Trazodone & Veterinary Examination Stress in Dogs

In the Literature

Kim S-A, Borchardt MR, Lee K, Stelow EA, Bain MJ. Effects of trazodone on behavioral and physiological signs of stress in dogs during veterinary visits: a randomized double-blind placebo-controlled crossover clinical trial. J Am Vet Med Assoc. 2022;260(8):876-883. doi:10.2460/javma.20.10.0547

The Research …

Difficulty transporting a pet to the clinic and associated stress of the patient and pet owner can be barriers to routine veterinary care.¹ Stress-reduction techniques can benefit the clinic, patient, and owner.

This double-blinded, placebo-controlled crossover study evaluated the impact of trazodone (9-12 mg/kg PO once) administered to dogs 90 minutes prior to transport to the clinic for complete physical examination with physiologic measurements (eg, heart rate, serum cortisol). Each dog was given trazodone or placebo in random order prior to 2 separate clinic visits one week apart, allowing each dog to serve as its own control. 

Examinations were video recorded, and behavior analysis was performed by blinded observers who showed fair agreement in scoring. Owners scored personal and pet stress, and investigators scored patient sedation, aggression, and compliance during examination.

Based on owner scoring and observer video analysis, patient stress scores during examination were significantly lower in dogs given trazodone; however, scoring by investigators was unchanged in dogs receiving placebo versus trazodone. In dogs receiving trazodone, respiratory rates were significantly lower and mean heart rates were higher; no other significant differences in physiologic variables were noted.

… The Takeaways

Key pearls to put into practice:

• Many dogs (63%-78.5%) entering the clinic show signs of stress and anxiety,^2,3 which can alter physiologic measurements and lead to fear and aggression directed at clinic staff and owners. Owners may therefore delay or avoid bringing their pet to the clinic.¹ Previsit medication should be administered when indicated.

• This study used a larger dose of trazodone (9-12 mg/kg) than is recommended (2-3 mg/kg) for adjunct treatment of canine anxiety, stress management during hospitalization, or postsurgical confinement.^4-7 Nonetheless, the only reported adverse effect was diarrhea in one dog 4 hours after administration that resolved without additional treatment. No severe or fatal adverse effects have been reported in studies evaluating trazodone as a previsit medication.^4,7,8

• Owners should be educated on how to alleviate stress and anxiety in their dogs. Previsit medications should be offered when signs of distress are detected. Preventing escalation and alleviating patient and owner stress can allow more effective, humane care and increase owner compliance.