Tags Posts tagged with "Ask the Vet"

Ask the Vet

By Matthew Kearns, DVM

This past Sunday just before the clinic closed we had a call for a dog that had a laceration she received while running around with her owner. Our clinic is only open a few hours on Sundays and the owner was grateful we could see her and her dog. However, what should she do if we weren’t open until the following day?

 Emergency clinics are expensive. Could there be a way to manage the wound until your regular veterinarian opens again? Before proceeding make sure to make your own safety a priority as much as your pet’s. It doesn’t do anyone any good for you to get seriously bit or scratched. When a pet is in pain and afraid, there is the potential for aggression. A leash wrapped around the muzzle prevents biting. Worst case scenario would be placing a thick towel over the pet to prevent biting (even if it is just to take them to the nearest clinic/emergency center).

First, stop the bleeding. If the wound is superficial and there are no larger blood vessels involved, direct pressure is usually enough. I was told in school that singing the “Star Spangled Banner” (either in one’s head or out loud, your choice) while applying pressure to the wound is the appropriate amount of time needed to stop minor bleeding. 

During this time it would be a good idea to pet and talk to your pet to calm them and lower blood pressure. After a few minutes recheck the wound. If the bleeding continues, try again. If the bleeding restarts a second time, then do go to the nearest clinic/emergency center.

Once the bleeding stops we can evaluate and clean the wound. What is safe to use to clean the wound? Running the wound under a hose or tap will remove dirt and other debris. Studies have shown tap water does not cause significant tissue damage when compared to isotonic saline. 

If you have an over-the-counter antiseptic like povidone iodine (Betadine) solution even better. Remember to dilute the Betadine solution. The exact appropriate dilution is 1 part Betadine to 9 parts water; but I was told that if the solution has the color of strong tea that is close enough. 

Many people ask about hydrogen peroxide solution. I remember that hydrogen peroxide was the “go to” antiseptic when I was a child and got a cut or scratch. It is an excellent antiseptic, but it tends to destroy more tissue and slow the healing process overall. It has also been implicated in the entrance of air emboli into the bloodstream when used to clean deeper wounds or abscesses. These emboli can have serious, sometimes fatal results. If you have no other antiseptic but hydrogen peroxide, then dilute it 50:50 with water.

Lastly, cover the wound. It is true that when a pet licks at a wound it does remove debris and dead tissue, but it also introduces bacteria from the pet’s mouth, which slows or prevents healing. To cover the wound one can use some gauze and an ACE bandage. Now, one can even pick up self-adhesive bandage material from the pharmacy or store. Just remember that the self-adhesive material tends to tighten as it dries out (after it is removed from the packaging).

I hope this helps. Please remember that these are temporary measures to allow you to wait for your regular veterinarian to open. I would recommend always having the wound evaluated by your veterinarian as soon as possible.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. Have a question for Dr. Kearns? Email it to [email protected] to see his answer in an upcoming column.

The power of massage. Stock photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

The smell of spring is in the air and we all want to be outside implementing our New Year’s resolution. However, too much too fast leads to injury. The same holds true for pets. This article will describe some techniques to loosen up your dog before exercise, as well as a modality after exercise to help with pain.

Heat: Heat packs can be used before exercise to improve hemodynamics (blood flow), neuromuscular (decreased spasms and pain) and flexibility. Increased blood flow relaxes muscles before any activity by slowing down the firing of nerve synapses. This decrease in nerve firing reduces pain associated with ischemic nerves. Lastly, heat increases flexibility in connective tissue such as tendons and ligaments.

Massage therapy: The word “massage” is derived from the Arabic word “mass,” which means “to press,” and creating pressure has both physiologic and positive psychologic effects. Physiologically, massage decreases edema and muscle spasms, reduces adhesions within tissues, and facilitates the regression of sensory pain. Massage can be performed both postsurgically and pre-exercise. Psychologically, multiple studies have proven that the physical touching of animals reduces the amount of stress hormones circulating throughout the body.

Range of motion: Range of motion exercises increase flexibility, prevents adhesions between muscles/tendons/ligaments and bone and prevents further injuries to joints/muscles/tendons/ligaments. There are two types of range of motion exercises: passive and active. Passive range of motion consists of flexing and extending of joints for the patient.

The most common orthopedic injury in veterinary medicine is an ACL tear, so we’ll use that joint as our example. Passive range of motion on the knee joint would include stabilizing the thigh with one hand and gently bringing the shin into as close to full flexion and then close to full extension as the patient will tolerate. This same technique can be used for any joint in the body.

Active range of motion would include active muscle contraction. Using the knee as an example one more time, active range of motion would include encouraging the patient to sit and then stand up again (this is much easier for dogs than cats). Usually five to 10 repetitions and two to three cycles (if the patient will tolerate).

Cryotherapy: Cryotherapy is derived from the two Greek words “kryos,” meaning “icy frost,” and “therapeia,” meaning “healing.” It is the use of cold to aid in healing. Inflammation triggers vasodilation and increased permeability of vessels leading to edema, or generalized swelling of the tissues. The result is decreased oxygen to injured tissues, secondary cell death, release of more inflammatory chemical and more edema.

Cryotherapy can be used both in the acute phase of tissue injury (trauma, postsurgically), as well as after exercise/rehabilitation to minimize adverse secondary inflammatory responses. Cryotherapy counters this edema and pain with vasoconstriction, reduction in edema, desensitization of nerves and decreased muscle spasm.

I hope this information helps. It is far from comprehensive but some basic exercises and treatment modalities that can be helpful in keeping our pets active, healthy and happy.

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

Stock photo

By Matthew Kearns, DVM

I authored an article on the benefits of medical marijuana and the legal restrictions of a veterinarian’s ability to prescribe anything with the psychogenic component of marijuana, tetrahydrocannabinol (THC), back in September of 2018. 

I touched on cannabidiol, or CBD, in that article and wished to expand on the reported benefits of CBDs. A quick disclaimer: As a veterinarian I am not legally allowed to recommend the use of this product. There is limited science behind it regarding safety, efficacy and purity of products.

CBD is a compound found in the non-THC portion of the cannabis plant. There are two known cannabinoid (CB) receptors in the body: CB1 and CB2. CB1 receptors are found in the central nervous system. These receptors are activated by THC, the psychoactive portion of the cannabis plant and gives people the “high” associated with marijuana. 

CB2 receptors are found associated with the immune system and associated cells circulating throughout the body. CB2 receptors are activated by CBD and other non-THC compounds found in the cannabis plant. 

Almost all of the information we have in veterinary medicine comes from studies done on the human side so a look at those studies may prove helpful. CBD oils were first isolated from the cannabis plant in the 1930s and ’40s, and it was compared to phenobarbital, as well as other anti-convulsants, for its anti-seizure properties. 

There was a more recent human study that anecdotally reported a reduction in both seizure frequency and duration using a purified CBD product. As a matter of fact, preliminary results show that this product is more effective at treating seizures than a 50:50 blend of CBD:THC.  

CBD has been shown in humans to have an anxiolytic (anti-anxiety effect) similar to the benefit of a benzodiazepine, but there has yet to be a study performed on animals to support this claim.  

CBD products may also have antimicrobial and anti-inflammatory effects. Studies on rheumatoid arthritis reveal that the administration of a purified CBD oil reduces the release of inflammatory chemicals such as gamma interferon and tumor necrosis factor, and CBD proved a more effective antioxidant effect than vitamin C. No studies have been performed in dogs or cats. Topical CBD activity has been shown  to be resistant against Staphylococcus bacteria in laboratory settings.

The future for the CBD oil appears bright, but some real studies need come about first to standardize some of the claims that are out there, as well as guarantee the purity and quality of products. There is only one CBD product approved for the treatment of epilepsy in humans. There are currently no approved products for pets. 

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

Stock photo

By Matthew Kearns, DVM

February is National Pet Dental Health Month so I figured an article on dentistry is appropriate. A quick tooth anatomy reference: Everything below the gumline is considered the “root,” and everything above the gumline is considered the “crown.”

Feline odontoclastic resorptive lesions, or FORLs for short, is a strange pathology of the feline tooth, essentially a “hiccup” in the tooth loss cycle. Normal deciduous (baby) tooth loss involves the root and the structures around the root below the gumline. The destruction of the dentin is achieved by a type of cell called odontoclasts. 

Odontoclasts are specialized cells whose sole job is to absorb the bone of the tooth root and the weakening of the structures around it. This process is critical in the loss of deciduous, or baby teeth, to make room for adult teeth to erupt. 

I previously described FORLs as a hiccup in this normal tooth loss cycle because these same odontoclasts destroy the dentin, or layer of the tooth just below the enamel. The FORLs pathology progresses to invade the pulp below the dentin, and this is where the blood supply for the entire tooth lies. Once the blood supply is compromised, the enamel on the crown of the tooth starts to resorb, exposing the dentin underneath. This is above the gumline and can be painful as H-E-“double hockey stick.” 

FORLs differ from a cavity where bacteria adhere to the surface of the crown of the tooth (the portion of the tooth above the gumline). Bacteria in the mouth produce acid that eats away the enamel until the root of the tooth is exposed. 

Cavities are very unusual in dogs and cats for multiple reasons: the shape of the tooth, diet, type of bacteria in oral cavity compared to humans, and dogs and cats live shorter lives than humans. Dogs and cats suffer more from periodontal disease, or problems associated with structures around the tooth.

What triggers FORLs in cats? There are theories that include previous trauma, accumulation of plaque and tartar, impacted teeth around the affected tooth, etc. Bottom line, we as a veterinary community, do not yet know what triggers this pathology (to try to come up with a way to prevent it). 

Treatment of FORLs requires removing the damaged portion of the tooth. This is a far less complicated and painful process compared to extraction, but the only way to determine if there is damage to the tooth is to perform dental X-rays. If the root is not involved, then it is FORLs (no extraction, just remove the damaged portion of the tooth); and if the root is involved, it is periodontal disease (extraction). 

As more information becomes available about FORLs, I will give an update. Until then, make sure to get your cat (or dog) in for a dental checkup. SMILE!!!!!

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

Holiday plants like mistletoe and holly are poisonous to your pets.

By Matthew Kearns, DVM

Dr. Matthew Kearns

Why do pets like holidays? There are many reasons.

Lots of extra attention!!!!! 

Family is home more and friends come over to celebrate. This means lots of extra attention. Most pets enjoy this but some can have some anxiety. Make sure that if your dog or cat tends to get scared with a lot of people around they have a safe haven: a separate room, kennel, etc. 

If your pet tends to get so fearful that they might snap or scratch at a guest, it might be best to find a friend to watch them or consider boarding them for a day or two. We commonly board at our clinic not only for vacations but also for a day or two during the holidays. 

If relatives are visiting, gently remind them of the danger of leaving medications out. Not just prescription medications pose a holiday hazard; over-the-counter medications are dangerous as well. A single ibuprofen or acetaminophen tablet could cause serious illness in a large dog and be potentially fatal to a small dog or cat.

Lights and decorations 

Whether you celebrate the Festival of Lights or “Oh Holy Night,” everyone loves holiday lights and decorations (including dogs and cats). Just make sure that they don’t have access to wires (risk of electrocution), tinsel (GI obstructions) and plants. Plants like mistletoe and holly can cause severe GI problems and sometimes cardiac dysfunction; so make sure they are away from curious paws and mouths. If you have a live tree, the water can become stagnant and bacteria will grow in it; so keep your dog or cat away from it.  

Gifts, gifts, gifts 

Even pets like gifts and, if your cats are like mine, the boxes gifts come in are more fun than the gifts themselves. Check these toys to make sure toys don’t have strings, ribbons or yarn that could come off and potentially be swallowed. If you like to give bones as treats (and what dog doesn’t love bones), make sure they are not turkey, chicken, pork or fish bones. These bones tend to splinter and present choking hazards, as well as perforate the stomach or bowels.

Food, glorious food!!! 

There’s lots of food around and usually on tables within reach of opportunistic dogs and cats. Be careful of leaving food around, especially chocolates. Chocolate has two chemicals: caffeine and theobromine, and both are powerful stimulants. Small amounts cause panting, hyperactivity, increased thirst and urination. Larger exposures of chocolate trigger irregular heart rhythms, seizures, coma and death.  

Chocolate is also very high in sugar and fat. Minimally, this will give your pet a tummy ache, but I have personally seen a few cases of serious gastroenteritis, pancreatitis and liver disease from ingestion of large amounts of chocolate and other candy. Any leftover food will tend to grow bacteria and mold on it if left out. Try to make an effort (even after a long night of reveling) to clean up so that you do not have to worry about your pet ingesting leftover treats.    

I hope everyone has a joyous and safe holiday season and a Happy New Year. Special thanks to Heidi Sutton and all the staff of the Arts and Lifestyle section for making my column possible and another great year. 

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

By Matthew Kearns, DVM

Essential oils are all the new craze in both human and veterinary alternative therapies. Are they safe? Do they work?

I would like to write a little disclaimer at this time: I do not work for or promote any essential oil products in my clinic. I am just aiming to put forth information in as neutral a position as I can. 

Essential oils are produced naturally by plants, and the term essential oil describes the plant’s “essence” or fragrance. They can be used to promote healing, decrease inflammation and pain, etc. Some essential oils are applied directly to the affected area (usually the skin), ingested (this gets a little bit scary because the essential oil industry is not regulated by the FDA for quality or purity) or inhaled (via a diffuser). 

The potential of using essential oils topically is very interesting. I have spoken previously about the risk of antimicrobial (bacteria and fungi) resistance in veterinary medicine. This, as in human medicine, is an unwanted sequelae of the overuse of antibiotics and antifungals in chronic, recurrent infections. Usually there is some underlying primary problem (allergic skin or ear infections, urinary incontinence, etc.) and a secondary infection. Initial studies show promise in their antimicrobial activity, but also show damage to the skin and lining of the ear itself. Basically, research is ongoing.

There is great potential for the use of essential oils in veterinary medicine but use caution at this time.

Using essential oils orally is also being evaluated. The three main essential oils are: ginger, turmeric and cannabidiol (the non-THC portion of the plant). I authored an entire article on the use of medical marijuana a little over a year ago discussing both marijuana and hemp so I will focus on turmeric and ginger for this article.

Turmeric’s main property is antineoplastic (anticancer) and anti-inflammatory effects. Turmeric not only has direct antineoplastic benefits, but there is also evidence that it has a synergistic effect when used with chemotherapy. Ginger’s main effect is to reduce gastrointestinal spasming and inflammation. It is particularly effective as an antinausea agent. The biggest problem with both turmeric and ginger is absorption. Absorption for both of these essential oils is very variable.

Lastly are aerosolized essential oils, or aromatherapy. These essential oils are mainly used for mood stabilization or behavioral issues. This form is the most controversial as in-depth studies have not been performed in veterinary medicine. I don’t want to say they don’t work, but it is more something that has to be evaluated on a case-by-case basis. Use caution if you have birds in your house. Many of the aerosolized essential oils can cause serious, life-threatening, respiratory inflammation in avians. 

In conclusion, my opinion is that there is great potential for the use of essential oils in veterinary medicine but use caution at this time. As more information is published in the literature, I will update everyone.

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

The origins of the advantages of grain-free diets seem to be driven by the pet food industry itself. Stock photo

By Matthew Kearns, DVM

I recently had a pet owner come in and ask me if grain-free diets were dangerous. I knew there were risks of bacterial and parasitic contamination in raw diets but had not heard anything about grain-free diets. Time to investigate.  

The origins of the advantages of grain-free diets seem to be driven by the pet food industry itself. There are advantages to using other vegetables (peas, potatoes, chick peas, etc.) as a carbohydrate source if your pet has a documented case of allergies to grains. 

However, the complex carbohydrates and fiber in grains (corn, rice, wheat, barley, etc.) are much better nutritionally and overall digestive health. More recently a new problem has arisen from grain-free diets: HEART DISEASE!!!!

I need to start with a disclaimer that there is no current evidence to link grain-free diets and heart disease but here’s what we know so far: New studies have found that some dogs on grain-free diets are more at risk for a heart condition called dilatory cardiomyopathy (DCM). 

DCM is a heart condition where the heart muscle becomes thin and the heart dilates, or the chambers of the heart expand. Unfortunately, as the heart dilates, the heart becomes an inefficient pump and the patient goes into heart failure. The lung and abdomen then fill with fluid, making it impossible to breathe and, without treatment, is fatal. Even with treatment the patient’s life span is reduced dramatically. Why would grain-free diets cause this? The link seems to be taurine.

A study led by Dr. Joshua Stern (a veterinary cardiologist at the University of California-Davis School of Veterinary Medicine) found a higher number of DCM in golden retrievers. Stern also discovered that many of these patients were on a grain-free diet and had abnormally low taurine levels. 

Taurine is an amino acid, or building block of protein, that is essential for normal heart function. It is found in higher concentrations in muscle of animals including red meats, poultry and seafood. Plants contain very little to no taurine. The lowest concentrations of taurine are found in legumes (peas, chick peas), potatoes and other plants. Some dog foods are supplemented with taurine and some are not.

What to do right now? If your dog is healthy and not showing any symptoms of heart disease (coughing, exercise intolerance, difficulty breathing), you can do a few things: (1) check the taurine content on your particular diet and, if not supplemented, change to a diet that is supplemented, (2) change to a diet supplemented with taurine without checking, or (3) have your dog’s taurine levels tested through your veterinarian’s office and only change the diet or supplement if the levels are low.

Research is ongoing and I will update everyone as soon as I have more information.  

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

By Matthew Kearns, DVM

This time of year (actually throughout the summer and fall) we have an uptick in ear infections. To call every dog or cat that comes in with itchy ears an ear infection is misleading. Otitis externa means “inflammation” (not infection) of the external ear canal. The bacteria and yeast we treat with medications fall into the category of “normal flora,” or organisms found in low numbers in healthy ear canals. 

Usually some other trigger is involved and the normal flora overgrow. Parasitic infections (ear mites), pets that swim a lot/get water in their ears, or ear trauma (plucking hair, etc.) are triggers for acute, or nonrecurring problems that are easy to treat. 

Chronic, recurrent infections are almost always secondary to allergies. I actually consulted with a veterinary dermatologist and she estimated that between 80 and 90 percent of all recurrent otitis externa in dogs is related to allergies.    

The anatomy of the ear plays a role in predisposing patients to ear infections. The normal canine and feline external ear canal have and “L” shape, with both a vertical and horizontal component to it leading to a greater distance from the opening of the ear canal to the ear drum. Additionally, clearing the healthy ear canal occurs through a slow process called migration. 

The ear canal contains epithelial cells (those similar to skin), ceruminous cells and apocrine cells (cells that produce earwax). Epithelial cells will turn over, or be replaced every few days and, along with a small amount of earwax, migrate toward the entrance of the canal. Once at the entrance a good shake of the head sends it out to the world. If the lining of the ear canal becomes inflamed, it narrows due to swelling (most likely due to some sort of food or environmental/seasonal allergy) and excessive ear wax is produced. This combination not only overwhelms the ear’s ability to clear the wax, it also leads to a warm, dark and moist environment and allows the normal bacteria and yeast to go crazy.

Certain breeds such as Labrador retrievers, golden retrievers, cocker spaniels, shar-peis and mixed breeds of this type have predisposing factors such as hair in the ears, floppy ears, narrow ear canals or a combination. 

Now, this does not mean that every member of these breeds is guaranteed to have chronic ear infections, rather it means that if you have a member of these breeds and they have even low-grade allergies, the ears can spiral out of control quickly. We are also starting to encounter antibiotic strains of bacteria (such as Staphylococcus) in chronic recurrent otitis in veterinary medicine.  

The main point of all of this is if your pet has chronic, recurrent ear infections, it is important to look for an underlying allergy and treat the allergy. Sometimes it can be a veterinary-approved prescription diet or sometimes the newer, safer allergy medications. Remember to discuss this with your veterinarian.

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

While these tumors develop most commonly in mixed-breed dogs, boxers, Boston terriers, Labrador retrievers, schnauzers and beagles are at a higher risk. Stock photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

Cutaneous mast cell tumors are the most common skin tumor in dogs (estimated to be at least 20 percent of all skin tumors in dogs), and one of the most commonly encountered tumors in veterinary medicine. Mast cell tumors can be quite aggressive and cause multiple symptoms (all bad). Where do they come from? What do they do? How do we treat them?

Cutaneous mast cell tumors are malignant skin tumors made up of mast cells, cells normally found in tissues throughout the body. Mast cells contain primarily histamine, a vasoactive protein (a chemical that affects the diameter and tone of blood vessels) and are responsible for allergic reactions. 

Small amounts of histamine cause swelling, itching and redness of the skin. Large amounts of histamine trigger constriction of the airway, dilation of the vessels and an unsafe drop in blood pressure (anaphylaxis). 

Mast cell tumors develop most commonly in mixed-breed dogs. However, boxers, Boston terriers, Labrador retrievers, schnauzers and beagles are pure breeds that are at higher risk. If you have one of these breeds and you see a lump on your dog’s skin, bring it to your veterinarian’s attention as soon as possible.   

Diagnosis of cutaneous mast cell tumors is relatively straightforward and minimally invasive with a procedure called a fine needle aspirate and cytology. This involves obtaining a sample of cells with a needle attached to an empty syringe and sending the sample to a laboratory for evaluation by a veterinary pathologist. Once diagnosed, the best treatment is surgical removal, and the surgery does have to be somewhat aggressive by requiring wide margins. 

“Wide margins” refers to taking a certain amount of healthy tissue around and below the tumor, as well as the tumor itself. This poses the challenge of closing the “hole” you leave behind. 

Why do we take such large and aggressive margins? Mast cell tumors are graded as one, two or three based on aggressiveness, and it is impossible to tell from a fine needle aspiration anything beyond the diagnosis of mast cell tumor. Previous studies have stated that certain margins, both width and depth, help ensure you get all of the tumor the first time.

What do we do for patients that may be too old or debilitated for anesthesia/surgery, or the location of the tumor makes it impossible to remove fully with surgery? There are options such as chemotherapy, radiation and even injections directly into the tumor. All these alternative protocols help, and a small percentage actually completely resolve, or remove the tumor.

If you see a lump pop up on your dog’s skin (especially if you notice it pops up quickly), bring it to your veterinarian’s attention immediately.  

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

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.