Dogs and Cat 27 Flashcards
Clinical signs of separation anxiety what are the main ones and 4 tips about identifying these patients
- Anorexia
- Housing soiling
○ Cats with mark and spray
○ Need to consider if owners issue? Can they actually soil? - Destructive
- Salivation/vomiting
- Vocalization
○ Generally occurs as a noise complaint
Clinical Signs-Tips to Remember
1. Signs will start before departure in most cases.
2. Signs usually occur within 20 minutes of owner departure.
3. Owners can gather a LOT of information via a webcam/ recording of their pet after their departure usually first 30 minutes.
4. The ‘Velcro’ dog - won’t let you go
5. nervous, excitable behavior in the consult room for over an hour
What are some important history points that are important in behaviour consult
1) how many other pets - are there any issues with them
2) schedule - has this changed recently - new job, working more etc
3) have they had obedience training and are they crate trained - important with safe space
4) are there irritating behaviors occurring - breaks down the bone between owner and dog
5) any destructive behaviors - indicates separation anxiety
When presented with a case that looks like separation anxiety what is the first step
Prerequisites- Veterinary w/up!!!
- Complete a full PE
- Further tests- bloods-haemogram and biochemistry, U/A, BP, C &S and possibly more may be required
- Neurological exam
- Species specific? - pain response - German shepherd may be able to radiograph elbows and hip
What are the 10 main signs of separation anxiety
- Destruction
- Defecation
- Urination
- Loud disruptive vocalisation
- Licking and dermatological lesions
- Salivation/saliva straining
- Salivation without saliva straining
- Soft non disruptive vocalization
- Transient anorexia/pacing
- Withdrawal/freezing
What is separation anxiety
- Separation= absent from owners OR able to hear / see owners however no access to them
- Anxiety= anticipation of a danger or threat to the individual. The threat may be real or imagined…feeling insecure/ unsafe.
What are the 3 main areas behaviour is influences by and therefore target with treatment
- Genetics- Some animals are born with a mental disease. Statistically possibly 1 in 8 animals.
- Environment- some environments may predispose more than others to particular diseases.
- Learning- Learning starts from 2 weeks of age and continues through life.
○ Particularly between 8 and 16 weeks of age
Behaviour modification in the treatment of separation anxiety
○ Create a Safe Space in the home-
§ Crates already exist- utilize them (Mat/crate)
§ Training in owners presence first
○ Short departures may be accepted
○ Lying down/ calm –always reward quietly
§ Also can do when they largely exhale
○ ‘Look-Sit-Stay’-relaxation program training, allows for longer periods of time away-Ajax stays longer on mat.
§ Get them into cognition zone
○ Decouple departure cues? - DOESN’T WORK
○ Never punish Ajax Punishment….
§ Increases anxiety
§ Impedes learning
§ Damages human bond
§ Welfare Concerns
§ Difficult to perform properly
§ Must be effective after 2-3 attempts- if not this becomes abuse!!!
Environmental modification in the treatment of separation anxiety
1) Crate training/ mat training to encourage a safe space
§ Reduce visual triggers which include windows access in Ajax’s case.
§ Choose a quiet area
§ Corner space best
§ ‘All good things happen in the crate!’
□ Progression ->
§ NOT MORE THAN ONE DOG WITHIN
2) Dog appeasing pheromone (adaptil)
§ Collar (dog aggressive animals), spray (acute - vet visits, in the car, create - only 2-3 hours), diffuser (have to leave on) -> safe space
§ DAP/Adaptil do’s and don’ts
□ Diffuser- have switched on 24 hours for 2-3 months
□ Low to ground/ accessible- dog can lie down
□ Avoid plugging device under/ behind furniture
□ Spray- great for the ‘safe space’ or car trips
□ Collar- great for outside/ walks.
□ Collar- remove when swimming or bathing
Medication in the treatment of separation anxiety is it needed, how effective, why used and the main one used
○ Is Necessary- damage to property and potentially to animals.
○ Patient improves 4 x faster in combination w Bmods than Bmods alone.
○ Anxiety& Separation
§ Anxiety is a true mental disorder of the brain. As vets we can offer treatment.
§ If your dog had diabetes would give it insulin?
○ Medication will reduce anxiety or arousal
○ Types
§ SSRI - Fluoxetine was implemented at 0.5mg/kg SID - STARTING DOSE
□ Prozac®/ Lovan®/Zactin® 20mg tablets from human pharmacy/ supplier.
□ effects serotonin metabolism and post synaptic receptors on the neuron
® Increase amounts of receptors for serotonin as well as increase amount of serotonin
In terms of medication for separation anxiety what is the main one, when does effect start and what else may need to be used in some situations and why
1) Fluoxetine (SSRI) 4-8 weeks initial effect
- Requires at least 12 weeks to assess - FOR receptor to grow
- Maintain minimum 6 months-12 months
- Side Effects seen: - usually transient
○ Minimal- lethargy 3-4 days, reduced appetite
○ Soft stools 1-2 days.
○ Can we wait for 4 weeks ???
- Immediate medical attention required - CANNOT WAIT 12 WEEKS
2) Trazodone-SARI (serotonin antagonist and reuptake inhibition) was initiated at 3mg/kg once a day prior to Fluoxetine (check side effects)
§ Get tolerance - more give the more needed
○ Available via compounding pharmacy
Monitoring of separation anxiety patients and medication
6 weeks - clinical signs - web cam seeing eating food or playing with toys while gone - good sign
every 12 months - blood work performed to ensure liver and kidney can handle the medication
Medication
- may need to be lifelong or could possibly wean off (some dogs keep the new receptors that is made from medication)
What are 3 other medications that can use in separation anxiety cases and when use
- TCA’s- Clomipramine, Amitriptyline.
○ Useful for cases with additional compulsive disorders or neuropathic pain. - Anxiolytics-used in combination with
○ TCA’s/SSRI’s
○ Benzodiazepines-Alprazolam, Diazepam, Clonazepam- best used prior to departure - Clonidine- Noradrenergic blocker.
○ By blocking Noradrenergic stimulation in the brain, we reduce hyper-aroused states.
○ Dose rate 0.01-0.05mg/kg prn / bid.
§ need to give
○ Usually effective one hour pre required effect.
○ Side effects- mild sedation & lethargy, can reduce BP.
define fear and phobia - what is the difference
- Fear- Normal response to a threatening stimulus
○ Protects
○ Important for survival - Phobia- A maladaptive fear response that is out of proportion to the stimulus / threat.
○ May endanger the animal
○ May endanger others
○ May generalize to other issues
○ May cause long term generalized anxiety
What are the 2 main phobic behaviours
- Noise phobia- most commonly presented ○ Thunderstorms ○ Fireworks ○ Grand Prix Airshows - Contextual phobia ○ Veterinary Clinics!!! ○ Vet phobia ○ Car phobia ○ Men/ Men wearing hats
noise phobia what can also have, what drug can predipose, when start and causes and what to do
- Dogs with noise phobia have a high probability of also having separation anxiety
- Administration of C/S (corticosteroids) is associated with increased reactivity to thunderstorms and noises
- Can start suddenly even over 6 years of age
- Strongly influenced by genetics- inherited fear responses
- Fears may generalize- noise to clouds, wind etc.
- Change in approach- soothe them don’t ignore them!
What are some common clinical signs of phobic behaviours
- Panting
- Salivation
- Shaking
- Cowering
- Seeking out the owner -> 207% increase cortisol
- Restlessness
- Hypervigilance
- Vocalizing/ whining
Treating noise phobia principles
- Get the animal away from the source of noise as best as possible. Bring your dog inside!!!
- Give your animal support and calm your dog by allowing him/ her to feel safe. Do not ignore the animal.
- DAP (dog appeasing pheromone) may be of use
- Thunder shirt may be of use
- Calming Cap may be helpful
What has historically been used for medication for phobia and the 3 common ones used now
- Historically - ACP - NOT USED NOW, animals become more noise reactive
1) Anxiolytics - BZ
2) trazodone - SARI
Medications work best when used in combination with behaviour modification
3) zylkene - hit and miss
BZ use in phobic animals what does it do, when give, what animals avoid in, positives and negatives and side effects
○ The BZ group are useful at treating intense situational anxieties
○ Short acting –if home, LA if away.
○ Best when administered before the noise event.
○ LA medications usually take a little longer to work/ take effect.
○ Amnesiac
○ Avoid with aggressive animals
○ Be aware of the side effects
§ Dysphoria -> NEED TO GIVE BIGGER DOSE - knock them cold better
§ Paradoxical effect of BZ’s
○ May require higher dose
○ Care in cats
○ Addictive substance
○ Not for long term use if frequent episodes
○ Can be used in combination with SSRI/TCA
Trazodone use in phobic animals what is it, why used and dose effect seen in
○ SARI (serotonin antagonist and reuptake inhibition) very useful past few years and superseding the BZ’s due to fewer side effects.
○ From compounding Pharmacy
○ Off label
○ Usually see effect @ 2-3mg/kg
Behaviour modification in phobic animals what does and doesn’t work
DON’T DO
- systemic desensitization - causes flooding, difficult to implement, required 15min for 30-60 days
- counter conditioning - impossible to implement and no appetite when stressed
- NEVER punish these animals - being phobic is feeling out of control
DO DO
- INSTEAD -> want to change response to stimulus from anxious to happy
○ Give high value treat every-time the noise happens, irrespective of the dog behaviour
○ Can be tricky
1. Create a safe space - crate/mat where the dog retreats to
2. DAP (dog appeasing pheromone)
3. Thunder shirt
Euthanasia what need to consider
- Barbiturate usually most appropriate ○ Prior sedation? ○ Catheter? ○ Owner present? ○ At home or in clinic? § At home -> different behaviour ○ Disposal of body? ○ Payment? § Before or after
What are the 5 main types of acquirement of immunity
- Passive
- Maternal
- Live / modified live = infectious
- Killed / inactivated = non-infectious
- Recombinant – nucleic acids, recombinant
Passive immunisation what does it involve, examples and how common
- Administration of exogenous antibodies in serum or immunoglobulins against infectious agents
- E.g. in failure to colostral transfer (large animals)
- E.g. antisera in Parvo virus, (rarely done, EBM against it)
- Need a strong source
- Risk of transfusion reactions (serum)
- Not common in small animals
Maternal immunity and vaccination what is involved and what is important to consider, how does this influence vaccines
- Neonate protected for 6-16 weeks by passive transfer of immunoglobulins
- These antibodies have a variable half-life, specific for each disease
- Maternal antibodies can interfere with vaccination for first 8-12 weeks in most dogs
○ Which is why vaccinate at multiple time points -> unsure when maternal antibodies decline and at risk of disease - Unpredictable degree of passive transfer in each individual
○ High MDA -> protected, can’t respond to vaccine till ≥ 12 weeks
○ Low MDA -> at risk, able to respond to vaccine earlier
Live or modified live (MLV)/attenuated vaccines what does it involve. example with pros and cons
- Produced by serial passage in tissue culture or unusual host passage
- Must replicate in host to stimulate immune response
- SC, intranasal (kennel cough - rapid and local - good for disease outbreak)
Pros - Give good CMI and humoral response
○ Rapid, long duration - Low antigenic mass required
- One dose generally required
- Cheap
- Almost never cause local reactions
Cons - Risk for biological contamination - manufactory issue
- Easily inactivated by heat, chemicals - handling and storage is important
- Low risk but can revert to virulence (esp. immunosuppressed patient, pregnancy)
- Might insert into host genome
- Can cause immunosuppression (mild)
- Not possible in every patient
- Intranasal: sneezing
Non-infectious vaccines = killed or inactivated what is it, pros and cons - COMPARE WITH LIVE
- Inactivated, cannot revert to virulence
- Whole or subunit (part)
- No host replication required, can’t revert to virulence
- Contain adjuvants (local reactions / hypersensitivities)
- Often require two doses (slower / shorter duration of immunity unless adjuvant)
- Good choice in pregnant animals
- Rarely immunosuppressive
Recombinant vaccines how developed, what require and examples
- Develop by genetic engineering
- Produce in E.coli, yeast or insect cell lines
- Similar in efficacy to killed vaccines
- Require adjuvants
- Free of problems of insertion into the host genome or containing unwanted antigens.
- An example is the Leukogen® vaccine
What are some causes of vaccine failure and the most common ones - EXAM
- Interference of Maternal antibody in neonates*
○ Most common reason in neonates - Poor handling or administration* (most common)
- Inactivation by temperature extremes, (MLV especially)
- Inactivation by chemicals - don’t chemically alcohol swab the area
- Improper re-constitution of the vaccine
- Protective immune response not stimulated : CM vs. humoral
- Unable to respond due to immunosuppression fever, hypothermia, medications - avoid at this point
- Failure to complete initial vaccine course* (common)
- Exposure to highly virulent field strain
- Overwhelming pathogen exposure
- Incubating disease at time of vaccination
- Immunity waned
- Vaccine caused disease
- Manufacture failure (rare)
- Poor responder
What are some ways to avoid vaccine failure and the main ones
- Follow manufacturer’s temperature, dose, route and frequency recommendations
- UV protection
- Mix and use immediately (common)
- Don’t mix incompatible vaccines or give at same site drained by same LN (common)
- Don’t use chemically sterilized syringes, or local disinfectants (alcohol)
- Mix well if multidose vial
- Discard expired vaccines
- Avoid using in hypo/hyperthermia (common)
- Avoid anesthetized patients - HARDER TO RECOGNISE IF HAVE A NEGATIVE REACTION
○ Potentially immunosuppressed - Care immune mediated disease (?EBM for this)
- Care pregnancy - AVOID LIVE VIRAL (common)
- Care patient with chronic disease / immunosuppression
What is the dose of vaccines
- Dosed as minimum immunizing dose
- Not as mg/mg or mg/m2 ect..’
- ALL GET THE SAME DOSE
Post-vaccinal complications and how common
- Hypersensitivity (Common with Bordetella vaccines)
- Clinical disease (rare) – MLV FCV (feline caliciviral), MLV FPV (feline parvovirus) < 6weeks, CDV
- Local reactions
- Systemic reactions
- Contamination, multidose (rare)
- Focal Granulomatous reactions
Modified live vaccine FPV what occurs when vaccinate the bitch/queen
Cerebellar hypoplasia
- Shaking, tremors of kittens - can get better with age but will never be normal
What are the 5 main vaccine related diseases and how common
WEAK LINKS
- Hypertrophic osteodystrophy?
- Juvenile pyoderma?
- Immune suppression (other disease?)
- Autoimmunity, IMHA, IMTP and SLE?
- Feline Injection Site Sarcoma - common one
Feline injection site sarcoma (FISS) what associated with, due to, site, diagnosis and prevention
- Association with Rabies and FeLV vaccines
- Possibly chronic inflammation due to Aluminum adjuvants causes malignant transformation
- Site (Shoulder blades) may also be an issue
○ Difficult to get margins on - Frequency 1 in every 5,000 to 12,500 cats vaccinated - RARE
- Requires incisional biopsy for diagnosis
- Biopsy if
○ Mass present > 3 months post vaccination
○ Mass > 2 cm
○ Mass progressing after 4 weeks - Benefits vaccine»_space; FISS
- Prevention
○ Use non-adjuvanted vaccines when possible
○ Avoid interscapular injections
○ Use other SC sites
§ Consider ease of Sx removal VS. operator safety
○ Vaccine at different sites, and record location - Report FISS cases, national / manufacturer
What are the 4 main CORE dog vaccines and when give (regime)
- Canine Distemper Virus (CDV)
- Canine Adenovirus (CAV types 1 & 2)
- Canine Parvovirus type 2 (CPV-2 and variants)
- Rabies (if endemic) – killed vaccines with 3 year DOI (or repeat at 1 year if defined by local law)
When give
○ Puppy: (MLV (modified live vaccine), parenteral)
§ Core at 6-8 weeks of age
§ Then every 3-4 (2) weeks until 16 weeks of age or older
§ “Booster” at 6-12 months of age (or 26 weeks of age)
§ Then core every 3 (to 4) years - when used MLV
○ If dog > 16 weeks of age, single MLV, then every 3 years
What are the 2 non-CORE dog vaccines, when/how to give
(locally recommended) - low geographical risk
- Two main ones (makes up C5)
○ Bordetalla bronchiseptica
§ Life avirulent BB, intra-nasal
○ Parainfluenza
§ MLV CPiV
- When give/how give
○ Single intra-nasal dose from 3 weeks
○ Annual booster (or more often if high risk)
○ Both intra-nasal Greater local protection, more rapid
Or live avirulent BB PO – single dose from 8 weeks
- can also give parenteral - if aggressive
Seology testing in dogs to figure out when to vaccinate when would you use and why wouldn’t you
- An alternative to 3-yearly boosters (CDV, CAV, CPV-2) ○ Non-core annual booster - In-house test kits - Validated - More expensive than vaccination ○ Negative -> repeat vaccination ○ Positive -> vaccination not required - Should we use serology? ○ After puppy vaccines § If clients really want to know if need to vaccinate ○ Shelters, infectious disease outbreaks
What are the 3 main CORE for cats and duration of immunity
- Feline Panleukopenia (FPV) - long duration of immunity
- Feline Herpes Virus – 1 (FHV-1) - short duration of immunity
- Feline Calici Virus (FCV) - short duration of immunity
