to decrease or ameliorate the distress. This will ease owner stress and improve the pet\u2019s quality of life while long-term treatments are instituted.<\/p>\n<p><strong>Avoid departures in the initial stages of treatment<\/strong><sup>14<\/sup> through use of daycare, boarding, house sitters, or bringing the pet along when the owner departs. Confinement can prevent destruction but also can increase anxiety<sup>13,14<\/sup> and is generally avoided because of the comorbidity with confinement anxiety. If crated, the pet should not wear a collar because of strangulation risk with escape attempts.<sup>14<\/sup><strong>\u00a0<\/strong><\/p>\n<p><strong>Block off areas most likely to be damaged<\/strong> and clean soiled areas of the residence<sup>13<\/sup> with a bacterial\/enzymatic cleaner, like Anti-Icky-Poo (MisterMax Quality Products) or other cleaners such as Urine Off or Zero Odor.<sup>20<\/sup> Play the radio, white noise, or music to prevent the pet from retriggering to external stimuli.<sup>13<\/sup><\/p>\n<p><strong>Instruct the owners to avoid punishment<\/strong>, such as yelling, hitting, and shock collars. These types of treatments are contraindicated<sup>13,16<\/sup> because they can increase anxiety and make the course of treatment longer. Be sure to remind clients that their pet is suffering from an emotional disorder and no amount of punishment will fix it.<\/p>\n<p><strong>Pair owner departures with positive things<\/strong> by setting up food-searching games and food toys<sup>3,13<\/sup> before the first signs of distress. Adjust the pet\u2019s feeding schedule to increase the likelihood of eating when the owner is gone,<sup>8<\/sup> and use enticing food. Recommend that the owner keep departures and returns low-key.<sup>13<\/sup> A regular and predictable routine should be provided.<sup>16<\/sup><\/p>\n<p><strong>Consider medication.<\/strong> Medications can directly decrease anxiety and panic.<sup>14<\/sup> Situational medications that take effect within 1 to 2 hours of administration can be essential in the treatment of separation anxiety and should be considered at the first appointment. Ideally, the medication would take effect before the patient shows clinical signs. Benzodiazepines (avoid diazepam in cats), trazodone, gabapentin, and clonidine can be used to reduce anxiety quickly.<sup>13,14 <\/sup>Acepromazine is not a good anxiolytic so should not be used alone, but it can be used at low dosages as an adjunct if additional sedation is needed.<sup>13<\/sup><\/p>\n<h3>Step 3: Institute Behavior Modification So the Pet Can Learn to Stay Calm for Departures<\/h3>\n<p>Proper implementation of behavior modification maximizes the likelihood of a long-term positive outcome. In our experience, behavioral treatments increase the probability that medication doses can be reduced over time, if that is a goal of treatment, and decrease the likelihood of relapse. Ideally, a veterinary behavior technician within the practice would conduct behavior modification sessions in clear communication with the veterinarian so the plan and medications can be adjusted efficiently. All treatments should focus on conditioning the pet to feel calm and happy during departures by using things the pet likes.<\/p>\n<p>Independence and relaxation exercises are a cornerstone of treatment.<sup>8,13<\/sup> Examples include food-searching games at an increasing distance from the owner,<sup>10<\/sup> relaxation exercises, and rewarding calm behavior.<sup>16<\/sup> Treatment can be made simple in some cases by using food toys and remote treat-dispensing devices.<\/p>\n<p>Structured interactions between the pet and the owner through positive reinforcement (eg, cueing the pet to sit before the pet receives attention) can promote consistency and predictability in the pet\u2019s life.<sup>13,14<\/sup> Adequate exercise and enrichment should be given to meet the pet\u2019s general needs.<sup>13,16<\/sup><\/p>\n<p>Additional behavioral modification includes uncoupling departure cues and desensitization and counterconditioning to departures.<sup>13,14<\/sup> Dogs can be taught to be comfortable with confinement if that is a goal of the owner or helps the dog feel safe.<sup>13<\/sup> Caution should be exercised when recommending this because it can take months for often little yield.<\/p>\n<p>As a warning, if pets are pushed too fast through these protocols, these methods can backfire and actually sensitize the pet to departures, making the patient worse.<sup>14<\/sup> If you do not feel comfortable enacting these treatments and do not have a behavior technician on whom to rely, refer your patient to a board-certified veterinary behaviorist. If such a specialist is not available in your area, try the American Veterinary Society of Animal Behavior (<a href=\"http:\/\/www.avsab.org\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>avsab.org<\/strong><\/a>) to find someone qualified.<\/p>\n<h3>Step 4: If Indicated, Prescribe Longer-Acting Pharmaceuticals<\/h3>\n<p>Longer-acting pharmaceuticals may be indicated if owners have a difficult time predicting departures (making situational medications difficult to implement) or if situational medications are insufficient. Some patients may need polypharmacy.<sup>14<\/sup> Tricyclic antidepressants and selective serotonin reuptake inhibitors can be helpful in easing anxiety over time. Substantial evidence supports use of clomipramine<sup>21\u201323<\/sup> (Clomicalm, <a href=\"http:\/\/www.Novartis.com\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Novartis.com<\/strong><\/a>) and fluoxetine<sup>24,25<\/sup> for separation anxiety in dogs. Clomicalm is the only drug on the market with a Food and Drug Administration label for separation anxiety in dogs older than 6 months.<sup>26<\/sup> Other daily options to consider include sertraline or paroxetine.<sup>13,14<\/sup> Supplements (Zylkene <a href=\"http:\/\/www.vetoquinolusa.com\" target=\"_blank\" rel=\"noopener noreferrer\">[<strong>vetoquinolusa.com<\/strong><\/a>], Solliquin [<a href=\"http:\/\/www.nutramaxlabs.com\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>nutramaxlabs.com<\/strong><\/a>]), prescription diets (Royal Canin CALM [<a href=\"http:\/\/www.royalcanin.com\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>royalcanin.com<\/strong><\/a>]), and pheromone therapy can be considered.<sup>8,14,16,23<\/sup><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Onset of clinical signs of separation-related disorders in dogs and cats may occur with life events, lifestyle changes, or development of medical or other behavioral disorders.<\/p>\n","protected":false},"author":15,"featured_media":12970,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":230,"footnotes":""},"categories":[350],"tags":[13],"class_list":["post-12965","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-may-june-2017","tag-peer-reviewed","column-features","clinical_topics-behavior"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Separation-Related Disorders and the Differences Between Dogs and Cats<\/title>\n<meta name=\"description\" content=\"Separation-related disorders in dogs and cats may occur with life events, lifestyle changes, or development of medical or other behavioral disorders.\" \/>\n<meta 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