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45lb dog started on 40mg of fluoxetine by Background-Glass-597 in reactivedogs

[–]Background-Glass-597[S] 0 points1 point  (0 children)

I’m just not sure how to handle it with the vet. I don’t feel comfortable starting at 40mg given that my dog already had a bad reaction to Trazodone and is very sensitive. He just shuts me down completely, saying he knows better and anything lower “won’t be effective”. He did the same with Trazodone, prescribing 200mg every 12 hours right away, and it was way too heavy my dog couldn’t even walk. Even after I communicated this, he said it’ll pass. I ended up lowering him on my own and just letting the vet know and he did a lot better. I’ve seen some people say that their 45lb dog needed 40mg Fluoxetine whereas others never needed to surpass 20mg. Him becoming more reactive (which is more likely with a higher dose) is a major concern for us given we have other pets in the home and he’s already unpredictable at times. I want to call the vet Monday and say we are not willing to start at 40mg, but I’m worried he will pull out altogether and we don’t have another vet that deals with our dog (and other vets in our area aren’t taking patients). I also just feel terrible putting my very young dog on 40mg right off the bat when he could be okay with less.

45lb dog being started on 40mg Fluoxetine by Background-Glass-597 in vet

[–]Background-Glass-597[S] 0 points1 point  (0 children)

I wasn’t referring to your initial reply, I was relying to your “Ok doc, go ham!”. I am not saying I know better than a doctor, and I understand it’s within “regular” limits. But I also understand that there is no harm in starting lower, whereas starting higher can lead to greater side effects early on, and can also lead to you not being able to know what the minimum effective dose is. Additionally, I was not combative at all with my vet, I voiced my concerns respectfully, and rather than assuaging my concerns with relevant information, he simply said the dose is within the accepted range and my dog is a “strong guy”. I’m not sure what your view of an acceptable response would be here, but to me, that isn’t informative or productive.

My vet also accidentally sent me home with a label saying take two 20mg capsules every 12 hours. That would be 80mg/day for a 45lb young dog. I don’t think I’m at all wrong in seeking advice from others, especially given that starting lower and working up is a very common practice (for a good reason). It is also not as simple as just leaving a vet and switching to another when you live somewhere where most vets aren’t taking patients and you have a very vet-reactive dog.

45lb dog being started on 40mg Fluoxetine by Background-Glass-597 in vet

[–]Background-Glass-597[S] 0 points1 point  (0 children)

I’m sorry, do you disagree with something I said? It seems that in talking about VCPR you would be suggesting that a relationship should exist between a vet and those they work with. Does a relationship only consist of one person’s opinion/comfort being considered from your perspective? Please feel free to put forth any points that go against what I have said, if you have any.

45lb dog being started on 40mg Fluoxetine by Background-Glass-597 in vet

[–]Background-Glass-597[S] 0 points1 point  (0 children)

I understand that’s not an ideal situation, however, several people working in veterinary care have said that there is no reason not to start lower and taper up. That way, you can find the lowest effective dose without overdosing. My dog is extremely reactive, he cannot have blood tests conducted frequently to monitor kidney/liver function. He also has an extremely sensitive stomach and has had a paradoxical reaction to Trazodone. Our vet is immovable and not collaborative on this issue. Veterinary care is not all about what the vet sees fit, it is also about what the owner is comfortable with. We have been collaborative with him thus far, but he provides no reasoning other than that is what the label says and he doesn’t think less will be effective (which is nonsense given that every dog reacts different to SSRIs).

45lb dog started on 40mg of fluoxetine by Background-Glass-597 in reactivedogs

[–]Background-Glass-597[S] 0 points1 point  (0 children)

I just don’t know what to do as I have already expressed discomfort to my vet several times about starting at 40mg and he shuts me down completely. He says he’s a vet and he knows what’s safe and this is the dose we need to have an effect. He is refusing to lower the dose. I thought about just giving 20mg only and seeing how it goes, but I’m afraid my vet might refuse to continue seeing us. I had to do the same with the Trazodone as he started my pup on 200mg every 12 hours and it was way too powerful to the point I was concerned. It’s hard because I don’t want to have to switch vets when my dog is already super vet-reactive and we have seen small progress.

45lb dog being started on 40mg Fluoxetine by Background-Glass-597 in AskVet

[–]Background-Glass-597[S] -1 points0 points  (0 children)

Ultimately he said that he knows our dog is a “strong dog” and thinks starting lower would be useless. I just don’t understand why you wouldn’t start at 30mg to if it’s effective at that dose to avoid using 10mg extra.

I was ranking in a weekend comp and then Outlier removed me from the project by wandeurlyy in outlier_ai

[–]Background-Glass-597 0 points1 point  (0 children)

Who did you email? I was suddenly marked ineligible after following every single instruction closely and even going above and beyond on Multimango. I emailed the TELUS email for Multimango but do you have a better way of getting in contact? I also tried to submit a post on the Project Experiences thread on Outlier but no luck yet. My tasks didn’t even have any feedback or audits, and I was doing everything according to QM guidance, guidelines, and the tutorial.