Pharmacologic management in veterinary behavioral medicine

Comparative neurogenetics of dog behavior complements efforts towards human neuropsychiatric genetics

Domestic dogs display a wide array of heritable behaviors that have intermediate genetic complexity thanks to a long history of human-influenced selection. Comparative genetics in dogs could address the scarcity of non-human neurogenetic systems relevant to human neuropsychiatric disorders, which are characterized by mental, emotional, and behavioral symptoms and involve vastly complex genetic and non-genetic risk factors. Our review describes the diverse behavioral "phenome" of domestic dogs, past and ongoing sources of behavioral selection, and the state of canine behavioral genetics. We highlight two naturally disordered behavioral domains that illustrate how dogs may prove useful as a comparative, forward neurogenetic system: canine age-related cognitive dysfunction, which can be examined more rapidly given the attenuated lifespan of dogs, and compulsive disorders, which may have genetic roots in purpose-bred behaviors. Growing community science initiatives aimed at the companion dog population will be well suited to investigating such complex behavioral phenotypes and offer a comparative resource that parallels human genomic initiatives in scale and dimensionality.

Essential Oils and Melatonin as Functional Ingredients in Dogs

Simple Summary

Phytogenics are plant-based compounds with beneficial actions in feed technology and/or animal health. These so-called plant secondary metabolites are very diverse and with wide possible applications in humans and animals. Among them, essential oils (EOs) are the most used in feed for livestock and pets. Lately, melatonin has acquired new and interesting applications in dogs. Recent studies using EOs and/or melatonin in dog feeding and their involvement in health aspects are presented.

Abstract

The use of nutraceuticals or functional ingredients is increasingly widespread in human food; their use is also widespread in animal feed. These natural compounds generally come from plant materials and comprise a wide range of substances of a very diverse chemical nature. In animals, these compounds, so-called phytogenics, are used to obtain improvements in feed production/stability and also as functional components with repercussions on animal health. Along with polyphenols, isoprenoid compounds represent a family of substances with wide applications in therapy and pet nutrition. Essential oils (EOs) are a group of complex substances with fat-soluble nature that are widely used. Melatonin is an indolic amine present in all living with amphiphilic nature. In this work, we present a review of the most relevant phytogenics (polyphenol, isoprenoid, and alkaloid compounds), their characteristics, and possible uses as nutraceuticals in dogs, with special emphasis on EOs and their regulatory aspects, applied in foods and topically. Additionally, a presentation of the importance of the use of melatonin in dogs is developed, giving physiological and practical aspects about its use in dog feeding and also in topical application, with examples and future projections. This review points to the combination of EOs and melatonin in food supplements and in the topical application as an innovative product and shows excellent perspectives aimed at addressing dysfunctions in pets, such as the treatment of stress and anxiety, sleep disorders, alopecia, and hair growth problems, among others.

The Impact of Noise Anxiety on Behavior and Welfare of Horses from UK and US Owner’s Perspective

Noise anxiety is an over-reaction to loud noises commonly detected among pets and can greatly impact on their welfare and on their management. When exposed to noisy events, horses can show intense escape attempts, which may cause severe accidents for the horse and the rider/handler. The aim of the present study was to investigate, through a web survey, UK and US owners’ perception of noise anxiety severity in their horses, their management strategies and perceived efficacy. The questionnaire was shared via social networking and advertised as “What is your horse afraid of?”. Over a total of 1836 questionnaires filled out; 409 owners reported that their horse has shown unusual behavior during a noise event. A two-step cluster analysis identified two groups: very anxious (VA) and slightly anxious (SA). VA horses were reported to have higher frequency of anxiety behaviors; higher frequency of signs of noise reactivity; and their anxiety did not improve with time. The most used management strategies consisted in providing hay throughout the night, turning in/out their horse or moving it to a paddock. A binomial logistic regression identified that horses that have reported injuries during noise events were more likely to be clustered as VA (OR = 0.24, 95% CI: 0.08–0.76); while providing hay throughout the night was more likely to be very effective management strategy in SA horses (OR = 0.41, 95% CI: 0.16–1.01). Our results confirmed that noise anxiety is a growing behavioral problem that can lead to important welfare concerns for horses. New management strategies, including the use of medicinal products, should be considered to reduce behavioral and physiological signs and help horses to cope with noisy events.

Veterinary drug therapies used for undesirable behaviours in UK dogs under primary veterinary care

Undesirable behaviours (UBs) in dogs are common and important issues with serious potential welfare consequences for both the dogs and their owners. This study aimed to investigate the usage of drug therapy for UBs in dogs and assess demographic risk factors for drug-prescribed UBs within the dog population under primary-care veterinary care in the UK in 2013. Dogs receiving drug therapy for UB were identified through the retrospective analysis of anonymised electronic patient records in VetCompass™. Risk factor analysis used multivariable logistic regression modelling. The study population comprised 103,597 dogs under veterinary care in the UK during 2013. There were 413 drug-prescribed UBs recorded among 404 dogs. The prevalence of dogs with at least one UB event treated with a drug in 2013 was 0.4%. Multivariable modelling identified 3 breeds with increased odds of drug-prescribed UB compared with crossbred dogs: Toy Poodle (OR 2.75), Tibetan Terrier (OR 2.68) and Shih-tzu (OR 1.95). Increasing age was associated with increased odds of drug-prescribed UB, with dogs ≥ 12 years showing 3.1 times the odds compared with dogs < 3 years. Neutered males (OR 1.82) and entire males (OR 1.50) had increased odds compared with entire females. The relatively low prevalence of dogs with at least one UB event that was treated with a drug in 2013 could suggest that opportunities for useful psychopharmaceutical intervention in UBs may be being missed in first opinion veterinary practice. While bodyweight was not a significant factor, the 3 individual breeds at higher odds of an UB treated with a behaviour modifying drug all have a relatively low average bodyweight. The current results also support previous research of a male predisposition to UBs and it is possible that this higher risk resulted in the increased likelihood of being prescribed a behaviour modifying drug, regardless of neuter status.

Pharmacotherapeutics in clinical ethology: treatment efficacy, clinical pathology and outcome

The use of psychopharmaceutical agents is a core aspect of treatment in veterinary behavioural medicine. Psychotropic medication use has shifted the focus of treatment from purely behavioural and environmental interventions to a multi-modal approach. Objective measures of efficacy are required for the licensing of medication. Pharmacotherapeutics have come to encompass supplements and diets, in addition to prescription medications. The first part of this paper examines the efficacy of medications, supplements and diets used in behavioural medicine. Foci include the role of evolution in the types of behavioural concerns reported, the importance of defining abnormal or pathological behaviour, use of terminology that supports stratified mechanistic diagnoses aid in understanding presentation and response clusters, and rational use of medication to relieve emotional, mental and behavioural suffering, given these diagnoses and clusters. The second part of this paper examines the extent to which variation in patient response to medication can enlighten us about mechanisms and outcomes of distress using a series of 3 patient populations who are the focus of studies on separation anxiety and noise reactivity. This response surface approach can be useful for understanding differences in populations in susceptibility to behavioural pathology and in medication response, and may suggest new avenues for drug development and application.

Appeasing Pheromones for the Management of Stress and Aggression during Conservation of Wild Canids: Could the Solution Be Right under Our Nose?

Simple Summary

Many canid species are declining globally. It is important to conserve these species that often serve as important predators within ecosystems. Continued human expansion and the resulting habitat fragmentation necessitate conservation interventions, such as translocation, artificial pack formation, and captive breeding programs. However, chronic stress often occurs during these actions, and can result in aggression, and the physiological suppression of immunity and reproduction. Limited options are currently available for stress and aggression management in wild canids. Pheromones provide a promising natural alternative for stress management; an appeasing pheromone has been identified for multiple domestic species and may reduce stress and aggression behaviours. Many pheromones are species-specific, and the appeasing pheromone has been found to have slight compositional changes across species. In this review, the benefits of a dog appeasing pheromone and the need to investigate species-specific derivatives to produce more pronounced and beneficial behavioural and physiological modulation in target species as a conservation tool are examined.

Abstract

Thirty-six species of canid exist globally, two are classified as critically endangered, three as endangered, and five as near threatened. Human expansion and the coinciding habitat fragmentation necessitate conservation interventions to mitigate concurrent population deterioration. The current conservation management of wild canids includes animal translocation and artificial pack formation. These actions often cause chronic stress, leading to increased aggression and the suppression of the immune and reproductive systems. Castration and pharmaceutical treatments are currently used to reduce stress and aggression in domestic and captive canids. The undesirable side effects make such treatments inadvisable during conservation management of wild canids. Pheromones are naturally occurring chemical messages that modulate behaviour between conspecifics; as such, they offer a natural alternative for behaviour modification. Animals are able to distinguish between pheromones of closely related species through small compositional differences but are more likely to have greater responses to pheromones from individuals of the same species. Appeasing pheromones have been found to reduce stress- and aggression-related behaviours in domestic species, including dogs. Preliminary evidence suggests that dog appeasing pheromones (DAP) may be effective in wild canids. However, the identification and testing of species-specific derivatives could produce more pronounced and beneficial behavioural and physiological changes in target species. In turn, this could provide a valuable tool to improve the conservation management of many endangered wild canids.

Hippocampal monoamine changes in the Flinders sensitive line rat: A case for the possible use of selective α2C-AR-antagonists in stress and anxiety disorders in companion animals

Non-selective α₂-adrenoreceptor (AR) stimulation delivers favourable sedative, analgesic, muscle relaxant and anxiolytic actions in companion animals, but is associated with cardiovascular and respiratory side effects. Anxiety conditions underscore monoamine disturbances amenable to α₂-AR modulation. We investigated sub-chronic (14 day s.c.) treatment with the selective α_2C-AR antagonist, ORM-10921 (0.03, 0.1, 0.3 mg/kg/d) on hippocampal noradrenaline (NA), dopamine (DA), serotonin (5-HT) and their turnover levels in stress sensitive Flinders Sensitive Line (FSL) rats versus Flinders Resistant Line (FRL) controls, using high performance liquid chromatography. The effects of ORM-10921 were compared to the non-selective α₂-AR antagonist, idazoxan (IDAZ; 3 mg/kg/d), and to imipramine (IMI; 15 mg/kg/d), a reference antidepressant in this model. FSL rats displayed significantly reduced 5-HT (p = 0.03) and DA (p = 0.02) levels vs. FRL controls, while NA levels showed a similar trend. ORM-10921 significantly increased NA (all doses p ≤ 0.02), 5-HT (0.1 and 0.3 mg/kg p ≤ 0.03) and DA levels (all doses p ≤ 0.03), which correlated with decreased monoamine turnover. In contrast, IDAZ significantly elevated NA (p < 0.005) and DA (p < 0.004) but not 5-HT levels. IMI also significantly increased 5-HT (p < 0.009), with a tendency to increase NA (p = 0.09) but not DA. ORM-10921 exerts similar albeit broader effects on hippocampal monoamines than IDAZ, explaining earlier established efficacy associated with α_2C-AR antagonism in animal models of depression and cognitive dysfunction. These and the current studies encourage application of ORM-10921 in depression in humans, as well as raise the intriguing possibility that selective α_2C-AR antagonists may be beneficial in anxiety and stress-related disorders in companion animals. Both warrant further study.

Analysis of polymorphisms of canine Cytochrome P 450-CYP2D15

Cytochrome P450 (CYP) proteins constitute a large ancient family of oxidative enzymes essential for the efficient elimination of a wide variety of clinically used drugs. Polymorphic variants of human CYP2D6 are associated with the conversion rate and efficacy of several drugs such as antidepressants. Polymorphisms of the canine orthologue CYP2D15 are of interest because these antidepressants are also used in dogs with behavioral problems and the outcome of the treatment is variable. However, the annotated CYP2D15 gene is incomplete and inaccurately assembled in CanFam3.1, hampering DNA sequence analysis of the gene in individual dogs. We elucidated the complete exon-intron structure of CYP2D15 to enable comprehensive genotyping of the gene using genomic DNA. We surveyed variations of the gene in four diverse dog breeds and identified novel polymorphisms in exon 2 in border collies. Further investigation to establish the impact of these canine CYP2D15 polymorphisms on interindividual variability in expression and function of this metabolizing enzyme is now feasible. Further knowledge of CYP pharmacogenetics will help individualize therapy and thereby increase therapeutic efficacy, especially in the use of antidepressants in veterinary behavioral medicine.

Behavioral Therapy and Fluoxetine Treatment in Aggressive Dogs: A Case Study

Canine aggression is a major concern, affecting millions of people worldwide, and treatment can be challenging even for skilled veterinarians. Empiric use of fluoxetine is sometimes attempted, although few data regarding long-term effects in aggressive dogs are available. The aim of the study was to investigate clinical effectiveness of fluoxetine (1.5 mg/kg/die PO) combined with a behavior modification program for treatment of canine dominance-related aggression. Circulating levels of fluoxetine, norfluoxetine, and serotonin (5-HT) were also measured. Eight dogs with a diagnosis of dominance aggression (owner-directed) were enrolled. Before treatment (T0), and after one (T1), two (T2), four (T3), and six (T4) months of fluoxetine administration, clinical outcomes were graded using a five-point frequency scale (0-4), and blood samples were collected to measure fluoxetine/norfluoxetine (high-performance liquid chromatography) and 5-HT (ELISA) levels. Following treatment, a decrease in behavioral test scores was observed at T1-T4. Increasing concentrations of circulating fluoxetine and norfluoxetine were measured throughout the follow-up. Correlation between norfluoxetine levels and clinical scores was observed at T4. Starting from T1, a significant decrease in 5-HT levels was observed. Our data suggest that fluoxetine (1.5 mg/kg/day) when associated with behavior treatment is effective in controlling canine aggression over a six-month period, and that, in dogs norfluoxetine levels seem reliable in predicting clinical efficacy.

Leaching behavior of pharmaceuticals and their metabolites in the soil environment

Pharmaceuticals constitute a significant group of emerging pollutants (EPs). The use of pharmaceuticals in animal breeding causes them to reach the soil environment in excrement and fertilizers. Depending on their chemical properties, pharmaceuticals can be sorbed to the soil or be washed out with rainfall and eventually be entered into groundwater. This paper evaluates the mobility of tramadol (TRA) and carbamazepine (CBZ), and two transformation products, O-desmethyltramadol (O-DMTRA) and 10,11-dihydro-10-hydroxycarbamazepine (10-OH-CBZ) in soils. Both pharmaceuticals are applied in human and animal treatment, which makes them enter the environment in native and metabolized form in high doses. Experiments were carried out in accordance with the OECD 106 procedure (batch tests) and DIN 19528:2009-01 procedure (percolation column test). The adsorption coefficients (K_d) for TRA, CBZ, O-DMTRA and 10-OH-CBZ were, respectively, 1.41 ± 0.10, 1.87 ± 0.06, 0.90 ± 0.03 and 0.37 ± 0.07 for sandy soil RS04, and 18.09 ± 0.78, 2.56 ± 0.05, 10.89 ± 0.17 and 0.56 ± 0.38  L kg^-1 for loamy soil RS06. The percolation column test was carried out for sandy soil RS04. The results obtained for TRA and O-DMTRA under static conditions indicated a high mobility of these compounds in soil, whereas the column leaching experiment showed that these compounds bind strongly to soil particles. A correlation between static and dynamic tests was observed in the case of CBZ and 10-OH-CBZ. These compounds will probably be characterized by a high or moderate mobility in soil.

γ-[Glu]n-Trp ameliorates anxiety/depression-like behaviors and its anti-inflammatory effect in an animal model of anxiety/depression

This study compared the abilities of γ-[Glu]n-Trp (EW) and whey protein hydrolysate (WPH) with a high ratio of Trp : 5 large neutral amino acids (5LNAAs) to reverse chronic restraint stress-corticosterone injection induced anxiety/depression-like behaviors in C57BL/6 male mice. EW was synthesized using l-glutaminase from Bacillus amyloliquefaciens. Acid protease, trypsin, pancreatin or flavorzyme was used to produce WPHs. The WPH with the highest Trp/5LNAAs ratio (17.38%; by trypsin) was selected for animal trials. EW (dose 2.0, 5.0 or 10.0 mg kg^-1 d^-1) and WPH (dose 0.5, 1.0 or 2.0 mg g^-1 d^-1) reversed behavioral dysfunctions, suppressed serum inflammatory cytokines (TNF-α, IL-6, IL-1β and IFN-γ), and reduced the activity of indoleamine 2,3-dioxygenase (key rate-limiting enzyme of the kynurenine pathway) while increasing the activity of tryptophan hydroxylase (key rate-limiting enzyme of the serotonin pathway) in the hypothalamus, hippocampus and prefrontal cortex, with EW acting more effectively. EW could also increase body weight gain and might act more effectively via the kynurenine pathway. These findings are of significance to promote the future practical application of kokumi γ-[Glu]n-Trp peptides.

The use of fluoxetine by veterinarians in dogs and cats: a preliminary survey

OBJECTIVE

To describe the prescribing habits of a sample of small animal veterinarians pertaining to use of fluoxetine in dogs and cats.

DESIGN

Exploratory descriptive survey using a questionnaire, available on paper and through email, distributed to small animal veterinarians by convenience sampling.

PARTICIPANTS

Veterinarians practicing small animal medicine in North America contacted by email and at local veterinary meetings.

RESULTS

Of 127 initial respondents, 106 prescribed fluoxetine for dogs and/or cats. The majority (91 per cent) indicated the drug be given once every 24 hours. Respondents used one or more formulations of fluoxetine. Of those who prescribed fluoxetine for both dogs and cats (57 per cent), 80 per cent used a generic form. A third prescribed fluoxetine only for dogs (31 per cent) and 72 per cent of these prescribed the US Food and Drug Administration approved product that was available at that time. The primary use of fluoxetine was related to behaviour problems. Overall for dogs, uses of fluoxetine were organised into five major categories by the investigators: Anxieties, Aggression, Compulsive Disorders, Phobias/Fear and Other, Anxieties being the most common. Of those who prescribed fluoxetine, 12 per cent did so only for cats and the majority of these prescribed generic (58 per cent) and or compounded (42 per cent) forms. Overall for cats, uses of fluoxetine were organised into six major categories: Elimination behaviours, Anxieties, Aggression, Dermatologic/Grooming, Compulsive Disorders and Other, Elimination behaviours being most common.

CONCLUSIONS

This study indicates that practitioners prescribed fluoxetine in generic, proprietary and compounded formulations for a variety of behaviour problems of dogs and cats. The broad use by the respondents suggests how important psychotropic drugs are in veterinary medicine. Research, information and continuing education regarding such drugs and animal behaviour should be made available to the general practitioner.

Progestins to control feline reproduction: Historical abuse of high doses and potentially safe use of low doses

RELEVANCE

The high fertility rate of cats means that methods to control feline reproduction are a requirement for cat breeders and pet owners, as well as for those involved in the management of feral cat populations. Progestins continue to be used to prevent queens from cycling, and also as an adjunct or alternative to surgical sterilization within trap-neuter-return (TNR) programs.

EVIDENCE BASE

A considerable body of information exists on megestrol acetate (MA) and medroxyprogesterone acetate (MPA), thanks to the many studies and case reports published in the scientific literature over the past 50 years documenting their clinical use in cats. Comparatively less is known about the use in cats of more recent progestins such as levonorgestrel, proligestone, delmadinone, chlormadinone and altrenogest.

DOSING, SAFETY AND EFFICACY

Based on a combination of dose, frequency and duration of treatment, MA can be categorized into low (0.625 mg/kg/week for up to 30 weeks), medium (0.625 mg/kg q24h for 1 week or q48h for up to 2 weeks) and high (0.625 mg/kg q24h or q48h for several weeks, or weekly for months or years) dosages. Studies suggest that low dosages can be used relatively safely in cats, while higher dosages increase the risk and severity of adverse reactions. Early work showing that an oral MPA dosage of 0.01 mg/kg administered q24h for 12 months suppresses oestrus in queens effectively and safely has not been considered, and much higher MPA dosages (>6.25 mg/kg q24h) have been used in cats over the past 40 years.

RECOMMENDATIONS

Progestins should always be used with caution. Using the lowest possible dosages, MA and MPA may, however, continue to be used safely in pet queens as well as (in conjunction with TNR programs) for the control of feral cat colonies. More recent progestins appear to be effective and safe, albeit their efficacy and safety need to be further investigated.

Intranasal administration of oxytocin promotes social play in domestic dogs

In a recent paper,¹ we examined whether oxytocin in the domestic dog modulates the maintenance of close social bonds in non-reproductive contexts. We found that exogenous oxytocin promotes positive social behaviors not only toward conspecifics, but also toward human partners. Here we examined in further detail the effect that oxytocin manipulation has on social play. When sprayed with oxytocin, subjects initiated play sessions more often and played for longer periods of time than when sprayed with saline. Furthermore, after oxytocin nasal intake dogs displayed play signals more often than after saline administration, suggesting that oxytocin enhances dogs' play motivation. To our knowledge, this study provides the first evidence that oxytocin promotes social play in the domestic dog. We use these results to hypothesize on the potential therapeutic use of oxytocin for promoting social behaviors and treating social deficits in the domestic dog.

Blindness and behavioural changes in the cat: common neurological causes

PRACTICAL RELEVANCE

Blindness and behavioural changes occur relatively commonly in cats, either separately or in combination, causing devastating consequences for the cat and owner. Blindness can be caused by primary ophthalmic, metabolic or intracranial disease. Similarly behavioural changes may be the primary result of intracranial or systemic disease, but also occur secondarily to visual deficits or changes in interaction with the external environment (ie, non-medical problems). The anatomical pathways involved in vision are very close to those involved in behavioural regulation. It is, therefore, likely that a brain lesion (especially a forebrain lesion) that causes blindness will also cause behavioural abnormalities.

CLINICAL CHALLENGES

In cases of partial or unilateral blindness, obvious visual deficits may not be apparent to the owner or clinician. Rather, the visual impairment may manifest more subtly as changes in behaviour, reluctance to jump or unwillingness to go outside. Similarly, behavioural problems may be episodic and, hence, a cat presenting with behavioural disturbances may appear clinically normal on evaluation. Behavioural changes are unlikely to be noticed unless marked and associated with bilateral blindness or advanced systemic illness.

AUDIENCE

This article discusses these two major disorders separately, with the aim of highlighting for the clinician some of the important aspects of the general clinical and neurological examination that can be performed to identify these challenging cases.

Serotonin: a review

5-Hydroxytryptamine, or serotonin, is a biogenic amine most noted for its role as a neurotransmitter. Manipulation of serotonin in animal models was used as a tool for studying its role in humans. Through such research serotonin has been shown to modulate gastrointestinal motility, peripheral vascular tone, cerebral vascular tone, and platelet function and has been implicated in the pathophysiology of mood disorders, emesis, migraine, irritable bowel syndrome (IBS), and pulmonary and systemic hypertension. The knowledge gained is being directly applied back to animals in research on drugs that manipulate the serotonergic system in dogs and cats. Increasing use and availability of drugs that manipulate the serotonergic system has created a circumstance through which a novel toxicity was discovered in both humans and animals. Serotonin Syndrome describes the clinical picture seen in humans and animals with serotonin toxicity. This paper provides a review the physiology of serotonin and its involvement in the pathophysiologic mechanisms of various conditions, including the Serotonin Syndrome.

Training veterinary students in animal behavior to preserve the human-animal bond

Knowledge of animal behavior is an extremely important component of modern veterinary practice. Appreciation of species-typical behavior helps to ensure that veterinary patients are handled safely and humanely, and plays a pivotal role in the diagnosis of health and welfare problems in animals, including the recognition of pain and distress. Veterinary students who acquire a good understanding of animal behavior will be better clinicians and will be best able to promote and repair the "human-animal bond," that important connection between people and their pets. Animal behavior problems can negatively impact this critical relationship, leading to abandonment, re-homing, relinquishment to an animal shelter, and sometimes premature euthanasia of the animal. Therefore, identifying, preventing, and treating behavior problems is important in maintaining the human-animal bond. Education in animal behavior should be an essential part of the veterinary curriculum; a board-certified veterinary behaviorist should be an integral member of the veterinary college faculty.

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.