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Canine Behavior/In Chemo and my Lab's Separation Anxiety is uncontrollable

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Question
Since I started Chemo treatments in October, my 7 year old lab has had uncontrollable Separation Anxiety.  He is wrecking everything in his path.  When I go for treatments, I check him into a local kennel where he spends most of his day following the owner of the kennel.  He cannot stay in the enclosure because he tries everything to get out to the point of hurting himself.  He sleeps with the family of the kennel owner in their house!!  He has had full blood work done and his thyroid checked and everything is Normal.  During the day, he will sleep in the kitchen so in other words, he's not following me everywhere.  I have seen a behaviour specialist who believes that he's too old to rehabilitate. I'm not sure what to do as I have 5 more months of chemo.  I video taped my dog while my husband and I were out for an hour and it was horrific to see him and hear him crying.  We are currently looking into meds....we've tried the collar (with pheromones), Acevet and anxitane with absolutely no results.  I am waiting for a call back from my vet to find out if Melatonin would be a good option.  My vet believes that my chemo treatments, my stress and that of my family is being felt by the dog.  Any advice you have would be greatly appreciated.

Answer
Thank you for your question. I'm sorry that you're having to go through chemo, and that you have the added stress of your dog's tremendous distress.

I agree entirely with your vet that your current health, your stress and that of your family is taking its toll on your dog. Dogs are very sensitive to our emotional state. Couple that with the fact that chemo, in all likelihood, makes you smell different to him, along with your physical distress in the week after treatments... it's not surprising that your dog is out of sorts.

I wholeheartedly disagree with the behavior specialist who said there's no hope of helping your dog. That's ridiculous. From your question, I'm guessing that this behavior issue didn't come up until your cancer diagnosis, or possibly until treatment began and he was being boarded. This suggests that it's situational - it's the current circumstances that brought this out and not a life-long separation anxiety that you've been dealing with for this dog. But, even if it has been ongoing prior to your current health issues, there is still a good possibility of helping him feel more comfortable when unattended.

The problem isn't his age so much as you and your family's ability to devote the time/energy required to help him. Your health HAS to be your priority right now, and if you're unwell due to treatments, and your husband or others are unable to do the work with the dog, then it will continue to escalate - at which point, the kindest thing to do for the dog would be to find him a home that has the time to invest in the project of his anxiety issues - maybe a family member or friend so you can visit him. But, if arrangements can be made between your husband and other local family and friends, then your dog's separation anxiety issues can be worked on while you're going through the rest of your treatment.

The first thing I would recommend, because it sounds like he's have a severe manifestation of panic, would be to discuss with your vet (or a local veterinary behaviorist) the option of putting him on Clomicalm (clomipramine hydrochloride). This is a US FDA approved drug for the treatment of Separation Anxiety. It's not a fix in itself, but it can help ease his panic so that he can learn new coping skills when alone. It's a tricyclic antidepressant, and takes about 3-4 weeks of daily dosing to ramp up to a therapeutic level in his system.
http://www.clomicalm.novartis.us/

I would also recommend trying a Thunder Shirt or even just a snug t-shirt as this has been shown to reduce anxiety in dogs. The key here is understanding that the comfort of a snug shirt lasts about 60-90 minutes and then the dog has habituated to the garment. Leaving it on for a few hours won't actually hurt him, but the effect has worn off after about 90 minutes. The effect can be reestablished by taking the garment off for a few hours and then putting it back on.

In order to prevent the shirt from just becoming a cue that he's about to be left alone, make sure he wears it when happy things are happening. Put it on for meal times and play time, cuddle time, walks in the neighborhood, etc. Having him wear it for 1-2 hours, twice per day, every day not only helps him make good associations with the shirt - which enhance the comfort he gets from wearing it, but it may also produce a lingering effect of increased confidence because wearing it lowers his stress levels and thus lowers his stress hormones (cortisol and adrenalin), and thus increases his tolerance for stressful situations... If he must be unattended for a period of time, put the shirt on about 10 minutes before he's going to be alone, and keep it on for about 10 minutes after you return so that he doesn't associate departures or returns directly with the shirt.

Also note that chewing is a self-soothing behavior for dogs. So giving him things he likes to chew on such as Antlers, Bully Sticks, marrow bones or Kong toys stuffed with yummy food can be part of his coping mechanisms during times of stress. Again, you want to make sure he gets to enjoy these things with you and your husband (&/or other family/friends) so he associates them with happy, social periods. Giving him one or more of these options several minutes (5-10) before departures allows him to engage with them and not directly associate them with departures, but gives him something to focus some of his anxiety on.

Stuffing a Kong is easy. You can be as creative as you like, so long as you use dog-safe foods. For meals, the mixture should be roughly 80% his regular kibble, toss in a few tasty treats (dog treats, cheese, chicken, turkey, beef, lamb, pork, bacon, hot dog, a drizzle of honey, carrots, melon, peas, blueberries, slivered almonds, cashews.... anything your dog likes), and use a soft food binder to hold it all together. Binders can be a high quality canned dog food, apple sauce, pumpkin or sweet potato puree, mashed potatoes (no garlic), nonfat plain yogurt, cream cheese, cottage cheese, sour cream, peanut butter, apple butter, liverwurst, etc.

I will often cut high fat/sugar options with one of the lower fat/sugar options to avoid over feeding. Mix it all in a dish and spoon it into the Kong. If it's too tightly packed, he won't be able to empty it. If it's too loosely packed, he'll empty it in short order. So practice with him to find the right density for him so it takes him at least 15 minutes to empty a freshly loaded Kong. You can also prep them ahead of time and freeze them, thus making them take closer to 45 minutes to empty. You can do entire meals this way (most dogs will require 2 Kongs of appropriate size for them to get a full meal). You can also do lesser loaded Kongs for snacks or short "I need you to just sit still for a few minutes" moments.

DON'T USE ONIONS IN ANY FORM - FRESH, COOKED, DRIED, POWDERED - DON'T GIVE GRAPES, RAISINS OR CURRANTS OR ANYTHING WITH GRAPES IN IT, DON'T GIVE MACADAMIA NUTS, DON'T USE AVOCADO (HIGH IN FAT). THESE ARE ALL POTENTIALLY TOXIC.
http://thegooddogblog.gooddog-dogtraining.com/2010/03/20/tasty-but-toxic.aspx

A veterinary behaviorist or a Certified Applied Animal Behaviorist (CAAB), or anyone with a good understanding of the panic disorder called Separation Anxiety can help you and your family design a protocol for helping your dog feel more secure when unattended. But, the key in the beginning is that he can never be left alone to panic. This means having babysitters ready to stay with him or taking him with you when you go out, or staying home and having people pick things up for you or having them delivered.

This may be tricky while you're still in treatment. Some dogs are OK going to a friend's house (the boarding place), but others panic at being "abandoned" by their people when they're dropped off. It may be better to have someone come stay at your home with the dog so he's in his normal space and has all his usual smells and beds, etc.

If he MUST go to the boarding facility, make sure his usual bed and favorite toy goes with him as well as dirty shirts worn recently (the day before) by you and your husband so he has your smell with him.

I have a friend who just finished her chemo. She never had to stay over night away from the house, and they have 3 large dogs and 13 cats, which she never tried to avoid. The animals often avoided her the first few days after chemo (my guess is because she smelled wrong, and she was clearly feeling horrible), but there was no effort to keep her from the animals. Her doctors never suggested she needed to stay away from them. Of course, I'm not a doctor, and you should check with yours, but I'm not sure there's a need for your dog to go to a boarding facility for the day/s of your treatment, unless it's just felt like too much to be tending to him when your husband is also trying  to tend to you. But this is where family and friends come in - if the dog can stay at home with you guys, so he can check on you and know what's going on even if he doesn't get to cuddle you, and if a friend or family member can be responsible for feeding him or walking him or playing with him for a couple hours each day, that in itself may go a LONG way toward helping him feel right about his world again. Simply knowing that he's not being abandoned at the facility and that you're not leaving, even if you feel crummy, may make a great improvement in his life.

There are some books on the subject of separation anxiety that may be helpful as well. It's important to realize, though, that this is a true panic disorder. He's not trying to be difficult. And it's not a fast fix issue. It takes time to build up his courage and confidence about being unattended. And it's important in the meantime that he's not left alone so he doesn't have the chance to experience and practice panicking again as that will undermine any progress you're making.

Patricia McConnell (CAAB, world renowned speaker and author and one of my favorite people) has a book called I'll Be Home Soon! How to Prevent and Treat Separation Anxiety . It's a good primer for how to address this issue.
http://www.amazon.com/Ill-Home-Soon-Separation-Anxiety/dp/1891767054/ref=sr_1_sc

Nicole Wilde (another world renowned trainer and speaker) has a book called Don't Leave Me! Step-by-Step Help for Your Dog's Separation Anxiety
http://www.amazon.com/Leave-Step-Step-Separation-Anxiety/dp/0981722733/ref=tmm_p

These may be a great place to start if you don't have access to a veterinary behaviorist in your area. The drug Clomicalm can help ease his panic enough to help him learn new and better coping skills through the techniques explained in these books. Once those new coping skills are in place, you can wean him off the meds. But, just like humans who take an antidepressant, you can't stop it cold turkey once he's at a therapeutic dose or you risk the same adverse effects people experience which can include depression, increased anxiety, agitation, and aggression, among some other symptoms. Your vet will be able to help you get the proper dosing and through the weaning process when you're ready for that. If your vet is uncomfortable managing psychotropic drugs, he/she can consult with a vet behaviorist, even if they are none in your area. Or they can contact UC Davis school of veterinary medicine or Tufts School of veterinary medicine animal behavior department for guidance on dosing and weaning plans.

Good luck - both with your chemo and in helping your dog feel safer when alone. Please let me know if I can be of any further assistance.

Jody, CPDT-KA, APDT
Los Angeles Behaviorist
http://GoodDog-DogTraining.com

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Jody Epstein, CPDT- KA, APDT

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IF YOU BELIEVE YOUR DOG IS ILL OR INJURED, PLEASE CONTACT YOUR LOCAL VETERINARIAN IMMEDIATELY. THIS IS NOT THE FORUM TO ADDRESS URGENT MEDICAL ISSUES. I AM NOT A LICENSED VET AND HAVE NO DIAGNOSTIC SKILLS. ***I have been answering questions on All Experts for over 5 years now. I enjoy being able to offer assistance in this forum. I do need to be clear, though. If you’re looking for free advice about a specific behavior question, you MUST submit your question to me via All Experts. If you bypass All Experts and write to me directly through my website, I will ask you to submit via All Experts. On the flip side, if you’re local to Los Angeles and you wish to speak to me privately about an in person consultation, please go through my website. I appreciate your assistance in keeping my volunteer work on the volunteer site.*** I can answer questions about the following canine behavior issues: obedience, timid/fearful & fear-based aggression, nuisance behaviors, families that are expanding with either new human or new animal members. If you have potty training questions please first read my trio of blogs at http://CashewsCorner.wordpress.com/ If you still have questions after reading the blogs you can post your specific questions here. PLEASE be as specific as possible when asking a question. Give me a detailed example of the situation - dog's behavior, body language, circumstances surrounding the issue, what the consequences are (another dog's response, your response), etc. I can only provide insight if I can get a picture of the whole scenario. If I ask for further details, please provide them. In person I would normally observe for at least 90 minutes to assess the situation and the dynamics before offering tools and suggestions to modify it. In writing it is ever so much more difficult. Thank you for your participation in the process.

Experience

I have been professionally modifying behavior and training obedience for 7 years. I have owned dogs my entire life. I have just changed the name of my business. It is no longer Good Dog! Dog Training. The new name is Nutz About Mutz!. If you see previous questions with the Good Dog! website information, that is my response.

Organizations
I am a Certified Profession Dog Trainer - Knowledge Assessed (CPDT-KA), #2133301 ; I am a member in good standing with the Association of Professional Dog Trainers (APDT), #77763 ; I am an AKC certified Canine Good Citizen evaluator (CGC), #71253

Publications
http://NutzAboutMutz.com ; http://CashewsCorner.wordpress.com ; Multiple articles in the local pet magazine Pet Press (found across Southern California)

Education/Credentials
I have a graduate education in animal behavior and learning. (While I completed my coursework and did the requisite research, I did not defend a dissertation. I am qualified, but not certified and so technically not a doctor. This is commonly referred to as Ph.D.-ABD which means All But Dissertation.) My educational focus was with non-human primates, but my personal interest is with domestic dogs and their relationships with humans and other animals. I continue to educate myself to canine-specific behavior through extensive reading, online interactive workshops, vidoes and attending canine behavior conferences.

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