"Can you help me out Doc? Buster is shaking and hiding behind the toilet—he's afraid of thunderstorms and fireworks and I forgot to get his Xanax refilled!"

Over the years, I've been on call for Independence Day, and have receieved many calls with concern over stressed out dogs suffering from storm and noise phobias, including fireworks.

Here are some signs to watch out for: pacing, hiding, salivating, and trembling to urination, defecation and even seizures. Some dogs can even become destructive to their surroundings or themselves—even breaking their teeth to get out of their enclosures.

In the case of thunderstorms, we're not sure what the exact trigger is; some vets believe it's the change in barometric pressure, but just the noise and force of strong gusts of wind or your patio furniture blowing over can frighten dogs (and children, too!)

Studies have shown a prevalence in storm and noise phobias in herding breeds and also in dogs adopted from shelters. In almost all cases these syndromes start at a young age. Here are some tips for you to help your pet get through the summer:

• Teach him about a "safe place" in your home. It's not an instant fix and will take some time, as do most behavioral modification techniques, so it's best to start before the summer so your pet is prepared for when they really need it. A dimly lit, secluded spot would be ideal and playing white noise may help. Stay with your pet, and/or try to engage your dog in some activity there
• Positive reinforcement. It sounds simple, but may get complicated if you try to comfort your pet with treats and hugs while they're agitated. They may interpret this as a reward for the phobic behavior. The trick is to do this in advance when you are teaching them about the "safe place" so that they get their treats and rewards for being quiet and relaxed.
• Board your dog. One behaviorist suggested that taking your pet to an entirely new setting, such as a kennel, may distract your pet so much by the experience of being kenneled, that he forgets about the original reason he was so worried.

For more severe cases, pharmaceuticals may be warranted.

• Alprazolam (Xanax)-This is a valium like sedative used for phobias and anxieties in people and pets. Don't be alarmed that the dose for dogs is much higher than for people. In addition, the dose may vary from dog to dog, so your veterinarian may have you start at a low dose and tell you to double it if it is not effective. 
• Amitriptyline HCl (Elavil)-This tricyclic anti-anxiety medication commonly used for many reasons in cats and dogs. It needs to be in the bloodstream for several weeks to a month before it may take effect.
• Clomipramine HCl (Clomicalm)-Another tricyclic anti-anxiety drug, often used for obsessive compulsive behavior and separation anxiety. This may also take several weeks to take effect.
• Fluoxetine (Reconcile) (Prozac)-This is a commonly used selective-serotoninreuptake inhibitor (SSRI) for people and also used for a variety of dog and cat behavioral issues. This needs to be started well before thunderstorm season or fireworks.

All of the above medications are prescription only and your dog should have screening blood work before starting any of these, and if they will stay on them for an extended length of time. Talk to your veterinarian about possible side effects.

There are alternatives to prescription medications. Thundershirts are snug-fitting shirts for your dog available without a prescription; they're supposed to help with phobias, anxieties and excessive barking. I have just ordered one for my own barker. Dog appeasing pheromones come in the form of a collar or air diffuser. There is no odor or effect on people. They're available without prescriptions, are very safe, and may be helpful for a range of anxieties. And, there are anecdotal reports that melatonin supplements may be helpful as well, but that should be given under the direction of a veterinarian.

My brother's quirky Chesapeake Bay Retriever has an interesting reaction to thunder and lightning. He runs outside and actively chases and bites at the flashes of lightning visible in the wide open Montana sky. I'm not sure that fits in the category of phobias however!

Dr. Sarah Cutler, V.M.D., has practicing veterinary medicine for 13 years, six of them at Somers Animal Hospital. She'll soon launch a housecall practice, At Home Vet Care. She resides in Katonah with her husband, three children, one schnauzer and three cats. ! I