Dogs that are fearful or aggressive present the small animal practitioner with a number of difficulties. These patients are challenging to fully assess and pose a safety risk to the staff of the clinic, the veterinarian, and occasionally even the owner. Additionally, a nervous dog increases stress levels in the workplace, which affects both people and other animals. Pre-hospital sedation can significantly enhance the experience for all those involved in the patient’s care in cases where the dog is known to be aggressive in the hospital setting or is so terrified or anxious that it prevents physical examinations and basic assessment.
It is crucial that the veterinarian acting as the prescriber has sufficient knowledge of the dog’s health status and is aware of when a medication is contraindicated before thinking about pre-hospital sedatives. Before recommending any of the suggested medications, a thorough physical examination should be conducted. Each go-home medication should also be discussed with the owner in terms of any potential patient risks and what to anticipate at home. Acepromazine, Gabapentin, Trazadone, and Melatonin, the treatments described in this brief article, are intended to supplement low stress handling (e. g. bringing overly aggressive dogs directly into an exam room vs. putting these dogs in a clinic waiting area with other anxious/loud animals) to make a patient more receptive to handling
In the veterinary industry, acepromazine, a member of the phenothiazine class of sedatives, is frequently used, especially during the perianesthetic period. Acepromazine primarily affects behavior by attaching to and blocking dopamine receptors in the limbic system and basal ganglia. The medication is available for veterinary use in two dosage forms: oral and injectable. The oral formulation has historically been used to treat anxiety in the home (e.g. g. thunderstorms, fireworks, etc. ), it may not always produce the desired level of sedation, and its onset and duration are frequently unpredictable. However, the injectable form, given orally and transmucosally (OTM), provides very consistent moderate to marked sedation in 20 to 30 minutes. The dosage closely adheres to the recommended intramuscular (IM) dosing with this route of administration (Table 1). Sending owners home with the injectable without a needle and two doses in case one is lost during administration attempt is the best course of action when treating an aggressive or fearful dog with this medication, according to 2, 3, and 4, as the effects are most noticeable after absorption from the oral mucosa. The list of contraindications mainly consists of disease conditions that would prevent someone from using acepromazine in an anesthetic protocol (Table 1).
In recent years, veterinary medicine has begun to use the antiepileptic, anxiolytic, and pain-management drug gabapentin for the treatment of chronic pain in animals. 1,5 The interaction between analgesics and voltage-gated calcium channels is thought to be the exact mechanism of action. 2,3,5 Sedation following gabapentin administration is frequently severe in the acute setting (first one to two days of administration). Because of this, gabapentin is a great pre-hospital sedative to use on its own or frequently in conjunction with acepromazine for challenging canine patients. Dosing recommendations and timelines are proposed below (Table 1). Owners should be made aware that their pet frequently appears much more relaxed at home. Clients taking gabapentin either by itself or in conjunction with other sedatives should be advised to have supervision when climbing stairs and getting in and out of cars.
Trazodone is categorized as a serotonin receptor antagonist and reuptake inhibitor (SARI),2,6,7 and is commonly used to treat anxious patients in the acute hospital setting, as well as long-term as a sole or adjunctive agent in dogs with anxiety disorders. 7 Although trazodone has a good safety record, patients with known arrhythmias should use it with caution because serotonergic drugs may increase the heart’s potential for arrhythmias. 8 This medication has a wide dose range and a one-hour average time for onset of action (Table 1), but it is advised to start at 5 mg/kg for pre-hospital sedation.
For dogs, melatonin, a hormone naturally produced by the pineal gland, is marketed as a neutraceutical (http://www lignans. net/melatonin1. html). While melatonin has shown promise in treating some endocrine disorders, it also works well as a supplemental treatment for anxiety in dogs. Melatonin is therefore suggested as an over-the-counter remedy for the hospitalized dog who exhibits aggression and anxiety (Table 1).
*Timing recommendations based on morning appointments. The effects of morning-administered medications are likely to be minimal if appointment is in the afternoon or evening. Timing regimen should be adjusted based on dog’s appointment time.
Although each of these drugs can be administered alone, it is advised to combine them all gradually until the desired level of sedation is reached. When treating an aggressive or fearful patient, gabapentin and acepromazine are frequently very effective. This makes it possible to safely use a muzzle, an E-collar, or additional IM sedation without endangering the patient’s dog or the hospital staff. However, melatonin and then trazodone should be considered if more at-home sedation is desired.
It’s crucial to test the sedation prior to the event when sending owners home with pre-hospital visit sedation so they know what to anticipate. The dog frequently appears much more sedated at home than in the clinic, and the amount of sedation can vary and last up to 24 hours. This is normal and safe. For anxious and stressed dogs, practice and learned comfort with oral sedation can significantly improve their hospital experience, but doing so requires staff, clients, and staff members to be ready to reduce additional stressors in the hospital setting. The result is a dog that is more able to adapt to a new setting, enabling better patient evaluation and patient-doctor relationships.
The animal is not completely unconscious during sedation, but its awareness of its surroundings is significantly altered, and it is unable to control its muscles.
There are different âlevelsâ of sedation. Some animals only require light restraint, so we give them medications to cause light sedation so they can still move their heads or wag their tails in response to our calls.
We only use sedation when it is impossible to perform the necessary procedure with the animal fully awake, as it is a major medical procedure and should not be taken lightly. Veterinarians and nurses must keep an eye on an animal while it is sedated to make sure that its heart and breathing are not being compromised.
People who receive the types of sedation we employ don’t remember the procedure afterward, and it appears that animals share this trait.
Others need more restraint and are heavily sedated, reaching a level of immobility and altered awareness that is comparable to general anesthesia in the animal.
How Do I Know If My Dog Is Anxious?
Some signs of anxiety, nervousness, or fear in dogs are overt, while others are more subtly expressed. Some signs to watch for include:
Affected dogs may show just 1-2 symptoms or several. A pup’s symptoms can help guide diagnosis and treatment. So try to observe as much as possible.
Prior to administering a sedative, your dog’s veterinarian may advise diagnostic testing, such as blood work, because some of the aforementioned symptoms can also signify a medical condition.
What Are Some Natural Remedies for Dog Anxiety?
Veterinarians may advise beginning with these treatments for dogs who exhibit mild anxiety before prescribing sedatives or anxiety medications:
Before giving your dog any new medication or supplement, always consult your veterinarian to ensure that it is safe and won’t interact with any medications they are already taking.
FAQ
How do vets sedate aggressive dogs?
When treating an aggressive or fearful patient, gabapentin and acepromazine are frequently very effective. This makes it possible to safely use a muzzle, an E-collar, or additional IM sedation without endangering the patient’s dog or the hospital staff.
What happens when a dog gets sedated?
Pets that have been sedated are in a “sleepy” state. It helps them unwind physically and mentally during potentially unpleasant investigations. In a manner similar to humans who have undergone a procedure under sedation, they are unlikely to remember what has occurred.
How long does a dog take to recover from sedation?
The effects of the general anesthetic and/or sedative can take several hours to subside, and in some cases, patients may appear sleepy for a day or two. They ought to behave normally over the course of the following day or two.
Do dogs feel pain when sedated?
If you give your pet a sedative, they’ll be able to unwind and not experience some mild discomfort. Sedatives are typically prescribed for performing diagnostic procedures that are not particularly painful but might be uncomfortable without the sedative’s action and may call for particular positioning.