Stella's New Friends

The farm walk had some bonuses yesterday! Stella met Opie and Aunt Bee, the pigs on a new farm being built in George the Border Terrier's neighborhood. Stella and Douce were nose to nose with those pigs, who were making very piggy noises. I had to hold the dogs' leashes tight to keep them from sticking their faces through the electrified fence. The pigs, for their part, seemed incredibly uninterested in the Shih Tzus. Stella, on the other hand, seemed to find the pigs much more interesting than the 8 week old, completely adorable Sheltie puppy brought to agility class last week. The humans gush over him, but Stella thinks he's a complete snooze.

I called Tufts today to notify them that nothing has happened since Stella started on Buspar. Absolutely nothing. Yesterday, I saw Stella out watching the neighbors use a backpack leaf blower to blast every blade of cut grass from their lawn to kingdom come. You would think that would send a dog with noise phobias racing for cover. Nope. She was at her post, calmly monitorning the situation. This is, remember, the same dog who still runs from the toaster popping as if the whole house were exploding.

Grandma is Coming Home!!

Well, it's been about two weeks since Stella has been on the Buspar, and I've seen no effects, positive or negative. My mom is coming home to Maine on Tuesday, and that's one of the best drugs in the pharmacy for Stella. She LOVES her Grandma. I'm really hoping that having Grandma here will help Stella get through the mornings better. Even though I'm not teaching now, and won't be feeding the dogs and leaving, Stella is struggling with breakfast. She may or may not eat, but always runs from the food bowl like I sprinkled her kibble with phobia powder. Lately she's been heading for her safe spot in the living room, because that's where I've been checking email.

Yesterday, she decided it might be safer to crawl under the couch to get near me, rather than to come out of her hiding spot and sit on the rug. Unfortunately, I have "apartment sized" (dinky) furniture, and she got stuck. Okay, when your 7 inch Shih Tzu gets stuck under your furniture, you know it's time to upgrade. I heard heard scrambling under there like a squirrel in the wall, and I looked under the three inch space between the floor and the bottom of the couch to see EYEBALLS. Her top knot was mashed down, and her chin was on the floor and all I could see was her big buggy eyes. I called her to come out and she wiggled. I extracted her gently, and she decided the rug was not so bad afterall.

Stella is still enjoying her agility classes. She is afraid of the teeter, and not performing the A frame like she did last summer. I wish I had this equipment in my yard so that I could let her practice at lower heights, and build her confidence up. But, my yard is in the dinky category too. Here she is last night at Tree Frog. I love her fast run at the end! She wants it! She's entered in Novice Jumpers in Cumberland the third week of the month. I pray and cross my fingers that she won't be stressed about the trial and poop in the ring. I'm prepared for that, but having your poop in the ring gives you a pretty low feeling. I know, because Stella and I have been there . . .

Insomnia??

Stella has been on buspar and generic clomipramine for three days--since Wednesday. The generic clomipramine comes in 25 mg capsules, so she's getting a bit more of that than she used to. There's so much powder in the capsules! I feel like I must be giving her 5 times as much medication as she got in the tiny Clomicalm pills, but I checked the capsule image online, and it is the 25 mg dose that she has. I think I'll try leaving some powder on the plate instead of mixing it all into the pill pocket.

On Thursday morning, she woke me up early. I think she had to pee after all the water she drank in agility class! For the last two nights, she has jumped out of bed in the middle of the night. Thursday, I got up and brought her back to bed. Last night, I left her alone until about 4, when I woke up missing her. I found her sleeping under the bed in the guest room. Maybe I should leave her where she is, but I like to have everyone in the bed. She stayed with me the rest of the morning. I'm not sure that there is any connection here to the change in drugs. It has been warm and a bit breezy for the past two nights, so the windows have been open and the curtains have been blowing. Maybe that keeps her awake.

She's still stressed in the morning, and skipping her breakfast. Her baby fat is gone and she looks very trim. Dr. Dodman says that the clomipramine can cause a loss of appetite. Her anxiety seems worse in the morning, though, and I think that's also why she is not eating.

Medication Adjustment

After a conversation with Dr. Dodman this morning, we are going to add a little bit of buspirone to Stella's drug therapy to see if that will help with the noise phobia. It was good to get a "big picture" sense of the treatment options. Apparently, and unfortunately, there are not many good pharmacological choices that target phobias, in humans or dogs. The plan is to treat the global anxiety, and hope that in that process, we see a decrease in Stella's reactivity to noise.

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.

More Clomicalm??

I talked to the doctors at Tufts yesterday, and they want me to try increasing her Clomicalm. I have very mixed feelings about this, and do not really understand the logic behind this decision. One the one hand, the Clomicalm has proven effective for the separation anxiety. Although Stella does not come upstairs on her own like she used to when it is time for me to leave, and she still exhibits some anxiety--her tail is down and she hides in her crate--she is able to take a food treat, and she is no longer pacing, vocalizing, panting and clawing at the gate. I am happy with her progress in this area, and I think that we could both live with this if it never improves.

On the other hand, Stella is getting worse in the noise phobia department, and her mornings seem really horrible. Even when I am not making any preparations to leave, Stella often seems particularly stressed in the morning, and the noise phobia is worse throughout the day. These are the behaviors that I think are new or worse:

• Dislike of getting out of bed in the morning.
  
• Reluctance or inability to eat in the morning.
• Hiding in the yard in the morning; when I bring her inside, she tucks tail and runs upstairs to hide there, often under or by the bed.
• Hiding in the living room under the coffee table, unless she is being held.
  
• Increased sensitivity to noises such as a cell phone or laptop being shut, pages of a book turning, tea kettle activity.
• Fear of objects that might be dropped or make noise--remotes, phones, books.
• Brand new-- fear of clippers, generalized immediately to wanting off the grooming table..

Why, I wonder, can this dog sit calmly in the yard while Lisa runs the weed whacker not ten feet away? Why can she watch the city workers tear up the street in front of the house with curiosity, but startle when I turn the page of a book? It's not the size of the noise, I think, it's the suddenness.

Those questions are interesting, but my questions about her treatment are nagging, and as persistent as her decline in behavior.

• If she is becoming more sensitized to noise, and her other fearful behaviors are getting worse, and in fact never seem to have improved on Clomicalm, why are we pursuing treatment with the Clomicalm alone?

• Is there a larger treatment plan that includes the Clomicalm, or are we hoping to see improvement with this drug? If so, why would we expect improvement in noise phobias?

• Is the improvement with separation anxiety predictive of improvement with noise phobia on Clomicalm? If so, why have we not seen improvement in this area already?

Agility Builds Confidence

Wednesday was full of highs and lows for Stella. Her grooming anxiety is detailed below, but we've been so busy that I haven't been able to report on her agility class. I took a different dog to class with me than I had on the grooming table in the morning. She turned from a shrinking violet (at least she was trying to impersonate one in the garden) to a happy and brave soul! She did a 19 obstacle sequence that seemed like it had lots of yardage for a little girl, and she was focused throughout. She even did the dreaded teeter. I was very proud of her. I've attached the video from the afternoon, where she is practicing agility. No comment on my clothes, please. Clearly, I need to get my track pants out of storage for the spring. Stella looks great though.

Circular Thinking--Behavior, Neurology and the "Ambipawed" Dog

Well, here's a new anxiety for Stella's list--grooming anxiety. She is usually an absolute angel on the grooming table--endlessly patient, and easy to work on. Last night she had a bath and blow dry. She always enjoys her blow dry. I scissored her ears and face, and she was as calm as could be.

Today, I put her on the table and turned on the clippers, and she shrank into a tiny ball. I have never, ever seen her do this, and I have been grooming her since she was a puppy. I had to do a really quick job with the clippers, as I had already made a path through an inch of fur on the middle of her back. Her cut is not even, and I didn't get to scissor her legs, but I had to let her off the table after she defecated. She ran into the garden and hid. Even a half an hour later, she was miserable when I put her top knot up, and usually she is just fine with that process. I'm at my wit's end. Everyday life seems to get harder and harder for her. Last night, she startled when I turned the page of a book.

I have been giving some thought to the possibility that she has seizures, and I really cannot decide if what I am seeing in her are behavioral responses to fear (freezing, retreat), or are focal seizures. The autonomic responses would be similar (trembling, increased heart rate)?? It seems very hard to sort out. What I'm not seeing is behavior that seems suddenly different. Stella can be playing one minute and fearful the next, but I can usually detect a noise stimulus. She can sometimes recover in the presence of a reward (food), which would suggest that her problem is primarily behavioral. The whole question starts to feel very circular to me though--how does one separate behavior from neurology?

For example, if, as some research suggest, the dog's paw preference ("pawdedness"??) is correlated with their susceptibility to phobias, aren't we talking about neurology? My very random trials with Stella and Douce suggest that she may have less of a paw preference than he does (she is "ambipawed"?). If true, this would correlate with her noise phobia. But I haven't done the recommended hours of trials.

Oh, just someone help me find a way to make this little Shih Tzu feel better!