"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...|
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.