Medication questions

[vickiegram]

I'm not sure if this is the single best subreddit to post this but upon google search the medications I searched for came up here a lot. Anyways, I have an almost 14 year old boston terrier. He is most definitely reactive. He has a whole host of other issues as well. He has suspected sundowners as he gets very agitated and barks in the evening, worse than the day. He also has general anxiety. He also has atypical cushings. He recently had cervical surgery for a herniated disk. That is important because he started trazadone during the pre and post surgery. Prior to his disc issues he was taking:

100mg gabapentin as needed for pain or as a sedative

0.5 mg of Xanax as needed (usually evening)

15mg Selegiline every day

Mitotane one day a week for cushings

melatonin and lignans every day for cushings

Pre and post surgery he was one a heck ton of pain meds and other things. They added the trazadone to keep him calm. Now that he is mostly pain free he is not on the pain meds. We brought up with primary what we can do to keep him calm since he can't have as much activity out of risk of re-injury. They suggested adding Prozac. Their current recommendation is to do:

Prozac 10mg once a day

Selegiline 15mg once a day

Xanax 0.5 mg every 6-8 hours

They also said I could give trazodone on a situational basis. This seems like a lot? He would also continue the meds for cushings. I hear of serotonin syndrome and I don't know how common it is. I have been hesitant to start the Prozac because Trazadone has seemed to work the best but I know it may not be the best long term. BUT, he is almost 14 and he has never shown his age as much as he has the last few months. I've heard Prozac can take a long time to work and can make things worse before they get better. We've been through hell the past few months and I am scared.

Because of his reactivity and risk of injury we don't go for "normal walks". I have a treadmill that we walk on. I have a fenced in yard for going potty and roaming around. We just have to be careful for neighbor dogs making noise and or bunnies/squirrels. He can't play with most toys because he gets aggressive with them. What I have done is kongs and other puzzle toys with peanut butter and treats but he gets them all so quickly and just barks and barks. I can't give unlimited pb and treats!

 

[rgw00]

@vickiegram I know you've likely had to pay for a ton of vet pills recently, but I would highly suggest you ask for a referral to a behavioural vet specialist. This is a delicate situations, considering the combo of issues your pup seems to be struggling with, and a specialist is going to be able to answer all your questions with a lot more expertise than a general practitioner. They will know the best way to unboard a medication like fluoxetine, or if there are better options out there. A lot of them are willing to work over Zoom as well, so you aren't limited to specialists in your area.

In terms of too many meds, a lot of reactive dogs are on a combo of medications (mine is on three). It's not uncommon and an ethical, experienced vet knows which combos are dangerous and which are not. Get a referral!

 

[vickiegram]

@rgw00 It’s something I’ve considered and honestly should have done years ago. Yeah there’s only a couple in like 500 miles from me. One does zoom. The initial consult is pretty pricey and insurance won’t cover it. I’m not sure.