Medication is a veterinary decision, and it is an adjunct to behaviour work rather than a replacement for it. It belongs in the conversation when the dog cannot stay under threshold at any duration, or is injuring itself.
The point of medication in this condition is to lower arousal enough that learning can happen. A dog in full panic is not in a state where desensitisation works, so for severe cases the drug is what makes the training possible — not what makes the training unnecessary.
That is also the honest test of whether it is working: not "is the dog quieter", but "can the dog now hold a duration it could not hold before".
A veterinarian, and specifically one who has ruled out the medical causes that imitate this condition. This site cannot tell you whether your dog needs medication, and neither can a trainer. Bring the footage to the appointment — the recording of what actually happens in the first ten minutes is the most useful thing you can put in front of a vet.
Why Your Dog Panics When You Leave is a 53-page guide in nine lessons, with every claim sourced in the margin of the page it sits on: finding your dog's threshold and protecting it, the training absence from one second upward, what crates and second dogs and bark collars actually do, and where medication fits. It comes with the Absence Ladder spreadsheet you log each departure in, and the owners' community.
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