Question: I currently have a dog that I believe is suffering from a recently acquired phobia/anxiety disorder. I have two other dogs that are just fine. Have had a complete workup at Vets-tried Elaviel 150 mg.q day with no results. Am just beginning on clomipramine-starting at 25mg.day -increasing weekly until 75 mg./day is achieved. Am looking-questioning wether Paxil or Zoloft has been used with any success in dogs. Paxil is marketed for panic disorder in adults, also anxiety disorder. This is a 117 lb. Malamute X, she is three years old. Began exhibiting startle response last year- has greatly incresed this past two months. She has broken out of 6 foot fences and through chain link fence. She is terrified of the hot air ballons overhead, even when they are very high. She scans the sky if she senses they are up. She is in the house when I am home, which varies as I am a nurse and often work double shifts-at least 2 times weekly..When I am home all dogs are walked for one hour daily and are kept with family. They are not isolated out side. My vet is very nice but is reluctant to try newer drugs because he has had no experience with them. His clients that have behavioral problems are usually referred to U.C, Davis vet school. Recently they have begun requesting videos of behaviors before assessing the animals. I am a psychiatric nurse and I do not have a video camera to set up and monitor my dogs daily, nor am I willing to do so. The broken fences and the neighbors are enough. I have consulted with an animal behaviorist- cost of her assessment and evaluation is prohibitive. Please answer . a
Answer: A- There are veterinary behaviorists using fluoxetine (Prozac Rx), paroxetine (Paxil Rx) and sertraline (Zoloft Rx) in dogs, usually for aggressive behavior but these medications may also help for anxiety. Other choices for anxiety are amitriptyline (Elavil Rx) and clomipramine (Clomicalm Rx). Of these medications, only clomipramine is actually approved for dogs, so that is one reason that general practitioners tend to shy away from using other medications, to some degree. The other reason is that medication alone is often (usually) not sufficient to control behavioral problems in pets, although they are often very helpful in controlling them. I am not sure what behavioral advice to give you for fear of flying objects, though. Alprazolam (Xanax Rx), diazepam (Valium Rx) and buspirone (Buspar Rx) have been used for situations that are predominantly anxiety related and often are helpful in these situations-- but I am not sure about the effects of long term use, as might be necessary in this case. I don't think there are controlled studies for dosages of the SSRI (selective seritonin re-uptake inhibitors) in pets, but the usual recommended doses for dogs, from meetings, information on the Veterinary Information Network and discussion with other vets are: fluoxetine (Prozac Rx): 1mg/kg of body weight, once a day ( 0.5 to 2 mg/kg range of recommendations) paroxetine (Paxil Rx): 0.5 to 1mg/kg body weight, once a day sertraline (Zoloft Rx): 1 to 2 mg/kg of body weight, once a day It is best to run at least a general chemistry panel and complete blood count prior to using these medications since there isn't too much information yet on their effects in dogs. Then check at least once after starting the medications. This is a precaution but it might make your vet feel better about using these medications. I worry about using medications when there really aren't controlled studies demonstrating safety and efficacy. The dosage for clomipramine is 1 to 3mg/kg every 12 hours. So your dog is in the lower end of the dose range at this time. Hope this helps some. Mike Richards, DVM 7/7/2000
Separation Anxiety and crate destruction
Q: Dr. Mike, I recently rescued a stray and decided to keep her. Annie appears to be a cocker/terrier mix and my vet believes she is around 3 or 4 years old. Unfortunately she is not in great health. She has tested heartworm positive and has cataracts - which I'm told is unusual for her age. She is also getting over a case of kennel cough. While those are big problems, my largest problem is keeping Annie in her crate! I've had her 4 days so far and I've only the house three times - twice for 2 or 3 hours and once for 6 hours - each time she has bullied her way out of the crate - bending the metal enough to bust open the door (at this point the crate looks like hell as you can imagine). With the cataracts, she can't see very well - bumps into things a lot - so I don't want her loose in the house when I'm not home for fear she will hurt herself or break things. Also, she is going in for heartworm treatment next week and I'm told she will need to be crated almost constantly for a month to keep her quiet and inactive. I have two other dogs at home as well, so she definitely needs to be crated and away from them during recovery when I'm not home. What can I do? I have to work and can't stay home all day with her. Even if I get a stronger crate, I'm scared the physical exuberance she uses to bully her way out of the crate will be very harmful for the heartworm recovery. It's a catch-22. The funny thing is - she is a very happy and docile dog - not aggressive or overly playful in any way except when she is left alone in the crate. She does fine in the crate when I'm home by the way (I've been trying to get her used to it). I don't know if it's the crate or if she just freaks out when I leave. Either way it's bad news. Any thought/suggestions? Thanks so much!!
A: . It does sound like the problem with Annie is more likely to be separation anxiety than it is a crate phobia. Dogs that get upset when they are left alone (not uncommon in adopted strays or dogs adopted from shelters) can get really upset when crated and will sometimes injure themselves in their frenzy to get out. Usually these dogs will also have destructive behaviors in the house, but not always. It is very difficult to decide what to do when faced with heartworm treating a dog that gets more upset when confined than it does when unconfined. The object is to keep the dog as quiet as possible and sometimes that means that you have to work with the dog's personality and figure out the best solution. If the heartworm treatment seems necessary immediately and it is possible to take Annie with you wherever you might go for a month, that may be the best solution for her. If the heartworm treatment can be delayed it may be possible to get Annie better adjusted to your home so that she can tolerate being alone with less stress and exertion. Even if that is not possible I usually think going ahead and heartworm treating is best. After all, most dogs die from the worms if they are untreated and lots of dogs live through the treatment even if they are not confined. Staying quiet increases the chances of survival and of avoiding complications but even if it isn't possible to arrange the treatment still gives better odds of long term survival than living with the heartworms. I hope all is going well. Mike Richards, DVM
Q: My German Shorthaired has severe separation anxiety. Even if we go outside for five minutes, he starts barking and crying, and he'll go on for hours. If we leave him out of the cage, he tears up everything. I was wondering if normal vets can prescribe medication, or if we have to go to a special behaviorist. I'd hate to have to give my dog up. We've been through two trainers to no avail.
A: Matthew- We work with clients whose dogs have separation anxiety frequently to try to help resolve the problems. We dispense medications when we think it is appropriate and try to give reasonable advice for dealing with the situation. I really like a pamphlet put out by Cycle foods and written by Victoria Voith, DVM, which details the steps in treating this condition. It is called "The Dog Who Can Not Be Left Alone". If your vet gets these from Cycle it would be worth reading it. In any case, if your vet doesn't feel comfortable helping with behavioral problems he or she may be able to refer you to a local colleague who does. If you are very lucky, there will be a behaviorist in your neighborhood -- but there are not enough veterinary behaviorists right now so it does take luck to have one nearby. Mike Richards, DVM
Q: Hopefully you can help... Have talked to my vet and also pet behaviorists. I have two chows, a female (3 years) a male (4 years). My female has always wanted to kill any other small (Rodent- squirrel, raccoon etc). Last year I got married and moved in to my husband's home. Previously I lived in my own home and had a dog door, so they could run in and out whenever possible. When I moved into my husbands house we opted not to put a dog door in, we now live on an acre and just decided that was best. My husband has a 14 year old retriever, all dogs get along. Last week we noticed that the plants from the window sills had been knocked down, I said okay just looking out the window, accidents happen, next day we noticed she had been on top of our glass dining table. What? Now nothing has been torn up, but we have no idea what's going on. These dogs have never been kenneled, I have worked since they were babies, (the same hours) and lived here for over a year now. They have never touched anything in their lives. The next day we noticed that in our kitchen (by the counter tops) we have tile and wood trim (she had stood up and chewed on the trim) not completely demolishing it, just chewing and then left it alone. Took her to the vet to make sure there was nothing physically wrong with her. Everything checked out fine. I have raised, showed, breed dogs, but have never had this problem. The next day we decided we would put up gates to keep her out of the kitchen, came home at noon to check and she had torn up the molding on the side of the door opening, trying to get in the kitchen. Now, she is in a kennel. She got out. Don't they always. I have kenneled before, but obviously have not had time to crate train her properly. Now it has occurred to me, that 2 weeks ago I saw a mouse in the kitchen.... Last night we set mouse traps in our basement which leads up to the kitchen, caught a mouse. This is the only thing in our lives that has changed, everyone keeps telling me that she has developed "separation anxiety", would this happen after 3 years, (just out of the blue?), do dogs just become destructive (something snaps?). Chows are not known, nor have I ever had one that has ever destroyed anything. What's your advice, any great thoughts? It kills me to crate her, because if really she thinks she's being good and I'm punishing her - I could be creating a whole new problem. All your help would be greatly appreciated.
A: It is not unusual at all for a dog to develop separation anxiety symptoms suddenly and it appears to be possible for it to happen at any age. I actually thought from your letter that you might be talking about your husband's 14 year old Lab --- we have seen separation anxiety develop in dogs of this age on several occasions. Almost anything that causes stress during a separation can lead to separation anxiety. We have seen this after boarding a dog, with thunderstorm phobia, after traumatic incidents, when the meter reader changed (I'm serious) and when the dynamics of the interaction between dogs in a household changed. Almost anything that frightens a dog can lead to separation anxiety behavior. Dogs with separation anxiety can really injure themselves in a crate if they are sufficiently frightened by the confinement. I have heard of injuries as severe as broken jaws and have seen a dog that developed heat exhaustion in its home from struggling inside a crate. In addition, as you point out, most crates will not contain a dog that is willing to injure itself in the effort to get out. As an immediate aid in buying time to treat this condition properly you may wish to ask your vet about the use of anti-anxiety medications. Diazepam (Valium Rx), buspirone (Buspar Rx) and amitriptylline (Elavil Rx) are the most commonly recommended medications. Fluoxetine (Prozac Rx) has also been used, although it is more expensive than the other medications. Drugs alone are rarely sufficient to control the symptoms of this disorder. You will probably need to use some behavioral modification to successfully get over this problem. The good news is that it usually works. The bad news is that it sometimes takes a fair amount of time and effort to work through a case of separation anxiety. If there is a board certified animal behaviorist in your area it would be worth consulting with this person. If not, your vet or a well informed trainer may be able to help. Mike Richards, DVM
Separation Anxiety - Things You Can Do
Q: Hi, I have been trying to find info to see if there is any way to help my dog. She is a 12 year old springer/beagle cross with selective hearing and chatarachs. She has always been a bit clingy but for the last year it has gotten so bad that i can't leave her at home alone because she gets so upset that her heart races and she shakes and exaughsts herself barking constantly, etc. we have been in transition and have moved, which i'm sure didn't help, but before this year i could at least leave her at home without worrying about her. at this point, we can't go anywhere without her or without leaving her in the car because she seems to feel calm and safe there. She also seems to be getting a bit more arthritic in her old age. I'm not sure if she's in pain because she's never complained loudly about anything (including, once, a large thorn in her foot - she just started limping quietly until i noticed her) Physically, she seems in excellent shape most of the time. she has lots of energy, looks good and healthy etc. she sleeps alot more now though and sleeps very deeply. her diet is good, appetite has always been low....any suggestions would be greatly appreciated!
A: Moving does seem to incite separation anxiety in some dogs that do not exhibit it otherwise. I have included the standard information on separation anxiety below. Hopefully you can devise a plan, with your vet's help, to deal with this situation. Separation anxiety: A dog is a social animal. It wants to be with the family and being alone is not an entirely natural situation. Some dogs can not adjust to this situation without help. As a puppy, a dog learns that making sounds brings its mother to it. So barking, whining and crying are natural reactions when the dog wants to be reunited with its family. It may also consider digging, scratching at the door or window and other behavior designed to allow it to escape the house and rejoin its family to be "normal". Dogs may become so anxious that they tear up objects indiscriminately, defecate or urinate without control. If a dog is punished for these actions, the resulting increase in anxiety can make the whole situation worse. It is best just to ignore the destruction if at all possible. In order to treat the disorder, it is necessary to set aside some time to figure out exactly what is happening and to help your dog adjust to separation. 1) The first thing you need to do is spy on your dog to figure out how long he or she waits before tearing up stuff in your absence. Some dogs literally start in one minute or less. Others wait a half hour or an hour or whatever. Once you have an idea of this you can work on the problem. It is also necessary to teach your dog at least to "sit" and hopefully to "stay" prior to working on the actual behavioral problem. 2) A dog that is so nervous that it must be in the same room with you all the time requires working with sit and stay until it can tolerate you being out of the room -- then start to work on leaving the house. It can help a great deal with steps 2 and 3 in this process to use an anti-anxiety medication, such as amitriptylline (Elavil Rx) or buspirone (Buspar Rx). Talk to your vet about this. It is also very helpful to consider asking about referral to a certified veterinary or animal behaviorist for assistance 3) Leave for short periods and come right back -- sometimes all you can do is stand outside the door for a few seconds. Don't stay away long enough for your dog to get upset. The idea is to lengthen the time gradually. It may help to vary the time some so your dog can't keep track of a "routine". Keep this up until your dog is comfortable with you gone for a reasonable length of time. Don't make a big deal over coming back in -- it is best to greet the dog quietly or ignore it. 4) Once your dog can tolerate you being gone for an hour or two, it will probably be possible to make the jump to longer durations without much problem. Usually, about the time your dog is very comfortable with being left alone, it is best to begin a slow taper off of any behavioral medications used to help in the treatment of the separation anxiety. Abruptly stopping the medications can lead to a relapse, so take a little time to wean your dog off according to your veterinarian's directions. A good booklet on this problem, "The Dog That Cannot Be Left Alone" by Victoria Voith, DVM, is distributed by Cycle. Your vet can get this booklet and others, by writing the Cycle Pet Care Center, P.O. Box 9001, Chicago, Il 60604-9001. It is not necessary that your vet sell Cycle foods-we do not. I am not sure the address is still valid -- hopefully it is. Mike Richards, DVM
Separation Anxiety in Husky
Q: Dear Dr. Mike: Our Siberian Husky has been giving us problems since he was 8 weeks old. He is now 16 months old. The vet and his trainer have told us this is separation anxiety. We have tried crating in a plastic crate and tore through that and was damaging his gums. We now have a steel crate but that is not working either. Some days he will go for 10 hours alone in the crate and nothing but some days he will be alone for 2 hours and he will have had a bowel movement. When he has these bowel movements he will eat them. The vet was talking about putting him on Prozac but we are unsure of the effects of the medication. Will he be on this for the rest of his life, what if he misses a day, will it change his playfulness? Thank you in advance.
A: Separation anxiety may be the most common behavioral problem in dogs. It is very likely that your husky is experiencing this problem. Dogs can not ask you where you are going and when you will be home. They can't be comforted by leaving a phone number where you can be reached. If they are worriers, their only option is to worry. This can lead to behavioral problems related to their stress if they exhibit it as inappropriate defecation or destruction of your home or possessions. It is a tough situation. Several things about your letter make me think that your dog has even more reason to worry than most. It helps a great deal if you keep a regular schedule. A dog who learns to count on you being home at a specific time is less likely to be stressed out than one who wonders when you will get home. Ten hours is a very long time to keep a dog crated. I think I can relate to the anxiety that this would cause having a touch of claustrophobia in my personality mix. If it is at all possible, crating for this duration of time should be avoided. Many dogs with separation anxiety are much worse when crated than when they are not. Of course, their destructive behavior makes crating them appealing. When they are self destructive (chewing to the point of hurting themselves) the situation is very difficult. In this case, confinement to a small room that is relatively secure from destructive urges might be best, if it can be arranged. In addition, there is a place for medication in treatment of these dog's anxiety. Fluoxetine (Prozac Rx) is one choice. I have not ever used Prozac because of the cost and my unfamiliarity with it. I have used amitriptylline (Elavil Rx) with reasonable success, when combined with a program to desensitize the dog to the anxiety. Some people use megestrol acetate (Ovaban Rx) for this purpose and there are probably other medications in use by vets. The first step in treating this problem is determining when the destructive behavior is occurring. Most of the time, it is going to happen shortly after you leave. Often, the dog is frantic for 5 to 15 minutes and then settles down. Some dogs have the reverse problem, just getting excited when they think you should be arriving home. If your dog is among the majority that have problems very quickly, the best approach may be to leave for very short intervals over the course of a weekend and come home before your dog has a chance to be upset. For some dogs, with severe problems, you have to start out with just leaving the room they are in. For most dogs, you can leave the house but may only be able to stay outside for a minute or two before your dog is overly anxious. Then "come home" and greet your dog. Repeat the process, varying the interval to make it longer and longer but still coming back before your dog is really upset. It can take a week or two of concentrated effort to reach the point that your dog is OK about being alone if it has mild separation anxiety. It can take a lot longer if the anxiety is severe. Once your dog is able to accept your absence, continue the anti-anxiety medication for two or three weeks and then gradually wean your dog off of it, perhaps over the course of a month. This seems to help prevent relapses in their behavior. I honestly don't know if you will ever be able to leave your dog for ten hours crated without some anxiety on his part or without risking him urinating or defecating in his crate, at least occasionally. That may be beyond his ability to control the emotional or physical urges. Do you have a neighbor, pet-sitter or friend who can check on him and let him go for a walk on these long days? Mike Richards, DVM
Last edited 01/30/05
Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...