October 25, 2017

AVMA 2017: Behavioral Problems in Senior Dogs

Improving quality of life for older dogs with behavioral problems entails first identifying the root cause of the problem and then taking a multimodal approach to treatment.
By Nicola M. Parry, BVSc, MRCVS, MSc, DACVP, ELS
Senior dogs represent a special class of behavioral patients for veterinarians, according to Marsha Reich, DVM, DACVB, from Maryland-Virginia Veterinary Behavior Consulting in Silver Spring, Maryland. Presenting at the American Veterinary Medical Association Convention in Indianapolis, Indiana, Dr. Reich discussed the proper approach to evaluating behavioral problems in older dogs.

She explained that behavioral problems in seniors can be sorted into 3 categories: true primary behavioral changes, behavioral problems that arise secondary to a medical issue, and problems related to cognitive decline.

True Primary Behavioral Problems
In senior dogs, primary behavioral problems are similar to those seen in younger animals and may include problems such as separation anxiety, aggression, and phobias. However, according to Dr. Reich, except for problems that existed at a younger age, true primary behavioral diagnoses occur less frequently than behavioral problems secondary to a medical condition. “A new behavioral problem in a senior dog is usually a result of a medical problem,” she said.

Behavioral Problems Secondary to a Medical Problem
Because a change in behavior is frequently the first indication of an underlying medical problem, Dr. Reich emphasized the importance of reviewing all medical records relating to the dog’s clinical history. And, because many medical conditions may have nonspecific or similar causes, Dr. Reich highlighted the need for clinicians to perform a thorough clinical examination, as well as baseline laboratory testing (complete blood count, biochemistry profile with electrolytes, thyroid profile, and urinalysis), to help identify underlying metabolic or endocrine abnormalities in senior dogs with behavioral problems. She advised that the findings of the clinical examination and baseline laboratory testing should then inform the clinician’s decisions regarding additional diagnostic testing.

Any medical problem can potentially contribute to a dog’s developing behavioral problems, said Dr. Reich. For example, discomfort or pain can lead to behavioral changes such as pacing, restlessness, night waking, and aggression. Dr. Reich noted that the most common sources of pain she encounters in senior dogs are of musculoskeletal and gastrointestinal (GI) origin.

Dogs with underlying musculoskeletal problems may show behaviors such as aggression when they are lying down and forced off furniture, excessive licking of their feet or joints, and aggression toward other dogs in the family that occurs outside. To help identify musculoskeletal problems, clinicians should question owners about whether their dog slides on smooth flooring, is slow to rise after lying down, or has become less active and maybe gradually gained weight as a result.

GI problems may cause food aggression. In particular, new cases of food aggression directed toward people should prompt questions from the clinician to obtain information to help rule in or rule out the possibility of underlying GI disease—for example, if a dog is refusing to eat but does not want the owner to remove the food bowl. Dogs with GI disease may also have nausea, which may cause anxiety that manifests as chewing of various objects. This can be difficult to differentiate from the destructive chewing associated with separation anxiety, said Dr. Reich. However, dogs with GI disease typically show other signs as well, such as excessive swallowing or picky eating.

Endocrinopathies can also affect a senior dog’s behavior. Hyperadrenocorticism may cause irritability, lethargy, and polyuria/ polydipsia and may even contribute to food aggression, said Dr. Reich. Hypothyroidism may be associated with behavioral changes ranging from lethargy to aggression. “Cushing’s disease is one of the most common endocrine disorders that I have seen associated with behavioral problems,” she said. “However, although hypothyroidism is a common endocrine disease in dogs, I rarely see it associated with behavioral problems.”

In all cases of behavioral problems, Dr. Reich stressed the importance of carefully questioning the owner to obtain as much specific information as possible about the dog’s behavior. Clients may be unaware that certain observations or information about their pet could be useful to the veterinarian and thus may not mention some things. Clients also frequently become accustomed to some behavioral changes in their pet and may not think to discuss the problems, she said.

Additionally, “what the owner calls a problem may affect its diagnostic path,” she cautioned. For example, an owner may describe a dog’s abnormal urination behavior as marking, whereas it may in fact be pollakiuria.

Dr. Reich also stressed the importance of performing urinalysis on any dog that is urinating in the house. She requests this of referring veterinarians before they refer a dog to see her. “I want to rule out urinary tract infection,” she said.

However, regarding any diagnostic testing in senior dogs with behavioral problems, Dr. Reich reminded clinicians that “failure to find an abnormality does not mean nothing is wrong—it just means nothing was found.”

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