Alternatives to psychotropic drugs: operant and respondent means (Proceedings)
One aspect of veterinary behavioral therapy is the use of psychotropic drugs to control behavior. To set the context for my comments, I am not a veterinarian. I do not claim any direct working knowledge of these drugs – but I routinely work with animals who do. Specifically, this presentation is not about abandoning or curtailing the use of chemical therapy for treating behavior problems. Diagnosis and treatment with psychotropic drugs is often the key to a dog's sustained mental health. The goal of this presentation is to offer a different perspective and potential solutions that dovetail standard medical diagnosis and treatment.
About six years ago I received a promo package for a drug billed as a "doggie anti-Alzheimer's drug. The packet came complete with a foam rubber model of a human brain with the name of the drug silk screened on the side. Inside were pages and pages of data and testimonials of professionals claiming the efficacy of the drug. The drug is currently manufactured, marketed and prescribed for the condition of Canine Cognitive Disorder AKA Canine Cognitive Dysfunction. (Also abbreviated CDS for Cognitive Dysfunction Syndrome.) I present this information as a critique of some of the difficulties that exist in implementing a healthy balance between drug and training solutions to behavior problems. These were the questions and thoughts that first occurred to me while examining the company's best shot at selling their product.
First, the pharmaceutical company plainly states in their literature that the drug should be used in conjunction with a "behavioral program." What they mean by a behavioral program is unknown. No actual program is described or cited in the literature. There is no indication that any training or behavior program was used to justify this recommendation. A logical assumption is that the drug wasn't fully effective by itself and that someone guessed that a training program might make it work. (The same is true of the drug most commonly used for behavioral problems by veterinarians. i.e. The manufacturer's website, as of February, 2007, states plainly that a behavioral program is needed to achieve effectiveness but no program is described or cited.)The claims of efficacy in the literature were not based on a traditional double-blind trial. Instead, the claims of effectiveness were based on owner responses only. Once the numbers were crunched, there was a mere 15% perception of improvement in the dog's condition based on owner response. This perceived improvement is not particularly significant and was not balanced by any reported attempts to control the dog's behavior without the drug.
Alzheimer's Disease, in humans, is accompanied by observable degeneration of brain tissue in particular areas. A CT scan will yield tangible evidence that leads to correct diagnosis. If a similar decay of brain tissue is connected to CCD then prescribing the drug should be based on objective findings, not the owner's impressions. Efficacy of the drug must them be evaluated by several criteria, including whether it arrests physical damage or and/or promotes healing.
Drugs cost money. Many owners have their finances tapped by neurological exams and medication. If behavioral treatment is added as an expense, many pet owners become unable to cover the long term cost of drugs and the short term cost of training. If the behavioral treatment is integral to the drug's effectiveness it should be arranged by the veterinarian prescribing the medication. This allows for the veterinarian to monitor and control the procedure and track the treatment.
Symptoms of the disorder/dysfunction/syndrome include staring into space and housetraining issues. These are behaviors (or lack of them) that are easily tested using simply operant and respondent conditioning protocols. For instance, as the dog stands blankly looking into space, say "Where's the kitty?" or some other phrase that has previously excited a response. No such protocols were reported by the drug company. Additionally, the many websites that are now devoted to this burgeoning condition/syndrome/dysfunction don't list operant tests that might indicate other than chemical treatment. Instead of specific recommendations, general suggestions abound, like "do more training" and "increase exercise levels."
General psychotropic drug treatment
Several drugs are currently being used to control unacceptable behavior. Some of these drugs influence maladies that are the result of neurological dysfunction. However, some dogs are given psychotropic drugs without a clear indication that a brain malfunction is the cause of the problem or that the specific chemicals contained in the drug have a connection to that brain function. For instance, giving a dog Prozac or Valium as a first solution to excessive barking at the door is a questionable practice. Barking uncontrollably at the doorbell is a normally occurring behavior in the vast majority of indoor dogs. It is also easily controlled through operant and respondent conditioning protocols. (see later in this paper) To illustrate the problem of making pharmaceutical solutions a first line of treatment, I offer the following.