Psychogenic stress in hospitalized veterinary patients: Causation, implications, and therapies

Abstract

Objective: To review the sources, adverse effects, diagnosis, treatment, and prevention of psychogenic stress in hospitalized human and veterinary patients. Data Sources: Data were collected by searching PubMed for veterinary and human literature from the past 10 years. Human Data Synthesis: Psychogenic stress has been linked to immune suppression; gastrointestinal, cardiovascular, and cutaneous diseases; delayed wound healing; alterations in pain perception; and neurologic impairment. Sources of psychogenic stress include environmental alterations such as excessive noise and light, social and physical factors, sleep disruption, drugs, and underlying disease. Nonpharmacologic options for stress reduction include environmental and treatment modifications, music therapy, and early mobilization. Pharmacologic options include sedation with benzodiazepines and dexmedetomidine. Trazodone and melatonin have been examined for use in sleep promotion but are not currently recommended as standard treatments in ICU. Veterinary Data Synthesis: Activation of the stress response in veterinary patients is largely the same as in people, as are the affected body systems. Possible sources of stress can include social, physical, and environmental factors. No gold standard currently exists for the identification and quantification of stress. A combination of physical examination findings and the results of serum biochemistry, CBC, and biomarker testing can be used to support the diagnosis. Stress scales can be implemented to identify stressed patients and assess severity. Nonpharmacologic treatment options include low-stress handling, pheromones, environmental modifications, and sleep promotion. Pharmacologic options include trazodone, benzodiazepines, dexmedetomidine, and melatonin. Conclusion:The prevalence and clinical significance of psychogenic stress in hospitalized veterinary patients is unknown. Future studies are needed to specifically examine the causative factors of psychogenic stress and the effects of various therapies on stress reduction. The recognition and reduction of psychogenic stress in veterinary patients can lead to improvements in patient care and welfare.

Musical Dogs: A Review of the Influence of Auditory Enrichment on Canine Health and Behavior

“…However, Bowman et al (2015) reported that heart rate variability measurements were not consistent throughout the trial, suggesting that dogs may have individual preferences for certain songs [12]. It is important to recognize that humans also have auditory physiological and anatomical differences from other species, and so music that is generally calming to humans may not have the same influence on nonhuman animals [4,[27][28][29]. Moreover, some individuals may prefer silence to music.…”

Evaluation of post-operative pain and stress in dogs after elective ovariohysterectomy under hospitalization

“…Minimizing pain and stress is a common goal of veterinary surgeons (Michelsen et al, 2012). Hospitalization of these animals, often necessary for their full recovery, is another stress-triggering factor due to confinement, loss of familiarity with the environment, social isolation, lack of predictability of events and absence of an animal's familiar caregiver (Hekman et al, 2012;Lefman & Prittie, 2019;Väisänen et al, 2005).…”

“…Cortisol (μg/dL) is the main indicator of stress (Broom, 1991;Hekman et al, 2012;Möstl & Palme, 2002;Zanella et al, 2009), and another important indicator of metabolic stress is serum glucose (mg/dL), which tends to be increased after surgical trauma (Freeman et al, 2010). Physiological parameters such as body temperature, blood pressure and heart and respiratory rates are also reported as indicators of stress and pain in dogs (Freeman et al, 2010;Hekman et al, 2014;Hellyer & Gaynor, 1998;Hellyer et al, 2007;Lefman & Prittie, 2019;Srithunyarat et al, 2016;Väisänen et al, 2005;Zanella et al, 2009).…”

“…Furthermore, behavioral signs can be used to assess the presence or absence of stress in animals (Väisänen et al, 2005). Vocalization, change in feeding habits, facial expression, interactive behavior and atypical body postures can reveal signs of pain, discomfort, disease or suffering (Beerda et al, 1997;Hellyer & Gaynor, 1998;Lefman & Prittie, 2019).…”

“…Pain is related directly to emotional issues, such as fear and anxiety. However, these concepts are subjective (Lefman & Prittie, 2019), and to distinguish an animal's pain from a stress response becomes challenging (Matičić et al, 2010).…”