Published May 15th, 2019
Anti-anxiety medications for vet visits
By Mona Miller, DVM
Dr. Mona Miller lives in Lafayette with her son, two cats and yellow Labrador. She attended UC Berkeley as an undergraduate, and received her DVM from UC Davis. She has been happy to call Lafayette home since 2001. She can be reached via email at MonaSDVM@aol.com. She welcomes questions from readers that may get incorporated into a column.
This is the last of a four-part series addressing pets who are anxious (especially during veterinary visits), in which I will cover the specific topic of anti-anxiety medications.

For many years, veterinarians did not have anti-anxiety medications available, and we relied solely on sedative medication. This is still an option that serves a useful purpose. I've discussed in this series of articles how a pet's anxiety level and temperament can often impede achieving the veterinary visit goals - checking ears, pulling a foxtail out of a paw, examining and treating eyes, as well as drawing blood for diagnostic tests, taking radiographs or administering vaccines. Sedation will allow these goals to be achieved, and the most common sedative is a pill that the pet owner administers at home a couple hours prior to the vet visit. On occasion, animals require full anesthesia in order to accomplish the veterinary goals.

While sedating a dog or cat does slow the pet down and allow for procedures to take place, most sedatives do not actually alleviate the internal anxiety. Thus, an alternative approach is to actually provide anxiety relief. I have addressed some non-medication options in this series of articles, published in the last few months. These include the use of a Thundershirt, calming agents and social visits.

Anxiety can be manifested in specific situations, or can be present as a long-term problem. Specific situations include vet or grooming visits, noise phobias such as fireworks or thunderstorms, or construction occurring in the house. Long-term anxiety is more of a temperament issue - an incredibly nervous dog who startles or becomes aggressive, and needs a reset of his brain chemistry, for example. For this latter problem, this falls in the realm of "behavior" management and is most often successfully addressed with a combination approach of anti-anxiety medication (such as generic Prozac) and behavior modification.

For the first category, though (specific situations that often last only a couple of hours), short-term anti-anxiety medication can be very helpful in alleviating anxiety. Additionally, a common side effect of most of these medications can be mild sedation, so that can contribute to the success of the situation. For example, a client's dog gets very nervous when being held in order to get his ears examined. It is understandable why this might be nerve-wracking - the dog is held closely by a nurse, holding his head very still, while a vet gets very close to his head with an otoscope that feels funny going into the ear canal - and the dog has to stay still for a few minutes. If the dog's ear is infected and uncomfortable, or has a foxtail and is uncomfortable, it is easy to understand that the dog might be resistant to all this attention. By giving a pill at home, a couple hours prior to the appointment, it is possible to lower the overall anxiety level (and possibly induce a mild amount of sedation), and the dog might be much more tolerant of the ear exam and cleaning when at the vet hospital.

Most short-term anti-anxiety medications take effect within 1-2 hours, and last about 6-8 hours. Thus, if any sedation occurs, it will be short-lasting. Often, the dose can be somewhat variable, and it may take a couple of visits to get an effective level of anxiety relief. And, on occasion, it may not be possible to override the adrenalin rush of anxiety and the medication may not work. But if it does, it generally is a safe and successful alternative to full sedation, or even anesthesia.

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