Does Pet Remedy reduce stress in dogs?

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PICO question
 In stressed dogs, does using a Pet Remedy diffuser, compared to not using one, result in lowered stress levels?
 Clinical bottom line
 Three studies were reviewed, two that investigated Pet Remedy and one that investigated Valerian (an active ingredient in Pet Remedy) on aspects of canine behaviour associated with stress. The highest quality study was a randomised controlled trial that found that Pet Remedy had no significant effect on particularly stress-susceptible dogs exposed to an acute stressor. The weakest quality study was a randomised controlled trial that found a significant positive effect, but had high levels of industry involvement, weak and incomplete scientific reporting and methodology, and was not peer-reviewed prior to publication. Thus, the findings are unreliable. The final study, which was a quasi-experimental, fixed treatment order, controlled trial, found a positive effect of environmentally applied Valerian (on its own) on behaviour in shelter dogs. However, experimental design limited interpretation of the findings in relation to canine stress reduction, and external validity in relation to applicability to Pet Remedy use is weak.
 Where used as an adjunct, Pet Remedy is unlikely to do any direct animal welfare harm and may have a positive effect, based on studies that have unreliable findings and/or low external validity. However, unless further high quality research demonstrates a positive effect of Pet Remedy, veterinary professionals should be cautious about recommending it as an alternative to options with a stronger evidentiary basis, or as a delay to seeking more extensive professional support where needed. There is a need for further research to examine the efficacy of Pet Remedy on behavioural and physiological indices of canine stress reduction across a range of common stressful scenarios to further support veterinary professional decision making.