A behavior case study focusing on medication choices, training programs, treatments and outcomes.
Introducing Lola
THE CONDITION
Lola, a 16-month-old American Staffordshire mix, presented to our clinic because she was experiencing significant daily anxiety that had been present since adoption at 8 months of age. In addition, she was aggressive to new people and dogs, and would lunge, bark and growl while walking past them, and the owner had been unable to introduce her to any friends or family at their home. During the consultation, the owner also revealed that Lola was terrified of loud noises in their environment (cars backfiring, air brakes on buses, etc); was scared and aggressive at their veterinary office and groomer; and was destructive and vocalized during owner absences from the home.
Lola’s family veterinarian started treatment with a non-veterinary approved source of fluoxetine hydrochloride (20 mg; 0.6 mg/kg) and referred the owner to a qualified rewards-based trainer and our practice for evaluation. After two months without significant improvement in any clinical signs, and no forward progress on training and behavior modification (and while she was still waiting to be seen by our office), the veterinarian increased the dose of the fluoxetine (40mg; 1.3 mg/kg).*
THE DIAGNOSIS
In the exam room, Lola was an FAS score (Fear, Anxiety and Stress) of 4/5, and would lunge and bark at the clinician and assistant with any sudden movement. After full assessment of her health and behavioral history, Lola was diagnosed with:- Generalized anxiety disorder
- Fear based aggression towards unfamiliar people and dogs
- Separation anxiety
- Noise phobia (environmental)
- Situational phobia (vet visits and grooming appointments)
THE TREATMENT
The clinician discussed the options for medication changes, including a switch from the current source of fluoxetine they were using to PRN® Pharmacal’s Reconcile (fluoxetine hydrochloride); a veterinary-specific formulation with approved weight-band dosing. The owner agreed to make the switch to Reconcile (48mg; 1.5 mg/kg).** After 4 weeks, Lola was reassessed and the owner noted a significant reduction in the intensity of her reaction, and her ability to recover when she was triggered. At that time, it was determined that she was ready to proceed again with behavior modification with the force-free trainer she had previously been referred to.A OUTCOME
At the six-month recheck, Lola was significantly less anxious in the exam room, she tolerated movement by the clinician and staff members, and took treats the entire time. She received an improved FAS of 1/5, even without any additional event-based medication given prior to the appointment (or other stressful events). Lola’s owner was pleased with the progress she had seen during training for her reactivity to people and dogs, and the improvement to Lola’s general level of anxiety and reaction to noises. Lola was also able to stay home alone with no signs of distress for departures of up to 6 hours in duration (the longest she had tried to date).ABOUT THE AUTHOR
This case study was provided with permission by Boarded Veterinary Behaviorist Dr. Amy Pike who owns Animal Behavior Wellness Center with locations in Richmond and Fairfax, VA. You can read more about Dr. Pike and her work here: https://www.abwellnesscenter.com/
