2014-09-17

Bailey's Behavior Modification Medications

Some of you know that Bailey has been struggling physically and mentally lately. Really struggling. She couldn't seem to settle unless she was sleeping and she was often restless even then. Unfortunately her "just not right"-ness has actually been going on for about a year with quite vague symptoms that seemed to change week to week.

She takes a variety of prescription medications as well as supplements. I've learned it can be quite difficult to manage so many medications successfully, there are so many potential interactions! One of the things her vet(s) and I have discussed recently was the possibility of incorrect medication doses. In medicine there are "relative overdoses" and "frank overdoses." The simple way to explain it is that a "frank overdose" means the patient received too much. A "relative overdose" means that even if the correct, calculated dose was administered, it was too much for that patient.

I'll start by saying I am so very lucky to have the resources I do. As we reviewed Bailey's symptoms, time-frame of onset, various diagnostics, and medications for the hundredth time I heard "what if one of her medication doses is now wrong for her." And we all paused. So we started looking up side effects of ALL the medications she takes. Fluoxetine is metabolized by the liver. Earlier this year, Bailey's liver values were elevated. She was started on a supplement from Standard Process and at her next recheck, her liver values had normalized. She, however, did not normalize. Hyperserotonin syndrome is not common as far as I can tell, and the onset is usually very quick with serious consequences if it isn't addressed. However, many of Bailey's symptoms were the same. She was more anxious, she was nauseous, she was ataxic (all four limbs didn't seem to get the correct signals from her brain), and she was restless (just to name a few). We had tried to rule in or out so many other causes without success. Nothing else added up the way this did.

Bailey was weaned off her Fluoxetine completely (and very carefully) over the course of 6 weeks. The lower her dose got, the more she improved. Both physically and mentally. She is no longer ataxic, she has more coordination than I've seen in a year. Her appetite is much better. And she is able to relax.

I've hesitated to share this publicly, because I am an advocate for behavior medication in dogs. Her life changed, for the better, because of it many years ago. As dogs age, their bodies change. It was a lesson for me to keep looking for an answer, because there was one for Bailey.



1 comment:

HCG said...

I think this is an important blog. So nicely stated. Medication changes for many people as they age - why not our canine companions too. So good to know options are out there that were not available or considered before.