Monday, September 12, 2011

You mean I'm not crazy?

So we had our meeting with the vet behaviorist.  Prior to meeting with her, I completed a ten page questionnaire about Abby's behavioral issues, complete with real life examples of her behavior.  Admittedly I was a bit worried about this appointment for a few reasons.  Perhaps based on some of the judgement we've received, I was worried that the work we've done with Abby would somehow not have been correct or enough.  I know I've spent lots of time working with her on her relaxation and general behavior, and you never want for that investment to be incorrect.  But I was even nervous that I somehow had fostered some of her reactivity.  I take the issues of Abby's behavior very personally, and when analyzing some of the things she does I think on some level you are doing a disservice to your pet if you don't at least consider your behavior and reactions to at least rule out that you aren't fostering some of the behavior you're working to correct. 

In a word the vet behaviorist was phenomenal.  Our trainer was so awesome and met us at the facility to be part of our discussion, and she was also able to inject some of her observations into the conversation, which truly ended up being helpful at several points.  I should tell you that the appointment that we had scheduled for Abby was a two hour consultation.  My first thought was "How the heck am I going to keep her attention for two hours?  She's going to try to bolt out of the room in under 20 minutes."  So I came prepared. 

Over the last few months, we've been doing mat work with Abby.  We have a mat that we use for her to relax on and chill out.  We bring it to class, we bring it to the vet, and we use it anywhere where she could possibly be overwhelmed by what is going on around her.  We gave it a queue - "Places!" - and she knows that she can just relax and hang out on her mat.  I also brought some toys for her to chew on and play with, and plenty of treats. 

So when we met with the behaviorist she brought us downstairs to her office.  Essentially it was a big open basement that was divided in half.  On one side of the room chairs set up in a U-shape for training, and the other half of the room had couches, a rug, and a desk for consultations.  We sat down and I put Abby's mat down, and Abby immediately went down on it.  We spoke for awhile about some of her behaviors and the things I had completed on the form, and the entire time Abby is just chilling.  I thought, "This woman is going to think I am crazy!  Abby is so well behaved and chilling right now that she's going to think I have the dog owner's version of Munchausen Syndrome."  After a little while Abby heard a noise, and then everything I was saying had been confirmed.  Abby was on patrol, hair raised, and we were unable to call her back to the area we were sitting in.  And it didn't just end there.  Once she had the first reaction, it did not take much to prompt further reactions. 

The appointment was just so positive though.  The behaviorist reinforced that Abby's dosage of Clomicalm is considered a light dosage, and she praised us for the work we've done thus far in light of the light dosage.  I felt like I didn't have to defend the choices we've made for Abby or the work we've done because she already understood where we were coming from and communicated her desire to help us. 

What a change! 

So we're going to do a slightly small increase with her Clomicalm, and we're going to work with her on the relaxation protocols and continue the mat work.  We've started working on down stays so that we can try to have Abby not freak out when people come to the house, and I feel like we have a clear direction on where we're heading with Abby's next phase of training. 

In other news, a few weeks ago I had received a call from the vet's office that we bring Abby to for her routine care because I had previously ordered a few cases of the Purina OM but I hadn't picked them up.  While trying to figure out what we were doing for her food, I just figured that I would leave them there because I didn't know if we would possibly use that food in combination with something else.  I explained some of the food issues we've been having and that I was going to wait on picking it up, and the receptionist asked if she could try running Abby's GI issues past one of their other doctors that she has not seen.  I told her that it was OK to do this, but that with all due respect I wasn't necessarily feeling a need to make more appointments or follow ups with nutritionists because at this point they've picked a food that did not work for her on any level, and frankly I can pick foods on my own at this rate through trial and error.  So she said she would try the other doctor's opinion. 

A few days later I got a call from one of the technicians saying the doctor had reviewed everything, and that without doing an intestinal ultrasound it is possible that she could have IBD.  But that he was really recommending that I do a month of Tylosin to kill any bacteria that could be in the intestine.  I told her that I needed to think about it.  I said that without trying to sound defensive or dismissive, I've yet to have anyone be able to explain why Abby would have perfect stools for a period of time, then have diarrhea, then have the loose stools again.  I explained how I felt like on some level that this could possibly be anxiety related, particularly given the timing of the reactivity, and the way in which she seems to be generally anxious as we try to taper off the clomicalm.  We continue to throw tests, medications or diets at Abby under the hopes that they will work, and I never get to the root cause of her issues and again the diarrhea reccurs.  This is when she reiterated that she felt the Merrick food was too fatty and the pancreas and intestine pretty much can't handle it anymore.  I guess I'd buy into that if I hadn't just done the malabsorption tests on the heels of this diarrhea getting kicked off.  Additionally when I bought into the idea of Abby having IBD, my questioning of whether or not it could have an anxiety component to what triggered or aggravated it was dismissed. 

What was interesting to me was that she mentioned that although the Tylosin could work, there was a possibility that Abby could have this happen again even with the Tylosin, and then in which case we'd be back to where we started where we would do another course of treatment. 

Those who have read with any regularity can already guess my answer to this treatment:  No.  A resounding no. 

I'm not sure what I was more astounded by.  Even if I did an ultrasound on Abby to see if she had IBD, what would I learn?  That my dog is prone to diarrhea?  I already know this and I didn't have to spend $1,000 to figure that out or put her through the testing.  Second, what person just gives a month long treatment to their dog without having a test to prove that she needs it?  We wouldn't do this with our children, and I'm certainly not doing this to Abby. 

Throughout her reactivity, anxiety and digestive issues I'm starting to learn that doctors, and in particular veterinarians, are not Gods.  Sure, they're educated people who have spent thousands of dollars earning a degree certifying them to answer the questions and solve the problems we encounter with Abby.  But they don't live with us.  They don't see Abby day-to-day, and they don't know what she struggles with day-to-day.  Abby can't answer questions to tell me how she feels, why she gets nervous, or why her food isn't agreeing with her.  The only voice she has is ours.  The only advocate she has is us.  And these experiences have taught me that I need to remain dilligent in asking questions to insure that she gets adequate care.  Not treatment - care.  There is a fine line between these that I think is often lost. 

With that said, onwards and upwards.  We will continue to search for people committed to Abby's care, who support the decisions we make for her, and who appreciate and trust the total focus we give to helping her.  The camp of people we have in Abby's life who do this only continues to grow.

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