Tuesday, November 20, 2012

What have we done?

"One thing that has me particularly concerned is (Bella) shows no interest in playing with me any more - in fact, she has little interest in me at all now. We used to play chase and ball a few times a day. She hasn't accepted a play invitation from me in over a week. On the bright side, she's not barking at every falling leaf in the yard but she's not barking at anything at all. She's not showing interest in going outside or chasing anything when she is outside.

I expected us to work with her to learn to control her chase/prey instincts but we haven't - this is just a reaction, I believe, to the meds. I wanted to be able to focus her so we could teach her some more appropriate behaviors but it seems she's a completely different dog. To some that may sound great but she wasn't a bad dog before, she just had too much stress. She seems to have lost her joie de vivre, her spunk (spirit) and her enthusiasm for anything that used to mean something to her.

To be honest, I feel like I've lost my dog."

-- Email to Dr. Dodman, Tufts Small Animal Hospital, 9/23/2011


Last week, I was telling you about Bella's bad reaction to being "left" at my mom's house for a mini-vacation. Just over a week after that event, I wrote the above email to Dr. Dodman.

Jan and I had been talking about Bella's change of demeanor but were also trying to remain upbeat and optimistic about it. "Could just be temporary..." "Maybe there's an adjustment period?" "Let's see how she does tomorrow..."

Comments in her diary leading up to this email show an increase in anxious behaviors (not sleeping through the night, wanting to go to her 'safe space' in the basement, not eating...) but the final straw that brought me to tears one night was that she no longer had any interest in play and I honestly felt that I had "lost" my Bella.

The Bella that, while always fearful, still had such an insatiable curiosity of life. When Bella isn't fearful, she's a wonder. She inquisitive, enthusiastic, eager and willing to try whatever I throw at her. She's a bit of a skeptic but once she's over her misgivings, she faces life with an incredible zest.

Three weeks on this new medication and she just seemed so disinterested in everything.

I don't feel so good...
We had been warned, we had thought this through, we'd talked about "revealing" her "true" personality. But this wasn't it. Everything I knew and trusted inside me said this was wrong.

Luckily, Dr. Dodman is a true professional. He wasn't so hung up on being right that he dismissed our concerns. He heard me and he believed me and he trusted that I knew my dog better than anyone else ever would. And he offered me hope.

My biggest fear in watching Bella's changing demeanor was that we wouldn't be able to get her back. I never wanted to change "her", I just wanted to change her behavior towards Jan - and even then only in some very limited, albeit terrifying, situations.

Dr. Dodman immediately recommended we take Bella off the Fluoxetine for a week and start her at a lower dose after that. I can't begin to tell you how relieved the following email made me feel:
"HI Leslie, I think what you said is right. Let's skip the next couple of doses of fluoxetine and then restart at 20mg per day - instead of 30 - when she is back to normal. We may need to go back up to 30 at some time but Bella seems very sensitive to side effects so we will have to go slowly. Nick Dodman"
(I don't know if I need a legal disclaimer for that or not but please don't have me arrested, okay? :)



Much to my relief, Bella's sparkling, if sometimes snarky, personality came breaking back through the haze after only a couple of days. It's very good to know that while we tinker with her doses, we're not doing any lasting damage to her personality. It has made us much more willing to make adjustments and give things time to work.

And, as Dr. Dodman noted, we have discovered Bella to be extremely sensitive to medications and have been quite conscientious in our management as a result.

We have yet to get her up to the recommended dose of Fluoxetine and other meds we've pursued have been administered rather conservatively. But having a behaviorist who listened to us, who trusted us and who was willing to work with us, gave us the confidence to continue our pursuit in trying to help Bella.

And time has borne out that approach. Stick with me over the coming months and you'll see what a little patience and a lot of perseverance can do to heal a damaged dog.


14 comments:

  1. Once again, I'm so thankful you're sharing this journey you took with Bella with all of us here.

    I've never used anxiety medications with a dog. But I've had family members with severe mental illnesses who struggled for years to find appropriate medications to help them live a balanced life without being surrounded by a haze.

    People who have a hard time coping with life are sometimes medicated inappropriately to make them easier to deal with at the cost of their individuality and spirit. Bella has been lucky living with you.

    You have been such a watchful advocate for Bella and are lucky to have found such a knowledgeable and caring clinician to help you help her.

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  2. Whew!  the beginning of this post had me worried!  I'm glad to hear that decreasing her meds is bringing back your spirited girl! It's great that her vet will work with you on this. :)

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  3. As someone who has just recently started a dog on anxiety medications, hearing about your story has made me feel a lot better. Thank you for sharing. 

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  4. I know how disturbing it is when your dog's personality changes and she becomes quiet and subdued. Georgia is very much like that these days though thankfully, it's not due to meds. I miss the old her too! You have a good vet. I hope Bella plays with you again some day soon X

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  5. You have an awesome vet! Thank you for sharing your story about Bella. It's truly inspirational
    Nola

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  6. I'm glad that we've never needed to use anxiety meds for any of our dogs.  We did have to use some other medicines for a medical issue at one time, though, and it was pretty scary to see certain changes happen.  I'm glad you found a vet that was a good fit for you and Bella!

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  7. Alright Dr. Dod! Wow, if all vets were like Dr. Dodman, I bet the world would be a happy place. I hate stuck up vets. I've been through over confident ones and I hate them very much. I am glad you found a true professional near you.

    By the way, we won a LED collar from Lisa and I was hoping you could check your inbox for an email I will be sending you since I'm giving the collar to you guys... Think of it as a Bella Get Well Present.

    Huggies and Cheese,

    Haopee

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  8. So good that your vet LISTENS to your concerns. That is so important. Having been on some anxiety drugs in the past myself, I know how they can mess one up (and interestingly, without necessarily making one feel any better). I don't think any of these drugs would have lasting effect, once out of the system, things go back to normal, whatever normal is.

    Did you discuss the option of using Inositol?

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  9. She's a very lucky girl to have such patient and loving owners.... Deccy x

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  10. I am so so glad you found the right person to help you help Bella. When we were learning how to manage Shiva's anxiety, we had considered medication as well. But the vet we had at the time was not a good one and I didn't think the potential problems were worth the risk. I just didn't trust the idea. It's great Dr. Dodman has been such a wonderful source of understanding and support. I know Bella has come a long way since you wrote that email. I am excited to read about the rest of her progression.

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  11. That's the saddest email I have ever read.
    I'm so glad Bella has such a great doctor and I'm so happy to see how far Bella has come. You and Jan and Bella's doctor are truly amazing for not giving up on her. Bella is truly amazing, too. She has come so far.

    Marquie, Lassie & Petal

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  12. Hey Karen, I've been thinking of you and Pearl. Hope it's going well. The one bit of comfort I can offer you is to know that, even if things get weird, it does all appear to be reversible. We have finally gotten the combination right and I cannot tell you the difference it has made in her life. I wish your first dog had been easier for you but hang in there, they are worth the effort.

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  13. "to make them easier to deal with" - that's a huge question there for people and animals as well - are we looking to make their lives easier or our own?

    Dr. Dodman has been a godsend but so have many of the people who've participated in our journey with Bella including our blogging friends.

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  14. Thanks - it's good to know that these things are reversible.

    We tried the B vitamin route previously but it didn't seem to do much for Bella. I'm a firm believer of using holistic remedies where ever possible but I think Bella's just a little more damaged. None of the natural supplements or relaxants worked for us. We have had to be diligent with her dosages but the results have, finally, been amazing.

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