Sunday, February 10, 2013

Prozac...Day 5

We visited a new vet this week, and my baby, Chloe, was put on Prozac. For the past five years or so, since Mia died in January, 2008, she's been chewing the fur off her stomach and legs. Our vet at the time (who was fabulous, and still missed) advised we'd need to rule out allergies first before we could consider it behavioral. Apparently cat allergies fall into four main categories: food, flea, seasonal, and dust. Things like dust and pollen that would cause sneezing and congestion in humans cause skin reactions in cats. She was put on a food trial for 12 weeks where she had to eat a special, limited ingredient diet with an unfamiliar protein (I think we went with duck and pea, they also had rabbit, and venison) and none of the traditional grains (wheat, rice, corn, etc.). She couldn't have any treats or her regular wet food, just the prescription diet. It didn't help, so then we did a flea trial where she had to have a round of prescription flea meds, even though I don't think she's ever had a flea in her life. That also didn't help. Her symptoms didn't seem seasonal to me (i.e. they didn't get better or worse at different times of the year). If she's allergic to dust, she's sh!t outta luck, as housekeeping isn't my forte. She was put on chlorpheniramine, an antihistamine, to no effect. 

Our regular vet then relocated and a few months later we also moved, so we changed to a different practice. The new vet put her on 5mg of cetirizine (Zyrtec), also an antihistamine  which also didn't help and wanted us to go to a dermatology specialist for allergy testing, which I don't object to in theory, and I believe is also covered by her insurance, but he was about an hour away with a cat who is very stressed by vet visits and car rides. So the decision became was it bad enough to warrant the stress of additional vet visits and lengthy car rides to find out what she was allergic to? I really didn't care what she was allergic to, just give me something to fix it, and I really didn't want steroids (which weren't suggested by any of my vets, but are sometimes used I think). We weren't really getting anywhere - it was probably my fault, in not wanting to see the specialist, she most likely got the impression I wasn't the type to "go over and above" for my animals which is not the case at all. So for a combination of small reasons, this being among them, but not the overriding deciding factor, I decided to give another practice, which also has the benefit of being much closer to us, a try. 

The new office had a lot of dogs running around (staff bring theirs in and they seem to run loose through the back area and play together - cute, but a cat only day would be nice) and a barky patient who arrived at the same time as we did, but otherwise I liked it just fine and the doctor we got seemed great. She listened to what we'd already tried, she spent a lot of time just looking at Chloe's skin, and told me she wasn't seeing any redness or bumpiness, which we've never had, and that allergies usually were accompanied by such symptoms. She then asked if Chloe was an anxious cat. Bingo! Yes, she is. My initial feeling five years ago was that she was stressed from Mia's illness, death, and absence, but we'd been on the allergy bandwagon for so long I never even thought about the alternatives any more. She did blood work to make sure Chloe could safely take fluoxetine (Prozac), and while her one liver value was a little high (it was a few years ago when she had blood work done prior to a dental cleaning too), it wasn't elevated enough to warrant keeping her off it. We were prescribed 5mg a day and sent home with 30 10mg tablets (a 60 day supply) for $6. We were warned she might seem a little "off" or lethargic for a few days and that it would take three or four weeks to see any kind of response to the drug in terms of positive behavioral changes.

So here we are, five days in. The first two or so days she definitely seemed dazed and a little out of it. Not sleeping really, just kind of sitting and staring like she wasn't quite sure where she was. Her appetite has been greatly reduced, and this is a cat who not only loves to eat, but has made a career out of developing annoying behaviors aimed at getting food and treats. She's the smartest cat I've ever known but manipulative and also very sensitive. In some ways, the personality changes have been positive: I've inadvertently reinforced her negative behaviors - scratching door frames, pushing things off the dresser or nightstand, banging at pictures or mirrors - by getting up and giving her what she wants (food, treats) because I can't stand the noise. On the Prozac she's stopped most of this, but also some of her cuter behaviors (flopping on the floor and rolling over on command to get a treat, tapping at me to get her head scratched). For the first four days she didn't seem like my cat and I had to convince myself we were in "try it and see" mode; I don't like the idea at all of squishing her personality down with drugs, but also feel like if in addition to the over grooming problem this might also work to deal with her weight issues it is worth trying out for awhile.Now that we're on day five I do feel like she's getting back to more of herself - she's sitting on my lap as I type; she patted at me earlier when she wanted a taste of my hummus; and she just seems more engaged with me again but without the incessant begging and whining. Her appetite still isn't what it was (not necessarily a bad thing) but she is eating, so I think we're OK there too.

What I think is that she is/has always been very anxious about where her next meal is coming from. Why I don't know - I've had her since she was about 5 weeks old and she was with her Momma cat before that, so she's never gone hungry. She was feral born and not weaned properly (I more or less grabbed her when I could, so it was abrupt and too early). She was never taught "cat things" like hunting or how to get along with other cats. More or less she's always been dependent on me for her next meal and therefore wants to control her environment and me and know she can get fed whenever she wants because she's never felt the self-sufficiency of being able to go out and catch a mouse or a bird whenever she wants to (she's an inside only cat anyway, but I think having that ability, even if she doesn't have the ability to use it, provides a sense of security that she can meet her own needs). It's still too early to tell if the Prozac will solve the over grooming problem, and I don't know what the long term plan is: I hope this isn't something she has to be on forever, although it's cheap and she's easy to pill (thank you Pill Pockets people). I'm hoping we can break what is most likely at this point some bad habits and move on from there.

We'll be checking in again as this unfolds. Please know I'm not a vet or an expert on cat behavior. I'm putting out there what I've been told as I understand it and my own experiences. I like to think of myself as a "cat whisperer" in terms of understanding my cats' thoughts and behaviors, but this is more than likely my own delusions, as any cat will tell you they're complex and mysterious creatures not meant to be understood by inferior human minds. Please consult your own vet about what is best for your cat and your situation.

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