# Anti-anxiety medications not working for vet visit...



## raven414a (Feb 2, 2017)

Hi everyone,

I have posted a few times about our German Shepherd mix, Bailey, who suddenly became fear aggressive after we adopted her. She does not like people approaching her (she can approach you), she will growl if a stranger approaches and tries to pet her. We had about 6 sessions with a trainer, who was very impressed at how fast Bailey learned everything, and 3 sessions so far with a behaviorist. We are making progress with the behaviorist. She asked what my goal is for Bailey and I told her that I want Bailey to be able to be examined by the vet without growling and lunging. This behaviorist, fortunately, has a lot of experience with dogs who are aggressive with vet exams. She did a few exercises with her at our last visit, and Bailey actually laid her chin in the doctor's hand, and later while working on focusing on a treat with me she actually let the doctor touch her and she leaned against her legs. 

For now, Bailey is going to have to be sedated in order to be examined, which I'm fine with. She has one more heartworm pill left so she is due for her heartworm test soon. The problem is, we have tried different medications (trazodone, clonidine, gabapentin). The trazodone did nothing. The clonidine and gabapentin both had about a 50% effect separately, so she had me give Bailey 3.5 tablets of clonidine and 1 gabapentin, and try a test run at the vet's office in the exam room. Bailey was really sleepy, but still growled at the staff. It's as if no medication will work on her! She is also on citalopram for her hyperactivity and that one is actually working. For those of you who have to have your dog sedated for a vet exam, what do you do? How do you get the dog sleepy enough in order to be sedated? I'm updating the behaviorist tomorrow on the vet visit today to see what she wants to try next, but I was wondering if anyone else had any ideas or experience with this.


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## Momto2GSDs (Mar 22, 2012)

raven414a said:


> She is also on *citalopram* for her hyperactivity



Maybe this is interacting with the other drugs you are trying.



These are the 

*Common side effects of citalopram:*


problems with memory or concentration;
headache, drowsiness;
dry mouth, increased sweating;
numbness or tingling;
increased appetite, nausea, diarrhea, gas;
fast heartbeats, feeling shaky;
sleep problems (insomnia), feeling tired;
Did you ever try natural herbals? That's an awful lot of drugs to give a dog.



Moms


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## Malibu (Jul 27, 2017)

I can not understand why anyone would need to sedate a dog so strongly to go to a vet. 

I feel for you


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## middleofnowhere (Dec 20, 2000)

Is there a way that the vet could come out to the car? Or do the exam outside of the office? 



While my dogs do not show threats to vets or their staff, they get somewhat weird in the exam room. I've noticed two things: At the office they are much happier when they are out in the waiting room for a while, especially if someone is talking to them. Second, the vet was out for the horse's annual exam and brought the vaccines for the dogs. He gave the shots at the house and it was an entirely different ball game.


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## Magwart (Jul 8, 2012)

Since you were making really good progress with the behaviorist, I would continue that work!!!

Some thoughts:

1. *Those drugs are sometimes scary in and of themselves for dogs. *I think most general practice vets don't understand nearly enough about how psychotropic drugs effect dogs' emotional state. As more research is done on this class of drugs in canines, sometimes we realize they're not being used well -- Ace is one that lots of general practice (and even shelter) vets used to use widely in these fear-based situations...but then we learned it increases fear but paralyzes the dog (a terrifying experience in and of itself)--but it "seems" sedate to the owner/vet because of the paralysis. So the drugs could possibly be making matters worse, not better.

Terrified dogs fight sedation. Once their fight-or-flight response is triggered, their bodies are pumping out neurotransmitters to desperately try to counter the sedative. Not good!



Also, if the only time she is made to feel loopy and out of control is when she goes to the vet (being drugged), she's going to associate that feeling with the vet visits. It's not really a solution at all, and it might be undermining the good work that you were doing with the behaviorist. 

If you're lucky enough to live in a city with a board-certified veterinary behaviorist (vets who've done extra years of intensive study, training and research into animal behavior), they may be able to help because they have much more extensive knowledge about psychotropic meds in dogs and interactions with behavior modification...but there are only a few of them in the whole United States:
https://www.dacvb.org/search/custom.asp?id=4709

However, some of them do remote consultations with general practice vets about psychotropic meds, so you might ask your vet if she's willing to do that sort of consultation, if you want to continue down the medication route. You may not need to, though!


*2. Look for a Fear Free Certified veterinary practice*. Since this is fear-based behavior as you've described it, a Fear Free certified practice could benefit the dog. Here's the directory:https://fearfreepets.com/fear-free-directory

This is something I've only learned about fairly recently, as one of the clinics I use got certified, and suddenly lots of things changed there. They're handling and restraining differently -- for example, someone was feeding the dog a bunch of peanut butter while the scary thing was going on, and the dog didn't even notice the scary thing happening. 

They started with one vet who wanted to learn how to make patient experiences better and went to the course, and then they ended up certifying all the techs too because of how well it was working. They consistently use distraction and de-escalation/calming techniques that they practice before and during exams, and they really do make a difference for scared dogs (and cats)! They're trying REALLY hard to make vet visits less traumatic for patients over the course of their entire lives -- it's not a "fix the vet-fear in a single visit" philosophy but a consistent, long-term strategy. They are even doing some classical counter conditioning with patients who already have negative associations. Of course, this is one of the most expensive clinics in my area, so they have longer appointments, fewer appointments per day, excellent vet techs with very little turnover...and they just practice differently than high-volume/low-cost clinics. However....if you have a healthy dog that only sees the vet once or twice a year, it would be worth paying more for a clinic that practices this way!

You can read more about it here:
https://fearfreepets.com/about/what-is-fear-free/


Here's a video for vet clinics about it:




 

*2. Acclimate your dog to a basket muzzle before the next vet appointment, and use it regularly enough that it won't be traumatic to use it during vet visits. * It's important for it not to be "the thing that comes out at the scary vet" but rather "the thing we wear to go walking in my favorite place" or something along those lines. This will at least keep the vet and the staff safe until you work through this. 


*3. Visit the vet clinic regularly, for treats.* Buy whatever her absolute favorite treats are (something meaty and very, very high value). Now that treat will only come out at the vet clinic. Take her by once a week for the front desk staff to give her lots of the treats you bring. Then go home. If the clinic is willing, build up to having the vet techs come out, take the leash, and give more treats. Then build up to walking her into an empty exam room, with more treats, then walk out and go home. The clinics I know would let clients do all this at no cost because it builds a positive association (nothing bad happens...just lots of treats).


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## Malibu (Jul 27, 2017)

Sad you have to deal with such an issue. We go to the vet 10-15 times a year. Luckily my dogs have loved our vet. They hear his voice behind a door and the whine to get in. I did have one that din't care for it to much and we never had any issues. He came to my house to put that girl down because he didn't want her to have any added stress. My vet is the BEST...


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## raven414a (Feb 2, 2017)

Momto2GSDs said:


> Maybe this is interacting with the other drugs you are trying.
> 
> 
> 
> ...


Yes, I agree it's a lot. I hate it. I always try to go the natural way on everything. Unfortunately, I tried all the natural supplements before I even took her to the behaviorist. I tried melatonin, the Adaptil collar, lavender essential oil, soft music, I know there are other things that I can't think of right now, lol.


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## raven414a (Feb 2, 2017)

middleofnowhere said:


> Is there a way that the vet could come out to the car? Or do the exam outside of the office?
> 
> 
> 
> While my dogs do not show threats to vets or their staff, they get somewhat weird in the exam room. I've noticed two things: At the office they are much happier when they are out in the waiting room for a while, especially if someone is talking to them. Second, the vet was out for the horse's annual exam and brought the vaccines for the dogs. He gave the shots at the house and it was an entirely different ball game.


I've thought of that as well, but I have a feeling that she would still growl since she has an issue with people just approaching her. I'll mention that to the behaviorist though and she what she thinks. Thanks!


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## raven414a (Feb 2, 2017)

Magwart said:


> Since you were making really good progress with the behaviorist, I would continue that work!!!
> 
> Some thoughts:
> 
> ...


Thank you, Magwart! I keep meaning to get her a basket muzzle, now she just has the mesh one, but it's obviously hard to get the treats which is what she lives for, lol! I do have a great vet who is very patient, and she did let me bring Bailey in once a week for a while so she could give her treats. Bailey actually let her pet her, but once she even looked like she was going to exam her Bailey would growl and lunge at her. That's when I decided it was time to see the behaviorist.


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## [email protected] (Jan 16, 2018)

I feel for your dog! I hate flying and tried having a bunch of gin & tonics before a flight to relax. All it did was make me buzzed AND nervous!
Let us know if the behaviorist helps Bailey!


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## Sunsilver (Apr 8, 2014)

The director of the Spanish riding school once had a stallion that hated to be shod. He would have to be sedated before every shoeing session, and afterwards, he wouldn't let his rider, Alois Podhajsky, touch his neck when grooming him for several days. Podjajsky could also feel the effects of the sedation affecting his performance.

He decided there had to be a better way. He began with rewarding the horse for allowing him to handle his feet. He would do this for a minute or two every day. Gradually, the horse became more and more comfortable with it, and eventually, the vet could shoe him without any trouble.

This is the way I'd approach the problem. And if the dog growled at the vet, I would correct it. I would also muzzle it if necessary. The dog will eventually realize that a routine exam, with touching of its ears, paws, etc. is not going to hurt.

Dogs aren't dumb: they realize VERY quickly that growling gets them what the want!


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## raven414a (Feb 2, 2017)

[email protected] said:


> I feel for your dog! I hate flying and tried having a bunch of gin & tonics before a flight to relax. All it did was make me buzzed AND nervous!
> Let us know if the behaviorist helps Bailey!


:laugh2: Thank you!


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## raven414a (Feb 2, 2017)

Sunsilver said:


> The director of the Spanish riding school once had a stallion that hated to be shod. He would have to be sedated before every shoeing session, and afterwards, he wouldn't let his rider, Alois Podhajsky, touch his neck when grooming him for several days. Podjajsky could also feel the effects of the sedation affecting his performance.
> 
> He decided there had to be a better way. He began with rewarding the horse for allowing him to handle his feet. He would do this for a minute or two every day. Gradually, the horse became more and more comfortable with it, and eventually, the vet could shoe him without any trouble.
> 
> ...



I started muzzling her as soon as this behavior started, I definitely don't want anyone getting bit. The thing is, she never minded the exams when she first started going. What I'm wondering if what happened is maybe either when the tech was doing the worm test up the butt at one visit or when she was getting her nails trimmed at a different visit they might have been too rough and she snapped. When she snapped, they of course walked off, and she thought, "hey, I got them to leave me alone"; like you were saying. I'm thinking that maybe this is more of a learned behavior than genetic, because she has NEVER shown any aggression towards us, or anyone who she is close to; no food aggression, no toy aggression, no biting, nothing. Thank you for the response!


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## Sunsilver (Apr 8, 2014)

Edited to add: since the dog is already used to the vet, knows her, and allows her to touch him, THAT is why I'd correct the dog for growling. The growling is the dog trying to get its own way, and there are times when a dog can't be allowed to have its own way, because medical treatment is necessary.


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