Trazadone may lessen patient stress while in the veterinary hospital
The SEresults of this study may change up your go-to sedative for your anxious hospitalised veterinary patients .
Gilbert-Gregory SE , Stull JW , Rice MR , et al . Effects of trazadone on behavioral signs in hospitalized dogs . J Am Vet Med Assoc 2016 ; 249 ( 11 ): 1281-1291 ..
Summarized by Jennifer L . Garcia , DVM , DACVIM , VETERINARY MEDICINE
Why they did it
The more we know about the detrimental effects of stress in our patients , the more important it is to find ways to minimize stress and improve the welfare of our hospitalized veterinary patients . In this study , thFe authors evaluate the use of trazodone , a serotonin receptor antagonist and reuptake inhibitor , in mitigating behavioral markers of stress in hospitalized dogs .
What they did
The study authors evaluated stressrelated behaviors in 60 dogs ≤ 45 minutes after trazadone administration and again at 90 minutes . For each dog in the treatment group , there was an environmentally matched control dog that was not treated with trazadone ( n = 60 ). Behavioral observations were performed at the same time and by the same person for each pair of dogs . Dogs were excluded from the study if they had received mentation-altering medications ( e . g . sedatives ) ≤ 2 hours before observation .
For dogs in the treatment group , trazadone was administered starting at 4 mg / kg every 12 hours , which increased to 10 to 12 mg / kg or was administered every eight hours as needed for desired effects . The mean trazadone dose used in the study was 4.65 ± 0.97 mg / kg . The drug was continued for the duration of the hospital stay as needed but did not exceed 300 mg / dose or 600 mg / 24 hours .
An observer , blinded to the identification and allocation of each of the dogs , performed 60-second behavioral observations for each dog at the two time points — about 45 and 90 minutes after administration . All paired dogs were housed near each other but could not see the observer during evaluation of the other dog . The observer did not speak to nor did they interact with the dogs at any time during the study .
Behavioral observations were performed at each time point using a behavioral checklist that assessed specific stressrelated behaviors . The checklist was used to create an individual behavior score for each dog . The behaviors were also grouped into categories ( frenetic , freeze and fractious ) to create a behavioral summation score for each dog . The categories intended to describe an individual dog ’ s overall behavior response and to determine if dogs with certain stress-related behaviors would be more likely to benefit from trazadone .
Behavior categories *
Frenetic Lip licking Pacing Panting Spinning Trembling Whining Yawning Wet dog shake
Freeze Averting gaze Pinning back ears Whale eye sign
Fractious Growling Lunging Showing teeth Snapping
* Pupil dilation and lifting of a forelimb were signs that were included in all three categories .
What they found
The authors found that treatment with trazadone resulted in a significant decrease in individual stress-related behaviors including panting , whining and whale eye sign when compared with the control dogs .
The drug appeared to be well-tolerated , with only one dog developing signs of aggression after trazadone administration . The researchers also found that frenetic and freeze summation scores were lower for dogs in the treatment group compared with those in the control group . They noted , however , that frenetic and freeze behavior summation scores were higher in the treatment group to begin with , which may explain why there was a statistically significant decrease in these scores when compared with the control dogs . In addition , they note that a higher proportion of dogs in the control group were evaluated postoperatively , while a higher proportion of dogs in the treatment group were observed preoperatively . The authors suggest that these variables may have affected the dogs ’ behavior and subsequent behavioral scores as the postoperative dogs had more time to acclimate to their environment .
Take-home message
Trazadone appears to be well-tolerated and may lessen stress-related behaviors in hospitalized dogs . Further studies are warranted to determine the effects of surgical status and duration of hospitalization , as well as to compare effects between groups with comparable baseline behavioral scores .
If in the past you ’ ve reached for acepromazine to help calm stressed dogs in the hospital , this study ’ s findings may make you take note . “ The standard use of acepromazine , a sedative medication with negligible anxiolytic benefits , in stressed dogs may be detrimental to the behavioral and physical health of those dogs ,” write the study authors . For this reason , they recommend that acepromazine not be considered the first choice when managing stressrelated behaviors in hospitalized dogs and that trazadone may be considered as an alternative . vet360
Issue 06 | FEBRUARY 2017 | 18