QUARTERLY BEAT
APRIL 2026
SHORT-ACTING MEDICATION EXAMPLES • Clonidine: Clonidine is an alpha-2 agonist used 2 hours prior to stressful events, and repeated up to every 8 hours. • Trazodone: Trazodone is a serotonin antagonist and reuptake inhibitor (SARI) used 2 hours prior to stressful events, and repeated up to every 8 hours. • Gabapentin/pregabalin: These are gabapentenoids used to treat anxiety and neuropathic pain, as well as seizures. These medications have a wide dose range and are used 2 hours prior to stressful events, and repeated up to every 8 hours. • Sileo ® (dexmedetomidine) oromucosal gel: This is an alpha- 2-agonist medication labelled for noise aversions. It is typically applied 30 minutes prior to stressful events or at the onset of a sudden stressor. It can be re-dosed every 2 hours, up to 5 times in a single day. Sileo can be used off-label for other stressors, such as fear of veterinary handling, to lower fear and provide better focus during behavior modification training, or travel. Owners should be educated on application and safety of administration should be considered for dogs with any owner- directed aggression. • Benzodiazepines: This is a large drug class that works by potentiating the effects of GABA in the brain. There are multiple different medications that may be chosen based on duration of action needed, clinician preference, or trial and error testing. Benzodiazepines can cause disinhibition of aggression and are not typically first-line choices in a case involving aggression. Long-Lasting Medications Long-lasting medications are pulled from the anti-depressants developed in people. These medications are intended for longer-term use and take 4 to 6 weeks to take effect. Long-lasting medication can be utilized for a wide variety of behavior concerns including, but not limited to aggression, generalized anxiety, noise fears, separation related problems, compulsive disorders, urinary marking, and global fear. It is a common misconception that daily long-lasting medications are contraindicated in aggression. In fact, long-lasting medications, such as selective serotonin reuptake inhibitors (SSRIs), are often a cornerstone of treatment to help dogs with aggression. Any behavior medication can cause agitation, which can lead to increased aggression. However, this is rare, and the proportion of pets that can improve with these medications is significant. It is important to have a conversation about possible side effects and provide follow-up for continued management. Early implementation of a long-lasting medication can help supplement a behavior modification plan and lead to best outcomes. Long-lasting medication should not be considered a last resort option. The goal of long-lasting medication is to reduce anxiety, fear, and improve impulse control without causing sedation or other long term side effects. Transient, mild side effects (e.g., reduced appetite or sedation) may be tolerated for 1 to 2 weeks. However, if side effects are persistent, even if mild, medication should be discontinued and another option should be trialed. If medication causes significant side effects (e.g., profound sedation, agitation, significant GI upset), it should be discontinued right away. The goal is a happier and safer dog, not to have a lump in the corner. It is very helpful to proactively go through these expectations with the owners when discussing medication, as many owners hesitate to start long-lasting medication because they don’t want their dog sedated.
Dosing should start at half of the typical starting dose for 1 to 2 weeks to watch for any side effects before moving to the standard starting dose at the low end of the dose range. Increases can be considered once a pet is on the standard dose for 4 to 6 weeks.
EXAMPLE #1: A 6-month-old female spayed mixed breed dog presents for starting to growl at strangers on walks. You’ve had to start restraining carefully during vaccines. This dog is a good candidate to combine a long-lasting medication with a comprehensive behavior modification plan. Six months of age is an earlier than typical onset for fear-related aggression and should be treated urgently.
EXAMPLE #2: A 5-year-old newly adopted Newfoundland is destructive, having accidents and vocal when home alone. This was reported in the previous home and was the reason for relinquishment. The owner works out of the house 3 days per week and has an active social life out of the home. This dog is a good candidate for long-lasting medications to help treat a long-standing problem of separation-related problems and help provide some potential independence from – or, at minimum, amplification with - the use of fast- acting medications used for departure, which are also likely indicated in this case. LONG-LASTING MEDICATION EXAMPLES • Selective Serotonin Reuptake Inhibitors (SSRIs): This drug class blocks the reuptake of serotonin and includes medications such as fluoxetine (generic or Reconcile®), sertraline, paroxetine and escitalopram. There are mild differences in each medication that may point us towards one versus another, such as fluoxetine being more likely to reduce appetite. • Serotonin-norepinephrine reuptake inhibitors (SNRIs): This drug class blocks reuptake of serotonin and norepinephrine. Venlafaxine is the main medication used in dogs within this category. • Tricyclic antidepressants (TCAs): TThese medications block
reuptake of serotonin, norepinephrine and dopamine. They also are antihistaminergic and anticholinergic. The most common medication used in this category is clomipramine (generic or Clomicalm®).
14 VETGIRL BEAT EMAGAZINE
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