Tuesday, August 9, 2011

Meds and Your Dog, Part II: Proceed with Caution

In my last post, I shared some situations that I think merit a consultation with a professional about whether or not your dog would benefit from behavioral drugs. As I said then, I am neither a vet nor a trainer, and the ultimate decision lies with you. Today's topic is the flip side- times that I think you should either avoid the use of medication, or that you should approach the subject very cautiously.

You haven't had a thorough veterinary exam done.
Before you initiate behavioral medications, it is vital that you have a full physical work-up done. I'm not talking about the garden-variety wellness check, either: you want an in-depth medical consultation, especially if the behavior has a sudden onset. This is important because there is a wide variety of health conditions that can impact a dog's behavior. I cannot even begin to ennumerate them all- that's why you need the checkup, after all- but things as common as unaddressed pain or an out-of-whack thyroid level all the way down to rare neurological problems like brain tumors or epilepsy can cause behavioral concerns. Don't jump to meds unless you've treated any medical needs your dog might have.

There are underlying health conditions that contraindicate the use of medication.
Again, I can't possibly talk you through all of the conditions that might impact your dog's ability to take behavioral drugs. Some things are obvious, though: if your dog has a serious liver or kidney issue, for example, adding more strain to those already taxed organs may not be wise. Likewise, if your dog is already taking medication for a health issue, you will need to make sure that there are no drug interactions. Maisy's medicine will even interact with certain flea treatments and some supplements, so I have to be very careful about what I use with her!

You don't plan to do any training with your dog.
I truly hope none of my readers fall into this category, but just in case, I need to emphasize this point. First and foremost, you have to understand that there is no silver bullet. A pill is just that- a pill. It is not a magical cure, and when it comes to behavioral issues, there is no easy way out. Whether a dog is on medication or not, you still need to put in the work. It's true- medication alone will cause a certain level improvement in your dog. However, you will see more progress if you combine it with behavior modification.

However, that's not the most important matter at hand. It is my very strong opinion that using medication alone is dangerous. This is because some medications have a disinhibiting side effect. If you are not working to teach your dog what he ought to do, should he experience a loss of inhibition, it's likely he will fall back on old coping mechanisms. And he'll probably take them further than before, leading you into very dangerous territory.

This happened to Maisy. She was doing amazing on medication. Her fear and anxiety had reduced, and I could tell she was feeling more confident. Unfortunately, this newfound bravery meant that when she saw a strange man in a winter hat come shuffling down our alley last winter, she took off in his direction instead of running away. We came very, very close to having a bite incident, which could have had disastrous consequences. Because I was actively working with Maisy, I was able to redouble my desensitization and counter-conditioning efforts around men, and got her through this scary time.

There is a heightened risk of aggression, or other liability concerns exist.
As my story with Maisy indicates, the use of medication can lead to problems, even when you are being diligent. You need to be very, very careful, and if you let down your guard even slightly, like I did (I was letting her go from the car to the house off leash), you could be setting yourself up for heartbreak. Find an expert in pharmacology and behavior, and rely on her ability to prescribe a medication with the smallest likelihood of such side effects, as well as to advise you on how to manage or prevent any issues.

You want to isolate the factors of success.
This isn't so much about avoiding the use of treatment altogether, but rather, about delaying it. The fact is, if you implement multiple treatment approaches at once, you'll never know which worked and which didn't. If you're short on time, this won't matter, of course- you want to throw everything you've got at the problem- but if you're like me, you probably want to measure how each variable impacts your dog's behavior. I recommend that you set clear goals and time limits if you go this route, though. If a certain treatment isn't helping within 8-12 weeks, you should try another. It's not fair to let your dog suffer in the name of intellectual curiousity.

These are just some of the situations that I think should cause you to approach the use of medication very carefully. It's possible that your dog might still benefit from medication even if he fits in one of these categories, so I urge you to find the best educated, most experienced professional you can. There are lots of options out there, and my next post will discuss some of the various people you might consult with as you weigh the risks and benefits of behavior modifying drugs.


Ninso said...

For behavior issues involving potentially dangerous behavior, I agree that you should not use medication if you don't plan to train. But for Lok's separation anxiety it has done wonders for us with no training. I simply do not have the flexibility in my schedule to do proper b-mod for SA. I put Lok on Prozac and while the issue is not totally cured it is WAY better! He is no longer sitting in a puddle of drool when I get home and going through a crate tray a week due to chewing, and he doesn't lick his paws as much! It's also helped with his storm phobia. I had my regular vet prescribe the Prozac. I may be able to get even better results with the help of a veterinary behaviorist or if I had time to train, but even without these things his quality of life is much improved! So my opinion is that in certain cases where training is not an option, medication still may be worth looking into to get at least some relief from the problem--particularly SA, OCD or noise phobia issues that really affect the dog's quality of life.

Crystal Thompson said...

Ninso, I'm torn on my response.

On one hand, yes, I can totally see your point- the training you do (or don't) depends on the issue. I have no experience with separation anxiety (knock wood!), so that's a great point. That's part of why I called this post "proceed with caution," not "do not use"- because I'm not a veterinary behaviorist!

On the other... while you don't do the specific SA training, I know you work with your dogs. I'm mostly trying to caution the average owner from thinking of medicine as a "quick fix," because I don't think it is, for any issue.