Anxiety, and the behavior problems stemming from it, is increasingly common in our companion dogs. If you have one of these dogs, you know how heartbreaking and disruptive this can be. Anxious dogs are not comfortable. They can’t relax. Sometimes they are downright panicky. This can lead to dangerous destructive behaviors, house-soiling, and even aggression. Luckily, there are many safe and effective anti-anxiety medications for dogs that can help your quivering canine.

The trick is to find the right ones, at the right dose, and the right combination. Take detailed notes of your dog’s behaviors, and response or lack of response to any drugs and dosages tried. Your veterinarian will use this information to tweak your dog’s protocol until the desired result is achieved. It’s a process that can take some time, so be patient and work closely with your veterinarian.

What medication can and cannot do for your dog

It’s important to mention that medication alone is not likely to be a magic bullet, miraculously turning your anxious dog into a calm, confident, well-mannered one; however, it drastically enhances the effectiveness of desensitization to triggers and behavioral modification – the mainstay of treatment and long-term management of anxiety-associated behavior issues.

Many highly anxious dogs fail to show the kind of progress in training that is typical for dogs without anxiety; that’s because anxiety, fear, and panic impair a dog’s ability to focus and learn. Anxiolytic (anxiety-reducing) medications ease the symptoms of anxiety, fear, and panic, allowing your dog to absorb and learn during desensitization and behavior modification exercises. The combination of medication and behavior modification, under the direction of a force-free trainer and veterinarian or veterinary behavior specialist, is the gold standard for treating canine anxiety.

Types of Anti-Anxiety Medications for Dogs

There are several classes of drugs used for anxiety in dogs. Some are long-acting and meant to be used daily. Others are short-acting and meant to be used situationally as needed, although they can be used daily in combination with a long-acting medication.

Most of the drugs used for anxiety in dogs are prescribed off-label, meaning the U.S. Food & Drug Administration (FDA) has not determined the safety and efficacy of the medication for the intended purpose.

Don’t let off-label use be a deal-breaker for you. These medications have been used safely and effectively in veterinary medicine for decades. Your veterinarian should have a conversation with you regarding off-label drug usage so you can give informed consent, and you’re ready to get started.

When multiple medications are necessary to achieve the desired result, drugs from different classes can be safely combined. This enhances their beneficial effects without doubling up on side effects. Never use two drugs from the same class at the same time.

We’ll take a look at each of the main classes of drugs used for anxiety in dogs, which are:

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Tricyclic Antidepressants (TCAs)
• Benzodiazepines
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
• Alpha-2 Agonists
• Anticonvulsant/neuropathic pain relievers

Selective Serotonin Reuptake Inhibitors (SSRIs)

The drugs that belong to this class and are commonly given to dogs are:

• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Citalopram (Celexa)
• Sertraline (Zoloft)

Serotonin is a neurotransmitter highly involved in mood and emotions. It is known to produce calm and lessen overactive responses to normal stimuli. SSRIs decrease the reabsorption of serotonin, resulting in increased amounts circulating in the brain, which helps manage anxiety, aggression, and obsessive-compulsive behaviors (e.g., self-mutilation by licking or chewing, flank sucking, tail chasing, pacing/circling, incessant barking) in dogs.

SSRIs are long-acting medications that are prescribed for dogs with generalized anxiety issues needing help on a daily basis. They generally take four to six weeks to reach full effect, so shorter-acting anxiolytic medications are usually prescribed with them in the beginning.

Never use an SSRI with a TCA, nor use two SSRIs at once, as this can result in serotonin syndrome (see sidebar). If you don’t see the desired result from the first SSRI medication you try, your vet should guide you through tapering your dog off the first medication before prescribing another.

Tricyclic Antidepressants (TCAs)

The drugs that belong to this class and are commonly given to dogs are:

• Clomipramine (Clomicalm)
• Amitriptyline (Elavil)

TCAs affect several different neurotransmitters, including serotonin, resulting in increased calm and dampened panic responses. They are long-acting medications given daily to help manage anxiety and obsessive-compulsive behaviors in dogs. They do not work for aggression. TCAs usually take three to four weeks to maximum effect. Do not use with an SSRI, and never use more than one TCA at a time. Do not stop abruptly. Always taper off these medications.

Benzodiazepines

The drugs that belong to this class and are commonly given to dogs are:

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Lorazepam (Ativan)
• Diazepam (Valium)

Benzodiazepines are fast-acting (60 to 90 minutes), short duration (4 to 12 hours), anxiolytic medications that promote calm by increasing the effects of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the central nervous system. They can be used alone or in combination with other classes of behavior-modifying drugs. They can be used “as needed” for situational triggers, or included as part of a daily multi-drug protocol.

Benzodiazepines are federally controlled drugs (meaning there are legal limits on their prescription).  Physical dependence with increasing dose tolerance is unfortunately a possibility when benzodiazepines are used long-term. To avoid withdrawal symptoms (confusion, vocalization, tremors, twitching, seizures, and death), always slowly taper off these medications after long-term use.

Serotonin Antagonist and Reuptake Inhibitors (SARIs)

Only one drug belongs to this class that is commonly given to dogs:

• Trazodone

Trazodone is pretty much the only SARI used in veterinary medicine. SARIs keep more serotonin circulating by both decreasing its reabsorption and blocking its receptors. SARIs have both anxiolytic and sedative effects. They are rapid-acting (30 to 90 minutes), have a short duration (4 to 8 hours), and are non-addictive. They can be used alone, as needed for situational anxiety, or included daily as part of a multi-drug regime.

Trazodone has a wide dosage range so it will typically be started low and ramped up from there. Because SARIs increase serotonin, combining them with SSRIs and TCAs comes with a slight risk of serotonin syndrome. However, trazodone is routinely used together with SSRIs in dogs, with few reports of this.

Alpha-2 Agonists

The drugs that belong to this class and are commonly given to dogs are:

• Clonidine
• Dexmedetomidine (Sileo)

Alpha-2 agonists inhibit the release of norepinephrine (adrenaline) in the central nervous system. As inhibitors, they really work only if given before your dog gets upset. Once he’s upset, adrenaline has already been released along with its “fight or flight” response, and it’s too late.

Alpha-2 agonists are given prior to stressful situations known to invoke fear in your dog (such as veterinary visits or any situation that tends to trigger your dog’s separation anxiety, noise phobia, fear aggression, or leash reactivity). Onset is rapid (30 to 90 minutes), duration is short (2 to 4 hours), and they are safe to use with most other anxiolytic medications. As such, they can be added to a daily multi-drug regimen.

Anticonvulsant/neuropathic pain reliever

Only one drug belongs to this class that is commonly given to dogs:

• Gabapentin

Gabapentin is frequently used in combination with other anxiolytic medications for its mild sedative effect. It works by blocking certain biochemical channels in the brain, which calms overstimulated neurons, helping lessen feelings of anxiety. Gabapentin takes effect within 1 to 2 hours and lasts 6 to 8 hours. There is a wide dose range. Your veterinarian will likely start with a low dosage and increase the dose as needed. It can be used situationally, often in combination with trazodone, or it can be added to a daily multi-drug regime.

For more information about gabapentin, see “Gabapentin for Dogs: What You Should Know,” WDJ April 2021.

Be persistent when finding the right anti-anxiety medication for your dog

Finding the right medication (or combination of medications) and the right doses for your dog’s anxiety can be challenging. If a medication is not working well enough and maximum dose has not been reached, sometimes simply increasing the dose may work, assuming the side effects aren’t too bad. Other times a different drug from the same class will work better. Combining medications from different classes is often the ticket. And remember, SSRIs and TCAs take weeks to reach full affect, so adding a short-acting drug in the beginning is always helpful.

Here are some examples of how a case may be managed:

A dog with separation anxiety might be started on fluoxetine daily, with alprazolam as the short-acting medication for the first 4 to 6 weeks. If this isn’t working, the veterinarian may add gabapentin, or discontinue alprazolam and add trazodone. At 6 weeks, if the desired effect has not been achieved, the vet may increase the dose of fluoxetine and add clonidine. If this doesn’t work, fluoxetine may be tapered off and a different SSRI or TCA started as the long-acting daily medication.

A dog with generalized anxiety who is also reactive on leash (see “On-Leash Aggression)” may do well with a daily SSRI or TCA, and clonidine given an hour before going for walks.

Trazodone combined with gabapentin is frequently used for fear and anxiety associated with veterinary visits. If this isn’t enough, clonidine or dexmedetomidine may be added.

Fortunately, no matter what your dog’s issues are, there are many possible medications and medication combinations available to try, with the simple goal of finding what works best for your dog with the least amount of side effects.

Most Commonly Prescribed Medications for Dogs with Anxiety

Choking puts otherwise perfectly healthy dogs at an imminent risk of dying – within minutes – if first aid is not successful.

Choking is the inability to breathe due to an obstruction of the upper airway (trachea or windpipe) that blocks air flow. In dogs, choking is usually caused by foreign objects like balls or bones. Note: Trauma and swelling in the throat can also block air flow but require immediate veterinary help. The techniques below are used to remove the object stuck in the dog’s throat.

What to Do When a Dog Is Choking

If you encounter a choking dog, the first thing to do is ascertain if the dog is really choking. “Blocked air flow” is key here. If a dog can cough, there is airflow. So, if your dog is coughing, as harsh, uncomfortable, and scary as that may be, he is not choking. If coughing persists, he needs to see a veterinarian for sure, but you can relax and leave your superhero coat in the closet for now.

Signs of Choking in Dogs

Signs of choking in dogs include:

• Obvious distress
• Pawing at the mouth
• Gagging
• Trying to cough
• Producing no sounds, or just faint whistling sounds
• Salivating
• Tongue and gums turning blue
• Collapse

How to Save a Choking Dog

1. Do a Finger Sweep Inside the Mouth

If you can safely put a finger in the dog’s mouth without being bitten, try a finger sweep first. If you can’t safely do this with a still conscious, panicking dog, it is the FIRST thing you do when they become unconscious. Be careful not to push anything you may feel at the back of the mouth deeper into the throat. If you feel something thin enough to grasp with your fingers, you may be able to retrieve it and clear the dog’s airway.

If you have a hemostat in your first-aid kit, you may be able to grasp the object. (A hemostat is a surgical tool normally used for clamping blood vessels, but its blunt end and grasping characteristics make it perfect for grabbing something heading down your dog’s throat.) If you feel something but can’t grasp it, your next move is to try to dislodge it by compressing the chest.

2. Chest Compression

With the dog standing, stand over him facing the same way and with both hands simultaneously push on his rib cage. Strong, forceful, repeated thrusts will likely be required. If this is unsuccessful, move on to the Heimlich maneuver.

3. The Heimlich maneuver

The way to do a Heimlich maneuver depends on the dog. The key is to use repeated, forceful, upward thrusts with a fist underneath the dog behind where the rib cage ends. Place yourself over the dog in whatever position allows you to place your hand/fist right below the rib cage and apply a maximum pressure gradient force from the abdomen/chest up toward the throat.

For small dogs, this position might be holding them with their spine against your body while applying the force.

For larger dogs, the Heimlich can be performed with them standing up on their hind legs, facing away from you (as is done with a human), or lying on their sides or backs if you can’t hold the dog up.

4. Rescue Breathing

If you successfully dislodge the object, but your dog is not breathing, you must perform rescue breathing – like CPR for humans, as you’re administering artificial respiration – to get the dog breathing. Close the dog’s mouth, extend the neck, place your mouth over both nostrils to create a seal, and breathe hard enough into the dog to see the chest rise and fall. Wait a few seconds for a response and repeat as needed.

Prevent Choking in Dogs

Be careful with what you allow your dog to chew on and always supervise chewing sessions.

Choking occurs most commonly during play, especially with balls. Make sure your dog only plays with a safe type and size ball. A ball that is too small for the dog could easily make its way to the back of the throat and choke the dog. This is especially important in large exuberant dogs.

If the ball is compressible, like a tennis ball, it might be easier to retrieve if it becomes lodged. Balls with holes in them are even easier to grasp.

Warning: NEVER, EVER LET DOGS PLAY WITH LACROSSE BALLS! These balls are hard and dense and the most difficult, if not impossible, to retrieve when stuck in the back of the dog’s mouth.

When your dog needs an annual rabies shot depends on if he previously received a one- or three-year vaccine. However, even if he got a three-year vaccination, your dog’s rabies shot schedule is still dictated by state laws. Both the one- and three-year versions are approved by the U.S. Department of Agriculture.

Fortunately, most states (Ohio and Hawaii have no rabies vaccine requirements) rely on the “Compendium of Animal Rabies Prevention and Control, 2016,” published by the National Association of State Public Health Veterinarians, to make decisions about when dogs needs rabies boosters, and they accept the three-year vaccine.

Extending Rabies Booster Intervals

The 2020 Rabies Challenge Fund Research Study, with esteemed lead researcher W. Jean Dodds, DVM, set out to determine if rabies booster intervals could stretch to five or seven years. The reason for the study was to maximize revaccination periods to reduce vaccine-related adverse events. Reactions to rabies vaccines are rare, but they can occur, especially in ill and senior dogs. The study demonstrates that the duration of immunity to rabies in vaccinated dogs extends beyond three years and that immunologic memory exists even in vaccinated dogs with a low serum antibody titer.

Further research is required, but if you have a dog who severely reacts to vaccinations or cannot have a rabies vaccination due to other health concerns, there is hope. At least 16 states offer waivers. Applying for a waiver requires the help of your veterinarian.

When to Vaccinate Your Dog for Rabies

When a dog can get a rabies shot depends upon his age. A puppy should have his first rabies vaccination at 14 to 16 weeks of age and another vaccine a year later. He then needs a booster shot every one to three years, depending on the vaccine. Only licensed veterinarians can give rabies shots, so discuss the vaccine with your vet.

What To Do When Your Dog Encounters Rabid Animal

Rabies is carried mostly by raccoons, skunks, foxes, and bats, which even city dogs may encounter. A study in the Sept. 15, 2009, Journal of the American Veterinary Association showed that rabies cases in vaccinated animals are rare, but they do occur.

If a dog is exposed to rabies and vaccinated, he will be revaccinated immediately and put under the owner’s control. The dog must be watched for signs of rabies for 45 days, according to the Centers for Disease Control and Prevention (CDC). Signs of rabies include:

If the dog was never vaccinated, the CDC advises euthanasia. If the owner objects, an immediate rabies vaccination may be given, and the dog is required to undergo a four-month strict quarantine.

Georgia has by far the most documented cases of rabies in wild animals, followed by New York, Pennsylvania, Texas, Florida, and California. Surviving rabies is rare in both dogs and humans, and the cost of treating a canine rabies case can run to $12,000 or more with no guarantee of survival.

Can dogs eat chicken bones? Well, yes, he can. Should a dog eat chicken bones? If the bones are cooked, the answer is absolutely not! Cooked bones are dangerous.

There are many people who feed raw chicken (including bones) to their dogs as part of a “bones and raw food” (BARF) diet. But there is more involved to feeding raw chicken safely than just handing your dog a raw wing or leg. For guidance on feeding raw bones as part of a BARF diet, see “Feeding Raw Bones.”

Why Chicken Bones Are Bad

Many veterinarians will say the dangers of eating chicken bones are a myth, adding that dogs have eaten them for centuries. But, in the next breath, the same veterinarian will likely tell you about a dog or two who choked or had to have emergency surgery for a perforated intestine, adding, so your dog shouldn’t eat chicken bones.

Once they reach the dog’s stomach, acids and enzymes normally dissolve chicken bones. But there’s always that one dog who chokes (from eating too quickly and not chewing sufficiently) or gets a bone fragment caught or a piece embedded somewhere in his digestive tract . . .

Treatment If Your Dog Ate Bones

What should you do if your dog ate some cooked chicken bones? First, stay calm—it will do neither of you any good to panic! If you catch him in the act, take the bone out of his mouth, if you can. If you have a hemostat in your first-aid kit, use that.

If you’re not quick enough to remove the bone before he swallows it, check for blood in his mouth or in his throat. If you see none—and your dog is acting normally—he’ll probably be OK. Note: Do not induce vomiting. There is more risk from the bone fragments coming back up.

Even so, though, it’s wise to give him soft food, like a little white bread and/or a tablespoon of plain canned pumpkin in his meals for a few days, to help move the bone pieces out. Encourage consumption of water, adding a little broth, if necessary, to keep him well-hydrated. (Always have a second bowl of plain water available, too.)

Check his poop for three days to see if there is any bone or blood and to monitor him for bloating, vomiting, bowel changes, or other discomfort like lethargy, lack of appetite, whining, and so on. Call your veterinarian immediately if you see these things.

To be sure your dog is fine, put chicken bones where he can’t reach them—even though he’s telling you that chicken and turkey taste great!