Read This BEFORE You Give Up Your Pet Due to Allergies…

July 13, 2008

Pill-Popping Pets

By JAMES VLAHOS

Max retrieves Frisbees. He gobbles jelly beans. He chases deer. He is — and this should be remembered when discussions of cases like his blunder into the thickets of cognitive ethology, normative psychology and intraspecies solipsism — a good dog. A 3-year-old German shepherd, all rangy limbs and skittering paws, he patrols the hardwood floors and wall-to-wall carpets of a cul-de-sac home in Lafayette, Calif., living with Michelle Spring, a nurse, and her husband, Allan, a retired airline pilot. Max fields tennis balls with his dexterous forelegs and can stand on his hindquarters to open the front door. He loves car rides and will leap inside any available auto, even ones belonging to strangers. Housebroken, he did slip up once indoors, but everybody knows that the Turducken Incident simply wasn’t his fault. “He’s agile,” Allan says. “He’s healthy. He’s a good-looking animal.” Michelle adds, “We love him to death.” That is why they had no choice, she says. The dog simply had to go on psychoactive drugs.

I arrived the night Max was to receive his first pill. He picked at the food in his chow bowl while the Springs sat at the kitchen table discussing his problems. For starters, there was his overpowering need to be near people, especially Allan. If they put Max outside, he quickly relieved himself and then rushed back indoors; he raced into rooms that Allan was about to occupy; he rested his head against the bathroom door during his master’s ablutions. “Watch this,” Allan said. He and Michelle stood up to hug. The moment they touched, Max unleashed a string of high-pitched barks. “He likes being close to us, but he doesn’t like us being close to each other,” Allan said.

These behaviors, however, weren’t what prompted the psychiatric intervention. The Springs led me downstairs to the family room — Max, supper unfinished, bounded ahead. Downstairs, Allan pointed to Max, who was lying on the floor and staring at his tail. He looked angry at it, disturbed by it. “You can see the pressure building in his psyche until he’s ready to explode,” Michelle said. And then he did: Max jumped to his feet and lunged. His jaws snapped, catching only air, and he spun counterclockwise in place, an accelerating blur of fur and teeth and frustration. Tail-chasing is normal — except that Max did it daily, often for hours on end. “He’s like a junkie needing a fix,” Allan said. “At times he can’t not do it. He goes berserk.”

Allan went upstairs and returned moments later with a bit of ground turkey and a pill. He hid the pill in the meat and extended his hand to Max, who had stopped spinning. The medicine was chemically identical to clomipramine, a tricyclic antidepressant used in human psychiatric care, but it came in a green-and-white Novartis box brightened by the picture of a happy yellow lab. This wasn’t Anafranil, the brand name for the human version of the drug; it was Clomicalm, just for dogs. Approved by the Food and Drug Administration for treating separation anxiety, a problem that can occur when dogs are left home alone, the medication is also commonly prescribed off-label for patients with Max’s diagnosis: compulsive disorder. He was the canine version of a person who washes his hands 20 times an hour. Max leaned forward and gulped the pill down.

The practice of prescribing medications designed for humans to animals has grown substantially over the past decade and a half, and pharmaceutical companies have recently begun experimenting with a more direct strategy: marketing behavior-modification and “lifestyle” drugs specifically for pets. America’s animals, it seems, have very American health problems. More than 20 percent of our dogs are overweight; Pfizer’s Slentrol was approved by the F.D.A. last year as the country’s first canine anti-obesity medication. Dogs live 13 years on average, considerably longer than they did in the past; Pfizer’s Anipryl treats cognitive dysfunction so that absent-minded pets can remember the location of the supper bowl or doggy door. For lonely dogs with separation anxiety, Eli Lilly brought to market its own drug Reconcile last year. The only difference between it and Prozac is that Reconcile is chewable and tastes like beef.

Doggy diet pills may be plainly absurd, but scientists in an expanding field known as behavioral pharmacology say that the combination of new drug therapies and progressive training techniques can solve problems that in the past almost always resulted in euthanasia. The supposed effectiveness of psychiatric medicines in treating mood and behavior issues is prompting new questions in the centuries-old debate over what, exactly, separates mankind from the beasts. If the strict Cartesian view were true — that animals are essentially flesh-and-blood automatons, lacking anything resembling human emotion, memory and consciousness — then why do animals develop mental illnesses that eerily resemble human ones and that respond to the same medications? What can behavioral pharmacology teach us about animal minds and, ultimately, our own?

ON SEPT. 5, 1379, A TRIO OF French pigs, agitated by the squealing of a piglet, bowled over their keeper’s son, who died shortly thereafter of the injuries. As E. P. Evans recounts in his 1906 monograph, “The Criminal Prosecution and Capital Punishment of Animals,” “the three sows, after due process of law, were condemned to death” along with several other pigs who had “hastened to the scene of the murder and by their cries and aggressive actions showed that they approved of the assault.” (The accomplices were later pardoned.) Fast-forward to December 2007 to witness a curious animal proceeding of the modern era: Mitzi-Bitzi, a lap dog, modeling a $118,000 diamond bracelet at the opening of Chateau Poochie, a pet hotel and spa near Miami. “She’s just so special,” her owner, Marilyn Belkin, told me later, as if that explained things. The sows and Mitzi got opposite treatment, but the beliefs of Belkin and the pig prosecutors weren’t so different. In medieval times and in the present, we often act as if animals had thoughts, feelings and desires that resemble those of people. How else could you justify the porcine death penalty; why splurge on a blueberry facial when a simple roll on the lawn would do?

Marketers have a new name for the age-old tendency to view animals as furry versions of ourselves: “humanization,” a trend that is fueling the explosive growth of the pet industry and the rise of modern pet pharma. Americans forked over $49 billion for pet products and services last year, up $11.5 billion from 2003; other than consumer electronics, pet products are the fastest-growing retail segment. The market expansion is being driven both by more pets and by more spending per pet, especially by affluent baby boomers whose children have graduated from college. A third of the total spending, and the fastest-growing category, is health care, with treatments formerly reserved for people — root canals, chemotherapy, liposuction, mood pills — being administered to pets. “I get asked all the time, ‘What is it with this humanization — do we suddenly love our pets a whole lot more?’ ” says David Lummis, who analyzes the pet industry for the market research firm Packaged Facts. “My theory is that it’s always been there, but it’s been sanctioned now. It’s not just the crazy cat lady. It’s marketers and all of this consumer advertising that have made it O.K. to spend tons of money on your pet.”

Humanization has pharmaceutical companies salivating like Pavlov’s dogs. Surveys by the American Pet Products Manufacturers Association found that 77 percent of dog owners and 52 percent of cat owners gave their animals some sort of medication in 2006, both up at least 25 percentage points from 2004. Sales of drugs for pets recently surpassed those for farm animals. Eli Lilly created its “companion animal” division at the beginning of 2007 and over the next three years hopes to release several other drugs. Pfizer Animal Health, whose revenues have grown 57 percent since 2003 to nearly $1 billion, hopes to develop medications for pain, cancer and behavioral issues. Most consumer spending is still on traditional pet medications like antiparasitics, but Ipsos, a marketing research firm, estimates that at least $15 million was spent on behavior-modification drugs in the United States in 2005. “As people are seeing more complex and sophisticated drugs for themselves, they want that same quality for their pets,” Dr. Melanie Berson, a veterinarian at the F.D.A.’s Center for Veterinary Medicine, has said. People’s willingness to employ behavior-modifying medications stems in part from a growing desire for more convenient, obedient household animals. “Our expectations are really going up,” Lummis says. “Owners want their pets to be more like little well-behaved children.”

Potent as a marketing trend, humanization has long been scorned as scientific practice by researchers working in the behaviorist tradition of B. F. Skinner. In “Inside the Animal Mind,” George Page summarizes the reasons: “Since we cannot get inside the animal’s mind . . . and since the animal cannot report what’s going on — not in a ‘language’ we can readily understand — all we have left are guesses and speculation fatally tainted by anthropomorphism.” Strict behaviorists focus instead on observable stimulus-response conditioning: for example, a puppy learning to sit to receive a treat. Actions that cannot be explained this way are usually attributed to blind instinct. As such, hard-core Skinnerian philosophy amounts to a perversion of cogito ergo sum: I can’t prove that animals think, therefore they don’t. In dealing with problem pets, veterinarians with a behaviorist bent don’t concern themselves so much with what might be happening inside the brain of the animal or try to correct neurochemical imbalances with drugs. Instead, a compulsive or anxious animal is seen as one that just needs to be better-trained.

The debate about animal minds is at least as old as Aristotle, who posited that men alone possess reason. The 17th-century French philosopher Nicolas Malebranche wrote that animals “desire nothing, fear nothing, know nothing,” while Voltaire asked, “Answer me, mechanist, has Nature arranged all the springs of feeling in this animal to the end that he might not feel?” Darwin’s view was, Of course not. In “The Descent of Man” he wrote, “We have seen that the senses and intuitions, the various emotions and faculties . . . of which man boasts, may be found in an incipient, or even sometimes in a well-developed condition, in the lower animals.” The staggering assertion of Darwin’s theory is that evolutionary continuity applies not just to bodies but to brains. “The difference in mind between man and the higher animals, great as it is, certainly is one of degree and not of kind,” he wrote.

For much of the 20th century scientists willfully dismissed this line of thinking, which has been rekindled only in the past three decades with the rise of a field known as cognitive ethology. The guiding belief is that while it is scientifically baseless to assume that animals think and feel just as we do, it is equally foolhardy to assume that they don’t think and feel at all. In laboratory experiments and field observations, practitioners have presented evidence of analogical reasoning by apes, counting by rats and the capacity of pigeons to distinguish the paintings of Picasso from those of Monet. Researchers have demonstrated that animals can grasp basic abstractions like “same” and “different” and use mental flexibility to solve novel problems in the laboratory for which hard-wired instinct couldn’t have prepared them. It is impressive but perhaps unsurprising that a parrot was taught to categorize colors or that dolphins learned the syntactic distinction between “take the surfboard to the Frisbee” and “take the Frisbee to the surfboard” — we already tend to think of these animals as being smart. More eye-opening are glimmers of cognition from way down the phylogenetic chain. Research has shown that bumblebees can remember which flowers they have already visited and that two-inch-long cockroaches from Madagascar can tell the difference between a familiar person and a stranger. (If the bug hisses loudly at you, it’s time to introduce yourself.)

Cognitive ethologists have had more difficulty gathering evidence for animal emotion. To any pet owner who has stroked a purring cat or watched a dog cavort when his chow hits the bowl, it seems intuitively obvious that animals experience feelings. But intuition isn’t hard science — it’s just more humanization. Enter behavioral pharmacology, which has provided a tantalizing new window into the animal mind. Dr. Nicholas Dodman, who pioneered the field and founded the Tufts University Animal Behavior Clinic, says that skeptics of the premise that animals have emotional states used to ask him how he could say that a pacing, hyperventilating dog was actually feeling anxious. “Well, how about this?” Dodman would reply. “We’ll give him an antianxiety drug and see what happens.”

THE GROUNDS OF THE CUMMINGS School of Veterinary Medicine at Tufts sprawl over 640 acres of rolling greenery in central Massachusetts. When I arrived to visit in March, one of the first things Dodman told me was that the campus used to be the site of a state mental hospital. Like other facilities, it had been shuttered in the 1960s following the revolutionary discovery of drugs that treated schizophrenia and other disorders so effectively that many patients no longer required institutionalization. “Ironically, this paved the way for our school, our behavior program, and novel pharmacological treatments for animal behavior problems,” Dodman said. Or, as he later said, “we traded one group of inmates for another.”

Dodman, an Englishman, began his career in the early 1970s as a roving country vet in the tradition of James Herriot; he went on to write a popular series of advice books for pet owners, the latest of which is “The Well-Adjusted Dog.” In 1981 he moved to the United States to become a professor of anesthesia at Cummings. Drugs interested him greatly but comatose patients, increasingly, did not, and he began to wonder: Could medications transform veterinary behavioral medicine just as radically as they had human psychiatric care? He says he quickly realized that the field was “completely wide open, like virgin snow.” At a veterinary conference in the late 1980s, he presented his vision of the psychoactive frontier and “saw jaws drop around the room. It was like, ‘Who is this strange masked man?’ ” Three decades later, “it’s almost mainstream for behaviorists to know something about pharmacology,” Dodman says.

Inside his small office, Dodman, wearing a tie-and-tasseled-loafer ensemble topped by a white lab coat, received the day’s first patient. A muzzled dog on a short lead towed Joe and Mahala Richards, from Mendon, Mass., into the room. “So here we have Zoey, who’s a yellow black-mouthed cur, 5 years old, and you got her at 7 months,” Dodman said. “I’m already picking up that she’s fearful and anxious, and that usually stems from a disturbed childhood.”

“We know she was abused,” Mahala said.

“There you go,” Dodman replied.

Joe said Zoey’s problem was that she sometimes attacked when food was around. The worst incident had happened a week ago when Mahala was watching television and reached for a piece of cheese. “She just came after me,” Mahala said. Joe added, “Zoey had her on the couch — she’s screaming at the top of her lungs— and Zoey just kept going at her hands.” Mahala held up a scarred wrist. “My God, that’s nasty,” Dodman said. He listened for 20 minutes and then issued a diagnosis: something called “conflict aggression,” which meant that occasionally Zoey forgot that she didn’t need to fight to get her share of food. Zoey was to be kept from hot dogs, peanut-butter bones and any other culinary provocations. High places like beds were forbidden (elevated positions can make dogs feel more confident), and exercise was essential. Outlining what he called the “nothing in life is free” program, Dodman said that Zoey should be made to sit before feeding and that affection was to be rationed. The overall goal was to get Zoey to respect the leadership of her owners, which would raise her inhibition to attack. These behavior modifications alone might be enough to cure Zoey, Dodman concluded.

“We don’t want to have to put her down,” Mahala replied quietly.

“No,” Dodman said. “A serious bite is a risk factor for euthanasia for the dog, which is why another component of the program might be some medicine. If we were to ask Zoey: ‘Look, if you slip up in the future, and you bite someone like that again, the chances are you’re not going to come out of it alive. But we can make you feel better if we give you some medicine like, for example, Prozac. Would you like to have the medicine that might save your life?’ And she might go, ‘Grrr-rrr rrrup — yeah, yeah, I’ll take the medicine.’ It’s a lifesaving thing.” Joe and Mahala left a half-hour later with a scrip in hand.

Aggression is the leading issue that brings animals into clinics; it and other behavior problems are the top reasons that pets are surrendered to shelters. Half of them are euthanized, roughly three to four million animals per year, and an equal number are believed to be put down in private practices. Treatment with psychoactive medications is then a very real alternative to lethal injection. Prozac, a selective serotonin reuptake inhibitor (S.S.R.I.), prolongs the effects of that neurotransmitter to reduce impulsivity, stabilize moods and lower anxiety, Dodman says. He is friends with the noted Harvard psychiatrist John Ratey, and they once compared the drugs they employ to treat violent people and animals. “You superimpose my portfolio on top of his, and it’s the same thing,” Dodman says. He has patented his S.S.R.I. approach and is working with a pharmaceutical company, Accura Animal Health, that plans to bring it to market as the first F.D.A.-approved treatment for canine aggression. (The current use of Prozac and similar drugs is prescribed off-label.)

Aggression is a feline problem too. A few weeks after visiting Dodman, I went to the home of a man in West Los Angeles whose pet was on Prozac. The owner, Doug, asked me not to use his last name because he didn’t want business associates to know about what he called his “cougar psycho little miniature stalker” — Booboo the cat.

The first incident took place four years ago after Booboo ate some decorative dried flowers. Booboo scaled his cat tree and sat there with his eyes “a little dilated and cross-eyed,” Doug said. He started “growling like a banshee,” released “a high, shrill wail” and lunged. “He ripped my leg up and wouldn’t let go.” Doug fled, and Booboo pursued. Finally he was able to trap the cat in a bedroom. From then on Booboo was different. He would periodically ambush Doug. Over time, Doug noticed that attacks were more likely if he smelled at all abnormal — for instance, if he had been near a woman wearing perfume — so he would take a shower after coming home and then change into his designated cat-wrangling outfit.

Doug consulted a behaviorist, Dr. Karen Sueda. One hypothesis was that Booboo suffered from a feline version of schizophrenia — there is evidence that animals experience auditory and visual hallucinations and can temporarily enter deluded states in which they attack. Sueda didn’t think that was likely with Booboo, nor did she think his attacks were motivated by fear, as is often the case with animal aggression. In Booboo she says she saw a dominant, confident cat who “wanted to control his personal territory.” One theory about such animals is that they suffer from a neurochemical imbalance. As Dodman explained in his book “The Cat Who Cried for Help,” “By engaging in and winning aggressive encounters, dominant animals drive up serotonin levels and gain in composure.” Sueda prescribed Prozac to boost the effects of the neurotransmitter.

Doug led me up the stairs in his house to the second floor. He donned a pair of khakis that he had lined with heavy-gauge ballistic nylon and washed up because he had shaken hands with me. He crept toward the master bedroom, where Booboo was permanently quarantined behind a door that had been remounted to swing outward to facilitate quick escapes by Doug. “Just behind this door lurks the Tasmanian devil,” Doug said before slipping inside. I squatted at ground level and watched through a transparent doggy door. The 400-square-foot room had a walk-in closet, a four-poster bed and a floor-to-ceiling view of Beverly Hills mansions dotting a scenic canyon. The suite belonged entirely to Booboo, though Doug said he was now able to sleep over a few nights a week. Booboo slinked past the window and gave me a steady gaze. He had a tuxedo coat, mostly black but with patches of white on his feet, underbelly and forehead. Doug scooped him up and they nuzzled face to face. “He’s just warm, soft and fuzzy, and he purrs, and he’s cuddly,” he murmured.

Separation anxiety, bane of modern home-alone dogs and target of Lilly’s new Reconcile, is a problem millennia in the making. Archaeologists and geneticists estimate that the domestication of wolves (Canis lupus) into dogs (Canis lupus familiaris) began at least 15,000 years ago. One hypothesis about how this happened is that as humans settled down and established villages, piles of discarded food scraps and plant matter accumulated on the outskirts. Wolves that were genetically predisposed to be slightly less fearful of humans would feed off the free bounty, while the more skittish animals would steer clear. “At this point, natural selection would take over,” Jake Page explains in “Dogs: A Natural History.” “As the dump-loving wolves reproduced with each other, their tameness would probably become more and more pronounced.” The gentler animals were increasingly favored and brought into our lives to the point that many dogs (42 percent, according to a survey by the American Pet Products Manufacturers Association) now sleep in the same beds as their owners. Extreme attachment to people is one of the defining traits of dogs.

Extreme attachment, unfortunately, also causes some dogs extreme suffering when deprived of their owners’ company. Martha and Phil Bridges live in Sacramento with a 2-year-old lab mix named Rocco. The Bridges told me that when they left home and went to work each day from 8 a.m to 5 p.m., they would lock Rocco in a large cage in the dining room to keep the young dog from running amok. One day last fall they returned to find the dog loose with his nose bloodied from prying the cage door open. They locked him in it again. The next evening Rocco was still inside but had shredded his pillow bed and reared up so violently that the cage was destroyed. Next the Bridges used a baby gate to block off part of the house so that Rocco would have more room to roam. He stripped five feet of carpeting from the floor. They locked him in the bathroom. Shower curtain shredded, shampoo swallowed, door frame torn. Realizing they needed help, the Bridges took Rocco to see Dr. Rachel Malamed, a resident at the Behavior Service at the School of Veterinary Medicine at the University of California, Davis. She diagnosed separation anxiety, outlined a retraining program and wrote a scrip. The happy outcome: Rocco “has never had another problem since we put him on Reconcile,” Martha says.

An estimated 14 percent or more of American dogs have separation anxiety. The problem signs include home and self-destruction; prolonged whining, barking or drooling; or simply standing by the front door all day in a lonely, panting vigil. (“Nannycam”-type video recorders have captured all of the above.) The terms for Reconcile’s F.D.A. approval were that the drug had to be prescribed with a course of behavior modification. In Rocco’s case, Malamed taught the Bridges to stage mock departures — jingling the car keys, opening the front door — while giving treats so that Rocco would associate their leaving with a yummy reward. When the Bridges left the house for real, they were to slip out with zero fuss; frantic barking and jumping were to be ignored. “We brought on this anxiety with him being so attached to us,” Martha says. “Now we have to break that bond — without breaking it to the point where he won’t know that we still love him.”

When it comes to retraining, however, some people are slackers. Dodman estimates that 25 percent of the pet owners he sees don’t take his advice. At U.C. Davis I observed one couple impatiently shrugging off Malamed’s directives. I was watching the appointment via closed-circuit television with another vet, Dr. Jeannine Berger, and she sighed in exasperation. “They just want the magic pill,” she said. “People always want the magic pill.” The studies of Reconcile show why behavioral pharmacologists prefer not to rely on the medicine bottle — or for that matter, retraining — alone. Dr. Steve Connell, a veterinarian at Eli Lilly, told me that “behavior modification by itself works. There’s not any question about that. But if you use behavior modification in conjunction with Reconcile, it works quicker and it works better.”

How do researchers know that? The patients, after all, can’t describe the subtleties of their moods to therapists. Efficacy studies instead rely upon people to record signs of animal distress, like barks per hour and household objects destroyed. The study Lilly submitted to the F.D.A. in support of Reconcile involved 242 dogs scattered around the United States and Canada; in the double-blind trial, neither the veterinarians nor the owners involved knew which dogs were receiving Reconcile and which ones got a placebo. All dogs received behavior retraining. The results were strong enough to demonstrate efficacy but hardly earthshaking: 72 percent of the dogs on Reconcile showed improvement after eight weeks of treatment, while 50 percent of those receiving the placebo did. The study also found that more than half of the dogs on the drug experienced short-term side effects, including lethargy, depression and loss of appetite.

One thought had haunted me as I listened to the Bridges’ story: If I were locked inside the bathroom all day, I’d swallow the shampoo, too. Although most animal-behavior problems are believed to have genetic roots, their expressions are typically triggered by the unnatural lives that people force their pets to lead. “A dog that lived on a farm and ran around chasing rabbits all day would be more prone to being stable than a dog living in an apartment in Manhattan,” Dodman says. Undomesticated canids, neither confined nor excessively attached to people, don’t suffer from separation anxiety. Some captive horses endlessly circle their stalls or corrals — a compulsive behavior similar to Max’s tail chasing — but such purposeless repetitions have never been observed in the wild.

Pharmacological treatments, furthermore, are sometimes more for the convenience of owners than they are for the health of pets. When the dog bites, when the cat pees — “a lot of the ‘behavior problems’ we see are actually normal behaviors for the animal,” Dodman says. Cats aren’t mentally ill if they attack a new feline in the household or claw furniture to mark their domain. Food guarding and aggression toward strangers boost a dog’s survival rate in the wild but don’t cut it in the living room. And both cats and dogs demarcate territory with urine. “If a dog goes to the bathroom on a bush outside, you don’t mind as long as it’s not your bush,” Dodman says. “But when he comes back to the house and lifts his leg on your chair, it’s like, ‘Is the dog mentally sick?’ ”

In many other situations, however, a medicated animal may be a better-off one — for his own sake and not just for his master’s peace of mind. Obsessive dogs like Max sometimes injure themselves by spinning right into furniture or chewing their legs or tails until they’re bloody. You could also argue that Max would be happier not spinning and chasing squirrels instead — an anthropomorphic judgment, perhaps, but one that is hard to dispute after seeing the panting, possessed animal on the whirl. Medicating dogs like Rocco, meanwhile, makes some people queasy because separation anxiety is so clearly related to the absentee lifestyles of owners. Dr. Jean Donaldson, director of the San Francisco S.P.C.A. Academy for Dog Trainers, told me that she has always insisted that people who don’t have enough free time shouldn’t own dogs. But she recognizes that many ill-equipped people will do so anyway and supports employing drugs. In her view, our complicity in the problem’s creation doesn’t absolve us of responsibility for finding solutions, even ones with mild side effects.` “Can you imagine having separation anxiety?” she asked. “We’re talking ‘Silence of the Lambs’ here, being in the pit so that you rip off your own fingernails and break your teeth because of the degree of panic attacks you’re having. Do we really think that the problem here is a dry mouth from Reconcile?”

NOT EVERYBODY AGREES that America’s pets are facing a major mental-health crisis — or that whatever their problems, that drugs are necessarily part of the solution. One of the most passionate voices in the just-say-no camp belongs to Dr. Ian Dunbar, a veterinarian who has his doctorate in animal behavior and is the founder of a highly regarded instructional empire called Sirius Dog Training. “I have never in my life had to resort to using drugs to resolve a behavior problem,” he says. The rush to the medicine bottle for easily resolved problems like canine obesity — “Just feed the dog less!” — shows a disturbing parallel to the human approach to health care, he says. “We lead an unhealthy lifestyle and then rely on drugs to correct it.”

Dunbar lives down a winding lane high in the Berkeley Hills. When I arrived to visit, he led me into the living room, where we were joined by his three bounding dogs, Claude, Hugo and Dune. Claude had been a troubled S.P.C.A. shelter dog. He bit, was often anxious and had a problem known as pica, meaning he compulsively devoured nonfood items. When Dunbar rescued him a few years ago, Claude was recovering from an operation to remove a basketball from his intestines. “He would have been the ideal candidate for a drug treatment, but to me that was unnecessary if you know some of the simplest things about dog training,” Dunbar said.

Pharmacological aids are helpful in extreme circumstances, Dunbar acknowledged, but for the vast majority of cases, behavior modification alone does the trick. For problem dogs like Claude, he employs the simple, unswerving strategy of a trainer: Ignore unwanted behaviors and reward desired ones. The magic pill in Dunbar’s arsenal is a rubber chew toy stuffed with food. As I took a seat on the couch, he tossed three of them on the floor. The dogs ignored me completely — there was none of the usual canine pouncing on the visitor — and set to work. Absorbed, they gnawed and shook the toys, which slowly released kibble. It would take 45 minutes before the supply was exhausted. Claude, his attention refocused with the help of chew toys, no longer bit people or gobbled indigestibles. He was calm and the best-behaved of the household’s three canines. “The dog is creating endorphins of his own, his own natural drug therapy, while enjoying a totally acceptable activity,” Dunbar said.

To critics like Dunbar, separation anxiety is the attention-deficit disorder of the pet world, a problem that is overzealously pathologized, carelessly diagnosed and liberally medicated. His critique is unabashedly Skinnerian: “We’re confusing behavior problems, which are observable and quantifiable, with terms like ‘anxiety,’ which describe the dog’s internal mental state, for which we have absolutely zero proof,” he says. On a personal level, Dunbar suspects that animals do have thoughts and feelings and can become genuinely anxious when their owners are gone. But he is careful to not let assumptions cloud his professional judgment, because not every situation that looks like separation anxiety is in fact that condition. Lilly’s Web site for Reconcile states that “separation anxiety is a clinical condition in your dog’s brain.” Dunbar offers possible alternate explanations: Some dogs that are physically punished have inadvertently learned that they can get away with whatever they want when the humans are gone. Others are just bored and having fun. “What do we expect dogs to do when we go to work — watch the telly, do the crosswords or read the paper?” he asks. Hiding stuffed chew toys around the house is a good way to keep dogs occupied. “In the wild, the dog’s major activity is looking for food,” he says. “What most owners do is they feed the dog in the bowl, and within two minutes you’ve stolen his raison d’être. So now the dog is looking for activity, which we label ‘trouble’ and diagnose as all sorts of things like compulsion and separation anxiety.”

Dunbar is working with a pet-products manufacturer on an electronic dog-sitter that combines the reward elements of a classic Skinner box with the unblinking surveillance of Bentham’s Panopticon. Employing a network of sensors, the device monitors when the dog barks, how many steps it takes during the day, how long it lies down in its bed and when it plays with chew toys. Acting as a sort of robo-Dunbar, the gizmo automatically dispenses small treats when the animal is calm and well behaved. “Rather than the very general deadening of an anxiolytic or tranquilizing drug, what I want is a very specific education effect to teach the dog how he should act,” Dunbar says.

Modern owners are increasingly trying to “sterilize” pet ownership, he adds, trying to pharmacologically control dogs so that they don’t act like dogs. “What people want is a pet that is on par with a TiVo, that its activity, play and affection are on demand,” he says “Then, when they’re done, they want to turn it off.”

Back in the living room, we watched Claude and his housemates work at the chew toys. “Training is basically about forming a relationship, but for some people, that interactive process is now giving the dog a pill.”

TWO YEARS AGO, on the Fourth of July, a dog named Dixie was sitting in the backyard of her owners, Pat and Jen Morphy of Martinez, Calif. Around dusk, the sky above her exploded with the flashes and percussive booms of fireworks. Perhaps kids detonated firecrackers on the street nearby as well. Whatever happened, Dixie hasn’t been the same since.

Earlier this year the Morphys brought Dixie to see Rachel Malamed at the U.C. Davis Behavior Service. The Morphys reported that they take Dixie for a walk every day after work and then put her in the backyard. As soon as the sun sets, Dixie bolts for the house and cannot be dragged from it for the rest of the evening. She paces, stares and scans the air overhead. “You can just tell she’s waiting for something to happen,” Pat said. Dixie is eager for bedtime and scootches under the couple’s bed to sleep. But in the middle of the night, Dixie often jumps up on the bed and walks on Jen’s head. When she turns the lights on, the dog looks terrible, shivering and blank-eyed. It takes anywhere from 15 minutes to four hours to calm her enough to go back to sleep. “I can’t live with this dog any more how she is,” Jen said.

Malamed put a sound-effects CD into a boom box and set the volume to low. Dixie sat serenely through a trumpet fanfare, a toilet flush, a metal saw, ringing bells and raspy hinges. But at the sound of fireworks, during the long whistle and well before the climactic pop, Dixie tensed up; she tried to climb into Jen’s lap and began trembling. Malamed hit stop. “I’m sorry I had to do that,” she said. Noise phobias, especially those related to thunderstorms, are fairly common in dogs, and Malamed determined that Dixie had a phobia to fireworks.

So how did Dixie’s curious phobia develop? A Skinnerian would explain her problems within the bounds of stimulus-response conditioning, unthinking and automatic. On that first Fourth of July, Dixie correctly learned that fireworks are painfully loud but mistakenly linked the traumatic event with nightfall. Now every dark sky scares her. Her odd after-hours activity was very likely strengthened by more conditioned learning: every time she jumps on the bed in the middle of the night, Pat or Jen give her attention. Believing that they are soothing Dixie, they are actually rewarding and enforcing her troubled behavior.

But is her problem more complex than that? Most scientists now accept that animals experience basic emotions like pleasure, excitement and fear. These primal feelings provide useful motivation: to mate, kill prey or avoid danger. But whether emotional states like anxiety, obsession and depression exist is more controversial. The difference between fear and anxiety, after all, is the difference between a gazelle spooking at the sight of a lion and a gazelle worrying that a lion might appear. If you believe that the latter is possible, consider that Dixie might have some memory, however dim, of the original fireworks and that when she sees the sun setting, she becomes tense at the thought that they might percuss her eardrums again. In other words, her cognition goes beyond in-the-moment processing of sensory information; to paraphrase Eric Saidel, a professor of philosophy at George Washington University, she is not responding to the world but instead to the way she pictures the world. She thinks and, critically, is aware of her own thoughts.

By most any definition, this amounts to consciousness, the trait that people have traditionally been most loath to credit to animals. Many thinkers are hesitant to make definitive statements about any aspect of an animal’s internal life, much less to conclude that they are self-aware. In an influential essay published in 1974, the philosopher Thomas Nagel posed the question “What is it like to be a bat?” What is it like, really, to wheel blindly through the night sky hunting insects and navigating by echolocation? The sum of a being’s unique sensory and cognitive worlds constitute its Umwelt, and Nagel concluded that it was impossible to know any Umwelt but that of our own species. The words we use to describe animal mental states are hazy approximations at best. Hank Davis, an evolutionary psychologist at the University of Guelph in Canada who has studied cognition in rats, rabbits and the aforementioned hissing cockroaches, told me that “I am as big an animal lover as anybody I’ve ever met. I can go on and on about how sweet and smart and emotional my pet rat is. But we have to be careful about saying that when my rat appears anxious or obsessive that she is experiencing the identical set of neurological conditions that a human would.” Prescribing drugs under those circumstances, he says, is “questionable ‘Twilight Zone’-type medicine.”

The skeptics are correct that there’s no smoking gun proving that human feelings and Dixie’s are similar, but on the flip side, there is a preponderance of circumstantial evidence. The limbic system, critical for human emotional responses, is structurally similar in all mammals. “People have a physiological response to the thing they fear,” says Steven Hamilton, a psychiatric geneticist at the University of California, San Francisco. “They get tremulous. Their heart rate goes up. They perspire. Their respiration will go up. Dogs do the exact same thing.” The clinical presentation of the problem is similar, too. Confronted by what they fear, phobic people and dogs try to get as far away as they can from the dreaded stimulus, be it spiders or fireworks. In both populations, susceptibility appears to be heritable. And finally, “humans respond to particular anxiolytic and antidepressant medications, and we find similar responses in dogs to the same drugs,” Hamilton says.

Dodman made the same points to me and concluded, somewhat exasperatedly, “If it looks, waddles and quacks like a duck, then maybe it is a duck.” He bristled at the charge that behavioral pharmacologists practice “Twilight Zone” medicine. The primary source of outrage for most critics is the thought of veterinary kooks dosing helpless animals with human drugs. But that misstates the matter. Long before Prozac, Paxil and the like were taken by people, they were tested for safety and efficacy in legions of laboratory creatures. You can plausibly argue — and Dodman and others do — that humans are in fact using animal drugs.

At the U.C. Davis clinic, Malamed told the Morphys that “we need to change Dixie’s emotional response to the noise.” She prescribed Clomicalm, to ease Dixie’s anxiety and make her more receptive to training, and Xanax, which in the short term would dull her panic attacks and help her sleep. She recommended that they play the recorded sound of fireworks very quietly while rewarding the animal for being calm. A few weeks later, Jen reported that Dixie was sleeping through the night.

THREE WEEKS AFTER MAX started Clomicalm, Allan and I took him for a walk along a creek. He sniffed the grass on the banks; he barked at a passing dog. We got back to the house, and as we took turns tossing the Frisbee to Max on a lawn out front, I asked how things were going with the tail chasing. “He still does it,” Allan said. “But it’s not as bad as it was.” According to the vet, the drug needed another couple of weeks before it would be fully effective on Max’s neurochemistry, so Allan was withholding judgment until then. A couple of months later, Allan told me that he thought Max was only spinning half as much as he had.

Dodman says that the serotonin-affecting drugs like Clomicalm have the effect of “oil on troubled waters” — they may calm the animal but don’t attack the underlying problem. To learn more about why dogs chase their tails, and in hopes of developing more precise drug treatments, Dodman and other researchers at other universities are hunting for the genetic underpinnings of the disorder.

Dogs are a geneticist’s dream. Lab rats can be artificially induced to suffer certain problems — for example, electrically shocked to create a fearful state — whereas dogs are natural models, exhibiting anxiety, phobias and compulsions on their own. The canine genome, whose sequencing was recently completed, is considerably easier to analyze than the human one. The canine gene pool has been highly restricted and segregated during the creation of distinct dog breeds, much of which happened within the past 200 years. Members within a breed are highly similar genetically, making mutations that might cause behavior problems easier to spot. Purebred dogs are also excellent for testing theories about heritability. “There are fantastic genealogical resources that can connect dogs within a century for dozens of generations,” Hamilton says.

In certain breeds, almost all of the dogs alive today are descendants of a handful of popular sires that exemplified traits that breeders liked — for instance, a snowy white coat or exceptional herding ability. In selecting for these desired traits, however, the breeders sometimes inadvertently selected for the sires’ undesirable genetic mutations. This appears to be the case with canine compulsive disorder. A half-dozen or so breeds are predisposed to get it and in fact are susceptible to particular forms of the disorder — for example, German shepherds tend to tail-chase, while Doberman pinschers suck their flanks. Dodman and his colleagues are running genetic analyses of 146 Dobermans, more than half of them afflicted and the others not. His hunch is that a genetic glitch that leads to overactive glutamate receptors may increase susceptibility for developing compulsive behaviors. The same may be true for people. If this is correct, then it would ratify an approach that Dodman and a colleague have patented for treating both animal and human compulsive disorders with drugs that inhibit the glutamate receptors. Similar hunts are under way for the genetic underpinnings of what looks like psychotic rage in cocker spaniels and phobias in Australian shepherds, and those searches, too, may yield drug treatments for the canine and human versions of those problems.

Though certain dogs are probably genetically predisposed, environmental factors are clearly involved as well. “All of the animals I see that have O.C.D. are anxious individuals who’ve been in a rock-and-a-hard-place conflict situation in their lives which precipitates their condition,” Dodman says. Stressful situations in which an animal is repeatedly prevented from doing what it wants to do lead to anxiety, and anxiety can be relieved by indulging in a repeated behavior that long outlasts the original situation. That, it turned out, was exactly the case with Max. Though he lived a perfect dog’s life in California — plenty of love, company and exercise — Allan said that for most of the first year of his life, when he belonged to another owner, he was confined inside and all alone.

At end of the day that I visited Dodman, we sat watching video clips of dogs repetitively pacing, chasing shadows and snapping at nonexistent flies. Dodman, leaning back in his chair, launched into a story about a human obsessive-compulsive-disorder sufferer he had met — a man who repeatedly tugged at his beard. Dodman asked him if he had ever stopped, and the man said he did during a hitchhiking trip across Canada. Dodman thought he knew why: “He went back to being a human being. He was watching out for real dangers. He was trying to go to real places. He was concerned about his next meal. He was thinking about where he was going to sleep. And he wasn’t concerned about the stupid beard pulling, because now he had a real life. When did the problem start again? The minute he sat back in front of a flickering computer screen.”

Dodman’s theory, essentially, is that the causes of mood disorders and obsessions in humans and our pets aren’t so different — faulty genetics, dreary environments. Whether cubicle- or cage-bound, we get too little exercise; we don’t hunt, run or play enough to produce naturally mood-elevating neurochemicals. Strangely enough, I had already heard this theory — from a pharmaceutical company executive who, for obvious business reasons, didn’t want to be named. “All of the behavioral issues that we have created in ourselves, we are now creating in our pets because they live in the same unhealthy environments that we do,” he said. “That’s why there is a market for these drugs.”

James Vlahos writes for National Geographic Adventure, Popular Science and Popular Mechanics. This is his first article for the magazine.

re-print from LA Times

Fido’s little helper

By Carla Hall, Times Staff Writer
January 10, 2007

Photo Gallery

Animal meds

WHAT could be wrong with Shadow? The green-eyed, long-haired cat had adapted well to his Santa Monica home. There was a carpeted cat tree in the living room for his climbing pleasure. He appeared to have reached an understanding about sharing the house with the other resident feline.

Then one day his owners saw wet spots around the house: Shadow was urine-spraying. The door was a favorite target. So was the side of the sofa. And a corner wall of the living room.

Not to be confused with eschewing the litter pan, spraying is a ritual of territorial marking that cats sometimes do whether they are spayed or neutered — as Shadow is — or not.

Shadow’s keepers, Fernanda Gray and Elliot Goldberg, were distressed. Pet ownership, they believe, is a trust not to be betrayed. “I don’t throw animals away,” said Gray, who with her husband now owns three cats.

But Shadow’s spraying had tested the couple’s resolve. They had to replace draperies, carpeting and the sofa. Their veterinarian was running out of ideas to discourage Shadow’s habit.

Then Gray saw a small newspaper ad in 2001: “Spraying Cats Needed for Study.” Shadow was accepted into a double-blind study of an undisclosed medication’s effect on the behavior.

Fourteen days later, the spraying abruptly stopped.

The drug was Prozac. Five years later, Shadow is still taking the medication — half a 10-milligram tablet once a day — in its generic form, fluoxetine, a $16 supply of which lasts about four months.

“He’s still active, he’s still his hyperactive self,” Gray said. “But it just takes that anxiety away.”

THEY are the new “Prozac Nation”: cats, dogs, birds, horses and an assortment of zoo animals whose behavior has been changed, whose anxieties and fears have been quelled and whose owners’ furniture has been spared by the use of antidepressants. Over the last decade, Prozac, Buspar, Amitriptyline, Clomicalm — clomipromine that is marketed expressly for dogs — and other drugs have been used to treat inappropriate, destructive and self-injuring behavior in animals.

It’s not a big nation yet. But “over the past five years, use has gone up quite a bit,” said veterinarian Richard Martin of the Brentwood Pet Clinic in West Los Angeles. Half a decade ago, no more than 1% of his patients were on antidepressants. Now, Martin estimates that 5% of the 8,000 cats and dogs seen at the clinic are taking drugs for their behavior.

The use of antidepressants is another example of the growing sophistication of medical care available to animals and willingly financed by owners who see pets as cherished companions. For these owners, drug therapy is not just another indulgence like Louis Vuitton carriers and day spas for the pampered pet. In their eyes, medication is urgent. Indeed, the new Prozac Nation is not populated with the worried well of the animal kingdom; it’s filled with animals behaving so badly they’re in danger of being cast off to a shelter and, possibly, a death sentence.

“If you have a cat that sprays constantly, that’s not a cat you’re likely to keep,” said Elyse Kent, the veterinarian who owns the Westside Hospital for Cats. “We were compelled to try these behavioral modification drugs.”

Kent has been treating cats with psychoactive drugs, mostly for spraying or aggression, for 12 years. After a UC Davis study published in 2001 showed that fluoxetine reduced feline spraying — and following the success of Kent’s patient, Shadow, in a Prozac trial — Prozac became a frequent choice at her clinic.

“I’d say twice a week, someone comes in to get a prescription for Prozac or fluoxetine or clomipromine,” said Kent, who nonetheless estimates that at any one time only 1% of her practice’s 3,000 patients are taking a psychoactive drug. (“Six weeks to three months is the average” length of treatment, she said.)

Veterinarians who prescribe psychoactive drugs insist they are not Dr. Feelgoods for the animal set. They do medical work-ups on animals, they say, to rule out physical causes for destructive or neurotic actions and prefer to use behavior modification instead of — or, at least, along with — drug therapy. Sometimes they have to deflate the expectations of owners eager to place their pets on antidepressants.

“I tell people if I had a magic pill, I would give it to them,” said veterinary behaviorist Karen Sueda, who works at the VCA West Los Angeles Animal Hospital. “In most cases when we give medication, it is not going to be a quick fix.”

Said Curtis Eng, chief veterinarian of the Los Angeles Zoo: “My feeling is they are a useful tool — one of many — to decrease stress and anxiety on an animal. If you can relieve the stressors through a behavior management program, I would much rather do that. But sometimes you need a little extra help to get them over that hump.”

When the zoo was coaxing a male orangutan, Minyak, back to respiratory health and enough energy for mating, veterinarians consulted with a psychiatrist and put the primate on the antidepressant Remeron.

“He was put on it for depression,” said Eng, who noted a beneficial side effect: Miknyak hadn’t been eating well and the drug increased his appetite. The orangutan bred successfully, fathering a healthy baby in 2005, and he is being weaned off the antidepressant.

THE drugs administered to animals fall mainly into two classes of antidepressants commonly prescribed to humans: selective serotonin reuptake inhibitors (SSRIs) and tricyclics.

Both groups control the levels in the brain of serotonin, a neurotransmitter that is believed to affect mood, depression and anxiety. The tricyclics also work on other neurotransmitters, including norepinephrine, which is thought to affect attention and impulsiveness.

In most cases, the drugs are being administered off-label, meaning they have not been put through the trials required for FDA approval for use in specific animals. (The Food and Drug Administration regulates drugs for both animals and humans.)

Clomicalm, a tricyclic manufactured by Novartis, is the only antidepressant approved by the FDA for dogs as a treatment for separation anxiety.

Veterinarian Scott Huggins, manager of technical marketing for Novartis, maker of Clomicalm, said that dogs are not intended to stay on it for life. “We don’t have specific studies on long-term use,” said Huggins, adding, “I do know it happens.”

In general, vets prefer to taper their patients’ use of the drugs. “We try to use these medications short-term,” said Kent. “Because they are not without side-effects.”

Antidepressants are believed to work on animals’ brain chemistry the same way they do on humans’. The difference is that veterinarians will not say they are treating clinical depression; many don’t believe an animal can be clinically depressed.

“A lot of the outward manifestations — decrease in appetite, trouble sleeping, not taking joy in activities — are there in dogs and cats,” Sueda said. “But you can’t ask a dog or cat, ‘Are you despondent?’ ”

But veterinarians will say that animals experience anxiety. Dogs with separation anxiety can bark endlessly, destroy household furniture, gnaw through fences or even fling themselves out of windows after owners leave. Birds have compulsively plucked themselves to partial baldness. Troubled cats maul their owners, hide for hours or refuse to use their litter boxes.

Bob Stewart, now the sole owner of a cat since his companion, Anne Marie Schmitt, died of cancer, recalls how his otherwise mellow feline would turn into a leopard-like creature. At one point, when Serendipity clawed Schmitt’s arm badly enough to send her to the hospital, Stewart says they considered drastic action. “If we could not have gotten her controlled, as much as we loved the cat, we probably would have had to find a way to get her adopted or send her to one of these shelters,” said Stewart, a retired game show producer who created the original “The Price is Right” and “Password.”

The owners refused to have the cat declawed. Instead, for the last several years, a daily dose of “triple fish-flavored” fluoxetine has, for the most part, quashed Serendipity’s desire to practice her hunting skills on humans.

“I thought it made sense,” said Stewart, sitting in his apartment with Serendipity resting nearby. “They feel pain as we feel pain. They feel happiness as we feel happiness. I didn’t question the idea that a drug could change the persona of an animal.”

As with humans, choosing the right drug and dosage for an animal is a process of trial-and-error. “A lot of behavior treatment is an art,” Sueda said.

No one knows that better than Amy Weber, who adopted Sam, a spayed female dog, 10 years ago. The Labrador/beagle mix appears sweet-natured and calm as she lies in the living room of the rambling Beechwood Canyon home Weber shares with her partner, Wendy Schwartz, and five pets. The couple’s other dog, Scout, busily scouts for affection. A hulking orange cat, Stripper, saunters by, pausing to swat Sam. The action elicits a gasp from the humans but only a quizzical look from Sam.

For several years, Sam was anything but calm when her owners left the house. She scratched doors, chewed through washing machine hoses and gnawed the wood trim on windows, sometimes cutting her mouth. If she was left outside, she either dug her way out of the yard or ripped through wire fences, scratching her head in the process.

Weber tried Clomicalm, tranquilizers, homeopathic remedies and Cesar Millan, the “Dog Whisperer.” But Sam’s separation anxiety defied all drugs and therapy for a time.

Although Weber, who edits movie trailers, put together a nearly full-time schedule of sitters and walkers for Sam, that didn’t stop the dog from going into a frenzy if Weber and Schwartz went out for the evening.

Then Weber hired Sueda, who put Sam on a regimen of Amitriptyline during the day and recommended Xanax at night if the couple wanted to go out. And she started the dog and her owners on a behavior training program.

(There are only 42 board-certified veterinary behaviorists in the world, according to Melissa Bain, chief of behavior service at the teaching hospital at the UC Davis School of Veterinary Medicine. Technically, Sueda is not one of them — she hasn’t taken her boards yet — but she is, practically speaking, L.A.’s veterinary behaviorist.)

“I never look at medication as a cure-all — just like with people,” said the veterinarian, who delves into the history of each animal’s situation.

Appointments with Sueda aren’t cheap. A package of two lengthy visits — the first is two hours — follow-up phone calls and e-mails is $550, not counting what Sueda charges if she travels to the owner’s house.

Brand-name Prozac can cost more than $100 a month, but most vets now prescribe fluoxetine, a monthly regimen of which can cost pet owners a few dollars a month to about $20, depending on the dosage.

Bain is wary of medications. “Drugs don’t work that easily,” she said. “And they don’t work without behavior modification.”

Much of what animals do, Bain said, is normal, just unacceptable — a result of owners incorporating their pets into close urban quarters. “Breeds of animals have not changed that much in 20 or 30 years, but human society has,” she said.

“What have we done to our animals? In the last 30 years, we’ve kept them inside, we’ve made multiple-cat households. A border collie, 20 years ago, was living on a ranch in Colorado, and now he’s living in downtown San Francisco. So he can’t do his typical behavior.”

Moustafa Seoud, a veterinarian for 17 years, sees drugs like Clomicalm or Prozac as “an easy way out.” Seoud, who practices at the Laurel Pet Hospital in West Hollywood, relies on massage, acupuncture and homeopathic treatments. “Homeopathic flower essence works well for cats with different problems — stress and anxiety and kidney problems.”

He dispenses different types of remedies for different problems: “Camomile is calming; Ignatia for grieving; Nux Vomica for nervousness.” One of Seoud’s clients said that one time, as he prescribed a homeopathic remedy for her withdrawn cat, he popped some of it into his own mouth and declared: “You can take it too.”

Conventional drugs seem to be working for Sam, the dog with the bad case of separation anxiety. Weber tells Sueda that Sam has been fine when she’s left the dog alone for a few hours during the day. And Sam has stopped following Weber around the house constantly. “She’s just calmer,” Weber said.

“That’s what we’re aiming for,” Sueda said. “A general, overall sense of calm.”

that is the question

Know the difference… Regurgitation is a favorite pass time for my cats.

Cats can have “non-specific vomiting and/or vomiting and diarrhea… Know you pet..

good article below:

Vomiting is a very common problem in dogs and cats. There are many causes of vomiting. Primary or gastric causes of vomiting are those that are due to diseases of the stomach and upper intestinal tract. Secondary or non-gastric causes of vomiting are caused by diseases of other organs that cause an accumulation  of  toxic substances in the blood. These toxic substances stimulate the vomiting center in the brain causing the animal to vomit.

A problem that can be confused with vomiting is regurgitation. Vomiting is the ejection of contents of the stomach and upper intestine; regurgitation is the ejection of contents of the esophagus. The esophagus is a narrow, muscular tube that food passes through on its way to the stomach. In health, food moves quickly through the esophagus to the stomach. If the muscle of the esophagus loses tone, the esophagus dilates, a condition called megaesophagus. A dilated esophagus does not effectively move food to the stomach and the animal will regurgitate food usually shortly after eating. The food may also be inhaled into the airways causing pneumonia and cough.

When you present your pet to the veterinarian because he or she is vomiting, the veterinarian will ask questions in attempt to differentiate between vomiting and regurgitation and to try to determine if your pet is vomiting due to gastric or non gastric disease. Vomiting is an active process. The pet is apprehensive and heaves and retches to vomit. If food is present in vomit, it is partially digested and a yellow fluid, bile may be present. Regurgitation is fairly passive. The animal  lowers its head and food is expelled without effort.  The food brought up by regurgitation is usually undigested, may have a tubular shape, and is often covered with a slimy mucus. The pet will often try to eat the regurgitated material. You may bring a fresh sample of “vomit” for the veterinarian  to examine. The pH of vomit containing food is acid, the pH of regurgitated materials is higher. Your ability to answer questions about your pet’s activity, habits and environment will help the veterinarian decide which causes of vomiting are most likely in your pet. A history of any drugs your pet is receiving is important. Over-the-counter pain medications such as aspirin and ibuprofen can cause severe stomach ulcers in dogs depending upon the dose and duration of treatment.  The veterinarian may ask you to describe the appearance of the vomit, as well as describe how your pet looks when it vomits and the relation ship of vomiting to eating. If the vomit contains blood it may be fresh, red blood or look like coffee grounds if the blood is digested. Blood is most often seen with stomach ulcers, stomach cancer or uremia (a collection of signs including vomiting seen in pets with kidney failure). Stomach ulcers can be caused by drugs or the presence of a mast cell cancer in the skin. Mast cell cancers release histamine that leads to stomach ulcers. Regurgitation often, but not always, happens right after eating and the pet will try to eat the regurgitated food.  Vomiting occurs a variable time after eating or may occur in a pet who is off food. Animals with a twisted stomach, gastric dilation-torsion, may make frequent attempts to vomit without producing anything. Pets with a hacking cough may retch and sometime vomit at the end of an episode of forceful coughing.  An accurate description in this case would lead to an investigation of the causes of coughing, rather than vomiting.

If your pet vomits just occasionally and has a specific series of actions associated with vomiting, you may consider video taping an episode of vomiting to help describe the episodes to the veterinarian.

The physical examination of the vomiting pet can also provide information to narrow the list of possible causes.  The presence of fever, abdominal pain, jaundice, anemia or abnormal masses in the abdomen will help the veterinarian make a more specific diagnosis. The mouth should be carefully examined as some foreign objects such as string can wind around the base of the tongue with the rest of the object extending into the stomach or small intestine. A nodule may be palpated in the neck of cats with hyperthyroidism.

The list of non-gastric causes of vomiting is long.

Pancreatitis in the dog causes vomiting that is sudden in onset and often severe. The dog may have a painful belly. Pets with pancreatitis often have a  history of eating garbage or fatty table scraps. Tumors of the pancreas can cause similar signs to pancreatitis. Pancreatitis occurs in the cat but the signs are subtle and non specific and often don’t  include vomiting

Kidney failure is a common cause of vomiting in dogs and cats. The kidneys can be acutely (suddenly) damaged by poisons such as antifreeze or by severe dehydration.   Waste products that the kidneys normally get rid of, rise to high levels in just a few days. The kidneys can also gradually lose their ability to remove waste products from the body as the pet ages. Early signs of kidney failure include drinking and urinating large amounts called polyuria and polydipsia or PU-PD. PU-PD may be present for months to years before the kidney failure is severe enough to lead to waste product accumulation and vomiting. Vomiting in chronic kidney failure may began as occasional episodes and progress to severe, frequent vomiting. The pet with chronic kidney failure will often lose body condition and may have pale gums due to anemia.

Non-spayed, middle aged female pets can develop a uterine infection called pyometra. Pyometra occurs within 2 months after a heat cycle and often results in discharge of pus from the vagina. The pet may frequently lick the vagina so discharge may not be seen. Dogs develop pyometra more often than cats. Other signs may include PU-PD and depression.

Liver failure causes vomiting as well as other signs depending on the type of liver disease. Other signs of liver disease may include seizures, jaundice (a yellow discoloration of the areas of skin not covered by fur), PU-PD and fluid accumulation in the belly or legs. Bladder obstruction or rupture will cause a sudden onset of vomiting. The urethra that leads from the bladder to the outside can get plugged by stones or tumors. The animal  will strain and pass just a free drops of urine or none at all. They will also have a painful belly. Bladder obstruction if not corrected, is fatal in just a few days. The bladder can be ruptured by blunt trauma such as being hit by a car or kicked.

A form of diabetes called ketoacidosis will cause vomiting along with depression and PU-PD.

Addison’s disease is a deficiency of hormones from the adrenal gland and causes vomiting, diarrhea and weakness. Addison’s disease occurs most commonly in young to middle aged dogs, most of which are female. Addison’s is rare in the cat.  The signs of Addison’s disease may be intermittent or may be very severe and constant.

Diseases of the inner ear can cause vomiting accompanied by incoordination, circling and tilting of the head to the side. Motion during car rides stimulates the inner ear and can cause vomiting.

A sudden onset of vomiting in young, poorly vaccinated pets may be caused by infectious agents including canine distemper, canine parvovirus and feline panleukopenia virus.

There are many toxins including lead, insecticides, antifreeze and other chemicals that can cause vomiting.

Cats with elevated thyroid function, hyperthyroidism, may vomit in addition to other signs including, increased appetite, weight loss, hyperactivity and a poorly kept coat. Heartworm disease in cats may cause vomiting in addition to coughing, respiratory distress, weight loss and depression.

Primary causes of vomiting include acute gastritis often due to eating garbage or other types of dietary indiscretions; the ingestion of large amounts of hair during grooming; ulcers of the stomach; stomach or upper intestinal cancer; parasites; food allergies; the presence of a foreign body stuck in the stomach or upper intestine; twisting and dilation of the stomach; and intussusception which is a telescoping of one part of the intestine into another piece of intestine.

The stomach is usually empty 6 to 8 hours after eating. Vomiting of  food when the stomach should be empty suggests an obstruction of the stomach or abnormal motion of the stomach muscles that normally grind food and push the ground food out of the stomach.

Tests to differentiate primary causes of vomiting include x-rays or ultrasound of the abdomen and endoscopy. Endoscopy is the technique of passing a flexible scope into the stomach and upper intestine to examine the inside of these structures. It may be possible to remove a foreign body with endoscopy and small biopsies of the lining of the stomach and intestine can be taken for microscopic evaluation. Endoscopy requires general anesthesia.

If the pet vomits sporadically, the results of all tests may be normal. Many healthy dogs and cats vomit occasionally without identifying a cause. Sometimes the cause of vomiting is as simple as the pet eating too fast.  The treatment for vomiting depends upon the cause. Nonspecific treatment for vomiting includes fasting, and fluids to correct or prevent dehydration.  In episodes of sudden onset of vomiting,  food is withheld for 24 – 48 hours and water for 24 hours. Water should never be withheld from an animal with known or suspected kidney disease without replacing fluids intravenously or subcutaneously (under the skin). If vomiting stops, small amounts of a bland low-fat food are fed 3 to 6 times daily for a few days, with a gradual increase in the amount fed and a gradual transition to the pet’s normal diet. Water is also reintroduced in small amounts on the second day. You may start with  ice cubes and then gradually increase the amount of water over the day if vomiting does not reoccur.

If the pet is bright and alert and has had no previous health problems, episodes of acute vomiting  may be managed at home, although veterinary consultation prior to home treatment is advised.  Consultation with a veterinarian in your region may reveal a recent outbreak of an infectious disease causing vomiting or identify  a cluster of recent poisonings. With this type of knowledge you will want to have your pet evaluated rather than waiting a few days. Dogs and cats who vomit for longer than a few days or are depressed or dehydrated should be presented for veterinary evaluation.

Flea shampoo or dog shampoo?  Don’t buy into it, or buy it..

If your dog does have fleas.. use flea spray then shower ..and then use something like, Advantage or Revolution.. so worth it.. forget the off brands..  do a google search for best prices.

Have your dog shake with before he or she leaves the shower.. then keep the towel over them when they get out cause they will shake again.  Then you can get back into the shower and rince off..

Jackie Brown leaving the shower…

video

Condider using Palm Husk or leaves to feed and water so that the dishes do not call attention.. see great ideas at web site below..

Feral Power…

The below is borrowed from Stray Cat Alliance

http://www.straycatalliance.org/index.php

ONE:
Feral cats should be humanely trapped. Cats should be vaccinated for feline disease, including rabies and spayed/neutered. After recovery, feral cats should be returned to the colony, at the original location. Surgeries and treatments (including inoculations) must be administered by a consultant veterinarian(s).

TWO:
At the time of the sterilization, Colony caregivers should consider requesting the veterinarian to draw a blood sample from some colony members, for the purpose of monitoring any zoonotic disease that might affect the colony or caregiver.

THREE:
Colonies should not be located near endangered species.

FOUR:
Colonies can only be allowed with written permission from the landowner.

FIVE:
A caregiver and alternate caregiver must agree to take responsibility for the colonies. Ideally, the landowner should take responsibility for their colony. In all cases, caregivers must be trained and certified in humane trapping, recognition of symptoms of feline diseases, principles of feral cat care and maintenance, and policies/guidelines regarding TTVAR-M Feral Cat Colony Control.

SIX:
The organization should monitor caregivers and audit colonies on a regular basis. It is suggested that inventories and detailed records should be kept regarding each colony, and include identification characteristics (including numbers) for cats, medical records, and pertinent history regarding trapping, deaths, and vaccination dates.

SEVEN:
Newcomers to the colony, cats that are losing fear of humans, and kittens should be removed from the colony. A size “cap” should be determined for the colony. While the colony will decrease in size due to attrition, it may be possible that at some point the cats may feel it necessary to allow the addition of a newcomer, or young neutered male. While, the maximum size of a colony will be unique to the environment, under no circumstances should the colony be allowed to grow for any other reason.

EIGHT:
Discreet shelters should be provided for each colony. Diet should be arranged after consultation with a veterinarian(s). Food should be removed before nightfall, in order to prevent attraction by wildlife. Water should be provided in areas lacking a natural and safe supply.

NINE:
In no instance should cats be trapped and released to other locations without the permission of both landowners. Relocation of non-socialized cats to other locations should only occur if absolutely necessary.

TEN:
In order to discourage abandonment, information regarding locations of colonies should not be released to the public.

FAQs

Frequently Asked Questions

What is a feral cat?

Feral cats are outdoor, free-roaming cats who have never been socialized to humans and are living in a “wild” state. This could be a formerly domestic cat who has been abandoned and has reverted back to a “wild” state, or a cat who has been born on the streets and has never had any contact or interaction with humans. Feral cats look like regular domestic house-cats, but because they have never been socialized, they are very fearful and distrustful of humans. Some arch their backs and hiss and show aggression, others just avoid eye contact and run. With true ferals, you can’t pick them up or handle them. Very often you can’t even get close to them. They are the un-owned cats or “community cats.”

What is a stray cat?

Stray cats are former pets or companion cats who have been abandoned or “strayed” from home and become lost. Stray cats are generally tame and handleable. These cats used to be cared for by an owner, but are now trying to survive on their own on the streets. Stray cats can be handled and held, although they still may be skittish or frightened and run away from people. Generally, though, stray cats exhibit similar temperaments as pet cats and can be rescued off the streets and adopted into homes again.

What is a tame cat?

A tame cat is a friendly, domesticated cat. “Tame” refers to the disposition of the cat. Tame cats can either be someone’s pet or companion, or they can be a friendly stray cat making his/her way on the street. Tame cats can generally be picked up, held, touched, and are used to being around or living with people.

What is TNR and what does it stand for?

TNR stands for Trap-Neuter-Return. Trap-Neuter-Return is a community-based program. It involves concerned citizens like you trapping feral, free-roaming cats in your neighborhood, bringing them to a clinic like FixNation to get them spayed or neutered, and then returning the cats to the exact spot where you trapped them so they can live out the rest of their natural lives.

Why does TNR work?

Spaying and neutering the cats will end the cycles of homeless kittens being born so the population stabilizes, and over time it reduces naturally. Once the cats are fixed, the problematic behaviors of howling, cat fighting and spraying also subside. Trap-Neuter-Return is the only humane way to effectively reduce the feral cat population, so that people and cats can peacefully co-exist.

Can’t I just trap the cats and remove them?

Trap and remove does not work. Cats are there in the environment because of two main reasons: 1) there is a food source (intended or not) and 2) there is some sort of shelter. When cats are removed from a location, the surrounding cats breed rapidly to fill in the gap, plus new cats move in to take advantage of the natural food and shelter. This “vacuum effect “is well documented. Trapping and removing cats often results in you having even more unsterilized cats than when you started. Apart from being ineffective, trapping and killing is inhumane and very costly to taxpayers. Trap-Neuter-Return is the only proven solution. TNR stops the cycle of kittens and caps the population growth, so that the population will naturally be reduced over time.

What if I take the feral cats to the shelter? Can the shelter find homes for them?

If you take feral cats or feral kittens to the shelter, the shelter will euthanize them. Feral cats have never been socialized to humans so they are deemed “unadoptable” by the shelter and they are not even shown to the public. They are held for the mandatory state holding period of three days and then killed. Even supposedly no-kill shelters are not able to place feral cats in homes and the cats are killed.

I feel bad for the feral cat. Can I just keep it as a pet?

Feral or “wild” cats are not pets. Feral cats already have a home… outside. Feral cats are very fearful and distrustful of humans and therefore un-adoptable. Confining them in a home is like keeping them in captivity for life. Feral cats live outdoors just like other wildlife.

Feral kittens can often be adopted into homes, but only if they are socialized at an early age. Generally kittens up to around 12 weeks of age can be tamed relatively easily. However, the older the kittens get, the harder it is to tame them. Whether you can tame them or not also depends on the temperament of the kitten; some are more gentle and friendly than others. There is a critical window of time in which kittens must be socialized, and if they aren’t handled in time, they will remain feral and therefore unadoptable.

Stray cats, however, can be taken into homes as pets. Remember, stray cats used to be someone’s pet and were either abandoned or they “strayed” from home and became lost. These are cats who are used to being in homes and are struggling to survive on the street. Tame, friendly stray cats can and should be picked up off the street and adopted into homes again.

I’m way too busy to trap. What happens if I just ignore the cats?

If you ignore the cats, they will continue to breed prolifically. Cats can start having litters when they’re only five months old, and they can have 3-4 litters a year, usually of 5-6 kittens per litter. If you just ignore the situation, in a short time you can easily go from three or four cats to 30+. Trap-Neuter-Return is the only solution to control the population growth. Start TNR’ing now before the problem gets out of control.

What is FixNation’s free feral program?

FixNation offers free spay/neuter services for homeless, stray and feral cats. Under our free feral program, all homeless cats who will be “eartipped” for identification purposes will receive the following free services at the time of surgery: Spay/neuter, rabies vaccine, feline distemper (FVRCP) vaccine, flea treatment, de-worming, fluids, antibioitic and pain medication.

What is an eartip? Why do I need to eartip a feral cat?

Eartipping is the universal symbol to identify that an outdoor or free-roaming cat has been fixed. This involves clipping off, or “tipping” the upper 1 centimeter of the cat’s right ear so that it’s straight across instead of coming up into a point. This is done while the cat is under anesthesia, is relatively painless for the cat, and it does not significantly alter the appearance or beauty of the cat. (See photo below.) Since feral cats are wild, you cannot get close enough to them or pick them up to tell if they have been fixed before. The eartip allows you to recognize at a distance whether the cat has been fixed. It is a sign to your neighbors, other trappers and caregivers in the area, and even to Animal Control that the cat has been fixed.

Eartip example

I have feral cats in my neighborhood that I would like to get fixed. Where do I start? What do I need to do?

Before you can come to our clinic, we first require an application. You can download our application from our website. You will find both our Feral Cat Application and our Tame Cat Application on our homepage in the lower right-hand box under our Forms & Resources section. You can complete whichever application is most appropriate to your situation. When you’re done, you can either email it back to us, fax it to us or mail it in. Our fax number, email and physical address are all listed on the top of the application form.

Once we receive your application back, a staff member will call you within 48-72 hours to get you started, loan you humane traps if need be, and get you scheduled for initial reservations. Reservations must be made in advance. Please do not bring cats to our clinic without a confirmed reservation, as you will be turned away.

I want to get my own pet cat fixed, but I can’t afford to. Can you help me?

FixNation will provide free spay/neuter services for any cat, regardless of your income qualifications, provided that the cat gets eartipped. Under our free feral program, all homeless cats who will be “eartipped” for identification purposes will receive the following free services at the time of surgery: Spay/neuter, rabies vaccine, feline distemper (FVRCP) vaccine, flea treatment, de-worming, fluids, antibioitic and pain medication. We can do a small eartip on request, particularly if the cat is your own companion cat, a stray cat who you rescued and are trying to find a home for, or for any kittens who you rescued who you are trying to tame down and adopt out.

What if I don’t want to eartip the cat?

For any tame, companion cats or rescued kittens who are not getting eartipped, we do offer spay/neuter services at reduced rates. The cost of a female spay is $55 and a male neuter is $40 (as of 1/1/10). We also offer vaccines and flea treatment for tame cats for an additional cost and only at the time the cat is here for spay/neuter surgery. If you live in the city of Los Angeles, you may qualify for a city spay/neuter voucher good for $30 off the price of the surgery (or $70 off for low-income families). City vouchers can be picked up at any city animal shelter provided they have some available.

What if the cat is pregnant?

It is safe to spay your cat even if she is pregnant. The pregnancy will be humanely aborted. While later term pregnancies pose a slightly higher surgical risk, our veterinarians are highly experienced and it is safe to spay your cat at any point during the pregnancy.

This female cat just had kittens. When should I get her spayed?

We request that you wait until the kittens are 5 weeks old before you trap and bring in the mom. Kittens under 5 weeks need their mother since they have to nurse every couple of hours. They also require their mom to be able to keep warm, since they can’t hold in body heat on their own yet. The kittens also can’t go to the bathroom on their own yet; the mother has to stimulate them to go. After 5 weeks of age, kittens can go a slightly longer time without their mother and they are able to eat wet food and go to the bathroom on their own.

After the spay, can the mother cat still nurse her kittens? Is it safe for the kittens?

Yes, the mother cat can still safely nurse her kittens after the spay surgery. She will continue to produce milk, and nursing won’t interfere with her ability to heal post-surgery. It is also safe for the kittens to nurse and the spay won’t interfere with the milk production at all.

Ron Hines DVM PhD

Next to fleas, allergies are the most common cause of itching and scratching in your pet.

Also common, are two forms of mange, sarcoptic and demodectic which can also be responsible for hair loss and scratching. Fleas are dealt with in another article in this series and sarcoptic and demodectic mange are also covered elsewhere.

I included a diagram of the flea life cycle here, because over half the cases of allergic skin diseases have fleas – seen or unseen – as the underlying cause. Once you are certain that no fleas or mites are present, it is likely that allergies are the cause of your pet’s scratching. In human beings, allergies are often expressed through the respiratory system. If you yourself have allergies, you are likely to have a stuffy nose, sneezing and watery eyes. This is because the histamines that humans produce are released primarily in the membranes of the respiratory system and eyes. In dogs, histamines are released primarily in the skin.

How Allergies Occur:
All chronic allergies are based on the body recognizing protein substances as foreign and trying to rid itself of them. Mold, dander, bacteria, pollen, flea saliva along with a host of other substances are allergens made up of proteins foreign to the body.
We will talk about pollen allergies for an example because they are so common. In this case pollen is called an allergen – something the body recognizes as foreign. When a pet’s immune system is exposed to pollen for the first time, some pollen attaches to the linings of the nose and lungs . The body’s immune system recognizes that pollen is not supposed to be there and, in response, produces antibodies against the pollen called immunoglobulins of the E class (IgE) and G class (allergen-specific IgG). This process is called sensitization. The IgE attaches to cells in the body called mast cells. These cells then leak and release histamines, bradykinins, and proteolytic enzymes, which cause the symptoms of allergy. In people large numbers of mast cells are located in the respiratory system. That is why our allergies usually have respiratory system symptoms. In dogs and cats, more mast cells are present in the skin. That is why dog and cat allergies usually cause signs associated with the skin and ears such as itching, hives and inflammation. This allergic disease is called atopy. Only 15% of pollen allergies in dogs and cats cause respiratory system signs, such as nasal stuffiness and sneezing.

Types of Allergies:

There are two types of allergies that cause dogs and cats to itch. Because susceptibility to allergies is inherited, it is quite common for pets to have both types.
Canine Inhalant Atopy
This is the type of allergy for which we used pollen as an example. It is the most common form of allergy in dogs and cats, making up over ninety percent of the cases I see. About nine percent of the canine population has this disease. Certain breeds are more susceptible to than others. Among the most susceptible are Shar-peis, Fox Terriers, Golden Retrievers, West Highland White Terriers, Scottish Terriers, Shih Tzus, Dalmatians, Lhasa Apsos, Boston Terriers and Labrador Retrievers. Cats of any breed can be affected. Dogs usually show their first signs of itching between 10 months and 4 years. If a dog does not have this condition by the time it is four years of age it is unlikely that it will ever have atopic skin disease. The disease often begins as a seasonal problem but after a number of years (or moving to a southern climate) the itching occurs year round. Some common allergens are flea saliva, tree, grass and shrub pollens, house dust, mold, dust mites, and feathers.
Flea saliva allergy is a special form of Atopy. Fleas survive by sucking blood from your pets. To get this blood they drill their mouthparts into the dog or cat’s skin and inject special anticoagulant saliva into the site to keep blood flowing while they engorge. This saliva is highly irritating to some dogs and cats. These pets do not only itch at the site of the flea bites, they itch all over. The pads of their feet are often itchy, puffy and inflamed. Areas between the toe pads as well as the ears often become infected with bacteria due to the pets constant licking and chewing. Because of the availability of excellent flea-control products such as Advantage and Frontline, I see less flea allergy than I used to.

Food Allergies:

Food allergy cases are less than fifteen percent as common as canine atopy but occur with about the same frequency as atopy in cats. The itching food allergies produce is constant throughout the year. Cocker Spaniels, West Highland White Terriers and Labrador Retrievers are particularly susceptible to food allergies. However, the majority of these breeds that have itching problems do not have food allergies. Dogs and cats can be any age older that a few months when signs first begin. Some common food allergies in dogs are to beef and pork, fish, dairy, eggs, corn, soy, wheat and preservatives and dyes in food and treats. But almost any diet ingredient can be involved. The most common allergens in cats are to fish, beef and chicken.

Symptoms:

Canine Atopy and food allergies are not visually distinguishable because the signs of both diseases are the same. The most common sign of the conditions is constant itching, scratching and licking. Dogs will often rub on objects. The degree of discomfort the pet undergoes is partly dependent on its temperament. High strung breeds and very active pets do severe damage to their skin. The face, lumbar area at the base of the tail (particularly if fleas are the cause) ears and paws show the most damage. In severe cases the skin of the whole body is inflamed and covered in crusts while the hair coat is thin and broken. In mild cases the pets only lick these areas, discoloring light hair coats with salivary stain. When fleas are the problem, small pepper-like granules are present over the neck or in the dorsolumbar area. These specks of digested blood or flea dirt will “bleed” a rust-colored trail if moved to white tissue paper and wetted with water.

As the dog or cat scratches, it destroys the outer waxy layer of the skin. This allows bacteria and mold to enter the skin and causes a musty, oily skin condition called seborrhea. Because ears are covered with skin, ear canal redness, odor and inflammation are common in canine atopy. Sometimes ear problems are the only sign present. When this is the case, we treat the ears with specific antibiotic, antifungal, corticosteroid preparations but must treat the whole dog with medications as well.

Cats develop a condition called milliary dermatitis in which the surface of the back and scruff of the neck are covered with bumps and scabs. Allergic cats sometimes develop another condition called eosinophilic granuloma complex in which ulcers form on the lips, tongue and surface of the body. After months and years of scratching, the skin of the inner thighs and flank often becomes thickened and blackish. This condition is called acanthosis nigricans.

Damaged skin due to the pets scratching often leads to superficial staphylococcus bacterial infections (pyoderma) and infection with the yeast, Malassezia. Mild bacterial conjunctivitis or eye infections with greenish matter at the inner corner of the eye are common. It is important to realize that although a bacterial or fungus condition is present and may need treatment, the root of the problem is allergic dermatitis. In very severe cases of skin allergy, the superficial lymph nodes of the body enlarge due to secondary skin infections.

Diagnosis of Allergic Skin Problems:

The clinical diagnosis of allergic dermatitis is one of exclusion of other causes of skin disease. I usually do skin scrapings when pets with this condition are presented to me for the first time. Through skin scrapings, I try to rule out mange as a cause of the pet’s problems and locate bacteria and fungi. If I cannot rule out mange, if the dog’s history suggests it might be mange, or other members of the household are itching, I may put the pet on a test dose of a safe anti mange medicine called ivermectin. I next try to rule out fleas as the source of the problem. Some dogs are so good at grooming that no fleas remain on them when they are examined. Even when I cannot locate fleas on the pet I can often locate flea dirt. In some of these pets the presence of tapeworms is the only indication of fleas or I may find fleas on another household pet, which does not have skin problems.

There are other signs that the problem may be allergic. Typically atopy occurs in dogs between one and three years of age. This makes the diagnosis of allergies in puppies and older dogs less likely. The first two or three years that the condition exists it is often seasonal occurring only in the spring and summer months. Flea-related allergies tend to subside after the first few freezes of the winter. Golden retrievers and arctic breeds with thick oily hair are susceptible to a special form of dermatitis called hot spots or acute pyotraumatic dermatitis. In these cases the dogs suddenly become extremely itchy over a small area. They are so troubled that they pull out the fur of this area and infect it through chewing in a matter of hours. The itching sensation departs rapidly thereafter -with or without treatment. It is not known if they represent a true form of allergy. Another form of the disease is called acral lick dermatitis. In these cases a small area of skin itches over an extended period. Licking leads to a well-defined small area of raw skin, scarring and bacterial infection.

I try to learn if the parents of the dog or cat or its brothers and sisters also have itchy skin disease. Canine atopy as well as food allergies runs in families.

In diagnosing food allergies I look for uniform involvement of the skin over the entire body. I rarely find that diarrhea accompanies food allergies. Often the best way to rule out food allergies is to put the pet on a sixty to ninety day trial eating a hypoallergenic diet exclusively. Many hypoallergenic diets are available. Until recently these diets relied on novel protein sources such as lamb, venison duck or fish. The problem is that with time, pets eventually became allergic to these diets too. Now two brands of hypoallergenic diets are available that use heat and hydrolysis to break food proteins into a size too small to cause allergies (less than 10,000 daltons). The biggest problem with these diets is that some pets won’t eat them.

I will usually examine pets with skin disease in a darkened room with an ultraviolet lamp. Hairs that glow are diagnostic for ringworm. Ringworm is almost never itchy and glowing hairs are not found in cases of allergic skin disease.

Il often encounter Malassezia yeast in skin scrapings of dogs with itchy skin. This fungus is a normal inhabits the skin of dogs. It only becomes a problem when the pet has an underlying problem such as allergic skin disease. Antifungal shampoos are quite helpful in controlling it.

Allergy Tests

Rast Test (In-vitro (laboratory) test, performed on your pet’s blood)

As in humans, allergy testing can be helpful in diagnosing allergic skin disease. Two forms of allergy testing are available. The easiest and most commonly performed test in animal hospitals is called the RAST test. This test, which is performed on a blood sample from your pet, stands for radioallergosorbent test. In the test, the presence of IgE antibodies to specific antigens is determined by a central laboratory. Pets must not have had corticosteroids or antihistamines administered for thirty days prior to testing. The problem with this test is its high number of false positives. If the test determines that a pet is not allergic to an antigen – that is probably correct. But positive reactions often turn out to be wrong. If the RAST test is used, the central laboratory will prepare an antigen extract, which can be injected into the pet’s skin periodically to decrease the effects of allergies. The most current research indicates that this test extremely inaccurate in pets and humans. Go with skin tests if at all possible.

Skin Test

A more reliable test is an intradermal skin test. Before the test is administered, the pet is taken off all corticosteroid, tranquilizing or antihistamine medications for 30-60 days. In this test, small amounts of various allergens are injected into the skin. The entire side of the pet must be shaven to perform this test. Then the injection sites are monitored over an hour’s period to judge the degree of redness and swelling at each site. A list of offending antigens is used to prepare an allergen extract, which is injected periodically into the pet. With time and success, these injections lessen the pet’s allergies to these allergens. Because a high degree of skill is necessary in giving and interpreting the results of this test, veterinary dermatologists usually perform it.

Occasionally, when I am uncertain if the problem is a routine case of allergy, I will take a biopsy specimen of the skin involved and send it to a pathologist for evaluation and diagnosis. This can rule out the presence of other disease such as lupus. Blood tests may detect elevated levels of eosinophiles, which occasionally also occur in allergic skin disease.

Treatment of Allergic Skin Disease:

It is next to impossible to avoid all the environmental allergens that plague allergy-prone dogs and cats. The exceptions are pets that are chiefly bothered by fleas. I enforce strict flea control – even if I am uncertain that fleas are present. Many dogs and cats are cured by this simple task alone.

Approximately one in twenty of my clients elect to undergo skin testing and desensitization of their pets. This figure differs from practice to practice. The procedure takes a bit over a year to show results. Dermatologists argue for the procedure pointing out, correctly so, that even if desensitization does not cure the pets, it may lower the dose of corticosteroids they require later in the disease. Skin testing also identifies the allergens and perhaps some of them can be avoided or eliminated from the pet’s environment. The procedure is extensive, expensive, and requires a life-long commitment to frequent injections. Most owners learn to give these injections themselves.

Medicines of the cortisone class are effective and dramatic in controlling the symptoms of allergic skin disease. The problem is that this class of drugs has substantial and serious side effects when given in high doses or over extended periods of time. My challenge is to treat these pets as long as I can without the use of these steroids. To do so, I use medications that are effective but less dramatically so.

Medicated Shampoos.

Medicated shampoos are quite soothing to inflamed skin and lessen itching. I begin using clear tar preparations such as lye tar shampoos. If these are not adequate, I dispense selenium sulfide or benzyl peroxide shampoos. Benzyl peroxide is quite effective in eliminating secondary bacterial infections in these cases. Some pets are helped by oatmeal and antihistamine shampoos. With all these products, the skin should first be cleansed with soapless soaps and then the medicated product massaged in and allowed a long contact period with the skin – the longer the better. Weekly shampooing along with flea control is often sufficient for a number of years. Some pets cannot tolerate weekly bathing as it dries out their skin too much. Use of a skin conditioning rinse helps in some cases. Also, use temperate, not hot water, when you bath your pets.

Antihistamines and tranquilizers

Antihistamines block the release of histamines by mast cells. They are quite helpful to some pets. Unfortunately, the effects are not as dramatic as in humans. Ciproheptadine given twice a day, hydroxyzine or even OTC Chlorpheniramine maleate are effective in lessening symptoms in some dogs and cats. Many antihistamines have a calming effect in dogs. I have had cat owners discontinue their use because they did not like personality changes in their cats while on these medications. Some antihistamines can be applied in shampoo form. Some dogs do well when given mild tranquilizers such as acepromazine at 0.25mg/ pound.

Corticosteroids

Many owners are worried when we suggest that their pets receive measured doses of corticosteroids to treat stubborn allergy cases. They should not be. These drugs have nearly miraculous powers in both human and animal medicine. They just should not be over used. Some drugs of the cortisone class are prednisolone, prednisone, triamcinolone, dexamethasone, beclomethasone, and betamethasone. Often I use so little of these drugs that a bit of itching persists but at a tolerable level. I usually give prednisolone or prednisone two or three times a week. At a low dose I do not encounter noticeable side effects. There will often be a point, many years into the disease, when higher cortisone doses are required. Combining topical medications, antihistamines, desensitization and cortisone let us keep the cortisone dose as low as possible. I do not feel that I have ever used cortisone to an extent that an allergic pets life was shortened although some have suffered weight gain. I do know that the use of these drugs has greatly improved the quality of many pets’ lives. Whenever possible, the use of long acting corticosteroids such as methylprednisolone acetate should be limited to a single yearly injection or oral forms of corticosteroids used instead. You may notice that your pet drinks more and urinates more on these medications. If they are over used a disease called Cushings Syndrome or hyperadrenocorticism can result (see article on that subject).

Antibiotics

Dogs that are presented to me with severe bacterial skin infections subsequent to self- trauma (scratching) need a two-week course of antibiotics to clear up the infection. I like to use a broad-spectrum antibiotic such as one of the fluroquinolones (Batryl) or a potentiated cephalosporin such as Clavamox (Augmentin). I begin antihistamines and medicated shampoos in these cases immediately but I delay any corticosteroids until the skin has healed. If yeasts are an important component of the problem I treat them with ketaconazole shampoos.

Food Supplements

There are a very large number of “neutraceutical” products marketed for allergic skin disease. Many of them have never been scientifically tested. The best that can be said of many of these products is that they can do no harm. When I recommend these products, I usually suggest one that combines omega-3 and omega-6 fatty acids. Many of these products also contain zinc. Some clients find them beneficial.

Distractions

No matter what the underlying cause of itching is in your pet, boredom, inactivity and unoccupied time will make it worse. It is not unusual for the underlying cause of itching to be eliminated by your veterinarian, only to have the pet continue to scratch and lick itself from force of habit. To minimize this, give your pets plenty of distractions. Hidden food morsels, toys and chew toys, walks, play time, other pets, and view through a porch, kennel or window all take your pet’s mind off of its skin. Try these distractions, and others you might think of, before you resort to tranquilizers and mood-altering medications.

Your Pet’s Future:

Allergic dermatitis is a life long condition. Unless the problem is solely fleas there are no cures. Luckily it is not a life threatening or a life shortening condition and it can be managed with a minimum of inconvenience. Often, there will be periods of a year or more when the disease is not as severe and needs less or no medications. When a family moves the disease is often left behind. Unfortunately not too much time passes at their new location before the pet becomes allergic to new allergens. Because this is an inherited trait, pets with this disease should never be bred. The fact that so many pets suffer from allergic skin disease shows that many breeders disregard this advice.