Showing posts with label clonidine. Show all posts
Showing posts with label clonidine. Show all posts

Thursday, July 7, 2011

Be Careful What You Wish For

As the owner of a high-energy dog, I have often longed wistfully for something a bit quieter. I have specifically envied my friend Elizabeth, who has a greyhound. For those of you who foolishly believe that as ex-racing dogs, greyhounds must be impossible to live with, let me reassure you: they take retirement very seriously. If a surface is horizontal, a greyound will lie on it. Which, of course, makes Elizabeth's greyhound Beckett seem perfect to me and my fellow crazy-dog-owning friends.

That said, this weekend, when we tried out clonidine as our new short-acting "event" drug, I realized that I sort of prefer a crazy dog over a more mild-mannered one.

Ahhh, that's much better.

Maisy has had some mixed responses to medication. Paroxetine has been a wonder-drug for her, but her experience with trazodone was awful. So, I was nervous when I gave her half of a 0.1 mg tab of clonidine last Saturday. I shouldn't have been- I didn't really see much of a difference in her demeanor.

Still, it was a pretty low-key day to go with a pretty low dose, so the next day we tried a full one. We also happened to be going to a BBQ with dog-friends, and they all commented that Maisy seemed more subdued than usual. She wasn't lethargic, they said, just a bit slower.

I should have been thrilled. I've been saying for years that I want a quieter dog, but to be honest, it wasn't quite as awesome as I'd hoped. I missed Maisy's flitting about, her obnoxious begging, and her quirky antics. While the paroxetine seems to filter out the "static," the clonidine just turns the volume down entirely.

When I shared that with Dr. Duxbury, she replied that she understood completely. While she felt the response was favorable, she recommended only using it for high-anxiety situations. I can use it up to twice a day, but if I need to use it for several days in a row, it's best to taper it off. For example, at the end of the month, Maisy will be staying at a boarding kennel for four days. Once I return, I will give her half doses twice a day for two to three days, and then once a day for a few more days after that. I foresee a very boring week...

While the medication will be helpful for situations like boarding or emergency vet visits, I know I won't be using it regularly, nor for things like trials. I just don't like the quiet Maisy. I'd much rather have my enthusiastic, outgoing, crazy dog. So, be careful what you wish for, guys- you might find that you've been wrong!

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.