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56 SEPARATION-RELATED DISORDERS PEER REVIEWED crated, the pet should not wear a collar because of strangulation risk with escape attempts. 14 Block off areas most likely to be damaged and clean soiled areas of the residence 13 with a bacterial/enzymatic cleaner, like Anti-Icky- Poo (MisterMax Quality Products) or other cleaners such as Urine Off or Zero Odor. 20 Play the radio, white noise, or music to prevent the pet from retriggering to external stimuli. 13 Instruct the owners to avoid punishment, such as yelling, hitting, and shock collars. These types of treatments are contraindicated 13,16 because they can increase anxiety and make the course of treatment longer. Be sure to remind clients that their pet is suffering from an emotional disorder and no amount of punishment will fix it. Pair owner departures with positive things by setting up food-searching games and food toys 3,13 before the first signs of distress. Adjust the pet's feeding schedule to increase the likelihood of eating when the owner is gone, 8 and use enticing food. Recommend that the owner keep departures and returns low-key. 13 A regular and predictable routine should be provided. 16 Consider medication. Medications can directly decrease anxiety and panic. 14 Situational medications that take effect within 1 to 2 hours of administration can be essential in the treatment of separation anxiety and should be considered at the first appointment. Ideally, the medication would take effect before the patient shows clinical signs. Benzodiazepines (avoid diazepam in cats), trazodone, gabapentin, and clonidine can be used to reduce anxiety quickly. 13,14 Acepromazine is not a good anxiolytic so should not be used alone, but it can be used at low dosages as an adjunct if additional sedation is needed. 13 Step 3: Institute Behavior Modification So the Pet Can Learn to Stay Calm for Departures Proper implementation of behavior modification maximizes the likelihood of a long-term positive outcome. In our experience, behavioral treatments increase the probability that medication doses can be reduced over time, if that is a goal of treatment, and decrease the likelihood of relapse. Ideally, a veterinary behavior technician within the practice would conduct behavior modification sessions in clear communication with the veterinarian so the plan and medications can be adjusted efficiently. All treatments should focus on conditioning the pet to feel calm and happy during departures by using things the pet likes. Independence and relaxation exercises are a cornerstone of treatment. 8,13 Examples include food-searching games at an increasing distance from the owner, 10 relaxation exercises, and rewarding calm behavior. 16 Treatment can be made simple in some cases by using food toys and remote treat-dispensing devices. Structured interactions between the pet and the owner through positive reinforcement (eg, cueing the pet to sit before the pet receives attention) can promote consistency and predictability in the pet's life. 13,14 Adequate exercise and enrichment should be given to meet the pet's general needs. 13,16 Additional behavioral modification includes uncoupling departure cues and desensitization and counterconditioning to departures. 13,14 Dogs can be taught to be comfortable with confinement if that is a goal of the owner or helps the dog feel safe. 13 Caution should be exercised when recommending this because it can take months for often little yield. As a warning, if pets are pushed too fast through these protocols, these methods can backfire and actually sensitize the pet to departures, making the patient worse. 14 If you do not feel comfortable enacting these treatments and do not have a behavior technician on whom to rely, refer your patient to a board-certified veterinary behaviorist. If such a specialist is not available in your area, try the American Veterinary Society of Animal Behavior ( avsab.org ) to find someone qualified. Step 4: If Indicated, Prescribe Longer-Acting Pharmaceuticals Longer-acting pharmaceuticals may be indicated if owners have a difficult time predicting departures (making situational medications difficult to implement) or if situational medications