Noise and Storm Phobias
It's that time of the year again for Noise (fireworks) and Thunderstorm phobias. Here's a nice article reprinted from VIN.
Storm phobias and noise phobias are frustrating for clients and vets alike. While many phobias cannot be completely eliminated, the severity of the disorder can be reduced in many cases.
Clinical Use Information |
Boom Crash Opera - dealing with Storm Phobias
Where do I start?
Is storm phobia the same as noise phobia?
What's the link between storm phobias and separation anxiety?
What factors might predispose dogs to storm or noise phobias?
What is the treatment strategy?
What can the owners expect?
Where do I start?
The first step, as with the other behavioral disorders, is correct diagnosis. Storm phobias can manifest in many different aberrant behaviors, ranging from inappropriate soiling, barking, explosive destructive behaviors, hiding, etc.
Phobias are markedly exaggerated irrational responses to a noxious stimulus, whether or not that stimulus has actually caused harm to the individual. They develop from fears, which might have a potential survival benefit (e.g. it is good to fear snakes, but not good to be phobic about them). Often, the stimulus that triggers a phobic response is innocuous, e.g. with storm phobias, the stimulus can be a change in barometric pressure, or gusts of leaves being blown around as the storm approaches or small rain showers.
Is storm phobia the same as noise phobia?
Technically, no. Dogs that have storm phobias may not have noise phobias, and vice versa. However, many dogs with storm phobias are also fearful of loud noises, such as fire-works, guns etc - about 90% of dogs with storm phobias have noise phobias, but only 75% of dogs with noise phobias have storm phobias (Overall 2001).
What's the link between storm phobias and separation anxiety?
Many dogs that have separation anxiety also have other behavioral problems (some estimate that up to 90% of dogs with separation anxiety have co-morbid disorders). The most common of these is storm phobia (Overall, 2003).
What factors might predispose dogs to storm or noise phobias?
One study examined this question by internet survey and found that almost 50% of the respondents had dogs classified as herding breeds, or herding-breed mixes. Interestingly, some of these breeds also display other fear behaviors. Almost 50% in that study were adopted from shelters. And most dogs developed the problem at a relatively young age (virtually no dogs developed the problem as geriatrics) (Cornwall McCobb et al 2001). A study examining behavioral problems in hunting dogs also identified specific breeds more likely to exhibit shooting phobias, and a reduced likelihood of shooting phobias in dogs that had completed obedience training (Rugbjerg et al 2003).
What is the treatment strategy?
1. Desensitization alone is unlikely to be successful. Desensitization is exposure to a noxious stimulus at an intensity insufficient to produce the phobic response, with gradual increase in intensity. Many dogs may display clinical signs at the sound of thunder - in these cases, a CD recording of thunder noises, played initially at a low level and gradually increased over time, may help. However, many dogs have multiple trigger stimuli, such as wind, barometric pressure changes, and rain - in these cases, desensitizing against many of these stimuli is not possible. In other cases, the trigger stimulus is not identifiable, so a desensitization strategy cannot be employed. A noise phobia CD might be made by using a video or tape recording device to record sounds of actual stimuli. Commercial recordings are also available ranging from the types of thunder and storm CD's available from stores that sell DVD's and CD's to products that have been specifically designed for desensitization purposes. Examples are listed below.
2. Counter-conditioning is the eliciting of a response that is physiologically and behaviorally incompatible with the phobia. For example, playing with or feeding the dog treats while the dog is subjected to the low minimal levels of the noxious stimulus (noise, thunder etc) should achieve a positive association (pairing) between sound and treats. Once accomplished the training should move to gradually greater intensity (desensitization). It is important not to give the treat or reward until the fearful behavior ceases - remember, comforting the frightened dog is a reward! Similarly, dogs should not be punished for this behavior. The increasing intensity of the stimulus should be managed so that at no point does it induce fearful behavior - the goal is to insure a positive association with the stimulus at all times.
Behavior modification takes time, effort and repetition. Training the pet to settle and relax in its own bed or comfort area should be a focus of reward based training, prior to desensitization exercises to insure that the pet can first be calmed and settled in the absence of potentially fear evoking stimuli. A head halter is a helpful training tool to insure more immediate success. Owners are encouraged to perform these activities several times every day. It is also recommended that the pet learn that reinforcers of any type (affection, attention, treats) will not be given unless the pet is settled and relaxed (either at the owner's feet or on its bed or mat. If the pet is to learn that attention seeking behavior will not be successful and that calm behavior is expected during exposure to the stimuli, this must first become the norm in day to day interactions.
Its best to begin training during times of the year, when exposure to the fear evoking stimuli can be avoided, so that the pet can be improved prior to the next thunderstorm season. Additional strategies include insulating the environment and using background noises such as fans or recordings, so that the noise (if that is the major trigger) is reduced; placing the dog in a strange facility, such as a boarding kennel or veterinary hospital to distract it from the phobia (since often the phobic behavior has specific stereotypies, such as seeking a particular room/place etc). Dogs that are head halter trained might relax more quickly if the head halter is applied at the onset of any anxiety and the pet is trained go to its settle area (bed or mat) where the fan can be turned on or the recordings played.
Both types of behavioral modifications are intensive - owners are encouraged to perform these activities several times every day. The increasing intensity of the stimulus should be managed so that at no point does it induce fearful behavior - the goal is to avoid fearful behavior at all costs.
Additional strategies include insulating the environment, so that the noise (if that is the major trigger) is reduced; placing the dog in a strange facility, such as a boarding kennel or veterinary hospital to distract it from the phobia (since often the phobic behavior has specific stereotypies, such as seeking a particular room/place etc).
3. Anxiolytic agents and behavior modifying agents are often necessary to combat noise or storm phobias, especially where specific triggers cannot be identified. Alprazolam is a short-acting anti-panic anxiolytic, commonly employed in treating storm phobias. It is administered prior to the storm developing (1-4 hrs before the storm approaches). Long-term anxiolytics, such as SSRIs and TCA help reduce low-level anxiety that many storm-phobic dogs exhibit (because minor stimuli, such as wind, rain, barometric pressure are often detected at a sub-threshold level by the dog). Additionally, these drugs help in situations that cannot be pre-empted by the owners.
Drugs used in treating phobias include:
Fluoxetine (Prozac)
Clomipramine (Clomicalm)
Amitriptyline (Elavil)
Alprazolam (Xanax)
Diazepam (Valium)
Drugs not proven to have any specific effect in phobia treatment:
Dog-appeasing pheromone (DAP) - VPL have developed a pheromone spray that helps with separation anxiety and noise phobias. It has no known side effects, and can be used safely alone or in conjunction with the other medications
Melatonin and other natural and homeopathic therapies have been used anecdotally to treat anxiety disorders. Most, can be used concurrently with antidepressants, except if their mode of action is to further enhance serotonin transmission (e.g. tryptophan and St John's wort should be avoided). However, no trials demonstrating efficacy exist.
What can the owners expect?
Phobias are difficult to treat because they require concerted efforts at desensitization and counter-conditioning. One survey suggested that only 20% (5/26) of respondents who attempted treatment felt that their pets' condition improved (Cornwall McCobb et al 2001). However, a second study suggested that 30/32 participants showed improvement (only 2 showed "cure") using a combination of behavior modification and pharmacotherapy (Crowell-Davis et al 2003). Often, improvement rather than cure should be anticipated - owners should not be led to believe that their pet will be cured of the disorder, but will better manage the condition.
