The risk of switching from Clomicalm to a new "background drug" is that we would lose the improvement in separation anxiety we have seen with the Clomicalm, so combination therapy seems the best way to go at this point. Dr. Dodman, Dr. Ogata and I will check in again in two weeks.
I did discuss the possibility of using xanax to relax Stella enough for desensitization and counter conditioning, which I had read about on some shy dog sites. But I had also read that xanax can cause memory loss, which would obviously negate any learning that took place during training. Dr. Dodman said that dosing to avoid memory loss was very tricky, and that xanax was therefore not used for training, but for episodes of panic.
I realize that med trials can take a very long time and may not ever result in 100% success, but I am relieved to be trying something different, as Stella's behavior seems to be worsening. So, Stella's medication changes are the following:
- Discontinue huperzine
- clomipramine 25 mg/day (up from 20 because the generic, which is MUCH less expensive, comes in 25 mg capsules vs. 20 mg. tablets)
- buspirine 2.5 mg/day
We also reviewed the possibility that Stella is having some type of focal seizure disorder, which is apparently more common in bracycephalic dogs. Neurological testing is available. The issues are that the tests are expensive, and not always conclusive. If her EEG showed evidence of seizure, we would know that was the problem. A negative test, however, doesn't rule out the possibility of seizures. So treatment "as if" she had a seizure disorder would be the way to pursue that possibility in the future.
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