22 Sept 2020
Emma Baker BVetMed, MSc, MRCVS Emma Brown BVSc, PGDip, CCAB, MRCVS Caroline Warnes BVSc, MSc, CCAB, MRCVS in the first of a two-part article – and with fireworks season approaching – describe the aetiology of this issue, as well as diagnosis and initial management.
The 2018 PDSA Animal Welfare Report stated that 40% of pet owners who completed the survey felt their dog was afraid of fireworks; 24% felt their dog was afraid of thunder and lightning, and 24% felt their dog was afraid of loud noises in general1.
These findings were similar to previous studies2,3. By anyone’s estimation, this is a large section of the UK dog population that does not cope well with loud sounds/noises.
A pet owner-focused survey found 71% of veterinary clients would ask their vet or vet practice about behaviour problems4. Another survey found owners who did not consult their vet instead chose to speak to breeders or pet shop assistants, or read information on the internet or in newspapers, although some did consult people calling themselves “behaviourists”5.
With the high expectation that veterinarians can provide behaviour advice – in addition to the concern the alternatives may lack an evidence base – it is important the general practitioner is up to date with how to address behaviour problems, including sound sensitivity.
This article – ahead of the UK’s busiest time of year for predicted noise events – summarises the aetiology, diagnosis and initial management of fear/anxiety‑based noise reactivity. A separate article with respect to longer‑term treatment will follow.
Reacting to noise is a natural, appropriate, self‑preserving behaviour. Simply put, for millennia, loud/unfamiliar noise may have been the predictor of danger.
After hearing a noise, those who subsequently feel unpleasant, aversive feelings of fear are motivated to escape the danger. Those who did not may have succumbed to the danger and not lived to pass their genes on.
Repeated or prolonged exposure to loud/unfamiliar noises – particularly if the animal is unable to perform a coping strategy, such as escaping from the noise by hiding somewhere sound insulated – can result in the animal becoming sensitised to that noise. Not only does that animal react more severely when a noise is heard, they may start to anticipate when and where the next noise will come (from), and listen out harder for subsequent noise.
This exaggerated response and increased vigilance for noises is no longer helpful and self-protective, but debilitating and will affect their welfare. This level of reactivity to sound/noise is considered a phobia6.
An animal can become sensitive to sound by various mechanisms:
Diagnosis is based on identification of signs of fear related to sound events. It must be remembered, however, that medical factors may impact both how an animal perceives a sound and its threshold for a fear reaction.
Pain (including chronic pain), sensory changes, endocrine disease and cognitive decline may all impact on an individual animal’s response to sounds.
All animals presenting for sound fears should have a full history taken and medical examination carried out.
Preparation
In whatever time the client has, he or she should plan. Examples would be:
Management prior to and during the event
Medication
Animals that have previously shown distress in response to sounds, for which exposure cannot be avoided, should receive effective evidence-based medication (Table 2). Clients should be approaching their vet at least two weeks prior to the event to discuss medication.
In the first instance, the aim is to protect the animal from the triggers of the undesirable behaviour/negative emotional reaction. This safeguards its welfare and lowers emotional arousal, which facilitates better learning for behaviour modification at a later date.
This article is concerned with the initial/emergency management plan (Panel 1). Follow-up treatment will be discussed in part two
A useful handout giving clients tips for preparing for fireworks night can be downloaded from the Fellowship of Animal Behaviour Clinicians website via https://bit.ly/3c0LT8k
Much conflicting advice exists over how owners should react if their pet reacts to sounds. The following advice may help clients manage situations:
For dogs that show a phobic or panic response, prescription medication is essential.
As veterinary professionals, we have a responsibility to use evidence-based treatments. Medications should provide anxiolysis and minimise further negative learning, and if the animal’s panic response is to flee, some level of sedation may be required.
Consideration should be given to the prescribing cascade, health of the animal and practicality of administration.
Table 2 comprises medication that can be used before or during a predicted noise event10. Longer‑term medication will be discussed in part two.
Extracted from the leaves and flowers of the Hemp plant, cannabidiol (CBD) binds to CB2 endocannabinoid receptors to give anti-inflammatory – but potentially also antidepressant and anxiolytic – effects.
In the UK, the VMD states: “We consider veterinary products containing CBD are veterinary medicines and should be regulated as such”.
No authorised veterinary products are available in the UK, so products derived for humans can be used as long as they are prescribed by a veterinary surgeon. However, no good evidence exists of efficacy as a short‑term medication for noise fears, so it should not be used in preference to the medications listed in Table 1.
Synthetic analogues of several pheromones are commercially available in the UK in a variety of formulations, including sprays, diffusers and impregnated collars.
The pheromones to consider for sound sensitivities in cats and dogs are feline facial pheromone fraction F3 and dog appeasing pheromone. These may be beneficial alongside appropriate environmental management and medication as required.
An ever-increasing array of supplements, diets and complementary therapies are being marketed for the alleviation of sound sensitivities in animals (Table 3).
Clients often like the idea of a “natural” product and may not realise some of these products can potentially cause toxicity, interact adversely with other medication or may not be suitable for all animals (see Table 2).
Although some of these products may be beneficial, and many have been researched and quality controlled, it must be remembered the regulations governing these products are very different to those covering pharmaceuticals.
Good-quality, placebo‑controlled research is lacking at this time for many of these products. This does not mean they will not prove in time to have value. However, they should not be used in preference to pharmacological agents with a more established evidence base in animals with more than very mild noise-related fear or anxiety.
Accessories that are available include:
Sound sensitivities – and fireworks events in particular – have a huge impact on the welfare of the animals that share our lives. With good practical advice and appropriate use of medication, veterinary surgeons can greatly enhance the welfare of their patients during these events.
In one study, less than a third of survey participants sought treatment for their pets’ sound sensitivity, even though almost half had described at least one behaviour sign of fear when exposed to noise2.
By teaching our clients to recognise the early signs of fear/anxiety, and encouraging them to discuss these with us, we can reduce the risk of animals becoming sensitised and the problem progressing.
