Casozepine for Reducing Stress in Dogs During Veterinary Visits

In the Literature

Schroers M, Juhasz A, Zablotski Y, Meyer-Lindenberg A. Effect of casozepine administration on stress in dogs during a veterinary examination – a randomized placebo-controlled trial. Vet J. 2024;306:106148. doi:10.1016/j.tvjl.2024.106148

The Research …

Stress is a common concern in dogs and cats, particularly during exposure to unfamiliar environments or separation from owners.¹ Complete avoidance of stressful situations may not always be possible, but therapies (eg, dexmedetomidine, trazodone, gabapentin, pregabalin) that can reduce stress, especially during veterinary visits or car travel, are available.^2-6 Casozepine, a peptide derived from breast milk that exerts anxiolytic effects by acting on gamma-aminobutyric acid receptors in the CNS, is another therapeutic option and is available in capsule and chew forms.^7,8 Research in cats has demonstrated casozepine can help manage stress in unfamiliar settings and during veterinary visits.^9,10

This randomized, placebo-controlled study examined whether administration of casozepine for 2 days prior to a veterinary visit reduced stress in dogs that showed signs of everyday stress but were not deemed too fearful to allow handling during a veterinary examination. Oral casozepine was administered daily to the study group (n = 36); a placebo was administered daily to the control group (n = 21). After 2 days, dogs receiving casozepine had significantly lower stress scores and pulse rates compared with dogs in the placebo group, although salivary cortisol levels increased in the casozepine group. Salivary vasopressin levels remained stable in the casozepine group and increased in the placebo group.

Although the reduced stress scores and pulse rates appeared promising, overall impact of casozepine on everyday stress was limited, with only a small percentage of owners (22%-31%) reporting significant changes; however, this may have been due to low baseline stress levels in familiar environments or subjectivity of owner-reported assessments. This study suggests short-term administration of casozepine before veterinary visits may be beneficial, but further research is needed to investigate long-term effects and optimal dosages to better understand effectiveness for reducing stress in clinical settings.

… The Takeaways

Key pearls to put into practice:

• Casozepine may be considered as a short-term intervention for patients prone to stress during veterinary visits, as administration for 2 days prior to an appointment can lower stress levels.

• Casozepine is a milk-derived, nonsedative alternative to previsit medications like gabapentin, pregabalin, and trazodone and may be appealing to owners who prefer a nonpharmaceutical approach to managing mild to moderate stress in their pets.

• Veterinary visits are a common source of anxiety for patients. Implementing techniques (eg, environmental adjustments, welfare-friendly handling) to reduce stress can improve overall patient experience.

• Previsit medications can offer significant benefits in reducing patient stress related to veterinary visits, but sedation may still be necessary to prevent escalation of protective behaviors. Cooperative care training is the ideal solution for long-term stress management.