Clinical separation anxiety occurs when dogs exhibits inappropriate behaviors specifically caused by their owners leaving them alone or when the dog does not have access to them.(3) In dogs these behaviors typically include vocalization, destructiveness, inappropriate elimination when the owner is away and excessive attachment behavior when the owner is home. It is the most prevalent canine anxiety disorder diagnosed in Mexico city.(1)

At the VH UNAM we diagnosed, propose a treatment plan which normally includes 4 phases:

1.  Client education, explaining what is SA and its causes.

2.  Environmental modification, by the means of adjusting the place for the dog to be safe and restrict the dog access to areas where destruction/elimination can occur.

3.  Behavioral modification by the means of different learning techniques to teach the dog to become more independent, like downplay departures and arrivals, extinguish pre-departure cues, graduated departures with a safety cue to teach the dog to habituate to different levels of owner's absences.

4.  Medication therapy if needed which must always be accompanied by environmental and behavioral modification.

Usually treatment lasts several weeks and requires a high compliance from the owners.(1,2,3)

Environmental Modification

 Restrict dog's access to areas where destruction/elimination can occur:

 Crate

 Dog day care

 Pet sitter

 Vary the toys that are available to the dog

Behavior Modification

Increase physical activities.

 Obedience training does not solve behavior problems by itself and it should not be used as a substitute for a behavioral treatment, but as a support element.(1,2)

 Teach the dog to sit or down and stay using positive reinforcement while relaxing, in a variety of circumstances; this is the foundation for teaching the dog context-specific appropriate behavior; the goal is not to get the dog to sit or down, sit or down are just a tool; the goal is teach the dog to relax.(1,2,3)

 Ignore attention soliciting behaviors and reward submissive and calm behaviors.

Downplay departures and arrivals.

 Ignore the dog while preparing to leave the house, don't say goodbye, having elaborate farewells may increase the dogs anxiety about the owner leaving.

 Ignore the dog when return, until can redirect into a "sit". When the owner comes home after being gone for a while must not interact with the dog until he is calm, by doing this the owner makes his arrival less exiting to the dog and therefore decrease the dog's anticipation for that moment (1,3)

Extinguish pre-departures cues

 Keys, briefcase, purse, working shoes, security system etc.

 Owner picks up keys (CS) dog anxious (CR)

 Owner picks up keys (CS) +does not leave (no US) Dog anxious (CR)

 Owner picks up keys (NS) dog no longer anxious (no CS). Extinction of the dog's reaction to pre-departure cues is easily done. Simply expose the dog to the cues that he already knows predict the owner's absence, but do so in a way that will not allow the dog to have a full anxiety reaction.

After the dog's reactions to the departure cues have been extinguished the dog is ready to begin desensitization.

Desensitization is a process where the owner very gradually expose the dog to the stimulus that makes him anxious (owner's absence), but will do so in a way that will not allow the dog to have a full blown anxiety response.

1.  Give the dog situations in which he will succeed. Do not progress to a next step of the schedule, unless the dog is calm for previous steps.

2.  If at any point the dog shows anxiety, back up to an easier step.

3.  Desensitization is a slow process. The owner can only progress as fast as the dog is capable of progressing (3). Graduated departures using a safety cue; visual, olfactory or auditory cue not known by the dog and given to the dog which is associated with the owner returning shortly.

We tell the owner to choose a place in the house where he would like his dog to be able to stay while gone. The dog has to associate this area with positive things, the owner has to give the dog special treats and toys whenever the dog is there, and also reward when the dog goes there by himself. Then start by putting the dog in that area and leave him alone for very short periods and very gradually increase the time the dog is left alone in that area. We also tell the owner not to use that area for any kind of punishment.

The benefit of this technique is that the dog does not need to be fully calm when the owner leaves and the owner needs to return before the dog exhibits full blown symptoms. The owner must perform these exercises where he wants the dog to be able to stay by himself later on. It is important to only use this safety cues during practice departures, otherwise they will lose their meaning, and extend the time the dog is left alone very gradually.

Pharmacological Treatment

The use of medications must be considered as a way of complement the behavior modification program and not as the only resource.

The choice of medication or the combination of drugs will be according to the intensity and duration of the problem.

There is an FDA approved medication for separation anxiety in dogs: Clomipramine "Clomicalm"^TM a tricyclic antidepressant, but as we don't have access to it in México, we have to use the presentation for humans "Anafranil"^TM at 1 mg/kg q 12h for the first 2 weeks 2 mg/kg q 12h next 2 weeks 3 mg/kg q 12h for the next 4 weeks and wean off the dose very gradually at the end of treatment.

Sometimes we can combine Clomipramine + Alprazolam at 0.01/0.1 mg/kg q 8h. If the symptoms are too intense and we wean off Alprazolam by the end of the 3rd or 4th week of treatment.

The prognosis depends on:

 The severity of the problem

 Mild symptoms has better prognosis that severe

 The duration of the problem

 Short duration of the problem has better prognosis than longer duration of the problem

 Compliance of owners

 High compliance will lead to better prognosis

References

1.  Heiblum, M memorias de etología clínica en el perro y el gato , diplomado de educación continua UNAM-UAB 2002

2.  University of Georgia, continuing education courses March 1999 Psychopharmacology and treatment of phobias in dogs and cats

3.  University of Georgia, continuing education courses November 2001 Update on diagnosis and treatment of small animal behavior problems.

4.  University of Georgia, continuing education courses October 2005 Veterinary Psychopharmacology: Selecting the best drug, monitoring the patient