Page 225 - WSAVA2017
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 Parameter Recovery
Welfare Environment
Risk
Predictability Latency to Arousal Severity
Prescribe Do not Prescribe long short
yes no
no yes
yes no no yes short long mod-sev mild
beyond that?
In the case above, you may decide to use Clomicalm® because it also blocks the H1 histamine receptor and will cause fairly quick slight sedation giving the owner some relief while you wait four to six weeks for the full effect to become apparent on the dogs primary disorder of fear. If the dog’s affect is more flat, but not depressed you may choose one of the selective serotonin reuptake inhibitors.
If the dog is apathetic and curled up in the corner of
the room, unable to even walk outside to a eliminate without fear you may choose to use a selective serotonin reuptake inhibitor and a benzodiazepine to elevate mood quickly so that the dog can have improvement in her quality of life before the time that it takes for the selective serotonin reuptake inhibitor to work. Keep in mind that there are many combinations. There isn’t one perfect medication for each diagnosis.
A full blood panel including a urinalysis and a thyroid hormone assessment as well as a physical examination should be done on all animals to be treated with medication. Patients treated with dietary supplements or a change in diet should still have a complete physical exam however there isn’t a need for lab work unless there is another circumstance which leads the veterinarian to believe that laboratory testing would be proper.
There are four possible outcomes when considering the seven questions above:
1. No medication
2. Primary medication
3. PRN medication
4. PRN and primary medication.
Once the veterinarian has determined based on the questions above that the patient does in fact need a medication or supplement to improve significantly, the question becomes which medication to choose. First, make a diagnosis. The diagnosis will generally point
you to a class of drugs. For example, if you diagnose a patient with generalized anxiety and fear, you will be led to the antidepressant category. From there, you will have to decide which drug class with in the antidepressant category would be best for this particular dog. Consider first the dog’s affect. Is the dog very kinetic and frenetic in it’s manifestation of fear? Which your transmitters might be at the root of this dog’s behavior disorder? Serotonin and norepinephrine are both involved in fear and anxiety. In addition, norepinephrine can affect energy level. What effect do you want from the medication? Do you want
it to slow the dog down, speed the dog up, or simply relieve the fear without any alteration of the dogs affect
An Urban Experience
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