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Myth: Anxiety Medication Should Only be used as a Last Resort
By Sara Reusche, CPDT-KA, CVT - http://paws4udogs.wordpress.com/
(nice wordpress blog with lots of interesting articles – worth a visit)
I’ve written about medicating anxious dogs before, and it’s such an important topic that I want to touch on it again. There are so many misconceptions surrounding this subject. The idea that anxiety medication should only be used after everything else has been tried is so sad and harmful, and is a myth I encounter on a regular basis. Let’s clear up some of the fog surrounding this common misconception.
Before we get any further, please remember that I am not a veterinarian and I don’t play one on the internet. The information contained in this blog is not meant to diagnose or prescribe, and is only provided for your information. I’m drawing from my experience as a certified veterinary technician, canine behavior consultant, and the owner of an anxious dog to educate you, but your best resource is always going to be a licensed veterinarian.
So, let’s start with what we know. Advances in neuroscience and imaging technology have shown us that anxious or depressed people and animals often display significant physical changes to certain areas of their brain, such as the prefrontal cortex (responsible for planning and executing activities) and hippocampus (responsible for memory). We know that fear and anxiety are processed in the same part of the brain as physical pain, and that emotional pain actually shares some of the same neural pathways with physical pain. That’s why we talk about profound grief or panic “hurting” – it physically impacts our bodies.
This is huge. We know that panic and worry “hurt.” Why the hell would you not treat this pain? If your dog were bleeding every day, wouldn’t you treat the wound? Would you wait to splint a broken bone because you wanted to “try everything else first”? Would you wait to give a dog pain meds after surgery until you saw that he “really needed it”? The truth is that these medications can provide very real relief for dogs who need them, and doing so can be the greatest kindness you can offer to a dog who’s hurting in a very real way.
Q: But aren’t anxiety medications dangerous?
A: Yes, sometimes. Any meds can have dangerous side effects. However, I think we need to be very honest about the risk here. Anxiety medications can have negative effects, but so can pain medication, herbal supplements, heartworm preventative, flea and tick medications, and the diet you choose to feed your dog. Furthermore, if you are considering anxiety medication for your dog, you have to take into consideration the impact of prolonged, excessive levels of stress hormones on your dog’s body. I can guarantee that if your dog’s issues are such that you’re considering anxiety medication for your dog, your dog isalready experiencing physical problems from their anxiety. In many cases,elevated stress hormones could be more harmful to your dog long-term than anxiety medication. This is a case where doing nothing is not necessarily any safer than trying medication for your dog.
Q: I’d prefer to stick to natural remedies…
A: Let’s settle this once and for all: natural does not mean safe. I see a lot of dogs who are on multiple herbs, oils, and other “natural” remedies with no concern for their safety ramifications. We have very little knowledge about toxicity, possible drug interactions (either additive or counteractive), side effects, or species-appropriateness for most of these remedies, and frankly, there is very little oversight regarding their safety for us, much less for non-human animals. Most modern medications have roots in herbal or other natural remedies. While the digitalis from a foxglove plant may be very helpful when used therapeutically for a patient with congestive heart failure, it can be deadly to a small child or dog. Arsenic and cyanide are “natural” compounds as well – that doesn’t make them safe. While melatonin, 5-HTP, or valerian root may help some dogs, the truth is that we don’t know that they’re any safer than a Selective Serotonin Reuptake Inhibitor or Tri-Cyclic Antidepressant, and any compound can cause issues.
Q: But, can’t training solve this problem?
A: Probably. I want to be very clear: medication alone will not solve most behavioral issues. However, repeated studies have shown that combining medication and training results in the fastest progress, and I would argue that this fact in and of itself is a good reason to consider medication for fearful, anxious, and aggressive dogs. There’s an underlying humane issue here. Medication can improve your dog’s quality of life while training is taking place and can make that training work more quickly and effectively. Just as using appropriate pain medication can decrease the amount of time it takes animals to heal after surgery, anxiety medication promotes emotional healing. This is a pretty big deal.
Q: Does my dog need to stay on meds forever?
A: Maybe, and maybe not. By far the majority of the dogs I work with are on anxiety medication for a short period of time. The medication helps to cut through the static of anxiety so that the dog is in a better place to learn. Once the dog is no longer fearful, anxious, or aggressive in the formerly triggering context, they are weaned off the medication and go on with their lives, happier and more balanced. That said, some dogs have a true neurochemical imbalance that needs to be treated. Just as a dog with hypothyroidism needs to be given thyroid supplementation, these dogs oftentimes need chemical help to regulate and maintain the levels of serotonin, norepinephrine, or other neurochemicals in their brain. For these dogs, anxiety medication may be a lifelong need.
Look, I’m not saying that every anxious dog needs medication. I’m not even saying that it should always be the first thing that we reach for or consider. However, it also shouldn’t be the last. After we’ve looked at environment and put together a training plan, we owe it to our best friends to be very honest about their current quality of life. If your dog is suffering, medication could give him some very real and very quick relief. Personally, I don’t want my dogs to be in pain, and I think we need to be aware that it is okay to consider medication as part of a balanced plan right from the start. It should not be the only thing that changes – medication is not a magic potion that will fix all of your dog’s ills. But it can be one important ingredient in your dog’s customized plan, right alongside management and training.
Before we get any further, please remember that I am not a veterinarian and I don’t play one on the internet. The information contained in this blog is not meant to diagnose or prescribe, and is only provided for your information. I’m drawing from my experience as a certified veterinary technician, canine behavior consultant, and the owner of an anxious dog to educate you, but your best resource is always going to be a licensed veterinarian.
So, let’s start with what we know. Advances in neuroscience and imaging technology have shown us that anxious or depressed people and animals often display significant physical changes to certain areas of their brain, such as the prefrontal cortex (responsible for planning and executing activities) and hippocampus (responsible for memory). We know that fear and anxiety are processed in the same part of the brain as physical pain, and that emotional pain actually shares some of the same neural pathways with physical pain. That’s why we talk about profound grief or panic “hurting” – it physically impacts our bodies.
This is huge. We know that panic and worry “hurt.” Why the hell would you not treat this pain? If your dog were bleeding every day, wouldn’t you treat the wound? Would you wait to splint a broken bone because you wanted to “try everything else first”? Would you wait to give a dog pain meds after surgery until you saw that he “really needed it”? The truth is that these medications can provide very real relief for dogs who need them, and doing so can be the greatest kindness you can offer to a dog who’s hurting in a very real way.
Q: But aren’t anxiety medications dangerous?
A: Yes, sometimes. Any meds can have dangerous side effects. However, I think we need to be very honest about the risk here. Anxiety medications can have negative effects, but so can pain medication, herbal supplements, heartworm preventative, flea and tick medications, and the diet you choose to feed your dog. Furthermore, if you are considering anxiety medication for your dog, you have to take into consideration the impact of prolonged, excessive levels of stress hormones on your dog’s body. I can guarantee that if your dog’s issues are such that you’re considering anxiety medication for your dog, your dog isalready experiencing physical problems from their anxiety. In many cases,elevated stress hormones could be more harmful to your dog long-term than anxiety medication. This is a case where doing nothing is not necessarily any safer than trying medication for your dog.
Q: I’d prefer to stick to natural remedies…
A: Let’s settle this once and for all: natural does not mean safe. I see a lot of dogs who are on multiple herbs, oils, and other “natural” remedies with no concern for their safety ramifications. We have very little knowledge about toxicity, possible drug interactions (either additive or counteractive), side effects, or species-appropriateness for most of these remedies, and frankly, there is very little oversight regarding their safety for us, much less for non-human animals. Most modern medications have roots in herbal or other natural remedies. While the digitalis from a foxglove plant may be very helpful when used therapeutically for a patient with congestive heart failure, it can be deadly to a small child or dog. Arsenic and cyanide are “natural” compounds as well – that doesn’t make them safe. While melatonin, 5-HTP, or valerian root may help some dogs, the truth is that we don’t know that they’re any safer than a Selective Serotonin Reuptake Inhibitor or Tri-Cyclic Antidepressant, and any compound can cause issues.
Q: But, can’t training solve this problem?
A: Probably. I want to be very clear: medication alone will not solve most behavioral issues. However, repeated studies have shown that combining medication and training results in the fastest progress, and I would argue that this fact in and of itself is a good reason to consider medication for fearful, anxious, and aggressive dogs. There’s an underlying humane issue here. Medication can improve your dog’s quality of life while training is taking place and can make that training work more quickly and effectively. Just as using appropriate pain medication can decrease the amount of time it takes animals to heal after surgery, anxiety medication promotes emotional healing. This is a pretty big deal.
Q: Does my dog need to stay on meds forever?
A: Maybe, and maybe not. By far the majority of the dogs I work with are on anxiety medication for a short period of time. The medication helps to cut through the static of anxiety so that the dog is in a better place to learn. Once the dog is no longer fearful, anxious, or aggressive in the formerly triggering context, they are weaned off the medication and go on with their lives, happier and more balanced. That said, some dogs have a true neurochemical imbalance that needs to be treated. Just as a dog with hypothyroidism needs to be given thyroid supplementation, these dogs oftentimes need chemical help to regulate and maintain the levels of serotonin, norepinephrine, or other neurochemicals in their brain. For these dogs, anxiety medication may be a lifelong need.
Look, I’m not saying that every anxious dog needs medication. I’m not even saying that it should always be the first thing that we reach for or consider. However, it also shouldn’t be the last. After we’ve looked at environment and put together a training plan, we owe it to our best friends to be very honest about their current quality of life. If your dog is suffering, medication could give him some very real and very quick relief. Personally, I don’t want my dogs to be in pain, and I think we need to be aware that it is okay to consider medication as part of a balanced plan right from the start. It should not be the only thing that changes – medication is not a magic potion that will fix all of your dog’s ills. But it can be one important ingredient in your dog’s customized plan, right alongside management and training.
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