Advocating for the Anxious Dog

Working on behavior cases such as aggression and anxiety can be incredibly rewarding. There’s nothing like watching the bond between a dog and owner deepen as both learn to trust one another and work cooperatively together. Seeing a fearful dog blossom or an anxious dog learn to relax always gives me goosebumps.

Working with behavior cases can also be incredibly frustrating and devastating at times, and nowhere is that more likely than when the subject of anxiety medications comes up. This is probably the biggest area (other than the dangers of punishment) where I meet client resistance and misconceptions. Perfectly reasonable people become perfectly unreasonable when I bring up the topic of seeing a veterinarian or veterinary behaviorist to discuss medicating their dog. This has to stop, for the dogs’ sakes.

Imagine that your dog is diagnosed with hypothyroidism. This means that his thyroid gland is not working as well as it should, and because of this physical problem he is suffering from a range of symptoms (possibly lethargy, weight gain or loss, poor temperature regulation, and skin/coat issues, to name a few). The vet prescribes daily medication to regulate his thyroid levels. Would you refuse to give him this medication?

Now, let’s say your dog is diagnosed with diabetes. His body can no longer regulate his blood sugar levels, and due to this physical problem he’s suffering from a range of symptoms, including excessive drinking, excessive urination, increased appetite, and weight loss. The vet prescribes insulin injections to regulate his blood sugar levels. Would you refuse to give him his insulin shots?

What if your dog is diagnosed with anxiety? His brain chemistry is imbalanced due to too little serotonin. Due to this physical problem he’s suffering from a range of symptoms such as hypervigilance, trouble sleeping restfully, irritability, and reassurance-seeking behaviors. Your vet prescribes a Selective Serotonin Re-uptake Inhibitor (SSRI) to increase the amount of serotonin in his brain. Would you refuse to give him this medication?

Here’s the thing: anxiety is often a physical issue. The brain is an organ. As such, it can develop abnormally (in utero or due to early experiences), suffer from physical trauma, or malfunction. There is a delicate chemical balance that can sometimes, due to genetics or environment, get disrupted. We know that the brain of a dog who was given a supportive, enriched environment as a puppy is physically different from the brain of a dog kept in a sterile environment or exposed to traumatic or neglectful stimuli during development. We know that the brains of anxious or aggressive animals are observably different from those of normal animals. This is not news. This is a fact that has been proven time and time again through rigorous scientific study.

We treat other physical problems with a combination of lifestyle changes (management) and medication. Severe anxiety that impacts a dog’s quality of life needs to be treated the same way. Not treating an anxious dog due to your personal misconceptions about anxiety medications is just as neglectful as not treating your dog’s diabetes or hypothyroidism. We may treat a severe heart arrhythmia by giving a dog beta blockers and limiting strenuous physical activity. Severe clinical anxiety is best treated with both medications and behavior modification. One or the other given separately just doesn’t cut it in many cases.

So why are so many people resistant to using anxiety medication for their dogs?

There’s a large cultural bias against anxiety. Because the symptoms are less quantifiable than, say, a kidney problem, it’s harder to definitively diagnose anxiety. There is still a large portion of the population who seem to believe that anxiety does not really exist. This is sad and harmful (not to mention ignorant).

The brain has an amazing capacity to heal itself and return to homeostasis, which I think also causes some resistance to meds. It’s true, there are many cases where dogs really don’t need medication and just behavior modification alone will fix the problem. Through learning, new neural pathways can be created and the problem behavior may resolve. This is why I rarely recommend anxiety medications as the first step when working with behavior cases. However, this is one issue where undermedication is much more likely than overmedication. Many general practice veterinarians do not feel comfortable prescribing anxiety medication, and between this and client resistance, I see more dogs suffering for years before they get the help they need than I see dogs who don’t need medication and are prescribed it anyway.

The bottom line is this: not every case needs anxiety medication. In fact, the majority of cases don’t. However, some cases legitimately do. In these cases, refusing to consider medication is as cruel and neglectful as refusing to give pain medication to a dog with severe hip dysplasia. If your dog’s quality of life is impacted by severe anxiety or aggression, you owe it to her to help her. You owe it to her to consult with a board certified veterinary behaviorist about whether medication may make her more comfortable.

You are your dog’s voice. Advocate for her. Do not make her suffer because of your misconceptions.

23 responses to “Advocating for the Anxious Dog

  1. Thank you for this really good post. I think a lot of the stigma toward mental health issues in humans carries over into dogs. You touched on the fact that a lot of people think anxiety doesn’t exist–there’s definitely a belief that people with anxiety or depression should just “get over it” rather than that they have a brain chemistry issue. So it’s not really surprising to me that undermedication is an issue with dogs.

    I think the fact that a dog can’t tell you what they’re experiencing, except through body language, exacerbates it too. If I heard someone going on about overuse of psych meds, I could explain to them how I feel with my SSRI as opposed to without it, how it affects me, and why it’s a huge help, but a dog can’t do that.

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  5. I think the problem is your analogy: we don’t mind giving thyroid meds or insulin, because those are measurable physical problems — you get a blood test, it shows the lack of insulin or thyroid hormone and you medicate to get to normal.

    WIth anxiety, it is subjective and unmeasurable. What is anxiety in one person (or dog), is normal in another. Also, at least in humans, you can’t just LIVE on anxiety drugs… will build up a tolerance, which can lead to abuse and dependence. In short, the drugs stop working well after a while, especially with daily use. I suspect as much for dogs too.

    It also should be overlooked that such meds for dogs can be very costly, and many dogs are VERY hard to “pill”. I lost my beloved dog this summer, and she was on thyroxine for hypothyroid for the last 9 months of her life — she was a wonderful, easy dog but it still very hard to get her to “take her medicine” every day. Medicine for a week (like antibiotics)? no problem. Meds every day? the dog learns to dislike and avoid them, making pilling a misery.

  6. Sorry, for the typo — “it also should NOT BE OVERLOOKED that such meds for dogs can be costly”….my bad.

    • Hi Lola,

      Just because we cannot yet easily measure the level of seratonin or norepinephrine circulating in the brain doesn’t give us the excuse not to treat symptomatic animals. There was a time when we couldn’t measure thyroid or insulin levels, either. Science is very, very clear that anxiety is often a physical problem.

      I believe we may be referring to different drugs when we talk about “anxiety medications,” as those that I am referring to such as most TCA’s and SSRI’s are usually quite cost-effective (many are covered under pharmacies’ $4 plans) and can be taken long-term. I know many people and animals who have been on these medications for years, and the meds allow them to experience a quality of life that they would not otherwise have, in the same way that the beta blockers and nausea meds I take for an autonomic disorder allow me to function day-to-day.

      I’m so sorry to hear that your dog was difficult to pill. There are lots of great options out there to make pilling dogs easier. Most dogs take their meds very easily when wrapped in sticky, palatable food such as cheese, braunschweiger, peanut butter, or commercial pill pockets treats. Compounding is also available for especially difficult cases, although this could be more expensive. Alternatively, animals can be trained to take “naked” (unwrapped) pills (Kathy Sdao has written about this if you’d like to learn more).

      Kindest regards,
      – Sara Reusche
      Paws Abilities Dog Training

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  9. What is a typical anxiety medication for dogs?

  10. Mmm controversial subject. I wonder what percentage of anxiety cases are as a result of inappropriate daily routines and environmental stress, rather than brain abnormalities and so which dogs improve when their life improves. I see a trend of advising medicating dogs, even online, without even understanding whether the dog’s needs are being met. The joke that my dog is on Prozac is not so much a joke anymore.

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  19. Barbara Beley Taber

    The theory that a “chemical imbalance” with low serotonin is the cause of anxiety and depression has been debunked in human medicine. I’m not denying that the drugs do SOMETHING, but it is possibly more likely due to dissociative or sedative effects. They can also cause paradoxical reactions, worsened symptoms, or entirely new health problems as they interfere with virtually ALL body systems via disruption of the endocrine system.
    Is it standard to check an animal’s endocrine function, minerals, etc, before initiating a daily, lifelong drug?

    I don’t know the best or least harmful path. I’m only trying to emphasize that these drugs are not as safe as once thought and ruling out measurable medical problems should be a first step. Hyperthyroidism? Low magnesium? Vitamin deficiencies, etc. Of course, situational stress is a tremendous factor, but not always easy to tease out.

    I appreciate you calling SSRIs “anxiety meds”. They often cause anxiety and agitation when used for depression, but do seem to be more effective for anxiety, in general. (Referring to human studies where benzos had to be added to SSRIs in depressed subjects and controls).

    • Barbara Beley Taber

      I realize you are not advocating for immediate use of serotonergic anxiety drugs and I do appreciate that. I’ve seen that far too frequently in human medicine and then underlying medical problems are never found.

      A few additional thoughts:
      1) people should always be warned about tolerance, dependence, and the need to slowly wean off of these drugs. They have been shown to be much worse than opiates and similar to benzos (Xanax, Valium) in terms of withdrawal, even after short term therapy in some.
      2) they have been documented to CAUSE agitation and aggression in people having no history of those feelings and behaviors. I assume that dogs may respond the same way.
      3) they can cause autonomic dysfunction which may manifest with anxiety-like symptoms, especially tachycardia, as I’m sure you’re aware.

      It’s convoluted.

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