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