10.13.16
NMVMA listserve Behavior Tip #22
Highly Stressed Hospitalized Patients

Jeff Nichol, DVM
Veterinary Behavior Medicine
Veterinary Emergency and Specialty Centers
Albuquerque and Santa Fe

Highly Stressed Hospitalized Patients

Pets in our hospitals can experience such intense and unrelenting fear that they may fail to eat, eliminate, or recover. There are no treatments that make a difference in every case but there are a few things that are simple and that are often effective in helping these patients feel better and get well faster.

As a very safe and rapid acting antianxiety treatment consider trazodone.

  • Classified as a SARI (serotonin antagonist/reuptake inhibitor)
    • 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 effects on serotonin 1 receptors.
  • For outpatient use:
    • Anxieties (generalized, separation), noise phobias.
    • As an adjunct antianxiety (given with SSRIs or TCAs) with minimal side effects.
  • In hospitalized dogs 1
    • 2.2 – 14 mg/kg/day for stressed dogs.
    • Can be given q 12-24 h or prn.
  • For hospitalized cats
    • 25 – 50 mg/cat
  • Can be used safely with tramadol
  • Drug Interactions:
    • MAOI’s like selegiline, amitraz (some tick collars).

In addition, music that has been scientifically developed to calm anxious pets can be played in your hospital area.

  • Through a Dog’s Ear
  • Through a Cat’s Ear

Pheromone diffusers, Feliway for cats and Adaptil for dogs, have been shown to calm stressed pets.

  1. Use of trazodone to facilitate postsurgical confinement in dogsMargaret E. Gruen, DVM, MVPH; Simon C. Roe, BVSc, PhD; Emily Griffith, PhD; Alexandra Hamilton, BS; Barbara L. Sherman, PhD, DVM

I hope this missive is helpful to you and your patients.

All the best,
Jeff Nichol, DVM