A review of treatment options for behavioural manifestations of clinical anxiety as a comorbidity in dogs with idiopathic epilepsy

Watson, Fraje; Rusbridge, Clare; Packer, Rowena M. A.; Casey, RA; Heath, Sarah; Volk, Holger A.

doi:10.1016/j.tvjl.2018.06.001

Cited by 27 publications

(26 citation statements)

References 117 publications

(118 reference statements)

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“…In humans, several and an increasing number of studies have identified a bi-directional relationship between psychiatric disorders and recurrent seizure disorders [62][63][64][65][66]. This co-morbidity has also been reported in laboratory rats [67,68] and companion dogs [69,70]. Depression and anxiety disorders, followed by psychoses and attention deficit disorders, are the most common psychiatric disorders in human medicine.…”

Section: Abnormalities In Laboratory or Imaging Work-up Examplesmentioning

confidence: 93%

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats

Camps¹,

Amat

Manteca

2019

Animals

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Simple Summary: Behavioral problems and medical conditions have been treated separately for years. However, behavior depends directly on an animal's health condition, and vice versa. Some behavioral problems are caused totally or partially by a medical condition. Additionally, some of these problems represent a diagnostic challenge for veterinarians because, in many cases, apart from behavioral changes, there are no other clinical signs or evidence of illness. Improving our knowledge of the most common medical problems that can modify behavior may help veterinarians to improve their diagnostic protocols and treatments. Based on our experience, most relevant medical conditions are some neurological problems, endocrine or metabolic problems, and pain-related conditions. Thus, the aims of this review are to describe the state of the art of the relationship between these medical conditions (among others) and behavioral problems, and proposing new lines of investigation.Abstract: Not all animals behave identically when faced with the same situation. These individual differences in the expression of their behavior could be due to many factors, including medical conditions. These medical problems can change behavior directly or indirectly. The aims of this review are to describe the state of the art of the relationship among some medical and behavioral problems, and to propose new lines of investigation. The revision is focused on the relation between behavioral problems and pain, endocrine diseases, neurological problems, vomeronasal organ alterations, and cardiac disorders. These problems represent a diagnostic challenge from a practical point of view. The most common sign of pain in animals is a change in behavior. Although the relation of pain to behavioral problems has been widely studied, it is not absolutely clear. As an example, the relation between sleep disorders and pain is poorly known in veterinary medicine. New studies in humans and laboratory animals show that a reciprocal relationship does, in fact, exist. More specifically, the literature suggests that the temporal effect of sleep deprivation on pain may be stronger than that of pain on sleep. Some behavioral problems could modify the sleep-awake cycle (e.g., cognitive dysfunction). The impact of these behavioral problems on pain perception is completely unknown in dogs and cats. Thyroid hormones play an important role, regarding behavioral control. Both hypothyroidism and hyperthyroidism have been related to behavioral changes. Concerning hypothyroidism, this relationship remains controversial. Nonetheless, new neuro-imaging studies provide objective evidence that brain structure and function are altered in hypothyroid patients, both in laboratory animals and in humans. There are many neurological problems that could potentially change behavior. This paper reviews those neurological problems that could lead to behavioral changes without modifying neurological examination. The most common problems are tumors that affect central nervous system silent zon...

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Section: Abnormalities In Laboratory or Imaging Work-up Examplesmentioning

confidence: 93%

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats

Camps¹,

Amat

Manteca

2019

Animals

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“…In addition to seizure control, there is an emerging need for therapies for co-morbid anxiety in dogs with epilepsy. Increases in anxiety following the onset of epilepsy have been documented in dogs with epilepsy (2); however, in a recent review on psychopharmacological options for the treatment of anxiety in dogs with IE, it was concluded that there is a scarcity of evidence of the effects of standard anxiolytic therapies in the IE population, with many drugs having pharmacokinetic interactions with AEDs, or contraindicated in these patients (50). Furthermore, patient response to anxiolytic medications may differ between healthy brains and epileptic brains.…”

Section: Is There a Need For Behavioral Therapy In Canine Epilepsy Pamentioning

confidence: 99%

“…In a recent study, 1 in 10 owners of epileptic dogs that were using dietary supplements reported that their aim was to improve behavioral problems associated with epilepsy (16). The use of behavioral therapy has been advocated in this population (50); however, its efficacy has yet to be ascertained with controlled trials, or indeed reported in case reports or series as yet.…”

Section: Is There a Need For Behavioral Therapy In Canine Epilepsy Pamentioning

confidence: 99%

Behavioral Interventions as an Adjunctive Treatment for Canine Epilepsy: A Missing Part of the Epilepsy Management Toolkit?

2019

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Epilepsy is a common, complex and often challenging neurological disorder to treat in the dog, with 20–30% of dogs resistant to conventional medical therapies, and associated with cognitive and behavioral comorbidities and early death. Behavioral interventions are an emerging area of focus in the adjunctive treatment of drug-resistant human epilepsy patients, with studies indicating positive effects of a variety of interventions including relaxation-based techniques and behavioral therapy interventions. Behavioral interventions have the potential not only to improve seizure control, but also improve behavioral comorbidities and general quality of life in this hard to treat patient group. Despite striking similarities between human and canine epilepsy patients, including the recognition of co-morbid anxiety in epilepsy patients, behavioral interventions have yet to be studied in dogs. This is compounded by several licensed psychopharmaceutical agents for dogs being contra-indicated in epilepsy patients. We present evidence from human studies of the efficacy of behavioral interventions to improve seizure control, psychiatric comorbidities and quality of life, and propose that adapting such interventions for canine patients may be a valuable addition to the epilepsy management toolkit. There is a need for multi-center, double-blinded, placebo-controlled trials to confirm the effects of behavioral interventions on seizure frequency in veterinary medicine. In the absence of such evidence to date, the use of established behavioral medicine techniques to reduce stress and improve the mental health of these often sensitive and challenging patients is advocated, with a greater role for behaviorists in the management of epilepsy patients alongside neurologists and general practitioners.

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“…Moreover, the prevalence of major depression occurs more frequently in patients with epilepsy (28). Behavioral changes due to an epileptic cause (23,29) and its impact on quality of life are also in veterinary medicine a topic of increased interest (30). In the current study, an association between behavioral changes and epilepsy could be detected within group one.…”

Section: Discussionmentioning

confidence: 50%

Behavioral Changes Under Levetiracetam Treatment in Dogs

et al. 2020

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In veterinary medicine levetiracetam (LEV) is a well-tolerated antiepileptic drug (AED) with only mild to moderate side effects. Behavioral changes are rarely reported in animals. In contrast, in human medicine the impact of LEV on behavior has frequently been described. Since in the Clinic for Small Animals at the University of Veterinary Medicine Hannover single canine patients were observed with behavioral abnormalities after LEV treatment, it was hypothesized that levetiracetam induces behavioral changes or causes an intensifying of pre-existing behavioral abnormalities in dogs with epileptic seizures. This monocentric retrospective study evaluated the incidence of behavioral changes in epileptic dogs treated with the antiepileptic drug LEV based on information obtained in a questionnaire completed by dog owners. Eighty-four client-owned dogs with recurrent seizures receiving LEV as monotherapy, add on treatment or pulse therapy met inclusion criteria. Approximately half of the dogs in the study population were reported to have preexisting behavioral changes before treatment with LEV, and some of these dogs were reported to experience a worsening of behavioral changes (14/44) or the emergence of new behaviors after initiation of LEV therapy (4/44). One quarter of the dogs without pre-existing behavioral abnormalities developed behavioral changes associated with the administration of LEV (10/40). Based on these results, the authors conclude that behavioral changes can occur in dogs being administered LEV, and this should be taken into consideration when discussing treatment options with owners.

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A review of treatment options for behavioural manifestations of clinical anxiety as a comorbidity in dogs with idiopathic epilepsy

Cited by 27 publications

References 117 publications

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats

Behavioral Interventions as an Adjunctive Treatment for Canine Epilepsy: A Missing Part of the Epilepsy Management Toolkit?

Behavioral Changes Under Levetiracetam Treatment in Dogs

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