Lilly’s new behavior modification plan is 26 pages long. On Saturday, I read through the entire thing, and I went back through the initial stages in detail. Then, I emailed a bunch of additional information to our behaviorist, along with a slew of questions. Here is the basic outline of the plan.
The New Drug
She selected clomipramine HCI (also known as Anafranil in human medicine or Clomicalm in veterinary medicine). It’s another tri-cyclic antidepressant. The thought is that since Lilly did well on the amitriptyline for a while, that this one might work better. If you look it up online, most articles say it’s used for separation anxiety and/or obsessive-compulsive behaviors — neither of which Lilly has. BUT, maybe it works for regular anxiety too. For example, this article about a noise phobic dog talks about clomipramine (and the other drugs as well).
There was also a big article about dogs and cats taking such medications in the NY Times Magazine this weekend, but it’s more of a trend piece, so you’ll find arguments for and against it, but not much practical info if, like me, you’re struggling in the reality of trying to counter-condition a very fearful dog.
Anyway, the dosage ramp-up looks like this:
- 20 mg twice a day for 2 weeks (then evaluate for side effects)
- 40 mg twice a day for 2 weeks (then evaluate behavior symptoms)
- 60 mg twice a day for 12 weeks (then evaluate overall response)
As a reference, I’ll add that Lilly weighs about 34-35 pounds.
We should know by weeks 8-12, if it’s going to work or not. If so, then the idea is we’d keep her at the top-most dose for 6-12 months before considering tapering her off. If not, then we’ll add or change medication.
New Measures
My old measure of success was the absence of or recovery from either shutdown or snarky episodes. The rule was if she’ll eat and she’ll do tricks or continue to work in some fashion, then she’s OK. Since I’m no longer allowed to ask Lilly to work through her fears, here are the new measures, along with the absence of barking/growling, for the effectiveness of my work:
- Small pupils
- Blinky eyes
- Deep breaths
- Relaxed body
- Normal posture (not flat, not overly alert)
- The ability to WATCH ME even in tough situations
For a while, it doesn’t matter what she will or won’t do command-wise. It’s all about how she feels, which I will attempt to counter-condition through use of food, along with my own body and voice and breathing.
Things to Avoid (for now)
- Any verbal corrections, if she growls, snaps, whatever
- Commands/tricks (other than sit) through her fear
- Exposure to strange people or dogs
- Any unnecessary cues for behaviors throughout the day (simply ask less of her)
Efforts at Home
I won’t go into it all right now, but I’m to use various strategies to deal with Lilly’s near-constant attention seeking (which I always thought meant she was bored or loved me A LOT, but is indeed anxiety), with her major fear episodes relating coming inside, especially at night, and with her total shutdown hiding once she comes inside (again, especially at night).
This includes sometimes giving her the cold shoulder, up to and including leaving the room and closing the door between us. Honestly, I’m having a hard time with that emotionally, but I’m doing it anyway.
Retraining Protocols
The baseline work begins with our behaviorist’s own version of the Relaxation Protocol, which as it turns out was originally developed by Victoria Voith in 1979. It’s somewhat different from the one from Karen Overall that Lilly and I did for about 45 days last fall. Many of the questions I emailed address these differences so that I can understand not just how but why I’m doing certain things. So, there’s a 10-day protocol at home as baseline work.
In addition, we’ll do a protocol for orienting and giving me attention, which clearly, she’s already good at, but we’ll use it to re-orient if she sees or hears something that might send her into a fit of fear or stress. Again, I have questions into our behaviorist about how this is different from the LEAVE IT, WATCH ME, LOOK AT THAT, we’ve been doing.
So, I’ll work through these Protocols 1A and 1 B at home, then I’ll do these same protocols in public places where I can easily control the distance and exposure to strange people and dogs.
Protocol 2 will deal with other environmental changes that freak Lilly out … like sounds, things flying overhead, things flapping in the wind, etc.
Again, this whole time I’m ONLY working to keep her relaxed.
Then, there are specific Protocols 3A and 3B that deal with exposure to people and to dogs. I’m trying NOT to worry yet about where I’ll find people and dogs to use during this stage.
Theoretically, we could get through all this work in a month, but I’m supposed to work at Lilly’s own pace, so it could be longer.
I know. I mean I realize I’m melodramatic sometimes, but this is A LOT to think about, absorb, and take action upon. Yep. I read the article last week. Apparently, they post things online a couple days before the article is published on paper. There’s a link to it in the entry above … for those who haven’t read it.
Shhheeewww! That’s a lot to absorb, no wonder you’ve been stressed about it. Sounds hopeful, though, like this vet knows her stuff.
Did you read Doolittler’s article about the article in NY Times magazine?