#34 – Fireworks Freak-Out

There are lots of remedies for this phobia. Beyond recommending drowning out the noise with fans and music, pheromones (Adaptil), and food toys to promote foraging, I urge you to dispense Sileo gel (dexmedetomidine).

I have a whole lot of happy pet parents who have reduced their dogs’ fear of loud noises with this quick acting oral-transmucosal gel. Here’s how it works:

• Sileo (dexmedetomidine) is a centrally acting alpha-2 adrenergic receptor agonist but at a much lesser concentration than the injectable form (Dexdomitor).
  • Sileo attenuates norepinephrine release from the neurons in the locus coeruleus of the CNS.
  • The locus coeruleus, located in the pons of the brainstem, mediates stress, anxiety, and fear.
• Noise phobic dogs are dosed with Sileo gel at sub-sedative dosages.
  • Your clients will administer Sileo at home by sliding the blunt plastic syringe between their dogs’ lower lip and gum and depositing the gel.
  • The anxiolytic effects have a duration of 2-3 hours.
  • Sileo can be repeated up to 4 times/day with a pause of at least 2 hours between doses.

There are certainly dogs who resist having stuff poked into their mouths.

• I encourage people to start teaching their dogs that the Sileo syringe is a good thing – before there is a need for its contents.
• Smearing the end of the syringe with peanut butter and allowing the dog to come to them to enjoy licking it will quickly lead to a pleasurable association with this device.
  • It’s natural for people to go to their dog to medicate them.
  • Armed with something that looks like the syringe that caused them pain in the veterinary clinic dog parents may inadvertently trigger old fears.
  • They can then fall into the mistake of trying to force the Sileo between their dog’s lip and gum.
• Instead, the dog should be allowed to become curious and choose to approach, thus finding the Sileo syringe to represent something good.
  • After several brief syringe-licking sessions it can be pushed a short distance into the side of the dog’s mouth as he/she licks the peanut butter.
  • After several short sessions have made a fun game of it the peanut butter slathered syringe can be moved further into the pocket between the lip and the last lower tooth.
• After the Sileo gel is actually released into this space the dog’s mouth should be closed.
• The dog’s chin should be held up for a couple of minutes before a bit of food is offered as a reward.

There are a few dogs who become so panicked during fireworks that Sileo alone may not be adequate.

• Trazodone and benzodiazepines have been used concurrently with Sileo without problems.
• Avoid acepromazine.
  • It has essentially no anti-anxiety properties.
  • Scared dogs on Ace, with their mobility compromised, are trapped in a “chemical straight jacket”.
  • Acepromazine can worsen noise phobias.

We have no good data on Sileo’s safety or effectiveness in cats.

• I prescribe lorazepam to be given in little frozen butter balls at 0.03-0.08 mg/kg.
• Most cats do well at 0.25 mg lorazepam (1/2 of a 0.5 mg tablet), ideally given about 40 minutes prior to the onset of the noise trigger.
• Redose every 8-12 hours as-needed.