CPD ACCREDITED ARTICLE
Medical Condition
Behavioural Problems
Neurological disease (brain neoplasia):
Partial seizures (temporal lobe epilepsy
Changes in temperament , vocalisation , sleep wake changes, altered aware-
ness, disorientation , confusion
Repetitive/stereotypic behaviour behaviours, self-trauma, changes in temper-
ament
Irritability, aggression, decreased/increased activity, night waking
Lethargy, decreased response to stimuli, irritability/aggression
Feline hyperthyroidism
Canine hypothyroidism,
Hyperadrenocorticism/ hyperadrenocor-
Altered appetite, house soiling, anxiety , decreased activity
ticism
Insulinoma/diabetes
Irritability/aggression, anxiety, lethargy, house soiling, altered appetite
Hepatic/renal disease
Signs associated with organ affected:
Altered response to stimuli, decreased activity, restlessness, unsettled, vocalisa-
Pain
tion, house soiling, aggression/irritability, self-trauma, waking at night
Peripheral neuropathy
Self-mutilation, aggression/irritability, circling, hyperaesthesia
Gastrointestinal
Licking, polyphagia, pica, coprophagia, house soiling, unsettled sleep.
Male: aggression, roaming, marking, mounting objects
Functional ovarian/testicular tumour
Female: nesting, possessive aggression
Urogenital
House soiling, waking at night
Psychogenic alopecia (cats) acral lick granuloma, self-trauma (licking/chewing/
Dermatologic
biting/sucking)
Table 3: Medical conditions which can cause behavioural problems
Drug
Dog
0.02 -0.1 mg/kg
Alprazolam
bid -qid
0.5 – 2 mg oid -
Diazepam
qid
0.2 – 1mg oid -
Oxazepam
bid
0.1 – 1.0 mg/kg
Clonazepam
bid - tid
0.025 – 0.2mg/kg
Lorazepam
oid - tid
Melatonin
3-9 mg/dog
Diphenhy-
2-4 mg /kg
dramine
1.0 – 2.0 mg/kg
Fluoxetine
oid
1-5 mg/kg oid or
Sertraline
2.5 mg/kg bid
Buspirone
0.5 – 2.0 oid – tid
2 – 5mg/kg as
Trazadone
needed up to 8 –
10mg bid - tid
Phenobar-
2.5 – 5mg/kg bid
bital
10 – 30 mg /kg
Gabapentin
bid -tid
10 – 35 mg/kg
Potassium
daily or in divided
bromide
doses
0.5 – 1 mg/kg oid
Selegiline
in the am
Memantine
0.3 – 1 mg/kg oid
1.25 – 4 mg/kg per
Amantadine
os oid -bid
Cat
0.125-.025mg/cat
oid - tid
0.2 -0.5mg/kg bid
– tid
0.2 – 0.5 mg/kg
oid - bid
0.02 – 0.2 mg/kg
oid - bid
0.025 – 0.05 mg/
kg oid - bid
1.5 – 6 mg/cat
1-4 mg/kg
0.5 – 1 mg/kg oid
long term decreased memory - highlighting the need
to test the full cognitive range when evaluating an
intervention.
Anxiolytics and Antidepressants
Alterations in neurotransmission can lead to irrita-
bility, decreased responsiveness to stimuli, fear, and
agitation. Antidepressants and anxiolytics may be
considered in some older pets. These include clomi-
pramin, amitriptyline, fluoxetine, and paroxetine ben-
zodiazepines and buspirone.
Cholinergic function in the brain is important for
memory and older dogs show a greater sensitivity to
cholinergic disruption which impairs working mem-
ory. Clomipramine, paroxetine and amitryptiline are
anticholinergic and should be used with care - drugs
selected should enhance and not reduce neuronal
cholinergic activity if possible.
0.5 – 1.5 mg/kg oid
0.5 – 1 mg bid
Not determined
2.5 mg/kg bid
5 – 10mg/kg oid
-tid
Not recommended
0.5 – 1 mg/kg oid
in am
Not determined
3mg/kg per os oid
Table 4: Drug Doses for Behaviour Therapy
Diet
Dietary strategies involve supplementation with anti
oxidants and mitochondrial co-factors to improve
anti oxidant defences as well as reduce production
of, toxic effects of, and increased clearance of oxy-
gen free radicals. Vitamins E and C, beta-carotene,
selenium, and other flavonoids and carotenoids from
fruits and vegetables have antioxidant and anti-in-
flammatory properties in the treatment of cognitive
dysfunction. B vitamins (thiamine, ri boflavin, niacin
B6 and B12) may also have antioxidant and neuropro-
tective effects as well as the ability to normalise neu-
rotransmitter levels. Enhancement of mitochondrial
function is achieved with the addition of L-carnitine
and DL-alpha-lipoic acid.
The efficacy of Hills B/D TM has been evaluated over
a trial period of 2 years using neurophsychological
testing well as in clinical trials and was found to im-
Issue 06 | DECEMBER 2017 | 37