animal psychiatry

A review of Nicholas Dodman’s Pets on the Couch

Can you guess the number one killer of pets in the US? It isn’t cancer; it isn’t kidney disease; it isn’t car accidents. It is “bad behavior.” This is one of the most striking, and most important, statements in veterinarian Nicolas Dodman’s new book, Pets on the Couch: Neurotic Dogs, Compulsive Cats, Anxious Birds, and the New Science of Animal Psychiatry. And it suggests why every vet and every pet owner should read this book. The emotional troubles of our companion animals are widely misunderstood and ignored. This leads not only to suffering on the part of the animals, but often also to anguished pet owners who cannot understand why their animals act the way they do and to veterinarians who don’t know how to help.

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Source: Atria Press

Pets on the Couch takes the reader on a tour through the new science of animal psychiatry. As Dodman explains, animals and people share the same neurological wiring. We experience the same basic range of emotions. And we also share many of the same mental illnesses—some of these caused by organic changes in the brain, some by traumatic experiences, some by genetic bad luck. Dodman asks us to understand animal psychiatry as intimately connected to human psychiatry, an approach called One Medicine.

To take us inside the world of psychiatry, Dodman tells stories about some of the most challenging patients he has treated over the years. One of the first patients he describes is a horse named Poker who cribbed obsessively and constantly. Cribbing is one of the more common “stable vices” displayed by captive horses and involves obsessive biting at a stall door or fence and sucking in air. Rather than try to thwart Poker’s cribbing through punishment or through some aversive “treatment” such as surgical alteration of the throat muscles or straps that prevent a horse from stretching his neck, Dodman wanted to get at the root of Poker’s trouble. Cribbing, says Dodman, is not misbehavior, but rather a product of confinement. Specifically, cribbing is a frustrated response to living in a stall and being unable to graze. In the wild, horses spend 60-70% of their time grazing; when kept in a stall, they can’t graze at all and might spend 20 minutes of their day eating hay or grain. In some horses, the inability to engage in highly motivated feeding behaviors develops into a serious pathology, a form of obsessive compulsive behavior. Cribbing stimulates the release of endorphins and is a form of self-medication for the hoses. The endorphin release feels good, and so reinforces the cribbing behavior. And it becomes a cycle. To break the cycle, Dodman tried treating Poker with Naloxone, a morphine antagonist and the same drug used to treat humans who have overdosed on opioids.

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In subsequent chapters, Dodman explores PTSD in dogs who have served in combat zones, emotional wounds in rescued animals with a traumatic past, compulsive behaviors in dogs (e.g., lick granuloma and tail chasing, as misdirected and frustrated predatory urges), animals with severe anxiety, phobias, and various types of aggressive behaviors.  Somewhat more surprising are his discussions of autism, Tourette’s syndrome, dementia and Alzheimer’s, ADHD, and depression—all of which tend to be associated only with humans.

Throughout each chapter, Dodman moves seamlessly back and forth between human and veterinary medicine. Often, he experienced an “aha” moment from seeing how a given drug worked in a human mental disorder and trying the same approach in animals (almost always effective), or taking a veterinary treatment and suggesting it as a novel approach to human mental illness.

As we quickly discover, animal psychiatry isn’t really a new science at all. Indeed, scientists have been studying mental illness and psychiatry in animals for decades, in the service of understanding the human brain and pharmacological treatments for human mental illness. Animal models have been used to develop drugs for depression and anxiety, on the assumption that nonhuman animals experience these mood states and are thus appropriate models for developing treatments. It should be no surprise, then, that these same drugs might then be used to treat animals when these animals are patients, rather than laboratory objects. The real question is not whether animals experience many of the same mental disorders, but why more hasn’t been done to help them. Why haven’t the various pharmaceutical treatments for mental illness been made more available for pets?

Dodman is clearly frustrated by what he sees as ideological foot-dragging within the veterinary profession. Veterinary medicine has been very slow to incorporate the treatment of behavioral problems in pets, in large part because of a reluctance to speak openly and scientifically about animal emotions, for fear of being seen as overly soft of mind or driven by sentiment rather than reason. But this reluctance—a kind of “emotion denial” similar to what we are seeing with climate change—is unscientific in the extreme. Even worse, it is harmful to animals and to the people who love them.  As Dodman writes, “animals are dying by the thousands because of obstinate, outmoded notions about their emotions and behavior.”

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Dodman’s book is critically important because we are in the midst of an epidemic of mental suffering in our companion animals. Dogs and cats and other creatures are stressed and bored and frustrated because they are asked to live in environments that don’t provide what they need, behaviorally. Human environments can be profoundly under-stimulating and, at the other extreme, can create  sensory overload from too much of the wrong kind of stimuli.

Here Dodman’s message is exceedingly important for all people who live with companion animals: are we giving them what they really need? Dogs and cats can become listless and depressed when left alone for long periods, either for an extended vacation, or as a daily owner going to work. “Some house cats can become depressed when they lack exercise and the opportunity to engage in psychologically gratifying, species-typical behavior. Cardinal signs of this type of depression are that the cat sleeps for hours a day, eats a lot, and is overweight.” (p. 238) It is not normal, he says, for a cat to sleep away most of the day. “Dogs—and other animals—sequestered at home during long family absences can become frankly depressed. And in such cases we can objectively prove the anguish that such animals feel, since research studies have turned up increased stress hormones in their blood. Eighty percent of dogs left home alone have increased cortisol levels, and cortisol is one of the stress markers in dogs and people.” So, he says, “the next time your sitter or kennel owner tells you that your dog merely sleeps while you are away, think again. He may be depressed.” (p. 240)

Again and again, severe behavioral issues in pets are successfully treated with drugs. But despite his emphasis on Prozac and other pharmaceutical interventions, Dodman’s key message is that treating our animals with drugs may make them feel better but it doesn’t address the underlying problems that are triggering the mental suffering in the first place. A horse who cribs may respond to Naxolone, but treatment must go much further than this: more space, a chance to graze, more exercise. The majority of behavior issues can be and should be “treated first and foremost with common sense, employing strategies that do not involve pharmacology at all, but changes in an animal’s environment and lifestyle, his interactions with you and other beings in his life.” (p. 253)

You can read another review of Dodman’s book here, on Psychology Today writer Marc Bekoff’s page.

Originally published on Psychology Today and republished here with the kind permission of the author, Jessica Pierce, Ph.D.

 

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Bioethicist and writer Jessica Pierce, Ph.D., is the author of Run, Spot, Run: The Ethics of Keeping Pets (Chicago, 2016) and The Last Walk: Reflections on Our Pets at the Ends of Their Lives (Chicago, 2012). Additional authored and co-authored books include Unleashing Your Dog: A Field Guide to Giving Your Canine Companion the Best Life Possible (New World Library, release date of Feb. 6, 2019, with Marc Bekoff), The Animal's Agenda: Compassion and Coexistence in the Age of Humans (Beacon Press, 2017, with Marc Bekoff), Wild Justice: The Moral Lives of Animals; Contemporary Bioethics: A Reader with Cases; The Ethics of Environmentally Responsible Health Care; and Morality Play: Case Studies in Ethics. Some of the questions she explores in her writings on death and dying in animals are: Do animals have death awareness? Why is euthanasia almost always considered the compassionate end point for our animals, but not for our human companions? Is there ever a good reason to euthanize a healthy dog? Why do people often grieve more deeply for their pets than they do for people?