What dose and timing of trazodone should I use for pre-visit anxiety in dogs?

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Trazodone for pre-visit anxiety in dogs is dosed at 3–7.5 mg/kg PO, administered 90 minutes to 2 hours before transport to the clinic.19 The dose range in the literature spans 3–12 mg/kg PO depending on the clinical context. The 2020 AAHA Anesthesia and Monitoring Guidelines list 3–7.5 mg/kg PO for dogs with low Fear, Anxiety, and Stress scores.9 The 2019 AAHA Dental Care Guidelines recommend administration ideally the evening before and at least 2 hours before presentation.3 For situational anxiety (thunderstorms, public outings, home-alone anxiety), trazodone has been used at 4.5 mg/kg PO q8–12h.6 Chronic adjunctive dosing begins at approximately 2.5–5 mg/kg PO q12–24h, titrating to a target of 5–10 mg/kg PO q8–24h.4 The single-dose trial demonstrating reduced owner- and video-assessed stress scores used 9–12 mg/kg PO given 90 minutes before transport.1 Onset of anxiolytic effect is within 90 minutes of oral administration.6 Following rectal administration of approximately 8 mg/kg, peak sedation occurs at a median of 30 minutes and lasts several hours, with effects resolved by 12 hours — a viable route when oral administration is contraindicated.8 Adverse effects include gastrointestinal upset and sedation, both reported with chronic dosing.4 Approximately 22% of dogs develop new or worsening postural reaction deficits after trazodone administration, so trazodone should not be given before a neurologic examination.2 Approximately 18.7% of dogs shift from bright, alert, and responsive to quiet, alert, and responsive.2 Trazodone also has the potential to suppress hypothalamic-pituitary-adrenal axis function, which could interfere with endogenous adrenocorticotropic hormone and cortisol testing — adrenal function testing should not be performed on the same day as trazodone administration.7 | Dose | Route | Timing | Context | Key Caveat | |---|---|---|---|---| | 3–7.5 mg/kg | PO | Pre-visit | Low FAS, pre-anesthetic | AAHA anesthesia guideline 9 | | 9–12 mg/kg | PO |