Thresholds and medications, oh my!

Some recent comments and conversations have questioned why we went the route of medication with Bella.

We've had Bella for a little over 4 years now and during that time we've become all too familiar with the the language of fearful dogs. But before I had a scared-y dog, I didn't even know there were such creatures - never mind that they had their own language.

As a result, I tend to find myself writing from my current place of reference. And I can forget that some of my readers may not be familiar with the terms one learns when living with fearful dogs. Most are likely living with nice, normal dogs at home.

So here's a word I throw around like everyone knows what it is: threshold.

What is a 'threshold' when we're talking about scared-y dogs? Threshold is the point at which a scared-y dog becomes scared.

Why does it matter?

Because you can't train a dog until you can get their attention. And you can't get their attention if they are over threshold - when a dog is past the point where they are so afraid for their own safety that they can't focus on letting you teach them better coping skills.

The goal then is to approach every situation so that the dog remains within their comfort zone, not pushed past it. Keep them at a place where they are still able to concentrate, they'll still take a treat, they're still able to hear you and focus on you.

I've been in situations with Bella where I know none of that is possible. She does not hear me. She does not see me. She won't take a treat from my hand if I stuff it in her mouth. She is in a zone that I cannot penetrate.

That's over threshold.

The reason I'm bringing this up now is that, as we worked with Dr. Dodman and Bella's medications, we began to realize that Bella had never really been under threshold. Pretty much ever.

She lived her life in such a constant state of fear, hyper-awareness and hyper-vigilance that she could be resting on the couch but a pine cone dropping on the roof would send her skittering for safety. I couldn't get her to come back. I couldn't get her attention. I couldn't get her to stop running out of the room.

In her own home.

Her reactions to people were much the same. No one has been able to pet Bella except me, Jan and my mother. No one. In 4 years. Not her trainers, not her vets, not our neighbors whose dog she played with every day.

Because when Bella is that close to people, she is so far over threshold that we can't even teach her to 'say hi'. And if we can't get her under threshold when she is in the presence of other people, we can't teach her that people are not something to be feared.

So the answer to why we chose to use medication on Bella is to help her to get below threshold, at least for ordinary, every day living. It gives us the opportunity to teach her, to reach her and develop appropriate reactions to non-threatening situations. We still have to work to keep her under threshold during scary events such as meeting people and other dogs. The medication isn't a substitute for hard work, it's an aid.

---

When we embarked on the journey of medicating Bella it wasn't without thought. It wasn't without trying every other avenue available to us first. The use of prescription medications was an informed, considered decision. We hoped that the potential side effects were worth the risk and would avert our other, less favorable, options.

This post may be borne from a place of defensiveness and I apologize for that. If you don't know Bella's entire story, it'd be easy to think we bypassed the more holistic steps that could have helped heal her wounds and jumped right to the part that makes our life easier. I assure you, we didn't.

As amateur gardeners and cooks, Jan and I try to live in harmony with the earth and maintain a holistic life-style. We believe it is always best to try the least invasive, least damaging, least dangerous approach to resolving any challenge. If we all did that, our earth and our health would be better for it. But sometimes, you have to draw a line over what could be lost if you don't put up your best fight.

Bella is not merely a somewhat nervous dog. She's not just a difficult dog that we use medication on in order to make our life with her easier. She is a dog who can be aggressive in her fear and we don't want to lose her as a result. Her life is what we are fighting for.

Black & White Sunday: It doesn't happen often...

Enjoy the spectacle while it lasts - Bella sits still for a picture!

WW 66 - Happy (Almost) Thanksgiving

What's that you say, Mom?
It's almost Thanksgiving Day?

Well then - Happy Thanksgiving Day to all our friends and family!

You're gonna leave me a bite of that, right?

Whether you are celebrating here in the States or just having another ordinary day, we hope this day finds you happy and surrounded by love.

Happy Thanksgiving, everyone!

---

What have we done?

"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...

We had been warned, we had thought this through, we'd talked about "revealing" her "true" personality. But this wasn't it. Everything I knew and trusted inside me said this was wrong.

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.

Black & White Sunday: A little intense...