Treating dogs with severe separation anxiety

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Chill Pills: Behavior-altering drugs can help dogs with phobias or anxiety disorders – but you have to learn which ones work best in each case. For years, Piglet reacted only to high-pitched beeping noises, such as cell phones, pagers, the microwave oven, the theme from The Twilight Zone, etc.
Piglet was normally a confident dog, cautious with people but not fearful, comfortable with other dogs, eager to explore new places.
As we could avoid “scary noises” most of the time, her anxiety attacks were not frequent and she was able to live with her phobias pretty well. Following is a summary of the different types of anti-anxiety drugs, what they are commonly used for, and what you need to know before using them. See below for more information on dosages, interactions, side effects and contraindications. Benzodiazepines are fast-acting drugs that can be used on an as-needed basis for dogs that need periodic help with anxiety, such as those afraid of thunder or fireworks.
Benzodiazepines commonly used with dogs include alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium). A combination of Prozac (fluoxetine) and Clonidine would be his first choice now for dogs with storm phobias, while in the past he has used clomipramine and alprazolam (Clomicalm and Xanax).
Diazepam is more sedating than the other drugs in this class, and may have less anxiolytic effect, so it is generally not recommended for anxiety. Because buspirone has few side effects and does not cause sedation, it is an excellent first choice for treating dogs with aggression or anxiety that is not too severe. I learned about buspirone from Amy Cook, a dog trainer in Oakland, California, who has a special interest in fearful dogs.
Combining Clomicalm with behavior modification therapy (BMT) for separation anxiety achieves a faster response than using BMT alone, but after three months, the results are similar. Tricyclic antidepressants are used with dogs to treat anxiety, panic, phobias, and obsessive compulsive disorders, such as shadow chasing and lick granulomas.
The tricyclic antidepressants most commonly used with dogs are amitriptyline (Elavil) and clomipramine (Clomicalm).
My own vet prefers to use amitriptyline as the first choice when treating anxiety, not because it is the most effective drug, but because he feels it is safer than clomipramine. Clomipramine is best suited for situations involving anxiety, including separation anxiety, as opposed to reactivity.
I tried giving Piglet  amitriptyline for her noise phobia before she developed generalized anxiety disorder. Aggression and separation anxiety generally respond very quickly (within a week) to the use of medications, while depression and compulsive behavior may take up to several months. Tryptophan, an amino acid supplement, can be combined with Prozac for dogs with low serotonin levels. SSRIs are antidepressants and anxiolytics, used to treat aggression, separation anxiety, generalized anxiety, panic disorders, and obsessive-compulsive behaviors. It is important to do blood work before starting, especially for older dogs, and monitor periodically after that. Fluoxetine (Prozac) is the most commonly used SSRI with dogs, and has the longest half-life in people. Fluoxetine is used to treat aggression, obsessive-compulsive disorders, separation anxiety, panic and avoidance disorders, including post-traumatic stress disorder. Suddenly, Piglet became progressively worse over several days, culminating in a full-blown anxiety attack; I do not know what caused it.
I have learned that when you find medications that work, you need to continue to give them for some time.
In hindsight, I wish I had tried using alprazolam for our walks when Piglet's reaction to outside noises first escalated; I think she would not have gotten so bad if I had treated the problem early.
Looking back on her life after she was gone, I became more aware of how different Piglet was after developing generalized anxiety disorder, even when the medications were able to keep her symptoms under control well enough for her to function.
Anxiety Wrap (“It’s a Wrap,” December 2002). Also see Thundershirt (also available at Amazon). Two of the articles above, Relieving Anxiety and Reducing your Dog's Anxieties, are also available in the WDJ booklet, Mending His Ways: Saying Good-Bye to Bad Behaviors available from the Whole Dog Journal. Melatonin (see below), SAM-e (s-adenyl methionine) and magnesium are also used to treat anxiety. One person reported her dog's anxiety improving greatly when she added fish oil to the diet. L-tryptophan, an amino acid, and alpha-casozepine, a component of milk whose action is similar to benzodiazepines, have been found to help ease anxiety.
An aromatherapy product called Chill Pill made by Aura Cacia may help calm some nervous dogs. Mutt Muffs and Happy Hoodie block loud noises and have helped some dogs who are afraid of fireworks or thunder.
When using benzodiazepines for noise phobias or separation anxiety, it is best to give them one to two hours before the anticipated noise or stimulus, and then repeat as needed. Because of its anticholinergic effects, clomipramine may be a good choice for dogs with elimination problems linked to separation anxiety. While I have seen warnings against using the pain medication tramadol with SSRIs or TCAs due to the potential for serotonin syndrome, the veterinary behaviorist I consulted said that her colleagues have used them together with caution, and I have done so with Piglet. A 2012 article on anxiolytic drugs, Beyond the Front Line: Trazodone and other Ancillary Treatments for Anxiety, by Margaret E. The article also contains information on benzodiazepines, clonidine, buspirone, gabapentin, and neutraceuticals, along with recommendations for specific situations. I was advised by both my vet and the behaviorist that Ace could be used for emergencies, to force her to sleep if absolutely nothing else was working, and I did use it once, when she was still up at midnight after being up all the night before, and after giving both alprazolam and melatonin without success, but it is not something I am comfortable using or would recommend. New research indicates that gastrointestinal disorders are frequently at the root of repetitive oral behaviors in dogs, including excessive licking of surfaces and fly biting. Composure Liquid (available at Amazon), also called Calming Formula (available at Amazon). Also see Thunderstorm Phobia by Sara Reusche, CPDT-KA, CVT, for a good overview of using both natural methods and medication as needed by a dog trainer with a special fondness for reactive and anxious dogs. Includes information on trazodone, benzodiazepines, clonidine, buspirone, gabapentin, and neutraceuticals, along with recommendations for specific situations. One of the very best all natural dog anxiety treatment products you can find on the market today is Anxietrex.


Anxietrex for Dogs is one of the most highly effective canine anxiety treatments on the market. Unlike other pet anxiety medications, it has no side effects and can be safely used on dogs of all ages. In order to understand how Anxietrex works, it is important to know a few things about canine anxiety and its symptoms. Anxiety is the anticipation of future dangers from unknown origins that result in normal body reactions associated with fear. Some dogs show signs of aggression toward humans or other dogs, while others have an aversion to people of a certain age or react fearfully to strangers or thunderstorms.
If the anxiety has developed suddenly, take your pet to the vet to eliminate medical causes. It provides relief for anxiety, tension, whining, hypersensitivity, fear, trembling, excitability and other related symptoms. Packed with quality ingredients, Anxietrex offers the peace of mind that your dog deserves.
Anxietrex contains alfalfa, phosphorus, Aurum metallicum, Argentum nitricum, Passiflora incarnata, Humulus lupulus, and Baryta carbonica. Alfalfa, one of the main ingredients in Anxietrex, is rich in vitamins, minerals and other nutrients that support the proper functioning of the body. Anxietrex also contains Passiflora incarnata, which has been used for treating insomnia and anxiety since ancient times.
These substances induce relaxation in dogs and help reduce anxiety, stress, and nervousness.
This homeopathic treatment for canine anxiety can be safely used on dogs of all breeds, ages, and sizes.
Below is the story of my struggle to help her cope with these phobias and, eventually, generalized anxiety disorder. I tried many natural treatments, including T-Touch, an Anxiety Wrap, melatonin, flower remedies, Adaptil dog appeasing pheromone products (diffuser, collar, and spray now available), counter-conditioning (scary noise = treat) and just about everything else I heard of that can help dogs with anxiety and phobias. When she was frightened by beeping sounds, she would pant, pace, tremble, try to hide, dig compulsively both indoors and out (to the point of making her nails bleed), and come to me for attention and comfort, though comforting her did not help. With the exception of clomipramine, the FDA has not approved the use of these drugs in dogs, as the drug companies have not submitted the necessary research. They can also be used in combination with TCAs or SSRIs when first starting treatment to hasten the effects, or on an ongoing basis, either regularly or as needed to prevent or lessen acute anxiety episodes. These drugs are used to treat anxiety, noise phobias (including thunder phobia), panic attacks, and separation anxiety. Dodman has had a lot of problems with Xanax (alprazolam) causing paradoxical excitement in dogs.
There are two recommended dosage levels for clonazepam: one for seizure control, and one for anxiety.
It is the shortest-acting of this drug class in dogs, and does not take effect as quickly as the others. Her anxiety was under control, but she seemed to be on something of a roller coaster, becoming more reactive each hour after the alprazolam was given.
Because the recommended dosage range of clonazepam for anxiety in dogs is similar to that for alprazolam, I tried giving Piglet the same dosage (1 mg), but quickly found out that was not enough.
It must be given continuously for at least four to six weeks in order to determine whether or not it will help. Amy has dealt with fear and anxiety in many dogs, including two of her own, and has learned a lot about the medications used for treatment.
Dodman's first choice for treating generalized anxiety and noise phobias, but he says it's important to give a high enough dosage.
It’s important to do blood work a couple of weeks after starting this drug (as well as before, for older dogs), then monitor every six months to a year thereafter.
Dodman does not feel it is necessary to do blood work or other tests prior to starting healthy dogs on SSRIs. Treatment must continue for at least 6-8 weeks before you can know for sure whether it helps.
Fluoxetine works well for conditions involving reactivity, including some forms of aggression. Instead, my vet suggested using Buprenex (buprenorphine), which is put into the cheek pouch and absorbed thru the mucosal membranes (this works very well with cats, they don’t really know how well it works for dogs). Because fluoxetine (Prozac) is considered to be two-and-a-half times as effective as sertraline (Zoloft) at the same dosage level in humans, but the dosage ranges given for dogs are similar, I twice tried to switch Piglet from sertraline to fluoxetine, but both times she got much worse and I switched her back.
I would encourage anyone who tries TCAs, SSRIs or buspirone to not give up too soon, keep using them for at least one to two months and preferably longer, before deciding that they’re not working and trying something else. Although they still disturb her a little, she doesn’t want to head for home when she hears them. A dog must be treated with SSRIs or TCAs for a minimum of three to five weeks before you are able to assess the effects; then, you must maintain treatment until all the dog's symptoms are gone or are at the same low, consistent level, for at least another one to two months. I have learned that it takes time to overcome anxiety disorders; they do not go away overnight.
I would never recommend anxiety drugs as a first choice, before trying to address anxiety with natural methods, but when a dog's quality of life is at stake, the drugs can perform miracles. My takeaway message is to take early signs of anxiety seriously, and to start medication sooner rather than later, particularly if signs are getting worse. Wrapping them in a bit of string cheese has solved that problem for us, but I've since found that Pill Pockets work even better -- the smell is very enticing, and you can pinch off just enough to cover the pill, making each one last a long time (I used to think they were too expensive because I thought you had to use a whole pill pocket each time you gave pills). Dodman says that when buspirone doesn't work for anxiety issues, it is usually due to the dosage being too low. They should be used with caution in dogs with liver or kidney impairment, heart problems or seizure disorders. Cyproheptadine (an antihistamine sometimes given for allergies) may decrease or reverse the effects of SSRIs. Dodman recommends beta blockers for dogs with separation anxiety, storm phobia, and other phobias. Dodman talked about a new class of drugs used to treat obsessive-compulsive disorder (OCD) in dogs.
They will work with you and your vet on anxiety and other behavior issues, including medications.


The most common symptoms associated with canine anxiety include excessive barking, destructive chewing, pacing, whining, digging, howling, and destructive behavior.
Dogs may also experience anxiety during storms, fireworks, loud noises and other stimuli that they do not understand. If these signs occur only in certain circumstances, try to determine how long it takes for him to return to normal. Some of them are recommended for emotional tension, trembling, and fear, while others can help relieve irritability, sadness, grief, anger, lethargy, or depression. Researchers have found that this Passiflora incarnata is highly effective in the management of generalized anxiety disorder.
Larger dogs and those who are under stress may need more than one bottle of Anxietrex per month. While I would urge anyone dealing with anxiety issues to first try natural methods of treatment, it is important to know there are medications that can offer your dog quality of life that may not be obtainable in any other way.
It is also important to do behavior modification as well, as drugs alone will rarely resolve a severe anxiety problem by themselves, just as behavior modification alone often will not work without drugs. For example, one might use a benzodiazepine with tricyclic antidepressants for a dog suffering from separation anxiety with a panic component. They should be used with caution in fear-aggressive dogs, as they may lower fear-based inhibition and increase the likelihood of the dog biting. As with all anti-anxiety medications, you should start with a low dose and increase only as needed.“The key to treatment for noise phobias and panic is to give the benzodiazepines early and often,” says Dr. It is important to be aware of this, as the dosage for seizure control is much higher than that used for anxiety. I generally had to get up once during the night to give her a dose, as it was too short-acting for her to be able to make it all the way thru the night without waking and becoming anxious.
Prozac is equally or more effective than clomipramine, and is safe and inexpensive, so it would be a better choice than amitriptyline, but his preferred medication for anxiety is Buspirone (see above). Paroxetine is used to treat depression, social anxiety, and agitation associated with depression. I put her back on Metacam and added tramadol, in case pain was still contributing to her anxiety, but that also did not help.
If needed, you can combine them with the quicker-acting benzodiazepines to get some relief while waiting for the other drugs to take effect.
Treatment should be continued after that for at least as long as it took to achieve that level, before even beginning to think about weaning them off.
Do whatever is necessary to shield your dog from whatever is causing anxiety, and use medications along with behavior modification to prevent anxiety and phobias from taking over your dog's life.
The dog is currently being weaned off anti-anxiety medications and so far has had no further signs of anxiety. Vetri-Science, a company whose products I like, offers Composure Liquid (available at Amazon), also called Calming Formula from Pet Naturals (same company, also available at Amazon) for dogs and cats that contains l-theanine and other ingredients. Note that Pill Pockets are now available in a Duck and Pea Allergy Formula for dogs with food allergies. Older dogs should have blood work done and possibly an ECG to check for cardiac arrhythmias before starting these drugs. He would give 3 mg for dogs weighing 40 to 60 pounds, but says it's fine to give 6 mg or even 9 mg if needed.
Propranolol takes about an hour and a half to take effect, and the effects last for a few hours. For example, when I started the clonazepam, my local pharmacy quoted me a price of over $85, while Costco charged $11 for the same prescription.
Anxietrex not only helps in treating canine anxiety, but also supports an overall healthy lifestyle. Alfalfa has a calming effect and helps in treating anxiety, depression, and nervous disorders. Numerous studies have shown that Argentum nitricum helps in chronic cases of anxiety disorders. If your pet suffers from anxiety, you should give him the medicine for at least three months. Clonidine helps with storm phobias, noise phobias, separation anxiety, and other types of fear-based behavior problems.
The alprazolam did not sedate Piglet; it just relaxed her enough to be able to sleep, without anxiety waking her up during the night. She was not as bad as she had been originally, but she was still having full-blown anxiety attacks periodically, and was on edge most of the time. She has not needed any extra medications in seven months, other than the small amount of alprazolam plus melatonin that I give prophylactically when I have to leave her for long periods at night. I have not needed to give her any extra medication, even when I have to be gone for long periods.
Note that some of these drugs are available in liquid form if smaller doses are needed, or you could use a compounding pharmacy. I also learned that I could get 50 mg sertraline for the same price as the 25 mg pills, and simply cut them in half with a pill splitter (no longer necessary now that the much cheaper generic version is now available). For dogs with thunder phobia, it should be given whenever a storm is expected, rather than waiting until it arrives, though more can be given at that time, if needed. She was on clomipramine for a total of only three weeks before I began weaning her off, as I did not feel it was helping, but in retrospect, I realize that she got much worse when I weaned her off the drug. On the rare occasion that her anxiety escalates (usually, I believe, due to vomiting medication), I give more alprazolam every half hour to an hour until she settles down.
Costco appears to have a broader range of low-cost generic drugs than the stores below, carrying everything except Clomipramine of the anxiety drugs listed below (Clomipramine is used only for dogs, not humans).
Huperzine-A has some anticonvulsant properties and so may help dogs with OCD related to partial seizures. L-theanine is also available in human supplements, though dosages (usually 100 to 200 mg per tablet) would only be suitable for large dogs.



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