Dog Anxiety: Signs, Medications, Treatment & Costs

Dog anxiety is real, common, and treatable. Research shows that 20-25% of dogs display fearfulness toward new people, animals, or situations. If your usually happy pup suddenly trembles during thunderstorms, destroys furniture when you leave, or shows aggression toward strangers, anxiety may be the cause.

The good news? With the right combination of training, environmental changes, and sometimes medication, most anxious dogs show significant improvement. This guide covers how to recognize anxiety in your dog, what causes it, and the most effective treatments available today.

Signs of Dog Anxiety

Dogs can't tell us how they're feeling, so recognizing anxiety means reading their body language and behavior. Signs range from subtle (lip licking when there's no food around) to obvious (destroying the door frame when you leave for work).

Mild Signs of Anxiety

These early warning signs are easy to miss but often indicate your dog is starting to feel stressed:

• Lip licking when not eating

• Yawning when not tired

• Avoiding eye contact

• Turning head away from a person, animal, or object

• Ears slightly back or flattened

Moderate Signs of Anxiety

At this level, most pet parents notice something is off:

• Panting when not hot or recently exercised

• Pacing or restlessness

• Whining or whimpering

• Refusing treats, even favorites

• Clingy behavior, following you from room to room

• Excessive drooling

Severe Signs of Anxiety

These signs indicate significant distress and often require professional help:

• Trembling or shaking

• Hiding or attempting to escape

• Whale eye (whites of eyes visible)

• Tucked tail and cowering posture

• Destructive behavior: chewing doors, furniture, crates, or window frames

• House accidents despite being fully housetrained

• Aggression: growling, snapping, or biting

• Self-harm: excessive licking that causes wounds, or broken teeth from trying to escape a crate

What Causes Anxiety in Dogs

Dog anxiety stems from both genetics and environmental factors. Some breeds and family lines may be predisposed to anxiety, but any dog can develop it based on their experiences. Most cases fall into one of three categories.

Fear-Related Anxiety

Fear-related anxiety is triggered by specific stimuli that frighten your dog. Common triggers include:

• Loud noises: thunderstorms, fireworks, gunshots, vacuum cleaners, construction

• Strangers: unfamiliar people, especially those in uniforms or hats

• Other animals: unfamiliar dogs, cats, or wildlife

• New environments: vet offices, grooming salons, boarding facilities, car rides

• Unfamiliar surfaces: slick floors, metal grates, stairs

Some dogs recover quickly after encountering a trigger. Anxious dogs have prolonged or intense reactions that interfere with normal life.

Separation Anxiety

Separation anxiety affects approximately 14-20% of dogs. Dogs with this condition can't settle when left alone or separated from family members.

Rather than being able to do something about their anxiety, some dogs become destructive, possibly to get some of those feelings out. They may chew or tear up their bed, furniture, rugs, or curtains. This isn't revenge or spite. It's self-soothing behavior driven by genuine distress.

Other common signs include:

• House accidents (urination or defecation), even in fully housetrained dogs

• Excessive barking or howling that starts shortly after you leave

• Escape attempts that can result in injury

• Pacing, panting, or drooling when they see you preparing to leave

Symptoms typically begin within minutes of the owner leaving.

Age-Related Anxiety (Cognitive Dysfunction Syndrome)

Canine cognitive dysfunction syndrome affects senior dogs, typically those 9 years and older. It's similar to early Alzheimer's disease in humans and causes:

• Confusion and disorientation

• Changes in sleep patterns, including pacing at night

• Forgetting previously learned behaviors

• Not recognizing familiar people or places

• Staring into space or getting stuck in corners

The confusion and disorientation lead to anxiety, as dogs struggle to understand what's happening around them.

How to Treat Dog Anxiety

Treating dog anxiety usually requires a combination approach: behavior modification, environmental changes, and sometimes medication. The most important first step is ruling out medical causes.

Start With a Vet Visit

Pain, thyroid imbalances, and other medical conditions can cause symptoms that look like anxiety. A dog with an undiagnosed injury might seem fearful or aggressive. A dog with a hormonal imbalance might pace or seem restless. Your vet will:

• Perform a physical exam to check for pain or illness

• Possibly run blood work to rule out medical causes

• Help identify the type of anxiety your dog has

• Discuss severity and recommend a treatment plan

• Refer you to a veterinary behaviorist if needed

Training Strategies for Anxiety

The most effective training strategies for dog anxiety are desensitization and counterconditioning. These two methods work best when used together.

Desensitization involves gradually exposing your dog to their anxiety trigger at a low intensity, then slowly increasing exposure over time. The goal is to help your dog learn that the trigger isn't dangerous.

For example, if your dog fears thunderstorms, you might play recorded storm sounds at a barely audible volume while your dog is relaxed. Over weeks, you gradually increase the volume as your dog remains calm.

Counterconditioning changes your dog's emotional response to a trigger by pairing it with something positive. Every time the trigger appears, your dog gets their favorite treat or toy.

Over time, your dog starts to associate the trigger with good things instead of fear. A dog who once cowered at the sight of strangers might eventually perk up, expecting a treat.

These methods take time and patience. Don't be afraid to work with a certified professional dog trainer (CPDT) or veterinary behaviorist, especially if your dog shows aggression or if your own efforts aren't working.

Anxiety Medications for Dogs

For moderate to severe anxiety, medication combined with training is often more effective than either approach alone. Several options exist depending on your dog's specific needs.

Important medication notes:

• Never give your dog human medications without veterinary guidance. Dosing is different, and some human drugs are toxic to dogs.

• Daily medications like SSRIs take 4-6 weeks to reach full effectiveness. Don't give up too soon.

• Situational medications (benzodiazepines, Sileo) work faster but aren't meant for daily use.

• Side effects can include lethargy, appetite changes, and GI upset. Report any concerns to your vet.

• Some dogs eventually wean off medication after successful behavior modification. Others need long-term treatment.

Natural Options and Supplements

For mild anxiety, or as a complement to other treatments, natural options may help.

Pheromone products like Adaptil mimic the calming pheromones mother dogs produce while nursing. They're available as plug-in diffusers, sprays, and collars. Research shows mixed results, but they're low-risk and may help some dogs.

Calming supplements contain ingredients like alpha-casozepine (a milk protein derivative), L-theanine, or melatonin. Look for products with the NASC (National Animal Supplement Council) quality seal.

CBD products have gained popularity, but scientific research on their effectiveness for dog anxiety is still limited. CBD products for pets aren't FDA regulated, so quality varies widely. If you're considering CBD, discuss it with your vet and choose reputable brands. It's not a substitute for proven treatments in moderate to severe cases.

Anxiety vests like the ThunderShirt apply gentle, constant pressure that may help some dogs feel calmer during stressful events. Research results are mixed, but they're safe to try and some pet parents swear by them.

How Much Does Dog Anxiety Treatment Cost

Anxiety treatment costs vary widely based on severity and approach. Mild cases may only need training and supplements. Severe cases might require specialist visits and years of medication.

Estimated annual costs by severity:

• Mild anxiety (training + supplements): $200-$600 per year

• Moderate anxiety (medication + training): $500-$1,500 per year

• Severe anxiety (behaviorist + medication + ongoing management): $1,500-$3,000+ per year

At Embrace, we often see anxiety-related claims ranging from a few hundred dollars for mild cases to several thousand for dogs requiring specialist care and long-term medication.

Does Pet Insurance Cover Anxiety Treatment

Yes, pet insurance can help cover anxiety treatment, including behavioral consultations, prescription medications, and veterinary behaviorist visits. The key is having coverage in place before anxiety is diagnosed.

What's typically covered:

• Vet exams related to anxiety diagnosis

• Prescription anxiety medications

• Veterinary behaviorist consultations

• Blood work to rule out medical causes

What's usually not covered:

• Pre-existing conditions (anxiety diagnosed before your policy starts)

• Over-the-counter supplements

• Training classes (unless part of a veterinary behaviorist's treatment plan)

Real Example: Maysie's Story

Here at the Embrace office, we have a dog named Maysie. Maysie suffers from anxiety that's best treated with sertraline (Zoloft) and visits with a veterinary behaviorist. Both are covered under the dog insurance policy her owner Diana purchased before Maysie was diagnosed.

While many pet insurance policies cover anxiety medications, not all chip in for behavioral consultations. Having this treatment covered comes as a huge relief to Diana, who can focus on Maysie's wellbeing without worrying about the cost of care.

The lesson? Getting pet insurance early, before you need it, is key. Once anxiety is diagnosed, it becomes a pre-existing condition that new policies won't cover. While others might have to decline life-changing therapy due to the price tag, Diana has the freedom to choose the best for Maysie without her budget ever standing in the way.

Managing Anxiety in Specific Situations

Different anxiety triggers call for different management approaches. Here's how to help your dog cope with common situations.

Separation Anxiety

Separation anxiety can be helped by gradually getting your dog used to your absence. Start by leaving the room for just a few seconds and immediately returning. Build up to leaving the house for a minute, then five minutes, then longer.

Other strategies that help:

• Keep arrivals and departures calm and low-key. No big emotional goodbyes.

• Give your dog a puzzle toy or stuffed Kong when you leave.

• Create a comfortable safe space with familiar items.

• Consider doggy daycare or a pet sitter for severe cases.

• Never punish accidents or destruction. It increases anxiety and doesn't help.

Noise Phobias (Thunder, Fireworks)

Sound sensitivity is best helped through desensitization and providing a safe place. Create a retreat in an interior room, basement, or closet with comfortable bedding. Additional tips:

• Use white noise or calming music to mask scary sounds.

• Close curtains to block lightning flashes.

• Pre-medicate before predicted events (you know fireworks are coming on July 4th).

• Don't force your dog out of their hiding spot.

• Stay calm yourself. Dogs read your emotions.

Travel and Vet Visit Anxiety

Make positive associations by taking practice car rides that don't end at the vet. Visit the vet clinic just to say hello, get treats, and leave.

For vet visits:

• Ask about pre-visit sedation for severe cases.

• Use pheromone spray in the carrier or car.

• Bring high-value treats.

• Look for Fear Free certified veterinary practices.

Preventing Anxiety in Dogs

While not all anxiety is preventable (genetics play a role), proper early experiences can significantly reduce your dog's risk.

Socialization

The critical socialization window is 3-14 weeks of age. During this time, expose your puppy to a wide variety of:

• People: different ages, ethnicities, people in uniforms, hats, and sunglasses

• Animals: other dogs, cats if possible

• Environments: cars, the vet office, pet stores, outdoor cafes

• Sounds: traffic, thunder recordings, household appliances

• Surfaces: grass, tile, metal grates, stairs

Keep all experiences positive with treats and praise. Continue socialization through adolescence, up to about one year old. Important: Unvaccinated puppies are susceptible to disease. Carry your puppy or use a stroller in high-traffic areas until they're fully vaccinated.

Obedience Training

Training builds trust and communication between you and your dog. Reliable commands like sit, stay, and come provide structure during stressful moments. A dog who knows what to do feels more confident.

Use positive reinforcement methods, which reduce stress compared to punishment-based training. Training classes also offer controlled socialization opportunities. For more tips, see our guide on how to train your puppy.

Exercise and Mental Stimulation

Physical exercise reduces pent-up energy that can fuel anxiety. Mental enrichment through puzzle toys, training games, and sniff walks tires the brain. A tired dog is generally a calmer dog.

Tailor exercise to your dog's breed, age, and health. A young Border Collie needs far more activity than a senior Bulldog.

Routine and Predictability

Part of a dog's anxiety may come from not knowing what to expect. You can help by setting a schedule and sticking with it. Feed and walk your dog at the same times every day. Try to leave for work and come home at consistent times. Make sure to give them one-on-one attention daily.

As Dr. Katherine Houpt from Cornell puts it: "What seems to work best is predictability. If dog does X, then Y happens."

You should also provide a safe space filled with familiar items, like a bed and favorite toys, where your dog can retreat when feeling anxious. A crate makes a great option for dogs who are properly crate trained.

When to See a Vet for Dog Anxiety

While mild anxiety can often be managed at home, some situations require professional help right away.

Contact your vet if:

• Anxiety appeared suddenly (could indicate pain or illness)

• Your dog shows aggression that could harm people or other pets

• Your dog is injuring themselves through excessive licking or escape attempts

• Anxiety is severe enough that your dog can't eat or function normally

• Home interventions aren't helping after several weeks

• Your dog's quality of life is significantly affected

Seek urgent care for:

• Self-harm or injury from escape attempts (broken teeth, torn nails, wounds)

• Aggression that has resulted in bites

• Complete refusal to eat for more than 24-48 hours

• Signs of pain along with anxiety symptoms

Not sure if your dog's anxiety warrants a vet visit? Embrace members have the added peace of mind of PawSupport with 24/7 access to veterinary professionals who can help you decide.