CynthiaATL
Member
J. Neilson, DVM, DACVB
Animal Behavior Clinic
Portland, OR
Separation anxiety syndrome has received a great deal of attention over the past several years due to the expanding interest in the field of animal behavior, the US Food and Drug Administration (FDA) approval of medications to control the condition (Clomicalm, Novartis Animal Health; Reconcile, Lilly), and animal welfare concerns. An estimated 17% of dogs in the United States suffer from separation anxiety— this equates to almost 10 million dogs. Less than a million of these dogs are receiving care. An evidence-based management plan for canine separation anxiety will be discussed, highlighting areas that are often neglected or are particularly challenging.
DIAGNOSIS
In order for treatment to be successful, an accurate diagnosis needs to first be established. Dogs that exhibit excessive distress responses when separated from their companions are classified as exhibiting separation anxiety. The clinical signs associated with separation anxiety include excessive vocalization, elimination, destructive behavior, anorexia, hypersalivation, pacing, depression/inactivity, and excessive greetings upon the owner’s return. It is important to remember that the clinical signs of separation anxiety are nonspecific signs associated with other anxiety disorders (eg, noise phobias) and primary medical conditions (eg, renal failure= indoor elimination). But with separation anxiety, all of these clinical signs are only expressed when the dog is left alone, usually within the first few minutes of being left alone. The owner often reports that the dog is “perfect†when they are at home. A thorough history and videotape of the dog when left alone can help to accurately diagnose the problem. In addition, dogs with separation anxiety often exhibit distress as the owners are preparing to leave. Trembling, closely following the owner, salivating, and pacing just prior to the owner’s departure can help to complete the clinical picture. Since the clinical signs of separation anxiety are nonspecific signs that are seen in a variety of conditions, occasionally there is an erroneous diagnosis. Sometimes the dog is actually suffering from a noise phobia. In these cases, the clinical signs of anxiety only happen periodically when the owners are gone and the dogs show some level of distress when noises occur in the presence of the owners. Dogs that house-soil either due to a lack of house-training or marking are sometimes inappropriately diagnosed as having separation anxiety. Many of these dogs have learned not to soil in the direct presence of the owners for fear of reprimands so they present with soiling only when the owners are absent. Vocalization has many motivations, including alarm barking and play related vocalizations. Neighbor complaints regarding excessive vocalization need to be thoroughly investigated since tolerance levels vary widely and may represent a normal level of canine vocalization. A thorough history and video of the dog during departures can help to clarify this diagnosis. With the availability of inexpensive disposable video cameras at major drug store chains, video monitoring of dogs during owner absence is possible for all clients. In some cases it may be difficult to predict exactly where to place the camera so that the pet is captured in the view frame but important information can be captured even if the pet is not constantly in the camera’s view, including vocalization and movement.
RISK FACTORS
In a study by Flannigan et al, a variety of variables were investigated in a population of dogs suffering from separation anxiety and in a population of dogs without separation anxiety but another behavioral condition to ascertain which variables could be risk factors for separation anxiety. Variables considered included age of onset; gender of pet; reproductive status; age at referral; age at acquisition; breed; weight; gender of owners; number of adults in the home; number of children in the home; number of previous owners; source of dog; number of dogs/cats in home; dog allowed on the bed; dog fed from the table; attendance at dog obedience class; and recent changes in home environment. Of those variables considered, the only two significant risk factors were having a single owner (2.5X) and reproductive status (dogs with intact status were more than 3X less likely to have separation anxiety). Other variables that approached significance were source (shelter/vet/stray more likely than breeder/friend/pet stores); change in home environment and lack of attendance at obedience classes. A recent study (Cannas) examined puppies via video monitoring during owner absences to see what “normal†behavior looks like. Most puppies exhibited calm/resting behaviors during owner absences. Therefore, if a puppy owner is complaining of significant distress in their puppy during departures, it very well may be significant.
TREATMENT
There are four basic components to the behavioral modification program. Each will be reviewed with attention paid to compliance, particular challenges, and alternative options.
Owner Education
The owners need to understand that this is an anxiety-related condition, not a spiteful dog. Giving the owners a basic understanding of the underlying motivation for behaviors can dramatically change the owners’ tolerance and response to the problem behaviors. Of particular importance is ceasing any punishment that the owners may deliver to the pet upon returning home to find destruction/housesoiling. If punished, not only is the pet anxious about being left alone but that anxiety is compounded by expectations of punishment when the owner returns. This intensifies the problem instead of resolving it. To successfully implement owner education, the treatment team should explain the basic premise of separation anxiety: dogs are social creatures and attachment behaviors are necessary for animals whose survival is benefited by group interactions as they serve to maintain social cohesion. When a social animal is separated from its companions, it is normal for that animal to engage in a distress response. Normal dogs habituate to separations from their owners. Dogs with an excessive distress response suffer from separation anxiety.
Restructure the Owner–Pet Relationship
Anxious dogs almost always benefit from addedstructure in their lives. Many dogs with separationanxiety live in a relationship with their owner that fostersdependence or uncertainty. The owners should be giventools to make the dog less attached in their dailyinteractions and to make interactions more structuredand focused. These tools include the nothing in life isfree program (earning attention), ignoring attention seeking behaviors, learning a sit/stay command andavoiding engagement in emotional/dependent displayssuch as emotional greetings. Abrupt and momentouschanges may propel the severely anxious dog into adownward spiral, so these changes may need to begradually introduced over a 2- to 4-week period.Exercise is a considered to have beneficial effects on avariety of challenges and, if not already provided,owners should provide adequate daily exercise for theirdog.
Desensitize and Countercondition the Pet to the Leaving Routine
Many separation anxiety dogs are so sensitized to the pre-departure routine that performing any parts of that routine will trigger the anxious response. A commonly touted treatment goal is to reduce the predictive value and, thus, anxiety-producing quality of the steps in the owner's departure routine. This is done by performing the tasks without actually leaving and by pairing them with an activity that is incompatible with anxiety. For example, one owner is playing a favorite game with dog (fetch/tug-of war) and the other owner picks up the keys and puts them down again. Desensitization can also be performed without counterconditioning; the keys are just picked up and replaced without anything good or bad occurring. Some typical challenges with this training step include owners being too enthusiastic—they overwhelm the dog with pre-departure cues and make the dog an anxious wreck. It is critical that they AVOID producing anxiety and only do a few exercises per day. Giving the owners a definitive number of cues that they can perform per day (5) will help to limit potential disaster. Also, they must try to limit or eliminate their pre-departure cues during a “real†departure; otherwise the dog is likely to relapse. Since many dogs have very astute observational skills and owners cannot eliminate all pre-departure cues when they truly are departing, this step has inherent challenges. Unless there is a patient that is clearly, significantly reacting to a specific cue, the author does not spend too much time on this particular step but instead suggests that the owners prepare for departures so that they can avoid a harried, frantic departure that involves a lot of emotion (yelling/searching for keys, etc.). By keeping the overall tone of the departure calm, it may minimize the dog’s arousal.
Desensitize and Countercondition the Dog to the Departures Using Graduated Departures
The ideal program would involve avoiding all anxiety provoking separations either by daycare or full owner accompaniment while the dog is gradually acclimated to departures by slowly increasing departure durations. However, this is rarely feasible. So we are faced with trying to rehabilitate the dog while the dog continues to experience over-threshold anxiety-producing departures. To do this I recommend trying to clearly distinguish anxiety-provoking departures that the owner can’t avoid from non-anxiety-provoking training departures. One way to do this is to designate different locations for anxiety and non-anxiety (training) departures. If a dog is currently experiencing anxiety in a gated kitchen, then it would continue to be left in the gated kitchen for nontraining departures. Then the owners would do graduated training departures with the dog free in the house. Training departures require the owner and clinician to predict tolerance…then the dog is never left for periods that produce anxiety. For example, if the dog starts to show anxiety 5 minutes after the owners depart, then the owners should start training departures at 4 minutes. They are instructed to give the dog a long lasting food treat or favorite toy and then exit the home, returning at 4 minutes. They repeat several times (three to five) to ensure that the dog is comfortable with this departure length before increasing it slightly, eg, to 5 minutes. To avoid a linear progression, shorter departures should be interspersed with the longer departures. Once again enthusiastic owners need to be told that they can only do two to three training departures per day. That schedule suggests that it will take a long time to progress…and it will! These cases are not resolved overnight. With time the dog should be able to be comfortable with longer and longer departures in the training location. When the training departure duration is equivalent to a typical departure, then the dog is left in the training departure location for all departures. One challenge with this step is creating a delicious long-lasting food treat to leave with the dog at departure. Since these dogs are still somewhat anxious, a moderately tasty= treat may not be enticing enough to overcome that anxiety related anorexia. By their very nature, delicious treats (eg, cheese/hot dogs) are usually readily consumable. Puzzle toys can help to make a very delectable treat long lasting. The Kong was one of the first toys utilized in this manner— the hollow inside cavity was smeared with peanut butter and then stuffed with treats. Now toys specifically designed for slow treat dispensing are commercially available. The Busy Buddy line from Premier (www.premier.com) has several toys that allow for advanced treat management: Twist N’Treat and the Squirrel Dude are two great options.
Animal Behavior Clinic
Portland, OR
Separation anxiety syndrome has received a great deal of attention over the past several years due to the expanding interest in the field of animal behavior, the US Food and Drug Administration (FDA) approval of medications to control the condition (Clomicalm, Novartis Animal Health; Reconcile, Lilly), and animal welfare concerns. An estimated 17% of dogs in the United States suffer from separation anxiety— this equates to almost 10 million dogs. Less than a million of these dogs are receiving care. An evidence-based management plan for canine separation anxiety will be discussed, highlighting areas that are often neglected or are particularly challenging.
DIAGNOSIS
In order for treatment to be successful, an accurate diagnosis needs to first be established. Dogs that exhibit excessive distress responses when separated from their companions are classified as exhibiting separation anxiety. The clinical signs associated with separation anxiety include excessive vocalization, elimination, destructive behavior, anorexia, hypersalivation, pacing, depression/inactivity, and excessive greetings upon the owner’s return. It is important to remember that the clinical signs of separation anxiety are nonspecific signs associated with other anxiety disorders (eg, noise phobias) and primary medical conditions (eg, renal failure= indoor elimination). But with separation anxiety, all of these clinical signs are only expressed when the dog is left alone, usually within the first few minutes of being left alone. The owner often reports that the dog is “perfect†when they are at home. A thorough history and videotape of the dog when left alone can help to accurately diagnose the problem. In addition, dogs with separation anxiety often exhibit distress as the owners are preparing to leave. Trembling, closely following the owner, salivating, and pacing just prior to the owner’s departure can help to complete the clinical picture. Since the clinical signs of separation anxiety are nonspecific signs that are seen in a variety of conditions, occasionally there is an erroneous diagnosis. Sometimes the dog is actually suffering from a noise phobia. In these cases, the clinical signs of anxiety only happen periodically when the owners are gone and the dogs show some level of distress when noises occur in the presence of the owners. Dogs that house-soil either due to a lack of house-training or marking are sometimes inappropriately diagnosed as having separation anxiety. Many of these dogs have learned not to soil in the direct presence of the owners for fear of reprimands so they present with soiling only when the owners are absent. Vocalization has many motivations, including alarm barking and play related vocalizations. Neighbor complaints regarding excessive vocalization need to be thoroughly investigated since tolerance levels vary widely and may represent a normal level of canine vocalization. A thorough history and video of the dog during departures can help to clarify this diagnosis. With the availability of inexpensive disposable video cameras at major drug store chains, video monitoring of dogs during owner absence is possible for all clients. In some cases it may be difficult to predict exactly where to place the camera so that the pet is captured in the view frame but important information can be captured even if the pet is not constantly in the camera’s view, including vocalization and movement.
RISK FACTORS
In a study by Flannigan et al, a variety of variables were investigated in a population of dogs suffering from separation anxiety and in a population of dogs without separation anxiety but another behavioral condition to ascertain which variables could be risk factors for separation anxiety. Variables considered included age of onset; gender of pet; reproductive status; age at referral; age at acquisition; breed; weight; gender of owners; number of adults in the home; number of children in the home; number of previous owners; source of dog; number of dogs/cats in home; dog allowed on the bed; dog fed from the table; attendance at dog obedience class; and recent changes in home environment. Of those variables considered, the only two significant risk factors were having a single owner (2.5X) and reproductive status (dogs with intact status were more than 3X less likely to have separation anxiety). Other variables that approached significance were source (shelter/vet/stray more likely than breeder/friend/pet stores); change in home environment and lack of attendance at obedience classes. A recent study (Cannas) examined puppies via video monitoring during owner absences to see what “normal†behavior looks like. Most puppies exhibited calm/resting behaviors during owner absences. Therefore, if a puppy owner is complaining of significant distress in their puppy during departures, it very well may be significant.
TREATMENT
There are four basic components to the behavioral modification program. Each will be reviewed with attention paid to compliance, particular challenges, and alternative options.
Owner Education
The owners need to understand that this is an anxiety-related condition, not a spiteful dog. Giving the owners a basic understanding of the underlying motivation for behaviors can dramatically change the owners’ tolerance and response to the problem behaviors. Of particular importance is ceasing any punishment that the owners may deliver to the pet upon returning home to find destruction/housesoiling. If punished, not only is the pet anxious about being left alone but that anxiety is compounded by expectations of punishment when the owner returns. This intensifies the problem instead of resolving it. To successfully implement owner education, the treatment team should explain the basic premise of separation anxiety: dogs are social creatures and attachment behaviors are necessary for animals whose survival is benefited by group interactions as they serve to maintain social cohesion. When a social animal is separated from its companions, it is normal for that animal to engage in a distress response. Normal dogs habituate to separations from their owners. Dogs with an excessive distress response suffer from separation anxiety.
Restructure the Owner–Pet Relationship
Anxious dogs almost always benefit from addedstructure in their lives. Many dogs with separationanxiety live in a relationship with their owner that fostersdependence or uncertainty. The owners should be giventools to make the dog less attached in their dailyinteractions and to make interactions more structuredand focused. These tools include the nothing in life isfree program (earning attention), ignoring attention seeking behaviors, learning a sit/stay command andavoiding engagement in emotional/dependent displayssuch as emotional greetings. Abrupt and momentouschanges may propel the severely anxious dog into adownward spiral, so these changes may need to begradually introduced over a 2- to 4-week period.Exercise is a considered to have beneficial effects on avariety of challenges and, if not already provided,owners should provide adequate daily exercise for theirdog.
Desensitize and Countercondition the Pet to the Leaving Routine
Many separation anxiety dogs are so sensitized to the pre-departure routine that performing any parts of that routine will trigger the anxious response. A commonly touted treatment goal is to reduce the predictive value and, thus, anxiety-producing quality of the steps in the owner's departure routine. This is done by performing the tasks without actually leaving and by pairing them with an activity that is incompatible with anxiety. For example, one owner is playing a favorite game with dog (fetch/tug-of war) and the other owner picks up the keys and puts them down again. Desensitization can also be performed without counterconditioning; the keys are just picked up and replaced without anything good or bad occurring. Some typical challenges with this training step include owners being too enthusiastic—they overwhelm the dog with pre-departure cues and make the dog an anxious wreck. It is critical that they AVOID producing anxiety and only do a few exercises per day. Giving the owners a definitive number of cues that they can perform per day (5) will help to limit potential disaster. Also, they must try to limit or eliminate their pre-departure cues during a “real†departure; otherwise the dog is likely to relapse. Since many dogs have very astute observational skills and owners cannot eliminate all pre-departure cues when they truly are departing, this step has inherent challenges. Unless there is a patient that is clearly, significantly reacting to a specific cue, the author does not spend too much time on this particular step but instead suggests that the owners prepare for departures so that they can avoid a harried, frantic departure that involves a lot of emotion (yelling/searching for keys, etc.). By keeping the overall tone of the departure calm, it may minimize the dog’s arousal.
Desensitize and Countercondition the Dog to the Departures Using Graduated Departures
The ideal program would involve avoiding all anxiety provoking separations either by daycare or full owner accompaniment while the dog is gradually acclimated to departures by slowly increasing departure durations. However, this is rarely feasible. So we are faced with trying to rehabilitate the dog while the dog continues to experience over-threshold anxiety-producing departures. To do this I recommend trying to clearly distinguish anxiety-provoking departures that the owner can’t avoid from non-anxiety-provoking training departures. One way to do this is to designate different locations for anxiety and non-anxiety (training) departures. If a dog is currently experiencing anxiety in a gated kitchen, then it would continue to be left in the gated kitchen for nontraining departures. Then the owners would do graduated training departures with the dog free in the house. Training departures require the owner and clinician to predict tolerance…then the dog is never left for periods that produce anxiety. For example, if the dog starts to show anxiety 5 minutes after the owners depart, then the owners should start training departures at 4 minutes. They are instructed to give the dog a long lasting food treat or favorite toy and then exit the home, returning at 4 minutes. They repeat several times (three to five) to ensure that the dog is comfortable with this departure length before increasing it slightly, eg, to 5 minutes. To avoid a linear progression, shorter departures should be interspersed with the longer departures. Once again enthusiastic owners need to be told that they can only do two to three training departures per day. That schedule suggests that it will take a long time to progress…and it will! These cases are not resolved overnight. With time the dog should be able to be comfortable with longer and longer departures in the training location. When the training departure duration is equivalent to a typical departure, then the dog is left in the training departure location for all departures. One challenge with this step is creating a delicious long-lasting food treat to leave with the dog at departure. Since these dogs are still somewhat anxious, a moderately tasty= treat may not be enticing enough to overcome that anxiety related anorexia. By their very nature, delicious treats (eg, cheese/hot dogs) are usually readily consumable. Puzzle toys can help to make a very delectable treat long lasting. The Kong was one of the first toys utilized in this manner— the hollow inside cavity was smeared with peanut butter and then stuffed with treats. Now toys specifically designed for slow treat dispensing are commercially available. The Busy Buddy line from Premier (www.premier.com) has several toys that allow for advanced treat management: Twist N’Treat and the Squirrel Dude are two great options.
