薬物に依存するペットたち／米国動物医療事情医師の一分/ウェブリブログ

薬物に依存するペットたち／米国動物医療事情

<< 作成日時： 2008/07/18 00:19 >>

　ここ15年間に人用にデザインされた薬剤を動物に使用することが増加している。製薬会社は、ペット用の「ライフスタイル」薬を販売し始めた。米国の動物は、きわめて米国的な健康問題を持っている。
　米国の犬の20%以上が体重増加であり、ファイザーのSlentrolは米国初のイヌの反肥満医薬品として昨年F.D.A.によって承認された。ファイザーのAniprylは認知症の治療に使う。分離不安の寂しい犬のためにイーライ・リリーは昨年Reconcileを発売した。プロザックとの唯一の違いは、かみ砕けて、牛肉の味がすることである。
　米国人は昨年ペット用の製品やサービスに490億ドルを使い、2003年より115億ドル増加した。特に子どもが大学を卒業したベビーブーマーにより、市場が拡張し、1匹あたりにかける費用も増えている。この中で最も成長している分野は医療である。2006年の調査で犬の77%、猫の52%が何らかの投薬を受けた。2003年には多くても25%であった。ペットへの薬の販売は最近家畜向けのものより多くなった。
　イーライ・リリーは、2007年“companion animal”部門を作って新たな薬剤を発売する予定である。ファイザーは、2003年以来この分野が57%増加し10億ドルとなり、痛みやガン、行動異常に対する薬を開発する予定という。多くの消費者は寄生虫薬のような伝統的な薬剤を使っているが、少なくとも行動異常に対して1500万ドルが使用されたと概算されている。ペットオーナーは、小さな行儀の良い子どものようでいて欲しいと思っている。
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Pill-Popping Pets
http://www.nytimes.com/2008/07/13/magazine/13pets-t.html?_r=1&oref=slogin
By JAMES VLAHOS　Published: July 13, 2008

The practice of prescribing medications designed for humans to animals has grown substantially over the past decade and a half, and pharmaceutical companies have recently begun experimenting with a more direct strategy: marketing behavior-modification and “lifestyle” drugs specifically for pets. America’s animals, it seems, have very American health problems. More than 20 percent of our dogs are overweight; Pfizer’s Slentrol was approved by the F.D.A. last year as the country’s first canine anti-obesity medication. Dogs live 13 years on average, considerably longer than they did in the past; Pfizer’s Anipryl treats cognitive dysfunction so that absent-minded pets can remember the location of the supper bowl or doggy door. For lonely dogs with separation anxiety, Eli Lilly brought to market its own drug Reconcile last year. The only difference between it and Prozac is that Reconcile is chewable and tastes like beef.

Doggy diet pills may be plainly absurd, but scientists in an expanding field known as behavioral pharmacology say that the combination of new drug therapies and progressive training techniques can solve problems that in the past almost always resulted in euthanasia. The supposed effectiveness of psychiatric medicines in treating mood and behavior issues is prompting new questions in the centuries-old debate over what, exactly, separates mankind from the beasts. If the strict Cartesian view were true ― that animals are essentially flesh-and-blood automatons, lacking anything resembling human emotion, memory and consciousness ― then why do animals develop mental illnesses that eerily resemble human ones and that respond to the same medications? What can behavioral pharmacology teach us about animal minds and, ultimately, our own?

ON SEPT. 5, 1379, A TRIO OF French pigs, agitated by the squealing of a piglet, bowled over their keeper’s son, who died shortly thereafter of the injuries. As E. P. Evans recounts in his 1906 monograph, “The Criminal Prosecution and Capital Punishment of Animals,” “the three sows, after due process of law, were condemned to death” along with several other pigs who had “hastened to the scene of the murder and by their cries and aggressive actions showed that they approved of the assault.” (The accomplices were later pardoned.) Fast-forward to December 2007 to witness a curious animal proceeding of the modern era: Mitzi-Bitzi, a lap dog, modeling a $118,000 diamond bracelet at the opening of Chateau Poochie, a pet hotel and spa near Miami. “She’s just so special,” her owner, Marilyn Belkin, told me later, as if that explained things. The sows and Mitzi got opposite treatment, but the beliefs of Belkin and the pig prosecutors weren’t so different. In medieval times and in the present, we often act as if animals had thoughts, feelings and desires that resemble those of people. How else could you justify the porcine death penalty; why splurge on a blueberry facial when a simple roll on the lawn would do?

Marketers have a new name for the age-old tendency to view animals as furry versions of ourselves: “humanization,” a trend that is fueling the explosive growth of the pet industry and the rise of modern pet pharma. Americans forked over $49 billion for pet products and services last year, up $11.5 billion from 2003; other than consumer electronics, pet products are the fastest-growing retail segment. The market expansion is being driven both by more pets and by more spending per pet, especially by affluent baby boomers whose children have graduated from college. A third of the total spending, and the fastest-growing category, is health care, with treatments formerly reserved for people ― root canals, chemotherapy, liposuction, mood pills ― being administered to pets. “I get asked all the time, ‘What is it with this humanization ― do we suddenly love our pets a whole lot more?’ ” says David Lummis, who analyzes the pet industry for the market research firm Packaged Facts. “My theory is that it’s always been there, but it’s been sanctioned now. It’s not just the crazy cat lady. It’s marketers and all of this consumer advertising that have made it O.K. to spend tons of money on your pet.”

Humanization has pharmaceutical companies salivating like Pavlov’s dogs. Surveys by the American Pet Products Manufacturers Association found that 77 percent of dog owners and 52 percent of cat owners gave their animals some sort of medication in 2006, both up at least 25 percentage points from 2004. Sales of drugs for pets recently surpassed those for farm animals. Eli Lilly created its “companion animal” division at the beginning of 2007 and over the next three years hopes to release several other drugs. Pfizer, whose companion animal revenues have grown 57 percent since 2003 to nearly $1 billion, hopes to develop medications for pain, cancer and behavioral issues. Most consumer spending is still on traditional pet medications like antiparasitics, but Ipsos, a marketing research firm, estimates that at least $15 million was spent on behavior-modification drugs in the United States in 2005. “As people are seeing more complex and sophisticated drugs for themselves, they want that same quality for their pets,” Dr. Melanie Berson, a veterinarian at the F.D.A.’s Center for Veterinary Medicine, has said. People’s willingness to employ behavior-modifying medications stems in part from a growing desire for more convenient, obedient household animals. “Our expectations are really going up,” Lummis says. “Owners want their pets to be more like little well-behaved children.”

Potent as a marketing trend, humanization has long been scorned as scientific practice by researchers working in the behaviorist tradition of B. F. Skinner. In “Inside the Animal Mind,” George Page summarizes the reasons: “Since we cannot get inside the animal’s mind . . . and since the animal cannot report what’s going on ― not in a ‘language’ we can readily understand ― all we have left are guesses and speculation fatally tainted by anthropomorphism.” Strict behaviorists focus instead on observable stimulus-response conditioning: for example, a puppy learning to sit to receive a treat. Actions that cannot be explained this way are usually attributed to blind instinct. As such, hard-core Skinnerian philosophy amounts to a perversion of cogito ergo sum: I can’t prove that animals think, therefore they don’t. In dealing with problem pets, veterinarians with a behaviorist bent don’t concern themselves so much with what might be happening inside the brain of the animal or try to correct neurochemical imbalances with drugs. Instead, a compulsive or anxious animal is seen as one that just needs to be better-trained.

The debate about animal minds is at least as old as Aristotle, who posited that men alone possess reason. The 17th-century French philosopher Nicolas Malebranche wrote that animals “desire nothing, fear nothing, know nothing,” while Voltaire asked, “Answer me, mechanist, has Nature arranged all the springs of feeling in this animal to the end that he might not feel?” Darwin’s view was, Of course not. In “The Descent of Man” he wrote, “We have seen that the senses and intuitions, the various emotions and faculties . . . of which man boasts, may be found in an incipient, or even sometimes in a well-developed condition, in the lower animals.” The staggering assertion of Darwin’s theory is that evolutionary continuity applies not just to bodies but to brains. “The difference in mind between man and the higher animals, great as it is, certainly is one of degree and not of kind,” he wrote.

For much of the 20th century scientists willfully dismissed this line of thinking, which has been rekindled only in the past three decades with the rise of a field known as cognitive ethology. The guiding belief is that while it is scientifically baseless to assume that animals think and feel just as we do, it is equally foolhardy to assume that they don’t think and feel at all. In laboratory experiments and field observations, practitioners have presented evidence of analogical reasoning by apes, counting by rats and the capacity of pigeons to distinguish the paintings of Picasso from those of Monet. Researchers have demonstrated that animals can grasp basic abstractions like “same” and “different” and use mental flexibility to solve novel problems in the laboratory for which hard-wired instinct couldn’t have prepared them. It is impressive but perhaps unsurprising that a parrot was taught to categorize colors or that dolphins learned the syntactic distinction between “take the surfboard to the Frisbee” and “take the Frisbee to the surfboard” ― we already tend to think of these animals as being smart. More eye-opening are glimmers of cognition from way down the phylogenetic chain. Research has shown that bumblebees can remember which flowers they have already visited and that two-inch-long cockroaches from Madagascar can tell the difference between a familiar person and a stranger. (If the bug hisses loudly at you, it’s time to introduce yourself.)

Cognitive ethologists have had more difficulty gathering evidence for animal emotion. To any pet owner who has stroked a purring cat or watched a dog cavort when his chow hits the bowl, it seems intuitively obvious that animals experience feelings. But intuition isn’t hard science ― it’s just more humanization. Enter behavioral pharmacology, which has provided a tantalizing new window into the animal mind. Dr. Nicholas Dodman, who pioneered the field and founded the Tufts University Animal Behavior Clinic, says that skeptics of the premise that animals have emotional states used to ask him how he could say that a pacing, hyperventilating dog was actually feeling anxious. “Well, how about this?” Dodman would reply. “We’ll give him an antianxiety drug and see what happens.”

THE GROUNDS OF THE CUMMINGS School of Veterinary Medicine at Tufts sprawl over 640 acres of rolling greenery in central Massachusetts. When I arrived to visit in March, one of the first things Dodman told me was that the campus used to be the site of a state mental hospital. Like other facilities, it had been shuttered in the 1960s following the revolutionary discovery of drugs that treated schizophrenia and other disorders so effectively that many patients no longer required institutionalization. “Ironically, this paved the way for our school, our behavior program, and novel pharmacological treatments for animal behavior problems,” Dodman said. Or, as he later said, “we traded one group of inmates for another.”

Dodman, an Englishman, began his career in the early 1970s as a roving country vet in the tradition of James Herriot; he went on to write a popular series of advice books for pet owners, the latest of which is “The Well-Adjusted Dog.” In 1981 he moved to the United States to become a professor of anesthesia at Cummings. Drugs interested him greatly but comatose patients, increasingly, did not, and he began to wonder: Could medications transform veterinary behavioral medicine just as radically as they had human psychiatric care? He says he quickly realized that the field was “completely wide open, like virgin snow.” At a veterinary conference in the late 1980s, he presented his vision of the psychoactive frontier and “saw jaws drop around the room. It was like, ‘Who is this strange masked man?’ ” Three decades later, “it’s almost mainstream for behaviorists to know something about pharmacology,” Dodman says.

Inside his small office, Dodman, wearing a tie-and-tasseled-loafer ensemble topped by a white lab coat, received the day’s first patient. A muzzled dog on a short lead towed Joe and Mahala Richards, from Mendon, Mass., into the room. “So here we have Zoey, who’s a yellow black-mouthed cur, 5 years old, and you got her at 7 months,” Dodman said. “I’m already picking up that she’s fearful and anxious, and that usually stems from a disturbed childhood.”

“We know she was abused,” Mahala said.

“There you go,” Dodman replied.

Joe said Zoey’s problem was that she sometimes attacked when food was around. The worst incident had happened a week ago when Mahala was watching television and reached for a piece of cheese. “She just came after me,” Mahala said. Joe added, “Zoey had her on the couch ― she’s screaming at the top of her lungs― and Zoey just kept going at her hands.” Mahala held up a scarred wrist. “My God, that’s nasty,” Dodman said. He listened for 20 minutes and then issued a diagnosis: something called “conflict aggression,” which meant that occasionally Zoey forgot that she didn’t need to fight to get her share of food. Zoey was to be kept from hot dogs, peanut-butter bones and any other culinary provocations. High places like beds were forbidden (elevated positions can make dogs feel more confident), and exercise was essential. Outlining what he called the “nothing in life is free” program, Dodman said that Zoey should be made to sit before feeding and that affection was to be rationed. The overall goal was to get Zoey to respect the leadership of her owners, which would raise her inhibition to attack. These behavior modifications alone might be enough to cure Zoey, Dodman concluded.

“We don’t want to have to put her down,” Mahala replied quietly.

“No,” Dodman said. “A serious bite is a risk factor for euthanasia for the dog, which is why another component of the program might be some medicine. If we were to ask Zoey: ‘Look, if you slip up in the future, and you bite someone like that again, the chances are you’re not going to come out of it alive. But we can make you feel better if we give you some medicine like, for example, Prozac. Would you like to have the medicine that might save your life?’ And she might go, ‘Grrr-rrr rrrup ― yeah, yeah, I’ll take the medicine.’ It’s a lifesaving thing.” Joe and Mahala left a half-hour later with a scrip in hand.

Aggression is the leading issue that brings animals into clinics; it and other behavior problems are the top reasons that pets are surrendered to shelters. Half of them are euthanized, roughly three to four million animals per year, and an equal number are believed to be put down in private practices. Treatment with psychoactive medications is then a very real alternative to lethal injection. Prozac, a selective serotonin reuptake inhibitor (S.S.R.I.), prolongs the effects of that neurotransmitter to reduce impulsivity, stabilize moods and lower anxiety, Dodman says. He is friends with the noted Harvard psychiatrist John Ratey, and they once compared the drugs they employ to treat violent people and animals. “You superimpose my portfolio on top of his, and it’s the same thing,” Dodman says. He has patented his S.S.R.I. approach and is working with a pharmaceutical company, Accura Animal Health, that plans to bring it to market as the first F.D.A.-approved treatment for canine aggression. (The current use of Prozac and similar drugs is prescribed off-label.)

Aggression is a feline problem too. A few weeks after visiting Dodman, I went to the home of a man in West Los Angeles whose pet was on Prozac. The owner, Doug, asked me not to use his last name because he didn’t want business associates to know about what he called his “cougar psycho little miniature stalker” ― Booboo the cat.

The first incident took place four years ago after Booboo ate some decorative dried flowers. Booboo scaled his cat tree and sat there with his eyes “a little dilated and cross-eyed,” Doug said. He started “growling like a banshee,” released “a high, shrill wail” and lunged. “He ripped my leg up and wouldn’t let go.” Doug fled, and Booboo pursued. Finally he was able to trap the cat in a bedroom. From then on Booboo was different. He would periodically ambush Doug. Over time, Doug noticed that attacks were more likely if he smelled at all abnormal ― for instance, if he had been near a woman wearing perfume ― so he would take a shower after coming home and then change into his designated cat-wrangling outfit.

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http://www.reconcile.com/
While you may not be familiar with canine separation anxiety, you are probably familiar with its symptoms. While you are gone, your dog may do one or several of the following:

* Chew destructively
* Bark or whine
* Inappropriate urination and/or defecation
* Drool
* Pace
* Tremble
* Vomit
* … or worse

Separation anxiety is a clinical condition in your dog's brain. Your pet is not a bad dog. Your pet's behavior is the result of separation anxiety.

Reconcile™ is a once-daily, chewable, flavored tablet for the treatment of separation anxiety in conjunction with a behavior modification plan.

Reconcile™, approved by the FDA, helps manage separation anxiety and improves your pet's receptivity to a simple training plan also called behavior modification. The four-step BOND™ training plan focuses on reinforcing positive behavior.

Reconcile™ and the BOND™ training plan form a logical, easy-to-follow program that makes it possible for you to treat and manage separation anxiety and restore a happy, healthy relationship with your pet.

The most common adverse reactions recorded during clinical trials with Reconcile™ were calm or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and, in infrequent cases, seizures. Click here for important safety information and full product label (PDF).