Commonly Overprescribed Medications for Dogs: When the Prescription Becomes the Whole Plan

I am increasingly frustrated by how quickly some dogs are handed gabapentin, trazodone, prednisone, metronidazole, Apoquel, acid reducers or another medication without nearly enough discussion about what is actually driving the problem. And no plan to attempt to shift to any alternatives.

Sometimes medication is absolutely appropriate. It can control severe pain, stabilize a crisis, treat a bacterial infection, make a necessary procedure possible or give an overwhelmed dog enough relief to function.

But sometimes the prescription is not treating the dog’s actual problem.

Sometimes it is treating the inconvenience of the symptom.

Sometimes it is compensating for poor handling, inadequate investigation or a lack of time to build a better plan.

And yes, that fires me up.

See your vet for a diagnosis and then you and I can collaborate on a custom strategy for your dog’s health.

I am not telling pet parents to stop medications, reject emergency care or assume that everything pharmaceutical is bad. I am saying that a prescription should not automatically become the entire health plan—and one difficult day should not sentence a dog to a lifetime of being doped up.

What I Mean by “Overprescribed”

I am not claiming that every prescription is unnecessary.

I am talking about situations where:

• Medication is prescribed before the cause has been adequately investigated.

• Sedation is mistaken for pain relief or emotional improvement.

• One difficult veterinary visit becomes justification for medicating every future visit.

• A medication is continued indefinitely without reassessing whether it is still needed.

• New medications are added to control side effects from existing medications.

• Recurring diarrhea is treated repeatedly without investigating the gut.

• Recurring itching is suppressed without investigating food, infection, the microbiome or environmental triggers.

• Pain medication is prescribed without discussing weight, muscle loss, rehabilitation or home modifications.

• The pet parent leaves with pills but no meaningful long-term strategy.

Medication can be an important tool.

It should not become the whole damn toolbox.

Harvey, Gabapentin and Trazodone: How Dogs Get Labeled

I have my own very personal example of how quickly the gabapentin-and-trazodone combination can become the default answer.

Harvey had spent a rough night at the emergency vet. He was exhausted, wired and already heavily affected by seizure medications—which have their own significant side effects.

We stopped by our local veterinary office for a blood draw, and it did not go well.

A rookie technician became alarmed when Harvey squirmed.

He was not aggressive.

He did not try to bite anyone.

He yelped and wanted to get down because he was frightened, overstimulated, medicated and being restrained in a way that was making the situation worse.

The technician freaked out. Harvey reacted to that energy and handling. From that one experience, gabapentin and trazodone were prescribed for future appointments.

No.

Not for us.

I later worked with an experienced veterinarian who proved that Harvey’s veins were not “too tiny,” as I had been told. His blood could be drawn from his leg instead of his jugular, and he did not need to be manhandled to get it done.

Imagine that.

The dog was not the problem.

Harvey was a medically complicated senior dog who had endured an awful night, was already dealing with the effects of seizure medication and needed someone experienced enough to slow down, assess the situation and handle him appropriately.

Instead, one poorly managed blood draw nearly earned him a permanent label and two additional medications before every future appointment.

This is exactly how it happens.

A dog has one frightening experience. The chart gets marked difficult, fractious or requires medication. Gabapentin and trazodone are prescribed before the next appointment. The dog arrives sedated, disoriented, physically unsteady or paradoxically more agitated. The experience still feels strange and threatening, so the medication becomes even more firmly embedded in the plan.

Now the dog may be medicated for every appointment for the rest of his life.

There are absolutely dogs who benefit from pre-visit medication. Some dogs experience true panic. Some have a bite history. Some require procedures that cannot be completed safely without pharmaceutical help.

But a dog who squirms, cries, pulls away or wants down is not automatically aggressive.

Sedation should not replace skilled handling, patience, creative positioning and common sense.

Before deciding that a dog needs gabapentin and trazodone for every veterinary visit, I would ask:

• Was the dog in pain?

• Was the dog already affected by other medications?

• Had the dog just experienced an emergency or traumatic event?

• Was the restraint excessive?

• Was the staff member experienced with fearful, senior or medically complicated dogs?

• Could the procedure have been performed differently?

• Could blood have been drawn from another location?

• Would a quieter room have helped?

• Would the dog do better with the pet parent present?

• Could the appointment have been slowed down?

• Could cooperative-care work improve future visits?

Sometimes the dog is not being “bad.”

Sometimes the dog is giving very clear feedback about how the situation is being handled.

Gabapentin for Dogs

Gabapentin was originally developed as an anticonvulsant. In dogs, it is commonly used for nerve pain, chronic pain, seizures, situational anxiety and sedation before veterinary appointments.

It may be helpful for certain dogs, particularly when nerve-related pain is involved. But it is now prescribed so routinely that many pet parents are never told how limited the evidence may be for certain uses or how to tell the difference between genuine pain relief and simple sedation.

You can read my deeper discussion in Gabapentin for Dogs: Side Effects, Concerns and Natural Alternatives.

Common Uses

Gabapentin may be prescribed for:

• Neuropathic or nerve-related pain

• Back or neck pain

• Arthritis as part of a pain-management plan

• Seizure support

• Veterinary visits

• Travel anxiety

• Post-surgical confinement

• General restlessness in senior dogs

What Pet Parents May Notice

Possible effects can include:

• Sleepiness

• Weakness

• Poor coordination

• A drunken or wobbly appearance

• Reduced engagement

• Increased confusion in some senior dogs

• Gastrointestinal upset

• Paradoxical restlessness or agitation in some dogs

A dog sleeping more is not proof that the pain has been adequately controlled.

A quieter dog is not automatically a more comfortable dog.

If a dog suddenly becomes restless, pants at night, resists stairs or reacts to touch, I want to know whether we are dealing with arthritis, spinal pain, soft-tissue injury, dental pain, abdominal discomfort, neurologic disease, medication effects or several things layered together.

Whole-Dog Support to Consider

Depending on the diagnosis, a broader pain strategy may include:

• Weight and muscle-condition assessment

• Physical rehabilitation

• Appropriate movement rather than complete inactivity

• Fresh, anti-inflammatory nutrition

• Omega-3 fatty acids

• Herbs selected for the individual dog

• CBD when appropriate

• Medicinal mushrooms and antioxidant support

• PEMF

• Cold laser or red-light therapy

• Acupuncture

• Massage and bodywork

• Supportive bedding, rugs, ramps and home modifications

• Evaluation of kidney, liver, endocrine and neurologic health

The answer is not necessarily to replace gabapentin with one “natural pain supplement.” That is still symptom chasing—just with a greener label.

Trazodone for Dogs

Trazodone affects serotonin activity and is frequently prescribed for veterinary visits, travel, thunderstorms, separation-related distress, post-surgical confinement and difficulty settling.

It can be useful. Some dogs are so fearful that lowering their level of arousal allows necessary care to happen more safely.

But trazodone is not therapy.

It does not teach a dog that veterinary handling is safe. It does not resolve pain, trauma, poor socialization, a chaotic environment, an overwhelmed nervous system or a history of being forced through frightening procedures.

Trazodone May Be Used For

• Veterinary visits

• Fireworks and thunderstorms

• Travel

• Separation-related distress

• Post-operative confinement

• Fear and reactivity

• Generalized anxiety

• Situations where reduced activity is needed

Possible Effects and Limitations

Dogs may experience:

• Sedation

• Poor coordination

• Nausea or digestive upset

• Restlessness

• Agitation

• Increased anxiety

• Changes in behavior

• Paradoxical excitement

• Increased reactivity in some cases

A dog who can no longer physically demonstrate fear may still be afraid.

That distinction is important.

Better Questions for Anxious Dogs

A full behavior and nervous-system plan should also consider:

• The dog’s specific triggers

• Pain and physical discomfort

• Sleep quality

• Gut and microbiome health

• Diet and nutrient sufficiency

• Previous frightening experiences

• Household stress

• Appropriate decompression

• Scent work and enrichment

• Behavior modification below the dog’s fear threshold

• Cooperative-care training

• CBD, herbs or essential oils when appropriate

• PEMF, Reiki and bodywork

• TCVM patterns involving Shen disturbance, heat, stagnation, deficiency or fear

My article on Essential Oils for Dog Anxiety explores one category of natural support. My comparison of a Veterinary Behaviorist vs. Dog Behavior Coach may also help pet parents understand where medication, behavior work and whole-dog coaching fit.

Acepromazine: Quiet Does Not Always Mean Calm

Acepromazine is a tranquilizer used for sedation, chemical restraint, travel and pre-anesthetic support.

It may make a dog less physically responsive without necessarily reducing the dog’s internal fear.

That means the dog may look quiet while still feeling overwhelmed.

There are medical situations where acepromazine may be appropriate. My objection is not to its existence. My objection is to assuming that physical stillness equals emotional comfort.

A frightened dog who cannot move normally may now feel even less in control of what is happening.

Sedation should be accompanied by skilled handling, appropriate restraint, pain assessment and an effort to reduce the fear connected to future care.

Fluoxetine, Clomipramine and Other Behavior Medications

Fluoxetine, clomipramine, buspirone and similar medications may be used for separation anxiety, compulsive behaviors, generalized anxiety, fear and aggression.

These medications can improve quality of life. In some cases, they lower anxiety enough for a dog to learn, rest and participate in behavior work.

That is a valid use.

But handing over fluoxetine without investigating pain, gut health, endocrine disease, diet, environment and the dog’s daily reality is not a complete plan.

A more responsible strategy may include:

• Veterinary evaluation for pain and neurologic disease

• Thyroid or other endocrine testing when indicated

• Review of medications and supplements

• Sleep assessment

• Diet and digestive history

• Trigger management

• Enrichment without constant overstimulation

• Appropriate exercise

• Behavior modification

• Household routines and boundaries

• Nervous-system support

• Ongoing monitoring for behavioral changes

Behavior medication should support the plan—not become the plan.

Prednisone and Other Corticosteroids

Prednisone and related corticosteroids can be lifesaving.

They may be necessary for:

• Severe allergic reactions

• Immune-mediated disease

• Spinal or neurologic inflammation

• Respiratory disease

• Serious inflammatory conditions

• Certain cancers

• Acute swelling

• Some gastrointestinal diseases

Steroids are powerful because they suppress inflammation and immune activity. That can create dramatic improvement very quickly.

It can also create the illusion that the underlying problem has been solved.

The Steroid Cycle

The dog itches, so prednisone is prescribed.

The itching stops.

The prednisone ends.

The itching returns.

Another round is prescribed.

Eventually the pet parent is told the dog simply “has allergies,” even though food intolerance, yeast, bacterial infection, fleas, environmental exposure, gut dysbiosis, endocrine disease and skin-barrier dysfunction may not have been fully addressed.

Longer-term steroid use can contribute to:

• Increased thirst and urination

• Increased hunger

• Panting

• Muscle loss

• Immune suppression

• Increased infection risk

• Gastrointestinal irritation

• Changes in liver enzymes

• Skin and coat changes

• Behavioral changes

Steroids may control the fire.

We still need to ask who keeps walking through the house with a box of matches.

Broader Support to Consider

Depending on the diagnosis:

• Elimination-diet work

• Fresh-food nutrition

• Omega-3 fatty acids

• Microbiome restoration

• Gut-lining support

• Medicinal mushrooms

• Targeted herbs

• Antioxidants

• Liver support

• Environmental toxin reduction

• Appropriate allergy testing

• Investigation of endocrine disease or infection

• TCVM pattern support

For a deeper look at the gut-skin relationship, read Nutrition for Itchy Dogs and Dog Gut Health and the Microbiome.

Apoquel, Zenrelia and Cytopoint for Itching

Apoquel, Zenrelia and Cytopoint are commonly used to control itching and allergic symptoms.

For a dog who is chewing holes in himself, cannot sleep or is developing repeated skin infections, reducing the itch can prevent further damage and provide desperately needed relief.

I am not suggesting that we let a dog suffer while we prove how natural we can be.

But controlling the itch signal does not tell us why the dog is itching.

What Could Be Driving the Itch?

• Fleas or mites

• Bacterial infection

• Yeast

• Food intolerance

• Environmental allergy

• Contact irritation

• Poor skin-barrier function

• Gut dysbiosis

• Histamine burden

• Endocrine disease

• Nutrient deficiencies

• Chronic moisture

• Household or lawn chemicals

• Repeated antibiotic or steroid use

• Immune dysregulation

Zenrelia also carries specific FDA warnings involving vaccination timing, immune response and susceptibility to infections. That does not mean no dog should ever receive it. It means pet parents deserve a real risk-and-benefit conversation before it is started.

Natural and Whole-Dog Support

Depending on the dog, support may involve:

• An elimination diet

• Fresh-food nutrition

• Appropriate omega-3s

• Microbiome restoration

• Digestive support

• Quercetin, nettles or other herbs

• Medicinal mushrooms

• Skin-barrier support

• Low-tox household and lawn changes

• Appropriate bathing and topical care

• Liver and detoxification support

• Stress and nervous-system support

• TCVM assessment

Skin is not separate from the rest of the body.

The skin is often where the body finally gets loud enough that we pay attention.

Antibiotics and the “Just in Case” Prescription

Antibiotics save lives. A dog with a confirmed or strongly suspected bacterial infection may absolutely need them.

But antibiotics should not be the reflexive response to every cough, loose stool, skin flare, urinary symptom or mystery fever.

Overuse can contribute to antimicrobial resistance and can significantly disrupt the microbiome.

My article on Antibiotic Resistance in Dogs explains why repeated or poorly targeted antibiotic use deserves more attention.

Before prescribing or repeating an antibiotic, appropriate questions may include:

• Do we know this is bacterial?

• Has a culture been performed when appropriate?

• Is this the right antibiotic for the organism?

• Has this infection happened before?

• Why does the dog keep developing infections?

• What immune, skin, gut or environmental problem is allowing recurrence?

• How will we support the microbiome during and after treatment?

Sometimes antibiotics are necessary.

“Just in case” is not the same thing as necessary.

Metronidazole for Every Case of Diarrhea

Metronidazole has long been prescribed for canine diarrhea, intestinal inflammation and certain bacterial or protozoal infections.

But diarrhea is a symptom—not a diagnosis.

Automatically reaching for metronidazole every time a dog has loose stool can disrupt the microbiome without addressing what caused the diarrhea in the first place.

Possible causes include:

• Dietary indiscretion

• Sudden food changes

• Stress

• Parasites

• Food intolerance

• Pancreatitis

• Dysbiosis

• Colitis

• Inflammatory bowel disease

• Liver or gallbladder dysfunction

• Addison’s disease

• Medication effects

• Toxins

• Foreign material

• Infection

Support after urgent causes have been ruled out may include:

• Hydration and electrolyte support

• A carefully selected temporary diet

• Digestive enzymes when appropriate

• Specific probiotics

• Saccharomyces boulardii when appropriate

• Gut-lining support

• Soluble fiber based on the stool pattern

• Herbs or homeopathy selected for the presentation

• Fecal testing

• Microbiome testing

• FMT or microbiome restoration

• Liver, gallbladder or pancreatic support

Repeatedly shutting down diarrhea without asking why it keeps returning is not gut-health care.

Read Could Your Dog’s Gut Be Behind the Itching, Yeast, Diarrhea and Allergies? and How to Rebuild Your Dog’s Gut Microbiome Naturally for more on the bigger picture.

Omeprazole, Famotidine and Acid Reducers

Omeprazole and famotidine may be prescribed for reflux, ulcers, nausea, vomiting, gulping, lip licking or suspected excess stomach acid.

They have legitimate uses.

But not every nauseated, gulping or grass-eating dog has too much stomach acid.

Symptoms can also be connected to:

• Delayed stomach emptying

• Pancreatitis

• Food intolerance

• Meal size or timing

• Excessive dietary fat

• Hiatal hernia

• Dysbiosis

• Liver or gallbladder dysfunction

• Kidney disease

• Medication effects

• Stress

• Intestinal inflammation

Long-term acid suppression can alter normal digestion and affect the gastrointestinal environment. If an acid reducer is prescribed, I want to know why, for how long and how the need for it will be reassessed.

Read Risks and Alternatives to Omeprazole in Dogs and Acid Reflux in Dogs for a deeper discussion.

Broader Digestive Support

Depending on the diagnosis:

• Smaller or differently timed meals

• Appropriate dietary fat

• Fresh, digestible food

• Food-intolerance investigation

• Digestive enzymes

• Gut-lining support

• Microbiome restoration

• Stress reduction

• Pancreatic testing

• Liver, gallbladder and kidney evaluation

• Review of every medication and supplement being used

Suppressing acid indefinitely without understanding why the dog is symptomatic is not the same as restoring healthy digestion.

NSAIDs and Pain Medication

NSAIDs can dramatically improve quality of life for dogs with arthritis, orthopedic disease, injury or surgical pain.

Pain control is not optional.

Allowing a dog to suffer because a medication is not “natural” is not holistic. It is unfair to the dog.

But NSAIDs can affect the gastrointestinal tract, kidneys and liver. Dogs taking them may need baseline and follow-up bloodwork, especially seniors or dogs with existing organ concerns.

Pet parents should know to watch for changes such as:

• Vomiting

• Diarrhea

• Reduced appetite

• Dark or bloody stool

• Lethargy

• Increased thirst

• Changes in urination

• Weakness

• Yellowing of the skin or eyes

A complete arthritis plan should not end with a bottle of pills.

It may also include:

• Weight reduction when needed

• Muscle building

• Physical rehabilitation

• Controlled movement

• Omega-3 fatty acids

• Joint and connective-tissue support

• CBD

• Herbs

• Medicinal mushrooms

• PEMF

• Cold laser

• Acupuncture

• Massage and bodywork

• Ramps, rugs and supportive bedding

The goal does not have to be “never use an NSAID.”

The goal may be better comfort, improved mobility, fewer flare-ups and the lowest effective medication burden appropriate for that dog.

Librela Deserves an Informed Conversation

Librela is a monthly monoclonal-antibody injection approved for the control of osteoarthritis pain in dogs.

Some dogs appear to experience substantial improvement.

Other dogs have experienced adverse events involving balance, weakness, difficulty standing, neurologic changes, urinary problems and seizures. In July 2026, the FDA announced safety-related labeling changes requiring stronger warnings and a client information sheet before each injection.

This is especially relevant to me as the parent of a dog with seizures.

That does not mean Librela is automatically wrong for every dog. It means the conversation should include:

• The dog’s neurologic history

• Previous or current seizures

• Balance or mobility problems

• Kidney and urinary health

• Other medications

• Changes since the previous injection

• What signs should trigger an immediate veterinary call

• Whether continued injections remain appropriate

Pet parents deserve informed consent—not a casual “it’s just a monthly shot.”

When Medication Is the Right Choice

Medication may be exactly the right choice when a dog is:

• In significant pain

• Experiencing seizures

• Having a severe allergic reaction

• Fighting a bacterial infection

• Recovering from surgery

• Unable to eat, rest or function

• Experiencing severe anxiety or panic

• Dealing with immune-mediated disease

• Medically unstable

• At risk of harming himself or others

Veterinary medicine is incredibly valuable for:

• Diagnosis

• Labwork

• Imaging

• Surgery

• Emergency stabilization

• Fluids

• Pain control

• Antibiotics when indicated

• Serious disease management

I am not anti-vet.

I am anti-lazy answer.

I am anti-prescription-without-a-plan.

And I am absolutely against blaming the dog when better handling, more investigation or a more experienced set of hands could have changed the entire outcome.

Questions to Ask Before Starting or Refilling a Medication

Ask your veterinarian:

• What diagnosis are we treating?

• Is this intended for short-term or long-term use?

• How will we know whether it is working?

• Is it treating pain, anxiety or simply causing sedation?

• What side effects should I watch for?

• Could it interact with other medications or supplements?

• Does my dog need baseline or follow-up bloodwork?

• Does this medication need to be tapered?

• What would make us reduce, change or discontinue it?

• What else should be investigated if the symptoms return?

• What nutrition, rehabilitation or lifestyle changes should accompany it?

• Are there alternative ways to perform this procedure or handle my dog?

Those are not disrespectful questions.

They are responsible questions.

The Individual Dog Changes the Plan

Before recommending natural support, I want to know:

• Age, breed and size

• Duration of symptoms

• Frequency of episodes

• Severity and progression

• Diet history

• Treats, chews, toppers, oils, scraps and hidden extras

• Current medications and supplements

• Previous medication reactions

• Lab results and trends

• Other diagnoses

• Stool and digestive history

• Weight and muscle condition

• Appetite, nausea and reflux patterns

• Stress, fear and sleep patterns

• Liver, gallbladder, kidney, endocrine, immune and inflammatory clues

TCVM may help identify patterns such as heat, dampness, stagnation, deficiency, digestive weakness, stress or inflammation. Muscle testing may help guide tolerance and direction in sensitive or complicated dogs. Experience helps recognize patterns, ask better questions and avoid wasting time on random product guessing.

This is also why my answer is often “It Depends”.

It depends is not a cop-out.

It means your dog deserves more thought than take two and call me if it gets worse.

Do Not Stop Prescription Medication on Your Own

Some medications can cause withdrawal effects, rebound symptoms, severe anxiety, seizures or other complications when stopped abruptly.

Speak with your veterinarian before changing:

• Steroids

• Seizure medications

• Behavior medications

• Gabapentin

• Acid reducers

• Heart medications

• Thyroid medications

• Insulin

• Immune-suppressing drugs

• Any medication your dog has taken regularly

The answer to overprescribing is not reckless discontinuation.

It is better investigation, informed choices and a thoughtful plan.

Your Dog Needs More Than a Prescription

A prescription may provide relief. Sometimes it buys the time and stability needed to begin deeper work.

But if your dog keeps needing medication for the same recurring problem, step back and look at the bigger picture:

• Food

• Digestion

• Microbiome health

• Pain

• Movement

• Muscle condition

• Stress

• Environment

• Medication load

• Organ function

• Immune patterns

• The way the dog is being handled

Harvey did not need two more drugs because one inexperienced technician had difficulty drawing his blood.

He needed someone who knew how to draw blood from a tiny senior dog without turning it into a wrestling match.

That experience reinforced something I already knew: sometimes the dog gets medicated because the humans need a better plan.

My job is not to tell you to disregard your veterinarian. My job is to help you understand the whole picture, ask better questions and collaborate around the diagnosis so we are not simply stacking medications on top of unresolved problems.

Read Why Dog Parents Need More Than “Ask Your Vet” and Why Random Dog Health Advice Is Costing Pet Parents Time for more of my perspective on building a real strategy.

To discuss your dog’s medications, diet, symptoms, lab trends and natural-support options, schedule a consultation.

For ongoing education, guides and whole-dog support, explore The Well Oiled K9 Membership.

This information is intended for education and wellness support and is not a substitute for veterinary diagnosis, treatment or emergency care. Statements regarding natural products have not been evaluated by the FDA and are not intended to diagnose, treat, cure or prevent disease.

Specific dosing is not provided because I do not know your dog’s diagnosis, medications, organ function, weight, diet, tolerance or what else may already be in the bowl or supplement cabinet. “Natural” does not mean universally safe, and the supplement cabinet should not simply become the new pharmacy.