by Lillian Roberts, DVM
Country Club Animal Clinic
According to Wikipedia, Anxiety is defined as follows: “… an emotion characterized by an unpleasant state of inner turmoil… It is the subjectively unpleasant feelings of dread over anticipated events, such as the feeling of imminent death… Anxiety can be appropriate, but when experienced regularly, the individual may suffer from an anxiety disorder.”
In humans, anxiety is a leading cause of stress – and humans can theoretically rationalize, recognizing, at least consciously, that no true danger exists; our lives are not being threatened, and most of what we fear is imaginary.
Our pets don’t have that ability. For anxious pets, the threat of death is a very real and sometimes constant feeling! And we have no way of explaining to them that everything will be fine. Of course, some situations would normally be expected to cause some anxiety in pets – any new situation, or any situation the pet associates with a previous unpleasant experience. Unfortunately, this can include visiting the veterinary clinic, but there are ways to reduce this stress, as we’ll discuss later.
Fortunately, great strides have been made in understanding anxiety in both humans and our pets in recent years. Alleviating this condition in pets typically takes one or more of the following approaches: behavioral modification, medication, hormones or supplements and physical or environmental comforts. This article will deal mainly with the use of chemical agents – drugs, supplements, and natural remedies – but in most cases we try to incorporate a multi-modal approach to reducing anxiety, especially in dogs.
Obvious symptoms of anxiety in dogs include cringing, hiding, running away, trembling, rolling onto the back and urinating, and even snapping/biting. More subtle, earlier clues might involve yawning, lip-licking, whimpering, tail-tucking, and clinging to the owner or another familiar person.
In addition to the unpleasant emotional state caused by stress and anxiety, physical symptoms can result. Many cases of chronic diarrhea, house / litter box training failure, urinary tract disorders, finicky appetite and skin disease can be partially or entirely secondary to underlying chronic emotional distress.
Anxiety may be situational – separation from the owner, noise-related (fireworks, thunderstorms), strangers or infrequent visitors such as guests or workers, and the infamous postal worker. But some dogs and cats suffer from continual, unrelenting anxiety every day. Obviously, the way these are addressed will vary depending on the circumstances, severity of the problem and owners’ willingness to pursue options. Typically, veterinarians will recommend some combination of environmental enhancement, drug or supplement administration, and behavioral conditioning (training).
Environmental Enhancements / OTC Remedies:
• Pheromones are scents detectable only to target species – the equivalent of aromatherapy for dogs (or cats). The best-known product is DAP, or Dog-Appeasing Pheromone. It is available in a collar, a plug-in diffuser, and a spray. This is a compound produced by female dogs beginning shortly before they give birth, and has been shown to have a calming effect on dogs of all ages and genders. It’s a drug-free option that can help with transitioning into new situations such as the introduction of a new pet or human into a household, moving to a new home, etc.
• Music aimed at dogs, cats, and horses has been much in the news recently. This is typically classical or jazz style music that helps humans relax, but research has shown that dogs, cats, and even horses respond to different rhythms and instruments that humans also find soothing. CD’s and other modalities are available from various sources on the Internet.
• The Thundershirt™ and various similar products provide strong tactile reassurance that has a significant calming effect on many dogs and occasionally cats respond well to it, too.
• Increasingly, natural, nonprescription remedies have been available to help alleviate anxiety in dogs. “Rescue Remedy” is a safe, very mild product that is readily available at pet supply venues and on the Internet. It contains Bach flower essences, which are believed to help calm humans and pets faced with various stressful situations. While some people feel it helps, in many cases it’s not successful in overcoming severe anxiety by itself.
From the Vet:
More recently, two non-drug products have been introduced.
Virbac’s Anxitane, is a palatable form of L-theonine, an extract from green tea leaves that soothes mildly anxious dogs or cats during times of turmoil, such as moving, introducing a new pet, going to the vet, etc. Anxitane is intended for intermittent use; its effectiveness tends to wane with frequent or continual use.
Zylkene, from Vetoquinol, is a derivative of cassein, from hydrolyzed cow’s milk. From the website: “Zylkene helps balance reactions in some situations (travel, moving, adoption, grooming, meeting new people, loud noises, etc.) and helps animals maintain normal and relaxed dispositions. Zylkene may also open pets’ receptivity to behavior-modification training.” Zylkene may be used on an “as-needed” basis, or daily.
Both these products are extremely safe, with no known side effects and no known interactions with other products, medications, etc. Both are safe for cats as well as dogs. But like most supplements, their effects may be subtle, and probably not enough to soothe a truly phobic or terrified pet.
Special Diets. Royal Canin’s CALM line of dog food and Hills’ “Stress” formulas for dogs and cats make a lot of sense to those of us treating anxious pets that need ongoing support. Each contains a proprietary combination of additives that combine to address anxiety and usually another medical issue such as intestinal distress or urinary tract problems. Ask your vet for more information.
Medications. It’s important to distinguish prescription medications from the supplements listed above. The primary difference (other than the obvious need for a prescription) is the potential for side effects and/or interactions with other medications or products. Medications prescribed for anxiety and other behavioral issues in pets are typically prescribed to be used only for specific situations such as travel, grooming, etc., or for no more than a few months to support a behavioral modification (i.e., training) program. Basic categories are as follows:
Sedatives and tranquilizers such as Acepromazine and Phenobarbitol have been used for decades to “take the edge off” for pets faced with frightening situations or where we require them to remain quiet – most commonly for long trips or when a frightening situation is anticipated, such as impending storms, fireworks, major grooming, etc. In recent years, studies have shown that these drugs may not actually relieve anxiety and don’t produce amnesia either, but only dampen the pet’s reactions.
Anxiolytics / Benzodiazapines such as alprazolam (Xanax), diazepam (Valium), and others in this category are also helpful in many situations. They tend to reduce anxiety without causing drastic sedation, allowing the pet to interact with its surroundings in a subdued manner. The main drawback for some is that the effect typically lasts only a few hours, requiring frequent dosing. However, in some cases, that may be an advantage.
Mood Stabilizers are basically human anti-depressants. Most work by increasing the amount of serotonin in the brain, a chemical that helps reduce anxiety. Since few studies have been done regarding use of these products in animals, almost all recommendations are based on anecdotal reports. Essentially, veterinary behaviorists or other specialists noted similarities in the behaviors of certain pets to those of humans with self-destructive tendencies and decided to try similar medications. For this reason, the drugs we are most comfortable prescribing tend to be older drugs such as amitriptyline (Elavil), fluoxetine (Prozac), etc.
It’s believed that the main advantage of using mood stabilizers is to help the pet develop a “habit” of experiencing stressful situations without reacting badly. Without providing that experience, simply medicating the pet will have limited impact.
Most vets have one or two medications they are more familiar with but there is no firm evidence that one is safer or more effective than another. Side effects are far more common, and it’s important to monitor closely. These drugs must be used on an ongoing basis to be effective, and if one is not effective, it’s essential to allow a “wash-out” period before switching to another. For these and other reasons, we tend to reserve such medications for fairly extreme situations, and strive for short term use only, in conjunction with environmental enrichment and behavioral reinforcement.
Therefore, most anxious pets will respond best to a multi-tiered approach. Talk to your vet (and a great trainer / behaviorist) about a strategy to help your pet deal with its anxiety.
This article appeared in the Summer 2016 issue, page 8.
Dr. Lillian Roberts, DVM, is the owner of Country Club Animal Clinic which is located
at 36869 Cook Street, in Palm Desert. 760-776-7555 www.countryclubdvm.com.