Separation Anxiety in Dogs
Debra F. Horwitz DVM, DACVB
Because domestic dogs usually consider the human family to be their social group, they become bonded to family members. When separated from family members dogs may experience distress and engage in problem behaviors related to the anxiety of separation. These behaviors include destruction, vocalization, elimination of urine and/or stool, anorexia, drooling, attempts at escape and/or behavioral depression. Treatment protocols include independence training, habituation, counter-conditioning and desensitization to owner departure and absence.
When taking a behavioral history, the owner may relate that the behavior began shortly after the animal was adopted. Dogs that are adopted from humane shelters appear to be over-represented in case loads of dogs diagnosed with separation anxiety.1 The problem behavior(s) are usually destruction, vocalization and/or elimination in the house while the owners are gone. The dog may engage in only one of these behaviors or all three. Geriatric dogs are more commonly seen for the behavioral complaint of separation related anxiety when compared to younger dogs3.
Owner complaints of destruction, elimination or vocalization are not enough to make a diagnosis of separation anxiety. In addition to these behaviors the dog will often show other signs of attachment and separation related distress. Dogs with separation related anxiety often follow their owners while they get ready to leave or keep them within their field of vision. As owners approach the end of their leaving routine, the dog may begin to look distressed and anxious the closer they get to leaving the house. Some dogs will show their anxiety by whining, panting or pacing while others become immobile. Most dogs engage in the separation related behaviors within 30 minutes of owner departure 2. Alternately, there may be dogs that experience separation related anxiety without destruction, but may drool and/or refuse to eat and become immobile while their owners are gone. Self-mutilation, excessive licking and vomiting or diarrhea can also occur as symptoms of separation distress. While most of the problem behavior occurs shortly after owner departure, some dogs may cycle through periods of re-arousal perhaps brought on by outside stimulus. 3
An additional component in the history of separation anxiety dogs is their excitement when their owner returns. Their greeting behavior is often exuberant and prolonged. They jump, whine, and run in circles for as long as 5-10 minutes at the return of their owner.
Before establishing a diagnosis of separation anxiety, other causes of house soiling, destruction and vocalization must be ruled out. Differential diagnoses for dogs that eliminate when left alone include medical causes of housesoiling, inadequate house-training techniques, marking and prolonged periods without access to appropriate elimination locations. If any of these are possible diagnoses, then house soiling should occur some of the time the owner is present not only when the pet is left alone. When dogs are destructive, alternate explanations such as young, energetic dogs with limited exercise or play and external stimuli that could arouse the dog should be explored. Dogs may be destructive at windows and doors during territorial displays. These types of problems will also be seen when the owner is present. Destruction may be a component in noise phobias such as thunderstorm phobias. External activities or territorial displays and not separation anxiety may also motivate barking dogs. Animals that get into trash may merely be exhibiting food-seeking behavior. Animals that attempt to escape may have barrier frustrations concurrently with separation anxiety and may be fine if not confined. Geriatric dogs may be experiencing changes in cognition and should show other signs of cognitive decline such as wandering, loss of house training, disturbances in sleep/wake cycles and other symptoms that have been associated with Canine Cognitive Dysfunction 4. If none of these apply, then a diagnosis of separation related anxiety is appropriate. If the history is not clear, then owner journals, audio and/or video tapings and appropriate medical testing are helpful.
An important component in the treatment of separation related distress is to explain to the pet owner that this is not spiteful behavior, but behavior rooted in anxiety or an attempt to escape. Therefore, punishment is contraindicated and may actually increase anxiety.
Restructuring the Owner-Pet Relationship
Integral to the success of a treatment plan is facilitating a change in the interaction between the owner and the pet in all phases of their relationship. It begins with how the owner behaves when they leave and when they return. The owner should strive to keep the leaving low key, just say goodbye,perhaps give the dog a favorite toy. Upon return it is important to keep the homecoming low key and not encourage the over excited greeting behavior of the past. The recommendation is for the owner to ignore the dog for 15-30 minutes prior to departure and upon return. This is done on all departures, both planned and routine ones and by all family members.
Many of these dogs are extremely attached to their owners and follow them everywhere. Another component to treatment is "independence" training. The owner is advised to train the dog to remain at a distance from them and gradually to be in another room away from them. The owner is instructed to begin with short down/stays as the owner gradually moves across the room and rewards the dog with food and praise for remaining in position. Then the pet is trained to remain in another room while the owner leaves and gradually increases the time the dog can stay in another room away from them. Many dogs with separation anxiety also engage in persistent attention seeking behaviors. The owner is requested to no longer attend to the dog when it asks for attention, instead they must ignore it or send it away. They only attend to the dog when it is calm and quiet.
Owners are encouraged to spend time with their pets in other activities such as games, walks and training sessions. To reinforce a "leader" role for the owner, the owner is told to request that the dog sit prior to receiving anything that it wants. If the dog sits without being asked, then it must perform another task. This program was devised by Dr. Victoria Voith and entitled "Nothing in life is free". It has also been called "Learn to earn" by William Campbell. Lastly, owners are encouraged to keep journals of treatment routines and pet responses.
Habituation to Departure Cues
Some dogs become so anxious at the impending departure of the owner that even very short departure results in separation related behaviors. In this case the owner needs to habituate the dog to their leaving routine. The goal is to decrease the importance and predictive value of pre-departure cues. This is done by the owner going through their leaving sequence, (putting on shoes, coat, taking keys, briefcase etc.) but not leaving. The owner then puts everything back and stays home. When the dog is calm this sequence is repeated. Continued repetition of the leaving routine is performed until the dog does not react with anxiety as they prepare to depart. Once that occurs, the owner attempts to step outside the door, remain there briefly and return. If the dog does not become anxious, then they are ready to begin graduated planned departures.
Counterconditioning the dog to the departure routine also helps decrease anxiety. The dog is taught to sit or down stay in a certain area where the dog feels comfortable while the owner prepares to depart. Then the owner leaves for an extremely short time and rewards the dog for staying when they return. Another method of counterconditioning is to provide the dog with a delectable chew item such as a Kong® toy or Redi Bone® filled with food while the owner prepares to depart on a routine daily departure.
Graduated Planned Departures
If the dog is not too anxious when presented with departure cues, or once habituation to departure cues has occurred, the owner is ready to begin graduated planned departures. Using short departures, we attempt to desensitize the dog to the owner leaving and being gone. These departures are as much like real departures as possible with two exceptions. First, the departures are going to initially be very short. Second, as the owner departs they leave a new and consistent cue or signal for the dog. In other words, the owner must make this departure look just like the real thing, if they always take their car keys and briefcase when they go then they must do so on a planned departure. If they always leave in their car, they must drive away. Then the initial departure will be very short, 1-5 minutes or less so that the dog does not engage in any separation related behaviors. But, they will leave the dog a new cue or signal like the radio or television or air freshner to aid the dog in distinguishing this departure from a real or work departure. If possible, the dog should be left in a novel location perhaps the place the owner would like to leave the dog if it did not engage in separation related distress behaviors. The message we want to send to the dog "the owner is only gone for a short time, they are coming right back and I can be good". The length of the departure is slowly increased at 3-5 minute intervals with short departures interspersed with longer ones. The increase must be irregular, not a progression. The new cue is only used on a planned departure, never when the owner must be gone for long periods of time. If the dog is destructive or engaged in any separation-related behaviors during a planned departure, then the owner was gone too long and the next departure should be shorter. For dogs that vocalize on owner departure, an audiotape should be set to monitor the pet's behavior. Owners must keep initial departures short enough so as not to elicit separation distress. When desensitization is done improperly, sensitization can occur and the problem behavior worsens. Usually once a dog can be left on a planned departure for 2 hours, they can usually be left all day. The cue or signal can be gradually phased out, or can be used for as long as the owner feels it is necessary. Most importantly, the owner cannot quickly go from a 20 minute planned departure to a 3 hour one. This can elicit separation-related distress and may render the cue useless. During training, owners should be encouraged to keep journals to assess progress and treatment success.
Another adjunct to therapy is pharmacological intervention. While many dogs improve with behavior therapy alone, the use of medication may facilitate a decrease in symptoms while behavior therapy is being implemented. The only drug approved for use in separation anxiety in dogs is Clomicalm®, which is Clomipramine Hydrocholoride. All other drugs are not approved for use in dogs and therefore constitute "extra label" usage. Animals that might be put on these medications should have a physical examination and a minimum database of a Chem Screen, CBC and urinalysis. Owners should be informed of potential side effects; and release forms should be signed. Owners should plan to be available to monitor their pet for side effects the first day or two that medication is given. Results with drug therapy may not be seen for 14-30 days, the owner must be committed to continue usage. Tricyclic antidepressants as a class of drugs primarily affect serotonin, norepinephrine, acetylcholine and histamine. Because most tricyclics have cardiac side effects, electrocardiograms may be indicated in some animals. They are also contraindicated in hyperthyroidism, seizure disorders, in animals on thyroid medication or animals experiencing problems with urinary retention or urine flow. Common side effects with tricyclic antidepressants include urinary retention, constipation, tachycardia, dry mouth, hypotension and mydriasis 5. Some animals may experience initial sedation due to antihistaminic action in conjunction with effects on serotonin.
In a multicentre, double blinded placebo controlled clinical trial Clomipramine (Clomicalm® Novartis Animal Health) was shown to be an effective adjunct to behavioral therapy for separation anxiety. Clomipramine is more selective in action than other tricyclic antidepressants and primarily targets serotonin reuptake. Clomipramine was used at a dose of 1.0-<2.0 mg/kg orally b.i.d (2-< 4 mg/kg total daily dose). 6 Clomicalm is contraindicated in dogs with known hypersensitivity to Clomipramine or other tricyclic antidepressants. Clomicalm should not be used in intact male breeding dogs. Clomicalm should not be given in combination with monoamine oxidase inhibitors (selegiline (l-deprenyl) or Amitraz) or within 14 days prior or after a treatment with a monoamine oxidase inhibitor. Clomicalm should not be used in dogs with histories of seizures or concurrently with drugs that lower the seizure threshold. The drug is for use in dogs suffering from separation anxiety that are greater than 6 months of age. The most common adverse reactions were vomiting, diarrhea and lethargy. Caution is advised in using Clomicalm with other CNS active drugs including general anesthetics and neuroleptics, anticholinergic and sympathomimetic drugs. Once the symptoms of separation anxiety have come under control, the dosage may gradually be decreased and/or discontinued.
Once the behavior has improved, medications can be slowly withdrawn. Medications are usually withdrawn by decreasing 25% of the total dose per week while monitoring for an increase in separation related distress behaviors.
Response to therapy is usually seen in 2-6 weeks depending on the number of trial departures that the owner is able to do and how the pet responds to the other components of the treatment plan. However, if the owner vacations at home, or boards the dog, they may need to do a few trial departures when they restart their normal routine.