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Owner attitudes regarding behavioral medications

Image by Charles Thompson

A heartfelt thank you to two of the researchers—Karen van Haaften, DVM, DACVB and Emma Grigg, PhD, CAAB —for sharing their feedback for this blog article!

Behavioral— or psychoactive— medication can be an important aspect of treatment for behavior issues in dogs. Many of the readers are probably more familiar with the term ‘behavioral’ medication than ‘psychoactive’ medication. Study co-author Dr. Karen van Haaften shared why she feels psychoactive is a better term:

I prefer the term ‘psychoactive medications’ over ‘behavioral medications’. To me, referring to them as ‘behavioral medications’ sets up the expectation that these meds are being prescribed to treat specific behaviors, when, in actuality, we are aiming at treating the underlying emotional states that drive some problem behaviors.”

Still, some clients may be confused or put off ‘psychoactive’, so, with clients, Dr. van Haaften uses the term ‘anxiety-reducing medications’ instead.

Some of you may be veterinarians or veterinary staff and may deal directly with the issue of recommending and prescribing psychoactive medications. However, even those of us not in a position to prescribe medication almost certainly work with dogs that have already been prescribed psychoactive medications or who would potentially benefit from them. It is helpful for us to understand what potential concerns dog owners have about using these medications for their dogs. A recent study by van Haaften et al. (2020) examined how dog owners feel about both prescription medications and their alternatives (pheromones, herbal and nutritional supplements, and cannabinoids) for the treatment of behavior issues.

The paper collected survey data from over 500 respondents. This paper, like several others, found that behavior problems in dogs are very prevalent. The behavior problems asked about were “aggression, anxiety or fear, leash reactivity, excessive vocalization, destructive behavior, repetitive behaviors, house-soiling, or other”. In this case, 100% of the respondents reported having had at least one dog with a behavior issue! This is a shockingly high number and something we almost never see in research! Another co-author, Dr. Emma Grigg, emphasizes that this is owner-reported data. As a result, some of the “behavior problems” owners reported may include normal dog behavior. However, if the owner perceives a problem, that is still an issue that may impact the quality of life for both the dog and the owner. Regardless, the “100%” figure highlights the need for additional owner education!

About one-quarter of participants indicated that they would consider using medications or supplements to address a behavior issue in their dogs. Another 56.5% said “maybe” and 17.3% said “no”. Participants were more comfortable with natural supplements than prescription medications.

What influenced owners’ perceptions about medication and supplement use? The factor that stood out most clearly was owner experience with personal use of medications or supplements. Owners that had personally taken anti-anxiety medication or antidepressants were more likely to be supportive of using such medications in their dogs (as well as pheromone and cannabinoid products). This was especially true if the owner’s personal experience with medication had been positive. Similarly, owners that had taken herbal or nutritional supplements for their own anxiety or depression were more comfortable with the idea of using similar products in their dogs (as well as slow-acting prescription medications). Again, this was especially true if the owner’s personal experiences had been positive.

Gender did not impact owners’ comfort levels with the use of prescription medications or cannabinoids. However, women were more likely than men to be comfortable with the use of nutritional supplements and pheromone products. Age did not appear to impact opinion on medication or supplement use and education level only impacted opinions on cannabinoid products. Respondents with higher education levels were also more comfortable with the use of cannabinoids.

Image by Fale Llorente Almansa

The most valuable information in this paper probably comes from the data on owner concerns and factors that would influence their willingness to use medications or supplements. Owners were concerned about unwanted effects that the medications or supplements may have on their dogs. At the top of the list was sedation (about 63% and 67% for fast- and slow-acting prescription medications, respectively), followed by the potential for addiction (about 44% and 50%) and the potential for negative personality changes (about 25% and 41%).  Owners had three primary concerns related to making a decision about whether to give medication or supplements to their dogs. They were the effectiveness of the product, the ease of administration, and whether or not their veterinarian recommended the product.

Owners were more concerned about slow-acting medications than fast-acting medications. This is interesting because the very side effects the owners were most concerned about—sedation, addiction, and changes to their dog’s personality—are more common in the fast-acting medications than the slow-acting ones (Herron et al. 2008, King et al., 2000).

This information is most helpful, of course, to veterinarians and their staff. Understanding that owners are particularly concerned about sedation, addiction, and personality change gives the veterinarian an opportunity to be proactive in bringing up and addressing these concerns. They can also provide evidence of the effectiveness of specific medications for specific behavior issues and provide tips for administering the treatment.

Image by Elena Borisova

It’s not appropriate or ethical for those outside of a vet clinic to discuss potential side effects with owners in any kind of detail. We also should not be making recommendations for specific medications or doses. However, we can still provide support and information in other ways. For example, the researchers found that roughly 40% of dog owners were not even aware that medication or supplements were an option when working with behavior issues. If that’s the case, owners may not think to approach their veterinarian about these concerns. In fact, previous research by both Herron et al. (2009) and Lord et al. (2008) found that owners were more likely to consult with dog trainers for behavior advice than veterinarians. This means that dog trainers (as well as behavior consultants and non-DVM behaviorists) play an important role in advising clients that medication may be an option for their dog.

We can direct them to their own veterinarian or a board-certified veterinary behaviorist (DACVB) for more guidance. If owners are reluctant, we can also encourage them to discuss their concerns with their veterinarian and suggest they ask about the likelihood of unwanted side effects and what to expect if their dog goes on a medication or supplement. We can also recommend that they ask about the evidence for effectiveness. In many cases, the veterinarian will be able to offer reassuring and encouraging advice in this regard as the most common psychoactive medications tend to be well-tolerated and effective. It’s also important for owners to understand that psychoactive medications and supplements are best used in conjunction with behavior modification under the guidance of a qualified behavior consultant or behaviorist. Success will also be increased if the veterinarian and behavior consultant or behaviorist can work together as a team to maximize success for the dog and their family.

Psychoactive medications can make a substantial difference in the outcome of treatment. In some cases, being able to convince owners to put their dog on medication can be critical to keeping the dog safe, improving their wellbeing, and keeping them in their homes. This article provides important information for addressing owner concerns about medication and will hopefully improve our ability to help people and animals living with serious behavior issues.

References

M.E. Herron, F.S. Shofer, I.R. Reisner, 2008. Retrospective evaluation of the effects of diazepam in dogs with anxiety-related behavior problems, J. Am. Vet. Med. Assoc., 233, pp. 1420-1424.
M.E. Herron, F.S. Shofer, I.R. Reisner, 2009. Survey of the use and outcome of confrontational and non-confrontational training methods in client-owned dogs showing undesired behaviors, J. Appl. Anim. Welf. Sci., 117, pp. 47-54.
J.N. King, B.S. Simpson, K.L. Overall, D. Appleby, P. Pageat, C. Ross, J.P. Chaurand, S. Heath, C. Beata, A.B. Weiss, G. Muller, 2000. Treatment of separation anxiety in dogs with clomipramine: results from a prospective, randomized, double-blind, placebo-controlled, parallel-group, multicenter clinical trial, Appl. Anim. Behav. Sci., 67, pp. 255-275.
Lord, L.K., Reider, L., Herron, M.E., Graszak, K., 2008. Assessment of health and behavior for animals one week and one month post adoption from three shelters in the metropolitan Detroit area. J. Am. Vet. Med. Assoc. 233 (11), 1715–1722.

van Haaften, K.A., Grigg, E.K., Kolus, C., Hart, L. and L.R. Kogan, 2020. A survey of dog owners’ perceptions on the use of psychoactive medications and alternatives for the treatment of canine behavior problems, Journal of Veterinary Behavior, 35, pp 27-33.

 

Kristina Spaulding

Kristina Spaulding

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