AbstractObjectiveTo quantify the behavior problems and prescription of psychoactive medications in dogs seen at primary care veterinary hospitals.MethodsMedical records of canine patients in a nationwide network of primary care veterinary hospitals in the US obtained between January 1, 2010, and December 31, 2020, were retrospectively analyzed. Information retrieved included prescription of clomipramine, fluoxetine, or trazodone; patient signalment; and common behavior problem labels (aggression, separation anxiety, and fear or anxiety unrelated to separation anxiety). Associations between behavior problem labels and drug prescriptions were assessed with Pearson χ2 tests.ResultsA total of 32,468,046 canine medical records were retrieved. The overall prescription percentage was 0.03% for clomipramine, 0.02% for fluoxetine, and 1.33% for trazodone during the study period. Prescription of trazodone started in 2013, with a sharp increase after 2015. The frequency of behavior problem labels increased 10-fold from 1.0% in 2010 to 10.2% in 2020, with an overall frequency of 5%. Among dogs with behavior problem labels, 0.15% were prescribed clomipramine, 0.14% were prescribed fluoxetine, and 8.4% were prescribed trazodone. Notably, about 70% of dogs receiving psychoactive drugs had no associated behavior problem labels used in the study.ConclusionsFrequencies of behavior problem labels and prescriptions in primary care settings were both low, with notable variations among psychoactive drugs. Furthermore, about 70% of cases prescribed psychoactive medications lacked target behavior problem labels.Clinical RelevanceThese findings highlight a critical need to bridge the knowledge gap between identifying behavior problems and effectively addressing them in behavioral practice within primary care veterinary settings.