Puppies on Prozac: How to Handle Your Pet’s Anxiety

Veterinarians say they have seen an increasing number of pets experiencing mental distress. Here's how to spot the signs.

When my dog Ozzy feels stressed, he emits loud, rambly groans that are ridiculously cute but also make me wonder if he's having a stroke. After noticing that his anxiety swells quite frequently, our trainer recommended that we give him CBD treats to soothe his nerves. Shortly thereafter, our veterinarian prescribed him the antidepressant trazodone for when he's especially stressed, including before vet appointments. Ozzy appears to be in good company: In the process of reporting this piece, I learned that two of my editors have cats on Prozac.

In a 2021 survey of 409 dog owners, conducted by the Center for Canine Behavior Studies, researchers reported that just over half of the respondents said they'd given CBD products to their dogs, most commonly to treat fear, stress and anxiety. And while there's no data, as of yet, showing that our furry friends are grappling with more mental health issues today than they did in the past, the veterinarians I spoke with said that pet anxiety is a common concern among dog and cat owners right now. "I do believe more pets are being treated for anxiety than in the past," said Dr. Leni Kaplan, a veterinarian at the Cornell University College of Veterinary Medicine.

Some 23 million American households adopted dogs or cats between March 2020 and May 2021. Lockdowns prevented many of these pets from being properly socialized, so it's not a reach to imagine that encounters with other people and animals may now make them anxious, Dr. Kaplan said. Many dogs and cats got used to having their owners around all the time, so the transition back to "normal" may have been hard for them, she added. Beyond that, pets can sense human stress and anxiety, which can cause them to feel nervous as well.

Here's what you need to know about dog and cat anxiety and the various ways to treat it — including with medications.

Recognize the signs of anxiety.

Anxious pets can behave in a range of ways, some more obvious than others, said Dr. Stephanie Borns-Weil, a veterinary behaviorist at the Cummings School of Veterinary Medicine at Tufts University. Hiding or cowering is one clear sign of anxiety. Anxious animals may also exhibit "displacement behaviors" — where they do things that make sense in some situations, but not in the situation they're in. For dogs and cats, these can include random sneezes, yawns, lip-licking, scratching or grooming. Ozzy always yawns and scratches his neck with his back paws right before he gets in the car, and I know it's because he's nervous.

Pets may also freeze when they're scared, and owners may interpret this immobility as calm — but really, they're "anxious beyond the ability to react," Dr. Borns-Weil said. With dogs, you can usually tell from their eyes that they're nervous, she said: Their eyes will open so wide you'll see the whites around them, or their pupils will be dilated. Cats' ears may flatten against their heads, and they may puff up to try to look bigger than they really are, she added. Aggression can be another sign of anxiety — pets often lash out when they're scared because they're acting in what they consider to be self-defense, she said.

Separation anxiety can cause animals to destroy things, bark or meow a lot, or urinate or defecate indoors (or outside the litter box if you have a cat) while you're gone. (Dr. Borns-Weil said that pets don't have accidents in inappropriate places out of spite or anger, but because of distress.) Some dog breeds are more prone to separation anxiety than others, said Dr. Jerry Klein, the chief veterinary officer of the American Kennel Club. These include herding breeds such as Border collies and German shepherds.

Take them to the vet.

If your pet is exhibiting anxious behavior, the first thing you should do is get them evaluated by a veterinarian, because there could be a non-psychological reason for their acting out. "Close to a third of the patients that come to me have medical issues that are either causing or contributing to their behavior problems," Dr. Borns-Weil said. She once treated a dog with an ear infection who anxiously snapped at its owner after the owner touched its ear.

"We want to really do a medical work-up and make sure that they don't have an organ issue, an infection, inflammation, discomfort, pain or itching," she said.

Drugs and supplements can help, but choose them carefully.

Once you've addressed any underlying medical issues, ask your vet about treatment options, Dr. Borns-Weil suggested. The Food and Drug Administration has recently approved a handful of prescription drugs for dog anxiety: One is Sileo (dexmedetomidine oromucosal gel), which can help nervous dogs tolerate loud noises like fireworks or thunder. There's also Reconcile (fluoxetine hydrochloride) and Clomicalm (clomipramine hydrochloride), which are F.D.A.-approved to treat separation anxiety in dogs (and can be prescribed off-label to cats, too). A number of other human drugs can be prescribed off-label for pets as well, including various other antidepressants, the anti-seizure drug gabapentin and the blood pressure drug clonidine, Dr. Borns-Weil said.

Over-the-counter anxiety aids could also help, but all of the experts I spoke with recommended consulting with a vet before trying one. That's because some products may not help and could actually be harmful, Dr. Borns-Weil said. For instance, although the cannabis-derived chemical CBD is safe for pets, THC is toxic for cats and dogs — and in 2020, the F.D.A. reported that nearly half of the 147 CBD products it tested were contaminated with THC even though the labels had no indication of its presence. Vets can usually recommend brands that have been independently tested and shown to be safe, Dr. Kaplan said — although Dr. Borns-Weil wasn't convinced that CBD would do much good, as there's no data to suggest it effectively treats anxiety in pets.

Dr. Kaplan said that studies show that other over-the-counter products can help with pet anxiety, too, including Zylkene, a calming supplement for cats and dogs that contains cow's milk protein; Feliway, a diffuser for cats that releases calming pheromones into the air; Adaptil, a similar pheromone diffuser but for dogs; and Purina Pro Plan Veterinary Supplements Calming Care, a probiotic supplement for dogs. But again, talk to a vet before using one.

Consider other interventions, too.

While certain drugs can help, "medication alone is not a silver bullet," Dr. Kaplan said. Owners may need to tweak their pet's environment to make them more comfortable, or teach their pet to feel less nervous. For instance, Dr. Klein said, separation anxiety can be treated by having an owner leave the home for brief periods — at first, just a few seconds — and gradually increasing their time away.

We can teach pets to feel more comfortable in other situations, too. Although our vet prescribed Ozzy trazodone to ease his nerves before appointments, she said it would be even better for us to bring him by the office every so often just to get treats. If we can teach him to start associating the vet's office with milk bones rather than blood draws, he may not need drugs. He'll be thrilled, rather than scared, when it's time for his checkup — and that'll make things easier for everyone.

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