madremissy wrote:Christine, He pants heavily, will not sit down or settle down. Racing heart. His thing now is that he starts whining and will not stop.
katiek0417 wrote:Michelle, it must've been me...I knew vets were doing it, but my friend Paula (who teaches at a veterinary school) actually explained why...so it sounds like something i might pass on to you b/c I know we've discussed anxiety in dogs...and meds...
Acepromazine and Chlorpromazine
Terry Kelley CVT, CPDT
Acepromazine (Promace ®) and Chlorpromazine are two commonly used phenothiazine tranquilizers in veterinary clinics. Their primary method of action is as a Dopamine antagonist, which suppresses both normal and abnormal behavior, including a decrease in coordinated locomotor responsiveness. They are not anti-anxiety drugs and do not provide any analgesia (pain relief).
Ace has a variety of uses (ex: anti-nausea, anti-emetic, decrease itching due to allergies) but is routinely used to sedate fearful or aggressive dogs and cats prior to veterinary visits or as an at-home remedy for noise phobias (thunderstorms, fireworks).
Chlorpromazine (Thorazine ®) is almost identical to Acepromazine and is just as potent. When called Thorazine, it elicits a much stronger reaction from audiences as it was the first antipsychotic to be commonly used in the 1950s and 1960s. Chlorpromazine is used in veterinary medicine as an antiemetic (anti-vomiting and nausea) and a tranquilizer.
Research has shown these drugs functions primarily as chemical restraints without affecting the animal’s emotional behavior. While under the effect of Ace, the animal still has a very strong fear, anxiety, avoidance or arousal response, but it does not physically display these reactions and is less able to react. The dog or cat appears calm and relaxed but mentally is lucid and still having an intense emotional reaction to its surroundings. Ace is a dissociative agent and prevents the patient from understanding his environment in a logical manner. So, the actual fear level of the animal is increased. Compounding the situation, the animal is being restrained and it makes a negative association with the entire experience.
According to veterinary behaviorist Dr. Vint Virga, DVM, ACVB, this is one of the reasons, why clinics are seeing so many animals, who have been previously given Ace, continuing to be fearful during veterinary exams. It becomes a never-ending cycle of chemical restraint and continued fear for the patient. Another potential danger from using Ace, is their fear may intensify to a level, where they override the physiological effects and can physically break through the chemical restraint. The animal seems ‘out of it’, but is having an intense emotional reaction and bites. Dr. Virga has seen serious trauma (typically to faces) to veterinary staff, when trying to restrain an animal on Ace and break-through occurs. He has also observed that clients have an overall negative response to the use of Ace for their pet and speak unfavorably of it. Owners leave with a highly sedated animal, which is ataxic or immobile and the drug effects may require up to 12 hours to disappear.
Ace is appropriate as a tranquilizer for the happy, jubilant, bouncing Laborador, who has no anxiety, stress or fear. These dogs simply need to be slowed down so an examination, ear swab, mouth exam can be performed. Ace is also appropriate when used as a pre-operative agent in a balanced anesthesia, with other drugs (ex: atropine) as it helps to lower the overall amount of anesthesia required and has antidysrhythmic (prevents arrhythmia, erratic heart rhythm) effects.
Side effects of Ace include (but are not limited to): increased noise sensitivity and startle response, decreased respiration, bradycardia leading to cardiovascular collapse (dogs and cats), hypotension, erratic thermoregulation leading to hypothermia or hyperthermia, a decrease in seizure thresholds, muscle spasms, excitation and sudden aggression (break-through response), absent pulse, unconsciousness. The duration of Ace also varies in each individual, thus making the fearful or aggressive patient even more unpredictable. Note: Ace should never be used as a tranquilizer for animals traveling due to the erratic thermoregulation effects (inability to control body temperature in cold or hot conditions).
Veterinary behaviorists now prefer the use of Benzodiazapenes such as Diazepam (Valium) and Alprazolam (Xanax) as alternative drugs which affect the central nervous system and actually reduce anxiety, stress and fear. They have a calming and amnesic effect on the patient and their fast acting effects begin within 30 minutes to 2 hours after oral administration. The dog or cat is sedated, its muscles are relaxed and their fear and anxiety is greatly reduced or eliminated.
Ace, used to sedate fearful animals, is no longer appropriate. Its use should be discontinued. We, as owners, need to advocate for our pets and do what is in their best interest both physically and emotionally. So, if your veterinarian wants to prescribe Acepromazine or Chlorpromazine to ‘calm’ your fearful Fido or Fluffy, politely decline the offer and ask for one of the newer alternative medications.
For veterinarians who want to research the effects of Acepromazine and Chlorpromazine drugs, two very good reference books are "The Handbook of Behavior Problems of the Dog and Cat" by Landsberg, Hunthausen, and Ackerman, and "Veterinary Psychopharmacology" by Sharon Crowell-Davis.
*The author would like to thank Dr. Virga for providing detailed information on Acepromazine and Chlorpromazine. Dr. Virga is a board-certified Diplomate of the American College of Veterinary Behaviorists. He is currently the president of Behavioral Medicine for AnimalsSM. Dr. Virga currently attends companion animal cases East Greenwich and zoo animal cases on site at zoological gardens and wild animal parks. His special interests include stereotypic behaviors, self-directed behaviors, and environmental and social enrichment for captive wildlife.
Of course, obtaining another pet is not something one should jump into hastily, and, depending on your anxious dog's history, a fellow canine companion may not be able to help. Other solutions are available, however.
Separation anxiety is rapidly becoming the most treatable canine behavioral disorder, probably in part due to the introduction of Clomicalm, a brand name for the drug clomipramine hydrochloride, manufactured by Novartis Animal Health U.S. Inc., of Greensboro, N.C. Clomicalm is the first such medication approved for canine use by the U.S. Food and Drug Administration; it is engineered specifically for the treatment of separation anxiety.
Prior to clomipramine's approval, other drugs had been used to treat separation anxiety. The following. as explained by Patricia Cahill, D.V.M., outlines some of those drugs and how they worked:
Acetyl promazine (acepromazine) is a tranquilizer that commonly is prescribed to blunt the behavior, but it doesn't actually change the anxiety; the dog still feels stress, but the drug reduces its ability to respond to the stress actively. Acepromazine would be inappropriate for treating separation anxiety because it does nothing to enhance learning or reduce the actual anxiety. It is fine for use in the treatment of short-term anxiety, such as a stressful visit to the groomer, unless you hope to recondition your dog to learn better self-control in such situations. Basically it works as a psychological crutch rather than a lifeline to treat the underlying problem; i.e., it is restraining rather than retraining. It can be effective, however, in reducing the symptoms of anxiety that might otherwise lead some owners to give up on their out-of-control pets.
Alprazolam (Xanax®) is a benzodiazepine tranquilizer typically prescribed to humans suffering from anxiety, and diazepam (Valium®) is another drug from this family. Both have been used effectively to help control canine anxiety. The downside in using these drugs is while they do decrease anxiety they do not enhance learning; therefore, once the dog stops taking the drugs any changes made in handling and environment may not have helped it gain better, independent, drug-free control.
Amitriptyline (Elavil®), an anti-depressant, is in the same family as clomipramine; it has been used effectively in the treatment of many separation anxiety cases. It is comparatively inexpensive and relatively free from side effects when used properly. It is a human drug, however, and is not specifically approved for animal use; as long as owners know this drug has not been clinically tested for animals, it can be used with the owners' consent. Anti-depressants, in addition to having a calming effect, increase the brain chemicals associated with learning. While on the drug, the dog can learn new behaviors that are retained once the drug no longer is used.
Fluoxetine (Prozac®) is another anti-depressant that has been used to treat separation anxiety. People have become very aware of this drug in recent years due to its effectiveness in treating a broad spectrum of human psychiatric conditions. Its effective use in the treatment of both canine compulsive disorders and anxiety disorders makes it another prescribed medication for the treatment of separation anxiety. It is not label-approved for use in dogs, however, and can be very expensive, especially with large-breed dogs.
Clomipramine, or Clomicalm, effectively relieves anxiety and doesn't dull the dog's personality or memory. In fact, it actually may enhance the dog's ability to learn more positive behaviors and responses to stressful stimuli. During FDA testing, 47 percent of the dogs treated with Clomicalm improved compared with 29 percent given a placebo during the first three weeks of treatment. By the end of two months, 65 percent of dogs receiving both the drug and behavioral therapy had improved, while 55 percent of dogs receiving behavioral therapy alone improved. Drugs certainly are not the only or even the most important tool in treating separation anxiety, but Clomicalm seems to make an important difference when combined with behavioral therapy, especially in the early stages of treatment. Clomicalm perhaps is the most exciting new drug on the market because it offers hope to desperate owners who have been held hostage by their dog's condition. Clomicalm is not a wonder drug, however, and the problem will not be resolved without behavioral modification for both the anxious dog and its family. The one possible negative side effect of the recent publicity Clomicalm has received is that people might view it as a "magic pill" offering a "miracle cure" for separation anxiety. People might look to the medication for immediate relief from their dogs' stressful behavioral symptoms, but once the acute problem has been resolved, they might not go the distance by following through with behavioral therapy.
Drug therapy is not always necessary or even appropriate in treating every separation anxiety case, many dogs suffering from this condition will respond to behavioral therapy alone, without needing drugs. But for some dogs, medication can provide the scaffolding they require to help keep them glued together until changes in their environment and social relationships enable them to stand more securely on their own four paws. For dogs that harm themselves due to separation anxiety, drug therapy can make the difference between life and death. And in some cases drug therapy calms the owners as much as the anxious dog, although the owners don't actually take the medicine themselves. Just knowing their dog has been given help to decrease anxiety and resulting outbursts allows some owners to leave home without feeling over-whelming anxiety of their own. With the help of anti-anxiety medication, many dogs that otherwise might have been given away or put down get a second chance and some bought time to begin behavioral therapy.
Thunderstorm season approaches! Is your dog ready??
Perhaps it’s time I addressed this issue (again!), since so many of you are experiencing the same kind of storms I’ve been trying hard to sleep through for the past couple of nights:
Yes, it’s thunderstorm season. Yes, it’s great for your garden. And yes, it sucks for your thunderstorm-phobic dog.
She may take flight to the closet, bathtub or bed. He may quake and quiver by your feet. She may even claw through her crate. Maybe one year he even tried to fly through the window (while it was closed).
Thunderstorm phobia is a potentially serious behavioral “disease.” Though your friends, family (and maybe even your veterinarian) may make fun or minimize your dog’s suffering, those of you who have experienced the angst of a severe sufferer know better.
The crazed anxiety of an afflicted dog is hard to watch. I’ve lived with one moderate sufferer and currently live with one mildly affected version. But I’ve seen the videos...and the aftermath, of course:
Bloody toenails torn or shredded to stubs on crates, windows, doors, walls...anything.
Fractured teeth from gnawing at enclosures or flinging themselves at walls and windows.
Bruises, broken legs, lacerations, eye injuries, etc.
I once even saw a neighbor’s dog hit by a car as he raced away from his home during a thunderstorm. He was notoriously thunderstorm phobic and was left outside for a few minutes when one of our fast-moving South Florida storms suddenly blew in. He died in the back of my car on the way to the hospital.
Then there’s the psychological damage:
Veterinary behaviorists preach the gospel of sensitization. They’ve studied these dogs and recognize that dogs become increasingly sensitive to storms. Each successive season brings with it a fresh round of fear as lightning crashes and thunder rolls, re-awaking an even higher level of alarm than they experienced the year before.
That’s why your dog seems to get worse and worse as he ages...until he begins to lose his hearing (which can be a blessing for these dogs).
The risk to the dog’s body is hard to deny. But sadly, the psychological aspects are too often swept under the rug. Unless the dogs violently react, dogs are not considered severely affected.
Yet I agree with the veterinary behaviorists on this one: The mental health aspects of this disorder generally proves a greater risk to any affected dog’s well-being––whether the disease means hiding under the bed in a quivering mass or hurling himself at the bars of his crate.
Then there are the misconceptions:
That dogs suffering from storm phobia should not be “coddled” or reassured, as it “reinforces the behavior.”
That nothing can be done for these dogs.
That dogs must never receive drugs for this condition...
...or the reverse extreme: that they must be zonked with drugs.
Regardless of what you might have heard, there IS a prescribed way to treat this condition. I repeat it every year. In case you missed it the first three times, here it is again, lifted from a previous post:
1-Behavior modification, using storm-sound CDs (played at an increasing volume while providing a positive stimulus like petting and treats), is a great place to start for the vast majority of pets. Try to find a CD with sounds recorded in your area for maximum benefit.
2-Natural therapies like lavender oil (recently found to reduce car anxiety in dogs), ProQuiet (a tryptophan syrup), and canine pheromone sprays or collars (like DAP) can be helpful for the mildly affected.
Veterinary behaviorists also recommend blankets that work to shield dogs from the electromagnetic changes perceptible during electrical storms (Anxiety Wrap and Storm Defender are two brands available online). Alternatively, a double coating of aluminum foil over a crate (secured with and hidden by a blanket) can do the same job.
3-Pharmaceutical intervention, the most common approach for severe cases, is also the one most fraught with complications. Usually, this method is reserved for our most anxious and self-destructive patients, or for dogs at the outset of their behavior modification regimens.
Creative combinations of anti-anxiety drugs (like Xanax) with Prozac-like drugs (like Clomicalm or Reconcile) seem to help many of our most serious sufferers. But remember, no drug is a substitute for behavior modification.
4-Reassurance and safety through crating (if you're not home) or providing a positive stimulus (like petting and treats) can be helpful. Try also drowning out sounds with a radio or white noise machine.
In the News: Tails of Marin
By Carrie Harrington
Fireworks are no fun for pets, so plan ahead
Fireworks displays will illuminate the skies during Fourth of July celebrations. As we enjoy these holiday festivities, it’s important to remember that this can be a very traumatic time for our pets. Loud noises can frighten animals, causing them to panic and even run away from home. In fact, animal shelters across the country report an increased number of lost animal companions after fireworks displays, and Marin County is no exception.
“Every year, dogs and cats bolt from their yards or homes in fear during the holiday festivities,” says MHS animal services director Cindy Machado. “In an attempt to find refuge, some pets become lost or wind up at the Humane Society.” Fortunately, there are steps you can take to ensure a safe and enjoyable holiday for you and your pet. Just follow these simple guidelines.
Keep your pets indoors during fireworks displays. A quiet, sheltered area is best. Close windows and curtains and turn on the TV or radio to help drown out some of the noise. Some animals can become destructive when frightened, so be sure to remove any items that your pet could destroy or that would be harmful if chewed. You’ll find that some dogs will prefer to lay in the bathroom as the small space will buffer the sound better.
Make sure your pets are wearing current identification and tags so that if they do become lost, they can be returned to you promptly. Keep current photos of your pets handy — and make sure the photos show any unique markings.
Never take your dog to a fireworks display. It’s usually hot. There are always large crowds. And the dogs really don’t enjoy it.
Never leave pets outside unattended, even in a fenced yard or on a tether. Pets who normally wouldn’t try to leave the yard may panic and try to escape. Dogs may become entangled in their tethers or hang themselves if they try to leap over a fence. To avoid injury, keep your pets indoors.
Other ways to help your pets
If you know that your pet is seriously distressed by the sounds of fireworks, consult with your veterinarian in advance. Your vet may recommend a fast-acting anti-anxiety medication, such as alprazolam and diazepam (the canine versions of Xanax and Valium), which generally take effect within 20 minutes and last for only a few hours. The key is to give the medications before the noise starts — they are less effective if you wait until the dog is already stressed. You may also need to give an additional dose later, depending on the duration of the noise. Note that, used routinely, these drugs can be addictive.
While the tranquilizer Acepromazine is commonly recommended, according to Whole Dog Journal, it does nothing to decrease the anxiety, but makes a dog unable to react — which can actually make your pet feel worse.
If, despite your best efforts, your pet does become lost, don’t panic. Check inside garages, yards, storage sheds, basements, closets, under cars and in the shrubbery at your home and throughout the neighborhood. The Marin Humane Society can assist you in finding a lost pet. Last year, we received a dozen lost dogs the evening of July 4th. Come to the shelter the next day to check the kennels, fill out a lost pet report and look over the “Found” reports. Download lost animal flyers from our Web site (www.marinhumanesociety.org). And check our 24-hour lost animal hotline at (415) 883-4621.
Carrie Harrington is the public relations associate at the Marin Humane Society.
Note: Ace should never be used as a tranquilizer for animals traveling due to the erratic thermoregulation effects (inability to control body temperature in cold or hot conditions).
Missy, when I drug Truman, I am going to hold him in my arms, too.
madremissy wrote:So the only thing that sticks out in my brain right now is that one of the articles said that ACE shouldn't be used for travel:Note: Ace should never be used as a tranquilizer for animals traveling due to the erratic thermoregulation effects (inability to control body temperature in cold or hot conditions).
Can someone please translate that into something I can understand.
iluvk9 wrote::shock: Missy! JUST TAKE THE DAMN DRUGS YOURSELF AND YOU WON'T CARE WHAT THE DOG IS DOING!!
mnp13 wrote:katiek0417 wrote:Michelle, it must've been me...I knew vets were doing it, but my friend Paula (who teaches at a veterinary school) actually explained why...so it sounds like something i might pass on to you b/c I know we've discussed anxiety in dogs...and meds...
Yeah, I can't think of anyone else I would have been discussing it with. Any idea of studies or other written material about that?
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