Thursday, May 12, 2016

Does PTSD Cause Brain Damage in Dogs?

How to Restore Brain Plasticity in Dogs With PTSD

“PTSD, depression, and other psychiatric disorders cause what is called ‘negative neuroplasticity,’ including activation of abnormal circuitry in the brain, and strengthening of those circuits over time. They also cause shrinkage … and decreased connectivity between parts of the brain.”                        —David J. Hellerstein, M.D.

How Common Is PTSD in Pet Dogs?
Post traumatic stress disorder is probably much more common in dogs than most people realize. We tend to think that it’s only found in military service personnel, including canine members of the armed services. But deeply stressful events have a lasting negative effect on brain plasticity and learning even in pet dogs. This is often clear in dogs who’ve suffered physical abuse by their owners (or trainers), but can also be seen in some dogs who’ve suffered a serious illness during their fear or social developmental phases and had to be kept in a kennel at the vet’s office for an extended period, or dogs who’ve been traumatized by attacks from other dogs, etc. Stress is the common denominator, not necessarily exposure to violence or physical trauma.

Of course, just as in humans, not all dogs experience stress in the same way. Some are more sensitive than others. But those that are more sensitive are deeply affected by stressful events, and can develop some symptoms that are quite similar to those found in human beings who suffer from PTSD, including neurological damage and memory loss.

One of the characteristics of PTSD is that the original trauma is continually re-experienced by the victim. And each time the stress response is triggered, or re-triggered, a cascade of hormones and neurochemicals are released into the bloodstream, causing oxidative stress resulting in brain damage. This damage to neural circuitry makes PTSD one of the most difficult psychological illnesses to treat.

Stress and Neuronal Toxicity
Neuroscientist J. Douglas Bremmer writes: “Stress in animals is associated with damage to neurons in the CA3 region of the hippocampus … and inhibition of neurogenesis [new cell growth].” Bremmer also says that high levels of glucocorticoids (via the body’s stress response) are also associated with deficits in new learning. [1]

Glucocorticoids—released during stress-related experiences—in turn cause an increase in glutamate, an amino acid that plays a key role in facilitating long-term connections between neurons, connections that are vital to learning and memory. This suggests that the more stress a dog experiences during a traumatic experience, the stronger his memory of a stressful event becomes and the more difficult it is to restore normal working memory, not to mention normal emotional and behavioral function. This is why it’s not only difficult to keep the dog who suffers from PTSD from over-reacting to certain triggers, it can also be difficult to teach him new behaviors as well.

Mind you, I’m paraphrasing and condensing some very complicated research into what I hope are easily understood bytes of information. But what essentially happens is that the fear circuits (connecting the amygdala, hypothalamus, and hippocampus), which are normally capable of being inhibited to some degree by the impulse control centers in the prefrontal cortex, create a kind of semi-permanent loop, blocking the higher parts of the brain from exerting impulse control while decreasing the ability of the hippocampus to provide normal working memory.

The dog’s ability to control his behavior is reduced dramatically. He’s classified as a “reactive” dog, or out-of-control, or hyper-vigilant.

Exposure Therapy or Play Therapy?
It may seem strange but some human victims of PTSD—specifically military personnel—have had their symptoms moderated a great deal, and in some cases apparently cured, by playing violent, virtual reality video games like Halo.

Some in the field believe that these games act as a form of “exposure therapy,” where the patient confronts a feared thought, image or memory associated with a past traumatic event. I’m not convinced that that’s true. I think what’s needed is research on whether these games can also facilitate healing in cases of PTSD that don’t involve combat, such as victims of sexual abuse, or witnesses of a major tragedy, etc.

Another possible way of determining if it's the content of the game or the act of playing that has a moderating effect on PTSD symptoms would be to have military or ex-military personnel play violent virtual reality games set in a make-believe world of sword and sorcery, as in the Warcraft series.

Play of any kind, and in any species, always has an element of aggression built into it. This is as true of a game of chase at the dog run as it is of working the controls of a violent video game. What differentiates play from actual aggression is the lack of real danger to the players: the moment fear enters the equation, the fun stops.

Another aspect of play is the mostly unconscious process of pattern recognition, a process that also tends to release dopamine, one of the brain’s “feel-good” chemicals. The more complicated the game (up to a point), the more dopamine is released and the better it feels to play. Plus, generally speaking, the more playful a dog is the more resilient and adaptable he is as well.

When working with dogs who have PTSD I’ve found that play is an essential part of the healing process. In some cases it can be play with other dogs, but the most important type involves the owner or trainer playing games like fetch and tug-of-war, where the dog gets to bite a toy, preferably as hard as he can. The harder a dog can bite a toy in play, the more pleasurable, and the more therapeutic it is for him.

There are caveats, of course. The dog has to “know it’s a game.” If the dog takes things too seriously, it’s only a matter of time before he flips over into real aggression. So if your dog doesn’t know it’s just a game, DON’T PLAY until you can get him to relax. The way to recognize the difference is in how tense or relaxed the dog’s body seems during play.

How do you do get a tense dog to relax?

You have to work very slowly, never act in a threatening manner toward the dog (this includes things like scolding or correcting the dog physically). You also have to find ways to gently activate the dog’s urge to play without reaching or even coming near his threshold. This means you work in small increments. Very small.

It also means that you can’t take things too seriously yourself. You have to relax as well. Long, protracted moments of just being with the dog, and deep tissue massage of a dog’s shoulders and haunches can be very therapeutic. So can Tellington Touch techniques.

It’s also important to remember that in cases of PTSD, the dog’s “fear circuits” are capable of overriding his “pleasure circuits” in a heartbeat. But if you can generate a feeling of trust, and a deep emotional bond with the dog, he’ll slowly gravitate more and more toward wanting to feel pleasure than to re-live his old fears.

There’s another important feature built into play; it requires high levels of impulse control. And finally, rough-and-tumble outdoor play tends to release tremendous amounts of BDNFs—brain-derived neurotrophic factors—associated with brain plasticity. Depending on how much trauma the dog has experienced, I believe it’s possible that just by getting a dog with PTSD to play with you outdoors, you can begin to reverse some of the brain damage and cognitive deficits that might otherwise make the dog’s recovery seemingly impossible.

Is that all there is to it?

No, there are a few other tricks I find helpful.

Transitional Objects, Fear, and Impulse Control
Always remember that the dog with PTSD doesn’t have the same capacity for impulse control, or for learning new behaviors, as a dog who hasn’t been traumatized. That doesn’t mean he can’t learn impulse control. It just means you have to take things more slowly.

When my dog Freddie was having panic attacks I found two strategies that helped him with his symptoms during the period where I was slowly working on getting him to play with me, and teaching him impulse control tasks. One was barking on command (fighting the fear), and the other was carrying a pacifier in his mouth on our walks.

Whenever Freddie went into his panic state—which could be triggered by any number of noises—I would tell him to “Speak!” As soon as he barked he went from being a terrified pooch—ears back, shoulders down, tail tucked, trying to run off in any direction—to his usual self.

This works better in cases of fear than it does with dogs whose PTSD manifests as aggression. But it still works.

The other tactic I took was having him carry a toy of some sort in his mouth. I got the idea from seeing how some dogs I knew tended to seem less anxious when their owners let them carry a tennis ball or other object around in their mouths. It worked wonders for Freddie, and many other dogs as well.

I’ve found that by using these strategies—taking things slowly, earning the dog’s trust, teaching the dog to play, using transitional objects, and teaching impulse control—I seem to have been able to reverse symptoms of PTSD in some dogs completely.

I hope these ideas can help your dog as well.

“Life Is an Adventure—Where Will Your Dog Take You?”

1) "Traumatic stress: effects on the brain," J. Douglas Bremmer, MD; Dialogues in Clinical Neuroscience, December, 2006.

Wednesday, April 27, 2016

Free Workshop on Diagnosing and Treating Canine PTSD

The next free workshop on diagnosing and treating Canine PTSD will be held on Sunday, November 26th, 2017, at Whiskers Holistic Pet Care, 235 East 9th Street, New York, NY, from 2 - 5 P.M.

Tuesday, March 1, 2016

Oxytocin & PTSD

How Oxytocin Has On Adverse Effect on Dogs With PTSD

What Is Oxytocin?
You may have heard about oxytocin, a neuropeptide that facilitates social bonding in mammals. For instance, some studies show that when we pet our dogs it increases blood-serum levels of oxytocin in both the dog and owner. Oxytocin is also released when dogs and dog owners make eye contact. Other studies show that reducing levels of oxytocin causes normally monogamous prairie voles, who usually mate for life, to become promiscuous, while increasing oxytocin levels cause normally promiscuous prairie voles to become faithful companions. Oxytocin has also been connected with feelings of trust and generosity.

Oxytocin is a neuro-chemical, a hormone found in mammals, which is released in both males and females. But women have a stronger response to its effects because oxytocin is enhanced by estrogen. The corollary of oxytocin in men is vasopressin. Its primary functions are water retention and constriction of blood vessels. It also has an influence on male sexual and social behaviors as well as paternal feelings.

Oxytocin also facilitates childbirth by causing the uterus to contract and helps shrink the uterus after delivery. Oxytocin is also released when a newborn suckles at his mother’s breast. It also promotes the emotional bond that takes place between mother and child. For instance, female rats generally dislike newly born rat pups. But after they’ve given birth, they develop strong feelings of attachment for them.

When a child is born, the interactions between mommy and baby cause an increase in the infant’s levels of the hormone, creating a kind of oxytocin glow, ensuring that mother and child will form a deep and lasting bonds.

Oxytocin levels go up five-fold during sex. In men, however, they drop almost immediately afterwards while vasopressin levels go up, which explains why men often feel a sudden sense of separateness from their partners after sex.

The Dark Side of Oxytocin
In the summer of 2013 the owners of a dog I had been working with for several years had a baby. Early in his life, this dog developed PTSD as a result of serious abuse by his original owner (a male). Before the birth of their child the dog had been very careful not to exhibit any aggression toward the husband, but was biting the wife, his dog walkers, and me. Strangely enough after the baby was born, the dog began acting in a very, though obsessively “loving” manner toward the wife and baby, but became guarded and aggressive toward the husband, a complete turnaround.

Before the baby was born the couple expressed their concerns that the dog might want to bite the baby. I told them I didn’t think that would happen because, as far as I knew, oxytocin would probably have a calming effect.

Within a few weeks, though, a strange thing happened, one that I hadn’t anticipated. The dog developed a kind of obsession for mother and baby. He couldn’t be separated from them. If left alone he would whine and cry. When he was with them, he was constantly trying to lick the baby’s toes and skin and fingers. This suggested to me that oxytocin was at work, creating a bond between dog, mother and child. However, it wasn’t a healthy kind of bond at all. Like I said, the dog seemed obsessed.

Then another strange thing took place. Whenever the husband was home, especially when he was interacting with mommy and baby the dog became extremely agitated and began growling and snarling at him, something he’d never done before. They thought he was “protecting” the baby. Strangely enough (or perhaps not so strangely), the dog was fine when he was alone with the husband. They got along very well. The dog only became agitated when the four or them were together: mommy, daddy, baby and doggie.

I suggested that they keep the dog crated when the husband was home with the baby. And that the husband should take the dog on long walks, play fetch and tug with him outdoors, and work on getting him to hold a long down/stay.

Then, a week or so later I came across a study showing that oxytocin can sometimes re-awaken and even strengthen memories of past abuse. (“Fear-enhancing effects of septal oxytocin receptors;” Nature Neuroscience, 2013.)   

“Oxytocin is usually considered a stress-reducing agent based on decades of research,” said Yomayra Guzman, the study's lead author. “With this novel animal model, we showed how it enhances fear rather than reducing it, and where the molecular changes are occurring in our central nervous system.”

“So that’s what’s going on,” I thought. The poor dog’s PTSD has come back to haunt him. He’s like the war veteran who hears the sounds made by a local news helicopter, and, in his mind, he’s instantly transported back to the battlefield. This dog felt he was back in his original home with his original, abusive owner. He didn’t see the husband coming home to hurt the baby. He didn’t see the husband at all, at least not while he was near the mother and baby. All he saw was his original attacker coming to attack him.

This is a very important point, because dogs form basic templates in their minds based primarily on emotional valences. This is why, for instance, a very smart border collie featured in a famous Youtube video (above), keeps dropping a stick at the feet of a statue of Alan Turing, hoping to get the statue to throw the stick for him to chase. He doesn’t see the statue, he sees a template of a human being (or humanoid) sitting in a position that indicates he’s ready to play with the dog. For dogs, deeply emotional past experiences—positive or negative—outweigh present circumstances.

The dog's owners decided that the dog needed to stay with me for a while, so that I could work out some of the emotional kinks in his system. They were right. As long as the memories of past abuse were constantly being re-triggered in the now-moment by the oxytocin—which dissipates within a few months after child birth—it would be a losing battle.

So I began doing the 5 Core Exercises with him again, deliberately putting the dog in stressful situations, initially just mildly stressful. Then I steadily and gradually started injecting more and more stress into the mix so as to increase his carrying capacity.

He’s fine now, by the way, a much different dog. We’ll see if that changes if his owners decide to have another child. 

But I dont think it will.

Lee Charles Kelley
“Life Is an Adventure—Where Will Your Dog Take You?”

Update: They had a baby girl in November, 2017. And everything is fine with the dog, mommy, daddy, and the now 4-year old boy.