Paradigms for pharmacologic use as a treatment component in feline behavioral medicine
Veterinary behavioral medicine remains an under-supported, under-appreciated, and under-taught specialty within veterinary medicine. Neuropsychopharmacology is the aspect that has provided the field with the most scientific legitimacy, but is also one of the most hotly debated. Paradigms for use of pharmacologic intervention include firstly ruling out any underlying medical cause. If a behavioral diagnosis can be made, treatment with psychotropic medication may be considered, although their use is most effective as part of an integrated treatment program that includes behavior modification. Used without an understanding of the mechanism of action, pharmacologic intervention may only blunt or mask behavior without altering processes or environments that produced the behavior. This paper reviews specific drugs, mechanism of action of those drugs, and relevant uses are reviewed for cats.
Future advances in treatment in veterinary behavioral medicine will be pharmacological and neurophysiological. As the field of veterinary behavioral medicine expands, its paradigm will enlarge to include routine combination therapy and the implementation of neuropharmacological intervention as a diagnostic tool.
A quarter of a century after its introduction into select veterinary curricula, veterinary behavioral medicine remains an under-supported, under-appreciated, and under-taught specialty within veterinary medicine. Oddly, the aspect that has provided the field with the most scientific legitimacy is also one of the most hotly debated: neuropsychopharmacology. It is important to acknowledge the extent to which a country's treatment ‘culture’ affects whether medication is prescribed. This association is clear from scientific meetings, industry-sponsored round-tables, sales data on the two pharmacologic agents licensed for use in dogs and/or cats (Clomicalm®[NovartisAnimal Health]; Anipryl®[Pfizer]), discussions on list-serves, and from reading the primary literature and recent multi-authored texts. Culture and finances interact to affect attitudes toward maintaining and having pets, and the extent to which behaviors are viewed as undesirable or ‘abnormal’. This is also true for humans.
The paradigms involving rational treatment of behavioral problems are affected by such cultural influences because interpretations of behaviors are also influenced by culture. For example, if one views ‘spraying’ in cats as a variant of ‘normal’ behavior, one is going to react differently in modifying the cat's behavior or environment than if one views spraying as ‘abnormal’ or, alternatively, ‘undesirable’. Such linguistic, cultural, and epistemological arguments are doubtless the result of incomplete knowledge and a relative absence of scholarship.
Our knowledge is more complete regarding neuropharmacologic and neuropsychopharmacologic agents. In fact, the one area in veterinary behavioral medicine where repeatable data involving hypothesis testing have been collected is in neuropharmacology. While most mechanistic paradigms have involved rodent and human models, extrapolation and independent testing is possible for both cats and dog. Unfortunately, the data lag behind the possibilities. Published data show that the addition of psychotherapeutic agents to more general treatments, such as behavioral and environmental modification, have lead to better treatment outcomes and faster improvement. Mere treatment of non-specific behavioral complaints and signs—especially for cats—is to be avoided. This outdated approach—where we treat spraying, rather than its underlying basis—has been replaced with one that includes criteria for diagnosis and pursuit of treatment that addresses specific underlying the neurochemical mechanisms.
Author: Karen L Overall
Source: https://journals.sagepub.com/
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