Thursday, November 25, 2010

This Thanksgiving I'm Thankful for Paxil: a 6 Week Update

Wow! What a difference two weeks makes! My last med update was kind of… lackluster. The numbers were actually a little worse, even if, subjectively, I felt she was doing better. This time around, the numbers have improved and my subjective impressions feel much more definite. For anyone interested, here’s the baseline, here’s the first update, at two weeks, and here’s the last one, at four weeks.

I did another round of behavior logs for 48 hours earlier this week. Here’s the cold, hard data:

The 45 minute resting test is where we chill out together and I measure how often she startles or raises her head during a nap. During the baseline, she had 11 instances, punctuated with lots of vigilance. At two weeks, it was also 11 times, but with less vigilance. At four weeks, it was an abysmal 19 times, but I think that was mostly because we’d gone for a walk first, which totally riles her up.

This week… Well, it’s getting much harder to count. Do I count when she lifts her head up or otherwise move? If so, there were 14 instances of that. But if I only count times where she was startled or vigilant, it was three. THREE. Most of her movements were stretching, and when she lifted her head, it seemed more like she was bored, not restless. She was sleepy-eyed, and moved slowly and lazily. This is in sharp contrast to six weeks ago, when her movements were quick, frantic, and she scanned the environment frequently.

Next up: startling or alerting towards subtle environmental stimuli. At baseline, she had an average of 3.375 per day, many at night, with prolonged vigilance following an incident 45% of the time. At two weeks, this number was 2 per day, with vigilance 25% of the time. At four weeks, it was 2.667 per day, and again with 25% vigilance.

This week… Again, it’s so much harder to count. Technically, there were four instances, putting her average at 2 per day. However, most of them were questionable. During one, I was sitting right next to her on the bed when she jumped off. My husband, who was in the adjacent room, said that it seemed like she was startled, but I hadn’t gotten that impression from my vantage point. During another, we couldn’t tell if she was rushing at a cat or not (I haven’t been counting those incidents because it was too hard to get accurate baseline data on them). It had all the qualities of being cat-related, but we hadn’t heard the cats do anything naughty. Finally, in a third instance, I honestly couldn’t tell if she was sneezing or if she was “wuffing.” Which leaves only one honest-to-goodness incident, which had only mild vigilance following it. And none of them were at night. (Yay!)

As for reactivity, this is the part where I have to admit that I haven’t been walking her as much lately; winter in Minnesota has set in with cold, snow, ice and early sunsets, all of which conspire against us. Still, she has had two reactivity-free class sessions, which is amazing!

So, while data looks pretty good to me, what’s even more amazing are the things that I can’t quantify- the little things that are going on around the house, and which prompt me to email my dog friends about five hundred times a day. I think they might be tired of things like “OMG SHE’S SLEEPING YOU GUYS.”

For one thing, she’s sleeping more. I don’t mean quantity- she’s lying down about the same amount as she used to- but rather, quality. Instead of dozing, she’s actually sleeping. On Sunday, she actually began running in her sleep, something I’ve never, ever seen her do before, and which indicates that she’s probably in REM, the deepest level of sleep.

Similarly, on Tuesday morning, I rolled over in bed. Maisy sleeps with us, and usually when I shift, she jumps up and moves. But that morning, she didn’t stir, not when I rolled over, not when I touched her, not even when I lifted her paws up and then dropped them. She was limp. She was asleep.

Further proof that she’s probably sleeping more is the fact that this weekend, my husband repeatedly commented on how cute she was, lying flat on her side. Wonderful though he is, he’s not a terribly observant man, so for something like this to make his screen is pretty amazing.

Maisy is also a world-class beggar, but she's polite about it: she'll lie down with her chin on my foot or leg, and stare at me with her big brown eyes. When she does this, she is very clearly working me, but this week, while begging, her eyes just kept closing. It was like she just couldn't keep them open.

She’s also beginning to demonstrate the ability to self-interrupt. She has long taken on the role of Cat Cop around our house, rushing and barking at them when they do naughty things like jump on the counter or scratch the furniture. Usually, that rushing includes running into them and bowling them over, but sometimes she will stop herself and then look at me, kind of confused about what she ought to do instead. I praise her lavishly when that happens.

All in all, I’m thrilled with how she’s doing. She seems so relaxed these days. Full medication effectiveness comes at eight weeks, so I’m hoping that the little bit of anxiety I’m still seeing subsides. But even if it doesn’t, I’m so thankful for how she now seems comfortable in her own fur.

I wrote this entry on Tuesday morning, because I knew we were leaving for my parents' house for Thanksgiving that afternoon, and that I wouldn't have time to crunch the numbers once there. Of course, I expected that a new environment would make Maisy edgier, but I wasn't prepared for how much. She's returned to pre-medication levels in terms of frequency of outbursts. She's barking, growling and rushing at things.

Even so, I do think the vigilance has reduced. Initially, she seemed to search out the causes of sounds (the hundred year old clock especially unnerved her), but she quickly adjusted. She isn't as relaxed as she has been at home, of course, but I'm pleased that the vigilance has reduced. Even better- she's sleeping here! The picture in this entry, poor quality as it is, was taken on my parents' couch. She was sound asleep, and was even doing that twitchy-almost-running in her sleep! Also, my dad commented that she seems "calmer" than she used to, and he didn't know she was on meds.

I have a lot to be thankful for today.


Megan said...

First of all, I will NEVER get tired of "OMG SHE IS SLEEPING" emails. They make my day in so many ways!

Second--I'm so darn happy she's improving so much. And the data you've collected is so fun to see.

Third--Happy Thanksgiving. :-)

Katie said...

This is fabulous! I am so glad that the drugs are working so well for her. She sounds like she's so much more comfortable in her own skin.

Happy Thanksgiving indeed!

Crystal said...

Oh, Megan. Now you're going to get like three times as many emails! ;)

Happy Thanksgiving to you guys, too! :)

Laura, Lance, and Vito said...

Yay, yay, yay!!! It's a Thanksgiving Miracle!

Kristen said...

I'm impressed with your diligence about the counting and measuring.

The sleeping one was a HUGE thing with Blaze too. Before he was on meds, I could count on one hand the number of times in his life that I had seen him voluntarily lie down in something other than 'offering a down' and I hadn't ever actually seen him sleep (...he had to have when I wasn't around...).

Great update!!

Anne said...

So glad she's doing well!!!! As someone who has some pretty severe bouts of anxiety, I can say it is not a good time. Bless you for figuring out what works for your girl!

Raegan said...

I realized I don't have any thing to compare this to, but is what you are describing "normal dog" stuff? Is that what normal dogs are like? I truly don't know.

Kristine said...

What good news! I'm so glad you are seeing improvement. *ahppy dance* I totally get the excitement. You can add me to your email list!

More and more I'm wondering if we should have looked into this for my dog. Her case doesn't sound as serious as she does actually sleep, contrary to what our friends believe. But the hyper-vigilence, the barking at random sounds, the constant pacing around the house, the reactivity towards people on the street, etc. that's all typical for her. Honestly, and I feel awful about this, I thought it was just part of her personality.

We've worked on most of her issues and she's improved so much in the year since we adopted her, but she is pretty much always on alert. I was hoping with more time these behaviours would fade. Maybe we should talk to a vet... I don't want my dog to have to feel this anxious all the time if there is something else we could be doing.

Anyway, I don't mean to take up all this space babbling, I am thrilled things are changing for you and Maisy. Hopefully you are entering into a brand new phase of her life.

Crystal said...

Who knew sleeping (well, the lack of) is such a common thread among anxious dogs?

Kristine- What I'm really struggling with is figuring out what's personality and what's anxiety. Certainly there are higher-strung personalities, and I suspect that, even medicated, Maisy will be one of those. I can't wait to talk to Maisy's vet behaviorist about that.

andrea said...

happy thanksgiving ..
I'm so happy for you all - I love watching dogs in deep REM sleep .. :)
to the folks asking about normal dogs - I have a very UN-NORMAL dog - she is ON if she is awake - no question of it but she is the opposite of anxious .. her desire to work and be successful is apparent and if she can convince anyone to do anything that's her preference ... but when she sleeps she sleeps deeply and contentedly

Anonymous said...

REM is not typically considered deep sleep. Deep sleep is actually considered sleep stage 4, or delta/slow wave sleep. If you see your dog running during sleep, she is not in REM as the muscles are actually paralyzed during this stage of sleep.

Crystal said...

Are you saying Google and The Internet failed me?? ;) Okay, so I looked up stages of sleep, and it's very interesting! I guess I didn't know much about sleep. I just thought there was REM and not-REM.

At any rate, two things remain:
1. I'd never seen her run in her sleep before, and
2. She was definitely soundly asleep that morning in bed.