Panic is No Fun for Anybody

Buddy was a really cute 2 year old dog when we met. Her problem was that she lost her composure and released a bladder full of urine with almost any hint of excitement. She didn’t show up alone, though, but with her Mom in tow. Buddy may be an unusual name for a girl dog but I am nobody to judge the monikers other people bestow on their non-human companions. I call my dog Miss America and that works just fine for both of us.

So there was Buddy, in the reception room, ready for some help. My job is to interpret and treat behavior disorders, so when meeting a new patient, I usually make only brief eye contact with the human half of the equation, directing my attention instead to assessing the emotional state of the pet. Avoiding an individual dog’s or cat’s fear triggers really matters. We certainly don’t want the heebie jeebies of being in the doctor’s office to devolve into panic. The subtle clues are more telling anyway.

Current behavioral research provides useful interpretations of canine body signaling. As I observed Buddy’s postures it became clear that she struggled with the risk of wetting her pants. She was scanning the room, on the lookout for any possible threat to her well-being. She held herself somewhat low, her weight shifted back. Her tail, hanging at about 30 degrees below the horizontal, didn’t move. Her ears were retracted. She was still under control, but not by a lot. No way was this girl leaving her mother’s side. Sweaty paws, to be sure. I would not have been surprised if she had arrived wearing Depends.

I could have strode up to my client (that’s the human on the other end of the leash) and vigorously shaken hands as I exchanged hearty greetings but that approach could well have provoked a fear response from Buddy. Her in-the-moment wellbeing was too important for that.

As a veterinary doctor my first responsibility is to do no harm. Scared dogs, who are leashed and indoors, have a clear understanding of their escape options. They don’t have any. If Buddy had her druthers she would have been out of there in a flash. But she was tethered to her person, stuck where she was.

Pets I encounter, who are in a state of serious anxiety, can quickly panic. Never mind that it’s a rare human who means to scare them. A much taller creature (me) approaching may cause an already wary dog to feel outgunned. Some can become immediately defensive/aggressive while others may regress into a shrinking puddle in about 0.5 seconds. We know that figure because modern brain imaging methods have measured the transit time between the fear center upstairs and the brain stem. The thinking part of the brain becomes immediately overwhelmed, making it impossible for a panicked pet respond appropriately.

This initial assessment is important with every pet seen in a veterinary clinic but even more so in behavior cases. Buddy came to me because she had the messy habit of urinating when greeting her dad as he arrived home from work each day. It wasn’t the mess that bothered her people; it was their girl’s distress. Nobody wants that.

Veterinary behaviorists are the go-to specialists for pets with serious behavior disorders but all veterinarians and their staffs can learn to provide gentle care for pets. Fear Free® training and certification is spreading quickly in our profession. You’ll want this level of expertise if your pets get wiggy at the doctor’s office. Look for the Fear Free® logo.

Buddy came by her anxiety quite honestly. Her current owners, undoubtedly her forever home, had adopted her a year and half earlier from a shelter but they were her third family. Buddy had been surrendered, the first time, to a humane facility when she was still a puppy. Just 2 weeks later the lady who adopted her threw up her hands and put her on Craig’s List. Buddy was snagged by her next owners who, for unknown reasons, relinquished her to the same shelter where she started. This is when she finally got her shot at a good life but despite being showered with love she had a hard time with trust. For Buddy, surprises could be around any corner.

From across the lobby I quietly invited my client into the exam room. By walking away from Buddy I wanted her to believe she had a choice. I sat down first and invited Buddy’s mom to relax in a chair on the other side of the table. After I convinced her to drop the leash, and with me already smaller (I was sitting), we both watched Buddy quickly relax as she engaged in the natural canine behavior of sniffing and investigating her new surroundings. These were good signs. The treats that I initially dropped on the floor and later handed to this curious dog (while I otherwise ignored her) further reduced her tension. We were doing OK. No urine had been spilled.

The history was that Buddy might squat and dribble anytime she got excited. When someone paid direct attention to her she lost her composure. She would leak urine when her dad opened the front door as he arrived home. This occurred if he entered the house slowly and before he spoke. Buddy routinely crouched and voided her bladder even when he ignored her and interacted only at his wife. It didn’t take much.

There were other triggers. Buddy’s people talking “sweetly” to her or to each other resulted in urine dribbling. Attaching the leash to Buddy’s collar caused her to squat and urinate. In the morning prior to breakfast she would hunt around the house for her mom. When she found her she would get excited, squat, and urinate. She usually released large quantities at these times. This poor dog was a urine faucet.

There were other triggers for Buddy’s anxiety. She startled with quick movements. She actually watched TV but would flinch when seeing sudden events. She paced nervously and whined during car rides. She was always hypervigilant.

With this wealth of information the behavioral diagnosis was pretty straight-forward. Buddy had generalized anxiety disorder, meaning that there was a growing list of situations that triggered her apprehension and worry. She also suffered from excitement/submissive urination. With the right kind of help, the outlook for significant improvement was good.

I explained that Buddy needed to abandon her old dysfunctional habit of freaking out when the anticipated “scary monsters” actually seemed to materialize. Going forward, whenever possible, there were to be no more fear triggers. A good starting point was for Buddy’s mom to kill the TV when Buddy was in the room.

Buddy really loved her dad but, like most men he is bigger than the female canine leader in the home. I advised dad to call or text on his way home from work so that Buddy could be put in another room prior to his grand entrance. After he was seated and enjoying a glass of scotch Buddy would be quietly released so she could approach him on her own terms. There would be no way for her to feel overwhelmed and trapped if she chose to close the distance, especially when the big man in her life was smaller (sitting). The fact that he was a truly gentle soul was never at issue; our challenge was Buddy’s perceptions.

Buddy’s mom needed to make a few adjustments too. Neither she, nor any human, was ever to approach, reach for, lean over, or stare at this dog. Anytime she, her husband, or anybody wanted to enjoy Buddy they simply needed to squat or sit, turn to the side, and while not looking directly at her, they could quietly invite her to share some love. These human postures work because they mimic neutral, canine-specific body signals that dogs innately understand. No longer feeling overwhelmed Buddy caught on quickly.

Ideally, every human interaction would be consistently non-threatening for Buddy but life isn’t perfect. People will sometimes forget the structure or get busy and inadvertently trigger the lurking fear in Buddy’s long term memory. Her knee-jerk tendency to panic would awaken and she’d wig-out and quickly drain her bladder with sudden events. Buddy needed a little more help to improve her chances of success. Serious behavior disorders result from recognized chemical imbalances. Reliable research supports modern medicine.

Imipramine is a safe antianxiety medication with a side effect that is custom-made for frequent urine dribblers. When dosed correctly imipramine reduces a dog’s heebie jeebies as it triggers moderate urine retention in the bladder. Rather than gushing urine at the drop of a hat Buddy was able to stay calmer and drier. Everybody’s well-being has improved since this well-loved dog found peace.

It is really quite rare when medication alone solves a behavior problem. For those dogs and cats whose brain disorders are not amenable to behavior modification and management changes alone we can adjust the neurotransmitters so the neural circuits work as they were intended to. Our brains are our most important organ; they make us who we are. Veterinary behaviorists help them feel better.

I hope this story about Buddy and her recovery has been helpful. If you know someone, a friend, or a family member, whose dog is scared and needs extra help you are welcome to share this narrative. You can find much more on the behavioral and physical well-being of pets on my website, drjeffnichol.com. My videos and blogs also show up on facebook.com/drjeffnichol.

Thanks for listening. I’m Dr. Jeff Nichol.