The treatment of FRA is similar to other medical disorders. First, stimuli that cause clinical signs should be identified so they can be avoided or addressed through behavior modification. Just as a client may be advised to avoid playing Frisbee with a dog that has osteoarthritis (OA), clients who own dogs displaying FRA should be instructed how to avoid situations that trigger a fearful or aggressive response. For example, if the dog is aggressive on the couch, advise the client to block access to the couch. These simple measures can reduce clinical signs significantly in many cases.
A veterinarian treating a patient with OA may discuss with the owner that an agility career is not a realistic expectation for the patient, but pain-free leash walks are a reasonable goal. Similarly, veterinarians should discuss reasonable goals with owners of fear-related aggressive dogs along with practical ways to achieve a positive outcome. For example, if a dog is aggressive toward the owner’s grandchildren, having the dog in the same room as the children as a form of treatment may be too dangerous or unethical to attempt. Owners should be advised that interactions between their dog and grandchildren may be an unrealistic goal, that working with the children to modify the behavior may not be an option, and that boarding or confining the dog when the grandchildren are visiting may be the safest and least stressful option for all concerned.
Continuing the analogy of a patient with OA, medication may be used to lower pain and discomfort so that physical therapy can be instituted. In the same way, psychopharmaceutic medications can be used to treat FRA by lowering neurochemical mediators of fear and arousal, altering the patient’s emotional state thereby making treatment more productive. Selective serotonin reuptake inhibitors and tricyclic antidepressants can help to mediate neurochemical imbalance. Multiple types of medications can be effective in the treatment of FRA. Research on mechanisms, duration of action, latency to positive clinical effect, and interactions should always be performed before starting medical treatment.
Just as the patient with OA would be sent to physical rehabilitation, the patient with FRA begins with a behavioral therapy plan. The first behaviors to be taught are control behaviors (ie, behaviors that do not change the pet’s behavioral state but control its actions), which are incompatible with the aggressive response (ie, cannot be exhibited at the same time). For example, if a dog is aggressive on the couch, it can be taught to go to a specific location away from the couch, such as a dog bed, and stay there on cue. Once control behaviors are in place and the dog is regulated neurochemically, counterconditioning techniques (eg, changing the pet’s behavioral response by pairing a positive stimulus with a negative stimulus) are instituted for maximum alteration in behavioral response.
Behavioral therapy (behavior modification) plans should be made by the veterinarian and implemented by a qualified veterinary technician or a qualified dog trainer if a veterinary technician is not available. Because the dog training industry is unregulated with no legal certifications or verification of claims, cases should not be turned over to dog trainers without a plan—constructed by the veterinarian—in place to guide treatment. Each time a trainer sees the patient, the veterinarian should receive a report so medical treatment and follow-up can be altered if necessary. Cases outside of the scope of the veterinarian’s knowledge should be referred to a board-certified veterinary behaviorist.
Information on how to select a qualified dog trainer is available through the American Veterinary Society of Animal Behavior.