The use of imepitoin (Pexion™) on fear and anxiety related problems in dogs - a case series.

BACKGROUND: Fear and anxiety based problems are common in dogs. Alongside behaviour modification programmes, a range of psychopharmacological agents may be recommended to treat such problems, but few are licensed for use in dogs and the onset of action of some can be delayed. The low affinity partial benzodiazepine receptor agonist imepitoin (Pexion™, Boehringer Ingelheim) is licensed for treating canine epilepsy, has a fast onset of action in dogs and has demonstrated anxiolytic properties in rodent models. This case series reports on the use of imepitoin in a group of dogs identified as having fear/anxiety based problems. Twenty dogs were enrolled into the study, attended a behaviour consultation and underwent routine laboratory evaluation. Nineteen dogs proceeded to be treated with imepitoin orally twice daily (starting dose approximately 10 mg/kg, with alterations as required to a maximum 30 mg/kg) alongside a patient-specific behaviour modification plan for a period of 11-19 weeks. Progress was monitored via owner report through daily diary entries and telephone follow-up every two weeks. A Positive and Negative Activation Scale (PANAS) of temperament was also completed by owners during baseline and at the end of the study. RESULTS: The primary outcome measure was average weekly global scores (AWG) from the owner diaries. Average weekly reaction scores (AWR) for each type of eliciting context was used as a secondary outcome. Seventeen dogs completed the trial. Treatment with imepitoin alongside a behaviour modification programme resulted in owner reported improvement with reduced AWG and reduced AWR for anxiety across a range of social and non-social eliciting contexts including noise sensitivities. Significant improvement was apparent within the first week of treatment, and further improvements seen at the 11 week review point. There was a significant reduction in negative activation (PANAS) with 76.5% of owners opting to continue imepitoin at their own expense after completion of the study. CONCLUSIONS: This study provides initial evidence indicating the potential value of imepitoin (Pexion™) alongside appropriate behaviour modification for the rapid alleviation of signs of fear and anxiety in dogs. Further research with a larger subject population and a placebo control would be useful to confirm the apparent efficacy reported here.

The Relationship between Signs of Medical Conditions and Cognitive Decline in Senior Dogs.

Canine cognitive dysfunction syndrome (CCDS) is a progressive age-related neurodegenerative disorder in dogs. Minimal research has been performed to investigate how clinical signs may be impacted by other medical conditions. A cross-sectional study was performed using the Canine Cognitive Assessment Scale (CCAS) to evaluate cognitive impairment as reported by owners. Owner-reported health-related measures included behaviour changes, the body condition score, and veterinary diagnoses of disease. The responses from 804 dogs in the last 25% of their expected lifespan were analysed. Factors were identified in the owner-reported behavioural signs of disease representing pathologies in four body systems: musculoskeletal-neurological, digestive, metabolic, and dermatological, with the items comprising these factors also compiled into a cumulative measure of health. The results showed a strong correlation between the CCAS score and both the musculoskeletal-neurological factor and the overall cumulative measure of health. Moderate correlations between the CCAS score and the digestive factor and metabolic factor were also observed. The correlation between the dermatological factor and the CCAS score was weak. This study highlights the need to screen dogs for concurrent diseases when using scales to assess cognitive impairment and to monitor dogs who have health conditions, particularly those that are painful, for the onset of cognitive impairment.

Development of a Cat Behaviour Issues Assessment Scale (CABIAS) Assessing Problem Behaviours in Cats.

Problem behaviours in cats, such as urine marking, scratching, fear, and problems of cohabitation between cats, can present a potential welfare problem for those affected cats and have a negative impact on the human-animal bond. The aim of this study was to develop a Cat Behaviour Issues Assessment Scale (CABIAS) for caregivers to assess these common problem behaviours in cats, and to investigate aspects of the validity and reliability of the CABIAS. The CABIAS uses an index score as a scoring system combining aspects of the frequency and intensity of the problem behaviour. An electronic survey was developed, and 384 households, each with two participants able to observe the cat's behaviour, were recruited for the study. The participants were asked to record their cat's behaviour independently at weekly intervals over a 6-week period. A FELIWAY Optimum diffuser (containing a commercial feline pheromone complex) was provided to half of the participants, to be used during part of the study. The participants were subdivided into four groups according to whether a problem behaviour was present (or not) and whether the pheromone diffuser was provided (or not). The results demonstrated that the index scores for each problem behaviour had very high inter-rater reliability. There was a high correlation between the index scores and the impact the problem behaviours had on the caregivers. In those cats with a declared problem behaviour where the product was used, a reduction in index scores was observed over the duration of the study. The CABIAS was shown to exhibit satisfactory validity, reliability, and sensitivity to change in the current study, suggesting that it may be valuable as a tool for assessing and monitoring scratching, inter-cat cohabitation, urine marking, and fear in cats. The CABIAS could be used by veterinarians and behaviourists to assess these problem behaviours in individual cats and monitor responses to treatment. The CABIAS could also be considered as a research tool to assess the efficacy of interventions aimed at improving these problems.

Behavioural and Physiological Correlates of the Canine Frustration Questionnaire.

Frustration is a negative emotional state implicated in a range of canine behaviour problems. The Canine Frustration Questionnaire (CFQ) is the first psychometric tool developed to assess frustration tendencies in dogs based on owner report. However, to date, no published studies have assessed behavioural and physiological correlates of this trait. A novel behaviour test battery was developed to induce frustration in dogs, mapping onto the CFQ. Forty-four dogs were recruited and filmed whilst undertaking the test battery, and a CFQ was completed by each owner. Targeted behavioural measures were assessed from this footage, based on hypotheses aimed at evaluating convergent and discriminant validity with facets of the CFQ. In addition, a saliva sample was collected pre- and post-testing for 39 dogs, and a cortisol assay performed using ELISA to provide a physiological measure of arousal. A range of predicted behavioural test measures (e.g., vocalising and lunging) positively correlated with CFQ scores. For 22 dogs with pre-test salivary cortisol levels of <4 ng/mL (indicative of normal arousal at baseline), cortisol change and post-test cortisol levels positively correlated with the CFQ PC5 'Frustration coping' score. These results provide further evidence of the validity of frustration tendencies as measured by owner report through the CFQ.

Development and Psychometric Validation of the Lincoln Canine Anxiety Scale.

Introduction: Anxiety in dogs, especially in relation to certain noises, is a common issue which can lead to clinically significant problems like noise phobias. While several scales have been used to assess sound sensitivity and reactivity, clinical monitoring has tended to depend on unvalidated methods, general assessment, and/or historical comparison with owners' recall of previous episodes. Therefore, we aimed to develop and validate a scale to assess canine anxiety. Materials and Methods: We used the data from 226 dogs from a previously reported double blind placebo controlled study in order to determine the validity of the 16 item "Lincoln Canine Anxiety Scale." Unidimensionality was assessed through correlation between individual item scores and total score, with internal consistency assessed using Cronbach's alpha. Factor analysis was used to determine the dimensionality of the scale. Item response theory (IRT) was used to gain insight into the value of single items to the overall scale scores. To characterize the score characteristics in an anxiety-eliciting context we analyzed the behaviors of placebo treated dogs assessed at 00:20 h, the time point of maximum noise stimulus during New Year's Eve fireworks. Sensitivity of the scale to treatment effects was determined from its performance in the wider study. Results: The majority of correlations between individual items and total score were >0.48, with Cronbach's alpha equalling 0.88, indicating good internal consistency. Principal Component Analysis (PCA) confirmed a unidimensional structure. IRT indicated that the scale could be reduced to 11 items without significantly reducing its value. The scale showed good treatment and stimulus sensitivity, with a score change of ~20 points differentiating "no/worse" effect from an "excellent" effect and a 30% difference between treatment (imepitoin) and placebo. Conclusion: In our initial validation the Lincoln Canine Anxiety Scale appears to provide a reliable method for determining anxiety and fear responses by dogs and monitoring the effects of treatment.

Pain and Problem Behavior in Cats and Dogs.

We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal's problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient's response to trial analgesia, even if a specific physical lesion has not been identified.

The Canine Frustration Questionnaire-Development of a New Psychometric Tool for Measuring Frustration in Domestic Dogs (Canis familiaris).

Introduction: Psychometric tools have been developed for the assessment of behavioral and affective traits in non-human animals. Frustration can be defined as an emotional reaction experienced after a given expectation is violated. Frustration is a negative emotional state and whilst it probably plays a key role in certain behavior problems in dogs (e.g., aggressive behaviors), there appears to have been little attempt to scale this affective tendency. Therefore, the aim of the current study was to develop a tool to assess frustration tendencies in dogs. Materials and Methods: An online owner survey was developed. Items covered demographics, the training/behavioral history of the dog, and 33 frustration related items scored using a 5-point Likert scale. The questionnaire was disseminated via on-line channels over a 5-month period. Two thousand three hundred forty-eight respondents completed the questionnaire. Of these, 273 respondents completed it a second time 6 weeks later, and a separate 276 respondents completed it a second time 1 year later. Additionally, 92 paired responses were collected where two carers completed the questionnaire independently about the same dog. Intra- and inter-rater reliabilities were assessed prior to structuring the items using principal component analysis (PCA) with a Varimax rotation. Items were retained if they loaded > 0.4 on at least one of the components extracted using the Kaiser criterion. Results: Twenty-two items were deemed to be reliable enough to be used in the PCA and 21 items loaded on a biologically meaningful 5-principal component solution. There was a significant positive correlation between each principal component and the owners' general perception of their dogs' frustration tendencies, alongside other expected correlates. Conclusion: This is the first reliable psychometric tool for the assessment of frustration in dogs-the Canine Frustration Questionnaire (CFQ). Further validation with behavioral tests and physiological measures is ongoing.

Common Risk Factors for Urinary House Soiling (Periuria) in Cats and Its Differentiation: The Sensitivity and Specificity of Common Diagnostic Signs.

Urinary house soiling (periuria) in the home is a common but serious behaviour problem in cats. Although many specific risk factors and triggers have been postulated, their importance is largely unknown. This study assessed: (1) the significance of purported risk factors for periuria as well as specifically marking and latrine behaviour in the home; (2) the specificity and sensitivity of signs commonly used to differentiate latrine and marking behaviour. Owner responses to an internet survey (n = 245) were classified into three groups: control, marking and latrine behaviour, along with 41 potential risk factors and 15 predictors used to diagnose marking and latrine problems. Univariate statistical analyses and non-parametric tests of association were used to determine simple associations. In addition the sensitivity and specificity of four cardinal signs (posture to urinate, attempt to cover soiled area, surface chosen and volume of urine deposited) were calculated. Significant potential risk factors were: age (marking cats were older than the other two groups); multi-cat household (increased risk of marking and latrine behaviours); free outside access and cat flaps in the house (higher frequency of marking); outside access in general (lower prevalence of latrine behaviour); defecation outside the litter box (higher frequency of latrine behaviour); a heavy dependence by the cat on its owner (lower frequency of latrine behaviour) and a relaxed personality (lower risk of marking behaviour). Litterbox attributes and disease related factors were not significant. Individual cardinal signs were generally not good predictors of diagnosis. This study challenges the poor quality of evidence that has underpinned some of the hypotheses concerning the causes of periuria in cats. The results, in particular, highlight the general importance of the social environment, with the presence of other cats in the household, the cat-owner bond and personality related factors, alongside factors like the use of a cat flap which might also alter the social environment, all implicated as significant risk factors. While the physical environment may be important in specific cases, it seems this is less important as a general risk factor. The findings quantify the risk of misdiagnosis if a single sign is considered sufficient for diagnosis.

Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success.

Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these. Therefore, the aim of this study was to develop an instrument for coding factors likely to impinge on pet owner adherence to behavior advice and validate its utility through the identification of the factors appearing to relate most closely to a successful treatment outcome in a sample population from our clinic. Potential factors affecting adherence were identified from human health and animal behavior studies, and a survey instrument developed with items matched to these factors. Forty-two dog owners who had attended the University of Lincoln Animal Behavior Clinic over a 2-year period provided data used in the analysis. The assessment of treatment outcome success by clients and clinicians was correlated, but clinicians tended to overestimate success by half a point on a 5-point scale. Eleven items relating to adherence were found to correlate with client ratings of treatment success in a univariate analysis, with three of these remaining in an ordinal logistic regression model. These three related to trust in the advice given by the clinician, concern over distress caused to the pet in the longer term and the perceived recommendation of treatment measures that had failed. By further examining the relationship between all of these factors in a hierarchical cluster analysis, we were able to postulate ways in which we might be able to improve client adherence and thus treatment success. This provides a model for the application of the instrument in any veterinary behavior practice wishing to use client feedback to rationalize areas of the consultation which might be improved.

Noise Sensitivities in Dogs: An Exploration of Signs in Dogs with and without Musculoskeletal Pain Using Qualitative Content Analysis.

Noise sensitivity is a common behaviour problem in dogs. In humans, there is a well-established relationship between painful conditions and the development of fear-related avoidance responses. Whilst it is likely that a relationship exists between noise sensitivity and pain in dogs, this does not appear to have been investigated. The aim of this study was to explore the signs of noise sensitivity in dogs with and without musculoskeletal pain by comparing case histories using qualitative content analysis. Data were extracted from the clinical records of 20 cases of dogs presenting with noise sensitivity seen by clinical animal behaviourists at the University of Lincoln, composed of 2 groups-10 "clinical cases" with pain and 10 "control cases" without pain. Loud noises as a trigger of noise sensitivity were a common theme in both groups but ubiquitous among "clinical cases." In "clinical cases" (i.e., those where pain was identified), the age of onset of the noise sensitivity was on average nearly 4 years later than "control cases." In addition, strong themes emerged relating to widespread generalisation to associated environments and avoidance of other dogs in the "clinical cases," which did not appear in the "control cases." "Clinical cases" responded well to treatment once the involvement of pain had been identified. Veterinarians and behaviourists should carefully assess dogs with noise sensitivities for pain-related problems especially if presenting with these characteristics.