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The Fearful, Anxious, & Worried Pet

Article · November 2015

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Theresa L. DePorter
Oakland Veterinary Referral Services
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Sponsored by an Unrestricted
Educational Grant from
Nutramax Laboratories
Veterinary Sciences, Inc.

November 2015

THERESA DEPORTER,
DVM, DECAWBM, DACVB
The Fearful,
clinical notes Anxious,
& Worried Pet
Oakland Veterinary
Referral Services
Bloomfield Hills, Michigan

A concerned client recently consulted me about anxiety

behaviors in her 3-year-old male neutered Labrador mix.
“The world seems too big for Ben,” she explained. The
comfort and ease that the dog displayed at home
evaporated whenever he walked a few blocks from his
yard. Ben would stop and frantically scan his surroundings
as if he sensed danger all around. He wasn’t disobedient;
he was afraid. He didn’t need training or authority, but
KEY POINTS rather compassion and understanding.
h Anxiety and fear in pets may develop
as a result of a complex interaction Empathy for Anxiety
of environment, conditioning, Anxiety and fear result from a complex interac- LEXICON
genetics, and neurological tion of environmental conditions, condition-
ing, genetics, and neurological adaptation. h Fear—a normal adaptive
adaptation.
Neurotransmitters, such as serotonin and response to the presence
h Empathy for the pet’s perspective is gamma-aminobutyric acid (GABA), influence of a specific stimulus (eg,
essential. how an animal responds to stressful situa- an object, noise, or
tions. Fear or anxiety may be appropriate in person) perceived as a
h Anxiety, stress, or fear may manifest some contexts (eg, being afraid of a bear) but threat1
as signs that may be difficult to detrimental in others (eg, hiding upon hearing
attribute to a specific trigger. the sound of ice cubes in a glass). The occa-
h Phobia—an intense,
sional startle isn’t unreasonable, but repeated maladaptive fear of an
h Anxiolytics, including nutraceuticals, overreactions to harmless situations suggest a object or situation that
are particularly useful for reducing failure to habituate to a benign stimulus. poses no real threat
stress when the primary stimulus
h Anxiety—the vague
cannot be completely controlled. Empathy, a sensitive and compassionate
apprehension to an
perspective of the pet’s distress, is essential
anticipated threat1
at all stages of diagnosis and treatment. Vet-
erinarians and clients must be sensitive to h Empathy—the action of
the pet’s perceptions of its current situation understanding and being
in the context of its collective experiences. sensitive to the feelings,
Often, the pet’s perspective of a worrisome thoughts, and experiences
situation may be underappreciated until the of another without having
signs have progressed to physical manifesta-
the feelings, thoughts,
tion of that distress.
and experiences fully
Dogs living with anxiety may suffer negative communicated
effects on health and lifespan that may be

1 Clinical Notes November 2015 November 2015 Clinical Notes 1

Sponsored by an Unrestricted Educational Grant from Nutramax Laboratories Veterinary Sciences, Inc.

owners only report the problematic manifesta-

tions, such as nighttime waking, destructive
SIGNS OF FEAR behavior, or excessive vocalization, without
AND ANXIETY3,4 recognizing these as clinical signs of anxiety.
h Pacing
Different animals may respond in different
h Panting
ways to the same type of stimulus, but the
h Yawning pattern displayed by an individual pet may be
very specific and consistent. My own cat,
h Lip-licking
Bacon, is wary of thunderstorms and fire-

1
h Averted gaze works. He often hides in the closet when he
h Vocalizing (barking or hears such sounds, but he recently lay down
in the middle of the hallway during a mild
whining)
storm. He rarely rests in that part of the hall-
h Avoidance d Bacon is fearful during thunderstorms and way, and I observed he was tense and vigilant
is seen here seeking refuge in a hallway far (Figure 1). The location he selected was
h Hiding
from all windows. Without empathy, he equally far from every window in the home—
h Increased activity might be perceived as just a cat resting in he was hiding in plain sight.
h Rigid, motionless posture the hallway.
In another case, Layla is a 10-year-old spayed
PHYSICAL female Pug that has been afraid of large black
compounded if corrective actions are misdi- dogs for years, reacting with screaming barks
MANIFESTATIONS rected.2 For example, Ben’s owner may have and squeals when she sees one. While out for a
OF ANXIETY considered using a prong collar to force Ben walk 6 years ago, she was suddenly attacked
h Drooling to walk if the dog’s behavior was attributed by such a dog, so her family tries to avoid such
to stubbornness instead of anxiety. Doing so encounters. Her owner can best assess Layla’s
h Stress-related anorexia
would have been detrimental, giving Ben yet anxiety, will have the strongest empathy for
h Stress-related elimination another reason to be afraid of walks. Empa- her distress and, ultimately, can best judge her
h House soiling thy for Ben’s fear guides family members to response to treatment.
make good training decisions and seek sup-
h Excessive licking or plements to reduce his anxiety. Diagnosis & Treatment
scratching Diagnosis is based on owner descriptions
h Pawing Manifestations of Anxiety and perceptions of the pet’s anxiety in
Anxiety may manifest as signs that are difficult response to identifiable triggers. Notice that
(attention-seeking)
to attribute to a specific trigger (see box). Own- none of the signs are unique to a specific
h Escape attempts ers who recognize their pet is worried will diagnosis or even a specific trigger.
(fleeing crate) report anxiety-related behaviors, but others
may inaccurately believe their anxious animals What is the trigger for anxiety? Your client
h Nighttime waking
are stubborn, jealous, or vindictive. Sometimes reports their adult housetrained dog is sud-
h Destruction denly eliminating inside the home. The dog’s
medical history is unremarkable, and physi-
cal examination and workup show no abnor-
malities. You recommend taking the dog
Veterinarians must be outside more and rewarding him for appro-
proactive and include priate eliminations. At the next appointment,
questions about behavior your client reports the dog has virtually
stopped eliminating outside and soils the
as a routine part of the house regularly. He refuses to eat his favorite
history-taking process. treats, is hesitant to leave the house, and now
has to be leashed in the backyard. Sometimes
his owner must drag him outside. While
standing in the yard, the dog is stiff and vigi-
lant, unable to relax sufficiently to eliminate.
He then wants to flee back into the home.

2 Clinical Notes November 2015

What is the primary cause of the anxiety? develop. In cats, chronic anxiety and fear
The underlying cause cannot be determined can also lead to secondary behavioral prob-
from the provided information. The initial lems, such as overgrooming, scratching,
trigger could have been fireworks, an spraying, and inter-cat aggression. The cat
encounter with a wild animal in the yard, or may become predisposed to health prob-
recollection of pain from a fall down the lems resulting from a compromised immune
stairs into the yard. Any of these triggers system.6 At the first sign of an anxiety disor-
could have provoked sufficient anxiety to der, the clinician should ascertain the diag-
cause a normal dog to avoid the backyard nosis and make recommendations for
and thus begin house soiling. behavior modifications and environmental
management.
Empathy & Early Intervention
Many of the clinical signs of fear and anxiety If warranted, an appropriate anxiolytic, includ-
are destructive and distressing to both pet ing pharmaceuticals, pheromones, and nutra-
and owner. Recognition, empathy, and early ceuticals, should be initiated. Anxiolytics are
treatment of anxiety are critical. Veterinari- particularly useful for reducing stress when
ans must be proactive and include questions the primary stimulus cannot be completely
about behavior as a routine part of the his- controlled (eg, noises, storms, grooming,
tory-taking process because less than half of walks, or veterinary visits). Nutraceutical sup-
owners seek veterinary advice when faced plements provide a comfortable early inter-
with an anxious pet, often turning to friends, vention option (see box). The goal is not Less than half of
the Internet, and breeders instead.4 Unre- sedation but rather the reduction of anxiety to owners seek their
solved behavior problems, such as house allow natural habituation. This optimizes daily veterinarian’s
soiling, separation anxiety, and aggression, experiences and allows the owner to direct the
cause veterinarians to lose approximately learning experience. By reducing the pet’s advice when faced
15% of their client base each year due to overall fear, anxiety, and distress, anxiolytics with an anxious
relinquishment to shelters and euthanasia.5 “open the door” to allow for successful learn- pet.4
Undiagnosed and untreated anxiety is likely ing during implementation of a behavior modi-
to worsen until significant clinical signs fication program.

NUTRACEUTICAL INGREDIENTS FOUND TO PRODUCE CALMING EFFECTS

h l-theanine is a structural analogue of the amino acid explain why these extracts produce benefits similar to
glutamate, the most important excitatory diazepam without the sedative effects.
neurotransmitter of the nervous system. Found naturally h Phellodendron amurense, more commonly called the Amur
in black, green, and white tea, theanine is uniquely cork tree, yields extracts rich in berberine, which has
palatable and lowers the stimulatory effects of glutamate demonstrated anxiolytic effects similar to those of diazepam
by increasing the levels of serotonin, dopamine, and GABA and buspirone. The combination of Magnolia plus
in the brain.7 Theanine also directly stimulates the Phellodendron extracts appears to be synergistic, controlling
production of alpha brain waves to create a state of stress and anxiety more effectively than either compound
relaxed daytime wakefulness and mental alertness that used alone.11 In one placebo-controlled clinical trial, the two
support a once-daily morning dosing regimen.8 Studies in extracts reduced noise-induced anxiety in beagles.12
dogs and cats indicate that theanine may ameliorate fear
h Alpha-lactalbumin is a purified extract from milk whey pro-
of humans,9 noise phobias, travel anxiety, and urine
marking. tein concentrate that is rich in the essential amino acid, l-tryp-
tophan, a precursor of the mood-regulating neurotransmitter
h Magnolia officinalis constituents have long been used in serotonin. Chronic stress and anxiety may lead to a depletion
traditional Chinese and Japanese herbal medicine. The of available concentrations of serotonin and tryptophan, caus-
plant’s extracts, most specifically honokiol and magnolol, ing serotonin to fall below functional needs.13 Alpha-lactalbu-
are thought to selectively bind to both synaptic and extra- min contains the highest tryptophan content (6%) of all food
synaptic GABA receptors to modulate the activity of neurons protein sources and has been shown to improve cognitive per-
overstimulated by fear and anxiety.10 This action may formance in stress-vulnerable patients.13

November 2015 Clinical Notes 3

Sponsored by an Unrestricted Educational Grant from Nutramax Laboratories Veterinary Sciences, Inc.

Conclusions
Because fear and anxiety and their underly-
SOLLIQUIN™ IS A DIETARY
ing neurologic milieu are so variable from
patient to patient, empathy and patience are
SUPPLEMENT INTENDED TO
important while the owner and clinician work SUPPORT BEHAVIORAL HEALTH
to identify the triggers. Pet owners may help IN DOGS AND CATS AND TO
the pet for whom the “world seems too big.” FACILITATE RELAXATION AND
Remember Layla? She barks frantically when WELL-BEING THROUGH THE
she encounters a large black dog. Layla SUPPLEMENTATION OF MULTIPLE
began taking SolliquinTM daily and a week NATURALLY DERIVED
later she came out of her veterinary appoint- INGREDIENTS THAT PROVIDE
ment, glanced at an unexpected black Great ANXIETY-REDUCING BENEFITS:
Dane sitting in the lobby, and walked by as if
that mighty dog wasn’t even there. She had h L-theanine
the courage to face the fears of everyday life. h Magnolia officinalis
Only her owners knew what an amazing
accomplishment this was for Layla; only her
h Phellodendron amurense
owners truly had empathy for her distress h Whey protein concentrate Remember
and could celebrate her bravery. (NMXSLQ05TM): a milk protein extract Layla? She barks
containing alpha-lactalbumin, a high-
A broad approach to environmental man- quality protein source that supplements
frantically when
agement and dietary supplementation can
10 essential amino acids including she encounters a
be beneficial for behavioral support. Use of large black dog.
cysteine and tryptophan
nutraceutical anxiolytics may provide a safe
and palatable option for pet owners as a Layla began taking
first-line intervention. SolliquinTM daily
and a week later
she came out of
her veterinary
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4 Clinical Notes November 2015

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