NMVMA listserve Veterinary Behavior Tip #19
Jeff Nichol, DVM
Veterinary Behavior Medicine
Veterinary Emergency and Specialty Centers

Albuquerque and Santa Fe Balloon phobia: avoidance, trazodone, & Sileo

There are dogs who are mildly nervous during the Balloon Fiesta and others who are so overwhelmed with panic that they scan the sky from the doorway. Similar to storm phobia cases, dogs who are wigged-out during this annual event are reactive to multiple sensory stimuli. Sound and sight can be equally frightening.

Consistent with any phobia, there is no logic in these dogs’ reactions. There is no desensitization/counterconditioning method that can make a difference in the immediate term. Here are the fundamentals of helping our clients with their completely freaked-out dogs over the next 10 days.

  • Avoidance of the arousal stimulus.
    • People can get up early to allow their dogs outside to eliminate and then quickly return them to the inside for shelter until early afternoon when the skies are again free of “scary monsters”.
    • Provide a safe, quiet, low-light interior room.
      • Either a room (walk-in closet) with no windows or one with dark blinds will prevent the dog from seeing the balloons and the changing outdoor light.
      • Masking the sounds of the balloons’ burners will matter.
        • A noisy fan, classical music loud enough to drown-out exterior noise, or a white noise machine can help.
        • Music that has been specifically developed to work with a dog’s brain waves is called Through a Dog’s Ear. It can be downloaded and played on a computer.
      • Isolation from other pets or active children can help diminish sensory over-stimulation.
    • Keep the dog occupied.
      • Many dogs will extract their sustenance from food-dispensing toys or puzzles if they have not been fed from a bowl that day.
      • This natural “foraging” method can require a dog to focus on the innate challenge of survival rather than freaking-out over flying aliens.
    • Anxiolytics
      • Trazodone is safe and effective, starting about 1-2 hours following oral dosing.
    • Classified as a SARI trazodone’s most potent binding property is 5-HT2A antagonism and inhibition of serotonin reuptake.
    • Trazodone and its active metabolite m-chlorophenylpiperazine (m-CPP) also have agonistic affects on serotonin 1 receptors.
    • Dogs with a history of balloon phobia should be treated prophylactically starting at least one day prior to the Balloon Fiesta.
      • Trazodone is not a narcotic nor is it controlled but after a few days some dogs develop a mild tolerance, necessitating a dosage increase. This is not necessary when it is given prn.
      • Dosing by body weight:
        • <10 kg: Give < 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.
      • Trazodone is inexpensive and available from any pharmacy in 50, 100, 150, & 300 mg tablets.
      • Sileo oral-transmucosal gel
        • Recently released by Zoetis Sileo is a low strength preparation of dexmedetomidine (Dexdomitor).
          • Sileo attenuates the norepinephrine release from the neurons in the locus coeruleus of the CNS.
          • The locus coeruleus, located in the pons of the brainstem, mediates stress, anxiety, and fear.
        • The anxiolytic, sub-sedative strength in Sileo alleviates acute anxiety and fears associated with noise for problems like storms and hot air balloons.
        • Administered at home Sileo should be given between the lower lip and gum.
          • The anxiolytic affects have a duration of 2-3 hours.
          • Sileo can be repeated up to 4 times/day with a pause of at least 2 hours between doses.
        • Trazodone and Sileo are safe and effective when used together. There may be mild sedation but the fear and anxiety should be well controlled.
        • Acepromazine
          • This antipsychotic tranquilizer has minimal anxiolytic affects.
          • People observe a quiet dog and believe he/she feels better but internally the pet is still panicked, just physically unable to manifest its fear or attempt to escape.
          • Frightened dogs given acepromazine are trapped in a “chemical straight jacket”.
          • Ace has no useful role in treatment of fears and phobias in dogs. It can lead to a worsening of the phobia.

I hope this missive is helpful to you, your clients, and their pets.

All the best,
Jeff Nichol, DVM