Many dogs and cats experience fear, anxiety, and stress at the veterinary clinic. Their anxiety often begins before they even arrive at the clinic, especially if they associate pet carriers and car rides with the clinic. Previsit antianxiety medications for pets can make clinic visits easier and safer for these pets, their owners, and clinic staff.
 
These are some of the benefits of previsit medications for anxious pets:

• Less stress at the clinic
• Better acceptance of future clinic visits
• Less stress for car rides
• Less need for restraint by multiple staff members
• Increased ability to have diagnostic procedures and treatments
• Increased safety for patients for whom stress and struggle are risky (for example, patients with heart disease, respiratory disease, frail condition, or brachycephalic head shape [flat face])

 
Previsit medications have benefits for pet owners and clinic staff members too. Being the caretaker of an anxious and fearful pet isn’t easy, so previsit medications for pets can reduce everyone’s stress levels. For clinic staff members, managing patients’ clinic anxiety reduces the risk of injury and decreases workplace stress (we love animals too and don’t want to cause them distress).
 
How to Know if Your Pet Needs Previsit Medications
Previsit medications aren’t just for aggressive animals. Pets with more subtle signs of stress are scared too, and they deserve help for their anxiety just as much as animals that can’t be handled without full sedation.
 
If your pet shows obvious signs of fear at the clinic, you probably already know that your pet would benefit from previsit medications. But maybe your pet’s signs are not as noticeable and you’re a little surprised when your veterinarian recommends medications.
 
Dogs and cats show anxiety and fear with a range of behaviors and body language cues. Anxious and fearful dogs and cats tend to start with subtle behaviors like lip licking or freezing. If the scary thing doesn’t go away—or tries to draw a blood sample—the behavior can escalate to aggression.
 
Dogs and cats that are anxious at the veterinary clinic can show these signs:

• Hiding
• Refusing to leave the carrier
• Freezing
• Yawning, lip licking (dogs)
• Pacing
• Panting
• Trembling
• Hard stare or side eye
• Struggling
• Growling, hissing, snarling, barking
• Swatting (cats)
• Warning snap
• Biting

 
How to Use Previsit Medications
Previsit medications work best if they’re used along with training and positive reinforcement. For example, a cat can make positive associations with the cat carrier if the carrier is left out all the time as part of the normal household furniture, sometimes with yummy treats inside, instead of appearing only when the cat is going to the clinic.
 
Veterinarians choose previsit medications according to the needs and medical condition of the individual patient. Some of the drugs commonly prescribed for situational (short-term) anxiety are gabapentin, trazodone, and clonidine. Motion sickness contributes to anxiety, so pets might also receive antinausea medication. Some of these medications can cause sedation, but the main goal is anxiety reduction, not sedation.
 
Previsit medications are timed to have maximum effect at the time of the clinic visit. They need to take effect before the pet experiences any stress. Most of these medications are given at least 1 to 2 hours before the clinic visit; sometimes a loading dose is also given the night before. They typically last for up to 8 hours, although the duration can vary.
 
Because individual animals respond differently to these medications, giving a trial dose can be very helpful. If you use a trial dose, tell your veterinarian how long it took for the medication to take effect, how the medication affected your pet’s behavior, whether your pet had adverse effects like vomiting or excessive sedation, and how long the medication’s effects lasted.
 
For some dogs and cats, previsit medications aren’t enough to overcome their fear. These pets might also need a sedative injection at the clinic. For these pets, previsit medications given at home make the sedative injection easier for the pet (and staff) and can also reduce the dose of injectable drug.
 
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Over-the-counter (nonprescription) pain medications can cause serious problems for dogs and cats. Because these medications don’t need a prescription and are used for children as well as adults, some pet owners mistakenly believe that they’re safe for animals too. But dogs and cats don’t process these drugs the same way as humans.
 
If your pet has signs of pain, call your veterinarian instead of giving your pet something from your medicine cabinet. Prescription pain medications developed specifically for dogs and cats are safer and more effective for them than over-the-counter human medications. In any case, animals that have a level of pain high enough to be obvious to a human need to see a veterinarian.
 
Nonsteroidal Anti-Inflammatory Drugs (Aspirin, Ibuprofen, Naproxen)
The most common human nonsteroidal anti-inflammatory drugs (NSAIDs) available without a prescription are aspirin, ibuprofen, and naproxen. Some brand names are Advil, Aleve, Ascriptin, Bayer, Bufferin, Ecotrin, Midol, and Motrin.
 
In animals, NSAIDs can cause these problems:

• Vomiting
• Diarrhea
• Decreased appetite
• Lethargy
• Stomach ulcers
• Kidney damage
• Liver damage
• Seizures

 
NSAIDs reduce inflammation by blocking the activity of cyclooxygenase (COX) enzymes, which are responsible for prostaglandin production. Prostaglandins are hormone-like substances with many functions; they’re involved in the inflammatory response and also protect the stomach lining and maintain blood flow to the kidneys.
 
Because NSAIDs decrease prostaglandin levels, these medications decrease inflammation and pain. However, the lower prostaglandin levels can also cause serious adverse effects like stomach ulcers and kidney damage. Some newer NSAIDs target specific COX enzymes and prostaglandins that are less likely to affect the stomach and kidneys.
 
Several NSAIDs have been approved for use in dogs, and a few are available for cats. Examples are carprofen, grapiprant, deracoxib, and robenacoxib. These species-specific drugs are available only by prescription from a veterinarian and are less likely than human NSAIDs to cause adverse effects in dogs and cats. Animals receiving prescription NSAIDs need regular examinations and bloodwork to monitor kidney and liver function.
 
Acetaminophen
Brands containing acetaminophen include Tylenol, Panadol, Excedrin, and Midol. Some pain relievers labeled “complete” or “dual action” contain acetaminophen plus aspirin or ibuprofen. Acetaminophen is also called paracetamol.
 
Acetaminophen is highly toxic and often fatal to cats. Acetaminophen is also potentially toxic to dogs, but it can be used in dogs with caution and veterinary oversight.
 
In humans and dogs, acetaminophen is broken down mainly in the liver through a process called glucuronidation. A toxic dose of acetaminophen in a human or a dog damages liver cells and causes liver failure.
 
Cats don’t have the enzymes needed for glucuronidation, so their bodies break down acetaminophen through a different process called sulfation. The sulfation process in cats creates products that react to hemoglobin, the substance within red blood cells that carries oxygen throughout the body.
 
In cats, acetaminophen exposure causes anemia and life-threatening oxygen deficiency. Cats that swallow acetaminophen are less likely than dogs to develop liver failure because they usually die of oxygen deficiency before the liver has a chance to fail.
 
An antidote to acetaminophen (N-acetylcysteine) is available, so dogs and even cats with acetaminophen poisoning can recover if they are treated immediately at an emergency veterinary clinic.
 
For More Information
Get the Facts About Pain Relievers for Pets (US Food and Drug Administration): https://www.fda.gov/animal-veterinary/animal-health-literacy/get-facts-about-pain-relievers-pets
 
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