Tucker's vet trip/behavior med consult

Maxy24

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#1
I took Tucker to the vet on Friday. He needed a regular exam and vaccines but I mainly wanted to go to ask about potentially getting him on meds for his fear aggression and reactivity. This was the first time we had seen this vet and I loved her. Tucker was a very good boy, he always makes us seem like fools at the vets because he never shows any aggression at all, though I am thankful because that makes it very easy to get things done quickly. By the end he was taking treats from and giving hi fives to the tech. Meanwhile we're trying to convince them he's aggressive (not really, they did believe us).

The vet talked with us (my mom was with me also) for a long time about his behavior. In the end she said she has no problem putting him on meds as long as we understand it's not magic and that it's not going to change his underlying temperament. She believes (as I do) that his behavior is mainly driven by his genes so, while the meds may help, Tucker will never be "cured". Of course I already knew this, I just think we could use all the help we can get. However, she'd really like us to talk to a vet behaviorist first. Partly because she'd like their advice on which medication to prescribe and partly because she'd like us to have the training advice to go along with it. Her main concern was that some meds have the ability to cause disinhibition of aggression which can lead a fearful dog who wouldn't normally bite to start biting. This is probably my main concern as well, though he's already more than willing to bite strangers so I don't know how much less inhibited he could get. I'm actually more worried it could cause him to bite us or the cats more rather than making his stranger aggression worse. There are instances where he growls at us that I worry could turn into biting on meds, and I'm afraid his reactivity towards the cat could turn more serious. I suppose we could always just take him off the meds if that happens.

So anyway, the vet suggested we go to the Tufts behavior clinic. If we couldn't actually go there then they have something called Pet Fax that one of her techs used with good success. I guess you fill out a bunch of forms on your dog's behavior and fax it to them then they respond with training and management suggestions plus med suggestions if they feel it's warranted. She wasn't sure what the cost was, she said maybe $300-400 but I'm not sure if she was referring to Pet Fax or to the in person consult. Hopefully that's for in person because there is no way I can afford that especially since I'm really only doing it for the med recommendation. I don't know how much training wise they're going to tell me that I don't already know. I'd rather spend the money on a reactive dog class or a trainer who can come to our house and work with us. The vet said if we really don't feel we can afford Tufts she is willing to prescribe us meds anyway, though she'd still like us to see a trainer. She just would really like the vet behaviorist's opinion on meds. She would likely give us prozac or Buspar, she's not 100% sure yet.


I've looked on the Tufts behavior website in the past but looking at it now it looks like they have changed their services a bit. They no longer list phone consults or Pet Fax. They have in person consults at Tufts or VetFax. Honestly I see no benefit to bringing Tucker in, his behavior will not present itself there like it does at home. He'll be too scared and shut down from being somewhere new to be reactive. Plus I'm better at explaining myself through writing than speaking so I'll likely give a better description of his behavior through the forms. So I'm interested in the Vet Fax. It's different from what the vet was talking about though. This service is a vet-to-vet thing, they fax the forms to the vet and you and the vet both fill them out then the vet faxes them back to Tufts. Your own vet determines the cost. Hopefully my vet will be willing to do this. I'm planning on calling Tufts in the next few days to learn more about how to do it.

Has anyone done a pet fax type thing before or have experience with Tufts specifically? I'll keep you all updated.
 

milos_mommy

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#2
I think meds will help Tucker quite a bit, especially with all the training you've done and it will likely help him become more receptive. As far as worries about him becoming agressive towards you/the cats, I'd just watch him extra closely for a week or two after he starts. Also, it can take a while for them to adjust, Milo was so mopey and sleepy and almost depressed-like on Prozac, but after about a week he leveled out (still much mellower and sleepier than off the drugs, but he plays and wags his tail and gets excited for stuff, just not as bat-sh!t crazy excited where he starts attacking his own shadow or murdering a toy and then redirecting).

Unfortunately, I do think we payed $800-$900 for his evaluation (included follow up phone calls). It's not cheap by any means.

ETA: doing it via a form seems weird to me. Half the time I meet with clients they start talking about their dog's behavior and it's so incredibly off base ("he tries to kill other animals" when the dog is just vocal during play, "he bites people aggressively" when it's just puppy mouthing, "he's terrified of strangers" when the dog is relaxed but disinterested, etc). I feel like you're knowledgable enough to give them a good account of Tucker, but for the general public or average (even experienced) dog owner I can't imagine that works as well as a consult with observation of the dog.
 

Maxy24

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I spoke with Tufts today. An in person consult is either $469 or $397 depending on which doctor you see. The Vet Fax is $222. The Vet Fax price is doable but I'm just afraid I'm wasting money. All I really want is their med recommendation. I don't know how much help their written instructions are going to be, I've read plenty of info on how to work with aggressive dogs. I've read some of their case examples online (though none of the ones I've seen have been for stranger directed aggression) and there is nothing there that I wouldn't have already known to do, it's not super specific to the dog.

I just feel like for actual training advice I'd be better off going to a regular trainer who can come to my house or going to a reactive dog class where I can get practice with a trainer's guidance. Someone who can watch him and me and tell us exactly what we're doing wrong (or right) as we're doing it. I probably need help with timing of rewards and with setting criteria, Tufts isn't going to help me with that.


There is a trainer in brookline who works a lot with reactivity and aggression that I've really wanted to go to. She charges $225 for an in home consult and has a reactive dog class that is $240.
 
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#4
Personally I would take your vet's prescription and find a local trainer. I did the veterinary behaviorist consult for Gambit and it was a waste of money. Nothing they told me was news to me, especially because I heard a lot of 'well he's a unique case', which I had already heard from the last behaviorist I went to.
 

stardogs

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#5
Those prices blow my mind - our vet behaviorist here is $225 for an in person consult and unlimited phone consults afterward.

I'd probably start with your vet's prescription and if that med doesn't work THEN go for the VetFax option.

I do have a client whose dog had a rough initial adjustment to Prozac (big increase in owner directed aggression due to lowered bite thresholds) but after the first 4 weeks he leveled out and is doing MUCH better.
 

pinkspore

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#6
I would get the prescription from your vet and skip Tufts. I wish I could recommend veterinary behaviorists to people more often, but it's $500 to walk in the door at either of the two within a day's drive. That's a lot for a vet visit.
 

milos_mommy

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#7
Maxy, will your vet write an RX without the consult?

Here, no veterinarian I've met will prescribe psychiatric medication without a consult from a behaviorist. So if you want your dog on meds, you don't really have a choice.
 

Maxy24

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Yes she said she'd write us a prescription without the consult she just would prefer having the vet behaviorists guidance when it comes to picking the right med.

I think we're going to go ahead and ask her for the meds without the consult and I'm going to try and get involved with the trainer in brookline and hopefully join the reactive dog class (if she allows human aggressive dogs).
 
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#9
In your 2nd paragraph you write a bunch of very good advice she gave you. I'd heed it. Medications aren't going to fix this dog, it isn't going to mean you can take a dog perfectly willing to bite a stranger, out around people because now it's on medication. It still needs to be managed every bit as strictly and with the safety of everyone in mind, as before you decide to put a dog on medication for temperament flaws and behavioral issues.
 

Maxy24

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I'm perfectly aware he will always have to be strictly managed and have no intention of allowing him to interact with strangers in public...I didn't think I implied that anywhere. I'd like him to be less reactive towards dogs so we want to kill him a little bit less for barking all day long. We've come a long way with barking at dogs and I think with meds we can maybe go all the way and make him stop caring about every dog he sees. I'd like him to be less upset by guests coming over so he's less dangerous. Right now all the work I've done has made his behavior more controllable so he appears better (doesn't bark anymore, doesn't pull to get to people, gives me very good focus) but his tendency to bite has become worse. Originally he would only attempt to bite visitors who interacted with him directly with prolonged eye contact, talking to him, or attempting to touch him. Now if someone walks by him close enough he may attempt to bite their heels after they pass. Clearly it's not working right. He used to just have to be leashed and we'd tell guests to ignore him. Now he must be leashed and muzzled or kept in a room (where he barks the entire time). He's getting worse.


I don't expect to make him all better, any improvements would be awesome.
 

pinkspore

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#11
All your posts about Tucker make me think you're doing a pretty darned good job of managing his behavior. You definitely express a realistic expectation of the medication and its effects, and I think it might be enough to help make Tucker a little more livable. For what it's worth, I've never gotten the impression that you believed medication would magically fix him, just that it might take the edge off a little so he can worry less about life.
 
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I'm perfectly aware he will always have to be strictly managed and have no intention of allowing him to interact with strangers in public...I didn't think I implied that anywhere. I'd like him to be less reactive towards dogs so we want to kill him a little bit less for barking all day long. We've come a long way with barking at dogs and I think with meds we can maybe go all the way and make him stop caring about every dog he sees. I'd like him to be less upset by guests coming over so he's less dangerous. Right now all the work I've done has made his behavior more controllable so he appears better (doesn't bark anymore, doesn't pull to get to people, gives me very good focus) but his tendency to bite has become worse. Originally he would only attempt to bite visitors who interacted with him directly with prolonged eye contact, talking to him, or attempting to touch him. Now if someone walks by him close enough he may attempt to bite their heels after they pass. Clearly it's not working right. He used to just have to be leashed and we'd tell guests to ignore him. Now he must be leashed and muzzled or kept in a room (where he barks the entire time). He's getting worse.


I don't expect to make him all better, any improvements would be awesome.
and in my response, I didn't imply that you would. But your vet gave you good advice and you obviously think the rest of that isn't important, just getting your hands on some meds is. Every response of yours after is about skipping any consult involving getting the right meds or coordinating it with training to make sure the right stuff is happening anyway is wanting to be skipped, by you, to save some money and get the meds. Even with the warning it could make things worse.

I'll just keep my mouth shut next time. I don't know why I thought this would be any different. People are never looking for advice, they're looking for validation. and you're right, just getting some meds will probably make things better, even just a little bit and you'll be happy and so will your dog.
 

pinkspore

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#13
Did you miss the bit where the veterinary behaviorist was going to be cost-prohibitive? How about the other discussion about prioritizing vet care for which pet because the budget was tight and getting tighter? This isn't about validation, it's about finding a way to afford getting meds for Tucker. Going through a veterinary behaviorist may be the correct way, but not everyone has the means to spend hundreds of dollars on it so the choice may be to simply not try meds for a dog who would clearly benefit.

At any rate, my own vet routinely prescribes Prozac for various issues without me spending $500 to see a veterinary behaviorist because she doesn't see many downsides to giving it a try. I believe others here have similar experiences, so insisting that the most expensive route is the only proper route seems unreasonable.
 
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Maxy24

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#14
I'm not planning on skipping behavior modification and just popping him some meds to see what happens, I said I'm planning on working with a regular trainer instead of a vet behaviorist. Yes I wish there was someone knowledgeable I could talk to if there are side effects, that is the benefit, and probably the only benefit, of a vet behaviorist over a vet plus regular trainer. I'm not just trying to save money I'm trying to figure out where my limited funds are going to be the most helpful. Either way I'm likely spending the same amount, actually I'll probably end up spending more with a regular trainer because they'll want to see him more than once, I just think the trainer will be more helpful for us than the vet behaviorist when it comes to working on his behavior. It sucks that there isn't just some way my vet could have a phone conversation with a vet behaviorist for advice that doesn't cost over $200. Tufts used to have a phone consult option, they no longer do.

I'm not disregarding what my vet said. I am aware meds will not cure Tucker. I am aware of potential side effects including increased aggression and I share her concerns about them. I heard everything she said and agreed with her and I'd still like to give it a try because Tucker's a mess and I think meds could help. The only thing I may be "disregarding" that she said is that she'd like help choosing a med and without me going to a vet behaviorist she isn't going to get that.

I'm not just looking for validation, I'm taking what you are saying seriously and just trying to work out what is best. I really thought that a regular trainer would be more helpful but now I am considering Vet fax again. I'm just so torn over what's going to be most helpful for him. Do I go to a vet behaviorist so that my vet can have help choosing meds and I can have help if there are side effects (well not me, I'm not allowed to talk to the behaviorist through vet fax, only my vet can) or do I choose a trainer so I can have help with behavior modification?
 
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Did you miss the bit where the veterinary behaviorist was going to be cost-prohibitive? How about the other discussion about prioritizing vet care for which pet because the budget was tight and getting tighter? This isn't about validation, it's about finding a way to afford getting meds for Tucker. Going through a veterinary behaviorist may be the correct way, but not everyone has the means to spend hundreds of dollars on it so the choice may be to simply not try meds for a dog who would clearly benefit.

At any rate, my own vet routinely prescribes Prozac for various issues without me spending $500 to see a veterinary behaviorist because she doesn't see many downsides to giving it a try. I believe others here have similar experiences, so insisting that the most expensive route is the only proper route seems unreasonable.
yes, psychotropic drugs should be readily available without proper consult LOL.

if all you want is a drowsey dog that might not react, just keep it on benadryl, cheaper option yet. Don't need a vet or a behaviorist or trainer, because clearly medicating animals is no thing, you can do it over the internet.

we medicate the crap out of our populace and now our animals and here our country sits, clearly better than the rest :rofl1:

anyway, my 2 cents, never met a dog that couldn't be trained or managed without medications. Ever. Find a competent trainer.
 

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#16
Gambit could be both trained and managed without medications. However, the meds made his quality of life so much better. He went from being an anxious wreck 24/7 to being able to relax and enjoy himself so much more.
I spent a ton of money/time/energy avoiding medicating him. Within 6 months of starting the meds, we were able to accomplish things that we hadn't in the year and a half I had tried before. Didn't change anything except starting on the medication.
He's not on them any more, but I really feel like the start they gave us is what saved his life.
 

milos_mommy

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#17
I don't think anyone who's posted in this thread wants a drowsy dog that might not react because they're sedated. And maybe you've never met a dog that can't be managed or trained without medication, but there are plenty out there - hence the many dogs put down for behavioral problems even after extensive work with trainers, and even for dogs that could eventually be managed without meds via behavior modification, it doesn't mean that's feasible for any typical family or that it's not unfair to deny a dog psychiatric help that will make them worlds more comfortable.

I guess there are people who believe people just make up mental illness and shouldn't take meds either.

My family spent, like I said, nearly a grand on a vet behaviorist consult. At the time, Milo was 6 years old and had been exhibiting fairly severe psychiatric symptoms/aggression since around 10 months old. I had been attempting to manage his behavior via training for that entire time, eventually taking college courses in ethology, etc. Very similar to what Maxy has done for Tucker, as evidenced in her many threads. Milo improved greatly, but was still an extremely unstable dog that was unsafe around the public and guests and still would aggress towards family, not to mention exhibit intense symptoms of anxiety, self-mutilation, and OCD - all of which I made much better through training, but was still present at a lesser level, a level that still damaged his quality of life.

I knew he needed meds and the vet wouldn't do it without a consult - no vet here does that I know of. So for $900 the behaviorist came to our house and told me my dog needed meds (no sh!t) and to do exactly what I had been doing. He showed me what training equipment to use, which happened to be the exact training wear I already used, and took us for a walk and showed us what warning signs of anxiety/distress to look for (I was already very familiar), and how to handle him during a pending reaction (exactly what I had been doing for 6 years).

Part of the problem is he's my parent's dog and they're extremely inconsistent in his training, but I think even with a more structured environment, he would have greatly benefitted from the meds. We all benefitted zero from the behavior consult, and while it's imperative for people without much background in animal behavior and the chemical reactions of medications on a dog's neurosystem, or someone who hasn't extensively researched behavior modification for reactive dogs, when someone has been working for years with their dog and doing it appropriately, a behaviorist isn't going to help any more than a typical trainer.
 

pinkspore

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#19
I managed Brisbane for nine years with training, but I couldn't make him any less OCD and I couldn't prevent him from developing a new phobia every time he had a bad experience. I had multiple vets offer to prescribe meds, none ever mentioned a veterinary behaviorist. When he started the meds it was like those nine years of training suddenly clicked all at once. It was the missing piece that finally allowed him relax and bounce back from bad experiences and not worry so much about the world.

The Prozac definitely doesn't make him drowsy. Actually, he gets a lot of benadryl every day and that doesn't make him drowsy either. All the meds have done is hell him feel safe enough to relax for the first time in his life.

At any rate, I don't think release the hounds is actually discussing "should Tucker see a veterinary behaviorist to get meds" so much as "is mental illness actually a real thing". None of the vets in my area require a consult with anyone else to try psychiatric meds because the effects are not usually dramatic and the risk of adverse effects is minimal. At least that's what they tell me, and we've seen quite a few in the last decade.
 

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