All the cool dogs take drugs. And now Napi is one of the cool dogs.
I took Napi to the vet today to discuss the possibility of behavioral medication for his extreme fear. First, I'm just gonna say it: I love my vet clinic. I chose Lake Harriet Vet in Minneapolis because I liked their mix of holistic and western medicine. I was thrilled to find out that across the board, their staff are really good at handling dogs with special needs. Today was no exception.
I called when I arrived to let the staff know that we needed to go straight into a room. They were more than willing to do this for us. We were a bit early, so we waited about 10 minutes before the tech came in. Napi was quite reactive during this time; he barked every time he heard a noise or someone walked past the door and refused to eat any of the yummy foods I'd brought with.
Here's a video of Napi before the tech came in. I did edit it lightly to remove stuff when he was off camera. He did start eating just at the end of the video; most of that is off camera, of course!
Napi finally started eating just before the tech came in. Naturally, her presence freaked him out a bit, so he stopped eating and started barking. She very wisely completely ignored him, and he quieted within a few minutes and was willing to eat peanut butter again.
When the vet came in, Napi had decided that peanut butter is better than barking, and he just made a little wuff and went back to the food. Yay! He did bark once in awhile during the exam, but overall, was very good. This gives me a lot of hope for his future progress.
For her part, the vet didn't push Napi for the sake of the exam; instead we agreed to try 5mg of fluoxetine daily, with the possibility of moving up to 10mg daily if needed. The vet also suggested a situational med - trazodone, up to 25mg every 12-24 hours - and I was thrilled that she suggested both the as-needed med and that it wasn't ace.
So. Fingers crossed this is the right med for Napi! I am super excited to see how much progress he can make between meds and training.
Showing posts with label trazodone. Show all posts
Showing posts with label trazodone. Show all posts
Friday, March 14, 2014
Thursday, June 30, 2011
Now I Understand
At my old job, I worked with adults with disabilities, but many of my clients were also diagnosed with some sort of mental health condition. Today, I want to tell you about Jerry. (Both his name and the details have been changed for privacy reasons. The essence remains true.)
Jerry was diagnosed with an anxiety disorder, but when I first met him, he was on medication, so I found it hard to believe that the mild-mannered man in front of me was the same man as described in his file. According to his paperwork, when his anxiety was really bad, he would become destructive and violent.
But his brothers didn't care that his medication was making him calm. He wasn't acting like the Jerry they knew, so at their insistence, the medicine was stopped. At first, everything went well. He became more talkative, and was really quite funny. As time went on, though, his cute sayings turned into perseveration. He began to pace the hallways and pick at his skin until it bled. It was heart-breaking to watch, and I'll admit I was quite judgmental. I just couldn't understood why his brothers, who claimed to love him, would do this.
You're probably wondering what all this has to do with dogs. Well, it's this: I tried the trazodone with Maisy the other day, and I hated what it did to her. For a good portion of the morning, she sat staring at me, but not really seeing me, if that makes sense. Every time I tried to interact with her, she'd blink slowly and lick her lips. She barely moved, and then only with significant coaxing. Even so, it was painfully slow and she appeared uncoordinated and clumsy. She just seemed drugged.
No matter how well the trazodone worked, I would have hated it because of that alone. Unfortunately, it gets worse. Within half an hour of taking it, she abruptly stopped eating breakfast and began whining incessantly instead. If I was sitting, she was in my lap, and if I was standing, she was curled up around my foot. For a dog who doesn't really like to touch or be touched, she was acting as though she needed to crawl inside my skin.
She refused to enter the bathroom- you know, the room where we keep the post-tooth-brushing-rawhides that she begs for every chance she gets? She seemed terrified of the tile floor, even though she's never before shown any hesitancy of walking on it (or any other tile floor) before.
Outside, she avoided locations and objects she normally loves, and she would stare and stare when she heard a noise. It wasn't hypervigilance so much as it seemed like she just couldn't process what she was hearing.
Thankfully, I knew that medication can and should work better, so I emailed Dr. Duxbury before it had even worn off completely, expressing my concern. She emailed back and called Maisy's reaction an “agitation response.” She advised me not to use trazodone anymore, and said she would phone in a prescription for clonidine instead.We'll try that this weekend.
But this experience gave me a new sense of empathy. I suddenly understood how Jerry's family must have felt. His anxiety may have been gone, but at what cost? For several hours, I felt like I'd lost my dog. Everything I love about my dog- her enthusiasm, her happiness, her energy, her intelligence- it was all gone. She wasn't acting like the Maisy I know. How must Jerry's family have felt, slowly watching their brother go from a funny guy to one who barely spoke? Sure, he wasn't injuring himself anymore, but he also wasn't doing much of anything.
I'm so glad that it's not an all-or-nothing proposition. I am thankful to have the support of a veterinary behaviorist who will help us find the drugs that work, who wants "only the best" for my dog. I am so glad that we found a long-term medication that allows Maisy to feel comfortable in her own skin, but that doesn't rob her of her personality. And I hope that Jerry's family can find that for him, too.
Jerry was diagnosed with an anxiety disorder, but when I first met him, he was on medication, so I found it hard to believe that the mild-mannered man in front of me was the same man as described in his file. According to his paperwork, when his anxiety was really bad, he would become destructive and violent.
But his brothers didn't care that his medication was making him calm. He wasn't acting like the Jerry they knew, so at their insistence, the medicine was stopped. At first, everything went well. He became more talkative, and was really quite funny. As time went on, though, his cute sayings turned into perseveration. He began to pace the hallways and pick at his skin until it bled. It was heart-breaking to watch, and I'll admit I was quite judgmental. I just couldn't understood why his brothers, who claimed to love him, would do this.
You're probably wondering what all this has to do with dogs. Well, it's this: I tried the trazodone with Maisy the other day, and I hated what it did to her. For a good portion of the morning, she sat staring at me, but not really seeing me, if that makes sense. Every time I tried to interact with her, she'd blink slowly and lick her lips. She barely moved, and then only with significant coaxing. Even so, it was painfully slow and she appeared uncoordinated and clumsy. She just seemed drugged.
No matter how well the trazodone worked, I would have hated it because of that alone. Unfortunately, it gets worse. Within half an hour of taking it, she abruptly stopped eating breakfast and began whining incessantly instead. If I was sitting, she was in my lap, and if I was standing, she was curled up around my foot. For a dog who doesn't really like to touch or be touched, she was acting as though she needed to crawl inside my skin.
She refused to enter the bathroom- you know, the room where we keep the post-tooth-brushing-rawhides that she begs for every chance she gets? She seemed terrified of the tile floor, even though she's never before shown any hesitancy of walking on it (or any other tile floor) before.
Outside, she avoided locations and objects she normally loves, and she would stare and stare when she heard a noise. It wasn't hypervigilance so much as it seemed like she just couldn't process what she was hearing.
Thankfully, I knew that medication can and should work better, so I emailed Dr. Duxbury before it had even worn off completely, expressing my concern. She emailed back and called Maisy's reaction an “agitation response.” She advised me not to use trazodone anymore, and said she would phone in a prescription for clonidine instead.We'll try that this weekend.
But this experience gave me a new sense of empathy. I suddenly understood how Jerry's family must have felt. His anxiety may have been gone, but at what cost? For several hours, I felt like I'd lost my dog. Everything I love about my dog- her enthusiasm, her happiness, her energy, her intelligence- it was all gone. She wasn't acting like the Maisy I know. How must Jerry's family have felt, slowly watching their brother go from a funny guy to one who barely spoke? Sure, he wasn't injuring himself anymore, but he also wasn't doing much of anything.
I'm so glad that it's not an all-or-nothing proposition. I am thankful to have the support of a veterinary behaviorist who will help us find the drugs that work, who wants "only the best" for my dog. I am so glad that we found a long-term medication that allows Maisy to feel comfortable in her own skin, but that doesn't rob her of her personality. And I hope that Jerry's family can find that for him, too.
Tuesday, June 28, 2011
Recheck with the Veterinary Behaviorist: Plans for the Future
After all my blathering on, I still haven't gotten to the crux of the appointment: where do we go from here? So today I'm going to share what Dr. Duxbury and I agreed to do next.
Medication
Not ones to mess with a good thing, we are not changing Maisy's paroxetine. She will remain on a daily 10mg dose for the forseeable future. I don't know when/if we'll ever take her off it, but for now, it remains effective and awesome.
However, given how traumatic her recent vet visits were, and considering that Maisy will be staying at a boarding kennel for the first time in her life next month, we decided that we do want have a little something for special occasions.
We did try trazodone at her ultrasound, and I was unimpressed with it then. Still, that day was weird- she was already stressed from her appointment the day before, and the city was doing ripping out the sidewalk in front of our house that day. Plus, Dr. Duxbury really prefers trazodone over the alternatives (it's typically less addicting and seems to have fewer side effects, including paradoxical effects), so we agreed to give it another try, this time on a day when nothing was going on.
Training
Based on the feedback Dr. Duxbury received from our reactive dog class trainer, we discussed the possibility of trying more conventional training classes. (I'm thinking I'll try an advanced rally class, but I might try an advanced obedience class, too- depends on what works best in our schedule, really.)
We're going to take it slow, though.
Maisy and I will remain in our current reactive dog class, but only attend every other week. Dr. Duxbury said we could start taking regular classes immediately, but I think I'm going to take it a bit slower instead. My plan is to go to the club where I plan to take classes every other week and set up Maisy's crate and do the same stuff as we do at reactive dog class: mostly chill in the crate, but have her come out to heel, work on a perch, etc., near the other dogs. I'll probably spend two to three months doing the every-other-week thing before actually signing up and attending a class.
The purpose of doing reactive dog class every other week is to give us a barometer of how Maisy is doing. If Maisy gets reactive in the regular class, but not in reactive dog class, we'll know that she's not ready for the regular class yet. If she gets worked up in the regular class and the reactive dog class, we know there's an issue, but that it's probably not related to the class schedule.
Beyond classes, though, we have two additional assignments: first, I am to condition Maisy to wear a muzzle. This was mostly my idea, but Dr. Duxbury did fit Maisy for a muzzle because I couldn't figure out what size she needed. (As it turns out, she's between sizes.)
Second, I am to condition Maisy to love being picked up. She doesn't care for this right now, but if she finds being picked up pleasant, it will make it easier to move her through crowded doorways and spaces without increasing her stress level. It's meant to be a management strategy, to prevent stress, as opposed to something I do in response to stress.
Trialing
Because Maisy did so well just hanging out at the last trial, Dr. Duxbury said we could enter the next one! However, we both agreed that the best course of action is to play it by ear. I'll go, hang out, and if Maisy's doing well, do a day-of-show entry. And then, depending on how she's doing as we enter the ring, I am to seriously consider purposely NQing, and either do just one to two signs, or have a “cookie run” instead of trying to actively compete. Either way, we've been given permission to enter the ring, and I'm happy about that!
Both Dr. Duxbury and I are thrilled with how Maisy's doing. We'll return in three to six months to reassess things again, and I am very excited to see where she's at then.
Medication
Not ones to mess with a good thing, we are not changing Maisy's paroxetine. She will remain on a daily 10mg dose for the forseeable future. I don't know when/if we'll ever take her off it, but for now, it remains effective and awesome.
However, given how traumatic her recent vet visits were, and considering that Maisy will be staying at a boarding kennel for the first time in her life next month, we decided that we do want have a little something for special occasions.
We did try trazodone at her ultrasound, and I was unimpressed with it then. Still, that day was weird- she was already stressed from her appointment the day before, and the city was doing ripping out the sidewalk in front of our house that day. Plus, Dr. Duxbury really prefers trazodone over the alternatives (it's typically less addicting and seems to have fewer side effects, including paradoxical effects), so we agreed to give it another try, this time on a day when nothing was going on.
Training
Based on the feedback Dr. Duxbury received from our reactive dog class trainer, we discussed the possibility of trying more conventional training classes. (I'm thinking I'll try an advanced rally class, but I might try an advanced obedience class, too- depends on what works best in our schedule, really.)
We're going to take it slow, though.
Maisy and I will remain in our current reactive dog class, but only attend every other week. Dr. Duxbury said we could start taking regular classes immediately, but I think I'm going to take it a bit slower instead. My plan is to go to the club where I plan to take classes every other week and set up Maisy's crate and do the same stuff as we do at reactive dog class: mostly chill in the crate, but have her come out to heel, work on a perch, etc., near the other dogs. I'll probably spend two to three months doing the every-other-week thing before actually signing up and attending a class.
The purpose of doing reactive dog class every other week is to give us a barometer of how Maisy is doing. If Maisy gets reactive in the regular class, but not in reactive dog class, we'll know that she's not ready for the regular class yet. If she gets worked up in the regular class and the reactive dog class, we know there's an issue, but that it's probably not related to the class schedule.
Beyond classes, though, we have two additional assignments: first, I am to condition Maisy to wear a muzzle. This was mostly my idea, but Dr. Duxbury did fit Maisy for a muzzle because I couldn't figure out what size she needed. (As it turns out, she's between sizes.)
Second, I am to condition Maisy to love being picked up. She doesn't care for this right now, but if she finds being picked up pleasant, it will make it easier to move her through crowded doorways and spaces without increasing her stress level. It's meant to be a management strategy, to prevent stress, as opposed to something I do in response to stress.
Trialing
Because Maisy did so well just hanging out at the last trial, Dr. Duxbury said we could enter the next one! However, we both agreed that the best course of action is to play it by ear. I'll go, hang out, and if Maisy's doing well, do a day-of-show entry. And then, depending on how she's doing as we enter the ring, I am to seriously consider purposely NQing, and either do just one to two signs, or have a “cookie run” instead of trying to actively compete. Either way, we've been given permission to enter the ring, and I'm happy about that!
Both Dr. Duxbury and I are thrilled with how Maisy's doing. We'll return in three to six months to reassess things again, and I am very excited to see where she's at then.
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