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Anxiety related to car rides requires firstly recognizing what is making the dog anxious and then based on those findings, a step-by-step approach along with creating positive associations with jumping up and then getting in the car may be necessary. Here are some tips for dogs who are reluctant to climb inside cars: https://www.braintraining4dogs.com/members/archive/fear-getting-car/ If your dog is nervous in the car, it's important to rule out possible nausea due to car sickness. Often, rather than suffering primarily from anxiety, dogs get scared in cars secondary to car sickness. Often car sickness and motion sickness go hand in hand, leading to a chicken-or-the-egg dilemma (dogs can even have a combination of both!), but often behind a case of car phobia is a case of car sickness acting as the leading culprit. Dogs are naturally prone to car sickness because their sense of balance in their brain is much better than ours so they become particularly susceptible to the motion of cars. Puppies are particularly predisposed to car sickness, and many luckily outgrow it with help, but not all dogs outgrow it as they mature. Also, dogs who have never been in cars or very little may be more prone to car sickness. Dogs prone to car sickness tend to salivate excessively, lip their lips, yawn and drool. They may also pace, pant, shake, and swallow often, and some even manage to vomit. What makes things particularly challenging though is the fact that dogs who are primarily anxious, also tend to drool, pant, shake, whine and pace when stressed, so often it is not possible to entirely distinguish one case from the other. In general though, dogs who are motion sick tend to feel better once the car stops moving although it may take a little bit of time to feel better. Other dogs may be noise sensitive and may act fearful upon hearing car honks, the sound of traffic and even the clicking turn signal. Some dogs are scared of rumble strips and speed bumps. And then, some other dogs may be afraid of their insecure footing, like when you use the brakes and your dog doesn't expect it. Attention should be paid on whether dogs anxious in the car appear to act fearful of specific stimuli or situations they are exposed to when in the car. Of course, dogs may also have fear of a combination of things/situations and the fear may generalize from one thing to another leading to a form of generalized anxiety. And then, there are dogs simply anxious in the car because they associate it with going to unpleasant places. Dogs have a very strong perception of things and many dog owners swear their dogs know the way towards the vet's clinic and the way towards the dog park. When turning towards the vet, these dogs start panting and shaking, when turning towards the dog park, they start acting excited with happy anticipation. It therefore makes sense that, if you take your dog too often on car rides that lead to the vet's office or groomer, and he dreads those events, he may start disliking going on car rides. Wise dog owners may therefore remedy this by making sure to take their dogs also on car rides that lead to pleasant places, but there's a potential flaw with this approach: at some point, dogs may start acting anxious of being in the car just out of mere uncertainty. "Is this car going to to take me to the vet or to the dog park?" Uncertainty can sure be disconcerting because it’s often the not-knowing that’s the worst! Dogs may not think too ahead of time and in the same critical way humans do, but they surely are capable of associating one event with another. These associations are often so strong, that just the mere fact of being in the car may evoke the same fearful reaction as being at the vet, even if the dog is in reality being taken somewhere else! As seen, there may be several causes for dogs acting anxious of car rides. Treating the anxiety therefore varies based on the underlying cause. Below are some general tips that tackle various underlying causes of fear of car rides in dogs. If you suspect motion sickness, avoid feeding your dog at least a couple of hours prior to the car trip. Vomiting is more likely to happen when your dog travels on a full stomach. Motion-sick dogs may benefit from breathing some fresh air. Keep a window lightly cracked open, enough to allow some air in but without allowing your dog to stick his head out. Schedule frequent stops to help your dog feel better and avoid roads with too many bumps and curves. Motion sick dogs may also benefit from antinausea medications. Ask your vet for help on dosages and the right medications for your dog. Medications may include diphenhydramine (Benadryl), dimenhydranate (Dramamine), meclizine (Bonine) and a prescription medication known as maropitant (brand name Cerenia). For anxious dogs, you may need to implement behavior modification using desensitization and counterconditioning. This entails taking baby steps in a systematic way while also creating positive associations. Start by allowing some fun time in the car while it's stationary. Give toys and treats and then end all the fun once your dog is asked to go out of the car. Rinse and repeat several times. Eventually, turn on the car, while offering some high-value treats and lots of praise. Stop feeding the treats, once your dog is asked to get out of the car. Progress gradually to driving the car for just a few seconds while a helper feeds treats or gives the dog a fun toy. Gradually increase the length of these trips, but randomly mix in some short trips as well. If, at any point, the dog shows signs of anxiety, the process should be halted and the exercise must resume at a level the dog was able to tolerate and gradually built from there. Consider that behavior modification may take weeks or even months of daily training to see results. Effort should be also made to ensure vet visits and grooming appointments are made more pleasant. Fortunately, more and more vet clinics are committing to provide less scary environments through Fear Free programs. Look for one near you if it's an option in your location. Calming aids may be necessary for anxious dogs. Adaptil pheromones, Bach flowers calming shirts (Anxiety Wrap, Thundershirt), calming music and calming supplements may help. For severe cases, your vet may prescribe Alprazolam (Xanax), trazodone (Desyrel) or other medications meant to help your dog relax. If your dog shows fear of occasional events or specific stimuli such as the sound of the car honk or driving over rumble strips, have a helper sit next to your dog and feed a high-value treat every time the car honks or you drive over the strips. If you dog won't eat, it's sign that he's too over threshold so you need to take a more graded approach. For severe cases, it is best to consult with a dog behavior professional. Behavior modification is delicate work, if we don't do things correctly, we risk exacerbating things, not to mention the risk for bites when a dog is overly stressed/over threshold, therefore, behavior modification for safety and correct implementation should be conducted strictly under the close in-person guidance of a professional in the field such as a veterinary behaviorist (DACVB) or certified applied animal behaviorist (CAAB). These professional can also prescribe meds to help the dog be calm long the process. The help of a dog trainer using force-free behavior modification focusing on desensitization and counterconditioning and with extensive experience on aggression can be enlisted as well (although cannot prescribe meds, but may refer to a vet for that.)