Dogs are increasingly given anti-anxiety drugs for behavioural issues, but do they need them?
But when Dr Lee is gone, Mabel can be a whole different animal.
"She wouldn't eat when I wasn't home. She would bark, she would whimper, she would cry. She sometimes wouldn't toilet," Dr Lee said.
"When we went overseas recently, for the first time in her life, she escaped the yard because there was a dog sitter with her and not our family."
Now, Mabel is one of many dogs on a medication called fluoxetine — a type of antidepressant sold under the brand name Prozac.
For Dr Lee, being able to prescribe fluoxetine for dogs like hers has been "a godsend".
While Dr Lee is comfortable with providing anxiety medicines to dogs like Mabel at her clinic in Blacktown, NSW, she said it wasn't suitable for every animal.
Dr Lee takes dog owners through one-hour long consultations about their pet's history and behaviours before deciding whether to prescribe medication.
But this isn't standard across the veterinarian sector, with some vets only getting a 15-minute appointment to make the decision.
This is creating concerns from some in the industry about how many dogs are going onto anti-anxiety medication as a first-line treatment.
A study looking at millions of canine medical records in the US from 2010 to 2020 found a 10-fold increase in behavioural problems, and an increase in antidepressant medications.
Dr Lee says she's seen an increase in dogs at her clinic with behavioural issues like aggression, separation anxiety as well as problematic behaviours.
Although Australia-wide data on use of drug therapies for animals is not recorded by groups like the Australian Veterinary Association, there is evidence that their use is on the rise.
Australian pet pharmacy YourPetPA listed fluoxetine on its website as its third "best selling" prescription medication.
But Paul McGreevy, a veterinarian and a researcher of animal behaviour at the University of Sydney, said the real issue for the dogs was the management by their owners.
"The danger is that pet owners demand a medication to resolve a problem, when the problem is actually them," he said.
Dogs, he noted, have different needs and wants to humans, which we struggle to respond to, and instead, we "expect the dogs to adapt to our way of life".
"If you want a dog, expect it to do doggy things, and expect it to have doggy needs," Professor McGreevy said.
Michelle Rassool, a behavioural veterinarian who works in both general practice and a behavioural clinic, said many owners were at their wits end with their dog's behaviour when they came to her.
"The average person gets a dog to have a friend, and they are normally not skilled in behaviour modification," she said.
"People should be aware that there are multiple options for intervening in behaviour.
Instead, Dr Rassool suggested positive behavioural training, changes to the environment, and changes to what the owners expect from their dog could all help create a better dog-owner relationship.
"Is the dog getting enough exercise? Are they fulfilled?
"If we've got a dog that's worried about being left alone, we don't just give medication and leave it alone.
"Our goals are always to use medication to leverage change and then look at weaning off or reducing where we can."
Dr Rassool said training needed to occur long-term to give dogs the best chance not to develop behavioural problems.
"Going to a couple of weeks of puppy school is not going to cut the mustard," she said.
"Most people should continue to go to — at a minimum — a weekly training session for that dog's first year because there's so much developmental change."
Dr Lee noted that using positive reinforcement, rather than negative, was also extremely important to ensure the behaviour didn't become worse.
"If you've got a dog and you use either a combination of punishment and positive [reinforcement], or if you use just punishment, you're actually more likely to end up with aggression in your dog," she said.
"[Negative reinforcement] will work for a while because the dog doesn't want to be punished, but because they're not solving the underlying emotions it will eventually make the behaviour worse."
Getting the balance right between appropriate training and medication can be life or death for dogs.
"Behaviour problems are the biggest killer of young dogs," Professor McGreevy said.
"Is that because they're they are not medicated correctly? Arguably. But is it possible that they were managed inappropriately to begin with?"
Navigating the fine line of when medication might be appropriate is something Dr Lee is very aware of at her clinic.
"I've got a patient that I treat now — Stannis — and he's one of my favourites because when he used to come in … he could have been euthanised in a pound somewhere for being unmanageable," she said.
Now, although Stannis will likely need ongoing anxiety medication, his owners have also undertaken significant behavioural work, and according to Dr Lee "his quality of life is so great".
"Those are the cases that just make your heart so full because you see people who believe in their dogs, and do the work."
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