At first, the idea of a dog needing behavioral medication to deal with anxiety might sound like something straight out of Real Housewives of Beverly Hills. However, anti-anxiety medications for dogs are incredibly useful when working with behaviorally challenging dogs.
While we can debate back and forth where behavior issues in dogs come from, that does little good to help the dogs that struggle with debilitating behavior issues.
These are not dogs that need more exercise or are “spoiled” — they are abnormal on a neurochemical level and benefit from pharmaceutical aids.
Our growing understanding of the emotional lives of animals has led veterinarians and behavior professionals to recognize that turning to medication might be the only way to succeed with some animals.
Let’s start with a necessary disclaimer. I am a behavior consultant and trainer, not a vet. K9 of Mine is no substitution for a veterinary visit. While our articles are well-researched and we had the input of several veterinary behaviorists for this particular piece, no blog post can take the place of veterinary advice.
Ultimately, the decision to seek pharmaceutical help for your dog should be a discussion between you and your vet. However, we can at least help you get a general idea if you should consider bringing meds up with your vet, and how to broach the subject.
Medication isn’t for pooches that are just a little skittish and nervous in new situations. Many dogs that need behavioral medications have something akin to a full-blown panic attacks. These dogs are not simply misbehaving — their brains are flooded with stress hormones that render them incapable of dealing with a situation.
Sarah Dixon, a behavior consultant at Instinct Dog Training in New York City, says she suggests a vet visit for many dogs with extra-intense reactions (intensity) that occur often (frequency), especially if they take a long time to return to baseline (duration). This is especially true if the dog’s “baseline” is still a very stressful state.
The intensity, frequency, and duration equation will sound familiar to readers who explored our article on aggressive puppies. When these three factors are out of whack, you have a problem canine.
As Dr. Jen, a veterinary behaviorist who is an expert on the subject, wrote in her blog post on behavioral medications,
The brain chemistry of a dog who responds to every stranger or novel object as a terrifying threat is fundamentally different from a dog who accepts these things in stride. The same is true for a dog who panics every time his owner leaves – his heart rate soars, he salivates uncontrollably, and his system is flooded with adrenaline. These are real, physical changes that preclude any kind of learning until we can get them under control.
In short, if you’re meeting your dog’s basic exercise and safety needs and still seeing significant behavior issues, it might be time to look at medication.
Medications are not a substitute for training and exercise. They should not be used to sedate your dog. When dosed properly, most medications won’t really “sedate” your pup anyway! Speak to your vet and experienced dog behavior consultants to get their opinions on if your pup’s poor behavior is due to a medical concern, or simply a lack of exercise.
An experienced professional will be able to let you know relatively quickly if your dog simply needs more exercise, or if medication is a good next step. It’s a bit of a myth that massive amounts of exercise can “fix” a dog. It’s simultaneously true that many dogs are woefully under-exercised, which leads to behavior issues.
Behavioral medications can be helpful for dogs that:
This isn’t to say that medication should be the last resort – in some cases, a professional may recommend that you seek medication for your dog early in the behavior modification process. However, most owners will likely start with increased exercise and significant training interventions. When that fails, it’s definitely time to speak to a vet.
Remember, behavioral medications should be used in conjunction with reward-based training and behavior modification to achieve the greatest effect. Most dogs with significant emotional and behavioral concerns will not improve with medication alone.
The medications will help to bring your dog’s underlying brain chemistry to a place where learning can take place, but will not magically “fix” your dog. There’s still work to be done!
Dogs that need medication will need the “big guns” as far as training goes, so don’t expect your local obedience trainer or PetCo class to take them on! This is a good time to remind yourself of the times a dog needs a trainer versus a behavior consultant.
A good behavioral modification plan with a credentialed behavior consultant (look for IAABC, CPDT, or CAAB credentials) will teach your dog the skills she needs to cope with life. The medications just clear the way to let the behavior modification plan get a toehold.
For example, a dog with a noise phobia may get situational medication to help them get through thunderstorms. In the meantime, a behavior consultant will help your dog learn to cope with increasingly startling sounds using a training plan.
In many cases, you are better off working with a qualified remote behavior consultant than trying to get an under-qualified local trainer. Many behavior consultants (myself included) offer remote training services for this exact reason.
Many vets are extremely knowledgeable and happy to help with your decision to medicate (or not) your dog. However, I have to say that I’ve encountered some highly skeptical vets who are reluctant to turn to behavioral medications, even in the face of pretty extreme behavior from a dog.
It can be helpful to document exactly what you have tried so far (and what the issue is) to help your vet understand which interventions may be best.
If you are getting stuck with your local veterinarian, many veterinary behaviorists will offer free consultations to other veterinarians on the subject of behavioral medication. Your vet might not know about this option, so don’t be afraid to bring it up. This is one of the best ways to get access to world-class expertise even if you don’t have a veterinary behaviorist in your area.
Veterinary behaviorists cannot speak to you over the phone without your vet in the room, thanks to laws regarding veterinary practice. This means that if you can’t drive to a vet behaviorist, you’ll have to work with your local vet and a remote vet behaviorist.
You can help your vet out by preparing properly for the consult and doing your homework.
Dr. Jen from Dr. Jen’s Dog Blog suggested preparing for a consult with your vet by:
Gathering information on your pet’s behavior. Be prepared to ask the questions below.
Filming the problem behavior if it is safe to do so. Do not provoke your dog, but capture the behavior on film if it happens on its own!
Making a separate appointment to discuss behavior issues. This will help your vet prepare ahead of time so that they can brush up on behavioral medications if they’re rusty.
This information will help your vet understand that this is not just a training issue, especially if your dog behaves well at the vet’s office.
Let’s look at some other information to gather for your vet. We’ll illustrate this using the example of a terrier mix named Zoey. Before speaking to your veterinarian about behavioral medication for your dog, it’s a good idea to document:
1. What “sets your dog off?”
Zoey begins to panic when I am out of sight for longer than a couple minutes.
2. How often does this happen?
Every time I go out of sight, even if I am still home, and even there are other people or pets present.
3. What does your dog actually do? Try to use objective information about calming signals and body language.
Zoey whines, barks, paces, pants, howls, tries to escape her crate, and bites on the crate bars to the point of harming herself, will pull anything she can reach into the crate, and sometimes will potty in the crate. When not crated she is destructive and has chewed electrical cords. She cannot relax until I am back, even if I am gone for days.
4. How long does it take for your dog to recover?
Zoey’s initial greeting is frantic but she will settle down within about 10 minutes. The chronic stress affects her appetite and attitude. She doesn’t want to eat or play.
5. What have you tried so far?
Different crates, crating in different locations, pen instead of crate, calming music, TV, crate covered, crate uncovered, chews like bully sticks, stuffed Kongs, raw meaty bones, darkening the room, lights kept on, having other people/pets home, exercise, training to teach her that I come back after being out of sight.
6. What sort of exercise does your dog get every day?
For physical exercise, Zoey gets a ~30-60 minute walk a few days a week; she chooses the route and is allowed to sniff and take her time. At first, she did not want to play with toys or other dogs, or with me. She does a lot of wandering, free running, and exploring on our property.
The dog highlighted here is a foster dog that my friend Megan fostered. Even though Megan is a professional trainer who owns The Mannerly Mutt, she made almost no headway into Zoey’s panic-induced self-harm until they started to use Fluoxetine (Prozac ®) and Alprazolam (Xanax ®).
The medications, combined with ongoing behavior modification, helped Zoey turn a major corner. She even started to play with toys and eat when Megan was gone!
Zoey was ready for adoption within about four months of starting medication. She has since been weaned off of the medication and is continuing to thrive without separation anxiety. For some dogs, long-term meds are the only solution, but for many dogs, medication is only needed temporarily. Some dogs just need medication to lower their stress levels enough that training can take effect. Once training is established, the medication is many times no longer needed.
In the case of severe separation anxiety, medication can have a truly staggering effect. Not all dogs can be weaned off of medication the way Zoey was, but it’s a possibility. Medications level the playing field and allow behavioral modification to work.
If your vet remains skeptical of your behavior concern – or suggests that you need to be more dominant, take your role as the “alpha”, or be harder on your dog – take your business elsewhere. Ear pinches, prong collars, shock collars, and Alpha rolls are unacceptable methods of dealing with anxiety, phobias, aggression, and fear.
Anyone who is struggling with serious behavior concerns with their dog should read the position statements from veterinary behaviorists on finding a trainer and why not to punish your dog for unwanted behavior.
Unfortunately, many misleading training techniques such as alpha rolls and ear pinches can severely worsen behavior concerns and make future treatment far more difficult. Trust the experts (veterinary behaviorists are some of the most educated people on the planet when it comes to the intersection of medical and behavioral issues), and find a good trainer and vet to work with.
There’s a huge variety of behavior knowledge in the veterinary world, but all vets want what’s best for their clients. Your vet is probably not a trainer (though some are). A good vet and behavior consultant can work together as a team to communicate about your dog’s needs.
While it doesn’t always happen, sometimes behavior consultants can even speak to the vet for you or visit the vet’s office with you. Other times, the behavior consultant just works with the medications that your vet hands down. The hands-off versus collaborative approach will vary based on the professionals you work with.
Elisheba Fay of The Art and Science of Animal Behavior recommends asking about scientific studies if your vet recommends using an e-collar or corrections to deal with anxiety or aggression. There is far more research out there supporting the use of medications and reward-based training for severe behavior issues than there is support for correction-based training. You might just help your vet learn something!
It’s worth noting that passing along research articles to your vet could mean stepping on their toes, so tread carefully and be ready to move on to a different vet if you burn bridges with your current one. However, it’s your job to be an advocate for your dog, so we think you should do whatever it takes!
There is still a stigma associated with medicating dogs in many cases. I’ve been met with dubious scoffs when I mention the idea of medication for an anxious dog. However, many dogs with severe behavior issues have underlying brain chemistry abnormalities that can be helped with medication (check out the excellent book Animal Madness for an easy-to-read yet deep dive into the research behind this).
The decision of whether or not to medicate your dog is between you and your vet. The stigma of using behavioral medications to help your dog has been decreasing in many circles, but it’s not gone. In fact, many vets and behavior professionals now recognize that medications are better used as an early intervention for many dogs, rather than a last-ditch effort after all else has failed.
The stigma against medicating dogs may be resulting in the withholding of life-changing medicine for dogs around the country.
To be short, no.
Trainers and animal behavior consultants are not medical professionals and should not recommend specific drugs or dosages to their clients.
They may suggest that a client talk to their vet if they feel that a behavior issue needs pharmaceutical help, but a trainer should not recommend a specific drug.
As Marjie Alonso, director of the International Association of Animal Behavior Consultants, says,
As trainers specializing in behavior, many of us have a fair amount of experience in working with vets, and animals on behavioral meds. However, what we don’t know is much more important than what we do. We don’t know about the various interactions between meds, the signs of dangerous side effects, and much more. The potential to do harm to the dog, the credibility of the trainer, and the relationship between the owner and the vet, is too high.
What Marjie is getting at is that it can be harmful for a trainer to say that an owner should look at a specific drug because the owner may get fixated on this drug. When the owner goes in to see the vet and the vet makes a medical decision to go with a different drug, the owner may be upset.
Likewise, human medical professionals should not recommend specific drugs for canine clients. This is a surprisingly common occurrence. While I was researching this story, in fact, I had multiple human doctors contact me offering advice that was way off-base from what the real pros (the veterinary behaviorists) were telling me.
Veterinary behaviorist Dr. E’Lise Christensen of Behavior Vets Colorado said it best:
Only licensed veterinarians are qualified both ethically and legally to prescribe medication to animals. While there are commonalities between humans and other species, there are important differences. For instance, acetaminophen is toxic to cats and people can die from dog-appropropriate doses of certain medications. Physicians, psychiatrists, and pharmacists often opine on medication options for animals, but unless they are also veterinarians, these recommendations should never be implemented without veterinary supervision.
Now that we’ve covered what sort of dogs may need behavioral medication and how to talk to your vet about it, let’s look at some of the options available.
There are a whole host of behavioral medications available for dogs. Many of these drugs are fully FDA-approved and have a long track record of helping dogs overcome anxiety, phobias, aggression, compulsive behaviors, and more.
We’ll break down the drugs available by broad sub-categories, then dive into the specific details of individual drugs. Remember that we are not endorsing or recommending a specific drug — talk to your vet if you really think your dog might need medication.
Don’t forget that all drugs can potentially cause an allergic reaction, and our list of “common side effects” is not exhaustive. Speak to your vet about the specific drug that they plan to prescribe.
These drugs mimic the function of the neurotransmitter GABA, which regulates movement, posture, and anxiety. Essentially, GABA helps reduce tension in the brain and body. These drugs have a similar effect.
These drugs block norepinephrine. Normally, norepinephrine causes a feeling of panic or anxiety during stressful situations.
These drugs change the serotonin levels in the brain when they are unbalanced. They are prescribed as antidepressants in people. They are sometimes taken with SSRIs or TCAs.
These drugs work by blocking the reuptake of serotonin, which ensures that more of this hormone is available in the brain.
These drugs generally reduce anxiety-related behaviors, fear of people/other animals, and separation anxiety. These drugs can also help with compulsive behaviors. In some cases, SSRIs can help with aggression, but in other cases can also make it worse.
Work closely with your vet if you are using an SSRI to help with aggression. Be careful with kidney and liver issues. SSRIs should not be used in combination with MAOIs. They are generally taken every day and act slowly. They generally take at least a few months to act and dogs must be weaned off of them under the guidance of a veterinarian.
Other SSRIs available include Paroxetine, Setraline, and Luvoxamine. These drugs are less common but are generally similar to Fluoxetine in many ways.
These drugs have a more general effect on the brain than TCAs, but are overall broadly similar in that they work on the neurotransmitters dopamine and serotonin. They should NOT be used with SSRIs, as the combination can increase serotonin to unhealthy levels.
These drugs are good for working with dogs that suffer from sudden and severe fear or panic.
They are essentially sedatives. They must be given before your dog shows signs of becoming anxious, ideally at least an hour ahead of time. This makes them tricky to use with unpredictable fears and phobias. They can interfere with memory and are better as short-term or as-needed drugs. They also can lower your dog’s inhibitions, so they may be a bad idea if your dog is aggressive.
Other BZs available include Chlordiazepoxide, Lorazepam, and Clonazepam. These drugs are less common but are generally similar to Diazepam in many ways.
TCAs increase serotonin and reduce norepinephrine. Each one is unique. Some dogs may not respond at all to one TCA, but have a strong and desirable response to another. TCAs can help with separation anxiety, general anxiety, compulsive behaviors. Like with SSRIs, they are generally prescribed for daily use, and you might not see results for several weeks. Use TCAs for at least 2 months before making decisions about the drug.
Double check with your vet before using these drugs if your dog has kidney or liver issues. They can cause water retention leading to thirst, diarrhea, foaming at the mouth, and constipation.
Other TCAs include Doxepin, Imipramine, Desipramine, and Nortriptyline. Each TCA works a bit differently, so be sure to speak to your vet about your options. It’s not uncommon for dogs to respond much better to one TCA than another.
Acepromazine is a drug that has fallen out of favor lately. This drug used to be commonly used for sedation prior to surgery, for long car rides, or to subdue an aggressive animal. It can also be used in far smaller doses as an anesthetic rather than a sedative.
Many vets are no longer reaching for Acepromazine as a sedative thanks to its long list of scary side effects:
In short, be extra-cautious if your vet recommends Acepromazine to subdue or sedate your behaviorally challenging dog. Be sure to politely ask questions to ensure that your vet is aware of the newer research on this drug.
Although not all vets are experts in behavioral medication (like not all doctors specialize in gynecology or cancer), your general practice vet is generally your first step. Be respectful, curious, and don’t be afraid to ask questions. Following our instructions on how to prepare for your veterinary visit will help set you and your vet at ease.
If your vet recommends that you see a specialist or needs to take some time for research, don’t get frustrated! This is a sign that your vet is trying to give you the very best care possible.
As you’re exploring your options with your vet, you may have a lot of questions. Karen Webster, a semi-retired dog trainer whose dog had severe anxiety for years before the help of Trazodone, suggests covering these bases at a minimum:
From there, you and your vet can go forward to create a treatment plan. Don’t forget that behavioral medication should just be a part of the puzzle when working through your dog’s behavioral issues. Drugs are not a replacement for a behavior modification plan from an experienced behavior consultant.
Does your dog take any behavioral medications? How did you find your solutions? We want to hear your stories!
Kayla Fratt is an Associate Certified Dog Behavior Consultant through the IAABC and works as a professional dog trainer through the use of positive reinforcement methods. She also has experience working as a Behavior Technician at Denver Dumb Friends League rehabilitating fearful and reactive dogs.