Pongu Off Prozac

After many months of behavioral rehabilitation, I finally took Pongu off Prozac a couple of weeks ago.

Almost 18 months ago, he started on 20 mg/day of Prozac. A few months later, after consulting with several trainers and behaviorists, we upped that dose to 30 mg/day. At the same time we embarked upon the long, slow process of teaching Pongu how to cope with everyday life and handle his anxiety in safer and more productive ways. This took many, many months of very small steps.

We had some setbacks and we had some delays (and I got to learn firsthand about how much fun it is to try regular counter-conditioning protocols with a dog too fearful to accept even the tastiest treats anywhere outside his safe zone), but eventually we reached a point where Pongu could tolerate more noise and chaos than I ever imagined possible, and could even focus well enough to do Rally practice sessions on city sidewalks.

I don't think we would have made it without the medication. I doubt Pongu could have coped with his daily anxieties without Prozac, and I doubt he'd have gotten past his terror of training facilities without Xanax. The medications not only made it possible for him to calm down enough to focus, but enabled him to have fun -- and once he learned that he could have fun while working, the work itself became fun, and that built into a spiral of positive reinforcement that eventually gave him the ability to self-control and self-calm by doing something as simple as a Heel Sit. The familiarity of the exercise, and (I believe) its strong association with feelings of pride and accomplishment, really seem to enable Pongu to mentally regroup and switch from fearful mode to thinking mode.

Once he earned his RL1 with an Award of Excellence -- a goal that I honestly was not sure this fearful little mutt would ever accomplish, since back in the early days all the trainers we'd consulted had cautioned me not to expect Pongu to ever trial in any sport (which, looking back on it with the benefit of what I know now, I believe was mostly hedging against the great uncertainty of owner compliance) -- I decided that it was time to phase out the Prozac. He was doing well enough that I didn't think we needed it anymore, and even though he'd been on it for a long time, I was and still am a little uncomfortable about using behavioral medications longer than strictly necessary.

Besides, there were some slight side effects. The biggest one was that Prozac gave Pongu a dry mouth, which in turn caused his teeth to get dirty a lot faster than Crookytail's did. I was worried that longterm use might compromise his dental health.

So I spent a month weaning him off the medication, dropping his daily dose from 30 mg to 20 mg to 10 to nothing. I noticed no behavioral changes during the period of decreased doses, but 4 or 5 days after he was totally off the medication, his behavior did start to change a little.

Pongu is now quicker to startle at unexpected noises or movements. He seems more vigilant when out on walks. He is noticeably more reactive to strange people and dogs; he'll go into barking/lunging episodes at longer threshold distances and more frequently than when he was on Prozac. It's not such a tremendous change that I feel a need to put him back on the medication, but it's a noticeable change.

He doesn't sleep through the night as soundly; he will wake up and rush to the door barking when the neighbor leaves for work around 6:30, which he didn't do before, and sometimes he wakes up and barks at strange noises outside. He seems more insistent about pushing against me for petting and cuddles (and won't go back to sleep until I pet him a little), which I interpret as linked to anxiety.

However, not all the behavioral changes are bad. Pongu used to be somewhat anorexic -- he'd regularly refuse meals if he was bored with a particular kind of food -- and his appetite seems better since he went off Prozac. His reaction times are faster and he's more responsive during practice sessions (sometimes overly responsive, in fact; I'm having to adjust my cues to compensate). He seems more athletic; he's more energetic during jumpwork sessions and while practicing on stairs. The overall effect seems to be like lifting off a layer of cotton wool that had been muffling certain aspects of his personality, for good and ill.

It seems like we've settled into the new reality, and it's not bad. Pongu can still focus in environments that would previously have overwhelmed him, and he can still trial successfully in APDT Rally. So, for the time being, the plan is to keep him drug-free and see where the new year takes us.

Pongu's Prozac Journal: The Xanax Episode (Day 8)

Yesterday I gave Pongu a Xanax half an hour before his obedience class, because (as noted in the previous post) this was something that another fearful dog owner (who, unlike me, is an actual certified trainer) reported doing with considerable success. So I figured, why not? The Prozac hasn't kicked in yet and the Thundershirt didn't help enough to let Pongu focus at all, so what harm could a Xanax do.

I should probably have dosed him a little earlier because, it turns out, this is how Pongu responds to 20 mg of Xanax:

0-30 minutes: no effect
30-60 minutes: whining, pacing, made a real big poop
60-90 minutes: TOTALLY HIGH. No fear of anything! Everything is fun! Let's play! Let's do obedience exercises! This is GREAT! I know all these tricks! I am so much better than any other dog in this class! Yes I LOVE jumping over stuff! I'm going to jump over everything! Five times! Oh crap my back legs are all wobbly woah what's going on *crash*
90-180 minutes: gradual comedown, legs still wobbly, really interested in sniffing every last blade of grass in the potty patch
180 minutes - rest of night: *snore*

So overall the Xanax was extremely effective in helping Pongu get past his fear and relax and even have fun in class, and I may well use it again, but I am definitely NOT using it anytime he needs to be especially well coordinated. By the end of class he was getting pretty loopy, everyone was all "why's your dog walking weird? are his legs okay?"

Then on the way home he decided that he was going to leap up an entire flight of stairs in a single bound and face-planted straight into the staircase halfway up. After that I made him go up and down the stairs on leash until the Xanax wore off.

I'm hoping the Prozac starts kicking in by next week. It would be real nice to have a dog who can relax in class and also walk a straight line at the same time.

Misc. Updates 9/15/11

Today's news from Mutt Town:

-- Health news: Pepper got spayed yesterday. Came through the surgery like a champ, was a little groggy and slow-moving when she got home that evening (to the point where two tipsy ladies having dinner outside demanded to know why I was mistreating my dog when we walked past, because clearly she was malnourished/abused to be tottering along so slowly... aaah, busybodies, always much improved by alcohol) but appears to be totally recovered energy-wise today. Having to keep her in the crate a lot to prevent her from bouncing around too much and straining her stitches.

I gave her the deworming pills this morning so hopefully we have seen the last of those gross terrible no-good tapeworms.

One thing I've noticed is that Pepper likes to eat immature grass seed heads. I wonder if they help scrape out the worms; I've definitely noticed more tapeworm segments in her poop when there's a lot of grass in the poop. It could be coincidental, though. Will be interested to see if she stops trying to eat grass as much once the worms have gone away.

-- Training progress: Pepper is no longer afraid of stairs and will take them up or down at a trot. She is still a little apprehensive about glass doors but doesn't collapse in front of them anymore; instead she's just careful to make sure that she's not walking facefirst into glass. Can't blame her for that!

Housebreaking is going very smoothly. She no longer insists on going to the Big Weedy Lot but is content to go potty anywhere she can find a reasonably sized patch of grass that other dogs are using. We aren't giving Pepper many opportunities to make mistakes in the house (go crate gooo!!), and so she hasn't made any since Day One.

Pepper now walks politely on leash 90% of the time. She prefers the right side, which I don't mind since I don't insist that the foster dogs heel, and sometimes swerves back and forth to investigate or avoid things that draw her attention. But for less than a week of not-very-intensive work, she's doing phenomenally. No pulling (except occasionally when she wants to greet another dog), very little lagging, with a little more practice she'll be a star.

I haven't done much work with commands yet but I suspect that Pepper will be a very quick study. She's already grasped that "Sit is the correct response when you don't know what to do" and could Down with a lure after one short session. My early impression is that she might just be the smartest foster dog I've ever had -- I'll know better once we can do more intense training sessions. I've been holding off on that for the first few days because she has enough to do just getting settled in, plus I've been uncertain of her potty reliability. But I think we're getting to the point where she can start some proper training.

-- Pongu's Prozac journal: no observable change after one week. Anxiety levels appear to be the same. He did try to chase after a stray cat a couple of nights ago, which was unusually brave of him (normally he's terrified of ANYTHING encountered after dark) and let me finally do a Premack principle exercise (instant off-leash recall --> hooray! we go chase the cat together!), but otherwise his general anxiety and terror of the unfamiliar seem undimmed.

I might try dosing him with a Xanax before obedience class this evening. Debbie Jacobs of Fearful Dogs has written about her use of Xanax to help her fearful dog Sunny through his obedience classes, and it seems like a thing worth trying. On the other hand, I wonder if I shouldn't try it at home first to gauge his reaction. Eh. Decisions, decisions.

Misc. Updates 9/12/11

Miscellaneous updates from the colony of mutt monsters:

-- Pongu's Prozac regimen continues with no apparent effect (not that I'm expecting anything so early). I thought he had a dry nose on Day 2 and some diarrhea on Day 3, but it's impossible to tell whether these issues are related to the Prozac, and in any event they both went away on their own within a day.

-- Pepper has tapeworms. She pooped on the deck again this morning, and as I was scooping it up, I made the awesome discovery of four or five sticky whitish proglottids glommed to the poop, just wiggling merrily away. GROSS.

The tapeworms are slated for destruction on Wednesday morning, when Pepper already had a vet visit scheduled for her spay surgery. I can't wait. In the meantime I have a wormy dog for two days and will accordingly be extra super vigilant in the house training because I cannot stand the idea of those icky ewie barfball worm segments wriggling around in my house.

I'm glad they're not contagious (in the absence of poop-eating fleas or mouse carcasses, anyhow) or I would have to burn my own house down as a precautionary measure. I am kind of tempted to do that anyway.

Tapeworms are the worst. The WORST.

But they will be dead soon, and that is a consoling thought. In the meantime, dogs at play:

Pongu's Prozac Journal, Days 1-3

On Wednesday I put Pongu on 20 mg/day of fluoxetine, better known as Prozac.

This was not a decision I reached lightly. Pongu has always been an anxious dog, but he's much better than he was. In the beginning he'd freeze and pancake on the ground and pee on himself when approached or handled; after a year's worth of structure and training and love, he can walk down a busy city sidewalk without completely losing his mind.

But there's a lot of space between not-completely-losing-your-mind and being comfortable in a situation, and while Pongu may never completely reach the latter goal (I'm not completely comfortable walking down a crowded street, and unlike the mutt monsters, I don't even have to contend with uninvited strangers trying to wave their hands in my face), I feel obligated to help him get as close to it as possible. He's my dog. I owe him the best care and comfort I can give.

And yet there is, and was, a reluctance to accept that an anti-anxiety drug might be that care and comfort. I had to overcome an unwillingness to admit that I couldn't just overcome the problem with sheer strength of will; I had to discard the belief that if only I loved him enough, or trained him better, or taught just the right confidence-building exercises, then my dog could let all his anxieties go.

It doesn't work that way. What finally brought that home to me was going to our first group obedience class and seeing all the other dogs going through the exercises with varying degrees of adeptness... and then seeing Pongu, panting and whining and frozen in fear, totally unable to participate in any of the class curriculum even though he knew all those exercises and could do them all perfectly, joyfully, at home.

It's not about the training. Training helps, but it does not overcome. It's about early socialization and early experiences (or the lack thereof) and who your dog is all the way down in his genes. And if those things afflict him with crippling fear, then in my view you are obligated to treat that as surely as you would a crippled foot*.

In Pongu's case, the problem was so obvious that practically the first thing the trainer asked me after class was "Have you ever considered a behavioral medication?"

Even then, though, I wanted to try other alternatives before resorting to pills. I tried Comfort Zone DAP (dog appeasement pheromone), a synthetic version of the pheromone that mother dogs secrete to calm their puppies. It did nothing. I tried Rescue Remedy, a Bach flower essence that's supposed to have a soothing effect on dogs. It did nothing. I tried the Thundershirt, a snug-fitting anxiety wrap that is said to calm dogs by enveloping them in gentle, constant pressure. That one actually helped a little, but only a very little -- nowhere near what Pongu needed to get over his terror in new environments.

So it was time to bring out the big guns: anti-anxiety meds. Prozac.

My scaredy little mutt has been on it for three days. I put a pill in his dog stew every morning and he gulps it down. I'm told that there will be little or no discernible change until at least two or three weeks into the treatment, but it can be very gradual, so I'm supposed to keep a journal recording any observations in the meantime (that would be what this is).

Even though I've been told not to expect anything for a while, I still find myself monitoring Pongu with paranoid intensity. Does his nose seem a little dryer than usual? He's not making as many turkey growls to greet me when I come home from work -- does that mean his throat's dry too? Is he maybe a little lethargic, or is that just because there's no foster dog for him to jump on right now?

Hard to say. What's not hard to say is that he's still as anxious as ever, but this early in the treatment, that's to be expected. We'll see where things find us in a couple more weeks.


* -- which, of course, Pongu also had. Poor little guy was not dealt a good hand at the beginning of his life.