Tuesday, October 12, 2010

Why, yes, she does.

Recently, I wondered if Maisy might have Generalized Anxiety Disorder. As a result, I scheduled an appointment with a board-certified veterinary behaviorist to find out. The short answer is yes. But the long answer is probably more interesting…

So, Maisy had her appointment with Dr. Duxbury yesterday. Before I go any further, let me just say that I really enjoyed working with Dr. Duxbury. Since she has so much education and experience, I was nervous that she might be one of those ego-driven specialists you run into from time to time, but nothing could be further from the truth! I really felt that Dr. Duxbury took the time to listen to what I was saying, and she was very respectful of me and the work I’ve done with Maisy. If anyone in the Twin Cities metro area needs a veterinary behaviorist, I would highly recommend her. It was an expensive appointment, but it was worth it.

The actual appointment was about 90 minutes long. Dr. Duxbury complimented me on the pre-appointment questionnaire I had sent in advance; I gave enough details that she had a really good picture of who Maisy is. This ended up saving a lot of time because she didn’t need to take much history from me. In fact, apparently I described things so well that she didn’t even review our behavior logs! Instead, we jumped right into watching videos.

I had about an hour’s worth of video that I had taken at home, in class, while on walks, and even at trials. I really enjoyed watching the videos with her, mostly because she found them so interesting. In fact, she ended up copying all of the videos I brought in so she can use them with her advanced students. She said Maisy is an excellent example of a “complicated case,” and that it will be very helpful for her students to see the video.

I think the video she liked best was the one below. It’s long- 10 minutes- but this is a very typical snapshot of Maisy “relaxing” at home. (The action starts around two minutes in.) Dr. Duxbury was especially interested in the interactions with the cats you see towards the end of the video, especially the stereotypic tail chasing.

Dr. Duxbury’s assessment of Maisy, after viewing the videos, and interacting with her in person, is that she is “functionally anxious.” Dr. Duxbury complimented me on the work I’ve done with her, and said that Maisy might not have been functional at all had circumstances been different for her. Here’s what she wrote in her report:
You have done a wonderful job trying to help Maisy learn to relax and to not react to other dogs and other environmental stimuli. Her continued reactivity and vigilance even in her 'safest' environments (e.g. at your home) suggests that she is generally anxious. This is likely related to her very limited early environment.

I also appreciated that Dr. Duxbury saw Maisy’s good qualities. Most people are quite charmed by Maisy when they meet her- she’s cute, of course, but she has a personality that just doesn’t stop. In fact, it is sometimes hard for people to see that she has issues because she is so functional. Dr. Duxbury described her as “outgoing and social and very eager to play and to work on training, but at the same time she seems overly attentive to subtle stimuli in her environment and reacts… to other dogs.”

Ultimately, Dr. Duxbury diagnosed Maisy as follows:
  • Fear related aggression (lunging, barking, growling only -- no bites) to unfamiliar dogs and certain unfamiliar people.
  • Resource guarding - directed towards the cats.
  • Generalized anxiety - increased sensitivity to environmental stimuli, exaggerated startle response, hypervigilance, long recovery after arousing events.
The main component of the treatment plan was, as I’d hoped, medication. Dr. Duxbury prescribed paroxetine (also known as Paxil). She said she’s had really good results with paroxetine for dogs like Maisy, and felt that it would be the best choice for her given her particular set of issues. The only downside to paroxetine is the dosage- Maisy will be taking 8mg a day, and it generally comes in 10mg tabs. Since that would be very difficult to split accurately, it will need be ordered from a compounding pharmacy, which increases the cost. (Of course, the upside to that is that it will be salmon flavored, which will make it much easier for us to give!)

Dr. Duxbury didn’t have any further suggestions for types of behavior modification. She said that about the only thing I haven’t tried is BAT, which she didn’t feel would be helpful for Maisy (although she didn’t rule it out for the future). She said that I should continue to do what I’m doing, including my classes with my current trainer, Robin Sallie.

She did have some suggestions on how I carry out the behavior modification. These suggestions are relatively small changes to how I do things, and probably things Robin has told me to do a million times before (in fact, I actually asked her if she’d talked to Robin in advance, it sounded so much like her!). Despite being fairly minor revisions to our training, I suspect that they will, in conjunction with the medication, make a huge impact on Maisy. Because of that, I’ll dedicate a separate post to the topic.

Anyway, Maisy will start her medication as soon as it arrives from the pharmacy. We probably won’t see any changes in her behavior until she’s been on it for 4-6 weeks, so she’ll have a recheck with Dr. Duxbury in about 8 weeks. At that appointment, we’ll discuss the medication, the dosage, and whether or not we want to add a second med to the mix (something which Dr. Duxbury said may be needed for Maisy). While I don't believe Maisy will ever be "normal," I am pretty excited to see how this will help.


Jules said...

wow, it sounds like you got a lot out of the appointment. I am so happy. I hope the small tweaks and medication help Maisy feel more comfortable.

Crystal said...

I'm thrilled, too. The medicine hasn't come yet, but I've been trying out the subtle changes to the way I reinforce calm behavior and am getting GREAT results so far.

Joanna said...

Thanks for the write-up; it's fascinating!

Laura, Lance, and Vito said...

I am so glad the appointment went well and I can't wait to hear more about the changes to your protocol

andrea said...

I'm so glad it went well :)
sounds like you have some validation now and another tool in your tool box

I do want to comment that I have no, NO IDEA, of what a normal dog is supposed to be though ...

probably the closest I live with is Thea and she can certainly be obnioxous when she wants her way

Anonymous said...

I'm fairly confident my dog Daisy has generalised anxiety disorder & it's really becoming a problem. What did the vet suggest you change to help Maisy, also what sort of training have you been doing with the dog trainer? We are currently trying to figure out how to try & help our little girl & any advice would be appreciated.

Crystal said...

Hell, Anonymous!

I'm sorry to hear that your dog Daisy might have GAD, too. It has been a long road for Maisy and I. We've done a ton of training throughout her life, and although it's been less than two weeks, I do think the medication is making a big difference. It might be worth it for you guys to get Daisy evaluated for meds too.

As for training, we've done a lot of counter-conditioning, we've played the games in the book "Control Unleashed," and we've done something called the Relaxation Protocol. These are all things that our veterinary behaviorist recommend we continue doing, but she also advised me to be calmer/slower/more deliberate in my movements. You can read about that here: http://reactivechampion.blogspot.com/2010/10/small-changes-yield-big-results.html

I don't know where you guys are at on your journey, so if you need more help, please let me know. I'd be glad to explain things more, help you find a trainer or vet behaviorist, or whatever I can do. :)