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• a paper given at the BVA Congress 20^th - 24^th September 1999
• Robin E. Walker BvetMed MRCVS writes

INTEREST IN canine behaviour has greatly increased over the last ten years. A greater understanding of problems has come with study of the ethology of the natural canine species and the increasing awareness of the emotional capacities of the mammaliam brain. The movement away from old fashioned and lamentably punitive styles of dog training and "habit breaking" has been accompanied by a very active interest on the part of the Veterinary profession.

A type of moral tyranny that expected animals to behave in a manner suiting the convenience and expectations of their owners is yielding to careful analysis of behaviour and recognition of causes of conflict and disaster. In just a few years the dog trainer's perception of the veterinarian as someone largely ignorant of the subject and likely to recommend euthanasia with alarming frequency has been changed. Increasingly people involved in all aspects of dog welfare, rescue, training and employment are looking to veterinarians for answers.

There is now a widespread recognition of the need for inclusion of behaviour therapy in the dog's veterinary medical records and that this is best achieved by actual referral of such problems by veterinarians.

Confused
There now exists a broad consensus that very few dogs are mentally diseased or of evil propensity but likely to be frustrated or confused by their circumstances. For example some breeds have very highly developed motivations to perform tasks. The unheeding owner who fails to give suitable employment or alternative activities to herding, hunting or retrieving breeds will often create severe emotional disturbance for the dog. The intuitive response of an exasperated or frightened owner of frequently unsuitable or may even precipitate disaster.

A partnership is emerging which is an alliance of veterinary surgeons versed in the nature of the emotional brain and affective neuroscience and behaviour modifiers or rehabilitators adept at discovering the needs of the patient. this knowledge increasingly permits the rational use of psychotropic drugs to ameliorate disturbances or emotion or mood in a manner that facilitates effective behaviour shaping by those with the time, skill and dedication.

This brief communication attempts to set out the most common problems, which result in the behaviourist seeking veterinary assistance. In the main the difficulties that hinder behaviour therapy are disturbances of fear control or reward capacity, which nullify the process of creating balance and contentment or prevent the learning of alternative behaviours.

Aggression
The most common problems confronting the behaviourist with seemingly intractable difficulties are longstanding phobias, frustrative rage, over attachment, reflex or addictive aggression and explosive (dyscontrolled) rage. The problem for the therapist is that the behaviours are stimulus bound and of such intensity that the owners cannot fulfil their own necessary role in the rehabilitation. The judicious use of psychotropic medicines can alter mood, modulate anxiety block panic and either restrain or enhance reward chemistry. The rational, however, is not a "cure" by medication but rather a facilitation of sound behavioural shaping techniques. The veterinary clinician must be alert to the complexity of emotional states and the often-paradoxical results of medication. Diagnosis by global labelling will not always suffice. An understanding of a given case will often evolve as the treatment progresses and co-operation between clinician and therapist must be of a high order. The health and wellbeing of both animal and owner demand no less.

Phobias
The clinician will often be asked to assist with a phobia to certain sounds such as thunder, fireworks, passing vehicles, household appliances and so forth. The reversal of eight years of phobia to a given sound, for example, is a challenge but not unusual. It must be accepted that recovery can take almost as long!

A most useful drug treatment is a combination of phenobarbitone at which propranolol (the beta-blocker) at a dose rate of 2mg per kg (of each drug) repeated twice daily. The phenobarbitone acts as an anxiolytic and the propranolol acts as modulator of memory. The beta-blocker acts within the amygdala reducing the intensity of the remembered emotional experience. Sound phobias are perhaps particularly distressing for the do, as there is no effective escape or relief.

Persuading the owners not to engage in contact with the dogs helps greatly. A den to which the dog can retreat is very helpful. It is the relative smallness of bathrooms and closets that appeals to the dog and the availability of mats to dig at in a futile effort to go to ground.

In order to alter the memory and significance of the noises feared, they must be endured for at least ten or more times whilst under the protection and modulation of the medication. To combine thunder fear reduction with fireworks fear reduction the dog may have to be on medication from April to end of November for about four consecutive years. It does seem vital that progress is not set back by repeated ambushes by the feared sound. Whereas the use of recordings of minor sounds such as smoke alarms, beepers, cap guns etc can be very helpful absolutely no artificial agency can reproduce the huge vibrations and reverberations of thunder. It would seem that the house itself becomes a reinforcer of the fear and violent attempts to escape may ensue. Associations with places or situations from which escape is successfully and repeatedly made will complicate the process of habituating the dog to the feared noise. In these instances the intense reward or relief achieved by the avoidance or escape may become almost addictive.

Frustration
In certain breeds and individuals the motivation to perform specialised routines such as retrieving or herding may be so intense that a form of frustration ensues when no opportunities for work or appropriate play exist. this situation will be made very much worse by punishment to the behaviour in question. Unequivocally clear instances abound where retrievers have been taught to become aggressive by repeated punishment of their innocent compulsions to retrieve anything and everything. Some very severe attacks upon owners by their dogs can be explained fully in this way.

The most effective use of serotonin enhancing diets seems to establish that some dogs are deficient in reward chemistry and suffer frustration from the inability to achieve contentment or learn tasks. The use of serotonin or dopamine enhancing medications can alleviate severe frustration and facilitate training of rewarding routines and successful task completions. Some of the most dramatic and satisfying results of combined medication and training attend these types of frustration problems.

Separation or over - attachment problems
Sometimes labelled as anxiety although the problem is one of bonding and the pain of isolation in the young and susceptible. Extensive research and comparison across species has shown that attachment and intense drives for social contact involve the opioid chemistry of the brain. Complications of isolation distress are depression and panic according to the temperament of the individual. Associative anxieties and even aggressive attempts to regain or maintain the bond can add extra problems.

Experimentally morphine and its derivatives reliably alleviate separation or isolation distress. Effectively the serotonin re-uptake inhibitors such as clomipramine and fluoxetine similarly reduce the discomfort and block the panic. It is vital that such respite is combined with a process of "emotional toughening" or training of clearly signalled time-out to develop independence and tolerance of periods of isolation. The services of an indefatigable and immensely persuasive behaviourist are indispensable.

Stimulus bound aggression
Typically this involves the dog that consistently flies at other dogs or people. The dog may have started as fearful and discovered that attack is the best means of defence. The behaviour may have become almost addictively enjoyable. Medication in these cases may be of help in reducing elements of fear or frustration in the motivation but this is the opportunity for long, patient rehabilitation by a process of line control and finely tuned exposure. The owner is taught not to exacerbate the behaviour and to reward the desirable alternatives. This seems to be by common consent the most challenging area for the therapist. The time scale may be months but the most (apparently) irremediably savage dogs can be transformed.

There seems to be little doubt that some dogs show behaviour that could be associated with something like "kindling" in humans. These dogs will have an array of signs that are variously described as "pyschomotor seizure" or "partial complex temporal lobe seizure". The symptoms may be hallucinations, sudden panics, and repetitive licking, circling, pouncing routines. Apparent inability to recognise their owner's faces or obsession with reflecting surfaces may be observed. A growing body of research is illuminating the effects of kindling in opioid enhancing and receptor upregulating, auto-addictive events in the brain. The effects of medication and the counterbalances of oppositional brain chemistry have relevance for understanding these cases. The various manifestations rapidly become stimulus bound and can be evoked by the environment or movements of the owners. The treatment I have used with some considerable success is phenobarbitone. This controls the hallucinations, bursts of fear, and strange vocalisations reasonably reliably.

However, the interruption off the seizure triggering may leave the individual in "withdrawal" literally and frustration can ensue. Quixotically phenobarbitone or any other GABA agonist can enhance this frustration as these drugs inhibit the limbic cascade of reward chemistry. This may explain the failure to prevent explosive rage episodes even though most of the symptoms are controlled.

The crucial element is the discovery of all the "cues" (vide giving up addiction to nicotine) and avoiding or removing them rigorously so that "extinction" or the "learned" (rewarded) behaviour patterns can proceed.

Currently the use of carbamazepine (Tegretol) is being investigated in this type of case, which can be both disappointing and dangerous especially in the "bull terrier" breeds.

The feasibility of rehabilitation and the long-term medication that may be needed and the determination to organise the extinction process are severe tests of an owner's courage and personal qualities.

Paradoxical effects of medication
In general the effects of medications upon mood and pleasure must be considered. The tendency of a given drug to increase or depress reward intensity may have a greater relevance in a given therapy that might be expected. If the proposition that a basal mood condition called "resting contentment" exists then we may postulate that reduction of reward intensity might induce euphoria or even manic over-reward.

Thus GABA agonists such as phenobarbitone can increase frustration in isolation and even aggressive outbursts. Where an unwanted behaviour is intrinsically rewarding the action of a reward enhancer such as clomipramine, fluoxetine or l-deprenyl might make matters worse.

The diagnostic challenge
Rather than reaching for a traditional label for a given behaviour it might seem better to attempt to discover the emotional state of the animal and its reward status. Careful selection of a medication can then be made with due warnings to the client of possibly paradoxical effects. On occasions the response to a medication may be diagnostic. The spinning, wall licking, fly catching dog that does not respond to medication may have learned to use the behaviour to engage the owner's attention. Aggression or solicitation of contact of a dog on phenobarbitone of diazepam might reveal a frustration that promptly responds to serotonin enhancing diet and clomipramine.
Dogs Worldwide.com - This article has been reproduced courtesy of Robin E. Walker BvetMed MRCVS a paper given at the BVA Congress 20^th - 24^th September 1999

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