VetInfo Digest            November 2001

This Month:

Behavioral Medicine

    General Information

    Aggression in Dogs

    Aggression in Cats

Pilling and Cats

    Avoiding Esophageal Strictures

 

This Month's Note:

In the aftermath of the September 11 terrorist attacks I received a number of emails in which people expressed the feeling that it was somehow wrong to be worrying about a pet when such terrible things were happening to people around the country.

I feel very strongly that the best hope for the future of the world comes in having more love to give and not less. Taking on the responsibility to care for another being is good, whether that being is human or otherwise. Not caring for others is what we should fear.

I hope that our web site and newsletter contribute a little to greater understanding and greater communication in the world. I hope that each of you feels a little pride for helping us make this very small effort possible. Please do not feel that loving your pet is somehow wrong. Friends come in many shapes, many sizes, many colors and many nationalities and learning to care for one friend helps you to be prepared to care for more friends, not less.

Behavioral Basics

Behavioral medicine is an area that I have many questions about and not a lot of firm answers for. This month I would like to present some basic information that seems to be pretty reliable. It is a small amount of information compared to the amount that is not known and I am pretty sure that some of what we feel we understand today will be understood in a different way in the future. However, I hope that you find what I can present with some confidence useful. Just as with the previous newsletters on cancer, it is necessary to explain a little bit about basic behavior and then to address medications and some more specific behavioral treatments in next month's newsletter.

One of the reasons that behavior is hard to understand clearly is that mammals have complex hormonal and neurologic interactions and it is unclear at this time exactly what effect each neurotransmitter, modulator of neurologic transmissions and hormone has on individual behaviors. For a long time it was thought that one of the major problems with behavior is that the body tries to respond to all stressful situations with a limited number of hormones, making the response seem similar in all cases. As more and more chemicals that have some effect on the brain and nervous system are discovered, it seems more likely that the reactions to stress and stimuli are actually complex. However, this still doesn't rule out the possibility that there are a few major modulators of behavior with many lesser modulators. In this situation, the individual responses to different behavioral situations might be viewed as similar but distinguishable if enough information is known. Someday, we might really have a clear understanding of the physiologic actions that lead to a particular behavior occurring and be able to moderate that effect specifically. At this time, for most situations, we are still in the trial and error period of medical knowledge in behavioral medicine, both in pharmacologic treatment and in behavioral modification.

I think that it is important to remember that domestic pets and humans use similar hormones, neurotransmitters and neurologic modulators to manage their behavioral states. There is undoubtedly some variation in the influence of these hormones based on the patient's logical ability and intelligence but these effects are extremely hard to understand, particularly in patients we can't communicate with well enough to ask them questions. To some extent, treating behavioral problems in pets will always involve guesswork.

Cat behavior is different than dog behavior and the common concerns among cat owners are usually different than those of dog owners. For dog owners the most common behavioral concern is aggressive behavior, followed by separation anxiety. For cats, elimination behavioral problems (house soiling and spraying) is the primary concern, followed by aggression. While there are different problems, thinking about the basics of behavior can be helpful in understanding what is happening and it is important to keep in mind the species when doing this. Human behavior comes into play in the relationship between dog and cat owners and their pets, as well. As we all know, human behavior is not easy to change, either.

Cats are not as antisocial as has sometimes been reported. Feral cats often choose to live in groups but the rules among group members tend to be different than they are for dogs. Cats tend to live in groups more often when the food supply is good. The social structure leans more towards mutual cooperation and mutual benefits than it does orderly behavior from top to bottom. Despite living together, cats tend to be solitary hunters and appear to have sophisticated signaling to prevent overlapping of each other's hunting territories within their group. Female cats are more likely to live in the groups and will even provide baby-sitting for or nurse female companion's kittens. Male cats will sometimes coexist within a group without problem and often tend to be close associates with each other in this situation. Among cats it is not unusual to see an individual cat have a definite preference to spend time with one or two other cats in a group. A band of cats resembles a group of cliques due to this tendency, although there is often some dominance ordering, at least when judging access to preferential spots and the best hunting or foraging territories. So it seems reasonable to state that cats are social creatures and that they seek out social relationships. They just don't do it the same way that dogs do.

Dogs have long been recognized as social creatures, probably because dogs tend to seek out structured relationships and seem willing to accept these relationships with other species, as well. All dog breeds are believed to have descended from wolf ancestry. This means that a pack relationship is the base from which dogs tend to operate and that there is a strong tendency towards predatory behavior when dogs can interact in groups. In order to prevent constant damage to pack members, a ritualistic signaling system exists among dogs. Positioning of the ears, tail and lips contributes to signaling behavior, along with eye contact, stance and mounting behaviors. Signaling in dogs is sophisticated enough that there are even signals that indicate the meaning of signals to follow. Dogs who lower their front half, lower their head and raise their hips in a gesture referred to as a "play bow" are signaling that they are about to start play behavior and that further actions, including normally aggressive acts, should be interpreted as play. Obviously, there is more room for misinterpretation among dogs when signaling reaches this level and some dogs won't recognize play behavior for what it is. Dogs tend to exist in a structured group in which there is one "alpha" dog who controls the pack behavior to a large degree and then varying degrees of dominance among subordinate dogs, so their social structure does tend towards orderliness, with a top to bottom power structure in place.

Humans have caught on to the idea that they can act as the alpha member of a pack but do not usually understand how to maintain the proper signaling or to respond to challenges to their authority. Many times people don't even recognize that their authority is being challenged, until the situation becomes difficult to reconcile. On the other hand I think that a lot of people make their relationship with their dog difficult by trying too hard to be dominating. Each of us tends to view what happens in life based on the way we were raised and our expectations for what social arrangements should be. Most of us have found ourselves in some situation in which our understanding of the social structure didn't quite match the existing organization. Usually it is possible to adapt enough to apply the set of rules we are used to using to the new social circumstances without totally abandoning them. I think that this is what dogs must go through when trying to live with humans. They have an innate desire for a certain structure and when they find themselves in a situation in which they don't get the exact feedback they expect, they adapt to the circumstances by trying to apply as many of their innate rules as possible and only abandoning those that don't seem to be working at all. So most relationships with humans are probably some sort of hybrid between what the human expects and what the dog expects.

There are a few pointers on social behavior among dogs that might be helpful in understanding your dog, or dogs that you meet in the future, though.

A wagging tail is not necessarily a sign of friendliness. The height that the tail is carried is a little stronger indication of how the dog feels about its interaction with you. An elevated tail is more likely to indicate the dog feels equal or potentially dominant and wagging in this case may indicate annoyance at your inability to recognize that fact. This is especially true if the dog is making strong eye contact, has its ears tilting forward toward you or if the hair along its back is standing up at all. At first, these gestures are just the dog's way of signaling its intentions. Aggression may or may not follow aggressive displays.

A dog who approaches you with its tail lowered is usually telling you that it is willing to take the submissive role and tail wagging is usually just a further sign of this in most cases. Fear based aggression can still occur when a dog is trying to signal that it is submissive, though. This is particularly true if the dog is trying hard to signal submission and the human it is interacting with continues to provide strong signs of dominance, such as rolling the dog over. In this situation the dog may decide that since following proper protocol didn't lower the level of aggressiveness the only alternative is to defend itself. Submissive dogs tend to hold their ears in a low carriage and not to rotate them forward, as well. Most dogs who "grin" when approaching you are signaling submission but this has to be distinguished from baring the teeth, in which the lips are not pulled back at the commissures (junction of the upper and lower lips on the cheek) but just elevated to show the teeth. Dogs that elevate the lip without pulling up the commissures are threatening you and the threat should be taken seriously.

Some of the normal signs of submission and dominance in dogs are hard for humans to fathom and difficult for humans to separate from behavior that occurs for other reasons. Submissive dogs often urinate when approached by a dominant dog or a human. This is normal behavior and can be difficult to change, as the submission is often a strong personality trait. Mounting behaviors can occur due to sexual frustration but are more often associated with a display of dominance in dogs. Dominant dogs mount their companions to demonstrate their dominance. The circumstances in which mounting occurs can be a big hint as to its underlying meaning. Consider dominance mounting as highly probable in situations in which there is interaction between dogs and humans, though.

Pets do not have the ability to associate "after the fact" punishment with an event. There is no effective way to punish a dog or cat for urinating in the house if you do not catch the pet in the act of urinating, for instance. The same is true for destructive behaviors, for aggression or any other behavioral problem you are attempting to deal with. If you can not set aside the time to ensure that you catch the pet performing the objectionable behavior you will almost certainly be unsuccessful in training the pet. Behaviorists recommend using the "one second" rule. If you can't administer punishment or a deterrent within one second of the action you want to stop, do not attempt punishment. That is the length of time that you have to be sure that the pet can really connect the punishment to the event.

If you can not provide a consistent response to objectionable behavior there is a also a good chance the pet will not be able to understand what you want. Some of my clients really believe that their pets should be able to discern between times it is acceptable to act in a certain way and when it is not. It is not likely that your pet will catch on to subtle differences. I have had pet owners who really thought their cats should be able to tell which birds they were allowed to hunt or that their dogs should be able to distinguish between chasing away stray cats and chasing the neighbor's cats. It takes a lot of careful training to teach a pet this sort of subtle difference between an acceptable and unacceptable behavior.

Dogs and cats are probably not capable of having really complex behavioral reactions such as guilt. An awful lot of people believe the their dogs act guilty when they come home and find urine spots, stool in the house or evidence of destructive behavior. There is good evidence in veterinary behavior literature to suggest that dogs do not really understand that the act of urinating or defecating in the house while their owner is away is the cause of the reaction by their owner when they come home from work and find urine or stool in the house. The dog just learns that when there is urine or stool and the owner is present, that the owner is not going to be happy. The dog then responds by showing submissive behavior to try to ward off the expected aggression from its owner and the result is an appearance of guilt. Many people with more than one dog notice that both dogs look guilty when there is an accident in the house and they come home. In most cases only one of the dogs actually did urinate or defecate, but both have come to recognize that the presence of stool in the house brings an angry response from the pet owner. There may be some dogs who are more sophisticated than others in their understanding of this sort of situation but it is best to assume that your dog isn't one of them when trying to reestablish housetraining, though.

Urine marking is a normal part of behavior for both dogs and cats. This is one of the reasons that it can be frustrating to control. There appear to be some differences in why dogs and cats mark, though. Dogs seem to use urine marking for establishing territorial rights and as a canine message system, sort of an "I was here" graffiti message. Cats may urine mark for a number of reasons. There is evidence that cats urine mark when in groups as an aid in keeping hunting territories separate. Urine marking can be intense when there are territorial conflicts but it also seems to occur in situations in which cats seem to be establishing "friendly" territory. Intact cats may urinate to indicate sexual availability. There are situations in which researchers have simply been unable to explain the purpose of urine marking entirely, which may mean that cats don't always apply a meaning to urine marking or that the meaning is subtle enough that an observer has a hard time guessing why the marking occurred. It is unclear why neutering decreases the incidence of urine marking among both dogs and cats but it does decrease urine marking about 80% based on the studies done so far on this behavior.

Cats display some behavioral signals that can be helpful in discerning their mood or the potential for an aggressive response from them, as well. Most people are familiar with the frightened "Halloween Cat" look of an arched back, hair standing on end, erect ears, hissing, with visible claws. This is the classic frightened and potentially aggressive cat but fortunately we don't see this total package very often. A cat intending to be friendly generally approaches with its tail up in the air, its head in a neutral position and with some confidence. The Halloween cat will also have its tail erect but the rest of its demeanor is clearly different. A cat intending to be aggressive may have its head held higher and often the head is moving slowly from side to side (head wagging). The ears are erect and the first part of the tail is elevated but then the remainder droops. Cats will sometimes growl and vocalization should be taken seriously in cats. Cats who are fearful of a person or another approaching cat usually hold their ears back and down, their tail down, they often crouch low and seem "scrunched up". Given time to do so, these cats will usually just avoid a confrontation by hiding or moving away from contact. For some reason, people tend to ignore this obvious clue and pursue frightened or submissive cats, making the cat feel defensive and pushing a controllable situation over the edge.

Frightened dogs sometimes come to their owners for reassurance but frightened cats rarely do this. Their instinct is to run away from the danger or to hide from it. If your cat ever does get loose outside the veterinarian's office or on a trip, it is really important to keep track of where it goes but to try to give it enough distance to remain calm (if the situation permits this), until it finally either stops showing signs of excessive fear or chooses a place to hide where it is possible to approach the cat slowly. Chasing cats or standing still and calling them while allowing them to disappear will make it very hard to catch the cat. When a cat escapes its carrier it is important to take action right away but not to overdo it. If you remain calm and keep your cat in sight, the situation will probably be resolved successfully.

Animal behavior, like human behavior, is strongly influenced by the circumstances it occurs in. Almost all dogs and cats will bite if the situation is stressful enough. An injured pet is very likely to be severely frightened and it is particularly important to be careful when handling pets when they have been injured. Approach an injured pet slowly and if it is necessary to lift or move the pet consider applying a muzzle or otherwise restraining the pet from biting. While this is a very short term behavioral problem it is important to remember that behavior will not always be normal in extremely trying circumstances.

If your dog or cat is likely to be stressed by a visit to the vet, take the time to make sure the visit will be as calm as possible. It is not a good idea to bring several children when a nervous pet goes to the vet. If you find that your voice rises and your stress level is immediately apparent when you are with your pet at the veterinarians, it may be better to have another family member handle the office visits if your pet is also nervous. If your pet has a history of aggression at the veterinarian's office it is best to remind the staff of that with each visit so that they can schedule visits when the best staff members for dealing with the aggression are present and when the clinic is best able to give full attention to your dog or cat.

While I think that pets have a wider range of emotions than many behaviorists will admit to, I do think it is important to remember that pets are not human and their behavior can't be viewed in the same way as human behavior. Keeping this in mind can be very helpful in understanding and treating pet behavioral problems.

Aggression in dogs

I can't really give you a good plan for dealing with aggression in dogs. Whenever it is possible, it is best to have the help of a board certified veterinary behaviorist when dealing with aggression directed towards humans. A certified animal behaviorist is another option. Some general practice veterinarians are good at treating behavioral disorders but if your vet is willing to assist, try to evaluate the level of care they are offering carefully. To treat aggression properly a complete medical history and behavioral history should be taken. There should be a plan that involves behavioral modification and possibly medications. Just using medication alone is not likely to be successful.

It is always a good idea to consider pain relief medications when older dogs suddenly become aggressive. Pain can make life miserable and some dogs respond by getting grumpy and biting when it has not been part of their past behavior. A few days of good pain relief can make a big difference and may also point out the need to deal with the underlying cause of the pain more effectively, as well.

If an underlying medical cause can not be found for the aggressive behavior and it really does appear to be a behavior problem, there are some things that it is necessary to think about before making the commitment to deal with aggressive behaviors in dogs. These are worth reviewing because it is best if you have thought about them prior to making an appointment with a veterinary behavior specialist.

All treatments for aggressive behavior in dogs are considered to be experimental at this time. There are no approved medications for aggression. Unless our legal system changes dramatically, there never will be. Why would a drug company produce a drug that they are almost guaranteed to be sued over when it fails to produce the expected response?

Behavioral modification protocols are also experimental in nature. Your veterinarian will almost certainly want your signature on a form that certifies your understanding of the uncertain nature of behavioral treatments for aggression. Read the form. Sign it only if you are truly comfortable making a sincere effort to control aggression and to protect your fellow human beings or neighborhood pets from an aggressive pet for the rest of its life.

Aggression in cats

Aggression in cats is a little easier for us to deal with, mostly because it is less likely to involve attacks on humans, which usually allows a little more flexibility in dealing with the problem. One situation that does seem to occur with some frequency is biting related to petting the cat over its back area. While this may be a behavioral problem it can almost always be stopped by avoiding petting in this region or by avoiding petting entirely. There is some argument about what initiates the biting in these cases but it is fairly easy for people to avoid being bitten, in most cases.

Previously I said that cats are social creatures. While this is true, it doesn't mean that they will always readily accept the companionship of a new cat or that adding a cat to a group won't result in fighting as the new cat seeks to find a place in the group.

When it is time to add a cat to a household there seem to be two approaches. Some people just bring the new cat home, set it free in the house and hope for the best. While this works a surprising percentage of the time, when it doesn't work it can set the cats up for a long term problem. The alternative is a planned introduction of the new cat to the household. This is probably the better approach when it is possible.

If it is possible to keep a cat that will be introduced to the household in a separate room for a few days this can be very helpful. When introducing one cat to one other cat, it can help to switch the living quarters daily for a few days so that the cats get used to each others presence through smells and sounds before actually meeting. We have found that spraying Feliway (tm) around the house can be very helpful when introducing cats. This is a synthetic pheromone product that mimics the "friendly" pheromones secreted by the cheek glands of cats. Another way of spreading this pheromone between cats is to rub a towel over the cheek and head area of each cat and then over the other cat.

Using a pet carrier or cage to keep the cats separate when introducing them can work in multiple cat households. Putting the new cat, in its carrier, in a room with the other cats while you are there to supervise can allow the cats to get used to each other while the new cat can still feel relatively safe in his protected environment. Porches with screen doors can work well as separation points, as well When the cats are physically introduced it can be helpful to have enough people around to make sure they can be separated if things go very badly. Instead of trying to handle fighting cats it is best to have something you can use as a moveable barrier, like a sheet of cardboard, to separate the cats and move at least one to a safe area.

It seems odd, but we get lots of calls about cats who come to the hospital for the day and then are rejected by another cat in the household when they are taken home, despite no prior history of trouble between the cats. Usually, if things really were OK between them it is possible to separate them a day or so, use the toweling technique to reintroduce their scents and then to gradually let them have access to each other again. If this doesn't work you may have to treat the problem longer term.

Sometimes cats who have lived together a long time suddenly decide not to get along. Once in a while it is possible to understand why this might have occurred, such as a change in groups that interact or the death of a previously friendly and protective cat. In other instances, it just seems to occur for no reason. If there is one aggressor cat and one cat who is the continued victim of aggression, the problem can sometimes be resolved by punishing the attacking cat. This usually only works if you can devise a way to administer punishment that will break off the attack and to use as the cat just makes up its mind to attack or within a second of the initiation of the attack.

Aggression between cats is one circumstance in which medications can really be helpful. Oddly, it is sometimes more beneficial to treat the cat being attacked than to treat the attacking cat. There really seems to be an inciting factor for attacks in fearful actions from another cat. Using an anti-anxiety medication to treat the cat who is attacked can lessen the fearful actions and decrease the frequency of attacks. One of the anti-anxiety medications, buspirone (Buspar Rx, 2.5 to 7.5mg/cat every 12 hours) sometimes causes an increase in aggression in the cat who was previously victimized, but when the cat who is attacked suddenly responds in an aggressive manner it may stop future attacks. There is some risk of one or both cats getting injured if this occurs, so it is hard to look at this as a consistently positive response to buspirone but it can be helpful in some cases. Alternatively, selective seritonin re-uptake inhibitors (SSRIs) like fluoxetine (Prozac Rx, 0.5 to 1mg/lb once a day) or paroxetine (Paxil Rx, 1/8 of a 10mg tablet per day) can be used to decrease aggressive tendencies in the cat who makes the attacks and will also sometimes be helpful in controlling aggression between cats.

Next month there will be information on specific behavioral problems in dogs and cats and information on medications used for behavioral therapy.

 

Pilling the Cat --- and Maybe the Dog, Too!

There has been a recent study on how capsules pass through the esophagus of cats that is receiving a lot of attention in veterinary circles. Dr. Donald Westfall and colleagues at Colorado State University (Journal of Veterinary Internal Medicine, Sept/Oct 2001) showed that it can take longer than five minutes for a dry capsule or tablet to pass from the mouth to the stomach of a cat. While the greatest length of time it can take wasn't addressed in their study, it may be considerably longer than five minutes, as that was the maximum time studied. When approximately 6cc of water was administered after giving tablets or capsules, the transit time was markedly improved, with 100% passage of the pill or capsule in 1 minute. Of course, your cat is not going to take a sip of water with its pills and capsules, so water must be given with a syringe or other device. While this definitely complicates giving medications, there is at least one case in which it is really important to give water after administering a capsule. In separate observations, veterinarians at CSU also reported that they are seeing esophageal strictures (scarring) after administration of doxycycline to cats and that in some cats the scarring is serious enough to cause death (Lappin, Oct 2001). It seems logical to assume that this is partially due to the slow transit time for capsules in cats. Therefore, if doxycycline must be administered in capsule or tablet form to your cat, you should get a syringe from your vet and administer approximately 6cc of water after the capsule. I know that this will be difficult but it could be very important for your cat's health. It would not be a bad idea to consider administering water after giving any pill or capsule, since it seems as if it may be uncomfortable to have a retained pill or capsule in the esophagus even if it doesn't contain an irritating medication. Giving food may also work if your cat will eat following pill administration, as this was successful in improving pill transit time in a study reported in the American Journal of Veterinary Research by Graham, et. al. in June 2000.

An alternative would be to have irritating medications such as doxycycline compounded into a gel or liquid that could be administered to your cat. There are compounding pharmacies in many areas of the country now.

It is reasonable to assume that the slow transit time for dry pills and dry capsules in cats also applies to dogs, although this has not been studied. It wouldn't be a bad precaution to give water to dogs after administering pills or capsules, either.

 

Last month, when reporting on algorithms, I forgot to explain why I thought pet owners should be aware of algorithms. It helps a lot if you know that there is a plan for finding a diagnosis starting from a particular symptom or lab result. If your pet has a difficult problem to diagnose, ask your vet to explain the diagnostic plan or algorithm that has been followed, or will be followed, to get to a diagnosis. If steps have been skipped in the plan, it may be necessary to go back and start the plan again. In some cases, even though the steps have been followed it is worthwhile to recheck lab results or clinical history to ensure that changes do not point towards a different path in the algorithm. I hope to put more algorithms online and in future newsletters to help clarify diagnostic procedures.

 

Thanks for Your Support!

The VetInfo Digest is published by TierCom, Inc., P.O. Box 476, Cobbs Creek, VA 23035. The opinions expressed in this newsletter are those of Michael Richards, DVM., author. Please send e-mail for Dr. Richards to mervet@inna.net

Copyright 2001, TierCom, Inc.

This page was last edited  06/21/04

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