when to use behavioral medications?

[megan]

At what point would you consider the use of medications, like fluoxetine or alprazolam, for a dog that is fear-reactive and/or aggressive? I have found there to be much controversy about the use of medication in the rescue community, and I'm curious about other people's thoughts.

To me, the point of using a medication is to reduce
a dog's anxiety level enough that they are under threshold and capable
of learning things that they couldn't do previously (not on the meds). I believe there are dogs on the very far end of the spectrum that just about anyone who understands behavior would medicate (for instance, a dog that is so petrified that he or she can not control their bowels or urinate uncontrollably when exposed to a trigger that they must constantly be exposed to).

I guess I'm not really looking for opinions on extreme situations, so much as what what to do when in a situation that's not very clear cut....? Say you have a dog that is relatively normal with it's own family and a handful of familiar folks. The dog has learned a number of things and has shown that they can learn in a variety of situations. And in fact, the dog appears normal in many situations, but is highly reactive to various stimuli and no amount of behavior modification has helped them, or b-mod has only helped so much and they hit a plateau? I know some dogs will simply always be management cases, regardless of the use of medication and no matter how much time is spent on b-mod, but at what point do you say, "This is it, we've done everything we can outside of the use of medication, let's try it." I know it's a very individualized situation, specific to the dog, the dog's owner/family, and the dog's environment, and of course consulting a veterinary behaviorist is extremely important, but I'm just sort of curious what everyone thinks and what, if any, experiences you may have had making this type of decision.

[maryellen]

i would do essential oils.. they are natural and have less side effects then drugs.... i used both for a dog i had that was very fearful. the prescribed drugs made her worse. the essential oils brought her down a notch and didnt make her look like a junkie and she didnt have any bad side effects from the essential oils.... the other dog i had i used prozac and it made her worse.. went to essential oils for her to and that made a huge difference...

[maryellen]

Dee here has helped me with oils with honey, and she has also worked with Sedona, but i dont know if that helped sedona you gotta ask dave

holisticbehaviorsolutions.blogspot.com/

[Dave]

I think you are a great candidate for BAT... ahimsadogtraining.com/blog/bat/

Check out this video...

I feel that meds for behavior problems are an absolute LAST resort. A good trainer can help you work through behavior problems, but it does take time. There are no quick fixes. BAT can be a godsend!

[melonie]

I would almost consider medication in Wrinkles situation, if I knew medication actually worked for the issues she has. But it's a last resort and we're pretty much there now.

[RealPitBull]

I'd not hesitate using behavior meds for OCD, sep anx or severe fear/aggression. I think meds in combo with behavior mod are perfectly acceptable although I'd use something like alprazolam as a last recourse due to addictive properties.

~Mary

[seamonkey]

I used prozac for George for separation anxiety in addition to behavioral modification while working in close contact with a behaviorist and his wife, who was a Karen Pryor trainer.

He was on it 6 months, then we tapered him off slowly and continued his training.

This was about 2 years ago and we only had a brief flare up with the separation anxiety when my Akita passed away

[michele5611]

I am not opposed to using behavior meds provided the dog in question is healthy.

Alprazolam (Xanax) is better suited for something like a thunderstorm anxiety or vet trip anxiety as opposed to long term usage.

[megan]

Thanks everyone for your input. Appreciate it.

The thing is, I have used medications for 2 foster dogs, one previously and my current boy Louie.

The first dog was Sonny, a Pit Bull Mix who came to use beyond terrified of everything. He spent a month living in a closet in the quietest room in my house. He was in a constant state of fear and nothing OTC / natural worked. Putting him on Prozac was the only thing that helped, and he really, truly blossomed on it. He went from too afraid to interact, look at people and sniff people, and who would defecate when he heard a man's voice, or any noise on a walk, to a happy, friendly dog who needed slow introductions to patient people because he spooked easily. I mean, after 2-3 weeks on the medication and some bx work, I came home and he was in his crate, holding his kong in his mouth, wiggling his butt, he had shredded his bed, and he was making woo-woo noises at me because he was so excited to come out of his crate and greet me. He was a totally different dog.

Louie came to be more indifferent than anything else, but very soon his fear escalated to running away when he saw us (in the house) while defecating and urinating. He started having what I can only describe as panic attacks, where he would actually wind up injuring himself. And he urinates, defecates, and vomits in the car. We put him on Prozac and we use Xanax situationally, for vet visits, nail trims or grooming, and car rides. Just recently we upped his medication because he started to spiral downwards a bit, and although I don't expect him to ever be a "normal" dog, he has become a bit more curious. He comes out and watches from afar when I'm prepping meals. He is spending more time sniffing than frozen and staring. And I have caught him laying down in the middle of the living room when no one is around. It doesn't seem like much, but for a dog who spent 5+ years of his life avoiding people because people mean bad things are going to happen, I'd say that's progress.

These two dogs were, for me, without question, candidates for some sort of pharmacological intervention. Granted, if medication made either of them worse, we would have ceased it. But the difference with Sonny was almost night and day. And Louie, well, without it, he would still be running around my house urinating and defecating everywhere.

Lately I've been considering medication with Roxy. We have tried a lot of OTC stuff with no success. She is an overall anxious or nervous dog. She is a "normal" dog when home with myself and my boyfriend, and has begun to display "normal" behavior with certain trusted people. But over the past few months her reactivity has begun to escalate. There have been huge milestones, as well, but there are definitely some behaviors that are escalating. There have been no changes, her blood work is normal (thyroid included) and is otherwise healthy. But we have hit this plateau with her fearfulness and it's at a point now where she's backsliding despite continued behavior modification (that includes traditional D/CC and BAT). She is extremely hyper-vigilant, and that is part of her problem... she is always on the lookout for "danger" and finds it in everything. She's begun to startle at things that didn't used to phase her (ears have been checked, no infections or hearing loss, etc.) and things she previously was curious about she is having a very hard time exploring things she previously was able to confidently explore. And, she is struggling with changes in her environment (i.e. a trash can misplaced on a walk) where she previously did not struggle. I'm at a point now where I am considering exploring adding Prozac to see if it helps her find some relief. The struggle for me is that she can appear SO normal in many environments. She doesn't have a poor quality of life overall. With Sonny and Louie, it was a very simply decision to medicate because neither had any sort of quality of life. Roxy is not there, and I doubt she will ever have such a poor quality of life as them in the sense that she loves her immediate family and is more than comfortable with us. I guess I'm struggling because it's actually been an easy decision for me in the past and her situation is not that black and white. Part of me wonders if maybe I'm expecting more from her than is possible, but there is a big part of me wondering if I can make her quality of life better and I'm just prolonging it because I am so conflicted.

[michele5611]

Megan you can always try the Prozac and see if you notice a significant difference in her behavior and go from there.

[suziriot]

We used Xanax with Dharma for fireworks and thunderstorms, in combination with the Thundershirt and behavior modification working with a Karen Pryor certified trainer. Anything that sounded like gunshots, fireworks, etc and she would have a major freak out. Running into walls, banging around in or out of her crate, even redirecting onto another dog. It took a couple years, but she has drastically improved. I remember the first thunderstorm that she completely ignored. I actually teared up, I was so proud of her! She doesn't notice a thing during thunderstorms now. We still have to use the Xanax around July 4th because it's just too overwhelming for her.

[megan]

That's sort of what I was thinking, Michele, talk to the vet and try the Prozac to see if it gets us anywhere. More than anything, I just want to be sure I'm doing everything possible to ensure she's as happy as she's able to be. I figured worse case scenario, the meds do nothing and we are in the same situation as we are now.

[michele5611]

^ I think that is the way to go. You really won't know unless you try it and like you said if the meds don't do anything or not enough to warrant you to keep her on it then you can stop.

[michele5611]

Just be sure to give it ample time to "work."

[megan]

Oh most definitely... I know it takes a while to build up in their systems. My vet has said that most of the time, its roughly 6-8 weeks to see a difference. I saw changes in Sonny and Louie much sooner, but they were subtle changes for the most part. Granted, I tend to log a lot of their behaviors when I'm considering medication so I have "data" to compare, so my vet said I'd possibly see smaller changes sooner since I was such a geek about it.... Lol. But even with the subtle changes, I saw pretty significant changes at or around the 2 month mark in both of them so I know not to expect big things too early.

[RealPitBull]

Just wanted to chime in that I agree with Michele and think trying Prozac out to see if it makes a difference is well worth it. If not, just discontinue it! This way, no matter the results, you won't be wondering/struggling anymore. You'll know you tried it and it either worked or maybe you need to move onto something else if not.

[megan]

Thanks for the input. I really do appreciate it. I'm going to discuss with my vet and see where we go. I think, at this point, it's worth a shot to see if helps alleviate any of her anxiety.

[michele5611]

Like Mary said at least you will have tried and if it doesn't work go from there. The worst is being on the fence. If you commit to trying it out if it works great and if it doesn't then at least you gave it a shot.

I used Clomicalm when I first got Harley many years ago. Harley's sep. anxiety has worsened over the years and we recently tried Alprazolam. I struggled with giving it to her or not because of her health. In the end we did try it and unfortunately it did not work but at least I know I tried.

[pitbullmamaliz]

Late to the party, but here's my 2 cents! I think people put off behavioral medication for TOO long in most cases. We all want it only as a last resort, but think of the dogs - do you think they're comfortable living in anxiety? I started Inara on Prozac back in like 2008, at the suggestion of Brenda Aloff. Kept her on for almost a year and then weaned her off. Tried to keep her off, but it didn't work. She's been on it for several years now, and it's great. She's always been mellow in the house, but out in public she'd be a beast. The Prozac took JUST enough of the edge off that she was still totally herself, still a pain in the ass, but a pain in the ass who was capable of using her brain. Without it, she wouldn't be where she is now.

That being said, I'm in the process of trying to wean her from the Prozac onto l-theanine. So far so good, but we'll see. I won't hesitate to continue her Prozac for life if that's what she needs.

[megan]

Appreciate your insight Liz. That's a lot of how Roxy is, when we're out in public she just can't use her brain. The only place, outside of home, that she can use her brain is at agility class but that's after repeated positive experiences where there are very few stressors present because our classes and trials are for reactive dogs. Things had started to get better, which is why I hadn't considered the medication before, but the more I think about it.... it's time to try and see how she does. Her general anxiety has gotten worse and I think I'm only doing her a disservice if I wait any longer.