The best treatment approach for behavioural concerns are often multimodal. Treatment generally requires both environmental management and behavioural modification. We cannot emphasise enough the value of desensitisation, counter-condition training and positive rewards.
We at Vetsy actively encourage owners to seek a qualified behaviourist to work with and we are more than happy to refer you to appropriate trainers. This not only supports your approach to training, but you are more likely to achieve success with the hands-on guidance of a trainer.
The additional use of medication can be considered in certain cases. This could be natural products, beneficial diets or drugs to address underlying issues and help facilitate learning.
Many owners see the use of behavioural medication as shameful, unnecessary and potentially “giving up” on the matter. The taboo talk of its use may make you reconsider. The vast majority of cases do not require medication, however in the few cases that do, the earlier the medication is prescribed, the less the patient will suffer from fear, anxiety or aggression and the associated negative experiences, that results from these emotions.
A Vetsy consultation will discuss your pets behavioural concerns, training methods and consider if medication is warranted, all from the comfort of home. We can weigh up the pros and cons together, to help you make a more informed choice.
We’ve heard all the reasons why an owner is reluctant to reach for behaviour medications. Including;
1. I don’t want my pets personality to change
And neither do we! Our drug therapy’s aim is to address unwanted anxiety, reactivity or potential compulsive behaviour. As with any medication, how one dog responds, may not be the same for another, therefore following the introduction of a particular medication we promise to closely monitor the response and its effects.
We usually suggest a two week review, where any effects can be discussed and simply reversed or lowered by tweaking the dose.
Through Vetsy’s on-site messenger system, we are always on stand by should you have a question or concern before the first two weeks.
2. Drugs are unhealthy and unsafe
There are many behavioural medications available and the majority are considered quite safe, even with long term use. Our aftercare plans often highlight the most common adverse effects to look out for, and often our use of such medication is usually short term.
If however, your pet requires the medication for a long period of time we may suggest screening blood tests or urine analysis every so often.
3. I don’t want my pet to be sleepy or sedated
Unless sedation is the goal (for example during fireworks or thunderstorms), we usually aim to use non-sedative drugs. If you do feel your pet is sedated on a particular medication, we may suggest lowering the dose or reaching for an alternative one.
It is good practice for a vet to start any behavioural drug at a lower dose, so we can gradually increase the dose should we need to.
The treatment goal of any behaviour problem is to modify the pets response.
First, we need to recognise potential triggers, closely read the body language of your pet around particular stimuli and then focus on ways to avoid that stimulus.
Secondly, we need to teach the dog to behave differently in response to that stimulus. This needs to be tailored specifically to the individual and their personal triggers. This could include anything from counter-conditioning a fearful dog, training an appropriate response to a positive cue or desensitising a separation-distress dog to its owner leaving a room.
In some cases, extreme stress or fear can actually interfere with a dogs ability to learn and modify their response. Whether its an overtly reactive dog, showing extreme avoidance, aggression or panic at a trigger, or an extremely anxious pup struggling to accept the training plan.
It is these patients, where the addition of behavioural drugs can significantly improve the response to training. If the underlying anxiety and fear is reduced, the dog is more likely to be receptive to training tactics and learning.
We have had many positive tales of dogs struggling with anxiety or reactivity and the incredible effect behavioural medication has had. Many owners regret not reaching out for support sooner.
One of our client’s descriptions about the use of Fluoxetine on her reactive rescue sums it up….
…”The cloud of sadness that had engulfed him started to dissipate, and we could see glimmers of happiness returning to his eyes. Now nearly three weeks into his new chapter we are overwhelmed with joy as we watch him find happiness once again.”
As we previously mentioned, sedation on a daily basis is not our aim, but slight sedation, as and when needed, can be beneficial to reduce stress in certain situations, such as;
Our overall aim is to reduce anxiety. Lower anxiety levels means less stress and therefore raising the threshold level for reactivity or fear responses.
The following conditions are usually associated with an underlying anxiety component:
Prior to starting any medication, we would conduct a video consultation, from the comfort of home to discuss behavioural traits and obtain a full history and physical assessment. Ensuring no evidence of underlying concerns, such as pain or skin irritation, that may be affecting the dogs threshold.
If warranted Vetsy will provide a written prescription (at no additional cost) to source the desired medication online to start a 2 week trial before review. If we see a positive response, we can continue to update the prescription in the future.
The duration of treatment may vary between cases.
Ideally, our initial aim is short-term (Eg. 6 months - to allow anxiety levels to be reduced to enable learning). However, some cases may require longer-term treatment (ie. years).
It is worth noting, it can take some medications (especially anti-depressants) 1 to 2 months to reach full effect. Hence, why we suggest waiting 2-4 weeks before any dose adjustments are made.
Abrupt discontinuation of behavioural medications may cause a rebound anxiety or exacerbate the problem further. Therefore, we advise gradually tapering the medication (over weeks or even months) depending on the duration of therapy. This way, allows the owner to report any re-appearance of signs of stress or anxiety. Our vets are happy to guide you on appropriate tapering.
The most commonly used anxiolytic agents include:
Reported adverse effects include agitation, increased anxiety, undesirable sedation or reduced appetite. These effects are often dose-dependent.
In cases where sedation or an extra boost of anxiolysis is needed, shorter acting drugs can be given as and when needed, including;
Reported side effects may include increased appetite, agitation or ataxia. Again these effects are usually dose dependant, so we would advise starting on the lower end of the dose range and working our way up.
There is the potential for a condition known as Serotonin Syndrome, when Trazodone is used in combination with either SSRIs, TCAs or MAOIs. This is when the serotonin levels are too high and become toxic to the dog. Owners are advised to monitor for the following early signs:
At standard doses, this reaction is rare, however, we need to be aware of its potential risk when deciding on therapies.
Behavioural medication can play a pivotal role in the management of anxiety related problems. However, please don’t think the medication will do most of the work. Ongoing training and re-learning is required for a successful outcome. Ultimately, medication should be considered a conventional option to aid these cases, rather than a “last resort”.
If you feel your dog would benefit from the use of behavioural medication, please do not hesitate to book an appointment with one of our Vetsy vets - we would be more than happy to help.
