With production animals, treatment focuses on group management, environmental or housing modifications, and, in some cases, moving individual animals out of their groups or into other groups.
With companion animals, treatment of behavior problems varies with diagnosis and prognosis. In general, the behavior treatment plan recommendations encompass 3 categories:
Management focuses on meeting the pet's behavioral needs, preventing and avoiding problems, and improving safety.
Modification is the development of effective strategies to modify the pet's motivation and behavior so that the animal might gradually be reintroduced to problem situations and achieve a desirable outcome.
Medication—including pharmaceuticals and adjunctive treatments—can decrease the intensity of the emotional state motivating the unwanted behavior, such that the pet is better able to respond and learn. Drugs or adjunctive treatments (eg, dietary supplements, nutraceuticals, herbal products, nutritional therapies, pheromones, therapy wraps) may be indicated for some pets and some problems but not for others.
Management of Behavior Problems in Animals
Keys to managing behavior problems in animals include meeting the pet's behavioral needs, avoiding stimuli that incite undesirable behavior, and preventing rehearsal of undesirable behavior.
Meeting the animal's needs can improve behavior and welfare, especially if the inability to express normal behavior is a contributing motivation to performing the undesirable behavior. Needs vary between species, and the motivation to meet those needs varies between individuals.
Initially, prevention is necessary to avoid further compromising the pet’s welfare and to ensure safety of the pet, owner, and any target of the problem behavior. Repetition of the behavior further aggravates the problem by triggering unwanted emotional states, rehearsing undesirable behavior, and teaching the animal to repeat or intensify the undesirable behavior in the future.
Each exposure in which the outcome is unpleasant can condition further fear and anxiety. Therefore, improvement is generally a slow and gradual process, and owners must have realistic expectations of what can be achieved.
To prevent repetition, either the stimuli that incites the problem behavior can be kept away from the pet or the pet can be kept away from the stimuli. Environmental modifications (eg, distance, visual barriers, auditory barriers, physical barriers) may be required to achieve this.
Modification of Behavior Problems in Animals
Modifying the pet’s behavior is accomplished by applying the principles of learning and behavior modification, primarily achieving and rewarding desirable outcomes along with using products that improve safety, decrease fear and anxiety, or help to achieve the desired response more effectively (eg, muzzles, head halters, no-pull harnesses, etc).
The most commonly used behavioral techniques include habituation, extinction, counterconditioning and desensitization, response substitution, and shaping.
Flooding is often talked about but seldom used because the practice is often inhumane and is likely to make most animals' behaviors worse.
Although punishment is frequently used with varying degrees of success, few people correctly use this technique. In addition, there are both humane and safety issues with the use of positive punishment.
Most of the humane, passive, or positive techniques involved in behavior modification in pets focus on cultivating a positive conditioned emotional response and developing the pet's coping skills through reinforcement of desirable behaviors in the presence of an inciting trigger. The longterm goal is not only to prevent undesirable behaviors but also to teach the pet a more desirable way to feel or respond when the inciting stimulus occurs. These techniques are not hard to learn and, together with preventive strategies, are often very successful. In fact, dogs trained with rewards have fewer behavior problems, less fear and anxiety, and less avoidance than dogs trained with punishment.
The following is a short review of the basic principles involved in the techniques of behavior modification and their associated implementation strategies.
Behavior Modification Principles
Classical Conditioning
The following terms are used in classical conditioning:
Unconditioned stimulus: a stimulus that naturally (ie, with no prior learning) elicits a response
Neutral stimulus: a stimulus that elicits no response
Conditioned stimulus: an initially neutral stimulus that comes to elicit a response through association with an unconditioned stimulus
Conditioned response: the response elicited by the conditioned stimulus
The pairing of an unconditioned stimulus with a neutral stimulus results in a conditioned stimulus and a conditioned response.
Classical conditioning can occur in both positive and negative ways. Examples of a conditioned emotional response include the following:
pairing of a clicker (neutral stimulus) with favored treats (unconditioned stimulus)
pairing of a doorbell (neutral stimulus) with presence of visitors (unconditioned stimulus)
pairing of a mail carrier (neutral stimulus) with verbal or physical discipline (unconditioned stimulus)
pairing of another animal (neutral stimulus) with restraint or pain from a choke/prong/shock collar (unconditioned stimulus)
pairing of a veterinarian (neutral stimulus) with restraint or pain (unconditioned stimulus)
Problems arise when a fearful conditioned emotional response is established toward a previously neutral stimulus (visual, olfactory, auditory, animate, inanimate) by repeated pairing with a fear-producing stimulus. Once this occurs, the stimulus itself will elicit the fear response.
For example, when a pet is meeting new people (neutral stimulus) and lunges or barks, the use of positive punishment (unconditioned stimulus), such as choke collars, prong collars, shock, and pinning to inhibit the undesirable behavior, may condition a new fear-conditioned emotional response in which unfamiliar people now represent a fear-conditioned stimulus.
A visit to the veterinary clinic that begins as a neutral situation can quickly become fear evoking if it is associated with unpleasant outcomes or is amplified by owner anxiety. In addition, all of the stimuli (sights, sounds, smells) associated with the event also become conditioned stimuli for fear.
In much the same way, rain, wind, darkening skies, and lightning can quickly become conditioned, fear-evoking stimuli for pets fearful of thunder.
Counterconditioning and Desensitization
Counterconditioning involves the consistent and repeated pairing of a stimulus that evokes an unpleasant response with something that is emotionally positive (eg, a reward) until a positive emotional association is made. To be successful, counterconditioning should be coupled with desensitization. In desensitization, the stimulus is minimized or decreased (eg, by decreasing volume, increasing distance, changing the environment, or modifying the stimulus to something less threatening) to a level that does not evoke the fear response. Once a positive emotional association is made at the decreased level, rewards can be paired with stimuli of gradually increasing intensity.
Desensitization and counterconditioning are extremely time-consuming. The exercises must be constantly repeated so that the response is altered to a positive emotional one. All stimuli (sights, sounds, odors, tactile sensations) that evoke fear must be considered. Clients often want both quicker fixes and less work. However, moving too quickly provokes anxiety and sabotages any behavior modification program.
Extinction
The ending of a behavior once all reinforcement is removed is termed extinction. For example, if people pet a dog that jumps up on them for attention, the behavior continues; if they stop, the dog will eventually extinguish its response because the reward is no longer there.
However, any form of intermittent reinforcement—even occasional petting of the dog in response to its jumping—will prolong the performance of the response. Valuable rewards, a long history of performance, and intermittent reinforcement all increase resistance to extinction.
Owners also must be prepared for the intensity of the behavior to initially increase before it is extinguished; this is called an extinction burst. Giving in will make extinction even more difficult as the animal learns that higher-intensity behaviors achieve the desired outcome.
Flooding
Flooding is used to treat fears of harmless stimuli by forcing the animal to stay in the stimuli's presence until the fear is extinguished. This procedure is seldom effective and has welfare implications in dogs because it initially enhances fear and cannot be stopped until all physiological and emotional signs of fear are gone. If done improperly, flooding can therefore increase problem behaviors (sensitization).
In practice, a controlled level of flooding, in which the stimulus is presented at a level low enough to cause mild fear and the pet is not removed until it habituates, is quite often used as a component of behavior modification. This process can then be combined with reinforcement—ie, the pet is given something rewarding (positive reinforcement), or the stimulus is removed (negative reinforcement), when the fear response subsides or abates.
Habituation
Habituation is the gradual lessening of a response to a stimulus. Usually this occurs with repeated presentation of a stimulus, whereby the animal learns that the stimulus does not signal anything important. For example, horses placed in a pasture bordering a road might at first run away when traffic passes but eventually learn to ignore it.
Stimuli associated with potentially adverse consequences are more difficult to extinguish with habituation than other stimuli. In prey species, responses to sounds associated with predators would be difficult to habituate because the responses have been selected for and generally are adaptive.
If the fear response is too intense, the animal may become increasingly more fearful of the stimulus instead of habituating. This is termed sensitization.
If an extended interval has occurred since the time an animal last experienced a stimulus to which it had habituated, the animal may again react when reexposed to the stimulus. This is termed spontaneous recovery.
Operant Conditioning
Operant conditioning is a method based on making an association between a behavior and the consequences of that behavior. The results either increase or decrease the likelihood of future responses. There are 4 types of behavior-consequence relations: positive and negative punishment and positive and negative reinforcement. "Negative" refers to the removal of a stimulus, and "positive" refers to the application of a stimulus. Reinforcement increases the likelihood a behavior will be repeated, and punishment leads to a decrease in behavior.
Positive reinforcement occurs when, as a consequence of the behavior, something is applied (generally something pleasant or appealing), so the behavior is increased in the future. In positive reinforcement training, a reward should be given immediately and consistently following the behavior until the behavior is reliably repeated. If the behavior is to be trained on command or cue, a signal (eg, word, hand sign) should then be added before the behavior-reward sequence.
Once learned, behavior can be reinforced on a variable schedule, so that the period of time or number of responses before the reward is given is varied. Rewards are used for positive reinforcement; however, a reward is not synonymous with positive reinforcement. Unless there is a clear relationship (timing, consistency, contiguity) between the behavior and the reward, the reward does not achieve the goal of positively reinforcing behavior.
Negative reinforcement occurs when, as a consequence of the behavior, something is removed (generally something unpleasant) and the behavior is increased in the future. Negative reinforcement must not be confused with punishment because punishment decreases behaviors, and reinforcement increases behaviors.
One example of negative reinforcement is avoidance or escape behavior. For example, if an animal anticipates an unpleasant outcome (eg, meeting another dog, veterinary visit), then the aversive outcome will not occur if the animal retreats. Similarly, if the owner puts pressure on a head halter until the desired behavior (eg, sit, back up) is achieved, the release of tension is negative reinforcement. One potential consequence of negative reinforcement is that if a pet’s threats or aggression lead to removal of a stimulus (eg, dog, delivery person, owner), the behavior is reinforced by the retreat of the stimulus.
Positive punishment occurs when, as a consequence of the behavior, something is applied (generally something unpleasant) and the behavior is decreased in the future. For positive punishment to be successful, the aversive stimulus (eg, startling with a loud noise, spraying compressed air) must occur sufficiently close to the onset of the behavior, with complete consistency and at an appropriate intensity, that the probability of the behavior's occurring in the future is lessened.
In positive punishment, if behavior does not decrease after the first few applications, then the punishment is not being appropriately timed, or the behavior is too strongly motivated, to be deterred by punishment.
Positive punishment applied by a person (eg, owner, trainer) is intended to cause the pet to become fearful of repeating the behavior. In fact, numerous studies have demonstrated that positive punishment–based training and confrontational techniques are more likely to lead to fear, avoidance, and increased aggression. A potential consequence is that the pet becomes fearful or defensive to the punisher or to an approaching hand. Relationships with people should always remain emotionally pleasant. Also, if an unpleasant consequence occurs only when the owner is present, the behavior may continue in the owner’s absence.
Another problem with positive punishment is that punishment paired with exposure to a stimulus (eg cars, other dogs, strangers) can result in a conditioned fear of the stimulus (see classical conditioning). In addition, some dog owners have been misled by inappropriate training advice that advocates confrontation, with the intent of asserting leadership (dominance). Often, punishment is more about the owner’s anger than about changing the pet's behavior.
Punishment cannot be used to achieve desirable behaviors, only to stop what is undesirable. If the goal is to make the pet fearful of repeating an undesirable behavior (eg, garbage raiding, taking things from counters, chewing plants) or to keep the pet away from an area (room, couch, bed), then environmental or pet-activated punishment (eg, motion detector alarms or sprays, upside-down carpet runners, aversive tastes, double-sided tape, or bark-activated sprays) or remote punishment (eg, spraying water while out of sight, remote-activated alarm or spray) might be most appropriate. However, before focusing on how to stop what is undesirable, the owner should first focus on providing a desirable alternative to allow the pet to meet its behavioral needs (eg, where to sleep, where to climb, what to chew).
Negative punishment occurs when, as a consequence of the undesirable behavior, something is removed (generally something pleasant or appealing) and the behavior is decreased in the future. For example, if the pet is receiving affection or play when an undesirable behavior (eg, play biting, mouthing, mounting, jumping) begins, the consequence of immediate removal of the play or affection will "negatively" punish the undesirable behavior. However, unless the pet can determine what behavior leads to the removal of play or affection, the undesirable behavior may actually intensify because of frustration over not receiving its reward (see extinction). The owner should also focus on positively reinforcing a desirable alternative behavior to meet that pet's behavioral needs (eg, play or affection when the animal is calm).
Overlearning
Overlearning is the repeated evocation and expression of an already learned response. It is a phenomenon frequently used in training for specific events but may be underused in preventing fearful responses in dogs. Overlearning accomplishes 3 things: it delays forgetting, increases the resistance to extinction, and increases the probability that the response will become automatic, or the response of first choice, when circumstances are similar.
Premack Principle
The Premack principle is that when a more desirable behavior—from the animal's perspective—is made contingent on a less desirable behavior, the less desirable behavior is more likely to be repeated. Thus, the more desirable behavior serves as the reinforcer. For example, if a pet wants to go out or cross the street for its walk, the owner can train a sit-stay before each of these behaviors. A horse or dog that wants to walk ahead can be taught that walking on a slack rein or leash will result in this behavior.
First-Order Reinforcers
A first-order reinforcer, more commonly known as a reward (or a primary reinforcer), is an event that is naturally reinforcing. A reward is anything desirable to the pet, from an activity such as petting, walking, or play to an item such as a toy, food, chew, or treat.
Second-Order Reinforcers
A second-order reinforcer, also called a conditioned reinforcer, is an event that is reinforcing because of its association with a first-order reinforcer. By being repeatedly and continuously paired with a primary reward such as a toy or treat, second-order reinforcers can elicit the same response that the reward would, as long as the pairing is repeatedly maintained. Second-order reinforcers can be created as a signal that can be used at a distance to convey that a reward is coming. The following are examples of second-order reinforcers:
the presence of a leash (second-order reinforcer) associated with a walk (first-order reinforcer)
the crinkle of a treat bag (second-order reinforcer) associated with treats (first-order reinforcer)
the click of a clicker, a whistle, or saying "good" (second-order reinforcers) associated with treats (first-order reinforcer)
Clicker training is an excellent way to immediately “mark” desirable responses, gradually shape new or more desirable (eg, longer, more relaxed) behaviors, or associate a positive emotional response with the stimulus. Clicker training requires frequent practice and excellent timing; however, once mastery is achieved, the animal can be reinforced each time the desired behavior is observed.
Response Substitution
Response substitution involves the replacement of an undesirable response with a desirable one. For example, high-value rewards can be used to train desirable target behaviors that are alternatives to an undesirable behavior. However, if the undesirable behavior is part of the pet’s natural repertoire (eg, greeting, barking), alternative behaviors can be particularly difficult to train. Specific examples of response substitution include training a dog to sit or lie down as an alternative to jumping up, mounting, or play biting; or training to sit, walk on loose leash, or back up, rather than forging ahead or running out the door.
Training should begin in a variety of environments where success can be most readily achieved. If the desired endpoint for the new response is for the animal to be quiet and calm, the owner must learn to read the pet's body posture, facial expressions, and breathing to be able to gradually shape the desired behavior. Training can then move to environments with increasing distractions and locations where the undesirable behavior is most likely to occur. Alternatively, the pet might be enticed to engage in a behavior that is incompatible with the undesirable behavior (eg, teaching the dog to fetch a toy when visitors arrive instead of jumping up).
To replace the undesirable behavior with one that is desirable, response substitution can be coupled with desensitization by beginning training with stimuli of low enough intensity while training the target behaviors (eg, relaxation) with high-value rewards. However, for pets that are fearful or anxious, the focus should be on desensitization and counterconditioning to change the pet’s emotional state, rather than the behavioral response.
Shaping
Shaping works through gradual approximations of a desirable behavior and allows the animal to be rewarded initially for any behavior that resembles the desired behavior. For instance, when teaching a puppy to sit, providing a food reward for a slight squat will increase the probability that squatting will be repeated. Over time, squatting behavior is ultimately rewarded only when it more closely resembles a sit, and finally, when it becomes a true sit. Shaping can also be used to reward both progressive increases in duration and frequency of a more desirable behavior.
Medication for Behavior Problems in Animals
Psychotropic drugs and adjunctive treatments (eg, dietary supplements, nutraceuticals, herbal products, pheromones, nutritional therapies) can be used to reestablish a more stable emotional state and to improve trainability in patients that are anxious, fearful, or overly reactive. Drugs might also be effective in the treatment of behavior that is abnormal or pathological. In addition, drugs may be indicated to improve compromised welfare.
Although drugs can improve the animal's emotional state and facilitate new learning, only with concurrent behavior modification can new neuronal pathways be established, new behaviors learned, and fearful responses to stimuli changed to positive ones.
Before dispensing drugs, clinicians should rule out underlying medical problems that might be causing or contributing to behavioral signs or that might have an impact on drug selection and use.
To rule out underlying medical problems, veterinarians should perform a physical examination and collect a minimum database (CBC, serum biochemical analysis, urinalysis, and measurement of serum thyroxine concentration—plus in cats, testing for both feline leukemia virus and feline immunodeficiency virus). Additional testing, such as blood pressure measurements, thoracic and abdominal radiography and ultrasonography, and thyroid panel, may also be indicated, depending on the patient, differential diagnoses, and medication considered.
Evidence-based decision-making is a way to provide the owner with the best treatment options. Treatment should be selected using the evidence combined with the clinician’s expertise regarding the specific animal, client, and problem.
Very few drugs have been adequately tested in rigorous randomized controlled trials for use in veterinary behavioral therapy. In fact, most drugs used in veterinary behavioral therapy are human drugs, very few of which have had pharmacokinetics established for animal species. Use of human drugs in animals can lead to inaccuracies regarding dosage, duration of effect, contraindications, and adverse effects. In addition, these drugs have a wide range of published dosages based on the application, individual variability, and desired outcome. Therefore, before dispensing any of these medications, practitioners prescribing drugs to modify behavior must remain current with veterinary behavior literature with respect to indications, recommended dosages, evidence of efficacy, potential adverse effects, and contraindications.
Depending on the drug and patient, compounding may be required to achieve an appropriate dosage and formulation for administration; however, reformulation may alter a drug’s pharmacokinetics, safety, efficacy, and stability. Studies on the use of transdermal preparations of behavioral drugs such as fluoxetine, amitripyline, and buspirone have found little to no absorption transdermally.
Considerations for medication choice include the following:
predictability of targeted situation
onset to drug effect
duration of drug effect
neurochemicals augmented
Drugs are differentiated not only by their drug class but also by their indications as "baseline" daily medications, "situational" medications, or adjunctive therapies.
Baseline medications usually are used regularly (daily to multiple times daily). Some drugs in this category may take weeks to reach optimal therapeutic effect. Baseline medications tend to work best for chronic or unpredictable stimuli that may elicit the behavior problem. Some examples of drugs that fall in the baseline category include selective serotonin reuptake inhibitors and tricyclic antidepressants.
Especially for patients with multiple behavior problems, a baseline medication can create a foundation for which a situational medication or adjunctive therapy could be synergistic or complementary:
Situational medications have a short onset to effect and a short duration of effect. Situational medications can either be used on a regular basis—usually in combination with a baseline medication—or as needed. Situational medications tend to work best for acute, predictable stimuli that may elicit an undesirable behavior. Examples of situational medications include alpha-2 agonists, benzodiazepines, trazodone, and gabapentin.
Adjunctive therapy, like baseline medication, involves regular (daily to multiple times daily) use.
A variety of adjunctive therapies (eg, dietary supplements, nutraceuticals, herbal products, nutritional therapies, pheromones, therapy wraps) have been used to treat fear and anxiety.
In reported studies, the following have been found to have potential therapeutic effects to calm and decrease underlying fear and anxiety:
dog-appeasing pheromone
feline cheek gland pheromones
feline-appeasing pheromone
l-theanine
alpha-casozepine
a diet supplemented with alpha-casozepine and l-tryptophan
a product combining Magnolia officinalis and Phellodendron amurense
a Souroubea spp supplement
Bifidobacterium longum BL999 strain of probiotic
anxiety-targeted pulsed electromagnetic field (tPEMF) treatment
melatonin
lavender aromatherapy
In reported studies, the following have been found to have potential therapeutic effects for cognitive decline:
S-adenosylmethionine (SAM-e)
Ginkgo biloba extract
a diet containing medium-chain triglycerides
Key Points
When evaluating an animal because of undesirable behavior, first gather sufficient evidence to exclude any medical problems that might be causing or contributing to behavioral signs.
Understanding the risk factors and safety concerns associated with the undesirable behavior is essential both before and during treatment interventions.
Regardless of species, for all treatment plans addressing undesirable behavior, management is an irreplaceable component. In addition, for companion animal cases, modification and medication may be indicated.
Management recommendations should meet the animal's behavioral needs, prevent placing the animal in situations where they might rehearse the undesirable behavior, and avoid situations that might prompt undesirable behaviors.
Modification recommendations involve the development of effective strategies to modify the pet's motivation and behavior so that the pet ultimately achieves a desirable outcome in problem situations.
Medication recommendations may include drugs and other adjunctive treatments to affect the intensity of the pet's emotional state so that the pet may respond desirably during training and learn desirable associations.
