By Dr. Becker
Not long ago I read a case report in a conventional veterinary journal about a dog diagnosed with and treated for owner-directed aggression.1 As I read the story of badly behaved Stevie, I grew more and more annoyed.
In my opinion, this dog’s case is a good example of a bad approach to treating a behavior problem that seemed to tie directly to the dog’s diet. It’s also a good example of why integrative veterinarians almost always start with a dietary review when we see a new patient.
Except in cases where an animal needs life-saving surgery or drugs, we almost always start by improving or adjusting a pet’s diet so that we get the basics — the foundation — right. Then we take a step back and observe what kinds of changes occur in the pet’s health as a result.
Once we’re confident the animal is receiving optimal nutrition, we can address any remaining physical and/or behavioral issues. In many cases, once we get the food right, there’s nothing left to address. That’s the power of a nutritionally balanced, fresh, biologically appropriate diet.
Stevie’s Background and Behavior Problems
Stevie was a 1-year-old neutered male Goldendoodle who was brought to a veterinary behaviorist for “growling, snapping, and biting at his owners since he was a young puppy.”
“The behavior occurred when his owners attempted to take items away from him (i.e., resource guarding) and sometimes when they attempted to pet him,” writes the report’s author, Dr. Lore I. Haug. As a result of Stevie’s threatening behavior, his owners avoided clipping his nails, cleaning his ears or even brushing him.
In addition, “The owners noted that Stevie frequently whined and paced at home and persistently mounted the male owner’s leg during stressful situations,” according to Haug.
Stevie came from a local breeder his owners had carefully researched. He was their first dog, and they were clearly trying to do everything right. From the age of 12 weeks, Stevie was continuously enrolled in positive reinforcement obedience classes or private training sessions.
As a result, Stevie learned basic commands such as sit and stay, and did less resource guarding. However, the training did very little to ease the dog’s anxiety and aggression. His owners dutifully reinforced his training every day. He got daily half-hour walks, and attended doggy daycare twice a week and socialized well with other dogs.
The Elephant in the Room: Stevie’s Diet
Now comes the part of Stevie’s case report that grabbed my attention:
“He was fed a limited-ingredient diet because of food allergies that caused pruritus, poor appetite, and chronic diarrhea. Poor appetite, however, impeded use of food-based rewards for training. At the time of presentation, Stevie continued to have chronic intermittent diarrhea. The owners reported episodes of poor appetite and social withdrawal at home followed by escalation of aggression within 24 hours.”
Since Stevie was only a year old when he visited the veterinary behaviorist and was already on a special diet (more than likely a processed “prescription” or “therapeutic” diet) to address food allergies, it means his symptoms appeared very early — much earlier than usual for a dog with food sensitivities.
So the poor little guy had been dealing with itchy skin, chronic diarrhea and lack of appetite since puppyhood. No wonder he had anxiety and behavior issues — he felt lousy all the time. This should have been a big red flag for Stevie’s veterinarian, if not his parents, that he had severe food intolerance issues that were very likely affecting every aspect of his life.
For crying out loud, he had “episodes” in which first he refused to eat, withdrew from his humans and then grew increasingly aggressive over a 24-hour period. That sequence of events points to a direct link between his diet and his behavior. It couldn’t be clearer! If ever there was a case for an immediate dietary review and adjustment as the first order of business, it was poor Stevie.
Stevie’s Problems Were Not and Were Never Behavioral in Nature
When Stevie was brought into the veterinary behaviorist’s exam room, he appeared anxious. He whined, jumped on his owners, hid under a chair, paced and humped his dad’s leg. He didn’t respond to verbal commands, and wanted nothing to do with the vet staff even though they had treats. Poor Stevie’s stress level was so high the vet could only complete a limited physical exam.
So here we have a dog from presumably responsible breeders who is part Golden Retriever and part Poodle — breeds known to be smart, eager to please and highly trainable — and who’s had extensive and ongoing positive reinforcement behavior training and socialization. He gets plenty of exercise, and his owners work with him daily to maintain his training and socialization. In addition, according to Haug:
“Adolescence can be one of the most difficult canine developmental stages for owners to endure; however, aggression is not a trait of adolescence. Stevie’s aggression manifested at an early age and persisted into adolescence. His aggression was unrelated to dominance or hierarchy issues with his owners. Although mounting is often considered a dominant behavior, it can also be a sign of sexual arousal, stress, play, or excitement.”
I’m not sure how anyone, at this point, could assume this dog’s problems were truly behavioral in nature.
‘Physiologic and Medical Issues’ Are the Root Cause of Stevie’s Behavior
Fortunately, the veterinary behaviorist concluded that based on Stevie’s history, “physiologic and medical issues are likely the most significant contributors to his behavior.” Unfortunately, the poor dog’s suffering wasn’t over. For reasons only his veterinary care team can explain, the first step taken was to adjust not his diet, but his behavior modification program.
“However,” writes Haug, “when his chronic GI disease flared, aggression increased and appetite decreased, which made training more difficult. Substituting petting and toys for food rewards was problematic and potentially dangerous because Stevie guarded objects and sometimes bit his owners during petting.”
I’m frankly appalled that Stevie’s GI issues (triggered initially by his food allergies) were put on the back burner once again in favor of more or different behavior training.
The veterinary care team ultimately decided they needed to deal with Stevie’s GI disease, while simultaneously finding an appropriate drug for the dog’s “baseline trait anxiety.” If Stevie were my patient, I wouldn’t assume he has a separate anxiety issue until I resolved his GI issues. Chronic gut misery has the potential to make any animal terribly anxious.
I have seen many dogs in practice that exhibit profound personality changes in the first year of life from the perfect storm of too many unnecessary vaccines blended with too many rounds of unnecessary antibiotics (puppy pyoderma, mild otitis/ear inflammation, etc.), and deworming chemicals (many given without a stool sample even indicating they had parasites in the first place) topped off with bowls of inflammatory, starch-based dry foods (full of GMOs, synthetic nutrients and AGEs — advanced glycation end products).
The result is dysbiosis, food intolerances and significant microbiome disruption, which research is showing can have a profound negative effect on mammalian behavior.
Stevie’s Treatment Plan
Stevie was started on a veterinary probiotic and a single protein diet (rabbit). Again, it’s safe to assume it was a processed kibble or canned diet. If I were treating Stevie, I’d start by transitioning him to a nutritionally balanced, fresh, novel protein diet, and supplement with both probiotics and digestive enzymes, along with an intensive protocol for dysbiosis.
Interestingly, microbiome restorative therapy has been used by many integrative practitioners, including me, to rebalance the microbiome, with notable improvement in the patient’s personality when the gut is finally healed.
An unprocessed, fresh, species-appropriate, whole food diet eliminates all the “extras” found in processed pet food (grains, starches, GM ingredients, preservatives, colorings, palatants, etc.) that have the potential to create gut issues, especially in highly sensitive dogs like Stevie.
I would simultaneously do a NutriScan food intolerance test and possibly a Canine Microbiota Dysbiosis Index test to nail down precisely what foods he’s sensitive to and how bad his dysbiosis is. This information is invaluable for a dog like Stevie with severe food intolerances.
Stevie was also put on paroxetine, a Selective Serotonin Reuptake Inhibitor (SSRI, e.g., Paxil), presumably for his anxiety. I avoid drugs whenever possible, and in this case I’m not even convinced Stevie has a separate anxiety issue, so this wouldn’t be my choice. I’d recommend his owners wait to see the results of the dietary change. If the dog’s anxiety persisted even after several weeks on the improved diet, I would probably continue to fine-tune the diet, while also adding a combination of natural remedies for canine anxiety.
What’s Ahead for Stevie?
According to Haug, once Stevie’s diet was changed and the correct paroxetine dose was determined, the diarrhea resolved. His appetite improved, he became more responsive to training, his anxiety was greatly reduced, he showed less aggression and was more sociable with humans in general.
Sadly, if my hunch is correct, this approach will only keep the dog feeling well temporarily. Chances are he’ll develop a sensitivity to either the rabbit and/or other processed ingredients in the food. When things start to go south again, he’ll probably be switched to yet another processed pet food with a different protein, and his drug dose will be adjusted upward or he’ll be given a different SSRI.
My approach would be to stabilize him with several months on a fresh novel protein diet he does well on, coupled with appropriate supplementation. Then I would attempt to introduce a different protein to see how he does. Whenever possible, it’s important to rotate protein sources to prevent another intolerance from developing.
As pet parents, we need to understand that Western medicine practices, both human and veterinary, are designed to treat disease, not prevent it. That’s why very few MDs and veterinarians connect the dots between nutrition and disease.
It’s also why there’s so little attention given to diet, even though it’s common knowledge that “we are what we eat.” The very first thing that should have happened with puppy Stevie the second he developed an itch and diarrhea, was a dietary review and adjustment. If you’re ever faced with a Stevie of your own, you’ll need to do your own research, trust your own instincts and advocate for your pet every step of the way.