Oromucosal Dexmedetomidine to Reduce Stress at the Clinic

A significant percentage (78.5%) of dogs exhibit fearful behaviors during visits to the clinic.¹ Increasing patient comfort in the clinic is important to pet owners and clinicians; thus, prescribed anxiolytics and sedatives (extra-label) to be given before visits to the clinic have become increasingly common.^2-4

This randomized, crossover, double-blinded, placebo-controlled study* evaluated the use of oromucosal dexmedetomidine gel in the clinic to decrease stress in dogs. Study patients were known to have anxiety and/or fear when at the clinic. Aggressive dogs were not included. Owners, clinicians, and observers (who used an ethogram with predetermined stress-related behaviors to assess the dogs) were blinded as to which dogs received dexmedetomidine oromucosal gel (125 µg/m²) or a placebo control gel, which was identical in appearance to the dexmedetomidine gel. After a wait time of 20 minutes to allow the drug to take effect, interactions between each dog and the owner and staff were recorded on video. Dogs served as their own control, as they returned 14 to 21 days later and were given the alternative medication or placebo. Observers noted a significant decrease in signs of stress in patients, but owners and clinicians did not.

Key pearls to put into practice:

Owners and clinicians may not be familiar with all the signs of fear and anxiety in dogs and may miss subtle changes.

Dexmedetomidine may have a better effect when given at home (before arrival at the clinic), possibly because the 20-minute wait time for the drug to take effect can be stressful for patients in an unfamiliar environment.

In dogs known to be fearful, it may be beneficial to delay examination/treatment and send medication home to be administered before the next visit to the clinic.