M4

Question 1

What is the most effective way of helping dogs over SA?

Answer 1

Medication + Bmod

Question 2

What is an obstacle to getting dogs on meds?

Answer 2

Reluctant Os!

Question 3

Why might O be reluctant to get their dogs on meds

Answer 3

1) Bias - family/cultural
2) Understanding of meds
3) worry about loss of personailty/robot dog

Question 4

What is the “try anything” approach

Answer 4

Throw all the things that “might” work at the dog.

Question 5

What are the normal “try anything” approaches O go to

Answer 5

Supplements
Pheromones
Music
Anti anxiety wraps/vests
Ignoring the dog dog
Food puzzles and toy
Increased exercise

Question 6

What is the problem with throwing everything at SA?!

Answer 6

A lot of the “might work” interventions won’t work which wastes time and increases defeatism in O!

Question 7

What is another problem with supplements?

Answer 7

1) Can be hard to administer
2) cost!
3) no or little evidence
4) no regulation
5) crush optimism in Os when they don’t work

Question 8

Does medication work immedietly for all dogs

Answer 8

NO its a journey and we must set O expectations up accordingly

Question 9

What is the golden circle in meds?

Answer 9

Right med or med combo, at the right time, at the right dose. It’s going to take some time to get there.

Question 10

How can we help meds reluctant O

Answer 10

1) coach their understanding
2) don’t blame them for their biases
3) explain how effective meds can be help them see the potential
4) help them open their minds

Question 11

What does success depend on in all SA T

Answer 11

The O ability to implement our TP and recommendations

Question 12

ARe meds risk free?

Answer 12

No, no medication comes without the risk of s/e we need to be open and honest in our conversations with clients to set their expectations accordingly

Question 13

Who needs to be the expert in meds?

Answer 13

Vets! Our job is to know whats out there and the differences in classes of medications

Question 14

What are the most commonly prescribed drugs for anxiety in dogs?

Answer 14

Antidepressents
Benzodiazepines
Trazadone
Clonidine
Gabapentin
Sileo

Question 15

What Antidepressent meds are commonly prescribed?

Answer 15

Fluoxetine (reconcile)
Clomipramine (clomicalm)
Sertraline
Paroxetine
Selegiline (MAOI)

Question 16

How are AD’s adminstered?

Answer 16

long term
Daily medications

Question 17

Are ADs short acting releif meds?

Answer 17

No! These take some time to work

Question 18

What are short acting meds used for in dogs anxiety?

Answer 18

Storm
Fireworks
Vet visits
home alone time

i.e. episodic events

Question 19

Is is ADs OR short term meds?

Answer 19

NO! Combination therapy is commong

Question 20

When should we say to O to talk to the vet about medications

Answer 20

Right away. there is no time to lose because this a journey and it takes time to get it right

Question 21

What expectations to we need to manage in O when dogs go onto meds?

Answer 21

It won’t be quick effect
There may be side effects
It can take time to get the right combination
It’s normally a long journey!

Question 22

Why do we need a level of understanding of medication for SA

Answer 22

So we can help clients through the process

Question 23

What medication types are there for SA?

Answer 23

Bmeds:

Antidepressents
SSRIs
SNRIs
TCA
MAOIs

Benzodiazepines

Question 24

Why do we need to understand the b-meds that are used in SA?

Answer 24

So we can understand the impact that might have on training

Question 25

What are the 2 most freq drugs used from the SSRI class?

Answer 25

Fluxotine Clomipramine

Question 26

What is the branded format of clomipramine?

Answer 26

Clomicalm. Generic not normally prescribed but from 2019 the generic version was approved for use in dogs.

Question 27

What other ADs might you come across?

Answer 27

Sertraline Paroxetine Selegiline

Question 28

Do AD'S kick in quickly?

Answer 28

No!

Question 29

Are AD's quick acting meds?

Answer 29

No!

Question 30

How are AD's taken?

Answer 30

Daily, long term

Question 31

Will the first med be a good fit for all dogs?

Answer 31

NO!

Question 32

What short acting meds are available?

Answer 32

Benzodiazepines Trazadone Gabapentin Clonidine Sileo

Question 33

What are short acting meds used for?

Answer 33

Episodic events (fireworks, storms, SA!)

Question 34

Can daily meds be combined with short acting meds

Answer 34

Yes! This is called combination therapy

Question 35

When should the client talk the vet about meds?

Answer 35

Right away - there is no time to lose. It takes time to get onto the right meds.

Question 36

Do we need to manage clients expectations about seeing quick results from meds?

Answer 36

YES! More likely its going to take some time to find the right meds, in the right combination, at the right doses at the right times!

Question 37

Why do we need an understanding of whats going on with B meds?

Answer 37

It helps us help the client move through he medication process

Question 38

What are the medication myths we commonly hear?

Answer 38

1) Side effects 2) My dog will end up as a zombie 3) It will change my dogs personality 4) too expensive 5) have to see a vet behaviourist to get b.meds 6) meds didn't work for my dog

Question 39

Will s/e be severe on anxiety meds?

Answer 39

No! Most meds have mild s/e.

Question 40

Do all medications have s/e?

Answer 40

Yes! A chemical change in the brain is going to produce s/e. This is common amongst lots of drugs! eg. antibiotics, pain meds etc!

Question 41

What else helps O get their head around the s/e's?

Answer 41

The side effect of living with chronic stress and anxiety likely outweighs the mild s/e of meds This is an important conversation to have.

Question 42

Will side effects last?

Answer 42

No! probably not. On the right med at the right dose these will likely disappear fairly quickly.

Question 43

How are s/e's classified?

Answer 43

Severity likelihood of s/e

Question 44

Are anxiety meds safe?

Answer 44

Yes! they have a long hx of use in dogs.

Question 45

Will dogs on meds likely end up as zombies?

Answer 45

No!

Question 46

When would we see "zombie" like s/e?

Answer 46

wrong med wrong dose Short term rescue med with sedative effect

Question 47

Can sedative s/e be useful?

Answer 47

Yes! JN at the dentist!!!

Question 48

Will the dog be a zombie all day,e everyday?

Answer 48

No the right daily med at the right dose won't do this! Newer drugs are even less likely to do this.

Question 49

What if the dog does become a zombie?

Answer 49

Counsel them to go back to the vet - that's not the state we are aiming for

Question 50

Will the dog lose his personality on bmeds?

Answer 50

Meds MIGHT change a dogs personality but for the better! Dogs that are constantly on edge are not the true personality

Question 51

Is an anxious, fretful dog a true personality?

Answer 51

No! The scared dog can finally decompress on b. meds.

Question 52

The right medication at the right dose allows ....

Answer 52

the dog to flourish.

Question 53

Will the dog still be joyful on meds?

Answer 53

YES! Probably more so becuase the worry has been taken away. You get the same dog, only better.

Question 54

How can we help O with costs of bmeds?

Answer 54

1) Encourage discussion with vet 2) Generic and cheaper drugs are available. 3) ask for a prescription

Question 55

What else is going to help O get over the cost of meds?

Answer 55

Cost is relative! Short-term pain for long-term gain. we can often drop mgmt and Training costs will decrease as we progress through training (likely faster with meds on board!)

Question 56

What do we need to discuss with O in regards to costs of bmeds ...

Answer 56

Cost benefit analysis

Question 57

You can only get b.meds prescribed if you see a vet behaviourist?

Answer 57

False!

Question 58

Why don't O see V behaviourists?

Answer 58

Financial (too expensive) Access (to far away) Take too long to see one

Question 59

Can GP vets prescribe B meds?

Answer 59

YES!!!

Question 60

Is prescribing bmeds. vet dependent

Answer 60

Yes, it certainly can be.

Question 61

What can you do to help clients with vets?

Answer 61

Build relationships with vets with deep knowledge and understanding of bmeds.

Question 62

What do O need to do if Vets won't prescribe meds?

Answer 62

Ask for a second opinion. We need to be our dogs best advocate.

Question 63

Are there different regulations in different countries regarding medications that can be prescribed to animals?

Answer 63

Yes, but they are broadly equivalent and have some similarities 1) Branded for dogs 2) Generic approved for dogs 3) Generic approved for animals 4) Off label

Question 64

Do all cases respond to anxiety meds

Answer 64

No.

Question 65

What is happening when o pronounce we tried meds, it didn't work

Answer 65

Often gave up too soon in the journey! High expectations not immediately met? Cognitive Bias - collecting info that confirms their strong belief.

Question 66

How can we tackle "meds didn't work" clients?

Answer 66

Remind them it takes time to get the meds right. encourage them to keep working with their vets and that they need to persevere.

Question 67

What is the placebo effect?

Answer 67

A perceived effect/improvement despite the fact we have a sham treatment

Question 68

Where do we see the biggest placebo effect?

Answer 68

When the measurement is subjective not objective

Question 69

Is counting subjective?

Answer 69

No! It's fairly objective!

Question 70

Is there benefit in humans to ahve the placebo effect?

Answer 70

Yes! Because we feel like we are improving.

Question 71

How high can the placebo effect be?

Answer 71

80%

Question 72

What is the "normal" level of placebo effect?

Answer 72

30%!W

Question 73

What is the gold std in medical trials?

Answer 73

Double-blinded, placebo-controlled trial

Question 74

What is double blind?

Answer 74

Researchers and participants blinded

Question 75

Do dogs know they are receiving meds?

Answer 75

No!!

Question 76

Are dogs blinded?

Answer 76

Yes!!!

Question 77

Do dogs benefit from the good part of the placebo effect? (improvement due to taking a med?)

Answer 77

NO!

Question 78

Who sees improvements where none exist in dogs?

Answer 78

Caregivers and vets

Question 79

What is caregiver placebo effect?

Answer 79

Caregiver see improvement where there is none.

Question 80

What is important in any medications/supplements marketed to dogs? Studies should be ....

Answer 80

Double blinded placebo controlled trials!

Question 81

Are double blinded placebo placebo-controlled trials common?

Answer 81

No. And even rarer in supplements and neutraceutacles

Question 82

What did the study into the joint health of OA in dogs show? What % were assessed as decreased in lameness?

Answer 82

50% of owners

Question 83

Why was the caregiver effect so big?

Answer 83

Subjective measurements (assessment by o of decrease in lameness!)

Question 84

What did the replicated study using the objective measurements (oa dogs forceplates) show?

Answer 84

40% owners perceived improvement and vets 40-45%!

Question 85

Why do we see a caregiver placebo?

Answer 85

1) Investment time and money (convince ourselves the outcome is there) 2) Hope and belief (cognitive bias) 3) Impact of our B - this can change when you are in a study just because you are in a study!W

Question 86

What B changes can we see when dogs are in trials?

Answer 86

Affection Attention Interactions Training/type/freq etc! ETC!

Question 87

Does caregive placebo come into play with treatments for anx in dogs?

Answer 87

YES!!!

Question 88

Is there good eveidence for "natural" treatments in SA for dogs

Answer 88

NO!

Question 89

Do we see people swearing by these supps in other disorders?

Answer 89

Yes!

Question 90

Why the difference between SA and other anxiety disorders?

Answer 90

SA measurement of improvement is SO objective (time on clock)

Question 91

What can we do if a new product comes on the market

Answer 91

1) Google scholar - sceince behind treatment and research 2) Manufactur research 3) evaluate critically!