The last couple of months have been really difficult.
I reached out to our veterinary behaviourist (VB) a few weeks ago and thought I would share here.
When I got feedback from his daycare that he had not been doing so well, I spiralled. We are so reliant on him tolerating daycare to get through life. I was already struggling and that feedback sent me into panic mode.
This is what I sent:
I know we have a consultation in a few weeks but I'd appreciate more urgent advice.
The past few weeks have been really tough. George's anxiety is still really high. It's off the scale panic immediately outside the house even with the high situational meds - he hyperventilates and struggles to breathe. His tolerance level of triggers away from the house is still really low - they can be a tiny pinprick in the distance.
I've tried so much to help outside the house - three different dog backpacks, a calming cap, carrying him...but it's still incredibly stressful every time we leave and return to the house.
One of his daycares have told me he has been "going at" other dogs which is new behaviour in the last 2 weeks. Dogs that he already knows and has been fine with for quite a long time. I'm terrified if he can't go to daycare - I don't know what we will do. He already takes his 'special events' extra situational meds on those days. I'm also really scared as he has a longer stay booked there in October - an essential trip to see my family and I don't have any other options.
His other daycare haven't said anything, but they are bigger. I'm really worried about there too.
I'm particularly concerned about the daycare behaviour as this feels like a significant escalation that could put his place there at risk. I wanted to flag this urgently rather than wait for our scheduled consultation.
This is week 5 (week 4 of 1/2 tablet twice a day) on the Clomipramine. No side effects other than two times vomiting over the 5 weeks. I know it is still early but I haven't seen even the most subtle signs of improvement. In some ways, he is worse.
I've been too scared to try switching the Lorazepam to the Clonazepam again given everything else we are dealing with, particularly as it seemed to make him a little more agitated (and really hungry) even at the lower dose. I'm scared of switching meds too often.
The situational meds take the edge off very slightly. Clonidine was the only one of all we've tried which made more than a minor difference by helping him settle at home and in the car. Although he doesn't settle as well nowadays. Trazodone made him more agitated. I'm wondering if the escalation could be another paradoxical response to the Clomipramine. I don't think we can increase the situational meds as he gets stumbly.
The high anxiety levels aren't new, it was why I wanted to switch from Sertraline in the first place, but I am worried that it is escalating, especially with the feedback from the daycare.
In all honesty, I'm exhausted and sad. It's been 3 years of carefully managing every aspect of our lives and making our world small. Views of the outside world are blocked in my house. I only leave the house to go to the office or the same Sniffspots. And he is still incredibly anxious. I'm normally pretty resilient but I'm struggling and don't know what else to do. I don't have any help.
I don't think we can work on any behavioural modification in this state but it feels like there's no hope to move forward and we're stuck in survival mode.
I'd appreciate your guidance on what we can do from here.
My VB replied really quickly and we had a phone consult within a couple of days. I was much more vulnerable than I normally am - I tend to be British "stiff upper lip" at times. I am grateful for her support.
We've since had our regular in-person consultation and have revised the plan going forward. I'll update in another blog post.
In the meantime, I'm sure others can relate to these feelings.