{"id":487,"date":"2017-05-01T09:47:48","date_gmt":"2017-05-01T16:47:48","guid":{"rendered":"http:\/\/cvm.wsu.edu\/advance\/?p=487"},"modified":"2025-01-23T09:46:01","modified_gmt":"2025-01-23T17:46:01","slug":"wsus-behavior-service-treating-the-whole-patient","status":"publish","type":"post","link":"https:\/\/cvm.wsu.edu\/advance\/2017\/05\/01\/wsus-behavior-service-treating-the-whole-patient\/","title":{"rendered":"WSU\u2019s Behavior Service: Treating the Whole Patient"},"content":{"rendered":"

Spring\/Summer 2017 Issue<\/a><\/p>\n

by Marcia Hill Gossard \u201999, \u201904 Ph.D.|\u00a0Photos by Henry Moore, Jr.<\/em><\/p>\n

Ann Patten was inside her home when she heard the ear-piercing sound of a cat howling. She thought one of her cats was in a fight, so she ran out onto the deck. She looked around, and there was Cleo, the newest member of their cat family, all by himself. \u201cIt was only Cleo chasing his own tail,\u201d says Patten.<\/p>\n

A slender, long-legged, gray tabby, Cleo had followed Ann and her husband Michael\u2019s cat, Maggie, home some months earlier. They tried to find his owner, but no one claimed him. \u201cHe looked like a sphynx, so we named him Cleopatra,\u201d says Patten. They later found out that Cleopatra was really Cleopatrick.<\/p>\n

Playful and affectionate, Cleo often seemed like any other young cat. He liked to put his paws around Ann\u2019s neck and nuzzle her hair. But if the doorbell rang, he would hide outside for days. Other times his ears would flatten, his eyes would get wide with dilated pupils, his breathing became labored, and he would start chasing his tail, pulling violently at the fur. Ann says they could distract him and he would stop, so they didn\u2019t think too much of it. He was also marking around the house spraying urine many times a day.<\/p>\n

When Cleo started having trouble urinating they took him to their local veterinarian. He received medical treatment to unblock his urinary tract and was put on a special diet to help prevent it from reoccurring. But six months later, Cleo was taken to the WSU Veterinary Teaching Hospital. This time, because it was New Year\u2019s Eve, he went to the emergency room. \u201cMany veterinary clinics were closed, so we were grateful for WSU\u2019s emergency service,\u201d says Patten. At WSU, he was diagnosed with feline idiopathic cystitis, or inflammation of the bladder with no underlying cause such as stones or crystals in the urine.<\/p>\n

Stress can contribute to a cat developing feline idiopathic cystitis. So, emergency care veterinarian, Dr. Angela Nguyen, started asking questions about Cleo\u2019s home life. \u201cIf there is more than one cat in the home we will ask if there are multiple litter boxes and multiple water bowls. We will also ask if there are toys and things for the cat to do,\u201d says Nguyen.<\/p>\n

At Cleo\u2019s home, there were not only multiple litter boxes, but ramps for the cats, places to hide, and plenty of toys to play with. \u201cThere was a lot of enrichment in the home,\u201d says Nguyen. \u201cEverything sounded perfect.\u201d<\/p>\n

But as Dr. Nguyen started asking more questions about Cleo\u2019s behavior at home, she began getting the sense that his behavior was not typical. \u201cWhen she told me about the screaming and self-mutilating while chasing his tail and marking 10 to 15 times per day, I knew it was beyond normal behavior,\u201d says Nguyen. \u201cBut it was very normal to them that he acted that way. As veterinarians, we need to ask for details because although it may be normal for them, it isn\u2019t normal behavior.\u201d Ann also realized just how different Cleo\u2019s behavior was when she saw how her other cats behaved when Cleo was in the hospital for five days. \u201cThey all seemed more relaxed,\u201d she says.<\/p>\n

Dr. Nguyen believed stress from a general anxiety disorder contributed to the inflammation in Cleo\u2019s bladder. Although she could help him in the short term by unblocking his urinary tract, once cats have urinary blockage, Dr. Nguyen says it usually happens again. Surgery is an option, but it comes with its own risks, and if stress is causing the inflammation then other parts of the urinary tract can become blocked even after surgery. So, Dr. Nguyen referred Cleo to WSU veterinary behaviorist, Dr. Leticia Fanucchi. \u201cAddressing the stress is the long-term solution and we recommend it for all cats who have urinary blockages,\u201d says Nguyen.<\/p>\n

Dr. Fanucchi came to WSU in 2010 for graduate school to study animal behavior. While earning her veterinary degree in her native Brazil, she had thought she would become a neurologist, but it was her Lhasa Apso named Betty Boop that helped her find her career path. \u201cShe had severe separation anxiety from day one,\u201d says Fanucchi. \u201cAnd I made the mistakes with her that everyone makes, so her behavior got worse, not better.\u201d By 2015 she had earned her doctorate, and the day after she graduated, she started the behavior program at the WSU veterinary hospital. Currently WSU has one of only eight animal behavior programs in the country.<\/p>\n

Dr. Fanucchi sees dog patients at the WSU veterinary hospital, but for cats, like Cleo, she makes house calls. \u201cWhen cats are outside their environment, they don\u2019t show their normal behaviors,\u201d she says. \u201cThey shut down and go into survival mode so they are more likely to want to hide or go into their kennel.\u201d<\/p>\n

After visiting Cleo in his home, Dr. Fanucchi prescribed him fluoxetine, a medication to help reduce his anxiety. Usually a month or more is needed to get the medication to effective levels, but in Cleo\u2019s case, his owners saw changes within days. \u201cThe spraying decreased by more than 50 percent after the first week on the medication,\u201d says Patten.<\/p>\n

\n

“It is not one thing that you do, it is a combination of many things\u2014chemical, nutritional, and behavioral therapy. If the brain is not balanced, no amount of training will solve the problem.\u201d<\/strong>
\n\u2014Dr. Leticia Fanucchi, WSU veterinary behaviorist.<\/p>\n

\n

Dr. Fanucchi also put Cleo on a protocol to desensitize him to the noises that were causing him anxiety such as the doorbell or other loud noises. \u201cWhen exposed to a stimulus that creates anxiety, I had them give Cleo a treat or play with him so he would have a positive association with the stimulus,\u201d says Fanucchi. She also used counter conditioning to help Cleo stop the undesired behavior of chasing his tail and replace it with a desired one. Whenever he would start to chase his tail, she had Ann and Michael distract him with a toy. \u201cPlay is more goal oriented, so he wouldn\u2019t think so much about his tail,\u201d Fanucchi says.<\/p>\n

\u201cA good environment combined with fluoxetine has really changed his life,\u201d says Patten. \u201cHe has more normal responses to loud noises and more control over himself. And he is happier now, too. It turned out to be the best option for him.\u201d<\/p>\n

\u201cIt is not one thing that you do, it is a combination of many things\u2014 chemical, nutritional, and behavioral therapy,\u201d says Fanucchi. \u201cIf the brain is not balanced, no amount of training will solve the problem.\u201d<\/p>\n

But by the time a patient comes to Dr. Fanucchi, their unwanted behaviors are often severe. \u201cWhen I see a patient, the animal usually has a combination of behaviors, and they are coming to me as a last resort,\u201d says Fanucchi. \u201cIt has usually been bad for a long time so the behavior has been reinforced.\u201d<\/p>\n

For dogs, the most common behaviors she sees are separation anxiety and aggression. Anxiety, she says, can show itself as aggression. Many dogs who are anxious have what is called fear aggression. They are afraid, so they act out aggressively towards people or other animals. But animals can also have obsessive compulsive behaviors where they lick a certain spot or even begin pulling out their own hair. Some animals develop these issues over time, but many are born with anxiety or fears, which can become reinforced unknowingly by owners until it becomes a serious problem.<\/p>\n

\u201cIt is a misconception that it is the owners fault,\u201d says Fanucchi. \u201cBut as owners, we can make it worse.\u201d For example, a dog who is nervous when looked in the eye, may try to look away to avoid eye contact, which is a signal to the owner that the dog is afraid. If the owner doesn\u2019t recognize it as fear and continues to try to get eye contact with the dog, the dog\u2019s anxiety could turn to aggression. \u201cThe dog is giving signals,\u201d says Fanucchi. \u201cBut as humans we may miss those signals, so when the animal becomes aggressive we are surprised.\u201d She believes it is important to try behavioral options as soon as possible, before the behavior gets severe.<\/p>\n

Although Fanucchi says treatment for behavior problems is a lifelong commitment, behaviors can change so radically that the pet can seem like a completely different animal, which was the case for Cleo. Not only is he calmer and happier, but he has not had a urinary blockage for more than a year.<\/span><\/p>\n

\u201cWhat truly helped Cleo was getting his generalized anxiety under control,\u201d says Nguyen. \u201cAlthough he may block again, behavior modification, in addition to medication, has really reduced the risk of his urinary tract reblocking. We feel very lucky to have someone like Dr. Fanucchi at WSU.\u201d<\/p>\n

For more information, visit WSU’s Behavior service<\/a>.<\/p>\n

\n

Pups Parading the Palouse<\/h2>\n

Every other week, 20 dogs in the community go for a stroll to learn good walking manners. Dr. Fanucchi and veterinary student Rachel Denney (\u201917 DVM) started the community program Pups Parading the Palouse<\/a> in 2014 to help dogs learn to walk on a leash without reacting to other dogs or people. \u201cAll breeds are welcome, and there are no behavior restrictions,\u201d says Fanucchi. But not all dogs on the walk need the training. \u201cWe have dogs that serve as behavior models to help teach other dogs appropriate ways of reacting,\u201d she says.<\/p>\n","protected":false},"excerpt":{"rendered":"

Ann Patten was inside her home when she heard the ear-piercing sound of a cat howling. She thought one of her cats was in a fight, so she ran out onto the deck. She looked around, and there was Cleo, the newest member of their cat family, all by himself. \u201cIt was only Cleo chasing his own tail,\u201d says Patten.<\/p>\n","protected":false},"author":1015,"featured_media":1543,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_wsuwp_accessibility_report":[]},"categories":[511],"tags":[619,614],"wsuwp_university_location":[332],"wsuwp_university_org":[425],"_links":{"self":[{"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/posts\/487"}],"collection":[{"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/users\/1015"}],"replies":[{"embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/comments?post=487"}],"version-history":[{"count":23,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/posts\/487\/revisions"}],"predecessor-version":[{"id":2587,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/posts\/487\/revisions\/2587"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/media\/1543"}],"wp:attachment":[{"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/media?parent=487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/categories?post=487"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/tags?post=487"},{"taxonomy":"wsuwp_university_location","embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/wsuwp_university_location?post=487"},{"taxonomy":"wsuwp_university_org","embeddable":true,"href":"https:\/\/cvm.wsu.edu\/advance\/wp-json\/wp\/v2\/wsuwp_university_org?post=487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}