The first medication we tried

I am obviously not well-versed in the different medication available and which is best for different situations so I am only writing from our own experience.

We had discussed whether to try a situational drug as well as the long-lasting (but slow-building) Fluoxetine. I decided to go ahead with the situational drug (Pregabalin) as George was clearly struggling at that point and waiting another 6-8 weeks for him to have any relief sounded tough.

The trainer thought that he might be experiencing some pain in his back leg. Nothing obvious was found on examination but they recommended a pain trial. Pain is often a key factor in reactive dogs, particularly those experiencing noise sensitivity.

So he was prescribed a quarter of a human Panadol once a day. The Pregabalin also has pain-relieving properties.

We started on tiny amounts. The Fluoxetine upset his stomach a little but it settled.

He went off his food for a while. He would eat sometimes if I played games with his kibble (find it etc). Toppers were also helpful.

A sprinkling of boiled chicken was 100% effective but I noticed George was getting quite itchy so I wondered if he had some sensitivity to too much chicken. When I pulled it back, the itchiness stopped.

So eating was a bit of a saga for a while (especially as the medication should be given with food) but this passed in a few weeks.

He was pretty sleepy in the first couple of weeks but this also wore off.

I couldn't see any noticeable effects from the Pregabalin. There was a decrease in reactions (see Reactivity Tracking) but I'm pretty sure that was because I improved the management and dramatically reduced exposure to triggers after meeting with the VB and trainer.

We gradually increased the Pregabalin to the maximum dosage for his weight. I still hadn't really seen any improvements.

Similarly, the Panadol didn't seem to be making a difference so we decided to wean him off by giving him the quarter every other day for a week then stopping.

We were advised not to make too many changes at once so some time after that, we did the same with the Pregabalin. I changed to one in the morning and one in the evening (as opposed to two).

I thought I did notice a worsening in reactions when I reduced the Pregabalin.

But there were other factors (increased exposure to unavoidable triggers plus an overnight in daycare) so I wasn't sure.

We went back up to the previous dose for a couple of weeks. After observing for a little longer, I thought Pregabalin wasn't making a difference so we started the weaning process again.

We were still struggling. The VB suggested trialling another situational medication, Clonidine. We started on a low dose again and built it up.

George didn't have an upset stomach this time but did have some initial drowsiness which soon passed.

Clonidine has been amazing for George's noise sensitivity and calmness in the car (see Our journey with noise reactivity and Reactivity in the car)

We had also slowly increased the Fluoxetine. I had been fully prepared for the 6-8 weeks loading but I think for George it actually took a lot longer.

George went off his food and/or had a little upset stomach each time we increased the dose but we were able to work through this and it passed.

It was a more subtle effect and being so close to the situation, it can be difficult to notice despite painstakingly tracking reactions.

On our third session with the trainer, she commented on his increased calmness.

Later on, we had a follow up with the VB who said he was like a "different dog".  She was very pleased with his progress and definitely thought the Fluoxetine was having a positive effect.

It was very reassuring. It can be difficult to know if you're doing the right thing when your dog is experiencing side-effects but you can't always see the improvements.

This is getting quite long so I'll write another post about where we are currently.

From reading others experiences, I knew it would be a long road to get the combination and dosages right. It's pretty rare to get it right on the first go. But we have come a long way from where we used to be.