Puddin's Story: A Behavior Case Study Focusing on Medication Choices, Training Programs, Setbacks, & Recovery

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The Condition

Puddin’, a 2-year-old spayed female Havanese dog, was presented because her caregivers reported consistent vocalization and eliminations when she was separated from people. The problem began immediately after they brought Puddin’ home from the breeder at 7 weeks of age. When she could not be watched, the family tried to place Puddin’ in a crate, pen, or bathroom or behind a baby gate; however, increasing her space did not help the problem. With the help of a reputable reward-based trainer using positive associations and a slow desensitization process, Puddin’ adapted to confinement in a pen when she knew someone was in the home, but when her progress seemed to plateau, she was referred to a boarded veterinary behaviorist for more insight. At the time the first session with the behaviorist, the family did not feel they could leave Puddin’ alone due to her level of distress and were arranging their schedules so someone could always be home with her. Alternatives were a dog play facility, paid sitters, or accompanying a family member on outings, but this created an emotional and financial strain on the family.

The Diagnosis

After assessing her health and observing her on webcams for other behavioral issues (eg, incomplete house training, reaction to external noises), Puddin’ was diagnosed with separation anxiety. The treatment plan included many layers to improve Puddin’s panic and distress immediately and in the long-term. The basic steps for treating separation anxiety include addressing the pet’s overall health and mental enrichment, behavior modification to change the emotional and behavioral response to being left alone, and addressing the neurochemicals creating the fear and panic, thus inhibiting learning.

The Treatment

After creating an enrichment, exercise, and behavior modification plan, Puddin’ began a once-daily regimen of Reconcile® at approved doses. In the early stages of her treatment plan, the family was encouraged to continue to avoid separation. Like many dogs with separation anxiety, additional exposure to separation generally does not lead to improvement. She is a good example of sensitization or worsening of the problem when individual dogs are exposed to their fears—in this case, separation from people—at high levels. In a 2-week follow-up conversation, Puddin’ was tolerating the medication well, and during brief training sessions, she could remain calm on a dog bed while a family member opened the exit door. Progress continued in a slow-but-steady manner over the next few weeks, with distress behaviors absent until ≈60 minutes into the departure training. Even though Puddin’ could not be left alone for extended periods, freedom for her owners to run small errands was beginning to seem like a possibility, creating a sense of relief for the family members. Approximately 6 to 12 months after the initial consult, Puddin’ was observed to be calm and resting for up to 6 hours alone in the home. Puddin’ was still administered Reconcile daily, and her behavior was very stable.

A Setback

At the 14-month period, Puddin’ was switched abruptly from Reconcile to another source by another veterinarian as a perceived convenience and cost-saving measure for the family.* Puddin’s family contacted the veterinary clinic after the reemergence of whining and barking at the exit door, with no other perceived changes in the household.

The Recommendation

Questioning quickly revealed the correlation in time between the medication switch and worsening of separation issues. It was agreed that Puddin’ would be placed back on Reconcile and the separation plan restarted. Although it took >1 month, Puddin’ was able to be left alone for >6 hours again. Approximately 2 years later, Puddin’ was able to be successfully weaned off all medications. Formulated specifically for dogs, Reconcile® (fluoxetine hydrochloride) is FDA-approved for the treatment of canine separation anxiety in conjunction with a behavior modification plan. Flavored and chewable for simple once-daily administration, Reconcile is veterinary-exclusive, available in 30- and 90-count bottles, and economical to stock and for pet owners to purchase.

The conclusion in this case study is for educational purposes only in order to highlight that changes related to drug brands or dosage amounts should be evaluated under the care of a veterinarian.

*No head-to-head studies were conducted between products. Recommendations are based solely on the treating veterinarian’s observation and experience.

IMPORTANT SAFETY INFORMATION

The most common adverse events reported in decreasing order of reported frequency are: decreased appetite, depression/lethargy, shaking/shivering/tremor, vomiting, restlessness and anxiety, seizures, aggression, diarrhea, mydriasis, vocalization, weight loss, panting, confusion, incoordination, and hypersalivation. Reconcile chewable tablets are contraindicated for dogs with a history of seizures or when used with MAOIs. For product label, including complete safety information, see package insert.