Category: Veterinarian

Mar 24 2010

Woof Wednesday With Dr. Lorie Huston: Behavioral Medications in Dogs

Depressed looking dog on a couch.While many veterinarians, behaviorists, and trainers are familiar with using medication to treat behavioral problems in dogs, it is still something that many dog lovers are suspicious about. I have met many people who feel that using behavioral medications on dogs is unwarranted. Some feel that using medications like this is a cop out; that you are merely drugging a dog in order to avoid putting in the training necessary to deal with problem behaviors. Others feel that the veterinary & drug industries are just padding their coffers at the owners and the dogs expense. And as always there is still a stigma, even in humans about using medication for behavior issues.

Our guest this week is Dr. Lorie Huston. Dr. Huston has more than 20 years experience as a veterinarian and is well versed in the field of behavioral medications in dogs. She agreed to address some of the myths and facts surrounding behavioral medications in dogs.

DLD: What are some of the behavioral issues that medications can address?

Dr. Huston:
Dogs suffer from separation anxiety, noise phobias (such as fear of thunderstorms or fireworks) and compulsive disorders of many different types. Many dogs with these types of disorders become destructive and can even create health hazards for themselves. Unfortunately, the household destruction that frequently accompanies separation anxiety and other behavioral disorders is one of the most common reasons dogs are surrendered to shelters, abandoned or euthanized outright.

The most commonly used behavioral medications, Reconcile and Clomicalm, are approved (by the FDA) for use in canine separation anxiety. However, in real world practice, they are also used for a variety of other behavioral issues, such as aggression, phobias and compulsive disorders. It is worth noting that while use of these medications to treat separation anxiety, phobias and other compulsive disorders is widely accepted their use in cases of aggression remains more controversial because of the dangers that some of our more aggressive dogs can pose to human safety. While I'm not suggesting that these aggressive dogs be abandoned or "written off", at the same time, threats to human safety are serious matters and must be properly addressed.

DLD: Aren’t these medications just a cop out? A way to say I don’t want to deal with my dog so I will just drug it?

Dr. Huston: No, these medications, if used appropriately, are far from being a "cop out". They are a means of providing relief for your dog's anxieties and making your dog more receptive to learning new life skills to replace the undesirable habits/traits. However, these drugs should never be used as a sole means of dealing with a behavioral problem. This type of usage is inappropriate and certainly could be called a "cop out". They should always be used together with a behavior modification training program designed to teach your dog to behave in an appropriate fashion to challenges in his/her life or environment. These types of behavioral modification programs require a great deal of commitment, time and effort and are definitely not a "cop out".

DLD: Are these medications the same as the ones used in humans, or are the developed specifically for dogs?

Dr. Huston: These medications are the same as those used in people. Reconcile (fluoxetine) is the same as Prozac. Clomicalm (clomipramine) is the same medication as Clopram, Clopress, Anafranil. However, these medications have been packaged in dosage sizes that are easily dosed for canine use. They are also being used in feline behavioral medicine.

Because Reconcile and Clomicalm take time to build up a blood level that is effective in relieving anxiety, other medications may be used as "rescue drugs" in situations requiring rapid anxiolytic (anxiety-reducing) effects. These medications would include drugs such as alprazolam (aka Xanax) and diazepam (aka Valium).

One medication that was commonly used in the past as a sedative but is no longer recommended in situations where anxiolytic effects are required is acepromazine. Acepromazine will sedate a dog nicely but will not calm the dog at the same time and may actually make the dog's condition worse because the dog will still be frightened but unable to react to the frightening stimuli.

DLD: When should an owner consider approaching their veterinarian about behavioral issues?

Dr. Huston: If anxiety or other behavioral disorders are affecting the quality of your dog's life or interfering with the human-animal bond between you and your dog, it is time to talk to your veterinarian about behavior modification and possibly about behavior modification drugs. Behavior modification can be accomplished in the absence of drugs as well. But for some dogs, the drugs will speed the rehabilitation by making the learning process easier for them.

DLD: Are these behavioral issues dealt with simply through medication, or are there other components?

Dr. Huston: Behavior modification training is always an essential part of using these drugs. These behavior modification training techniques take time and effort to teach. If you are unable or unwilling to pursue behavior modification training, behavior modification drugs are not appropriate.

DLD: Will using these medications require more trips to the vets office?

Dr. Huston: Your dog will need to be seen periodically for examinations and possibly even blood testing to make certain the medications are not affecting your dog in an unforeseen or undesirable way. In addition, your veterinarian will probably also need to discuss your training progress and how your dog is doing overall while on these medications. The frequency of visits will vary from one situation to another though. You should consult your veterinarian regarding how often your dog will need to be seen and/or examined

DLD: Once on a dog is on behavioral meds, is he/she on them for life?

Dr. Huston: No, the idea is to teach your dog new behaviors while receiving these medications. Once these behaviors are learned and have successfully replaced the undesirable behaviors on a regular basis, the medications are generally discontinued. It is a good idea when discontinuing medications like Reconcile and Clomicalm to gradually taper the medications rather than stopping them abruptly.

DLD: Do I need to take my dog to a specialist, or is this something all vets are familiar with?

Dr. Huston: Some veterinarians are comfortable dealing with these drugs and others are not and may refer you to a veterinary behavioral specialist. In some cases, your veterinarian may feel comfortable prescribing the medications for you but may ask you to work with a dog trainer who is experienced in behavioral modification techniques simultaneously. In almost all cases, behavioral modification training should be a positive reward-based system free of any confrontational or punitive training methods.

DLD: How can I find out more about these medications and the behavioral issues they are used for?

Dr. Huston: I have written several articles that may be helpful. Fluoxetine for Dogs, Clomipramine in Dogs, Dogs Who are Scared of Thunderstorms, Positive Reinforcement Dog Training, Separation Anxiety and Your Dog, Training Methods for Canine Seperation Anxiety.

In addition, Reconcile's website (http://www.reconcile.com/default.aspx) also has some helpful information relative to the medication itself and their recommended behavior modification training program for separation anxiety. Clomicalm also has a website (http://www.clomicalm.novartis.us/index.htm) that provides information about their product. They have a helpful FAQ's page about separation anxiety.

DLD: Why are using these medications so controversial in dogs?
 
Dr. Huston: I'm not sure about the answer to this question. Perhaps it is related to the stigma that is often (wrongly) associated with the use of these medications in people. Unfortunately, people requiring antidepressants or anxiolytic medications are sometimes incorrectly perceived as being "crazy" or "unstable". Perhaps it is related to the fact that many people do not like the idea of medicating or sedating their dog. Still others may not fully understand how and why these drugs are used in dogs. As stated previously, these medications are not appropriate for all pets. Owners electing to use these medications must also commit to extensive training and behavior modification for their dog. Not all pet owners are equal to these challenges. However, these medications can provide an alternative to surrendering a pet with serious behavioral issues and may, in some cases, prove to be a means of saving that dog's life by giving the dog owner options preferable to surrender or abandonment.

Dr. Lorie Huston is a veterinarian with over 20 years experience and is the author of the popular blog The Pet Health Care Gazette.

We welcome your comments and suggestions on this article. If you have other good resources of information on behavioral medications in dogs, please share them with us here.

Cheers

 

5 comments - Posted by Kevin Myers at 12:00 AM - Categories: Behavior | Behavioral Medication in Dogs | Health | Shy Dogs | Training | Veterinarian | Woof Wednesday

Mar 20 2010

Week In Review, March 14, 2010

This past week our Woof Wednesday guest was Rod Burkert of GoPetFriendly.com. Rod and his family are on the road travelling in their new GoPetFriendly Winnebago, and you can keep up with their adventures on the GoPetFriendly Blog. This week’s Woof Wednesday guest will be Lorie Huston DVM, a veterinarian for over 20 years and the author of The Pet Health Care Gazette; Lorie and I will be discussing behavioral medications in dogs. Guests in the upcoming weeks include Sarah Kalnajs of Blue Dog Training and Behavior and Peta Clarke of Animal Training Solutions.

A point of emphasis that I always try to make when talking about the behavior of dogs is that it is our responsibility to communicate clearly with them, to train them in the behaviors we want them to display. Kelly Gorman Dunbar wrote an excellent article about this recently on Dog Star Daily entitled Change Your Perspective and Train Your Dog.

Although I worry about over anthropomorphizing when it comes to dogs, the article The Ethical Dog appearing in Scientific American Mind has some interesting observations about how dogs keep it fair when it comes to play.

And finally, Debunking the Dominance Myth by Carmen Buitrago (provided by our friend Angela Adams of Fun4Fido) deals with the continuing fallacy of laying the blame for all dog behaviors at the doorstep of dominance.

Have a great weekend and we’ll talk soon.

Cheers

Kevin, Jackie, Gavin, Annie, Tosha, Elbee

0 comments - Posted by Kevin Myers at 8:49 PM - Categories: Behavior | Dogs | Dominance in Dogs | Health | Training | Veterinarian | Woof Wednesday

Mar 4 2010

Book Review: Am I Boring My Dog? By Edie Jarolim

Worry is part of the human condition, and it is something we seem to excel at. When we are put into unfamiliar situations and feel out of our depth, it's amazing the questions that can wander through our minds. Enter Edit Jarolim, her significant canine other, Frankie, and their wonderful book, "Am I Boring My Dog? (And 99 Other Things Your Dog Wishes You Knew)."

Written mostly for those considering adding a dog to their house and new dog owners, even veteran dog owners like me can pick up tidbits from this book. Covering 100 questions, from irreverent ones like "How should I refer to my relationship with my dog?" (I had no idea what a SCO was), to serious ones like "How much - and how often - should I feed my dog?" (A question I'm sure your dog has interest in), Edie's congenial style and sharp wit make this a fun and informative read. Chock full of great resources and some pretty clever insights, make sure to pay attention to the footnotes, they alone are worth the price of admission. So if you've ever wondered if you're dog will hate you if you dress him up, this is the book for you.
 
Edie has a terrific blog that can be found at http://www.willmydoghateme.com and you can find out more about her at http://www.ediejarolim.com.  She can also be found on tweeting away at http://www.twitter.com/willmydoghateme.

0 comments - Posted by Kevin Myers at 9:22 PM - Categories: Adoption | Advocacy | Dogs | Health | Humor | Nutrition | Rescue | Spay & Neuter | Training | Treats | Veterinarian

Mar 3 2010

Woof Wednesday With Dr. Krista Gibson

Dr. Krista Gibson DVM and her dog BaloneyIn the old days, before every car had computers inside, when something went wrong with our cars we had to try and explain the symptoms our car was displaying to a mechanic. Success in getting a quick and accurate diagnosis could rely heavily on your ability to speak in terms your mechanic could understand. Trying to produce the same noise your car did may have produced success at times and a good laugh for your mechanic at others.

Anytime we try and communicate for our dogs, we face the same challenges. Our dogs can’t speak for themselves so they rely on us to do so for them. We have to use our powers of observation about our dog and their behaviors so we can effectively communicate these to the veterinarian. Sometimes this is easier said than done.

My guest this week is veterinarian Dr. Krista Gibson of Animal Medical Services in Scottsdale, AZ. Krista has kindly agreed to answer some question I have about being an effective communicator for our dogs. Here is what she had to say.

DLD: What observations and information should I be able to provide my vet with? What information is overkill?

Dr. Gibson: This is a great question!  It probably seems obvious to you as a pet owner that something is wrong with your pet, but to us who don’t live day to day with them, sometimes vague or subtle issues are less apparent.

First and foremost, it’s helpful to have what we call a “presenting complaint.”  This is really just, in one word or sentence, what is your main problem/concern?  Some examples might be vomiting, diarrhea, lethargic, painful getting up and down, can’t go upstairs anymore, ears are bothering him, can’t chase the Frisbee as long as he used to, won’t eat his favorite food anymore and so on.  Short, simple, and to the point, this helps us with a place to start gathering more information.

Next, and this is especially true if you’re unsure of exactly what the problem may be, knowing your pet’s habits and how they’ve changed can be invaluable to us.  When did you first notice the problem? Has it gotten better/worse or stayed the same?  How much do they eat, drink, urinate and pass stools normally vs. now?  Are any of those increased or decreased?  Changed in character?  What is your pet’s activity levels now vs. normally?  If the presenting problem is pain, when do they seem most painful?  Are there certain activities that are more/less difficult?  Times of day they are more/less comfortable?  If they are vomiting or having diarrhea, what have they eaten over the last few days?  Anything they aren’t supposed to eat/drink? Have you been anywhere unusual?  What time of day does the vomiting/diarrhea happen?  When does it happen relative to eating, if they’re eating at all?  Have you noticed any subtle changes in your pet such as coat or breath changes, unintended weight changes, personality changes, or different sleeping habits?

One frustrating thing we veterinarians hear is, “Fido’s just not himself.”  That doesn’t tell us much, and people will sometimes feel like we’re interrogating them as we pepper them with questions trying to get a better handle on exactly what the problem may be. That doesn’t mean that we expect you as pet owners to know the ins and outs of every medical issue you might be facing and to show up with a diagnosis in hand (in fact, that’s a whole different frustration!), but since our pets can’t tell us what’s wrong, it’s up to us to put on our detective hats and figure it out.  The more specific information you can give us, the better we can be at finding the solution, and if we need to ask what seems like a ton of unrelated questions to better understand the problem, please be patient with us!  I promise we’re trying to help!

Last, if you’ve been to another vet and have any lab test results or other testing done, if you can, bring that along, too.  Some people are worried about asking for copies of test results or records to take for a second opinion, and that’s understandable.  Just let us know ahead of time where you’ve been, and we can usually get copies ourselves directly from the other veterinarian.  We’re all used to it, and we are happy to do it for you.  The most helpful thing here is to tell us BEFORE you come in so we have ample time to gather what we need. 

DLD: I like to use the internet to try and educate myself about potential health problems my dog may have; does this help or hurt the communication process?

Dr. Gibson: Ah, yes, the most dreaded words in many professions these days, I think: “So, doc, I’ve been doing some reading on the internet and…”  They strike fear in the hearts of many a veterinarian.

Seriously, though, the internet does have a ton of great information out there.  Places like your site and many others are doing a good job of helping to educate people with accurate, verified and useful information.  There are also tons of awful websites spreading rumors, unsupported opinions and just plain incorrect information. So, how does an inquisitive pet owner tell the difference?  I don’t have a great answer for that, but I do have a few websites that I trust to be reliable and accurate.  This is the electronic age, and we know it.  Most vets will have a list of places they recommend for reliable, accurate, and helpful information.  You should be able to ask your vet and get a handful of possible sources from which you can start your own research. If I were to list a few I would reccomend the following:

1. http://www.PetDocsOnCall.com - For full disclosure, I participate here, but I don't get paid - it's a forum site for asking veterinary questions.
2. http://www.veterinarypartner.com
3. http://www.healthypet.com - The website for the American Animal Hospital Association
4. http://www.petmd.com/health-library - Really comprehensive library of pet diseases and problems, the info is good but it's heavy on ads.

DLD: What should I do if I disagree with my vet?

Dr. Gibson: That’s another great question!  We veterinarians are still human beings, and we do have feelings, and much as I hate to admit it, sometimes we don’t handle our knowledge or expertise being questioned well. 

That said, good communication will always go a long ways.  If you think perhaps your veterinarian either didn’t clearly understand your issue or even that they may have missed it completely, before you get angry and go somewhere else, try having an open and frank talk with him/her about your concerns.  It’s uncomfortable for everyone, and sometimes it will go better than others, but we can’t try to do things differently or reassess our workup if we don’t know what the problem is. 

My own experience is that when someone is upset with me (yes, in 15 years it has happened once or twice!), it’s usually because either a: I didn’t fully understand their problem and the client was frustrated that I was, in their mind looking in the wrong place, either from lack of listening carefully on my part or from unclear communication on theirs, b: I didn’t fully explain what the diagnosis, treatment plan, risks, likely outcomes and reasonable expectations are and the client had unrealistic expectations because of it, or c: they are angry about a bill, probably because they were unprepared for it.  All of these situations can be resolved with good communication on my part, but also from the client.  If you have questions, don’t be shy, ask!  We can’t answer them if we don’t hear them!

I think it’s important to remember that most of us genuinely just want your pet to be healthy and happy, and we want you to be happy as well.  But, we aren’t mind readers and we don’t have crystal balls.  We don’t necessarily know or understand your values, financial situation or relationship with your pet, and this can often be a source of friction between pet owners/caretakers and veterinarians. If your vet either won’t or can’t take the time to listen to your concerns, and address them to your satisfaction, it may be time to find another vet.

Dr. Krista Gibson is the owner of Animal Medical Services in Scottsdale AZ. She is pictured above with her significant canine other Baloney. For more information about Dr. Gibson you can visit her website at http://amsscottsdale.com. Her Facebook page can be found at http://www.facebook.com/pages/Scottsdale-AZ/Animal-Medical-Services-Scottsdale/124795468856?ref=nf&v=wall - you can also find her on Twitter at http://twitter.com/Scottsdale_Vet

Ultimately, both vets and owners have the best interest of the dog in mind. Better communication between the two means healthier, happier dogs. We invite you to share your comments and suggestions about effective communications between owners and vets.

Cheers

Kevin, Jackie, Gavin, Annie, Tosha, Elbee

1 comments - Posted by Kevin Myers at 12:00 AM - Categories: Advocacy | Health | Veterinarian | Woof Wednesday

Mar 1 2010

Upselling at the Vet's Office

Little Boy Lost ElbeeAs many of you know I had a stray show up at my door on Saturday afternoon in dire need of some food and attention. Elbee, as we are calling him for now, seems to be doing better. I took him to the vets office this morning and apart from some general concerns about his weight (he is 19lbs and probably should be around 30), some minor skin issues, and some parasites, he is in good shape all things considered.

As I stated before, we will hang on to Elbee for a while and get him back on his feet. He is a sweet boy and although I won’t rule out our keeping him, I wasn’t looking to add a fourth dog to the family. But my post today isn’t about Elbee specifically, but about the subject of upselling at the vet’s office.  

If you have ever shopped at all then you have been the target of upselling. When the drive through attendant at the fast food restaurant asks you if “you want an apple pie with that?” that’s upselling. When a waitress asks you if you’ve “saved room for dessert”, that’s upselling. In fact anytime someone suggests or reminds you about other products or services they offer, other than the ones you have specifically asked for, that’s upselling.

Now mind you I understand that businesses need to upsell and I regard it as a legitimate business practice, indeed, it is probably a necessity. However there are places and situations that beg for a bit of decorum, and where I think upselling is inappropriate.

When I showed up at the vet’s office today with Elbee in tow, It was very obvious why I was there. Elbee is extremely emaciated and is obviously a stray or abandoned dog. When I was ushered into the exam room the vet tech did ask why I was there and took what history I knew of Elbee. But before even seeing the vet and coming to a diagnosis of what problems Elbee might have, the vet tech was trying to get me to buy a full series of vaccinations and other services offered by the vet. Now as I’ve said above I recognize that the upsell is a legitimate practice, but at least take my order before asking me if I want an apple pie.

Sadly in my area, this is not an uncommon practice at the vet’s office. And although most aren’t quite as blatant and obnoxious as this was, most all of them could benefit by being a bit more delicate and tactful about the process.

So tell us what you think. How is upselling handled by your vet? Do you think that upselling is legitimate practice for vets to increase their revenue? What is your experience with this?

My Woof Wednesday guest this week will be Veterinarian Krista Gibson (Scottsdale_Vet on Twitter) of Animal Medical Services in Scottsdale Arizona. http://amsscottsdale.com. We will be discussing ways to better communication between owner and vet.

Cheers

Kevin, Jackie, Elbee, Gavin, Annie, Tosha

 

8 comments - Posted by Kevin Myers at 2:51 PM - Categories: Adoption | Advocacy | Health | Rescue | Veterinarian | Woof Wednesday