by Richard Palmquist, DVM
Chief of Medicine
Centinela Animal Hospital
Veterinary medicine is adopting psychiatric drugs at an alarming rate. The field of behavioral medicine is being medicalized in a manner paralleling the human psychiatric profession. This is not a surprise as most veterinary behavioral graduate programs use psychiatric literature to educate their graduates. The result is an increasing dependency upon psychotherapeutic modalities and diagnostic matrices by veterinarians. What is currently a major problem for people in the mental health field is now spreading to the veterinary field as veterinarians look to human psychiatry as a solution for behavioral problems in animals.
Veterinary behaviorists are developing diagnostic criteria, which promote the use of psycho-active drugs as agents to solve behavior problems. The assumption that a behavior has a medical or biological basis can create a vicious trap for practitioner and patient alike. Many of these behavioral problems are real, but the use of agents not properly researched or approved for these uses is troubling. Since we know that many psychotropic drugs cause brain injury after relatively short periods of use, veterinarians need to be better informed before adopting such treatments. The current trend of human medical practitioners that are adopting non drug treatments for their patients is encouraging and proper documentation of successful methods will assist humans and pets alike.
As an integrative veterinarian of twenty years experience, I do not use psychotropic drugs as therapy. While it is true that some cases have elusive causes, it is generally worthwhile to pursue these causes and then administer effective treatment to resolve the condition. Veterinarians face similar challenges to the human mental health field and there is much that we can learn from one another. For instance, pets that suddenly display abnormal behaviors should have a complete medical evaluation including physical examination, blood pressure, urinalysis, complete blood count, serum chemistries and thyroid testing. Finding and treating the correct medical cause can solve many behavioral problems. In this regard, veterinary behaviorists are doing an excellent job.
Difficulty arises when no specific cause for the abnormal behavior can be located. There is a tendency to attach an agreed-upon label and then prescribe a drug to solve the problem. This happens for many reasons. There is a genuine desire to help these pets and their owners and drugs promise a quick fix. Veterinarians are trained to prescribe a pill for a problem and once a behavior has a medical name established then it becomes nearly habitual to prescribe whatever medication is currently trendy. One example of this is the condition known as “separation anxiety.”
Dogs that become overly upset and demonstrate annoying behaviors such as destruction of property or excessive vocalization when left alone are labeled as suffering from separation anxiety. We state that dogs suffer from separation anxiety, when usually the biggest suffering is on the part of the owner. If we consider that dogs are social animals and that instinct dictates that being left alone is akin to being left as a meal for a wandering predator, then we see that this disorder is actually based upon very survival oriented behavior. What these dogs need is correct training so that they come to understand that they are safe. Studies show that training helps the majority of these pets and that use of a psychiatric drug causes diarrhea and only shortens the problem by a short time over training. We have no studies on the long-term use of these medications, but veterinarians are prescribing them in large amounts, and they are very profitable to sell. Are we damaging brain elements? Do individual dogs treated have increased risks for allergies or cancer? We simply don’t know.
Scientific method originated largely in an effort to document fact in the physical universe and to establish a procedure to find and communicate phenomena, which when properly evaluated and understood could lead to better understanding and control of our environment. To this end, the medical arts adopted the scientific method and the result has been improved medical technology and patient survival.
Modern psychiatric therapy has been progressively medicalized. Scientific method is sadly missing. Often conditions are named merely to describe a set of findings with no real pathology documented. Once a name exists, it becomes easier to attach a therapy to the name. If the name is based upon a correct assessment and accurate understanding of the condition, then that therapy can be found to be truly useful. Sadly, in biologic based mental health there are so few truly effective therapies that we can become desperate to find a treatment before we really understand the condition.
Prescribing psychiatric drugs for mental disorders becomes a stimulus-response activity and the result is devastating. Practitioners who routinely use nutritional means, allergy testing and other modalities see many patients suddenly recover from illnesses that have only descriptive diagnoses before. A delusional patient recovers when his thyroid is properly diagnosed and treated. His actual working diagnosis is hypothyroidism, and while delusional psychotic may be descriptively accurate, the psychopharmaceutical agent given is often times extremely destructive, and may cause even more pathology to occur. Integrative and holistic practitioners frequently see these problems and are very concerned with the efforts to medicalize behaviors and to present drugs as solutions for many of these disorders. Hopefully, in the future behavioral problems will be better handled through the work of such groups as Safe Harbor.