Sunday, August 7, 2011

Meds and Your Dog, Part I: Should You Consider Meds?

Ever since I put Maisy on paroxetine last fall, I've gotten regular emails from readers asking if I think they should consider behavioral drugs for their dogs. The truth is, I don't know. I've never met their dog, and even if I had, I'm neither a vet nor a trainer. Still, I know from personal experience that the decision whether or not to put your dog on medication is a difficult one, and that sometimes a bit of hand-holding is needed. After all, the reason I chose to pursue it is because a friend was kind enough to share her experiences.

While I welcome emails from my readers- I always feel honored that people want my opinion- I figure there's probably a number of others who haven't emailed but are wondering the same thing: should they consider meds? That's why I'm going to devote this week to the topic of behavioral drugs for dogs. Today I'll discuss when you should consider meds. Later this week, I'll write about times I think you should not use meds, or that you should use them cautiously. And finally, I have a post about the different professionals you might consult with in your search.

So. Should you use medication for your dog's behavior problems? Generally speaking, I've come to the conclusion that if you're asking the question, then the answer is probably yes. This doesn't mean that you'll ultimately decide to use them, but I think if you're wondering, you should probably consult with a professional who can guide you in making your decision.

Still, that's awfully vague, so here are five situations that I think merit a consultation with a professional:

You have been following a good behavior modification program for 3-6 months and have seen very little or no progress.
Note the key phrase here- “a good behavior modification plan.” While it is beyond the scope of today's article to discuss what this means in detail, I broadly define it as one that has been designed by a professional trainer, and that includes a desensitization and classical counter-conditioning component. It does not include the use of pain or intimidation techniques.

I also specify allowing up to half a year because behavior modification takes time. Despite our society's penchant for quick fixes, you can't rush good training. While three to six months is probably not going to cure your dog- and depending on the issue, a cure may not ever come- you should see measurable progress in that amount of time. If you don't, it's possible that medication could help your dog be more receptive to training.

You initially saw progress, but it has since stalled.
Maisy and I fell in this category. While training made a huge difference for her initially, it eventually plateaued. Even though she was doing much better, there was still a lot of problematic behavior. Despite my best efforts, we just couldn't get unstuck. After several months, I began to consider adding meds to the mix. As it turned out, this was exactly what we needed to continue making progress.

You have been doing behavior modification training and your dog has gotten worse.
First, it needs to be said that a certain amount of regression is normal during the course of training, so if you have a temporary setback, don't go rushing for the chemicals. However, if your dog demonstrates serious or sustained backsliding, it's a cause for concern. If you haven't already, a vet check is in order- a variety of medical maladies can cause behavior changes.

It's also time to consult with a professional trainer if you've been trying to go it alone, and if you've already got one, you may want to seek a second opinion. A poorly designed or a poorly executed behavior modification plan can be worse than none at all. You need a trainer who can both design a great plan and coach you through it. However, if you're quite sure your plan is solid and that you're implementing it well, it's time to have a consult for medication.

Your dog has difficulty sleeping, can't relax even in familiar environments, you can't identify his triggers, is globally fearful, or just seems on edge all the time.
When dogs have predictable behavioral problems, they tend to respond to training alone beautifully. But for other dogs- the ones you just can't quite figure out- medication may be warranted. Anxiety and fearfulness often have a genetic component, and you can't train away a brain chemistry problem.

Maisy and I had this working against us, too. One of the great difficulties I had was that her triggers seemed to change a lot. She also had many of them- joggers, bikes, garbage trucks, ballons, things out of the place in the house. But they also fluctuated a lot- one day she'd lose her mind over a doberman and the next she'd barely blink. It was frustrating, and I never knew what to expect. It also made it very difficult to effectively do desensitization and counter-conditioning.

Worse, Maisy seemed incapable of relaxing. She was constantly moving. She rarely laid down, and when she did, she startled easily, jumping up to bark or growl at things that I couldn't even perceive. For a long time, I thought this was just who she was- which, I guess it was, but still- it wasn't normal dog behavior. Once I realized that she was probably suffering from Generalized Anxiety Disorder, I knew it was time to consider meds.

You're short on time.
In a presentation given at the 2010 APDT conference (I buy the CD-ROMs, which, while expensive, are absolutely worth the money), Dr. Barbara Sherman shared that her research has shown that the combination of behavior modification and medication works faster than behavior modification alone. Her study (Treatment of separation anxiety in dogs with clomipramine, authored by King, Simpson, and Overall, and published in Applied Animal Behavior Science in 2000) found that 51% of the dogs receiving behavior modification alone improved in 8 weeks, as compared to 73% of dogs who received behavior modification in combination with clomipramine.

While this study is talking about a specific medication and a specific diagnosis, in her presentation, Dr. Sherman mentioned several other studies that showed similar results for different medications and conditions. Therefore, I must conclude that if your dog has a behavior problem and you're faced with an “it's me or the dog” situation, you should consider the addition of medication to increase your chances of quicker improvement.

As I said in the beginning, I am not a professional. I have no idea if medication is right for your dog- I'm simply trying to share times that I think it makes sense to sit down with an expert to find out what they think. And anyway, it's ultimately your decision. I also know it's not an easy decision. I had wondered if meds might help Maisy for 8 or 9 months before I finally made the appointment, but I was worried about the cost, the side effects, and the perception that I was “taking the easy way out.”

Still, I'm glad I made the decision that I did in the end. Maisy is so much happier these days, and for the first time in her life, she seems comfortable in her own skin. If you're asking the same question, I hope that your decision- whether it's for meds or not- has an equally good outcome for your dog, too.


Robin Sallie said...

Success is being able to put your dog's needs first.

Katherine Ostiguy, KPA CTP said...

Great post! I have one additional situation: early onset of reactive behavior. My youngest became reactive at 4 months. By 5 months, if he perceived a human who was not from our household, he would instantly react. At 6 months we put him on Clomicalm and by 7.5 months we could -finally- make progress with our behavior modification!

I have read that dogs that begin to demonstrate aggressive behaviors as puppies are among the hardest to "fix", so I think all options need to be on the table from the start. My vet and I started with anti-anxiety supplements immediately, but when we saw no change after two months, we were ready to start the medication having discussed all of our options.

Eliz said...

Having watched you and Maisy and your amazing growth together, I would just want to emphasis that even though many may think that medication is a quick fix or easy way out, that wasn't what I saw. Instead (it seemed to me) instead of a fix the medication was a tool. A tool to help your training and behavioral conditioning work or work better. What a great post.

Anonymous said...

Absolutely fantastic post, Crystal. It is a hard decision to make. I know I personally felt like the decision to go on meds meant I had failed as a trainer. Thankfully, I have a wonderful vet who reassured me that it isn't a failure. Now, I wonder why I ever hesitated. Shanoa's made tremendous strides with the addition of Prozac to our toolbox.

Crystal Thompson said...

Excellent addition, Katherine. It seems like early onset of issues is likely genetic, and thus, would respond well to medication.

Elizabeth, YES. It is a tool, nothing more, nothing less.

Nicky- I felt the same way- that I had failed as a trainer. Even now, I sometimes feel like I took the easy way out, even though I know I've worked my butt off since putting Maisy on meds. I don't think it was easier, just that progress came quicker.

Laura, Lance, and Vito said...

You're the reason I ventured into the world of drugs to try and help Vito.

Crystal Thompson said...

And I hope you're happy with that decision, Laura!

Anonymous said...

Crystal, I agree the meds didn't make it easier, exactly. For us, it really allowed us to continue our progress. I think we'd hit the point where behavioral modification alone just wasn't enough. I really feel like Shanoa's "real" self is now evident, where before it was masked by the anxiety. She, too, was the dog that didn't sleep well and paced all the time. Even her favorite activities seemed colored by the anxiousness. Now, she is filled with joy and enjoys things without the fear. It's still a lot of work and training, but the meds really helped us "break through."

I'm excited to read the rest of this series. I'm constantly pointing people to your blog as a resource when they have a reactive dog.


Jessie said...

That's a great post because people often ask that question. I agree with what you've said. I have a dog who recently started medication because she seemed to be getting worse with training. She also had trouble sleeping and would freeze when walking outside. It came to the point that we couldn't take 2 steps outside without her freezing. It's a journey now trying to find the medicine that may help, but it's a step I'm happy I took.

Ninso said...

Yep. We decided to try meds because, though we had made progress with b-mod, it stalled out, and then she got worse again.