How to Not Feel Deflated When Meds Don't Work

So what if you've been thinking about putting your dog on anxiety medication for the longest time,

you've been hesitant and then finally you plucked up the courage.

Maybe you chatted to your vet, maybe you went to see a vet behaviorist but either way

you've gone for it, you've put your dog on anxiety medication.

But here's the thing, it feels like they are not working for your dog and this can happen.

Some dogs just don't respond to anxiety meds.

Why is that?

Well, we don't exactly know but I will go into some of the reasons why we think it might be

the case in this episode and in this episode I'm also going to talk about whether the fact

that there's no guarantee with anxiety medication, whether that should affect your decision to go

down the medication route in the first place.

Find out more in this episode of the Fixing Separation Anxiety Podcast with me,

your host Julie Naismith, trainer, author and a full-on separation anxiety geek.

Hello and welcome to the Be Right Back Separation Anxiety Podcast.

Hi, I'm Julie Naismith, dog trainer, author and full-on separation anxiety geek.

I've helped thousands of dogs overcome separation anxiety with my books,

my online programs, my trainer certification and my separation anxiety training app.

And this podcast is all about sharing my tips and tricks to help you

teach your dog how to be happy at home alone too.

Let's start off by talking about what we mean by anxiety medications.

So for dogs who are suffering from conditions related to anxiety or fear,

there are typically kind of two broad classes of medication that we see being used.

We've got medication that's given daily, it's longer acting, it typically takes a few weeks

to make a difference and you give it to the dog, as I said, every day.

Then we've got a group of medication that can be quite varied, but we would call them

situational meds. They tend to be shorter acting. You might use them as the name suggests

on an ad hoc basis. The certain situation you need to help your dog with an anxiety

related issue for a particular context. So you would use the situational meds

in that situation. Some vets and vet behaviorists might also prescribe these

shorter acting meds in combination with the daily use longer acting meds.

And why would you even consider medication for dog anxiety in the first place?

Well, anxiety medications or medications that help with conditions like anxiety or panic

or depression in humans do have a good track record of helping when combined with talk

therapy. So there's really good evidence to suggest that for some people,

talk therapy combined with the right meds is the best treatment approach.

But equally, they work in dogs. There's evidence and studies that show,

again, that when we combine medications for anxiety with behavior modification training,

with essentially training therapy for dogs, then we are more likely to see improvement.

So how do they work? Well, the medications either have a direct impact on brain chemicals like

serotonin or dopamine, or they might be making the brain more plastic. And what we mean by that

is they make the brain more capable of changing. And when a brain changes and repairs,

it's healing and creating new pathways. And those new pathways can be pathways that are

fear-free. So they are no longer the dog having a fear-based response.

We create new pathways where the dog responds in a non-fearful way.

When they work in separation anxiety, they can be game-changing for our training. And some of

the benefits include just lowering the threshold of the dog sufficiently that we can kind of get

a handhold on training. We get enough to get the training to start having traction. And it's really

important. It's the same with anxiety medication for people that, for the most part, the medication

on its own really isn't enough. So they help us get just enough reduction in threshold that we

might get some traction. Very often another benefit that we see is that they help manage

dogs' progress in a smoother way. So we see less variability. We see less of those really frustrating

crushing ups and downs that we get with dogs who aren't perhaps on medication. And it can be true

that on dogs who respond well to anxiety medication, we can see quicker progress. The dogs just seem to

be able to progress in chunkier, bigger steps. So as I said, when they work, when the dog responds

well to anxiety medication, separation anxiety training can be so much less of a heartache.

But many people are really reluctant to use medication, anxiety medication for dogs.

So if this is you, if you feel like, oh, I shouldn't be doing this, this is all wrong,

how could people possibly think about putting their dogs on anxiety medication? It's ridiculous.

If that's you, just know that you're not alone. If that's you right now or whether it was you

in the past, that's normal. It's natural. Lots of people feel that way. And it's no wonder that we

worry about putting dogs on medication for anxiety because there's a huge stigma about people going

on anxiety medication. There's stigma, there's the worry of judgment from others, other owners,

family members, friends. You worry about the side effects. So it's not uncommon to have a really

good, long, hard think before you put your dog on anxiety medication. It's just, that's just normal.

By the way, if you are worried about side effects, really dive into that. And when you

chat to your vet about medication or whether you're even not there yet and you're still doing

your research, have a look at the side effects because for the most part, and your vet will

be the best person to explain this to you, but for the most part, the side effects are temporary

and they can be unpleasant, but they are not usually highly serious. They're not, you know,

we're not talking about a huge amount of risk, but do check that with your vet because it varies

by dog, obviously. And when you're thinking about side effects, you need to factor in,

on the other side of the equation, when you're weighing up, you know, should I medicate my dog

because of side effects? On the other side of the equation, you've got to factor in the impact of

the chemicals that are produced in toxic stress. So hop onto Google Scholar and have a look,

type in toxic stress, or you can type into Google, type in toxic stress and you will see

there is a wealth of research about the impact on health of toxic stress in children. So that

always makes me think, yeah, we are worried about side effects, absolutely we are, but we should

also be really worried about the side effects of toxic stress. So do your research, but look at it

evenly, you know, consider the two halves of that equation. All right, but you've done your research,

you are okay with the fact that you might get judged and you know there's a bit of stigma,

so you've put all that aside and you decide to put your dog on anxiety medication.

However, you're now weeks, maybe months in and nothing is changing. Your progress is sticky,

your dog keeps regressing, it's variable, the progress is variable at best and you feel like

you're just not getting anywhere. Unfortunately, this is something that I see all too frequently

because the reality is it can take a long time to get the right med at the right dose

and it might even require a combination. Now, when my dog Percy first went on fluoxetine,

we were actually among the kind of the rare cases where he had the right med at the right dose

first time. Now, I was a massive, massive skeptic about putting my dog on anxiety medication. I

thought it was ridiculous, I, you know, wasn't the sort of person who would do that, who would do

that, who would put their dog on anxiety medication. But we tried all the things,

we've done all the natural stuff, we've wasted a fortune on things that didn't work and that just

took time, you know, we waited to see the results of things that were never going to

have any impact. So finally and reluctantly, we tried fluoxetine and it made a difference.

Oh my goodness, did it make a difference. The training just got smoother, we had way more

successful sessions than we had in the past and it just was just a revelation and he wasn't

changed in any unwanted way. So people are always worried and maybe this is you,

if you're listening to this and you haven't made the decision yet to medicate,

you might be worried about the zombie dog, you might be worried about losing your dog's

personality. But anxiety meds don't do that. I mean, I know from my own dog that what we got was

Percy, only better, Percy without the extreme stress and anxiety. Imagine if you could have

that, your joyful, happy, fun-loving dog but without the stress. Wouldn't that be amazing?

I like to remind people that if they think that anxiety medication or medication for depression

in humans make people into zombies, turns them into some kind of sleepwalking, sedated

shell of themselves, there are way more people in your social circle and your friends and your family

who are on anxiety medication than you will ever know. And how come you don't know? Because

they don't sedate, they're not turning your family and friends into zombies.

They are allowing that person to be the best version of themselves. So if that's worrying you,

put that to one side. If it does make your dog into a different dog in an unwanted way,

you chat to your vet. Anytime you get side effects that seem too extreme or unexpected or unwanted,

you chat to your vet. That's really important. So let me go back to this, how you get your dog

on the right med at the right dose. And let's talk about combinations of meds as well.

So I said Percy was right dose, right med the first time. We were very lucky. Actually,

if we hadn't been really lucky, I don't know if I'd be standing here doing this podcast today because

I might have given up on Percy's training. And hey, if I hadn't got Percy through separation

anxiety, I would never have embarked on this journey. So right med, right dose and possibly

combination. So we'll be looking at here. So when you work with a vet or vet behaviorist,

they'll be looking at possibly in the first instance, just one medication and they'll be

looking at dosage options, just like with any medication for you or for your dog.

And sometimes that first medication might need to have dosage changes. So your vet might start

at, say, a low dose and then want to increase the dose over time. So that could be one of the first

things that your vet is going to do. They might adjust the dosage. Then we've got, well, is it the

right medication at all? So what you often see is that your vet will potentially adjust the dosage

and look for results. And if that doesn't happen, if you're still not seeing any improvement in

training, any change in their stress levels when you attempt to go through the exercises,

any shift in their threshold, then it might be that it's not the right med or your vet might

consider a combination at that point. So I've seen both of those two options come into play

at that point. So you've gone through all the options on the dosage and then I've seen vets

decide, OK, well, either what we'll do is we'll switch to another med or we'll add another

medication into the mix, a combination approach. And that's a really common approach with humans

as well, with human patients. So adding another medication into the mix can very often be the

answer for lots of dogs. And you will see that some vets will do that. But it could be that that

combination doesn't work. So then maybe you have to think about switching out that first med,

the primary med that the dog had been on every day. And your vet might suggest, OK, well, we'll

switch. So maybe the dog was on fluoxetine and now your vet is suggesting that your dog should be

on clomipramine. You then potentially got to go through dosage adjustments on that medication.

And you might add a second medication in with that initial one and repeat that kind of attempt

to get the right combination. So can you see how it can take some time? It can take some time to

get that right med, right dose and the right combination. So there's definitely a need for

patience. And I don't know if I would have stuck it out. I have done. I have done that with my own

dogs, with Tex. We spent a long time working through dosages and combinations and switching

meds. But if I hadn't had success with Percy, I don't know. I don't know if I've been as persistent

with Tex. When you commit to going on medication, particularly if it's something you were reluctant

to do and the meds don't seem to be working, I feel so bad. I feel bad for you because it took

all your gumption and your courage and your commitment to your dog to actually have that

conversation about medicating. And I feel bad for your dog because we know that when we get a med

that works for a dog, it does help reduce the daily stress of life just enough. It turns down

that stress, that anxiety, just enough that they're able to be their best selves without a

constant sense of anxiety. And when I say meds don't work, as I mentioned, I see that it can be

quite common. Some dogs don't seem to respond regardless of the combination or the dose or

how well you're working with your vet to find the right, the magic combination or the magic med for

your dog. There is no wonder that lots of people get despondent and decide to give up. Like I said,

if it hadn't been the right med at the right dose first time for Percy, I would have given up.

So it's no wonder, I don't think it's any wonder that people do give up, especially

if it was something that you kind of had to convince yourself to do in the first place,

which was definitely me. So I was almost waiting for it not to work. So if you're feeling despondent,

if you're in the middle of this journey, stay with me because I'm going to talk to you about

some things that might help if you're feeling this is never going to work and I feel just

terrible about it. But why don't meds work for some dogs? The truth, we don't know.

If you look at the literature around medication for human depression, anxiety,

we don't know for people either. We don't exactly know why. There is more and more research being

done into people and conditions and attempts being made to really understand the nature of

mental health and brain health in order to match medication to the condition. But there are about

40 different drugs out there that act on neurotransmitters, the chemical messenger

systems in the brain, 40 different drugs. So no wonder it can be hard to work out which one is

right for which brain because we don't exactly know the chemical issues or the problems that

the brain is having, even though we might see presenting symptoms. We don't exactly know

for each subject's brain what's going on and therefore what remedy is needed. So if it's

that hard, if it's that difficult, if it's that much of a shot in the dark, should you even consider

medicating? The answer is yes. Yes, absolutely, because when they work, when you get the right

net, if you are lucky, and some people might not be, so I will talk about that, but if you are lucky

and it does work, you stand a really good chance of transforming your training. However, if you are

still thinking, is this for me? Should we do it? Or if you are struggling thinking, we've tried so

many options and we are not going to get there, here are some factors that I think you should

consider right now. So if you're starting out, so you haven't yet put your dog on medication,

here are three things I want you to ask yourself. Number one, how will I feel if medication doesn't

work for my dog? So think ahead, it could be a great outcome, medication could be a game changer

for your dog, but it might not be. So how will you feel when you get to the point where you realise

this isn't going to work for your dog? You've exhausted all options, you've worked with a

wonderful veterinary team and you're just not getting there. And everybody decides, okay, that's

it, you know, it just seems like for this dog, for your dog, it's not going to work. So imagine how

you're going to feel. You're going to feel pretty rotten, I'm sure you will, but I want you to make

sure when you set out that you know it's a possibility and you're ready for that feeling

of disappointment in case it does hit. So just think ahead so that you're ready. Number two,

ask yourself, how prepared am I to give this a really decent chance? And that means not just,

you know, a few dosage changes on one med, it doesn't mean you'll maybe try, you know,

one med for six weeks and then give up. It means really giving it a chance. It means

working with a veterinary team who are really committed to working this through. So it's like,

don't give up at the first obstacle, don't give up as soon as you think, oh, this isn't working.

We talked about the daily meds that lots of dogs end up on and, you know, those can take four to

six weeks before they have any effect anyway. So you don't even know for six weeks whether

there's been no effect or some effect because you're still waiting for that med to start

functioning in the dog's brain. So, you know, you're waiting a long time before you have any

data on whether it's working. So you have to be prepared to give this a decent chance. I would

almost say kind of don't do it unless you're prepared to dig in and be ready for the fact

that this is going to be an ongoing piece of work basically to get the right medication at

the right dosage in the right combination for your dog. Question three, the third thing I want

you to ask yourself is how ready am I for the cynics to say I told you so? Because you know

they are going to say it. If you've given this your absolute best shot, you come to the conclusion

with your vet that really you kind of explored all possibilities and it's just not worked out

for your dog. So you're going to walk away from the whole medication piece and somebody is going

to say, I told you so. I told you so. So in that moment, there's nothing you can do. They're going

to say it to you but just be ready for it. Brace for it because there's a chance that they will say

it to you. Those people who thought you were completely crazy or it was totally inappropriate

for medicating your dog, those people, just be ready for them to say I told you so. Now if you're

starting out, you're already in the process, you're already working with your vet to get the

right meds for your dog, here are four things I want you to say and I want you to say these to

yourself. First of all, I mustn't give up too soon. Keep saying that and ask your vet have we still got

options? Is this still worth pursuing? So you know keep that conversation going. One of the ways that

you can make this process go quicker by the way is keeping really good data, being really on top

of any changes or no changes and having regular conversations with your vet. So if you leave it

for a year but you knew after like two months there'd been no difference as a result of the

medication and you're only going back to your vet at the annual checkup, the whole process is going

to be slowed down. So you want to agree what's a reasonable time period to give this medication

and then when you're going to go back and talk to your vet. So keep the process moving on. That's

one of the best ways you can make this go quicker. Second thing, you can also say to yourself it's

okay to say that this isn't working. You are absolutely allowed to say that to yourself.

Don't judge yourself for having tried something that maybe didn't work out because if you've

done number one which is you've repeated to yourself I mustn't give up too soon and you've

really dug in. If you've done all of that then it is okay to say you haven't failed. It's okay to

say this isn't working. But number three what I want you to do is just check that you're not looking

to get out of this because you thought it was something that you shouldn't be doing in the first

place. So ask yourself am I just looking to prove myself wrong? Am I so skeptical about this that

I'm going to give up at the slightest hint that this might not be working? So that's number three.

Am I just looking to prove myself wrong? Am I looking to prove that this process,

this whole medication thing doesn't work? And number four just as with all the people who

haven't started out yet I want you to be ready for the told you so's. So ask yourself am I

prepared for the told you so's and if not brace yourself for when they do tell you.

If you give up after you've given this your absolute best shot then just put your fingers

in your ears when people tell you that it was a stupid thing to do in the first place. No it wasn't.

It wasn't wrong and it wasn't immoral and it wasn't unethical and it wasn't silly.

You were absolutely trying to do the right thing for your dog. If it didn't work out,

if it doesn't work out you still put your dog's interests first. I mean I hope it doesn't come

to this. I hope that you find that there is a way to help your dog's anxiety with medication.

But I just want to be there for you in case that doesn't work out and I always say in this whole

journey of separation anxiety training you need to lean in. You need to talk to other people who've

been through exactly what you're being through. See how many medications they've tried. How long

have they been trying? Your three months might seem like an eternity to you but you might find

that somebody worked on the medication combination with their vet for maybe nine months until they

saw results and if you find that out your three months, well you might say my three months isn't

enough so I'm going to keep going. So lean in, definitely absolutely lean in and above all

please be kind to yourself. If you do feel that you need to give up on the pursuit of finding the

right medication for your dog then provided you've given it your absolute best shot that's okay.

It's okay to stop and it's okay especially if you've given it your best shot and you've worked

with your vet and you've run out of options. It's okay to say all right we've done all we can

but I do need you to give it your best shot. Promise me? Good because if you find something

that works you'll never regret how long it took or how hard you had to try. I promise you you'll

never regret that. Okay that is it from me for this episode. Thank you so much for tuning in.

I know you have a lot of options when it comes to podcasts so I really appreciate you taking the

time to listen to mine. Don't forget to join the Facebook support group Dog Separation Anxiety

Support, an entirely free group that's full of resources and join me weekly on my Facebook page

for my question and answer live sessions. Meanwhile keep training and I look forward

to you joining me on another podcast soon. Bye for now. Thank you so much for listening to this

episode of the Be Right Back Separation Anxiety Podcast. If you want to find out more about how

I can help you further head over to julienasmith.com. Meanwhile if you enjoyed listening today I would

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show. Thanks so much, good luck with that training and bye for now.