Review of the Use of Pre-Visit Pharmaceuticals for Reducing Fear-Related Behaviours in Dogs

Fear, anxiety, and stress (FAS) in canine patients is a growing concern for the veterinary industry. FAS affects the health of the patient while also increasing the risk to veterinary staff. Studies show that many veterinarians do not feel confident in managing behavioural issues like FAS, making engaging effectively with clients more difficult. Pre-visit pharmaceuticals (PVPs) can be an important tool in mitigating the effects of FAS; however, conclusive research is lacking on the efficacy of many of the medications and combinations currently used for this purpose. A comprehensive literature search was conducted in multiple databases. The most current research available on medications identified as widely used for treating FAS, and available for use in New Zealand, has been reviewed and discussed. Combinations selected for inclusion were the ‘chill protocol’ of acepromazine, gabapentin, and melatonin. Single agents included are clonidine, dexmedetomidine, gabapentin, and trazodone. Research into the use of the ‘chill protocol’ suggests this may be a combination particularly useful in highly stressed and aggressive dogs; however, additional studies need to be conducted to strengthen the evidence for its use. A multimodal approach has been identified as being desirable when addressing FAS in a clinical setting, with less evidence to support the use of single-agent medications in mitigating problematic behaviours.