Objective—To evaluate efficacy of trazodone hydrochloride as an adjunctive treatment for anxiety disorders as well as treatment protocol, dose range, concurrent drug use, adverse events, and therapeutic response in dogs unresponsive to other pharmacologic agents.
Design—Retrospective case series.
Animals—56 dogs with anxiety disorders treated at a referral veterinary behavior clinic.
Procedures—Medical records of dogs with anxiety disorders adjunctively treated with trazodone were retrospectively evaluated with respect to signalment, primary and secondary behavioral diagnoses, physical examination results, hematologic data (CBC and serum biochemical panel), pharmacologic management, and outcome.
Results—Overall, trazodone, used as an adjunctive agent in combination with other behavioral drugs, was well tolerated over a wide dose range and enhanced behavioral calming when administered on a daily or as-needed basis.
Conclusions and Clinical Relevance—Although further controlled studies of dose range, efficacy, and safety are needed, trazodone may provide an additional therapeutic option for use in dogs that are unresponsive to conventional treatment.
Objective—To investigate the safety and efficacy of oral administration of the serotonin antagonist and reuptake inhibitor trazodone hydrochloride to facilitate confinement and calming after orthopedic surgery in dogs.
Design—Prospective open-label clinical trial.
Animals—36 client-owned dogs that underwent orthopedic surgery.
Procedures—Starting the day after surgery, dogs were administered trazodone (approx 3.5 mg/kg [1.6 mg/lb], PO, q 12 h) with tramadol (4 to 6 mg/kg [1.8 to 2.7 mg/lb], PO, q 8 to 12 h) for pain management. After 3 days, administration of tramadol was discontinued, and the trazodone dosage was increased (approx 7 mg/kg [3.2 mg/lb], PO, q 12 h) and maintained for at least 4 weeks. If needed, trazodone dosage was increased (7 to 10 mg/kg [3.2 to 4.5 mg/lb], PO, q 8 h). Owners completed electronic surveys rating their dogs’ confinement tolerance, calmness or hyperactivity level, and responses to specific provocative situations prior to surgery and 1, 2, 3, and 4 weeks after surgery and at the postsurgery evaluation (at 8 to 12 weeks).
Results—Most (32/36 [89%]) of owners reported that their dogs, when given trazodone during the 8 to 12 weeks following orthopedic surgery, improved moderately or extremely with regard to confinement tolerance and calmness. Trazodone was well tolerated, even in combination with NSAIDs, antimicrobials, and other medications; no dogs were withdrawn from the study because of adverse reactions. Owner-reported median onset of action of trazodone was 31 to 45 minutes, and median duration of action was ≥ 4 hours.
Conclusions and Clinical Relevance—Results suggested that oral administration of trazodone was safe and efficacious and may be used to facilitate confinement and enhance behavioral calmness of dogs during the critical recovery period following orthopedic surgery.
ANIMALS 10 healthy client-owned cats (2 to 12 years of age) with a history of anxiety during transport or veterinary examination.
PROCEDURES Each cat was randomly assigned to first receive trazodone hydrochloride (50 mg) or a placebo PO. The assigned treatment was administered, and each cat was placed in a carrier and transported by car to a veterinary clinic, where it received a structured veterinary examination. Owners scored their cat's signs of anxiety before, during, and after transport and examination. The veterinarian also assessed signs of anxiety during examination. After a 1- to 3-week washout period, each cat received the opposite treatment and the protocol was repeated.
RESULTS Compared with placebo, trazodone resulted in a significant improvement in the cats’ signs of anxiety during transport. Veterinarian and owner scores for ease of handling during veterinary examination also improved with trazodone versus the placebo. No significant differences were identified between treatments in heart rate or other physiologic variables. The most common adverse event related to trazodone administration was signs of sleepiness.
CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of a single dose of trazodone to cats prior to a veterinary visit resulted in fewer signs of transport- and examination-related anxiety than did a placebo and was generally well tolerated by most cats. Use of trazodone in this manner may promote veterinary visits and, consequently, enhance cat welfare.