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After two long years of many owners working from home and the influx of “COVID puppies” as well as many jobs now moving to fully remote positions, the topic of separation anxiety comes up almost weekly in my appointments. I’ve put together some information to hopefully help dog owners recognize the signs of separation anxiety and start intervention early which will give your dog the best prognosis.
What is separation anxiety? Separation anxiety is a distress response typically characterized by periods of destruction, vocalization (barking, howling), and elimination (urinating/defecating) that occur when the animal is separated from a person or persons in which they are most attached - typically their owner(s). Can I do anything to prevent my puppy from having separation anxiety? There are things you can do to help prevent separation anxiety before it even starts. We recommend exercising your puppy before you leave so that they will rest while you are gone. They should be left in a comfortable place in which they feel safe and given a toy or treat before you leave them. Do not display any emotion before your departure or for 5-15 minutes after you return. You can let your puppy out to use the bathroom right when you get home, but don’t use an excessively excited voice and start playing with them until the 5-15 minute period has passed and they are calm. How is separation anxiety diagnosed? With separation anxiety, the distressed behaviors can be seen right before departure, while the owner is gone, when the owner returns, or any combination of the three. Some of the clinical signs we see with separation anxiety are destruction of objects that bear the owner's scent or at exit points, self-inflicted trauma, excessive vocalization (howling/barking), hypersalivation, pacing, panting, escape attempts, decreased or no appetite, shaking/trembling, aggression when people leave the home or try to confine the pet, shadowing behaviors when the owner is home, uncontrolled urination and defecation, and excessive greeting when the owner comes home. Every pet should undergo an examination by a veterinarian to rule out other causes of distress such as pain and the owners should provide a thorough history of the behaviors being exhibited. Every animal that is urinating/defecating inappropriately should also have bloodwork, a urinalysis, and a fecal performed to rule out a medical problem. We will also discuss your pet’s daily routine to make sure their needs are being met on a daily basis - we may recommend incorporating an exercise routine or adjust your pet’s feeding times. You may need to set up a surveillance camera in order to get a diagnosis of separation anxiety as other anxieties such as noise aversion, thunderstorm anxiety, and barrier frustration can all present in a similar way. Why does my dog have separation anxiety? Dogs are very social creatures so when they are left alone, there can be some degree of distress, however, it is the severity of the level of distress that defines separation anxiety. There are a few theories as to why separation anxiety develops. Some studies show that hyper-attachment to one person could cause separation anxiety but the jury is still out on whether or not this is true. Another cause may be that the pet has general anxieties but is just able to better control them while their owner is around versus when they are alone. Breed type does not seem to predict whether or not a dog will experience separation anxiety nor does mixed-breed versus purebred dogs. A recent study did find that male dogs were more likely to have separation anxiety than females and while dogs of any age can exhibit signs of separation anxiety, over 50% have shown signs of anxiety before 3 years of age. Contributing factors include dogs who follow their owner everywhere within their home, dogs who greet their owners excessively when they come home, dogs who have never attended an obedience class, dogs who have been found as strays, and those who were acquired from shelters or rescue groups. How is separation anxiety treated? Behavior modification is used to treat separation anxiety. Before I go into further detail as to what that may look like, these are things you MUST understand:
Depending on the severity of the anxiety, you may need to incorporate some or all of these into your normal routine. I’ve broken up the exercises to correlate with either the timing of the distress response or the signs you may be seeing. Following you around the house with a strong attachment behavior or getting overly excited to greet you when you come home. Try to avoid responding to your pet when they are seeking out attention. Instead, move to more of a reward-based system such as asking them to “sit” or perform other tricks before giving them a treat or praise or your attention. If your dog is resting on their own or has occupied themselves with a toy, use calm praise to let them know you appreciate this behavior and reinforce it. You can try closing doors behind you, use sit/stay commands, or baby gates to discourage your pet from shadowing you. However, if this evokes a stress response then you may need to take a step back; try giving them puzzle games or treats that keep them busy for a period of time before walking away. Remember, during the training period we don’t want to do ANYTHING that provokes their anxiety. You may need to incorporate relaxation exercises. To do this, get a dog bed, mat, or rug, and have your pet lay or sit on it. Give them a reward for getting into position. In the beginning, you’ll want to stay within a few feet of them standing either next to them or in front of them. Take a couple steps back and then return to them with a small treat. During this period you can repeat the verbage “relax” or “good stay” in a calm voice. If your pet gets up from their spot to follow you or investigate something else, do not acknowledge it. Instead, walk back to their bed/mat and wait until they return to the position, then give them a treat for returning and try the exercise again. When you are ready to end the exercise, say “all done” and let them know it’s okay to move from their position. Training should be done in 5-10 minute increments. As your dog progresses in training, you can start to step further away, turn your back towards them, and alternate their prize with treats or verbal praise. Eventually, you’ll be able to incorporate leaving the room into the exercise but it can take time to get to this point so don’t be discouraged. If your pet is giving you an excessive greeting when you return home, ignore them for 5 to 15 minutes after you get home. If they jump up on you, say nothing and just turn away from them. Only once they have calmed themselves down do you start to give them your attention. If you pet needs to use the restroom during the 5-15 minute period, go ahead and let them out. Anxious behavior starts when they notice you are getting ready to leave (i.e. picking up your keys, packing your lunch, putting on your coat, etc). If you notice that your pet gets anxious when you start your routine to leave, start to do those things without leaving. For example, grab your keys and put on your coat but don’t leave the house. Do this 2-4 times daily until your dog no longer responds to these stimuli with anxious behaviors. Make sure your dog is calm between repetitions. It is important to discontinue the exercise if it causes your dog overt distress as this can actually increase the anxiety in some pets. You can also try switching up your routine. If you always pack your lunch in the morning, then put your shoes on, then your coat, then grab your keys instead try packing your lunch the night before, put on your coat first before getting your lunch out of the fridge, pick up your keys before you put your shoes on, etc. Again, take special note that this isn't increasing the anxiety response in your dog. You can also try giving your pet their food or a highly palatable treat before you leave. Consider getting a kong toy (a VERY large one they can’t swallow) and fill it with canned dog food then put it in the freezer before giving it to them. This can keep them occupied for a while. There are also puzzle feeders and food games that yield similar results. Just make sure they are also getting these treats/puzzles at other times of the day in which you don’t leave so they don’t start to associate it with your departure. It helps if your pet has a safe, relaxed place to go when you leave. See the instructions for a “relaxation exercise” above (4 paragraphs up) and use a favorite bed or space in the household for training so they have a safe place to retreat to when you leave. You should also start training with graduated planned departures and absences. Buckle up because this is a big one that HAS to be done correctly to be successful and not make their anxieties worse. You’re going to want to have some sort of camera surveillance set up so that you can monitor your pet’s response to your departure to get your timing down right.
Destruction and self-injury For dogs who eat the couch, your shoes, the door you’ve exited from or those causing self injury such as trying to jump through glass windows, they can not be left home alone. These are the dogs who really need to be seen by a boarded veterinary behaviorist. They often have other anxieties/behavioral issues and need a specialized treatment plan provided by a trained professional. I don't recommend starting any training exercises until you have consulted with a professional. You can easily make the problem worse rather than better, even when you have the best of intentions. What medications get rid of separation anxiety? None. No medications will get rid of separation anxiety without behavioral modification. Medications can help aid in the process and may decrease the length of the total training period but they WILL DO NOTHING ON THEIR OWN. Adding in a pharmaceutical to your training plan should be a discussion between you and your veterinarian. There are both long term and short term options depending on your pet’s needs. If your pet is put on long-term medication, we wait 1-2 months after the training period before we start to wean them off the medication very slowly. Non-prescription products that have been helpful in combination with training are pheromone products such as Adaptil plug-in diffusers or Adaptil collars or nutraceuticals such as Anxitane and Zylkene.
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One of the biggest questions I get from new puppy owners is “how do I trim their nails?” while seasoned dog owners ask “Will you trim their nails for us?”. I can’t blame those seasoned dog owners! Nail trimming is absolutely the most hated grooming necessity among all dogs and owners alike. However, it does not need to be a battle every time your pet needs a nail trim; it’s just going to take some time and a lot of patience. I’m going to share some tips and tricks on how to train your dog to tolerate nail trims and also go over how to properly trim the nails. Step 1: Desensitize paw touching in your pet You’ll want your pet to first allow you to pick up their paw and individually inspect their toenails. Some dogs will allow this without any training, others will immediately pull away as soon as the toes are touched. Start by petting your dog in a spot you know they enjoy (head, back, butt scratches). After a few seconds of that, slowly move your hand to your pet’s shoulder or thigh without breaking contact with their skin. Then, move down your pet’s leg until you reach the paw. If they are still doing well at this point, you can pick up the paw. Be careful not to pull their foot outward away from their body as this can be uncomfortable for them. Instead, try to keep their shoulder or thigh in its current position and just curve the paw backward like the motion your dog would make if it were digging. At this point, your dog’s paw pads should be facing the ceiling. Then, try touching the toes individually. If at any point in this exercise, your dog starts to pull away, give them a break and try again with a delicious distraction such as spray cheese, peanut butter, a Lickety Stik- something tasty that will keep them occupied for a short period of time! If you don’t have a helper, you can spread the treat on the side of a shower or tub for easy clean up after. If your dog shows any signs of aggression (growling, snapping, barking, ears pinned back) or signs of overt distress (panting, yawning, drooling, trembling) discontinue the exercise and consult with your veterinarian for you and your pet’s safety Another way to desensitize paw touching is to teach your pet to offer their paw to you! This trick is given many names such as “give paw”, “shake”, or “high five”. It’s important to note that while training your pet any tricks, they must learn the behavior first before they learn the command name. My favorite way to teach this trick is by putting a delicious smelling treat in the palm of my hand and make a fist so my dog can’t eat or see the treat. I hold my fist out at a level they can reach with their paw with my wrist facing upward. Then, I allow them to inspect it. Usually they’ll start sniffing, then maybe whining and giving me puppy dog eyes, but if you hold out long enough, most dogs will start to paw at your hand to try and get it to open. The second my dog’s paw hits my hand, I open my fist and reveal the treat. This is repeated over and over again until your dog’s first instinct is to paw your hand instead of sniffing or whining at it. Once your pet is giving you the action consistently, only then do you say your command of choice once (“give paw”, “shake”, “high five”), and hold out your fist again. Repeat this over and over. With time, you can remove the treat from your hand and reward them following the action.  Step 2: Desensitize your pet to the sight and sound of the nail trim device The most common way to trim a dog’s nails is with nail clippers. They work like pliers and make a flat cut across the entire toenail. The upsides: they are quick, make very little noise, and are pretty straightforward on how to use them. The downsides: the edges of your dog’s nails can still feel sharp for a couple days after trimming and if used incorrectly, you can cut or squeeze your dog’s quick which leads to pain and bleeding of the toenail. If you choose to use nail clippers, make sure they are the appropriate size for your dog, clean, and have sharp blades. Another option is to use a dremel which files the nails down. The upsides: the nails are smooth directly after trimming and it’s much more difficult to damage your dog’s quick. The downsides: they are loud, produce nail dust in the air, can catch the hair on furry paws, and have a bit of a learning curve to get the correct grip and use down. Once you have chosen which method you feel comfortable using, you need to make sure your pet is comfortable with the sight of them. Bring the nail trimmer or dremel out (do NOT turn the dremel on) and give your dog lots of pets and treats. You may be doing this step for days or weeks before you move on to the next if your pet is already afraid of nail trims. The next step is extending the tool towards them without touching them. Again, lots of praise and treats! Then, try touching the tool to their paw. If at any point your pet is uncomfortable, start back at the previous step for a longer period before trying to move forward. If you are using the dremel, you’ll need to repeat all of these steps one more time with the dremel on. Step 3: Trim your pet’s nails! First, let’s go over the anatomy of your pet’s nails. The outer casing of the toenails are made up of a protein called keratin, just like our nails and hair. This is what gives the toenail the hard protective shell. Within that shell is what is known as your dog’s quick. The quick is a cuticle that contains blood vessels and nerves. If your dog has white toenails, you may be able to see the quick - it’s pink in color. Because of the nerves and vessels, if you trim too close to the quick, you can cause pain and your pet may bleed. Within the quick, is an itty bitty bone. The goal of the nail trim is to only trim the overgrown outer keratin layer of the nail and to avoid the quick and most definitely the bone.  When you are first training your pet to tolerate nail trims, it’s important to focus on the very tip of the nail. While your long-term goal may be to get your dog’s nails much shorter, we need to allow them to get used to the feeling and sounds of the nail trims first. Plus, you are much less likely to cause pain by focusing on the very tip. If your pet experiences any damage to their quick, it’s going to cause a substantial setback in your training. For some pets, you may only be able to trim one or two nails a day in the beginning. Allow them to dictate how much they tolerate - forcing them to do something they don’t want to is only going to make matters worse in the long run. If you are using the nail clippers, starting at the tip of the nail, trim a small sliver at a time. If your dog has white nails and you can typically see the quick, stop trimming 3-4 millimeters before you reach the quick. Even if you don’t cut the quick, trimming too close can squeeze it and still elicit a pain response. If your dog has black or dark pigmented nails and you can’t see the quick, inspect the cut surface of the nail after each sliver you take off, and when it starts to look like you cut into the tip of a jellybean, you’re done! You’ll understand once you see it - the center of the cut surface will have a wet look to it like you’d expect to see in the middle of a jellybean [pictured below]. Remember, take tiny amounts at a time! If you accidentally cut your dog’s quick and the nail starts bleeding, you can use styptic powder (also known as Kwick Stop) or cornstarch to stop it. You may need to apply pressure for 1 to 2 minutes.  If you are using a dremel to perform the trim, hold the top ⅓ of the dremel handle between your thumb and pointer finger and wrap your fingers around the handle but keep your thumb sticking outward. Brace your thumb on the paw you are trimming. This will ensure that if your pet moves their foot, you and the dremel move with it. Use the dremel to smooth the pointed tip of the nail. Do not keep the dremel in one spot for too long, use small motions and check in to ensure you aren’t too close to the quick. Other information to note:
On average, dogs need their nails trimmed about once a month. Dogs who run on pavement will naturally file their toenails down and typically require less frequent nail trims. It is also normal for your dog to naturally file the toenails on the back paws more than the front - so some dogs only need the back paws done with every other nail trim. If you are unable to cut your dog’s nails very short because the quicks are so long, it is best to perform nail trims every 2 weeks. It will take time (months to years), but with frequent nail trims the quick will start to recede back and you’ll be able to get your pet’s nails shorter. There used to be a popular procedure performed at vet clinics called a “radical nail trim” or “show nail trim”. It is when the pet is under anesthesia and the nail is cut purposefully through the quick to make them very short and recede the quick back immediately. This is a dangerous and unethical procedure and I would never recommend any one putting their pet through this. If your dog absolutely hates nail trims and it stresses them out, we often will try training and trimming with anti-anxiety and mild sedative medications. The most popular medications used are gabapentin and trazodone. If your dog is still extremely uncomfortable despite getting the anti-anxiety medications, then we may need to look at using a stronger sedation protocol. Some dogs are not going to tolerate nail trims with clippers or dremels, no matter how much time and effort you put into training. For those animals, I recommend training them to use a scratchboard. A scratchboard is a board with sandpaper affixed to it. Dogs can be trained to scratch at the board which files their nails down. There is a Facebook group that has a ton of great information and resources on nail trimming. It is called Nail Maintenance for Dogs. It is a private group so you will have to request access before you can see all the posted information. Happy trimming! Please reach out if you have any specific questions about trimming your dog’s nails. I became a veterinarian because I love animals. Turns out, not all of them love me back because I am a veterinarian. While vet care is vital to keeping your pet healthy and increasing their longevity, trips to the vet can be a stressful time for both owners and pets alike. I’ve compiled some tips/tricks to try and help make the process as smooth as possible.
Disclaimer: This post is filled with general information that will not apply to 100% of cats and dogs. Please discuss with your veterinarian about your pet if you have any specific questions or concerns. 1. Practice handling your pet at home. If your pet doesn’t like it when you touch their ears and paws, it’s very unlikely they’re going to enjoy a stranger doing it to them. The best and easiest time to implement this training is in puppy or kittenhood but it can absolutely be started later in life. It’s important to have patience with your pet and respect their boundaries to keep both you and them safe during the training process. Make sure you are familiar with your pet's body language and what it's telling you as repeating these triggers can make matters worse. You can find a brief overview of body language here: https://www.akc.org/expert-advice/advice/how-to-read-dog-body-language/ https://www.tuftandpaw.com/blogs/cat-guides/the-definitive-guide-to-cat-behavior-and-body-language If you pet allows for it and doesn’t act troubled with touch, here’s a list of areas to examine and positions to put them in:
Paw touching can be an especially difficult one for pets since most pets directly connect paw touching with nail trims. For these pets, it can be helpful to train them to use a scratch board to file their nails in lieu of traditional nail trims. Also teaching the “shake” or “high 5” command can be helpful to put a more positive spin on paw touching. 2. Play with or exercise your pet prior to their visit. I want to be clear that this only applies to their healthy annual check ups and not for sick visits. If your dog is limping, the last thing I want you to do is take him for a 2 mile run before coming to see me. However, if your pet is a ball of energy, tiring them out some prior to a vet visit can be helpful. 3. Set your appointment first thing in the morning or call before entering the building. If your pet gets anxious when they see or hear other animals, the best time to set your pet’s appointment is the very first time slot in the morning. The clinic won’t be as busy and there is less of a chance that your veterinarian is running behind with emergencies and phone calls which means less time in the hospital for you and your pet. If you are unable to make an early appointment time, call the front desk before entering the clinic and see if there is an exam room available yet and if appointments are running on time- some pets would prefer to wait in the car than they would in the clinic. 4. Make sure you’re calm. This may mean you have to remove yourself from the equation. Our pets are very in tune with our emotions - this is what makes the human-animal bond so unique! However, there are downsides to that too. When we as owners are nervous or anxious, our pets can become nervous and anxious too. For some pets, they have a protective instinct when their owners are around. During the COVID-19 pandemic, we had to run as a curbside vet clinic for over a year which meant pets were separated from their owners for exams and treatments. As hard as it may be to hear as a pet owner, the large majority of pets did much better away from their owners. Your pet may benefit from you leaving the exam room during the exam or treatments. 5. Make sure your pet comes hungry. As long as your pet doesn’t have any diet-dependent health issues such as diabetes, skipping breakfast the day of their exam can be helpful. This ensures that there is plenty of room in their stomachs for good ole fashion bribes - a.k.a. treats. 6. Bring your pet’s favorite snacks. We try to have a good assortment of treat options for pets but we can certainly see a few picky eaters who don’t like what we have available. If there is a specific treat your pet loves, bring it along and give it to the veterinary staff to give your pet. This can help strengthen the trust between your pet and us a bit quicker. Same goes for toys! If your pet has a ball or fluffy toy they love to play with, we would love to use that toy to interact with them! 7. Get your pet used to car rides. For a lot of pets, the car ride itself is the worst part of their vet visit and they are already a ball of anxiety before they’ve even made it to their appointment. First, we want to rule out motion sickness which can also look a lot like anxiety - drooling, lip licking, panting. Untreated motion sickness can also lead to car anxiety. If you are seeing any of these signs, ask your veterinarian about using a medication called Cerenia (an FDA approved drug for motion sickness in pets) to see if it helps with their clinical signs. For car ride anxiety, there are a few things you can try.
8. Anti-anxiety medications. The normalization and use of anti-anxiety medications for vet visits has made a world of difference. Before these medications, it was not unusual to have two people holding a pet down and a third one giving vaccines to a poor, scared, yowling animal who is fighting for their life. This practice is outdated and unnecessary today. Many pets benefit from receiving calming and sedative medications prior to their vet visits. The two most common medications used today are Trazodone and Gabapentin. Both of these medications have a large margin of safety. Ask your veterinarian to learn more. 9. Seek out an at-home vet. Some pets are just not made for trips to the vet clinic. Luckily, there are at-home vets who are able to come to you where your pet can stay in their familiar environment to receive the general care they need. Please note that services may be limited - a home vet isn’t going to be able to bring an entire x-ray machine into your house, but this option is great for annual visits and minor illnesses such as ear infections. 10. Bring your pet in for “happy visits”. A “Happy Visit” is when you bring your pet in for an unofficial appointment to strictly get treats and attention and ZERO handling or treatments. I recommend doing this early in the morning or around the lunch hour when the vet clinic is less busy. It is helpful to call your vet ahead of time to check in with them when a good time might be to stop by. For these visits, the vet staff will give your pet attention and treats and keep the experience as positive as they can. The goal is to reframe your pet’s perception of the vet as being a place where they only get poked with shots or handled by strangers whenever they come. 11. Keep your pet carriers out all year around. I see this mistake made by pet owners - especially cat owners all the time. I know pet carriers aren’t the prettiest things to have in your living room but if your pet only sees the carrier when they end up in the car or at the vet, their anxiety is already building before you’ve left the house. Keep carriers out all year around. Throw high-value treats into the carriers every so often so your pet enjoys going into them. Place a comfy bed in there for them to nap in from time to time. NEVER lock your pet in the carrier thinking they will get used to it and wear themselves down if you keep them in there long enough or use it as a “time-out” space. Instead, make it a safe space for them that they enjoy being in. 12. Muzzle training. Muzzle training is extremely helpful for pets who need to wear a muzzle at the vet. Don’t be embarrassed if we have to place a muzzle on your pet at the vet - muzzles get a bad rap and are often associated with a negative connotation when in fact they are just another tool in our toolbox to keep you, your pet, and veterinary staff safe. I have examined many dogs who wear muzzles regularly at the vet who have never shown a single sign of aggression. The reality is, we are often strangers to your pets who may be doing uncomfortable things to them like examining their ears when they have an ear infection or moving their leg around when it hurts and they’ve been limping on it. We don’t blame them for their actions when they are in pain or uncomfortable. The concept of muzzle training is very similar to that of keeping your pet’s carrier out all year around. They are going to see it as a negative thing if every time they wear one they are getting a shot. Instead, purchase a properly fitting muzzle (such as a basket muzzle) for your pet and get them used to wearing it at home, on walks, on car rides. Keep it positive! They can still lick peanut butter and cheese through the muzzle and with basket muzzles are even able to chew on treats. Make sure the muzzle is placed prior to walking into the vet clinic for an appointment. |
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AuthorDr. Siri Horsley is a veterinarian and co-founder of City Limits Vet Clinic. She started the blog, From the Dogtor's Desk, to help provide pet owners with helpful information about vet care and their pets in general. Archives |
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