Prozac/Fluoxetine support & advice please

[tylerbalk]

My anxious and reactive whippet x grey x saluki has been on Reconcile (prozac/fluox) for around 4-5 weeks and I really need some advice and support.

So far it's been rough. Week 1-3 she barely ate, was very lethargic and way more reactive. Week 4 she's regressed with crate training (perfectly happy there before starting meds) so were back to square one with that. Now we're into our 5th week and still no improvement on walks (barking, lunging, over threshold).

Our main reasons for meds were general anxiety which isn't any surprise for a sighthound but also to help reduce her threshold. She's almost always over threshold out of the house, she won't take any high value treats (chicken, hot dog, steak, liver, raw etc) that she will go mad for in the house but mainly I can just see by her entire demeanour that she's stressed and on edge.

We were really hoping meds would help get her to a place where she would be able to respond to positive reinforcement. We have had a session with a very well regarded behaviourist who confirmed we were actually doing great with the methods we were using - walking on a long line practing engage/disengage with dogs/triggers at a distance. We've been working on this for about 9 months but since she's always over threshold it just doesn't stick. She will very occasionally take treats after around 45 mins out of the house on a very very quiet walk but more as appeasement.

Anyone who has experience with Prozac/Fluox please please let me know your thoughts. Wins or losses are both appreciated. I'd just love to know if I'm making assumptions too early about these meds.

 

[imagebeastmarkbeast]

@tylerbalk I think the loading period can be up to 8 weeks. My dog has been on it for 4 months now and he leveled out and started seeing changes after the 8 week period. I’d keep a log and also discuss concerns with your vet

 

[tylerbalk]

@imagebeastmarkbeast That's really helpful to know. I've been keeping my vet updated via email and they aren't concerned as her appetite is somewhat back to normal and there haven't been any real adverse effects. How was your dog in the 8 week period before you started to see positive changes? Also - what kind of changes have you noticed 4 months in?

 

[imagebeastmarkbeast]

@tylerbalk So mine is prescribed it for noise sensitivity.

In the first 8 weeks: lowered appetite and very sleepy. Some days he was fine and other days seemed more on edge, nervous, had big reactions to sounds.

Lately: much more confident on short walks in our neighborhood (which he previously hated). bounces back quicker and more easily redirected from big sounds. Appetite and sleep back to normal. Of course we still have to work on counterconditioning and training! But he seems much more confident and is not having nearly as frequent fear/anxiety as before.

 

[ansje]

@tylerbalk I really, really, REALLY sympathize with you. We have one who is HIGHLY treat motivated and one, like yours, who on most days only eats one meal a day if we are lucky (and that was pre-prozac too) and absolutely refuses to take treats outside. Inside he will 100% spit them out on the floor if he doesn't like what you have given him. Ours is on Reconcile (chewable prozac). He weighs around 80 lbs and he started out on 32mg/day and we worked our way up to 64mg/day. It was first RXd by our regular vet and then when we got into see a vet behaviorist she upped the prozac and added in 600mg of gabapentin 2x/day. The Gaba and increased dose of the prozac really helped him turn the corner. It is not perfect, but he will actually take treats right outside the front door and down the sidewalk to the mailbox now.

Our trainer gave us a good exercise to do with him. Start inside by the door with leash on and get REALLY high value treats and start tossing them side to side for him to get. Make it a fun game for him. Then bring him immediately outside and do the same thing. Toss side to side on the ground as you walk a bit further each time. We did that for a few days and it helped him. If there is a distraction, it doesn't work as well but at least he will kind of take them. We need to do it from the front door and then continuously down the sidewalk. It is difficult to test this out on actual walks since we walk as a pack and I don't want the highly treat motivated one to steal them from him and cause another issue on top of the ones he already has.

Someone mentioned clonidine as well - for some people it is a miracle. For ours, it just makes him SUPER sleepy/zoned out and then even more SUPER reactive as it is wearing off. We tried it for about 5 days and then stopped it. We only use it situationally now and we keep a steady dose in his system until bedtime so we don't go through the super reactivity as it wears off. For us, the gabapentin gives him the calm he needs but doesn't overly-sedate him. It has also made him more playful with us and our other pup.

Discuss with your vet and trainer and see how they feel about adding something in. It is definitely a trial and error long game.

 

[luke]

@ansje We have the same issue with clonidine! Our VB has us doing the same thing with the until bedtime if we have to use it (for grooming/vet care).

 

[convictionofgod]

@luke It was the weirdest thing. He was barking at EVERYTHING when it was wearing off. Like noises that we had previously gotten him accustomed to - cars driving, us walking around upstairs, closing the pantry door, the radio... I thought we were going to have to go through another few months of desensitization training again. Thank goodness he was back to "normal" as soon as we stopped it. He now only gets it for when we have more than 2 guests over and trash day.

 

[albe]

@convictionofgod I know this is old, but how long did the rebound anxiety after clonidine last? My dog went crazy for about a week after a single dose. I thought maybe it was a coincidence and I tried using it one more time for a stressful event and now the day after she is super hypervigilant and barking at nothing again. Do you think the after affects can last that long?

 

[convictionofgod]

@albe Is your dog on anything else besides clonidine? I can't remember its exact half life, but it should be completely out of their system by the next day. What dosage is it? Ours doesn't take it regularly, just situationally. We usually start with .2 in the morning and then follow it up with .1 mg 6 hours later and another .1 6 hours after that so he doesn't get the crazies coming off of it. He was also just increased from 600 mg gabapentin 2x/day to 800 mg 2x/day so that may be helping to keep him pretty steady throughout the day too.

 

[albe]

@convictionofgod Yes, unfortunately she is on week 6 of fluoxetine. I'm thinking it's probably loading period issues from that which were just exacerbated by the clonidine. She's had this reaction twice where the following day after clonidine she is absolutely insane. I'm honestly wishing I'd never started the fluoxetine and just used situational meds when needed. She's 42# and I gave her 0.2 mg. I do have gabapentin as well, which seems to be the most helpful, but I'm mainly using it to get thru this rough loading period.

 

[convictionofgod]

@albe Ugh! I can totally sympathize with you. The loading period is rough, but for us it was worth it. For context, when we started ours on Fluoxetine, he weighed 60 lbs (he was 7-months old at the time, and is a Great Pyrenees) and we started at 32mg. He was on that for about a month and then we increased to 48mg and he was on that for about 2 months, then he went up to his full dose of 64mg and this seemed to be the turning point. He was great for a long time on 64mg. He now weighs 87 lbs. The last time we brought him to the Behavioral Vet, she wanted to try increasing it to 72 mg. We did and it was HORRIBLE. You wouldn't think 8 mg would have such an effect, but he literally went crazy. Running away from squirrels and bugs in the backyard like a scared puppy. He previously would chase them and just other random issues inside the house too. We dropped him back down to 64mg after a week and increased his gabapentin instead. He is better, but I think some of the crazy from that week "imprinted" on him and we are still dealing with some issues from that dose. Do you see a behavioral vet? The daily gabapentin really helps but we do need the extra bump of clonidine for trash day and when we have company over. We also have trazodone that we give him occasionally too. He is like a walking pharmacy!

 

[albe]

@convictionofgod I do have an appt early May. But honestly, I'm scared I might not be comfortable with their recommendations. Because at best they are making a well educated guess, but they cannot know for sure how something is going to affect a patient. Just look at what happened to your dog on that increased dose! And I've read a few reports of others who had bad reactions and their dog was never the same. It is just so scary. I was thinking of dropping her prozac dose down a little, but to do that I have to switch brands and it seems that itself can cause issues. I'm just so scared I'm ruining her poor brain and any hope of her having a happy life. It just seems like these meds are kind of a crap shoot and I'm so scared I'm doing permanent damage! I'm glad your dog is doing better!

 

[convictionofgod]

@albe It is definitely a crapshoot and takes trial and error. Our vet told us right off the bat, that meds are a wait and see game and that we may have to try different meds/combinations to see what will be the best fit. It is the same with humans. One drug may be great and one might make things way worse, the difference is that we can communicate and our pets can't We have to be their advocates because we know them best. We were open to trying new things out for our boy because living the way he was before the meds was WAY worse than doing some trial and error on different meds that may help him. Living with anxiety and fear is no way for them to live, so being open to trying meds that can help is essential. He is not completely better, and he definitely has his good days and bad days, but the bad days are FAR fewer than they were before the meds, so that is a positive for us! One thing that really helped was keeping a journal. I made notes EVERY day on what was improving and what was getting worse. That way I could go back and re-read it and see whether the positives were outweighing the negatives and make an informed decision that way.

 

[albe]

@convictionofgod So glad he's got a good quality of life now!!! You're an amazing pet parent!

 

[albe]

@ansje How long did the rebound anxiety last after giving Clonidine for your dog?

 

[dr650adv]

@tylerbalk I would give it another week or two because some of those things are side effects that tend to go away over time, but adverse reactions to prozac do happen. My dog had a bad reaction.

The lowered appetite can be more permanent, and if your dog is usually food motivated, that alone might be a reason to discontinue the drug. There are lots of other options.

Whatever you decide to do, keep in touch with your vet about how to titrate the dosage up or down.

 

[tylerbalk]

@dr650adv I'm thinking the same. My vet said to expect changes after around 4 weeks, I read 4-6 weeks online but I'm seeing plenty of people say that it took their dog longer than that to adjust. Were you able to try any alternative medication for your dog?

Low appetite has always been an issue with my dog but she's thankfully a good weight and the vet doesn't have any concerns but it's very hard training a reactive dog that isn't a huge eater already! I am very jealous of owners with food motivated dogs.

Good shout about the dosage, I hadn't considered that adjusting the dose would be an option. I assumed it would be based mainly on her weight.

 

[dr650adv]

@tylerbalk Some dogs are more sensitive to meds, just like people, so it's a good idea to start low and only go higher if necessary. My dog who had the bad reaction to Prozac was extremely sensitive to all medications. I think that's probably not rare in dogs who are already anxious and sensitive.

Yes, we tried a ton of medications. I can't say that we found one that helped his reactivity, but there were several that he was able to tolerate better than prozac. That one just was not for him. As soon as he'd been weaned off of it, all the training we'd been doing suddenly appeared! He just hadn't been able to actively participate while on prozac.

 

[omandi111]

@tylerbalk It could be Prozac just isn’t the right med for your dog. However, I didn’t notice changes in my girl until 2-3 months in. She’s now 6 months in and the only thing she has issues with is other dogs on leash. She’s a completely different dog. She also still doesn’t have a big appetite so we started mixing wet food in her kibble and that helps.

 

[tylerbalk]

@omandi111 Your comment has given me the positivity I needed today! I appreciate it. I'd heard from my vet and read online to expect changes after 4-6 weeks so was worrying that Prozac just wasn't the med for her but knowing it took you 2-3 months to start to see changes is reassuring. How's your girls appetite on walks? I would give my right arm to have a dog who would take treats from me outside haha!