Lorazepam for dogs: Dosage and safety

In this article:

• Uses
• Safety
• Dosage
• Alternatives
• Summary

In this article

• Uses
• Safety
• Dosage
• Alternatives
• Summary

Lorazepam is a prescription drug people may better recognize by its brand name, Ativan. Lorazepam is a benzodiazepine like Valium (diazepam). Veterinarians may use it in place of diazepam to treat long-lasting seizures or anxiety behaviors in dogs. Doses can be given in tablet or liquid form, but veterinarians use lorazepam injections to treat seizures. Lorazepam is a powerful sedative that may cause problems or health issues in a small animal, so veterinarians use it for limited periods.

RELATED: Save up to 80% on lorazepam

What is lorazepam used for in dogs?

Veterinarians use lorazepam to treat long-lasting seizures or behavior disorders such as phobias, fears, or situational anxieties.

Status epilepticus

Long-lasting seizures are called status epilepticus, which means “epileptic state.” A dog experiencing status epilepticus has a seizure that lasts longer than five minutes without any clinical sign of stopping. Status epilepticus also describes repeated seizures without the central nervous system returning to normal in between seizures, again, with no sign of letting up.

Status epilepticus is a veterinary emergency. Treatment often continues even after seizure activity is ended because of complications. Statistics show that as many as 25% of dogs do not survive emergency treatment. Surviving dogs will have a shorter life-span expectancy than epileptic dogs that never have an SE seizure.

The AKC Canine Health Foundation estimates that 0.75% of dogs have epilepsy. About 60% of dogs with a seizure disorder will experience one or more status epilepticus seizures in their lifetime. 

Pet parents must immediately transport a dog to an emergency veterinary hospital if seizure activity doesn’t let up. The general rule is to bring the dog to a veterinary hospital if it has three seizures within 24 hours to catch SE early. 

Treatment is complex and involves many different drugs. Some drugs stop the seizures, some are used to stabilize the dog, and others treat or prevent complications. To stop the seizures, veterinarians typically use intravenous diazepam and levetiracetam, an anticonvulsant drug. Instead of diazepam, a veterinarian may use intravenous lorazepam or midazolam in place. That’s only the first part of the treatment. When the seizures end, the dog will be transitioned to other drugs.

Pet owners must start treatment at home if they can’t get to the veterinary hospital fast enough. In those cases, they may already be familiar with administering nasal midazolam or rectal diazepam to stop their dog’s seizures. All of these treatments require some training at the veterinarian’s office.

Problem behaviors or situational anxiety

Lorazepam is a powerful, short-acting sedative. It can quickly calm a fearful or aggressive dog before a stressful situation, such as going to the groomer, seeing a vet, traveling long distances, or enduring loud noises such as thunderstorms or fireworks. It can also cause problems. Side effects can be pronounced, and it can cause dependency and withdrawal. For this reason, veterinarians generally avoid using lorazepam as a long-term, daily therapy. 

For short-term sedation involving situations that elicit aggressive or fearful behaviors in a dog, veterinarians are most likely to prescribe trazodone, gabapentin, diazepam, alprazolam (also known as Xanax), or clonazepam (Klonopin). Lorazepam is not typically a first choice.

Is lorazepam safe for dogs?

Lorazepam is a risky drug, but it’s safe enough to give to a dog for a limited time. For this reason, veterinarians limit its use to extraordinary situations like long-lasting seizures or highly stressful situations.

Lorazepam is never given to dogs that have had an allergic reaction to any type of benzodiazepine. 

Veterinarians will use lorazepam cautiously in dogs with liver disease, kidney disease, or glaucoma or who are geriatric, debilitated, or aren’t breathing well.

One unexpected side effect of lorazepam is that it can make a dog more agitated. Although this is not a common side effect, it’s problematic enough that a veterinarian may avoid giving it to dogs with a history of aggressiveness.

Side effects of lorazepam in dogs

The most common side effects of lorazepam in dogs are:

• Sleepiness
• Muscle weakness
• Increased appetite
• Drooling
• Agitation
• Aggression
• Excitability
• Coordination problems
• Sluggishness

Call the veterinarian for advice if these side effects persist or worsen.

The most serious side effects of lorazepam in dogs include:

• Liver damage (symptoms include yellowing of the dog’s eyes, gums, or skin)
• Continual vomiting
• Appetite loss
• Extreme lethargy

If you notice these problems, contact the prescribing veterinarian.

Interactions of lorazepam with other pet meds

To avoid potential drug interactions, make sure the veterinarian knows about all the drugs, supplements, and herbal products the dog is taking, particularly:

• Any medicines that cause drowsiness, called central nervous system depressants
  • These include opioids, antihistamines, sleeping pills, barbiturates, antidepressants, or CBD products
• The bronchodilator and canine cough treatment theophylline

Lorazepam dosage for dogs

Veterinarians use lorazepam for epileptic emergencies or to calm a dog’s anxiety in stressful situations.

Recommended dosages of lorazepam for dogs include:

• For fears or anxieties such as separation anxiety: 0.02–0.5 mg/kg given one to three times a day
• For status epilepticus: 0.2 mg/kg single intravenous injection 

Lorazepam is not FDA-approved for animal use, so pet owners will use human-formulated versions or lorazepam specially formulated by a compounding pharmacy. 

Tablets for use in people come in dosage strengths of 0.5 mg, 1 mg, and 2 mg. They are usually not scored, so they may be difficult to divide into smaller doses. 

Pet parents could use lorazepam solution, but the human-formulated oral lorazepam solution is concentrated. It is meant to be mixed with a drink like water or juice and taken that way. Dosing requires great care because a dose may consist of only a few drops.

Can dogs overdose on lorazepam?

A lorazepam overdose can cause serious problems in a dog.

Because lorazepam is used off-label in dogs and hasn’t been well-studied, veterinary literature does not specify a maximum dosage. Among published dosages, the maximum recommended dosage for situational fears and anxieties is 0.5 mg/kg every eight hours.

Because dosage recommendations vary, consider the prescribed dose the maximum. It still may be too much, so veterinarians may use trial doses to begin with and gradually increase the dose until it’s effective. 

If a dog is given too much lorazepam or shows signs of a lorazepam overdose, immediately call an ASPCA animal poison control center or bring the dog to a veterinarian or veterinary hospital. 

Symptoms of a lorazepam overdose in a dog include:

• Drowsiness
• Loss of coordination
• Confusion and disorientation
• Lethargy
• Slow reflexes
• Low blood pressure
• Coma

Can I give my dog lorazepam every day?

Veterinarians typically prescribe lorazepam for a limited duration. During that time, the veterinarian may ask a pet owner to give doses several times daily for a few days or weeks. 

Long-term use of lorazepam usually causes problems. Dogs develop a tolerance for the drug, which will require larger doses to be effective. They will also become dependent on the drug, so the veterinarian will have to prescribe a steadily decreasing dose to fend off rebound or withdrawal symptoms.

How to give your dog lorazepam

• Only give lorazepam to a dog when prescribed by a veterinarian.
• Give the doses exactly as prescribed. Do not change the dose.
• If you are giving the dog lorazepam every day, do not discontinue this medication. Talk to a veterinarian first. The doses may need to be decreased gradually to prevent withdrawal side effects. 
• If you’re giving lorazepam to a dog daily, ask the veterinarian what to do if a dose is missed.
• If lorazepam is being used for stressful situations, give the dose at least one hour before the stress-inducing event.
• Give oral doses of lorazepam with or without food.
  • If the dog vomits up the dose, then give the dose with food
• How to give lorazepam tablets to a dog:
  • If you are unsure how to administer tablets to a dog, have a veterinary professional show you the proper procedure. A pill plunger is also an option if a veterinary professional has demonstrated its appropriate use.
  • Store lorazepam tablets at room temperature
• How to give lorazepam solution to a dog:
• • Lorazepam solution is concentrated (2 mg/mL). The veterinarian may be able to dilute the medicine or supply a diluted version.
  • Measuring a dose takes great care. Always use the calibrated dropper that comes with this medicine.
  • Ask the veterinarian about the proper procedure for administering a dose. Human versions of lorazepam concentrate are meant to be diluted in water or juice.
  • Store lorazepam concentrate in the refrigerator. It’s good for 90 days, so throw it out after 90 days.
• Lorazepam is a controlled substance. Giving it to others or taking it yourself without a prescription is against the law. 
• Keep lorazepam tablets or concentrate securely out of the reach of children and others.

Lorazepam alternatives for dogs

Diazepam is the drug of choice to treat status epilepticus. Lorazepam and midazolam are possible alternatives. If benzodiazepines don’t work, the veterinarian may turn to IV injections of antiepileptics like levetiracetam and phenobarbital or the anesthetic propofol. 

The preferred treatments for situational behavior problems in dogs are not drugs. Rather, they’re behavior modification therapies that involve avoidance of stress-inducing situations, desensitization, and conditioning. 

When situational problems are bad enough, then drugs are needed. Some drugs immediately calm a dog, and some are long-term maintenance treatments.

For drug therapy, veterinarians prefer to use long-term maintenance treatments with anti-anxiety drugs. These are safer for the dog and help behavior modification therapies to succeed. The most likely drugs a veterinarian will use include: 

• Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Paxil (paroxetine), or Zoloft (sertraline)
• Tricyclic antidepressants such as Clomicalm (clomipramine) or amitriptyline
• Buspirone in mild cases

Benzodiazepines are often a first choice for immediate relief of more extreme situational behavior problems. However, lorazepam is not the most commonly used benzodiazepine. Veterinarians usually turn to diazepam, alprazolam, or clonazepam to calm a dog rapidly. Other panic-reducing drugs include the alpha-blocker Sileo (dexmedetomidine), clonidine, or trazodone, an antidepressant.

Summary

In veterinary medicine, lorazepam is primarily used as an emergency treatment for long-lasting seizures called status epilepticus. Veterinarians may also use lorazepam for situational behavior problems due to fears or anxieties, but they are more likely to use drugs related to lorazepam. The drug is safe but has significant risks, so it’s rarely, if ever, given for extended periods.