Choosing the right medication for canine separation anxiety

In this video, Christopher Pachel, DVM, DACVB, CABC, discusses the clinical decision-making process for treating canine separation anxiety. He explains the distinction between maintenance medications, which take longer to take effect but provide steady support, and situational medications, which are utilized for intermittent or predictable stressors and offer short-term support. Rather than relying on a one-size-fits-all approach, Pachel emphasizes tailoring treatment plans to each patient’s needs and schedule.

The following is a transcript of the video, lightly edited for clarity and cohesion:

Pachel: The decision of what to prescribe is really influenced—I almost said “dictated,” but influenced—by the actual needs of that animal. And so, I look at these two things in terms of situational versus maintenance medication support.

One example of a maintenance medication would be fluoxetine—or the generic version of Prozac, or Reconcile on the canine side. For that particular medication, it is a medication that takes several weeks to be able to take effect, but then has a reasonably steady state from that point forward. If we have a dog who needs to be left home alone multiple times per week or on a highly variable schedule, oftentimes, something like fluoxetine or Reconcile is a great choice to be able to support that dog.

On the other hand, if we have a dog who only needs to be left home alone, or alone and separated from their caregiver, on an intermittent or predictable basis and the duration of those departures or separations is short enough that a situational medication like alprazolam or trazodone or clonidine could be used effectively, that may be a great way to support that particular dog.

So, it's really the schedule and the needs of the animal that has the greatest influence on what I'm likely to prescribe and what I try to coach other veterinarians to prescribe as well. Rather than simply saying, "Dog has separation anxiety, therefore, here is the medication." [Instead say] “Dog has separation anxiety. Let's fill in the gap on a couple of other data points and then decide what really fits their needs and the schedule.”