14 Oct 2019

Fireworks season: why proactive practice-wide approach is vital

Sarah Heath discusses the impact of noise phobias on pets, how and why they manifest, and the importance of ongoing comprehensive services to offer owners.

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Sarah Heath

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Fireworks season: why proactive practice-wide approach is vital

Image © lightscience / Adobe Stock

As autumn commences, we are preparing ourselves for shorter days, darker evenings and colder weather. Our thoughts also turn to a series of seasonal events that occur during the autumn and winter months.

In the UK, the horror of Halloween is taking on a whole new meaning in 2019, but for many pet owners the thought of this event – along with Bonfire Night, Diwali and new year – has long been associated with a sensation of pending disaster.

These are owners of pets for whom the celebratory firework displays, associated with such events, signal the onset of fear, anxiety and even phobia, which is not only unpleasant during the event, but can also lead to longer lasting emotional consequences that can be significantly debilitating.

Providing appropriate advice and assistance for these people and their pets is part of the remit of the veterinary profession, and it is important all practice staff are prepared to help clients who approach the practice with concerns at this time of year. Appropriate advice is not only needed to help clients and patients to deal with the unavoidable exposure to firework displays, but also in terms of advising on how to achieve longer-term changes in their pets’ emotional responses.

Incidence

Noise-related fears are commonly encountered in the caseload of veterinary surgeons working in behavioural medicine, either as primary complaints or as incidental findings during the extensive history taking process associated with clinical behavioural medicine. Published studies have stated high incidence figures within the domestic pet population, with one paper reporting “49 per cent of owners reported a specific fear response to loud noises”1.

Be proactive, not reactive

While many clients will come to the veterinary practice seeking specific advice about noise-related fears, it has been reported in the UK less than a third of owners sought professional advice about treatment for a pet’s response to noises2, and 57 per cent of owners were doing nothing to treat the phobia2.

This failure to seek professional advice is seen on a global scale, and was also identified in a paper related to New Zealand3. It is also reported many owners felt they were not dealing with their pets’ issues effectively, but claimed they were not offered sufficient advice or options from their veterinary practice2.

Two important messages can be taken from this data. The first is a need exists for practical and understandable advice for owners about dealing with noise-related fears in their pets, and the other is proactive messaging is necessary to encourage owners to come to the veterinary practice for help.

It is not enough to only respond to the queries clients actively bring to the practice. The use of social media and websites to spread the message firework-related fears – and, indeed, noise-related fear in general – is not inevitable and can be managed and treated is essential.

Justified fear anxiety versus debilitating emotion

The fear-anxiety system is one of the seven emotional motivational system identified by Jak Panksepp4, and is a normal and necessary emotion when it is justified and proportional.

Aiming for a situation where fear does not exist is not only unrealistic, but also potentially harmful. Life is not fear free, and for a valid reason. The fear-anxiety system protects animals from harm and ensures they have sufficient resources to survive. Loud noises can be indicators of potential harm and, as such, can be justified triggers for a fear-anxiety response.

A subconscious understanding of this is likely to be linked to the perception that “all dogs are scared of fireworks” and the normalisation of firework-related fear within the dog-owning population. The important distinction is that while fear of noises may have some element of normality to it, the experience of significant, negative emotion that impacts on normal living, and takes an excessive period of time to dissipate, does not. Research has shown dogs showing fear-anxiety responses to fireworks also show a higher frequency of negative emotional responses to other stimuli, such as thunderstorms and gunshots2,5.

One study showed the strongest correlation was between fireworks and gunshots, but a strong correlation was also found between fireworks and thunderstorms, and thunderstorms and gunshots, with a weaker correlation being found between heavy traffic and the other categories5. This study also discussed the potential for the dog’s “underlying temperament” to be an important factor in the progression of fear-related behaviour, and suggested “a dog that is anxious in general naturally will react to loud noises, no matter the origin of the sound”.

This raises very important considerations for veterinary practices in terms of not only identifying patients that are showing significant emotional responses to fireworks – to offer their owners appropriate management and treatment advice related to that fear – but also in terms of investigating the overall emotional health of these patients and offering appropriate behavioural medicine treatment, either in house or through referral to a veterinary behaviourist.

Role of management

When dealing with pets with both a justified and time-limited fear, the emphasis is on management of the emotional response and prevention of longer-term emotional damage.

Managing firework-related fears and anxieties involves supporting companion animals in selecting appropriate coping strategies to help them to recover more quickly, and using supportive medication that will limit potentially damaging learning in terms of negative emotional associations.

One risk of leaving firework-related fear unmanaged is the potential for generalisation of that negative emotional response to increasingly dissimilar stimuli, many of which are related to everyday living in a domestic environment. For example, the generalisation process may lead to the onset of fears related to sounds from household appliances, such as microwaves, boiling kettles and spitting wood burners. Fear related to these everyday items can lead to significant emotional debilitation and the onset of more life-changing emotional limitations.

For some pets, their fear related to fireworks is already outside the range of normal emotional responses when it is first identified. These pets show exaggerated emotional responses to the noises, and associated exaggerated behavioural responses. These responses may lead to highly significant outcomes for themselves in terms of the potential to react in ways that endanger them. Examples could include bolting across main roads to get away from a sound, or breaking out of rooms and sustaining physical injury in the process. Their enjoyment of life could also be severely limited; for example, if they refuse to walk in certain areas where fireworks have been heard. Such scenarios may also lead to significant outcomes for their owners, such as complaints from neighbours over vocalisation responses or expensive redecoration costs when a fearful pet has been home alone when the fireworks started and caused significant damage in their attempts to get away.

During the autumn months, when firework displays are commonplace, the risk is a significant number of these pets with excessive emotional responses are going to be exposed to unavoidable firework stimuli. The risk can be something of a postcode lottery in terms of proximity to locations for large organised firework displays, but without legal restrictions on the sale and use of fireworks, any neighbour can decide to use them during private festivities. Offering management advice to owners is, therefore, essential for these pets, but an additional requirement should be to also identify the need for more in-depth investigation of the emotional health of the pet after the immediate season has passed.

Approach to firework season

It is important for veterinary practices to offer a comprehensive service for pets suffering from firework-related fears, but, to be able to do this effectively, they also need to communicate effectively with clients and raise awareness of the significance of their pets’ behaviour. Three core messages can help to create an effective pre-season awareness campaign, which, in turn, can increase the uptake of advice and improve the welfare of patients.

Need for appropriate management for all cases

It is important to emphasise the need to offer appropriate management, even when the fear-anxiety response is apparently “mild”. A tendency exists to associate passive behavioural responses to any fear-anxiety motivation with a lesser problem, but, in reality, the four potential behavioural responses – which the author identifies in her sink model of emotional health – are of equal significance.

The fact that pets using the responses of avoidance (taking action to increase distance from, and reduce interaction with, the fear-inducing sound, such as by trying to hide) or repulsion (showing behaviours designed to make the fear-inducing stimulus retreat, such as barking at the sound) is more obvious to people does not correlate with the significance of the underlying emotional response to the pet. Those seeking to find out more about the situation through the other behavioural responses of inhibition (passively gathering information, such as staying very still, and watching and listening) and appeasement (actively seeking to exchange information with others, such as leaning into owners, lying very close to another dog in the household, and sniffing and licking at human or canine faces) are also indicating a significant level of negative emotional arousal, and these patients have an equal need for appropriate management.

Clients will often assume the veterinary practice approach will always involve medication, and they may be reluctant to approach the practice for advice for this reason. Medication may be appropriate for some patients as part of the management approach, but it may not always be necessary. It is, therefore, beneficial to explain that management involves a range of approaches6, including supporting species-specific coping strategies, making alterations in human interactions and using supportive strategies, such as pheromone therapy7,8,13 and administration of nutraceuticals9,10,11.

Where medication is indicated, the primary aims are to offer anxiolytic action with mild sedative action and amnesic action, where required. Low-dose dexmedetomidine gel has been reported to be effective in managing firework-related fears through its anxiolytic action12,13, and may be beneficial where limitation of memory formation is not a particular requirement, for example when the patient is effective in its use of coping strategies, such as hiding, and the aim is for them to learn from their use. The benzodiazepines alprazolam and diazepam have been indicated where amnesic action is required to reduce the risks associated with cumulative learning14.

Link with emotional illness

It is important to explain the risks of failing to manage firework-related fear, and some discussion of the potential for generalisation of the negative emotional response to other sounds is useful. In addition, veterinary practices can help to improve understanding of the concept of emotional health in companion animals by discussing the potential for firework-related fears to be seen in association with generalised anxiety, or with fear-related responses to other stimuli5. Encouraging clients to come to the practice to talk about their pets’ reactions can help to increase detection rates for emotional illness and enable the practice to offer appropriate in-house or referral-based behavioural medicine services.

Link with physical illness

One very important aspect of increasing awareness is to explain the potential link between behavioural change associated with fear of noises and underlying physical disease.

Considerable research has been conducted into the link between physical and emotional health in companion animals, and the results emphasise the need for the veterinary profession to take responsibility for investigating this link in clinical cases.

Work at the University of Lincoln has identified a significant role for chronic pain in cases presented with fear of noises15, and increasing owner awareness that fear related to fireworks may be an indication of underlying physical illness is important. Encouraging owners to contact the practice for a more in-depth discussion about their pets’ behaviour can then lead to appropriate clinical investigation – which can help to increase detection rates of chronic pain.

Conclusions

Over the next few weeks, some clients are going to be contacting your practice for advice about how to help their pets cope with the forthcoming fireworks season. Many more are unaware of the significance of their companion’s reaction to these significant noise events or have no understanding of the ways their local veterinary practice can help them to reduce the negative emotional impact of these events on their pet.

It is the responsibility of our profession to raise awareness and proactively educate our clients, so they can offer their pets the best possible management-related assistance during the difficult months ahead. In addition, practices need to develop strategies for maintaining contact with these clients, so patients can also be offered appropriate treatment programmes after the season. This will not only reduce the risk of these problems reoccurring year after year, but also help to improve patients’ overall emotional health.