Drug administration during a panic attack

Finally, there's even some benefit to giving a benzodiazepine to a dog after it has already reacted. This won't abort the attack but may shorten it and scramble some short-term memory about how terrible the experience was. Alprazolam is truly panicolytic, that is, it cuts through panic and can and should be given during a storm or panic attack. It's important to remember that we all learn to panic or become anxious the more often it happens, so the humane thing to do is use medication every time it's needed.

Finding the right regimen

Lifelong maintenance medication may be necessary; some of these animals may have a true deficit of serotonin or an altered serotonin, functioning in the same way diabetics can have a deficit of insulin. We generally ask clients to keep giving their dogs the drug for the amount of time it takes to get the dog as "perfect" as possible, plus 30 days. Then we wean the dog from the medication at the rate it took for the dog to improve. This translates to four to six months of treatment, minimally. If medication is long-term or lifelong, annual physical and laboratory evaluations are useful. There appear to be no side effects long-term. Of course, this all assumes that the client is also doing the relevant behavior modification. As noted previously, there are no quick fixes, and indiscriminate use of drugs leads to treatment failures.

Summary

Storm and noise phobias are common, debilitating and run in family lines. Without treatment, they worsen quickly and may make dogs more prone to other anxiety-related conditions. Noise and storm phobias are true welfare and quality-of-life issues and should be viewed as emergencies because of their comorbidity component.

Treating noise- and storm-phobic dogs with medication before the expected provocative stimulus—especially when combined with general behavior modification designed to teach the dog to relax while avoiding inadvertent reassurance of abnormal and undesirable behaviors—can be successful. As with most problems involving panic and anxiety, the earlier we can intervene, the greater the chance of success.

Also remember this condition will require a degree of management, including anticipating when the dog is likely to be exposed to a scary noise and protecting the animal while it continues to improve. For some dogs, treatment is lifelong, while for others it will be short-term. Once present, phobias are extremely difficult to completely obliterate because the memory of a phobic response can trigger another one.

In reality, it doesn't matter if the dog always has the potential to react throughout its life if we can alleviate the distress the dog feels whenever the noises that scare it occur. For most dogs, we can now alleviate the fear and panic experienced during a noise-phobic event, and that's a good place to start.

Dr. Overall, faculty member at the University of Pennsylvania, has given hundreds of presentations on behavioral medicine. She is a diplomate of the American College of Veterinary Behavior (ACVB) and is board-certified by the Animal Behavior Society (ABS) as an Applied Animal Behaviorist.

REFERENCES

1. Ogata N, Dodman N. The use of clonidine in the treatment of fear-based behavior problems in dogs: an open trial. J Vet Behav Clin Appl Res 2011;6:in press.

2. Crowell-Davis SL, Seibert LM, Sung W, et al. Use of clomipramine, alprazolam, and behavior modification for treatment of storm phobia in dogs. J Am Vet Med Assoc 2001;222(6):744-748.