The obsessive-compulsive collie that licks deep wounds into her forelimbs. The obese, food-obsessed chocolate Lab unable to relax in the presence of any potential meal. The dominant aggressive Maltese cross that rules her family’s roost with snarls and lunges. The severely thunderstorm-phobic GSD who impales herself on windows as she tries to escape her home’s confines during a storm. And the separation anxiety case that bloodies herself on her crate and once chewed through the upholstery of her mom’s Mercedes when she stopped for coffee.
What do they all have in common? They are my patients. And they all improved dramatically on Prozac (now marketed by Lilly in the canine-approved chewable, “Reconcile”).
While you may not have expected an impassioned defense of this drug’s use on this site, you’ll be treated to one all the same. I proudly use Prozac in my practice and I believe it makes a huge difference to my patients’ comfort and the quality of my clients’ relationship with their pets.
I know that many of you are trainers, advocates for minimal drug use and/or defenders of behavior modification as the mainstay of treatment for the vast majority of behavior-related issues. Rest assured, I still belong to your camp (though after this post perhaps you’ll no longer have me).
Let me be clear: Pets with moderate to severe behavior problems deserve behavior consultations, trainers, training, and smart behavior modification protocols. But they also deserve drugs if they promise to help—especially at the beginning of their treatment when their anxiety level is highest and their parents need the most encouragement.
Considering that the number-one cause of death in pets is behavior-related euthanasia, I’m all for drugs—particularly the effective ones.
We can all bemoan the state of our Prozac nation’s pill-popping road to wellness, but this drug has improved the lives of millions of people—most of whom would likely refrain from telling you they’d been helped by this product. Mental health is a touchy subject, after all, and no one relishes the scorn of their peers for the pharmaceutical “crutch” they might well be ridiculed for. But I’m happy to break the silence on this one.
Like many hard-driven, creative types, I, too, have used Prozac. When post-natal depression set in nine yeas ago, it was instrumental in improving the quality of my life. (And Mr. Cruise can go to hell if he likes on that subject.) So why would I deny my patients the same, especially if it can provide a much-needed sense of well-being during periods of extreme behavioral adjustment?
No, it's not a silver bullet. No, it’s not a drug I’d advocate for lifetime use. No, it’s not a drug I hand out like candy with nary a thought to the root cause of unwanted behaviors. Rather, it’s a welcome addition to a repertoire of thoughtful improvement in the quality of a pet’s life and a well-justified approach for any pet whose family ties are threatened by his behavior.
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I think the best thing about Reconcile is the fact that Lilly is actively advocating the use of behavior modification training along with the use of the drug. The BOND program should show itself to be a big help in lessening the dramatic effects we see with these poor OCD or separation anxiety dogs.
I too don't agree with the "give a pill and it's better mentality", but in this case, concurrent use of Reconcile with the appropriate training should lead to a better life for the pet as well as the owner.
Tomcat1765 November 30th, 2007 10:25:00 AM
Right on Dr Patty. Sometimes its all about chemistry and i think people need to understand that-
cyndi November 30th, 2007 10:29:00 AM
We had a rescued dog who had some pretty bad separation anxiety - our vet prescribed Ellovil (sp?) and it was a godsend. It didn't make the dog dopey or weird, but he wasn't panicked when we left the house anymore and we didn't have to worry about him destroying anything or worse, hurting himself. We were very grateful that our vet was willing to take a medication route for this. After a while he didn't need it anymore because he figured out this was *his* house and we were going to come back - but while he learned that, it made life a lot better for ALL of us.
Cindy November 30th, 2007 11:31:00 AM
Great post! We had a dog (@RB) who was dangerously storm phobic. He would chew through doors or walls if we were away during a storm. Even if we were home it took all of our energy to keep him from damaging our house or himself. The only thing that worked was to sit in the car with him. That was fine if we were around. In Houston storm events can be unpredicatble and we would race home if the weather turned -not in time to avoid him hurting himself and our house.
Our vet, after much begging and showing of reputable articles, prescribed generic xanax. It was a miracle drug. Our dog would remain alert and normal after taking it and storms didn't bother him at all. We only used it as necessary. Without it I think he would have killed himself (biting through a wall into electric wires or going through a window). We tried everything in the behavior mod bag but nothing worked. I suspect that xanax with behavior mods eventually could have ended the storm phobia.
Airedalelover November 30th, 2007 11:40:00 AM
I am a huge fan of medication when necessary and I know that psychotropic meds have made a huge difference in the lives of many humans and animals. Definitely not a silver bullet but when its a chemistry problem no amount of cognitive therapy alone will fix it, imo. Yeah and Mr. Cruise can bite me. :)
Jules November 30th, 2007 12:33:00 PM
Last spring I adopted a senior dog from the shelter. It turned out he was significantly thunderstorm and noise (and clicker) phobic. We put him on clomipramine BID and used xanax for thunderstorms. He still was not exactly at ease during storms, but it made things so much better for him (and for me!). He's now unmedicated for the winter months, but he'll be back on meds come late spring.
katie November 30th, 2007 12:52:00 PM
We didn't use psychotropics on my parents' firework/gunshot/car backfire-phobic dog, but we did end up using a sedative which would calm him and then let him sleep through everything. Every year it seems 4th of July get people going with fireworks earlier and earlier, and the poor guy used to go catatonic, slobbering, panting, digging at the floor, pacing obsessively and trying to squeeze into all kinds of bad places (many of them littered with electrical wiring). Behavior modification was pointless as his brain just seemed to shut off. Knocking him out for a few evenings per year let both him and us get through the season. (There's one upside to a dog going deaf in old age, and it's that he doesn't mind 4th of July or New Year's anymore. :) )
I also had a friend who adopted a dog with such severe separation anxiety that an extended trip to the bathroom on part of the owner would cause the dog to defecate and urinate in the apartment out of stress. Drugs were one of the many tools she used to rehabilitate it. I'm convinced most people are able to use these drugs smartly precisely because of the stigma of using them long-term and without trying to achieve results through behavior modification concurrently.
Agnes November 30th, 2007 06:01:00 PM
I had a storm phobic dog (she rode out a cat2 hurricane in the pasture -- I yelled and yelled for her as long as I could, but the winds grew too strong for me. She came running the next day or so, I can't remember how long it took to clear the roads, but not long because the pasture was close by). She got in the bathtub when she heard thunder. I soon learned to get out of the tub as soon as I heard distant thunder). After a while, she learned to get under a blanket as long as I was under it with her, and she was touching me. If I could do it all over, I'd sedate her for the bad storms, just so she wouldn't be so scared.
I took in a dog who lost both his human parents; he was SO depressed despite back rubs and treats I tried to cheer him up with. I took him to a family member when I had to go away a few days, and he perked right up with him! I guess my family member reminded him of his former owners. We all agreed the poor pooch would stay with who he preferred, so he'd know happy times again. But if we hadn't lucked out and found someone that made that dog happy, I would have given him depression pills. It was heart breaking to see him, especially since everything I did barely made him happy for long. The same person took over a bird that responded that way to him and him only =^)
Sherri November 30th, 2007 10:45:00 PM
I'm curious whether this medication works without the behavior training. The webpage shows some other statistics about its use enhancing behavior training, but doesn't show how behavior training enhances the drug use.
zandperl December 1st, 2007 08:57:00 AM
From the veterinary behaviorists who taught courses at Purdue, my understanding of these drugs with behavior modification is this: a panicked animal cannot learn. Its brain won't let it comprehend new things until it is calm enough to process them. Therefore, they advocate the use of drugs if necessary while the family (or behaviorist) teaches the pet better ways to cope. My thinking is that drugs alone would probably require long-term use (at least, longer than both together) since the animal wouldn't be learning a coping mechanism at the same time.
Sarah December 1st, 2007 04:27:00 PM
zandperl: For severe anxiety and phobia it doesn't seem to work well enough without behavior mod but it can still help. For OCD it seems to work much better, even all by itself. For my severe foot lickers and obsessive compulsive circlers it helps a great deal alone (ain't much behavior mod you can do on some OCD cases anyway).
Dr. Patty Khuly December 2nd, 2007 10:00:00 AM
Don't forget about the role of "anti-depressants" in significantly lowering an aggressive dog's bite threshold.
As a trainer, I normally won't work with a dog who is drugged. They don't project their intentions, and are far more likely to go straight to the bite, and to bite without inhibition. Dogs who have never shown a propensity to bite before, and are being drugged for "separation anxiety" or what I consider normal-range high activity levels (called "hyperactive" by sluggish owners) suddenly start biting without any threat displays. I haven't noticed any real differences among the various drugs in this regard. I have had many new clients call me when "the drugs made her worse!" Most of these dogs have responded well to training after the appropriate weaning from the psych drugs. I'm a fairly expensive trainer, but a lot cheaper than the months of psych drugs.
I can think of only one case in which a vet prescribed the pills and insisted that professional training go with it. (This was a case of general nervous, fearful temperament that was apparent from puppyhood, and the dog did not improve with either drugs or training. She did become an obedience-trained fearful, shy, nervous dog.) Vets up here are selling these pills with a two-minute "counseling" on dog behavior.
I just repossessed a dog I placed as a puppy four years ago, to a home across the state. For over two years, his former owners were dodging my inquiries about him -- I had gotten to the point of assuming he was dead in some accident they were afraid to admit to. Well, almost. After a terrible HBC injury that was never, IMO, properly treated, he started biting strangers -- territorial aggression aggravated by chronic pain and owner incompetence. The owners' vet gave them first Clomicalm and then, when he "got worse," amitriptyline. They continued to dodge me, and never consulted a trainer. (Broke my contract about six different ways.)
But the dog wasn't depressed. He was territorial, untrained, unled, insecure, fearful, isolated, underexercised, and in pain. The last bite, while under the influence of amitriptyline, was uninhibited and caused real injury to the recipient. (Pre-drugging bites had caused minor damage, this one was a doozy.) That's when they called me -- when they were too cowardly to kill their own dog, but smug in their belief that they'd "done everything."
He's doing much better here, with structure, training, leadership, weight loss, body work, and a pack of normal dogs. But he's also the most difficult rehab project I've ever taken on.
I'm not Tom Cruise Crazy. There is a place for psych drugs in human and veterinary medicine. There have been a few cases in which I've sent the client to their vet to discuss them. But that place is not *everywhere.*
Probably half the dogs I see who have been previously "treated" with psych drugs not only had nothing wrong with them organically, but 90% of their problems could have been prevented or addressed by a brisk hour of exercise every morning and five minutes of obedience training a day.
Is that too much to ask?
H Houlahan December 7th, 2007 02:51:00 PM
Add Melatonin to the list of drugs to try for noise phobias. It's non-Rx, widely available in pill and liquid form, and works WONDERS for 4th of July. I had a BC who chewed through a hollow core door during the 4th when the country club just down the street decided to up their budget and their shells were landing in our neighbor's yard.
Tried some Melatonin the next year and while he was aware of the noise, it never progressed to fear and especially not anxiety and an apoplectic fit. I use it prophylatically now during our Western thunder storms that can be almost as exciting and fear inducing as fireworks.
It's a fundamental and natural chemical found in almost all living things, it works, and there's little risk of over dose. A win-win in my book and it's always in my emergency kit.
I use it on my dogs, and I've also had luck with several other people who borrow it at agility competitions, Frisbee competitions, dog shows, etc. where noise sensitive dogs can really become neurotic from the other dog's barking, the echo, etc.
Border Wars - Christopher January 3rd, 2008 08:05:00 PM
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