Thursday, December 23, 2010
Medication Update: 2 weeks at 10mg
Maisy has been on her increased dose of paroxetine for two weeks now. At her re-check appointment, I was told to expect basically the same process as before: side effects possible in the first two weeks, with full effectiveness at six to eight weeks. Thankfully, on the former point, she’s been just fine- no side effects. On the latter, well, I come bearing behavior logs! (If you want to look at the last data set, it’s available here.)
First, and most importantly, the intensity and duration of Maisy’s anxiety-related behaviors around the house continues to decrease. I have three objective factors that I’ve used to measure this: First, did she leave the room? At baseline, she left the room 35% of the time. At both seven weeks and this week, she didn’t. Second, did she scan the environment during the behavior? At baseline, 30% of her behaviors included elements of vigilance. Again, at both seven weeks and this week, that had dropped to 0%. And third, did the behavior last longer than one minute? At baseline, 23% of the behaviors did. At seven weeks, 13% did. This week, none did. In fact, the average duration was just 9.3 seconds!
Subjectively, I’ve also felt that the intensity of her behaviors have reduced. In fact, I’ve started to have trouble defining the vocalization type. Her barks have been very soft, and almost “wuffy” in character. Interestingly frequency of each type of vocalization is more or less the same as it has been in the past: none were silent, 40% were a wuff only, 10% were a growl only, 30% were a bark only, and 20% included multiple vocalization types. However, this does represent a reduction in multiple vocalization types, which does support the idea that the intensity has reduced.
On average, she is having slightly more incidents per day now (2.5) than she did two weeks ago (2). Still, they have reduced from the baseline (3.58). Also, during her first two weeks on medication, she had a few oddities like this, so I’m not too worried. Given the incredible reduction in intensity, as well as the low duration of behavior, I’m very pleased with the current results.
I’m also very excited because only one behavior (10%) occurred during the middle of the night. In fact, there was one night where I was woken up by a large thump, and Maisy looked at me like I was crazy to be awake. At baseline, 35% of her outbursts happened at night. Needless to say, I’m sleeping much, much better these days.
That said, I have noticed a few interesting things. First, only one of the responses was what I’d label “reasonable,” and that happened when Brian came home fairly late at night. I’m really okay with her barking at people walking in the house after 10pm. However, the door does seem to serve as a source of anxiety: during half of all her behaviors, she looked at the door, I will have to start doing some desensitization around them.
Even more interestingly, food was involved a whopping 70% of the time. In half of all the behaviors logged this time, I was eating a snack, and Maisy was (politely) begging. Each time, a small noise caused her to vocalize, even though the exact same noise caused no reaction either prior to or after snack time. These instances did not appear to be resource guarding (she usually rushes at or snaps at the offending cat when it is). The remaining food-related anxiety behaviors happened while she was eating supper. In both of those, she was in a different room than I was, so it is possible those were resource guarding. Still, I don’t think they were based on the location of the cats at that time.
In terms of reactivity, I think she’s doing better overall. However, we have had a few incidents recently. The most troubling was The Dude Incident. After our recent snowstorm, Maisy and I were shoveling out our garage. Maisy was off leash, and we were playing the game in the alley. Occasionally she greeted a neighbor with enthusiasm, but when a man came walking down the alley, she lost her mind. Now, this, in and of itself, is not remarkable. In the past, a similar situation might have caused her to rush towards the scary thing/person, stop about five to ten feet away, and bark and growl. This time, she began circling the man, nipping at him (but never making contact) while growling and barking, somewhat like an overaroused herding dog might.
I’m not sure what to think. She’s never gotten close before, so why now? Has the medicine helped her feel brave enough to face her fears? And if so… is that a good thing? Frankly, I’ve been hoping that this is just a weird side-effect thing (she did something similar during her first two weeks on paroxetine, though she didn’t get as close), but realistically, I know it’s probably an issue. My trainer and I are working on setting up some training opportunities with men so that I can properly do the necessary desensitization and counter-conditioning. Needless to say, in the meantime she won’t be allowed off-leash.
The only other reactivity has been more understandable. In class on Sunday, she lunged at her greyhound friend, Beckett when he was wearing a coat, and at Beckett’s mom when she was carrying some jump standards. Both of those things are weird enough to cause her some anxiety. She did not, however, lunge at the two new dogs in class. In Tuesday night class, the only time she made a peep was when a child clomped through the area wearing snow boots. Once she saw the child, she was fine (and in fact, just about exploded with excitement because she really likes this particular kid), but the noise put her on edge.
Overall, I’m still very happy that I put Maisy on the paroxetine. I’m excited to see the changes over the coming weeks- I have a hunch that this is the right dose for her, but only time will tell.
Update: This afternoon, I emailed our veterinary behaviorist with the raw data logs and a short summary of how things are going. She responded very quickly, saying that she agreed with my theory regarding Maisy's Dude Issue, adding that this is why she worries about vets prescribing meds without discussing behavior mod to accompany them.
She also said that she thinks the increased anxiety around the cats may be an extension of her resource guarding. Her theory is that Maisy knows the cats are still in the house, and knows that they could suddenly appear even when they aren't nearby. As a result, she listens more closely to the noises around the house, and reacts to them a bit quicker. After she told me that, I looked at the logs again, and found that roughly three-fourths of her food-related anxiety behaviors were provoked by noises the cats made in the other room. (I didn't know the cause of the remaining quarter.)
I just have to say, her continued support between appointments is incredibly helpful, and I cannot recommend her enough. Seriously, if you live in Minnesota and need a veterinary behaviorist, you should see Dr. Duxbury.