Having The Meds Talk With My Vet

Last year I wrote a blog about the events at the vet, years ago, that have made my life with Shayne so much more challenging. In a total and complete nutshell, she had two idiot vet techs corner her in the exam room (after I told them to go slow and that she was fearful) to give her a vaccine they forgot to give her before she was adopted.  She was absolutely terrified by this and peed, pooped, and expressed her anal glands (but she didn’t bite even though those dumb techs deserved it)–ever since this visit she has been a nightmare going to vets.

I have spent the last 7 years trying managing and doing as much counter conditioning as possible to help her get over her fears.  We have seen improvements–in the waiting area she is no longer such a mess that she pees/poops on the floor or pants, paces, and will not take treats.  She is by no means comfortable but she can hand target, sit, down, and take treats readily–slower response and a bit sloppy but she does it.  Her problems still exists in the exam room–as long as I’m there and I’m the one restraining her, she just freezes and shakes.  Although she’s not snarling or growling or snapping, as soon as the vet tries to examine her, she tenses her whole body up and they can’t really examine her–they can’t palpate her abdomen, can’t check her ‘funny foot’ range of motion, or her other joints for issue.  For whatever reason, she was much better with our vet in NY so this wasn’t a huge issue for a few years, but since moving back we have taken steps backwards.
Up until this year (and one unfortunate year in NY where she had like three huge issues in a few months time), Shayne has been pretty much a low maintenance dog, she only went to the vet once a year and she was young and generally healthy so the vet issue wasn’t so much of an issue.  It was managed with ez-cheez, calming treats, and the fact that it just didn’t happen very often.  The last three months, with her now THREE big vet issues (yeah, if you wanted to know where I’ve been recently, blog-wise, Shayne got a slab fracture that broke off so we’ve been trying to deal with that), and the fact that she is getting older made me realize we have to make a change.  It is simply not going to work anymore with the vet not being able to appropriately examine her as she ages.
Before our most recent vet visit, on Monday, for her slab fracture, I gave her triple the ‘normal’ dose for the L-theanine based treats to see if that would help.  Even with this dosage she was a shaking, panting, eyes-the-size-of-saucers nervous dog, even in the waiting room (although she could take treats and listen to cues and I suspect it was made worse by a reactive dog barking and lunging towards her from across the room).  Having tried all the over the counter relaxation solutions that I know of (plus calming music on the way up and once used a thundershirt), I decided I had to talk to the vet about a regular prescription for her vet anxiety issues (our vet in NY had written her a very small prescription years ago to try).
So during our visit, I asked the vet I was seeing about the possibility of getting a prescription for something to help her anxiety during vet visits and only vet visits since that is the only time she’s a total mess.  I walked into the appointment knowing that a benzodiazepine was the route I wanted to take with Shayne.  This is the class of drugs that I felt would be the best fit for the issues she has–they are fast acting and can be used “as needed” which is what she needs.
I told the vet that I was thinking about using a psychopharmaceutical to help reduce her anxiety/fear during vet visits.  I explained that although she was not growling, snapping, or biting during exams, that she was never being examined the way she should be because she was so tense.  He kept saying, “well she is doing pretty well today” which was really frustrating because this is the second time she was “examined” by him recently and his “exam” was looking in her eyes, ears, nose, mouth, and listening to her chest.  He never really examined her at all, he checked her vitals. The time before the last two visits, this same vet did try to examine her more and he made the comment, “wow she just clenches up, I can’t really get a feel of her abdomen or check her joints.”
I told him that I wanted to try a drug in the benzo family to see if we can help her.  He responded by suggesting we use acepromazine instead.  This really caught me off guard because no vets in the ‘know’ prescribe Ace for fear/anxiety issues.  There are a lot of problems with using this drug for anxiety, fear, or aggression in dogs and knowledgeable vets never suggest it.  I could write a few paragraphs to explain why, but perhaps this video of Dr. Karen Overall, a highly regarded veterinary behaviorist would be better, since you know, she IS an expert.

So, you see, there are lots of reasons to never use Ace for anxiety, fear, or aggression issues.  I told the vet that I was absolutely not comfortable giving Ace and I pretty much told him the exact reasons that Dr. Overall used (though not as articulately as I would like I’m sure).  He seemed a bit taken back that I knew this stuff and he then opened up to other suggestions. This initial suggestion of Ace made me realize that he was probably not the right person to discuss behavior meds with but Shayne still needed something since with the tooth, she will be requiring more vet care soon.  We talked about using diazepam (valium) or alprazolam  (xanax) instead.  He suggested trying xanax first, which I was fine with, though it too has some drawbacks and isn’t always used.
I left with a prescription for xanax but I also left with questions about staying at my vets office.  This is a place that I have felt less and less comfortable with over the last few years as it has grown and had huge staff changes.  There are a lot of little things that have led me to really consider leaving them as my primary care place for the dogs, but the big thing is that I no longer feel really comfortable there.  The support staff I used to love and who knew me and all my animals by name and voice on the phone have all left and the new staff  (including the 2 new vets) just doesn’t wow me.  You all may be privvy to the journey of finding a new vet, so hang on to your hats!