Prescribing Behavior Medication
Through the years, I have found that many pet owners are reluctant to start their pets on prescription medication to help mitigate behavior problems. They often cite that they are concerned about the medication changing the pet’s personality and I often hear “I don’t want my dog doped up”. Some voice concerns that they feel there is a social stigma if their pet is on behavioral medication. Others state they want to use medication as a last resort.
Certainly, not every behavior case requires medication, it depends on the severity. In mild to moderate cases we can achieve an acceptable outcome by relying on environmental management and behavioral modification alone. However, in severe cases, I have to give a poor or grave prognosis if the owner elects not to use medication. In general practice, I hear almost every day, “I do not want my pet to suffer”. These are owners whose pets have some form of a terminal or chronic illness, but I will argue to my behavioral patients and victims of my behavioral patients suffer. I have treated repeat offender dogs for multiple dog fights, often requiring surgery. Emergency vet visits are costly and the outcomes are not always good. Dogs with separation anxiety suffer every day from the time their owner leaves to the moment they walk in the door. These poor dogs can break their teeth and bloody their feet trying to escape. The point is that animals with behavioral problems suffer, often for their entire lives.
For those clients who are concerned that medication may change their pet’s personality, I kindly remind them that there are obviously parts of their pet’s personality they WOULD like changed otherwise they wouldn’t have called upon my services. I rarely prescribe medication for the duration of the pet’s life. Once the problem has resolved, the goal is always to wean the pet off of medication.
For the clients who do not want their pets “doped up”, I am in complete agreement. My objective is to bring the pet’s stress down to a level that allows learning a new way of coping. If a pet is in the fight, flight, or freeze mode, the only thing that is learned is avoidance. Neurotransmitters, hormones, and peptides released during stress block nerve cells’ ability to manufacture proteins. On a molecular level, learning is all about manufacturing proteins in the brain. With that said, I don’t want my patient too relaxed because very little learning happens at that level either. I am looking for the sweet spot, a level where there is a little bit of stress. We have all had to study for an exam at some point in our lives. When the exam is weeks away it is hard to start studying and give focus and attention. The closer the exam gets the more focused we become. However, waiting until the last minute and staying up all night cramming often results in poor test performance because we have moved out of the “sweet spot” and are moving closer to fight, flight, or freeze mode.
When I reach for medication, my goal is to get the pet to the perfect level- not too stressed, not too relaxed but to quote Goldilocks “just right”. Because every pet is different and there is not one dose or drug that fits all, it can take some medication adjustments to get to the optimal level.
For clients who are concerned about the social stigma of having their pet on medication, just keep it a secret. No one has to know. If I have a patient with a kidney problem that I could prescribe a medication that would heal the kidneys and make them work better thus extending the life of the pet, most owners would not hesitate to administer the medication. Why should the brain be different? Most behavior problems stem from fear or stress. These pets live their life flooded with stress hormones. There is no question that chronic stress leads to a shorter life. Stress hormones weaken the immune system and make people and pets more susceptible to disease including cancer. On top of that, behavior problems are the leading cause of death in healthy patients. All too often, behavior problems are ultimately solved by euthanasia.
In my many years of practice, I have never had a client state they regretted starting their pet on behavior medication. I have had many who state that they only wished they had started it sooner.