Firework Fear First Aid: A guide to common noise phobia medications for pets
Author: Dr Joanna Woodnutt BVM BVS MRCVS
It’s that time of year again – your consult list is starting to fill up with noise phobic dogs and their worried owners looking for advice as firework season starts. Obviously, we all know the answer to noise phobias is desensitisation and counter-conditioning. But, unfortunately, it’s a little bit late now – a proper desensitisation programme takes months and starting it now could lead to sensitisation instead. While environmental modification can help, it’s quite likely you’ll be reaching for noise phobia medications for at least some of those pets. So, we thought we’d summarise what drugs are available to manage noise phobia in pets in 2024.
Prevalence and Severity of Noise Phobias in Pets
Firework fear is the most common noise phobia in pets, with a quarter to a half of the dog population thought to be affected, although studies suggest that only 15–22.5% of pet owners seek professional help. Dogs tend to show signs of noise fear within the first year to two years of life, and there’s known to be a genetic element to the development of this fear, with some breeds predisposed and high heritability. When firework fear suddenly starts after five years old, it’s usually associated with pain – investigating for hidden pain and disease and/or providing pain relief may be helpful!
There is far less data about the prevalence of noise phobia in cats, but two large survey-based studies placed the prevalence of adverse behaviour due to firework noise at 49% and 76% respectively. While it’s likely that these surveys are biased due to self-selection of owners struggling with noise fears, it’s also likely that feline noise phobia is under-reported to vets due to their fear behaviours being less obvious to pet owners.
Noise Phobia Advice for Clients
Before we get into the drugs, it’s important to recognise that many pets will find environmental modification hugely helpful when nearby firework displays are expected. The following advice should be given to clients to help keep pets with mild to moderate noise phobias calm during firework season.
Adapt the routine
Remind clients it’s ok to adapt their pet’s routine when fireworks are expected or likely. Dogs should be taken out to toilet before dark, reducing the chance of being outside when the fireworks start. In most cases, blocking a cat’s access to outdoors is also sensible.
Check chips
Checking microchips before bonfire night is a good idea, since spooked pets can run a long way and get lost. You should make this part of your checkup routine when prescribing firework fear medications.
Build a safe environment
Remind clients to close the curtains and turn on the television or radio to help disguise the noise of the fireworks. Several radio stations play ‘calming dog music’ for firework night.
Clients might also look to build a ‘den’ in an internal room without windows. Ideally, pets should have access to this for several weeks on the run up to firework night in order that they can get used to the area.
Interacting with the pet
Contrary to some schools of thought, interacting with the pet and comforting them can be helpful. It does not reinforce fear, since fear is an emotion. In one survey-based study of owner perceptions, feeding and playing with a dog significantly reduced fear scores.
Pressure wraps and vests
The efficacy of tight bodysuits like the Thundershirt was 44% in one owner survey study, which is better than expected placebo. An RCVS Knowledge review also resulted in a weak recommendation for pressure vests, as long as owners habituated their pet to the vest in advance.
Firework Fear Medications for Pets
Natural therapies
While there are a number of non-prescription herbal and natural remedies on the market for firework fear in pets, the evidence for these is generally weak. One independent owner-reported study put the effectiveness of Bach flowers, herbal products, essential oils, nutraceuticals and pheromones at a level expected with caregiver placebo, eg 27-35%. The only placebo-controlled study that evaluated DAP pheromones found that the Adaptil users had lower overall anxiety/fear scores but were more likely to hide in response to thunderstorm noises, suggesting a partial benefit to using DAP for noise phobias. One recent placebo-controlled study into a herbal supplement found significant decreases in owner-assessed behaviour scores and objective salivary cortisol measures, but it should be noted that the treatment was given for at least 40 days before the firework noises. For CBD, this recent review claimed no studies have shown a beneficial effect for noise phobia, and this study compared CBD unfavourably to Trazodone. Further studies (discussed here) looked at various ‘natural’ therapies and found low quality studies, reporting bias, and/or no significant difference in results.
While these ‘natural’ products can form part of a solution, vets should take care that owners are not recommended these products over and above medications with a higher efficacy.
Prescription medications for dogs
As mentioned above, it’s important to consider pain in any dog newly exhibiting noise phobia symptoms over 5 years old, and you may want to consider treating their pain.
| Brand name | Active Ingredient | Licensed for noise phobia? | Dose | Frequency and loading | Notes | Evidence |
|---|---|---|---|---|---|---|
| Sileo ® | Dexmeditomidine | Yes | 125 micrograms/m2 | At first sign of anxiety or detection of fear-eliciting noise. Some behaviourists recommend 2.5hrs before likely exposure. Can be repeated every 2 hours unless still sedated, up to 5 times. | – | Good evidence (1, 2, 3) |
| Pexion ® | Imepitoin | Yes | 30mg/kg | Every 12 hours. Start 2 days before expected noise event and continue through noise event. | Can be used long-term eg over several weeks of firework season. Keep tablet in relation to feeding consistent. | Good evidence (1, 2) |
| Xanax | Alprazolam | No | 0.01-0.1mg/kg, with most dogs getting 0.02-0.04mg/kg | 30 mins before expected event if possible, repeating every 4-6 hours with half dose (full dose if needed) | Controlled drug, prescribe minimum quantities. Potential risk of disinhibition so avoid in aggressive dogs or those with active dear behaviours. | – |
| – | Trazodone | No | 6-10mg/kg (max dose 300mg/dog) | 12 hours before exposure and again 2 hours before exposure | Risk of hepatotoxicity, so avoid in liver disease. | Moderate evidence (1) |
| Gabapentin | Gabapentin | No | 10-30mg/kg | 2 hours before exposure | May help when possibility of pain-related noise phobia | Moderate evidence (1) |
Please note, the above is taken from research, datasheets, and behaviourist advice and should only be used as a guide. Vets are responsible for their own prescribing decisions and should satisfy themselves as to the appropriateness of any prescription.
Prescription medications for cats
There are no licensed medications for noise phobias in cats. Gabapentin can be given at 50-100mg/cat (start at lower dose) 24, 12, and 2 hours before expected exposure.
Moving forward – treating noise phobias
Of course, in an ideal situation dogs wouldn’t need medicating for noise phobias. Desensitisation and counter-conditioning can prove very effective in reducing fear symptoms. It’s recommended that dogs are not exposed to an uncontrolled frightening stimulus when they are undergoing therapy, so this shouldn’t be started now – it’s generally best to wait until the New Year. Unfortunately, it’s common to lose dogs to follow up, until next year, so before they leave with their prescription you should make an appointment to discuss a desensitisation programme, or make a referral appointment, in order to reduce the likelihood of this.
Conclusion
Noise fear is very common in dogs and cats, although few owners seek professional advice. Owners should be given standard advice for routine adjustment and environmental modification, and consideration should be given to prescribing noise phobia medications. Before pet owners leave, attempts should be made to book them in to start desensitisation programmes after the firework period is over.
If you found this article interesting, you might want to read more about the psychology of pets. Or, if you’re interested in taking an animal behaviour course and even offering desensitisation programmes in-house, our Nurse Certificate in Small Animal Behaviour might be of interest.
P.S Don’t forget to log this free veterinary CPD in 1CPD! Our article “reflecting on veterinary CPD” may be helpful, too!
