Thursday, December 23, 2010

Medication Update: 2 weeks at 10mg

Maisy sleeping at my parents' house.
I still can't get over it.

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.

9 comments:

Sam said...

"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."

I wonder if food has become a contextual discriminative stimulus for the presence of scary things. Like, when food's out, she's more reactive, because that's how it's always been - food comes out when scary stuff is happening. I HAVE seen this happen with Marge to some degree on our walks.. I think I've over-used treats in certain situations. But, we're working on it and I'm using other cues to tell her "it's OK to keep going", and I'm starting to see some change.

Laura, Lance, and Vito said...

Great picture and fabulous news! Bummer about the guy. But she's not reacting more to other dogs right? Hopefully it will go as quickly as it left so you don't have to work on another issue!

I was just told yesterday that the tricks class might not happen now. Confusion with the reactive rovers class not switching nights and they take up all 4 rings. If it does go on I'll let you know, and we would likely be in that star room. I'm a little bummed, I would rather have taught tricks then adv obedience!

Crystal said...

SAM- That's certainly possible. (And I'm a little embarrassed I didn't think of it myself.) I've been very careful from the beginning to only bring treats out until AFTER the scary thing. Also, I pretty much ALWAYS have treats around, even when there aren't scary things around, so I hope that she hasn't made that connection. Still... she is the kind of dog who WOULD make that connection. SIGH.

That said, I emailed Dr. Duxbury with this same information, and her thought was that Maisy knows the cats are around, even if they aren't in sight, and that they could appear any time. As a result, Maisy pays more attention to her surroundings when food is around. This actually makes a lot of sense to me, especially since most of the time, the noises she was responding to were caused by cats.

LAURA- Yes, it IS a bummer about the guy. Dr. Duxbury agreed with my theory (that she's braver now), so I will need to do some hard-core behavior mod around guys.

She does seem to be doing better around dogs. She had her crate uncovered in class on Tuesday, and even though she could she the dogs moving around, she was fairly relaxed and didn't comment on them. That is HUGE progress for her! The only dog she had issues with was Beckett, who looked very different with his coat on.

Let me know if you teach the tricks class. That might be really fun. If that doesn't work out, I might try nosework with Jane. We'll see- I'm adding a (human) yoga class to my schedule in January, and I don't want to overschedule myself.

Sam said...

Classical conditioning can work in reverse (backward conditioning), which would explain a possible connection even if food came out afterwards.

I've really been thinking lately about how muddy the waters of behavioral intervention are - there are so many different connections that an animal can make!

The info about her responding to noise made by the cats does suggest that it had to do with the cats, though.

Crystal said...

And let's be honest- it's hard to hide food anyway. Maisy can smell treats even when they're in ziploc bags. That means that it wouldn't necessarily even be backward conditioning... conceivably, a dog could smell the treats, see the scary thing, and then associate the two that way.

I just hope it isn't a reliable predictor. Like I said earlier, I almost always have treats with me, even when there isn't a scary thing around. Of course... my dog is prone to single-event learning, so I can't rule anything out with her.

I'm glad you brought it up. Even though I think (hope!) it's probably related to her resource guarding, your comments on backward conditioning is really interesting to think about.

Kristine said...

This is fantastic news! I am so glad the medication is helping and your behaviourist is so supportive. That photo above is adorable. I hope together you are both able to manage and fix these new challenges.

Sam said...

Yeah, from the sounds of it, it's a cat-food issue, not a food-food issue. Plus, that's what the behaviorist thinks, too, and that's the opinion I would value above all! I was just thinking out loud (in your comment box - lol).

Either way, her progress is astounding! Good for you both!

Crystal said...

Yes, but Sam, your thinking out loud is very interesting. I'm glad you did it. We walked to the corner store today, and there were plenty of Dudes, so we had a good CCing session. I assume she smelled the treats before I brought them out, but even so, once the treats were out, well, I could see how the association could go backwards! I'd never thought too much about it before.

Kristine- I agree- I love that photo. I never got any of her sleeping before (what with never doing it and all), and now I take them every chance I get!

Ashley Hiebing said...

About The Dude Incident... back in my PetSmart days, I was doing a four week private with a woman who had a very undersocialized, anxious dog (a Shih-tzu mix). At first, the dog would freeze, only reacting when the stimulus was within 5-10 feet. After a few weeks of playing outside the store, then moving inside, he started to approach his triggers... and would bark and snap. This distressed his owner to no end.

The other trainer's theory was that he was becoming more brave, instead of shutting down in front of his fears, he was taking initiative. Still not what we wanted, but in a way, it was progress.