Appointment 1: Treatment Plan

Avoidance

Avoid leaving the dog alone or loose in the home. Determine if the dog can safely be crated by questioning the client and/or videotaping the dog entering a crate and remaining inside when the owner is absent. If the dog panics in the crate or resists entering the crate (e.g., freezes, destroys the crate, or injures itself) consider pet sitters, home day care, or boarding in the hospital so the dog can be observed and protected. Encourage clients to be calm during departures and either avoid or minimize cues associated with departure-based distress.

Pharmacology

Start medications that act quickly (e.g., BZDs, SARIs, 2A agonists) immediately after the baseline behavioral assessment. If necessary, dosages can be adjusted once lab results are available. Conduct laboratory evaluation [complete blood cell count, serum biochemical analysis, thyroid testing (thyroxine, free thyroxine), and urinalysis] to rule out any medical complications before starting long-term medications (i.e., TCAs, SSRIs). Arrange for a stable care situation for the dog for a period of at least 5 days while starting long-term medications and monitoring for adverse effects.

Management

Minimize absences from the dog. Have the owner offer the dog food toys when at home. If the dog uses them, offer those types of toys when the dog is alone. If the dog is able to eat the food obtained from the toy it is a sign that dog’s anxiety is lessening. Dogs that are extremely distressed cannot eat.

Behavior Modification

Encourage the client to practice passive behavior modification by praising the dog for calm behavior and ignoring behaviors that are not calm. Clients can videotape their interaction with the dog to identify behaviors they should ignore and those that should be rewarded.

Data Collection, Follow Up, and Further Recommendations

Request that videotapes be taken over a 7 day period when the dog is left alone and submitted for assessment. Schedule an appointment 2 wk later to start active behavior modification.

Appointment 2: Treatment Plan

Avoidance

Assess the client’s ability to avoid triggering the distress response in the dog.

Pharmacology

Question the client about subjective changes in behaviors the dog is exhibiting and objective changes (i.e., frequency, duration or intensity of problem behaviors, any change observed) since the last visit. Assess whether any behavioral changes should be treated with additional medications. For example, is panic a component of the problem? If yes, then a panicolytic medication (alprazolam) should be suggested.

Management

Decide whether food toys are helpful and what safe containment tactics are needed.

Behavior Modification

Teach the dog to relax using positive reinforcement steps (e.g., sit and look commands, offering a treat) in preparation for active behavior modification, including desensitization and counterconditioning to aspects of being left alone. Have the client keep a log of the dog’s behaviors. As soon as the dog has acquired calm learned behaviors, a qualified person can then coach the clients and dog through desensitization and counterconditioning using a stepwise program. Ask the client to provide short videos every few days so that the healthcare team can determine if the behavioral modification is progressing satisfactorily. Client videos also provide an excellent source of continuing education for veterinary personnel.

Data Collection, Follow Up, and Further Recommendations

Rechecks performed by veterinary medical staff should occur q 2–4 wk until the dog’s behavior is stable and q 3–6 mo thereafter. Electronic follow up using videotapes and behavior logs is helpful.