The 5 M’s of Working with Fearful Dogs – Part 1

Medical, Management, Modification, Medication, Modification (yes, Modification is included twice!)

This is the first of a four-part series that will help you and your eXtraOrdinary Dog minimize or overcome behavioral challenges in a systematic, completely force-free way. We will use the framework of The 5 M’s for easy reference:  Medical Assessment;  Environmental Management; Behavior Modification; introducing the possibility of anxiolytic (behavioral) Medication under the supervision of a Vet or Vet Behaviorist if management and modification alone are not enough to create positive changes; and if medication is prescribed, reevaluating and updating the Modification plan.  Each topic provides a foundation for the next, starting with medical and moving sequentially through Management, Modification, Medication, and Modification.

Medical – We will discuss how to assess whether your XO Dog’s behavior stems from physiological issues, emotional issues, or a combination of both.

Management – You will learn how to employ effective management strategies as a first (and maybe even last!) step in modifying behavior.  We will also discuss hiring a qualified, force-free trainer who can help you write and implement a management plan as well as a full modification plan, if necessary.

Modification – We will discuss the fundamental principles of classical conditioning, including counterconditioning and desensitization, which are modification techniques that seek to change the emotion behind the behavior and are absolutely critical to helping your dog feel safer in her environment. We will also discuss operant conditioning; teaching alternative or incompatible behaviors put on cue to help manage your XO Dog’s response to potential triggers.

Medication – Only licensed veterinary professionals can prescribe behavioral medications. If your vet is not comfortable with prescribing behavioral medications or has limited experience with behavior issues, ask for a referral to a Veterinary Behaviorist. A Vet Behaviorist is a veterinarian who, through advanced education and casework, specializes in diagnosing and treating behavior-related issues. Veterinary Behaviorists have an in-depth knowledge of modification protocols as well as the many medications (and combinations of medications) that can offer your dog the best quality of life possible.

Modification– Revisit your modification plan to incorporate the advice of the veterinary professional. You may, if you haven’t already, hire a qualified trainer to help you implement the modification plan once the medication has had a chance to take effect.

Medical Assessment

Behavioral challenges can range from subtle to debilitating for both the dog and the caregiver. Whether you have just recently welcomed a new fearful dog into your life or have noticed behavioral changes in your beloved canine family member of many years, the first vitally important step to addressing her fear is a thorough physical workup. Your vet can rule out or diagnose and offer treatment options for any underlying physical imbalances or ailments that could be causing or exacerbating fearful behavior.

Pain in any part of the anatomy, structural/orthopedic issues including bones, joints, tendons, muscles, and ligaments, unresolved injuries, dental issues, loss of sight and hearing, allergies, abnormal blood work (indicating chemical or hormonal imbalances or illness), neurological impairments, low-grade infections, age-related issues and many acute and chronic diseases can all create or be contributing factors to fearful behaviors.

If your dog is exhibiting any of these behaviors, please seek a medical opinion to rule out an underlying physical cause:

• Lethargy
• Hesitant to navigate certain flooring, stairs, or changes in elevation (ground to the car, floor to the couch, etc.)
• Reluctance to participate in activities that were once enjoyable
• Hand shy
• Noise sensitivity/phobia
• Hypervigilance 
• Sensitivity to being handled
• Inability to focus
• “Zoning out”
• Panting (with no physical exertion)
• Avoidance of people, objects or situations
• New, frequent requests for attention
• Appears not to see or hear normal sounds
• Stalling or hesitating while walking
• Walking in slow motion/change in gait
• Hiding
• Changes in tail carriage
• Growling, snapping, lunging, or biting
• Poor appetite (or markedly greater appetite)
• Increased water intake
• Whining, whimpering, new barking habits
• Inability to settle
• New or increased separation anxiety
• Frequent scratching or licking feet, flanks, belly 
• Accidents in the house
• Straining or inability to eliminate outside
• Stereotypic behaviors such as compulsive pacing, circling, air snapping, spinning, staring, tail chasing, sucking on legs, feet, or tail
• Changes in sleep patterns
• Changes in temperament
• Flinching or twitching when touched

As soon as you notice fearful behaviors, start keeping a simple log with the date and time, frequency of the behavior, and your observations to share with your veterinary professional. Write down exactly what you see, along with any relevant data, such as weather, activity prior to the onset of the behavior, time of day, and changes in the environment, family structure, or routine. If possible, take video clips (without stressing your dog) to augment your written notes. Provide a detailed medical history (as much as you know), which will supplement the physical exam and behavior log.

In addition to a thorough physical exam, blood work can be a useful baseline to compare against later tests, diagnose some diseases, and also to rule out very subtle hormonal, vitamin and mineral deficiencies. X-rays or other diagnostic tools may also be useful.

Your primary vet may ultimately suggest a referral to a specialist, such as a neurologist or a gastroenterologist. Digging deeper into areas of concern may actually save time, money, and additional pain and suffering if addressed by a professional with expertise in that area.

If locating a specialist within your geographic area proves to be challenging, ask if the specialist is willing to work remotely, in conjunction with your primary vet. The team approach to veterinary medicine is not new, but since COVID, remote consultations for some specialties are becoming more common.

Addressing underlying illness while alleviating pain, whether with medication prescribed by your vet, and/or a change in diet and exercise, can often decrease fearful behavior. If fearful behavior cannot be explained through a thorough exam or visits to a specialist, or if fearful behaviors remain once illnesses have been resolved, it’s time to build a management and modification program to address your dog’s emotional response behind the behavior you are concerned about.

In our next post, we will address the second of the 5 M’s: management.

Successfully arranging your XO Dog’s environment can help minimize or solve unwanted behaviors by removing or altering access to the place, person, or thing that causes a fearful reaction. Any behavior that is rehearsed gets stronger. If the opportunity for rehearsal is removed, your dog’s stress levels go down and the behavior may no longer be relevant.