Thunderstorm Anxiety & Storm Phobia
by Gloria Manucia, PhD. M.C.P ©2002
The presence of agitated, overly fearful behavior during a thunderstorm is far from rare among Golden Retrievers. For this discussion I will use the terms "thunderstorm anxiety" and "storm phobia" interchangeably. Some researchers argue that there is probably a genetic component, since certain breeds are overrepresented among dogs who suffer from this disorder. (Goldens are not among the breeds with the highest reported incidence of storm phobia, but the disruptiveness of the disorder can reach life-threatening proportions, so we feel it important to address it here.) Storm-phobic dogs typically tremble and whine, seek comfort from their owners, and many engage in strenuous efforts to escape from where they are confined, which can lead to frenzied scratching, chewing and digging. Not only can the dog's surroundings be damaged and the dog escape from a safely confined area, but some affected dogs will scratch and chew with such unending force that their muzzles and feet become injured and bloody.
We once had in foster care a beautiful 8-year-old Golden girl who would become so agitated in a storm that that she escaped from heavy-duty crates, chewed and scratched her way THROUGH dry wall, releasing all the other dogs with whom she was being fostered. Only the extra-strength cages available in some veterinary offices could maintain her when she became agitated.
No one knows what part of the storm frightens dogs most, but it could be something to which we are oblivious, such as a sudden drop in barometric pressure, the electrical charge in the air, even getting shocked by the ground. One study also argued that rescued dogs may also be more likely to develop storm phobias than other dogs, supposedly because these dogs are more likely to have had traumatic experiences prior to adoption that make them more anxious and fearful of the unknown. As a psychologist and a rescuer I will concede that such reasoning makes sense IF one believes that rescued dogs are more likely to be victims of trauma to begin with; however, I am not convinced that the typical "happy family dog" life experiences are so much more benign that those of many rescued dogs. Moreover, it can be argued that persons who relinquish a dog to rescue may do so specifically because of that dog's pre-existing destructiveness during storms, and they are likely to hide that information. We have seen this within the population of dogs that we have accepted into rescue: indeed one dog originally offered to us (reportedly because of the family's moving) was reclaimed by its owners when they found a drug that would treat its anxiety.
It would be irresponsible to suggest that one can properly diagnose and treat one's own dog for storm anxiety or any other behavioral disorder were we to neglect the possible contribution of purely medical conditions. For this reason, we recommend a basic veterinary check-up on any dog that demonstrates a disturbing change in its behavior. But you knew that already, didn't you? Dr. Nicholas Dodman discusses a few common veterinary causes for behavioral anomalies in Dogs Behaving Badly: An A-to-Z Guide to Understanding and Curing Behavioral Problems in Dogs (1999).
The Question of Separation Anxiety
In attempting to treat a dog for presumed storm phobia, it is crucial to determine whether it is the only anxiety disorder present. For example, many dogs suffer from separation anxiety, which is manifested in fearful and often destructive behavior exhibited when the caregiver is absent, irrespective of the weather.
Why would the possibility of concurrent separation anxiety make a difference in the diagnosis and treatment of a storm phobia? During the treatment of anxiety disorders, it is important to AVOID allowing the animal to be in the fear-inducing situation and to go on to become frightened, for--in a sense--it is then "practicing" associating the fear with the situation. The dog's calmness must be protected during this period. Think about it: It can be a challenge to avoid leaving your dog alone and vulnerable when it is storming, but quite another to be unable to leave your home at all! Therefore, treatment for separation anxiety can be much more demanding on the caregiver's time.
It is our experience that some owners may be resistant to the recognize true separation anxiety in their dog, unless the dog frequently acts fearful and overly dependent upon them much of the time. Sources as Jean Donaldson (Dogs Are from Neptune: Candid Answers to Urgent Questions about Aggression and Other Aspects of Dog Behavior, 1998) suggest that overly dependent and hypervigilant behaviors in the presence of their owners are not reliable indicators of true separation anxiety, which is exhibited primarily during the caregiver's ABSENCE. Unfortunately, one cannot rule out separation anxiety based on what most owners are able to report. To get around that, Donaldson recommends performance of feigned departures and the use of observers (not members of the family, or their presence would possibly reduce any fear symptoms) or video cameras to check on a dog's behavior following its owner's departure. Immediate escape behaviors focused on the route of the owner's departure are suggestive of separation anxiety.
The Question of Obsessive-Compulsive Disorder
A second disorder that should be ruled out before embarking upon treatment for storm phobia is that of obsessive-compulsive disorder, in which a dog performs odd, almost ritualistic behaviors in a "driven" way. Obsessive -compulsive behaviors in dogs come in many forms, including tail-chasing, pacing in patterns, and certain chewing behaviors, particularly those involving self-mutilation. (Many puppy-mill survivors exhibit obsessive-compulsive behaviors.) It can be argued that when dogs lick their front legs to such an extent that they form sores called lick granulomas (or acral granulomas), that this behavior has an obsessive-compulsive component. Most people would not call a dog obsessive-compulsive just for the existence of a lick granuloma, however. Some highly repetitive behaviors can result from brain damage, so the reader is again reminded that a veterinary exam should be an early part of any work-up for a possible anxiety disorder.
There are substantial similarities in the symptoms and the treatment of storm phobia and obsessive-compulsive disorder. However, the storm-phobic dog should not evidence symptoms in the absence of an imminent storm, whereas the obsessive-compulsive dog may show its symptoms at any time.
Treatment for Storm Phobia
A multimodal approach is most likely to be effective, that is, the problem should be attacked along many different fronts. Therapy for storm phobia typically includes behavior modification to reduce the anxiety associated with the storm. Owners teach their dogs to find comfort with a specific blanket, in a bed, crate, closet or other place. Many owners subsequently use audiotapes or CDs to mimic the noise of a thunderstorm, hoping to teach their dogs to tolerate it. Veterinarians can also prescribe anti-anxiety or antidepressant drugs to help dogs remain calm during storms. Often a dog is placed on one drug during the entire storm season, and then, if necessary, the drug is supplemented with another medication hours before a storm is expected. Unfortunately, pharmacotherapy alone is usually ineffective.
There's a great page by Helane Graustark on the web site "A Breed Apart"© about a Greyhound named Kody who is on Prozac© during thunderstorm season, and on Inderal© 40mg as needed for storms. Kody's owner consulted with veterinary behavior specialist Dr. Nicholas Dodman at Tufts Veterinary School. (If Dodman's name seems familiar, it is because he is author of Dogs Behaving Badly: An A-to-Z Guide to Understanding and Curing Behavioral Problems in Dogs , and The Dog Who Loved Too Much: Tales, Treatments, and the Psychology of Dogs .) Dr. Dodman's work with Kody was a fairly intensive and costly approach in terms of human effort and medication, but it met with substantial success. Again, the article on the website is very much recommended.
Having already reminded the reader that a dog's overall health should already be established via a recent veterinary exam, we shall first examine those potential treatments for storm anxiety that a caregiver can possibly implement without requiring additional veterinary consultation.
Some people use Rescue Remedy©, one of the Bach Flower Remedies©, a group of holistic herbal concoctions found in health food stores. I've given it to my Golden/Sheltie mix, Goldie, and never noticed a difference. At least it is relatively inexpensive and easy to administer, being in the form of drops that can be squirted onto the dog's tongue. A classically-trained pharmacist whom I greatly respect, thinks highly of Rescue Remedy© after using it on his own Golden. Even if my own experience with Rescue Remedy© was not encouraging, my trust in Skip's judgment forces me to share his opinion with the reader.
Relaxation training and systematic desensitization using tapes of storms, gradually increasing the volume until the dog seems to not react to the noise, sounds great in theory, but most people say it doesn't work. My guess is that it is barometric pressure changes or other stimuli that we cannot sense that cause the symptoms--not just sound--so unless you can change the barometric pressure at your house at will, I do not believe that playing loud tapes will be sufficient to increase a phobic dog's ability to tolerate storms. On the other hand--to the extent that a given dog HAS learned to associate the sound of thunder with whatever it finds most troubling about the storm--at least a dog appropriately treated with audiotape exposure should not react badly to storm noises alone.
This is not to say that teaching relaxation strategies is misplaced. Even if you cannot slowly challenge your dog's relaxed state by incrementally increasing the presence of storm-like stimuli, simply teaching your dog to associate certain smells and sensations with feelings of safety and security IS important and useful. Teaching your dog to relax and feel secure does not necessarily involve any terribly unusual behavior on your part, either. Think about what you do when you are relaxing quietly with your dog: stroking her fur, rubbing her ears and chest, patting her tummy, speaking to her in a gentle and happy tone. Are there set things that you typically say when you caress your dog? Perhaps you can supplement those words with the addition of a special pillow or quiet-time toy. See how my friend Michelle took these ideas of relaxation, added in some changes to minimize the intrusiveness of the storm (music and closed blinds), and found success:
"When we got Zerk 4 1/2 yrs ago he was so bad when it stormed he tried to throw himself through a window and would pace and pant and just be beside himself! I used to give him Rescue Remedy® and lay my whole body on top of him and hold his arms and legs to his body and wrap myself around him and start breathing in tune to his breathing and give him massage and slow my breathing so he would pace himself with me. Kinda like swaddling an infant. In the early days I can remember lying in bed at night with a storm going on and him drooling on me and panting so hard the whole bed shook. It was awful when I had to go to work and it would storm during the day and I'd come home to him all a mess where he had chewed himself and trashed the house. I retrained him to go to a safe place when he felt anxious - the master bedroom walk-in closet which has our bed blankets in it. When I know there is even a small chance of a storm, I draw the blinds and turn on some classical music station on the stereo and I close off all the rooms except our bedroom and make sure our closet door is open. He still gets a bit anxious but has learned the coping strategy well enough that I can go off and leave him and not worry about him. I will sometimes call the house and holler on the answering machine..."Zerk! Go to your safe place, Zerkie! Mommy be home soon!" which are words that he knows and that I used to train him with. When I come home he is always just fine now, and I no longer even have to give him any RR [Rescue Remedy©] either."
Closely related to the issue of relaxation training is that of sheltering-and-distraction, alluded to by Michelle above. Some people talk about putting the dog in a bathroom or other room without windows, cranking up the stereo, and playing games in a cheerful way. I like the idea of a bathroom, as it is typically less vulnerable to the damage that a frightened dog can produce: generally uncarpeted, may have tile on its walls rather than dry wall, and often window-less. Others argue in favor of crating, but Dodman says that is not a good idea. Perhaps an airline-style crate with an open door can provide security without stimulating escape efforts.
Confinement to the garage is another alternative that may allow less damage to the home, providing, of course, that there is nothing lying around in there on which the animal could hurt himself. However, if the dog is relegated to the garage only when there are storms, it is likely to associate the garage with being frightened. Use of a garage for confinement under those conditions would only aggravate the problem.
Distraction: A radio or television can help, and so can various dog toys or bones stuffed with treats. A Kong© toy can be stuffed with dog biscuits and then sealed shut with peanut butter and frozen. This would be a particularly good strategy if the dog were confined to a small non-carpeted area, such as a bathroom; otherwise it could be awfully messy.
The notion of confinement typically refers to restricting a dog's movement within a room or a cage. One resourceful firm has pulled in its focus more tightly, and explored the use of binding garments, called Anxiety Wrap®, that apply mild pressure to the animal's torso--all for the purpose of reducing stress. Although it may initially seem odd, there is much cross-cultural evidence that methods such as swaddling, papoose boards, and other techniques involving the application of gentle pressure can have stress-reducing effects on animals of various species. At our rescue, we have tried using an anxiety wrap with one dog, and he evidenced significant improvement in behavior. A trial with a second dog is forthcoming.
Even without involving one's vet, some caregivers resort to the use of sedative medications. We cannot recommend this strategy.
One of our foster parents tried sedation by using Benadryl©. A local vet gave a new adopter some acepromazine, but it was quite inappropriate for frequent use (quite a case of overkill). A good idea in theory, but again, most folks find it inadequate.
Pharmacotherapy for the Treatment of Storm Anxiety
As mentioned above, a storm-phobic dog is often placed on one non-sedating drug during the entire storm season, and then, if that drug does not control the behavior sufficiently, the drug is either changed, the dose increased, or the drug is supplemented with another medication to be administered one or two hours before a storm is expected. Antidepressants are commonly prescribed, despite the fact that the dog is not being treated for depression itself. (If this seems odd to you, just think about how being worried and pessimistic is part of being depressed. You can see, then, why a drug that can target such symptoms could be helpful to treat storm anxiety.)
One of the medications most commonly used to treat storm phobia is Clomicalm© (generic name is clomipramine), known as Anafranil© in the form used for humans. Clomicalm© is considered a first-choice drug for obsessive-compulsive disorder. Clomicalm© is also used to reduce male dimorphic behaviors (yes, those things that male dogs do that most annoy and embarrass people!), and other fear/aggression behaviors, including separation anxiety and noise phobias.
Clomicalm©/Anafranil©/clomipramine is available in 25 mg, 50 mg, and 75 mg tablets. My research yielded two primary dosing protocols: either to start at 1 mg per kg (of body weight) by mouth every 12 hours for 2 weeks; then give 2 mg per kg by mouth every 12 hours for 2 weeks, then 3 mg per kg by mouth every 12 hours for 4 weeks and maintain (Overall, 1997) or simply to start and maintain at 1-3 mg/kg (of body weight) once daily (Line, 1998).These doses (per kg. of body weight) are from Plumb's excellent Veterinary Drug Handbook (4th ed).2002.
Our foster dog, Rusty Shadow, was on generic clomipramine, which runs about $18 per month. He takes it twice a day (one tablet with each meal), and he shows no signs of any untoward side effects. On the contrary, the lick granulomas that he had on both front legs are vastly improved; one has disappeared without a trace, and the other he largely ignores.
Other medications used on a seasonal basis include Prozac© (generic name, fluoxetine) and BuSpar© (generic name, buspirone). Some veterinarians may prefer to use older antidepressant drugs with which they are more familiar, such as Elavil© (generic name, amitriptyline), Tofranil© (generic name, imipramine), or Sinequan© (generic name, doxepin). The older drugs have the advantage of being most familiar to the typical veterinarian who does not specialize in behavioral issues; they are also quite low in price. None of the drugs cited in this paragraph is considered habit-forming, which may be of interest if you are concerned by the possibility of someone's abusing the drug.
Prozac©/fluoxetine is available in 10 mg, and 20 mg capsules. It is one of several antidepressants developed in the last 10 years or so, and it has experienced immense popularity among prescribers for humans. As a group, the newer antidepressants (most of them known as Selective Serotonin Reuptake Inhibitors or SSRIs) are relatively clean drugs, and easier on the circulatory system than their predecessors. There are many of them and they vary in the degree of stimulation vs. relaxation that they provide and the length of time that it takes the body to process and excrete them. They do NOT cause any sort of inebriation in the way that a straightforward sedative may. They also require a MINIMUM of 4 to 6 weeks of administration before their effectiveness in a particular case can be judged.
Speaking specifically of fluoxetine, 20 mg per day should handle depression in humans. (Human doses are from Bezchlibnyk-Butler, K.Z. and J. Joel Jeffries (eds.), Clinical Handbook of Psychotropic Drugs, (9th ed), 1999.) According to Graustark's online greyhound article, Prozac is given usually at 1 mg/kg. in dogs, but Dr. Dodman made the dosage lower for Kody because of his breed: Kody ended up taking that same 20 mg daily.
Buspirone is an anti-anxiety drug also used for seasonal administration. Unlike the more common sedatives, the benzodiazepines (Valium©, Xanax©, Ativan©, Halcion©, and others), BuSpar© does not produce a recognizable high or buzz, so it has been heavily prescribed by psychiatrists who treat addicts in recovery.
Elavil©/amitriptyline was one of the first antidepressants ever developed for human use. It is available in 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg tablets. It has been used in the veterinary treatment of obsessive-compulsive disorder. In a 1991 paper, Marder recommended a dose of 2.2-4.4 mg per kg of body weight by mouth once daily (cited in Plumb, 1999).
Tofranil©/imipramine is another old-line antidepressant. Because it has the side effect of producing dry mouth and reducing urination, it has been widely used for the treatment of human bedwetting. As an adjunct treatment for storm phobia, imipramine is dosed at the same range as its older brother amitriptyline above.
Sinequan©/doxepin is an antidepressant used mostly to treat skin problems believed to have psychological causes. Of the three old-line antidepressants describe here, it is the most sedating.
Adjuncts to be Taken as Needed Before Storms
A variety of medications are used as adjuncts to be taken right before a storm. Although one might be loath to keep one's dog sedated for months on end, a fast-acting sedative that targets the fear response could be helpful when one has adequate warning and access to the dog ahead of the storm's arrival.
Tranxene© (generic name, clorazepate) is a long-acting benzodiazapine. Valium© (diazepam) was for years the most commonly prescribed drug for humans in the U.S. It is still used by veterinarians to treat and to prevent seizures (not in its oral form), and it is what my own vet prescribed for Rusty Shadow to use on stormy days. (The weather has been too good for me to be able to give a report on its efficacy.) Xanax© (generic name, alprazolam) is also mentioned as an option; it is the fastest/briefest-acting of the three benzodiazepines mentioned here. Although benzodiazepines are quite effective, they are also habit-forming, and can be abused by humans.
Propranolol, best known by its brand name, Inderal©, is a beta-blocker widely used for the prevention of human stage fright. It prevents some of the symptoms such as accelerated heartbeat that add to a person's perception that he is terrified. It is really considered a cardiovascular drug more than a psychiatric drug. For propranolol, doses of 10 to 40 mg are given 30 to 45 minutes before onset of the stressful situation.
Dodman's Multimodal Approach
In his books and in his practice (as glimpsed in the greyhound article cited above), Dr. Nicholas Dodman argues for attacking the problem on many fronts: using psychoactive medications, increasing daily exercise, certain changes in diet, practicing obedience, and being unceasingly upbeat and authoritative during storms, and showing no sympathy toward a dog when it is pathetically whining with fear. Lest I discourage purchase and careful study of his books, I shall not delve any further into the details here. They are simply the best treatment of the subject that I have seen, and they are informed by a systematic yet inventive attitude toward treatment. They are also fun to read! I suspect that The Dog Who Loved Too Much covers the topic of storm anxiety in greater detail than does Dogs Behaving Badly, but--admittedly--I cannot say for sure, because my own vet has my copy!
The caregiver of a storm-phobic dog faces substantial challenges. Many a once-loved dog has been discarded after its damaging home or furniture--and typically itself--after storm-related terror episodes. Many people who have not lived with a phobic dog will be unsympathetic, as they minimize the distress that a storm phobia imposes upon the entire household. Even some veterinarians may seem blasé until they are presented with photographic evidence of the dog's damage to the home (along with the probably-injured dog itself.) The photos below probably would not have impressed the vet who saw them, except that the dog who performed the damage had already been on medication for months.
Moreover, most veterinarians are not as focused on the treatment of behavioral disorders as they might be. Even if they are unusually well-versed in basic Skinnerian behavior modification techniques, most of them know relatively little about the use of psychiatric medications. I must always remind myself that even if WE want them to prescribe cutting-edge medications to treat our dogs, it IS entirely appropriate for them to demur, IF they feel they are not adequately trained regarding psychiatric medications! And sadly--this is quite likely to occur. (My admittedly subjective personal opinion is that veterinarians are probably like physicians in that they may believe that care of the psyche/personality/behavior/etc. is not as demanding or as worthy an endeavor as preservation of other bodily systems such as the digestive system or the cardiovascular system. Because others with fewer years of demanding and rigidly formalized education are allowed to modify behavior [i.e., dog trainers], they may feel inclined to delegate the entire enterprise to them.)
It is considered a leap to apply findings involving humans to situations involving animals, but the opposite is done all the time. The finding that I wish to apply is simply the common finding that "the combination of appropriate psychotropic medication WITH appropriate behavioral intervention is more likely to yield success than the administration of either one alone." So I must ask, if your dog is crying and bleeding, why should you settle for only half of the equation?
And if a veterinarian is not going to take advantage of the latest findings in medications, where is the advantage of choosing a veterinarian over a good animal behaviorist? One referral source that I have found useful is the American Veterinary Society of Animal Behavior (AVSAB) whose web site you can visit at - http://www.avma.org/avsab . Although AVSAB cannot certify the expertise of their members, it seems that a veterinarian who bothers to participate in such a group is probably more interested in treating behavioral problems than a vet who does not belong. As consumers and loving caregivers, it is upon us to demand that our veterinary care providers seek out whatever training necessary if they are to care for our dogs in an optimal manner.
References and Disclaimer
Bezchlibnyk-Butler, K.Z. and J. Joel Jeffries (eds.) Clinical Handbook of Psychotropic Drugs, (9th ed) Seattle: Hogrefe & Huber, 1999.
Dodman, Dr. Nicholas. Dogs Behaving Badly: An A-to-Z Guide to Understanding and Curing Behavioral Problems in Dogs. New York: Bantam, 1999.
Dodman, Dr. Nicholas. The Dog Who Loved Too Much: Tales, Treatments, and the Psychology of Dogs. New York: Bantam, 1996.
Donaldson, Jean. Dogs Are from Neptune: Candid Answers to Urgent Questions about Aggression and Other Aspects of Dog Behavior. Lasar Multimedia Productions, 1998.
Graustark, Helane. Thunderphobia Remedies [web page]. A Breed Apart [website], 1998.
Lyman, Michelle. (Personal communication).
Plumb, Donald. Veterinary Drug Handbook (3rd ed). Ames: Iowa State University Press, 1999.
Anafranil©, Kong©, Clomicalm©, Benadryl©, Ativan©, Xanax©, Halcion©, Elavil©, Tofranil©, Inderal©, Prozac©, Tranxene©, Sinequan©, Valium©, BuSpar©, Rescue Remedy©, Anxiety Wrap®, and Bach Flower Remedies© are trademarks or copyrights of their respective owners. The views expressed are those of the author and do not necessarily reflect the opinions of Old Gold Senior Dog Rescue, Inc. The author stresses that she is not a veterinarian, and that no advice on this page or on any of the pages to which it is directly or indirectly linked is presumed to take the place of consultation with your veterinarian, physician, or other health care provider.