Ask the Vet: The best medications for noise phobias

Ask the Vet: The best medications for noise phobias

July 4th can be a very stressful time for our pets. Stock photo

By Matthew Kearns, DVM

I commonly get this question around this time of year, “What can I give my pet (usually my dog) for all the fireworks before, during and after July 4th?” One point I tell pet owners to keep in mind is fear of loud noises is a natural, instinctive behavior in dogs and cats, telling them to seek shelter temporarily, alerting them to potential predators in the area, etc. However, I agree that when a pet is oversensitive to this noise stimulus to the point where they cower, shake, pace, urinate/defecate in the house, destroy furniture or even try to climb on your lap that becomes a big problem.     

Supplements: Alpha-casozepine, L-theanine (green tea extract) and aromatherapy (lavender, chamomile) are the safest and also have the widest range of efficacy in my opinion. I have had feedback from owners that report these supplements or homeopathic remedies are either “just what the doctor ordered” or are now of the opinion that I am more “snake-oil salesman” than veterinarian. My advice is it’s great to try these but have a backup plan.

Over-the-Counter Medications: The only over-the-counter medication that has been evaluated for sedation is diphenhydramine (Benadryl). Diphenhydramine can cause drowsiness, and I have heard a few owners tell me it is enough; but I have found that it is more effective for dogs that suffer from motion sickness during travel than sedating a dog climbing the walls from a noise phobia. My advice is the same. Have a backup plan.

Antidepressants and SSRIs: These medications can be quite effective; the mainstay of antidepressants in veterinary medicine is a tricyclic antidepressant (TCA) called clomipramine (Clomicalm). The mainstay of selected serotonin reuptake inhibitors (SSRI) is fluoxetine (Prozac). The problem is these medications can take a minimum of three weeks and sometimes up to 8 weeks to get to steady therapeutic levels. That means starting before Memorial Day, and my experience has been that pet owners (myself included) do not think that far ahead.

Benzodiazepines: The mainstay of benzodiazepines in veterinary medicine is alprazolam (Xanax). This medication has been studied extensively for all sorts of anxiety and phobias in dogs. It is helpful, but I have to admit that I have been less than impressed with the results with the use of benzodiazepines by themselves. These medications are designed to be used in conjunction with a TCA or SSRI where the TCA/SSRI is a maintenance medication and the benzodiazepine is situational. The problem is what is described above: It takes one to two months of steady use of the TCA or SSRI for the addition of a benzodiazepine to be effective.

Phenothiazine: Phenothiazines are tranquilizers, and the most widely used phenothiazine tranquilizer in veterinary medicine is acepromazine. Using acepromazine to sedate a dog is wonderful if one is looking to keep them still (and not destroy the house), but it does not address phobias or anxiety. I do prescribe it routinely around the 4th of July because it works so well in a “real time” basis, but I do not recommend it as a long-term medication. 

Dexmedetomidine: This medication is the newest kid on the block. Initially used for sedation prior to procedures, dexmedetomidine (Sileo) is now used to treat anxiety on a short-term basis similar to acepromazine.  

There are several choices for sedating our dogs for noise phobias this July 4th. Please check with your veterinarian to determine which is both effective and safe for your dog. Have a happy and safe 4th of July.  

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.