The Road Less Traveled

When we first embarked on our journey with Abby a little over three years ago, I had no idea the things that I would come to learn.  First and foremost, I've learned more about trust from one little yellow dog than I ever could have learned in a lifetime.  Her ability to put total faith in us for everything amazes me.  She trusts that we will always be home, that we will always do what is in her best interest, and that we will never ask more of her than she is capable of.  The ways I've defined bravery and courage have changed in some ways.  As I watch my reactive dog try to live in a world that makes no sense, I'm often humbled by how far she has come since the early weeks of chaotic walks in which every sight and sound seemed to be overwhelming.  And most importantly I've learned about unconditional love.  My husband and I like to believe that people who say dogs don't know emotions have never had an Abby.  Every single thing she does is so fueled by love that you can truly understand why she does the things she does.  

Along the way you learn the basics that apply to most dogs.  You figure out how to potty train a dog, and the proper equipment to use when walking your furry companion.  You learn about the newest toys to stimulate your dog mentally, and exhaust them physically.  You develop a sense for what toys your dog will rip to shreds in under 5 seconds, and which ones she won't play with at all.  

But people with a reactive dog begin to learn a whole new language.  You learn to read your dog's signals.  We've all heard that dogs can communicate with their body language, and those who live in a land of reactivity will find themselves reading the subtle queues of not only their dog, but of all of the dogs you're likely to encounter in your every day activities.  You learn where to walk, what to avoid.  You learn that your dog probably hovers a bit above threshold as compared with most other dogs, and that certain things can cause a reaction where they never effectively return to a calm state but an even more elevated state than before.  And for some of us with reactive dogs, you learn that sometimes you and your dog need a little bit of help.  For most this comes in the form of finding a trainer and confidant who helps to guide you on the adventure of raising a reactive dog.  And for some of us, there is the type of help that comes in the form of a prescription.  

I've never been shy about saying that Abby is on a prescription medication for anxiety.  At first there was some shame in admitting to this, either because most people aren't aware that such a thing exists, or because I felt judged as an owner - as if I was not enough of an awesome pet parent to do things on my own.  Whatever the reason, I think sometimes people have a hard time admitting that maybe your pet needs a little bit of help to allow them to relax enough to be receptive to all of the wonderful things you want to teach them.  That certainly was the case for Abby.  Abby's trip has been a difficult one with stumbling blocks along the way.  But through it all I would not change a single thing about the road we've been on and we're at with her presently.  

And so it is with that that I tell you we are starting a new fork in the road.  Today marked our annual recheck appointment with our vet behaviorist.  It is a time where we all come together to talk about Abby and what she's been up to behaviorally within the past year.  Much like with our own physicals with our physicians, it is also a time to assess the course of treatments we have been doing to see if they're helping or not making any impact.  We have always had discussions over what the medication is doing for Abby and what relief and benefit she receives from it.  However, recent production issues with Novartis have had a direct impact on the availability of her medication, Clomicalm.  For the past year we have been utilizing a compounding service for giving her a twice daily dosage of Clomipramine.  However, even the generic has gone up to such an egregious price that it has left our behaviorist questioning the ability to receive the medication long-term.  

So what does that mean for Abby?  It means that we are slowly going to lower her dosage of the Clomipramine with the end goal that she will be weaned off of it, and then we will begin a new medication that is more widely available with a good success rate, Prozac.  It is a scary thought, the idea of your pet coming down from a medication that had such great success.  But with it comes the opportunity to truly assess your pet's behavior and discover what benefit they're truly receiving from it.  The coming weeks will probably see more blog entries as I attempt to document and assess the changes we may see in Abby's behavior as a result of this change.  But I feel confident in the work that Abby has done and our ability to know our dog and her behavior that we'll be able to monitor the changes we see and work with our behaviorist to tailor this change to her needs.  

Your dog is on what?

In recent weeks I've come to realize that when you have a reactive dog, there is a certain stigma attached to it.  People ask you how your dog is.  And while some people are genuine in their interest in your dog, some people are clearly judgemental. 
I should back up at this point and tell you that Bill and I made an attempt at reducing Abby's clomicalm dosage.  A little over a year ago we put Abby on clomicalm.  It was a choice we didn't take lightly, but one that was the right choice for Abby at the time that we made it.  I cannot begin to tell you how heartbreaking it was to watch her get so anxious about her crate, insuring at least one foot was outside at all times for fear that she might be put in it.  Even just giving her a treat in the crate was clearly stressful for her.  If I put a treat in there for her to find so that only positive things happened for her in that crate, she would hop in and out of that crate at a speed befitting an Olympic Hurdler.  No matter what we did to make her crate positive, it clearly was not at all getting better.  Abby was so amped up to even look at the crate that we wouldn't be able to make it positive.  She clearly couldn't be receptive towards it in any way. 

Clomicalm has been a blessing and a curse all at once.  In combination with relaxation protocols that we work on, it allowed Abby to simply relax near a crate, and inevitably be crated while I am at work.  I would be lying if I didn't say that I tear up a little bit each day that I crate her in the morning because she literally races to the door of her room and looks back at me with a smile.  A year ago I would not have thought that was possible.  But clomicalm isn't without risks, and certainly its toll on the dog's physical health is one. 

However, there is another risk that most people don't realize accompanies the choice to give it to your dog:  judgement.  I cannot begin to describe the looks on people's faces if I do mention that Abby is on a medication for anxiety, or the way in which a vet she has not seen before will ask about the medication.  Some people are subtle about it, but most are not.  It all starts off the same way. 
Is she on any medication?
What is the clomicalm for?
Why clomicalm?
Have you tried (insert any form of accupuncture, vet behaviorist, or other things people have heard are effective)?

Ever since shows like "The Dog Whisperer" and "It's Me or the Dog," suddenly everyone is an expert on dogs.  Intentional or not, people have a way of being unable to ask the above questions without implying that I simply choose not to take my pet's health and psyche seriously and just choose medications as my easy fix.  They do not know the countless hours I have spent over many months doing relaxation protocols with Abby just to get her to lay down, then to drop her chin, kick out a back leg, sigh, etc.  Then to spend these hours once again to do all of this near a crate.  They do not know that Abby has her own iPod that we keep downstairs, that sits docked in the iHome I received as a birthday gift and plays "Through a Dog's Ear" for her all day while she is crated so that she can have some white noise.  And to ask the above questions so succinctly while the answer is not so succinct always leaves me feeling annoyed and judged. 

Clomicalm is not a medication that I necessarily want Abby to be on long term.  If she can be without medication that would be ideal.  But if she can't, I want to make sure that she is on the right medication for her.  Towards the end of June, we asked for instructions to taper off her clomicalm.  Abby was taking a half tablet twice daily, and the instructions given were to do a half tablet daily for two weeks, and then half a tablet every other day for two weeks, then off the medicine entirely.  I opted for a longer tapering off, and figured we would do the half tablet daily for one month before moving to the next level.  However, after only a week it became clear that a half tablet drop was too much too soon.  Suddenly the world seemed a scary place in general for our girl.  She barked at everything.  And while some dogs bark, Abby greeted every creak in the floor, or voice outside as an imminent threat.  She barked at everything in a way that communicated she definitely was freaking out.  Now granted, it wasn't a level of barking like when she was panicked to be in the crate.  But it was clear that she was nervous and anxious about every sound.  Hell, she was nervous about sounds we couldn't even hear!  We tried instead half a tablet in the morning and a quarter tablet at night.  After about a week this still left her amped up and really hadn't helped to improve her outlook either.

So we've now made an appointment with a Vet Behaviorist to discuss Abby and her anxiety.  Part of me worries that Abby is just an anxious dog, and perhaps the crate and separation anxiety was the most obvious display.  The crate anxiety is under control now.  But in combination with Abby's GI issues that kicked off around the time she displayed dog reactivity, and the GI issues she continues facing, I would not be surprised if we were to find that she has some sort of general anxiety disorder that we work on either through new methods of relaxation, or a different medication in a light dosage. 

In other news Abby continues to have issues with soft stools and diarrhea.  We switched her from the Purina OM as I had mentioned in the last post because of the way she was going through food bloat, was lethargic because she was eating too much, and burping up her food because of the volume she was eating.  So far I tried Wellness Simple Solutions in salmon and rice, and the results were rather mixed.  We were mixing it with the Purina OM as we were slowly integrating in the Wellness, and she was doing better.  But with her being on just the Wellness the stools weren't great - sort of a soft service ice cream consistency.  I tried the Natural Balance Bison and Sweet Potato, and that was disastrous.  She had what hubby and I like to call "Poop Soup."  So now we're back on Wellness, and I'm attempting to find a food that will work for her.  Orijen is probably my next one, and perhaps after that Taste of the Wild if I don't find one that works.  I have decided not to enlist the help of the nutritionist at Angell Memorial again because I felt like the food she chose was so grossly NOT the right food for Abby, both in volume and in effectiveness, that I'm not throwing more money her way.  If someone with a degree managed not to pick the right food for Abby, then it communicates to me that they're just going to go by trial and error, and frankly I can do that cheaper on my own. 

So stay tuned for an update once we go to the behaviorist on the 27th of this month!