(Haaretz) — It’s a lazy afternoon. It’s hot and the family’s hanging out. Suddenly a rocket siren shatters the peace. Everybody, including the family’s five dogs, heads promptly but calmly to the reinforced “safe room.” Meanwhile, in Tel Aviv, as the siren wails, D.’s dog pees on the floor in terror. Jasmine’s three cats twitch an ear, at most, but otherwise – nada.
We all react to terrifying stimuli in different ways, and, after it, some of us may develop the chronic, debilitating condition known as post-traumatic stress disorder (PTSD), which is sometimes treated with the help of animal therapy. But animals can suffer lingering after-effects of trauma, too, and their only recourse to healing is us.
“I don’t call it PTSD,” says Dr. Ofra Gallily DDM, an animal behavior consultant, right off the bat. “But animals can certainly have post-trauma symptoms. If their brain chemistry is normal, if the animal is normative, they’ll get better. If the problem lasts years, they had a problem with their brain chemistry to begin with.”
PTSD is not a recognized syndrome in veterinary medicine, but many believe it exists – including the American army. Certainly the conditions in Israel are ripe for shock, and while PTSD may be difficult to diagnose in the nonverbal, stress is not.
“A huge number of dogs have been abandoned or fled from bombs in southern Israel and Gaza, and got lost,” says Eti Altman, spokeswoman for the animal rights and rescue organization Let the Animals Live. “The ones who’ve been caught and placed in shelters demonstrate acute stress at every rocket siren or explosion.”
Some dogs race to hide if possible – under tables, for instance, Altman says. Many have begun circling as if chasing their own tails and can do this for hours. “Dogs have much more acute hearing than humans,” she points out. “They hear the sirens and booms 100 times more loudly.”
Dr. Nicholas Dodman, a globally celebrated veterinary behaviorist and expert on PTSD in animals, now at Tufts University in Massachusetts, calls it by name and has been doing so for years.
“I diagnosed PTSD in a dog years ago,” says Dodman. The dog had been shot by a Boston policeman and recovered, physically. But he had all the hallmarks of PTSD. “He was totally anxious, hyperventilating and couldn’t sleep. Apparently he was having bad dreams,” says the doctor. “When the dog’s owner and his son came to me with the dog, they hadn’t had a full night’s sleep in two years. They had to do a tag team with the dog at night because he was so anxious.” Dodman successfully treated the dog with medication, he says.
Gallily isn’t alone in declining to associate the symptoms in animals with PTSD per se. The U.S. army is just as squeamish – but has admitted to the existence of “CPTSD,” says Dodman. Yep, that “C” stands for “canine.” “A lot of people can’t possibly call a dog’s condition by the same name as a human condition, lest it be mortifying to the soldier,” Dodman sniffs.
Moreover, the U.S. army set rather draconian criteria for acknowledging CPTSD, he says: The dog must have experienced the theater of war, has to have been involved in a catastrophic incident, and has to experience specific signs. But any dog that underwent a traumatic experience – like being shot or in a car accident – or underwent intensive, invasive therapy – most notably being attached to a ventilator – can develop the condition, Dodman says. And you can call it what you like, but the devil has a name and it’s PTSD.
Preventing memory formation with drugs
In fact, the U.S. army was one of the first venues to recognize the problem of post-traumatic damage to dogs, Dodman relates, having been called in to consult in the case of Gina, a bomb-sniffing young German shepherd who developed problems after a six-month tour in Iraq. She was exposed to any number of bangs and flashes, and upon her return home exhibited the classic signs of PTSD, including extreme stress when her handlers tried to get her to enter a house. She would hyperventilate and resist; if forced inside, she would slink around.
Not every soldier, dog or gerbil develops PTSD even after a terrifying event, though in theory any mammal can, says Dodman, adding, “I’ve not seen PTSD in cats but it probably works the same way. All mammals have basically the same neurotransmitters.”
That said, only a fraction of people, soldiers or police dogs wind up with PTSD – at most, about a fifth of individuals who underwent a traumatic experience. Dodman agrees with Gallily that who gets it and who doesn’t ultimately boils down to brain chemistry.
In 2012, researchers at the Boston University School of Medicine identified a gene linked with PTSD, findings they reported in Molecular Psychiatry. The gene, RORA, is associated with protecting brain cells from the damaging effects of stress.
Individuals – soldiers, cats, rats - with the RORA risk variant are more likely to develop PTSD after a horrid experience.
Nice to know. What’s even better to know is that blocking the gene (in people who have it) can prevent the development of PTSD following trauma, Dodman says. The drug that does the trick is a beta-blocker, scientists showed in 2010 through a series of “awful, unkind” experiments with rats as he puts it – exposing them to terrifying experiences of the sort pretty much guaranteed to cause PTSD.
One symptom of PTSD is chronically reliving the traumatic event, in dreams and while awake.
“If you are susceptible genetically or epigenetically, in the face of terrible catastrophe your body floods with catecholamines like epinephrine and norepinephrine, and dopamine also. One of the effects is to prepare you for fight or flight. Life is terrifying,” explains Dodman. And that terrifying moment creates an indelible memory.
“These chemicals are responsible for ingraining the memory to the point that it becomes so permanent and causes flashbacks that you never forget. You can’t erase PTSD once it’s formed,” he says. “But if you take beta-blockers within hours of the traumatic event, the memories don’t imprint and you don’t develop PTSD in the first place.”
Dodman’s conclusion is that soldiers in combat should carry a beta-blocker – specifically, propranolol – in their packs and, if they see or experience something horrendous, they should take it to avert the syndrome. The U.S. army, however, decided not to devote budgets to pursuing the topic through research done on dogs, to his chagrin.
Lest you wonder why our bodies would evolve to remember something we’d much rather forget – think of this. Pretend, for a moment, you’re a mouse and you go around activity corner and see some great huge serpent that opens its maw to devour you. “You wouldn’t want to forget it’s there,” Dodman points out. “Nature has equipped us with this very vivid memory of things that are terrible, so we don’t go back there.
“Of course, you can have too much of a good thing,” he adds. And that’s where healthy aversion turns into PTSD, which is classified in the manual of psychiatry along with other phobias as an extreme and somewhat irrational fear.
Whimper if you must, but take control
Okay. The siren went off and the dog freaked, the cats hid under the sheets and the hamster scuttled into its den. What should you do?
Gallily suggests that relating to the animal’s fear is worse than unhelpful: “If we try to comfort them, we are reinforcing and rewarding their fearful behavior,” she says. Our pets like attention and come to associate fearful behavior with wonderful things. We are conditioning Fido to freak out, she avers.
Not so, says Dodman, though he acknowledges that it’s a widespread school of thought. But it’s outdated, in his view – a “chestnut that refuses to die,” rather like “dog whisperer” Cesar Millan’s use of domination in dog training, which is a highly controversial topic.
“There’s nothing ‘not to do,’” Dodman notes. “Personally, I don’t see how you can reward fear. Fear is what fear is. I don’t think you could train a dog to be fearful. What I think is that if you are terrified, your dog will pick up on that fact and that might magnify its fear.”
So what should pet owners do when the siren wails? “You need to be strong, above it all, behave with your pet just as with a child,” Dodman prescribes. “Even if you’re upset inside, take charge. Take control of the situation. It’s a much better way to be.”
What he would do if his dog experienced an immediate catastrophic and traumatic event – hyperventilating, enlarged pupils and salivating – is take him to the vet immediately and ask for propranolol, Dodman says.
Certainly, conversations with pet owners seem to support Dodman’s sense that pets pick up on our emotional state.
Eitan Pollack’s family has five dogs that quickly learned to react to sirens. If they’re inside the house when one goes off, they’ll go to the safe room, not waiting for guidance. But there’s no panic in the family or their furry friends. D., on the other hand, finds the situation absolutely terrifying and when a siren goes off, her dog pees on the floor. It’s also taken to sleeping under the couch, she says.
During the first Gulf War in 1991, your correspondent had three cats, who reacted much like I did to missile sirens. I was terrified – mainly fearing chemical attack, which never came. But every time the sirens would go off, my body would flood with fight/flight chemicals and the cats would go nuts. This time, in 2014, I don’t react to the rocket sirens at all (why is another story) and our seven cats ignore them, too.
Gallily’s best advice when a siren goes off is to let the animal hide in peace: in a closet, under the bed, under the sheets. Better yet – “I’d say the secret to success is to find a place relatively insulated from the bad noise – a safe room, or the bathroom with the shower turned on to create white noise,” she suggests.
Now, try to keep the animal occupied – a game, a tasty treat – “the best, pastrami or sausage,” says the doctor. “This isn’t the time to indulge in veganism.”
If that works, you may turn what could be a traumatic event into a relatively benign one. But if nothing works, if the animal remains locked in terror, “if nobody’s home” as Gallily puts it – drug therapy may be needed.
Spot has a problem
How do you know your pet has PTSD, and not just a sane reaction to something awful?
Say Spot is bitten by a white dog. It would be natural for Spot to avoid white dogs for some time, weeks even, and eventually forget the whole thing. If he never does, or worse – snowballs into an aversion to all dogs – then we’re talking PTSD-like extremity that requires help, says Gallily.
But if all has failed and you realize Spot’s trauma has lasted months, it’s time for external help. In the worst cases, Gallily advocates a combination of behaviorist therapy with drugs, just as one would do for a person. Yes, there are psychiatric drugs for animals – “hundreds of them,” she says. You start with drugs to stabilize the situation, and once they take effect, behavioral therapy can begin.
That’s all very well with dogs, but what about administering medicine – over weeks – to cats?
To pill your cat, you have breathe deep – and reach into your wallet. The trick lies in getting the cat used to getting SMALL balls of delicious wet food over some days. Then you hide pieces of pill in the small balls.
The balls should be tiny enough for the cat to swallow in one bite, not have to chew, says Gallily.
Think top-notch cat food and, if that doesn’t work, anchovy paste, deli, chicken breast – things kitty would cheerfully kill you to eat.
If that doesn’t work, then try to get the medicine in a tasty syrup form, she suggests. And if that doesn’t work, learn to appreciate the finer points of psychokitty.
Kitten in a tank
Under conditions of combat, it’s difficult to take a time-out to help animals, especially when you’re in the field. Some do try, though.
“Just this week I heard about a soldier in Gaza who found a small white kitten in the rubble,” says Let the Animals Live’s Altman. Not having many options, the soldier simply took the tiny thing into the tank, where it lived for some days until it could be taken to a veterinarian for treatment. “Its mouth was full of ulcers and it was infested with fleas,” says Altman.
Happily for the kitten, under the circumstances, it’s deaf – and the soldier has vowed to adopt it when he gets home from the war, Altman adds. But talk about traumatic conditions – that kitty hit the PTSD jackpot. Will he develop it? That will take weeks to find out.
Meanwhile, abandoned dogs in the south who were rescued and taken to a pound in Ashkelon barely react to sirens, if at all, attests Dr. Sharon Maoz Navon, a veterinarian with Let the Animals Live. The pound is a noisy place to begin with, and, being from the south with its frequent rocket attacks, they may have become used to the sound of the sirens, she speculates.
But more to the point, the sirens have no cost for them. “Nothing happens that causes them direct pain. If they felt a blow after the siren, they would associate the noise with pain. But in this case it’s just noise. They don’t know a missile is on the way. If a siren were to be followed by a missile falling on the pound, they’d feel differently and a proportion of them would likely develop PTSD.” So why would a dog inside a house who’s suffered no pain pee on the floor? “They can smell our pheromones. They can smell our fear,” Maoz Navon says. “And then they react with fear.”