Separation Anxiety: Medication

Medication is generally a very touchy subject; it certainly was for me when it was first recommended to me. But before I get into all the inner turmoil I dealt with and how I went back and forth for weeks before finally deciding to give it a try, I really have to emphasize that I am not a veterinarian and everything I write here is strictly regarding my experience with Charlie. If you're battling SA with your own dog and think medication can help, I strongly recommend you seek help from a veterinary behaviorist with experience prescribing for SA dogs, and if one is not available, developing a strong relationship with your regular vet is crucial.

It was five years ago and Charlie was six years old. He was at his worst, SA-wise. We had just recently moved into an apartment after living in a private home for his entire life (where we let him bark all day when no one was home - there was no one to complain and we didn't take it seriously back then - in all fairness I was a teenager and although he was my best friend I had no idea what to do about his behavior) and he wasn't coping well. He was urinating on all the moving boxes and black plastic bags; he was barking continuously from the moment I left until I came home, resulting in a collapsed trachea and breathing problems that still crop up to this day; he would often lose his voice; he scratched up all the doors and windows, basically plug in your average over-the-top anxious dog behavior and he was doing it. 

We sort of coped with it haphazardly for some time, I don't really remember what we were doing about it, though I did, at one point, call a dog trainer to come help us. Unfortunately I was a CM fan back then and she was recommended from his site - turns out she didn't really help us much (for whatever reason she felt teaching him how to walk on a leash and giving him leash corrections was going to fix his SA. All it did was exacerbate his already delicate throat and lead to an increase in his hacking and coughing). We continued to receive complaints from the Department of Environmental Protection and were cited for his barking more than once.

Then one day in 2008 it got really serious.  

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Charlie, circa 2006, right around the time we moved and his separation anxiety sky rocketed.

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One of my neighbors (and I have a good hunch who it was) left us a folded piece of paper (OK this is a little graphic, so if you're sensitive, please skip to the next paragraph - I'm getting worked up just thinking about it) with a drawing of Charlie "burning in Hell" and showing how they were going to kill him (they had him hanging from a noose). Of course after that I kind of freaked out and knew that we needed to do something, immediately. On top of the note, my mom was also threatening to give him away and we were all going through a lot of personal problems. It got so bad that I shipped him off to live with my father in New Jersey for a few weeks - it was the hardest thing I've ever done. That didn't last long, since my dad didn't know what to do with his problem anymore than we did.

I'll admit that I tried a Citronella anti-bark collar. It didn't work. For whatever reason I could never get it to sit right on him, so it ended up spraying the side of his face, or missing his face altogether and I would just come home to an extra-uber-anxious dog who smelled like citrus. To be perfectly honest, I'm sure that even if I did get it to work correctly it would never be enough to dampen the level of anxiety he used to experience back then, really it just made him worse. I tried for months and months a variety of other things that any person recommended, including putting a nylon muzzle on him during the day. Besides being incredibly stupid and dangerous (if he needed to vomit he would have died, if he got too hot, he would have died, and a bunch of other "ifs" that could have ended in his death bother me deeply to this day) it just made his anxiety worse. We used it as a crutch for longer than I'd like to admit to, since it pacified our neighbors and stopped the death threats and calls to the police, but it always made me uneasy and he hated it more than I want to remember. Note: nylon muzzles should only be used for short periods under direct supervision for things like veterinarian visits, grooming appointments, and other short-term handling experiences. If you need to muzzle your dog for aggression-related behavior, you must get a properly fitted basket muzzle that will allow your dog to safely pant, drink, and even take treats. My favorite basket muzzle is the Baskerville Ultra Muzzle. Please learn from my mistakes and don't put your dog at risk! I really lucked out but could easily have come home to a dead dog. Despite all the damage I did to him back then (and from what you can see, there was quite a lot), I am somewhat proud to say that although I considered buying an anti-bark electronic collar, I never did, and I hope that you never have to consider it.

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My first truly constructive step was to wake up two hours early every day and take him running in the hopes that it would exhaust him (if you read my previous post, you'll know that it did help quite a bit, and even got me in shape too!). I also started asking him to wait to be fed before I left in the mornings (was still using a bowl at that time) and would release him just before I left (thankfully he was always willing to eat, which isn't always the case with SA dogs). It was around this time that I met the person who introduced me to clicker training and I attended the 2009 Clicker Expo in Rhode Island. Finding this "new" way of training was really a godsend for Charlie and me. We both took to it like naturals and have never looked back. After the Expo I was hooked (and left all barbaric training behind), joined an online forum for clicker training, and wrote about my Charlie woes. Someone on the list brought up the fact that I should seriously consider getting him on some type of medication. My first response was to recoil in disgust, stating all these "facts" I knew about modern medication and all about how it would make him sleepy and lethargic and how I would never do that to my dog (yes, folks, hypocrisy at its finest). Prozac for dogs was a joke! Only really unbalanced people even considered it!

(I should probably add here that I'd tried all the OTC remedies that everyone suggested - everything from Benadryl to flower essences and nothing worked - I think the Benadryl actually made him more anxious. In my experience he'd always been very resistant to drugs and even needed higher doses of anesthesia for surgery, but I attribute that to his anxiety as well. It was just another factor that made me feel drugs weren't the answer.)

But she was patient, and blunt with me and pointed out (which I still very clearly remember) that if he were diabetic, I would get him insulin, right? Well, of course, I said, he'd need it. Well, then, she countered, he may actually have imbalances in his brain that make it impossible for him to relax, he needs the medication to help him think clearly - to be able to dull the edge of his anxiety just enough so he can learn how to be calm without it. Oh, I thought. I didn't even consider that. She went on to explain that modern medication, especially the types and doses used for anxiety, often don't have side effects, and if they do, there are many options to try out. She also explained how the medication worked in the brain (which I've all but forgotten) but pointed out that most of these medications (at least the ones I should be interested in) took weeks to take effect and weren't used for immediate sedation.

I sort of gathered my pride and went to see my veterinarian about this. Charlie had always been very unhappy about the vet's office, so she was well aware that he had anxiety issues (understatement of the year?). I brought up medication and she was on board with my plan. 

We started him on a low dose of Clomicalm. My vet said that she had had good success with this drug and preferred it to Prozac for starting out, and we increased it after a few weeks. I didn't keep a log at the time, but I think it took six weeks or so for me to notice any significant changes in his behavior. (By this time Charlie and I were also no longer living with my mother and were sharing an apartment with a dog-savvy friend. He was much happier in the new place, although the move was stressful, as could be expected.) And then he just kept getting better and better. It certainly helped that I was gaining skills as a trainer quite rapidly (and he learned most of his 100+ tricks and behaviors during this time!) and was gung-ho about our training plan, so was able to develop a behavior modification treatment for him with the help of the wonderful people on the forum. I also started working in the dog world and was able to take him to work with me almost every day where he was learning it was OK to not be right next to me every second.

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Circa January 2010, a few months into his medication treatment.

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Charlie is a generally anxious dog (to this day he's more anxious than your average dog and always will be) but for the first time in his life he was able to relax. His SA slowly got better, though I was a little anal about not leaving the house more than I had to (for a long time he was stuck to a routine that dictated I was only allowed to leave the house once a day - it was so ingrained in me for so long that to this day I have a really hard time leaving more than once, even though now I can!).

There were a lot of facets to his recovery, some which I have already covered in previous posts, and others which are still to come, but the medication was what allowed him room enough in his brain to think and be able to relax on his own. From my experience with him, I can confidently say that it's absolute folly to force a dog to deal with situations they're incapable of dealing with on their own, without the proper tools (of course this doesn't apply only to medication!). Certainly not all dogs need medication for every problem, but when you and your dog are really struggling, there's nothing wrong with getting support where appropriate. 

I just want to add that only very recently (within the past year) I learned about canine thyroid disease and that it can have many, many manifestations in dogs that were previously unattributed to it. Dr. Dodd's wrote an excellent book on the subject and if you plan to get your dog tested (which you should!), I highly recommend you do it through her lab (they were actually less expensive than my regular vet!). Since confirming that Charlie is hypothyroid and getting him on the proper dose of thyroid medication, I have noticed that he's calmer than ever, almost dramatically so, and a good deal of his anxiety in the past ten years may have been thyroid-related. To kind of underline that, I have also been able to wean him off onto the smallest dose of anti-anxiety medication he's ever been on, it's actually half his starting dose! We also switched him to Prozac off of Clomicalm this year for a variety of reasons, the most important of which is that Prozac is generally considered to be safer and has fewer side effects. He's currently on 5 mg twice a day (which is a very low dose). I'm hoping to lower it even more to just 5 mg once a day, but of utmost importance to me is that Charlie's content, so we're taking it very slowly. (I have tried weaning him off in the past to disastrous results, which really underscores how crucial the medication is to his mental well-being.)

If you'd like more information on the various anti-anxiety medications available, this is an excellent site to check out. If you're currently battling with the separation anxiety monster, I wish you patience, love, acceptance, and the clarity of mind to make the right choices for your dog.