I welcome opportunities to answer behavior questions from my colleagues. Here is a recent one that you may find helpful in your practice.
I have a 12-year old neutered golden retriever cross. He lost his [canine] house mate a few months back and had become more anxious. Then, the owners moved. Things got a LOT worse. He will salivate excessively and defecate in the house when they leave him. If in a kennel, he will gnaw on the cage so hard that his gums will bleed. He won’t defecate in his kennel but he will salivate to the point where the bedding is soaked.
I was reading in my behavior textbook that fluoxetine is better for separation anxiety than Clomicalm if we have a more explosive behavior set. I had also considered gabapentin as an adjunct. Would you feel okay using clonidine in a dog this old? It was my other thought.
I told the owners that behavior modification is going to be necessary in addition to meds but it sounds like we need to get [this dog] a bit calmer before he’s able to learn much of anything. Any and all help is much appreciated!
Fluoxetine and clomipramine, as primary anxiolytics, are each good choices for separation anxiety. Trial and error may be necessary; for some dogs one of them may work better than the other. Specifically, Clomicalm (clomipramine) generally necessitates higher doses than recommended on the insert. We usually give 1.5-3 mg/kg bid, sometimes a little higher. If higher doses are necessary it is less prone to cause side effects if we start low and increase q 2 weeks.
If Clomicalm doesn’t make a significant difference in 4-6 weeks, you can stop it one day and start fluoxetine the next day. On the other hand, if you start with fluoxetine your client may need to wait 4-6 weeks to determine its effectiveness. We usually use fluoxetine starting dose of 0.5 – 1.0 mg/kg sid. You can gradually increase that to about 1.5 mg/kg in most dogs.
There is good news with fluoxetine. The canine approved chewable Reconcile has finally returned. Now manufactured by PRN Pharmacal it is significantly less expensive than it was several years ago when branded by Elanco.
The best reason to dispense the Reconcile rather than prescribing generic fluoxetine from a pharmacy is consistency. Reconcile is reliable because it’s formulated for dogs. Some generic brands of fluoxetine are not well absorbed by dogs and cats. Clients are happy with Reconcile because it’s easy to administer.
Gabapentin and/or clonidine, as adjuncts to Clomicalm (clomipramine) or Reconcile (fluoxetine) are safe and may be helpful. But rather than either of these we more often add trazodone, given about 2 hours prior to the owner’s departure. (Dosing chart below) You are right that a less anxious dog will be more amenable to learning healthy alternative behaviors.
Finally, no dog with separation anxiety should ever be crated. Just ask any veterinary dentist about fractured teeth and exposed root canals. Instead, pet parents can lose the food bowl and require their dogs to forage for their sustenance while alone. By having to wait for the owner to drop a loaded food toy (Twist ‘n Treat is a favorite for many), previously wigged-out dogs can learn to anticipate their person’s departure knowing that they will finally have a chance to extract food.
Video monitoring helps a great deal in understanding the effectiveness of an individual dog’s’ management. You are welcome to refer this case if it’s unresponsive.
All the best,
Jeff Nichol, D.V.M.
Residency trained by the American College of Veterinary Behaviorists
Veterinary Behavior Medicine
Albuquerque and Santa Fe
I invite you to peruse and use any of the information from this and past nmvetlist missives. You will find the entire archive on the For Veterinarians page of my website, drjeffnichol.com/
Trazodone dosing for dogs:
- <10 kg: < 25 mg. q 12-24 h for 3 days, then < 50 mg. q 8-24 h.
- 10-20 kg: 50 mg. q 12-24 h for 3 days, then 100 mg. q 8-24 h.
- 20-40 kg: 100 mg. q 12-24 h for 3 days, then 200 mg. q 8-24 h.
- >40 kg: 100 mg. q 12-24 h for 3 days, then 200-300 mg. q 8-24 h.
- Give no more than 600mg/patient/day total
- Available in 50, 100, 150, & 300 mg tablets.