What are you experiences with medicating anxious dogs?
January 30, 2014 12:41 PM   Subscribe

My dog has always been the nervous type, but this past year her anxiety has escalated to the point where she's a basketcase more often than not. We're exploring medication options. Blizzard inside.

We have an 8-ish (maybe?) year old rescue beagle that we love to pieces. [Obligatory photo] She's always been a nervous and anxious dog, but over the past 12 months we've noticed her anxiety has really escalated. Years ago it started with mostly storm and firework phobia, which I'm familiar with from dogs I've lived with before. The summers were rough, but she was mostly fine in the winter. After an unfortunate incident with a faulty carbon monoxide detector a few years ago, she also became afraid of certain high pitched noises, including but not limited to the ding from the toaster oven. We love her so much I got rid of the toaster oven 3 years ago.

Fast forward to about 3 months ago: the battery in one of our smoke detectors started to die. The smoke detector chirped 3 -5 times before I managed to change out the battery. Since then, her overall anxiety has noticeably escalated. She's been reacting to sounds on the TV, which she's never done before (whistles during football games, elevator dings, bird chirps, basically any high-pitched noise). Within the past month, she's had 2 episodes that I can only describe as panic attacks, where her anxiety suddenly skyrocketed for no reason apparent to us. During one of the episodes, she was clawing at our bedroom door in an effort to get inside - something she's never done before.

We're at the point where we feel some sort of medication is necessary to make her life less miserable and to keep her from potentially hurting herself.

Difficulty factor: the vet prescribed Prozac, but after 3 days of pills she was more nervous than ever and refusing to eat anything at all. We have discontinued the Prozac on the vet's advice.

We're getting ready to try Zylkene, a "natural" anxiety medication, but I don't have high hopes for this stuff. I mostly agreed to try it because it has little to no side effects. If (when?) this fails to work, what else should we try? What are you experiences with medicating anxious dogs? I hesitate to try another SSRI because of side effects, but the vet has offered to let us try something else on her if we want to.

Possibly relevant details:
- Despite being a beagle, she is not at all food motivated and has always been a difficult/picky eater. One of the side effects with the Prozac is anorexia, which is a real problem. In the 3 days she was on Prozac, she went 2 days without eating.
- When she's anxious, behaviors including: pacing, restlessness, panting, refusing to eat, generally acting clingy, cowering/hiding, constant alertness with ears pinned back and sometimes nervous licking.
- She already has a thundershirt/thundercoat. It helps to a minor degree. She still gets nervous, but it seems to help her calm down slightly more quickly than without it.
- She has a crate that she loves and hides in frequently.
posted by geeky to Pets & Animals (21 answers total) 8 users marked this as a favorite
Best answer: I have some good friends who had a dog with escalating anxiety like this. She was always a skittish, jumpy dog, but as she got older, she'd get totally freaked out and sometimes attack their other dogs. They finally took her to the vet and tried Prozac, which happened to work for their dog.

The ASPCA has a good, informative article about various behavioral issues and possible medications for them; perhaps you can discuss other medication options with your vet. One thing to note from the article, though: "SSRIs are rarely effective the first day, and in fact can increase anxiety in some dogs before they begin to have therapeutic effects. Because SSRIs create changes in the brain, they must be taken for at least six weeks before they produce therapeutic results." Maybe three days wasn't a long enough trial, or maybe you could try a different category of medication.
posted by bedhead at 12:46 PM on January 30, 2014

Have you looked at counter conditioning her response? I don't have time to type up a long response, but my guess is you could fix her reaction to these high sounds. Right now she's being sent into a tailspin where the anxiety begets more anxiety. The trick is to halt that cycle.

Google "counter conditioning" and "clicker training" for dogs. Karen Pryor is the place to start. You can make the sound mean something new -- whereas high-pitched sound means anxiety right now, you can transform it to mean "treat" and "yay".

If nobody else answers in more detail, memail me and I'll put up a longer response here.

In short, my guess is medication might help a tiny bit, but (a) it takes longer than 3 days, and (b) you can do behavior modification training to really get things fixed.
posted by barnone at 1:09 PM on January 30, 2014

Best answer: My dog is on Prozac.

Now, I see that you say you tried Prozac and after 3 days it did not work for your dog, and that you discontinued based on your vet's advice. Obviously your vet knows what's best for your dog.

However. Prozac took several weeks to take effect in my dog at all. During those three weeks, I didn't have any particular expectations that it would work, and while I watched for extreme anxiety, I didn't credit unusual (but within the realm of normal for my anxious dog) behavior as having any significance. I just let him be for three weeks, and if that meant he yawned and licked his lips more than usual, or ate less than usual, so be it (within reason).

FINALLY the Prozac started to take effect.

I immediately noticed a change in his anxiety level. Before, he would follow me around the house anytime it seemed like I might start getting ready to leave. I couldn't brush my teeth or comb my hair or look in the bathroom mirror or get dressed without my dog whining and drooling and pacing. He wouldn't eat* because he was afraid that, if he dug in, I would leave. Once the Prozac started to go into effect (after that 3-week waiting period), this stopped immediately.

We also got into a world where there was room to train him. Before, I could not work with him about anxiety triggers or do any kind of conditioning or counter conditioning, because he would go into an anxiety cycle before we could even properly start. After Prozac, I could find the ten seconds before he started to lose it, and I could build from ten seconds to thirty to a minute and beyond. Prozac didn't immediately solve all our problems, but with Prozac, some sessions with a private trainer, some changes, and sustained training, I've noticed HUGE changes in my dog. And it really all started with the Prozac.

I don't know if I'm recommending that you try Prozac again specifically, but if your vet has any alternate suggestions for actual real non-hippy dippy** anxiety meds, please at least try. I really didn't want to medicate my dog, and then I did, and it turned out to be exactly the key I was looking for.

*This made it difficult to gauge how the Prozac initially affected his eating habits.

**Maybe it's because I live in California, but my vet wanted to try just about every half baked "natural supplement" type of thing before she was willing to go with Prozac. Not only did I have to ask for my dog to be medicated, I had to basically call up in tears and say "my dog hasn't eaten in a week and I can't brush my teeth without triggering a panic attack and DRUGS NOW".
posted by Sara C. at 1:12 PM on January 30, 2014

Best answer: There are many other options for mood-altering drugs for dogs beyond Prozac. Unfortunately, it is still an emerging field of veterinary medicine, and most general practice vets are not very well-educated or very confident about dealing with anti-anxiety drugs. Your vet should not be looking to you for other things to try. I'd suggest you look for a Board-certified member of the American College of Veterinary Behaviorists near you.
posted by Rock Steady at 1:19 PM on January 30, 2014 [4 favorites]

Have you tried her on Clomicalm instead? It might agree with her better.
posted by Trivia Newton John at 1:21 PM on January 30, 2014

Doesn't look like there are any in your area (if your profile is correct), but I work at the NC State University Veterinary Health Complex in Raleigh, and we have an amazing Behavioral Medicine department here. I'll buy you a coffee if you come down here for a consult.
posted by Rock Steady at 1:24 PM on January 30, 2014 [1 favorite]

Response by poster: Not to threadsit, but I want to add that I know Prozac (and certain other anti-anxiety medications) take more than 3 days to work. The problem with the Prozac is that she started experiencing side effects right away. I can't wait for 3 weeks for the Prozac to help her anxiety when she is literally refusing to eat any solid food at all. It also seems kind of cruel to me to make her go through 3 weeks of increased anxiety (another side effect) on the Prozac before she gets any potential relief.

I am willing to wait out a different drug, perhaps, so long as it doesn't cause prohibitive side effects.

My vet is fortunately very understanding and willing to let us try whatever we want, hippy-dippy or traditional medication :)
posted by geeky at 1:24 PM on January 30, 2014 [1 favorite]

Yes, I was more trying to speak to trying other drugs, not so much that you need to go back to Prozac specifically.

The first weeks, I drugged my dog with no real light at the end of the tunnel, hoping it would work, but also worrying that he would be anxious and food aversive forever and that maybe I was making things worse. It can be especially difficult when the vet is either not experienced with administering anxiety medication or is reluctant to do it for whatever reason. I really didn't feel like I got any support at all from my vet, which, again, is hard when you have a psychotic dog that won't eat and you're worried that you're making it worse.
posted by Sara C. at 1:32 PM on January 30, 2014

My dog was on prozac for a few years; he didn't have side effects, but didn't really have that big of an improvement either (he had an obsessive licking problem, and it was only mildy improved). Doesn't hurt to try another, but I wouldn't have high hopes -- it's hard enough getting the right SSRI for a human, let alone a dog who can't talk to you.

Have you tried/explored a veterinary behaviorist (a vet with extra specialization, not just a trainer) and/or acupuncture (yes, it exists, I can give you my vet's name if you have trouble finding someone)?

Honestly, the thing that calmed our dog down the most was getting another (super chill, go with the flow) dog.
posted by melissasaurus at 1:38 PM on January 30, 2014

Best answer: Clomicalm works for many dogs. The Prozac issue may have been dose-related, you could try a smaller dose and work up to the therapeutic level needed. My anxious dog was on Prozac daily and Xanax for occasional breakthrough anxiety (like thunderstorms or fireworks). The Prozac/Xanax plus a Thundershirt when needed worked wonders (this dog was so noise phobic before he would literally try to climb your head and his heart would beat so hard you could see it). But you need counter-conditioning and other behavior modification in addition to meds, meds alone are not the best solution.

I would see about getting a consult with a veterinary behavorist (that's a DVM who specializes in behavior). They are often much better at meds than most regular vets are, unless your regular vet has a special interest in behavior.
posted by biscotti at 1:40 PM on January 30, 2014 [3 favorites]

Adding structure to her life cannot hurt. If she has nothing to do with her mind, she will find things to do. Like freaking out.

Dogs are similar to us in this way.

Help her build her confidence in other ways (tricks, agility, doggy dancing - as long as she needs to use self control she'll benefit.)
posted by Lesser Shrew at 2:02 PM on January 30, 2014

- Despite being a beagle, she is not at all food motivated and has always been a difficult/picky eater.

This may sound a little strange, but I think the underlying issue here could be stomach problems.

Dogs have stomachs as acidic as ours if not more so, depending on diet, and stomach acid is produced with the essential aid of an enzyme called carbonic anhydrase, which can pull carbon dioxide out of the bloodstream.

But if she has a stomach problem such as ulcers or acid reflux, stomach acid could make that much worse.

Anxiety comes into the equation because the increased breathing anxiety induces lowers the amount of carbon dioxide in the blood and could thereby lower her stomach acid production and help her cope with gastritis or acid reflux.

Helicobacter pylori is the main cause of ulcers in humans, but appears not to be a problem for dogs, although other Helicobacter subspecies can cause problems in dogs, including Helicobacter felis. By coincidence, beagles were the test subjects in some early studies showing that H. felis can cause gastritis in dogs.

The period before she was rescued might have been a perfect time for her to pick up some kind of stomach bug which could still be bothering her.

In short, I think your dog could have anxiety because it helps her cope with stomach problems by reducing gastric acid; I'd ask the vet to evaluate her for such problems and consider treatment with appropriate antibiotics.

Difficulty factor: the vet prescribed Prozac, but after 3 days of pills she was more nervous than ever and refusing to eat anything at all. We have discontinued the Prozac on the vet's advice.

And by the way, Prozac increases gastric acid secretion in humans.
posted by jamjam at 2:14 PM on January 30, 2014 [2 favorites]

Best answer: Clomicalm worked beautifully for our sweet lab mix when she developed some pretty severe separation anxiety (e.g. tearing apart a door.)

Behavioral therapy works too, particularly once you've gotten the Clomicalm on board, to gradually convince your dog the scary thing produces wonderful treats.
posted by bearwife at 2:17 PM on January 30, 2014 [1 favorite]

Advice from a long time veterinarian - "A good dog is a tired dog." He used to walk 5 miles a day with his own dog.

Hyper dogs that I meet are cooped up in a house or apt all day....and having to "hold it" for 8+ hours? Recipe for emotional disaster.
posted by Tullyogallaghan at 4:56 PM on January 30, 2014

Best answer: My dog is superanxious and has a lick granuloma on her front leg from obsessively licking/chewing on it (like sucking her thumb). My vet has recently put her on melatonin twice a day. She's a small dog (about 12 lb) and she takes 1 mg twice a day. I've seen improvement in her anxiety without the sedating effects you can get with other medications. I buy my melatonin directly from my vet because it is "pharmacy" grade and is a little more precisely calculated than some over-the-counter brands, which can make a difference when you are only dosing to 1 mg.

Good luck, as a fellow anxious-dog owner, you have my sympathy (as does your pooch).
posted by SweetTeaAndABiscuit at 6:26 PM on January 30, 2014 [1 favorite]

You have my sympathy; having a nervous, anxious dog is really, really tough. Thanks to our veterinary behaviorist, we were able to get a balanced medication for our rescued dog to help her generalized anxiety disorder.

You didn't mention if you are doing training for your dog as well. However, we did. In parallel with the medication, we started behavioral treatment. First was Dr. Karen Overall's Relaxation Protocol. Huge, huge increase in her overall happiness and state of mind. When she sees the mat come out for Relaxation Protocol, she runs over eagerly and goes into a down position, and awaits for me to do the strange behaviors followed by treats that just calm her down considerably.

Once we got RP working, we also started doing clicker training. It's something we do in just 2-3 minute sessions a few times a day: first, just learning she would get rewarded for pushing a small shoebox around with her nose. She knows all sorts of behaviors, and it really changed the way she looks at the world: she doesn't have to freak out as much anymore; she knows she has control over her environment. A helpful resource: When Pigs Fly: Training Success with Impossible Dogs.
posted by apennington at 6:11 AM on January 31, 2014 [1 favorite]

Response by poster: Thanks for all the answers guys! The ASPCA link from bedhead was VERY helpful. It's good to hear Clomicalm has been helpful for some of your dogs. It's not an SSRI, so I think we will ask the vet about trying that one next. Perhaps she just needs a different type of drug. The melatonin is an interesting option too. I think biscotti may be right about a dosage issue with the Prozac too. The vet said they were starting her on a higher loading dose, which may be why she got strong side effects so soon.

I appreciate all the suggestions of behavioral specialists, but there don't seem to be any within 4 hours of my house (thanks for the coffee offer though, Rock Steady!). Also, like Sara C. pointed out, I don't think any retraining is going to be possible without getting her panic under control first. Once she's anxious (which is pretty much all the time now) there's no getting through to her. She's not at ALL food motivated and she doesn't play with toys either, so we've never really found a good motivator for training. (Yes, my dog is very very weird.) If we can find a medication to help calm her, we'll definitely consider training!

jamjam, your stomach problems theory is really interesting because in fact she does have stomach issues! (previously) Unfortunately, even after several rounds of testing we're not really sure WHAT exactly her issues are, but it does seem to have something to do with stomach acid. We do suspect it has something to do with the time she spent as a stray before we got her.

The good news is that 2 days after discontinuing the Prozac she's finally eating a little bit and seemed happier and less panicky this morning, so I think the side effects are waning.
posted by geeky at 6:16 AM on January 31, 2014

Best answer: My parents have a super anxious dog. It took about a about a year, but he's finally stabilized enough that he can walk down the block without barking at parked motorcycles, open mailboxes, or unexpected shadows. He no longer throws himself into bushes to get away from things that scare him. That being said, he still has some anxiety, but it is more manageable. I do not think he will ever be completely cured, but he is doing much better.

Here's what my parents did:

-Took him to a veterinary behaviorist who specialized in difficult to treat cases. She knew which combinations of medication worked best for dogs like him. Then, my parents worked with her to tweak his medications to get the right balance. The magic combo for him was a combo of Clonidine, Zoloft, and Lorazepam. The medication took 6 weeks or so before he got the maximum benefit.

-Took him to a trainer who specialized in anxious dogs. She taught my parents techniques to help him work through his anxiety. The training started after the medication was at full effect. The veterinary behaviorist had advised to wait to use a trainer because his anxiety was such that it couldn't be "trained away." (Note: My parents had trained him and he knew all kinds of tricks and commands, but when he was scared, he could only think about the thing that scared him.)

Figuring out the right combination of medication and the training techniques that worked best for him was not easy. However, the effort my parents put in has paid off. He's a MUCH happier dog. Before he started treatment, he was refusing to leave the house and becoming agoraphobic. It's interesting because his treatment seemed very similar to that of a human.

It's also interesting that someone else brought up the idea of diet and anxious behavior. I'm not sure if they related, but my parents' dog can't absorb B12 and other nutrients, so he was put on a special diet/medication and is given B12 injections monthly. (We found all of this out when he started losing a ton of weight and his fur started falling out.)

I recommend that once you find what works for him, don't change it! My parents don't really like the idea of having a highly medicated dog, so they have tried eliminating his medications (with the help of a vet), but he always ends up getting bad again.

Lastly, don't blame yourself. My parents had blamed themselves for the dog's behavior. They had adopted the dog as a puppy, so they thought they must have done something wrong. We ended up getting in touch with his littermate's family and she was just like him! It seems at least in his case, his behavior is genetic/biological.
posted by parakeetdog at 1:53 PM on January 31, 2014 [1 favorite]

Response by poster: That's really interesting about the B12 parakeetdog! Our dog has had sporadic periods of hairloss/thinning, but we thought it was allergy related. Might be worth having the vet check on that next time we take her in. It's nice to hear the training worked so well too. If we can find a medication that works for my dog, we'll definitely look into some training for her too.
posted by geeky at 8:07 AM on February 2, 2014

Response by poster: Just a little follow up, in case anyone is interested: I asked about Clomicalm, but on the vet's recommendation we ended up starting our dog on Trazodone instead. (The vet seemed to think the Clomicalm wouldn't be strong enough for her anxiety.) The Trazodone is working great so far! Aside from a little drowsiness, she's had no other side effects and it's definitely helping keep her calm. She no longer runs away when we turn the TV on. She does still react to some sounds on the TV, but she'll just go sit in her crate for a bit - no shaking or pacing or panting. She did have another "panic attack" last week when the @#$! carbon monoxide detector started beeping, but once I shut it off she was back to normal and even eating (!) 15 minutes later. Most importantly, she definitely seems just generally happier than she was before. She's even been eating really well! So glad we gave medication another shot. Fingers crossed that it will also help with her storm anxiety (if this winter ever ends)!
posted by geeky at 8:07 AM on March 25, 2014 [3 favorites]

She does still react to some sounds on the TV, but she'll just go sit in her crate for a bit - no shaking or pacing or panting.

This is great! It means she's capable of self-calming and is learning coping skills, which is a huge step toward getting her better across the board, not just "provided she's heavily medicated".
posted by Sara C. at 9:32 AM on March 25, 2014

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