Home Cattery Staff Contact News Exotics Links Information
|
|
BEHAVIOURAL
DRUG THERAPY WITH RELEASE FORM How
are drugs used for behaviour modification in pets? A
number of drugs are now being used to treat pet behaviour problems.
Prior to their use it is essential to have a full behaviour history and
diagnosis. Drugs are indicated when
behaviour techniques alone are unlikely to improve the problem, in those cases
that have not responded successfully to behaviour therapy, or where it might be
difficult, impractical or dangerous to proceed without the aid of drugs.
For some problems drug therapy can be an essential component of the
treatment programme (e.g. compulsive disorders), or is indicated because of
underlying medical conditions (e.g. epilepsy, hyperkinesis). Which
drugs are licensed for veterinary use? Traditionally
there have been very few licensed drugs available for use in veterinary
behaviour therapy, with the exception of some of the sedatives and reproductive
hormones. More recently though, a number of different psychoactive preparations
have been launched for dealing specifically with some of these cases.
Still the majority of drugs are taken from human medicine; this means
doses, side effects and applications for animals have been extrapolated from
human use. Such drugs can be used
under the direct supervision of your veterinary surgeon but you may be required
to sign a form acknowledging your informed consent for such use.
Each behaviour case needs to be handled individually.
The appropriateness and choice of drug therapy is assessed for each
animal. Medications are specific for each pet and must not be
transferred to other pets in the home nor, of course, used by owners. Do
all behavioural drugs act by sedation? Many
of the behavioural drugs that have been used in the past are sedatives that have
broad effects and significant side effects.
Recently behaviourists have been turning to certain human medications,
which have effects on the individual that are more specific.
For example, by using anti-depressant medications we may be able to treat
certain fears and phobias without significantly compromising social, play or
exploratory behaviours. When
would drugs be prescribed? Before
drugs can be considered, in addition to the full behavioural history, the pet
must have a full assessment to rule out medical problems that might be
contributing to the behaviour problem, and to ensure that there are no
contraindications for drug therapy. Prescreening
laboratory tests including a general blood profile, urinalysis and blood count
may be required. Additional blood
tests including thyroid function profiles may also be indicated.
In some cases an electrocardiogram (ECG) is advisable.
For some drugs and some problems it may be necessary to monitor the blood
throughout the course of drug therapy. Since,
in most cases the drugs are intended to allow safe and effective implementation
of the behaviour programme, all aspects of that programme must be followed
diligently. Do not be scared by these extra tests, they may be just
precautionary and are aimed at safeguarding the welfare of your pet. Are
there likely to be side effects? Because
the use of the behavioural drugs in veterinary medicine is still relatively new,
many of the potential side effects are extrapolated from the human drug
literature. When used under careful veterinary supervision, the risk of
serious side effects is generally low and should be kept in perspective.
Just because a drug has several potential side effects, it does not mean
that there is necessarily a high risk of any of these occurring.
Your vet will aim to prescribe the best medication for your
circumstances. You should discuss with your veterinary surgeon the possible
adverse or side effects that could occur. If
you are concerned about any unexpected health or behavioural changes that
develop while your pet is on medication, please report these changes to your
veterinarian immediately. Antihistamines:
how are they used in behaviour therapy? Antihistamines
may be useful in behaviour therapy for their antipruritic (anti-itch) and
sedative effects. They have been used in pets for sedation prior to car travel,
for pets that are waking through the night, and for some forms of compulsive
scratching and self trauma. Antihistamines
are sedating, especially during the first few days of therapy, and are
contraindicated in pets that might be prone to urinary retention (e.g. prostate
disease), glaucoma, thyroid disease, heart disease, or liver disease. Anti-anxiety
drugs: how are they used? For
anxiety, urine marking, noise phobias, fear induced aggression, generalized
fear, waking at night, and some panic disorders, anti-anxiety drugs such as the
benzodiazepines (e.g. diazepam, alprazolam) can be used.
Because of their short onset of action and relatively short duration,
these drugs are primarily used for situations that might produce temporary
anxiety, and less frequently for long term on-going problems.
Potential dependency effects mean that gradual withdrawal is usually
recommended after continuous therapy. Liver
function should be monitored prior to, and during therapy with benzodiazepines
because of potential effects on the liver, particularly in cats. Benzodiazepines
may cause sedation and appetite stimulation, and some pets might even become
more agitated or anxious when therapy is first initiated.
These effects usually resolve within a few days.
In some cases, as pets become less fearful, there may be an increase in
aggression, especially between members of the same species.
Immediately report to your veterinary surgeon any unexpected changes in
behaviour, or any other changes such as decreased appetite or vomiting which may
be associated with a medical problem. Antidepressants: when are they used? Most
anti-depressants work by causing changes in a brain chemical called serotonin.
This chemical is vital in transmitting signals between brain cells.
Since each antidepressant has a somewhat different effect on the balance
of neurotransmitters in the brain, they have a number of different applications.
Antidepressants have been used to treat urine spraying in cats, urinary
incontinence, anxiety and panic disorders including separation anxiety, sleep
disorders and some forms of aggression. These
drugs are generally used on a moderately long-term basis.
They take from several days to several weeks to reach full effect.
Tricyclic antidepressants such as clomipramine and amitriptyline may
cause a dry mouth, urinary retention, sedation or constipation especially during
the first few days of therapy. So
don’t be surprised if your pet drinks a little more or has a little difficulty
in going to the toilet during this time. Additionally,
tricyclic antidepressants can cause tachycardia, an increase in heart rate.
For some pets an electrocardiogram may be advised prior to their use
depending on the age and health status of your pet.
Clomipramine is licenced in dogs for treatment of separation related
anxiety and is also used to treat some repetitive and compulsive disorders in
dogs and cats. Fluoxetine and
paroxetine may have fewer side effects and are less sedating.
They are most useful for compulsive and panic disorders but may also be
useful in the treatment of stress or anxiety induced inappropriate elimination,
and for some forms of aggression. In
humans, they may occasionally cause restlessness, agitation, insomnia, weight
loss and gastrointestinal upsets. It
can take up to a month for them to achieve their therapeutic effect. Progestogens: when are they used? The
female hormone, progestogen, has been used in the past to treat a variety of
behaviour problems. They have a
general calming effect, and can be used in the treatment of some forms of
aggression, urine marking, and compulsive grooming.
They are also used to suppress male behaviours such as marking and
mounting. Progestogens may lead to
a number of adverse effects including increased appetite and thirst, lethargy
and a tendency to gain weight. Potentially serious medical complications include
diabetes, suppression of the bone marrow, adrenal gland and immune system, and
breast tumor development. As a
result they have largely been surpassed by other more specific psycoactive
medications. Sedatives:
when are they used? Sedatives
have generalized effects on behaviour, caused primarily by sedation, as the name
indicates. They can be useful on a
very short term basis for the treatment of excessive vocalization, noise
phobias, sleep disorders and to control the anxiety and excitability associated
with events such as car rides, nail trimming or veterinary visits.
They are also effective in preventing nausea.
They are not recommended for long term use and are contra-indicated in
patients with seizures, liver disease or heart problems.
They can also lead to a dry mouth or urinary retention. Propranolol:
when is it used? The
human heart drug, propranolol can be useful in reducing anxiety without causing
sedation. The drug works primarily
by blocking some of the physical effects that accompany fear.
The heart rate is slowed, blood pressure is lowered, and the tremors,
sweating, or diarrhea that might be associated with the fear are reduced.
The theory is that if the pet cannot exhibit the physical effects of
fear, the behaviour signs are less likely to be exhibited.
Propranolol should not be used in pets with certain heart, respiratory or
liver problems. Stimulants:
when are they used? Stimulants
such as methylphenidate, are used for attention deficit disorders in people.
Although extremely rare, some dogs that have short attention spans, that
are difficult to train, display repetitive behaviours, or are extremely active
and have difficulty settling down may also have an equivalent disorder. Most
apparent cases of hyperkinesis are in fact just ordinarily overactive dogs.
Stimulants generally cause an increase in heart rate and activity level,
but in clinically hyperactive pets, they actually have the opposite effect,
leading to a calmer pet with a slower heart rate.
Anti-convulsants:
when are they used? Anticonvulsants,
such as phenobarbitone and some benzodiazepines, are used to control seizures.
Since certain parts of the brain control behaviour, a seizure limited to
any of these parts of the brain could lead to sudden and bizarre changes in
behaviour which come and go without any apparent stimulus.
If a seizure focus is suspected to be the cause of unusual behaviour,
anticonvulsants may be effective. Anticonvulsants
have also been used on their own, or in combination with other medications for
some anxiety, panic and sleep disorders, since they raise the threshold at which
nerve cells become excited. Selegeline:
when is it used? This
drug belongs to a group of chemicals known as MAOB inhibitors and is licensed
for use in dogs. The drug may be used to treat a number of emotional disorders
in the dog as well as certain behavioural manifestations of senility in older
pets. The drug helps to reduce the
breakdown of several neurotransmitters, so it has wide ranging effects, it also
protects brain cells through neuroprotective action. Nicergoline:
When is it used? This
chemical effects the turn over of neurotransmitters in the brain and improves
the activity of a chemical known as acetylcholine within the brain.
It also protects the brain cells from certain types of damage due to a
lack of sufficient oxygen. It is
licensed for the treatment of certain specific age-related effects in the older
dog but may also be used to treat some behavioural problems in the older dog
associated with senility e.g. loss of house-training. Practice name
and address:
............................................................................................. Telephone:
....................................................................................................................... INFORMED
CONSENT FOR BEHAVIOUR MODIFYING DRUG USE Pet’s name:
________________________________ Sex:
_________ Age: _______ Owner name:
.................................................................................................................. Owner address:
............................................................................................................... Telephone:
...................................................................................................................... I , the
undersigned, being the owner or duly authorized agent for the owner of the above
animal, understand that the drug
___________________________________________________ has not been licensed for
use in dogs or cats. I
have been advised that the drug is being used on an extra label basis and I
accept the consequences of its use. I
will not hold the veterinary surgeon responsible for any adverse effects, be
they physical or behavioural, that might arise out of the use of this drug.
I
have been advised of the potential side effects and adverse effects of the
medication, such
as:__________________________________________________________________ and
will discontinue the use of the drug and contact my veterinarian or the after
hours emergency hospital immediately should any adverse or unexpected effects be
exhibited. I understand
that the following laboratory tests need to be performed prior to drug use:
_____________________________________________________________________ I understand
that these tests should be repeated on: ___________________________ I
understand that this drug may not alter the course of the behavioural problem,
and that my animal may continue with the problem behaviour and may injure
itself, other animals or other people. I
hereby give my informed consent to the administration of this drug to my animal.
I accept full responsibility, legal and financial for all actions that
may occur from the use of this drug.
I
have been advised that a follow-up examination or assessment is next due on :
____________________________________________________________________
Signed:
____________________________________
Date: ____________________ |