u/Easy_Personality_895

This case has progressed at an incredible rate over the past three weeks and I’ve been trying to keep up, but I’m slow since I try to read as many court documents as I can.

Has anybody seen or compiled a full timeline of all of the documents that have been released thus far? So many things were filed & unsealed in late April that I lost track (at least it felt that way, but my algos are skewed!)

Thank you!

Hi everyone - I’ve posted this in the Ask Vets group without much success, so hoping a smaller community may have more insight!

Context : Rat Terrier Mix, about 5 years, Male, 23 lbs, doctor says wouldn’t hurt to lose 3-5 lbs. Alert, Energetic, Reactive, and hesitant around, well..everything that moves (or looks sus). UTD on everything, fixed, and has been on heartguard his entire life.

Two health incidents have prompted recent vet trips - a back spasm, likely caused by his jumpiness / zoomies, and a seizure - like episode (he’s had three total, only one including drooling / peeing, other two have been mild in comparison. I know an MRI or Bloodwork would provide more insight, but given their infrequency, it’s not something we’re exploring yet). The seizures don’t occur in close proximity to his heartguard, and there aren’t any behavioral changes we can observe that would lead us to believe it’s something like his blood sugar.

Vet prescribed a medication for the anxiety and recommended that we give CBD a shot. I’ve been researching and trying to educate myself, but there is just an overwhelming amount of information and I figured I’d post directly for help.

I’m considering starting a topical / transdermal CBD oil or cream, which I’m hoping would 1. address the back inflammation / irritation, 2. Help with the reactivity 3. Help with the seizures / prevent them.

I’m hesitant to start gummies or direct oral route supplements because he has a sensitive stomach.

Has anybody had success in treating similar issues with a similar plan? What products / ingredients did you use or avoid?

Thank you!

Long Post Incoming -

TDLR Questions Only -

1. Assuming the mild / seemingly unpredictable and sudden nature of the seizures and their onset - do the potential behavior benefits of Clomicalm outweigh the possibility of serotonin syndrome? His behavior impacts his quality of life, but the seizures we’ve witnessed are terrifying (not snapping, not localized shaking or kicking)

2. How much time does it take for serotonin from the clomicalm to “build up” in his system? (about 22 pounds, small and stocky terrier)

3. Is clomicalm as effective when given every other day, or does it require that “build up” to be effective?

4. How quickly would it take for him to “flush out” (I know it’s more complex than this) any serotonin build up if we began to be concerned about signs of serotonin syndrome?

5. Are there any long term effects on the receptors of serotonin if we start him on Clomicalm? If he goes off of it, will he have a harder time “opening” them back up (and would that make it easier for the build up to occur, leading to serotonin syndrome?)

6. Topical CBD v Supplement - are there any topical pain CBD Oils or creams we’d be able to use? I’m thinking that, even if transdermal isn’t as potent, perhaps it will be enough to reduce the inflammation in his back, while also having the calming effect behaviorally, without causing the serotonin build up.

7. Heartguard - Is there any correlation between administration date of his preventative & seizure occurrence in your experience? He usually just feels a little icky from his heartguard - no seizures observed in close time proximity to when he takes it.

8. Am I overthinking this?

I understand that the mechanism of action is that Clomicalm increases norepinephrine & serotonin (TCA and not SSRI), which theoretically would produce a calming effect and help manage his anxiety / issues. I just don’t know why he would be given a TCA and not an SSRI, since SSRIs are usually tolerated better.

Full post below -

First time poster, Terrier Mix, about 5 years old. He’s been on heartguard forever. He's a tad overweight for context.

Behavioral - Fear-reactive, displayed resource guarding previously but managed by interventions. Very insecure socially - fearful and hyper aware, hates walks. Can't settle in public, can't be around strangers, very excitable, and whines in the car, but not with certain members of the family. We’ve trained him, and, maybe I’m biased - but he is so, SO smart. He gets things right away and understands commands. It’s just that he’s usually too wound up to be able to understand or follow them.

Physical - X rays recently revealed a back problem, believed to be caused by jumping up and off the couch, sliding around on the floor, and jumping when we come home. Changes made include getting doggy stairs, carpets, keeping his nails shorter, and reinforcing calm reactions when we come home so he doesn't jump around as much.

Mental - He's had three seizures. One was serious - urination and drooling.

Vet reccomended that we try CBD Supplements for the anxiety, but also prescribed us clomicalm.

After doing some research, I'm concerned that with his history, seizures / seizure- like episodes would be worsened (both intensity and frequency) if we were to start the clomicalm, since I believe seizures can be caused by overactive serotonin.

(I know an MRI is the only thing that could reveal the cause, but it's candidly not in our budget, and he's had three episodes in five years).

I'm also so confused about serotonin syndrome - how long does the “build up” take in order to produce symptoms, and how can we walk the fine line between the serotonin causing the behavioral changes we desire (clam, relaxed, not as reactive) and the potential danger of serotonin syndrome (including more seizures!)?

CBD - I’m hesitant to give him CBD since he has a sensitive stomach, and I’m personally still trying to learn about it, but I acknowledge that CBD has been shown to be beneficial in all three of my concern areas. Are there any topical / transdermal products we can use to target the back directly, and hope that the secondary effect on his anxiety would follow?

Finally - HeartGuard / Preventatives - He’s been on this his entire life - I know seizures can be a side effect of these meds. IF they are causing the seizures, should we be seeing them within days of his dose, or is administration date completely unrelated? Is it random?

Thank you in advance - I’m sorry if this is convoluted or unfounded. Just trying to understand how I can best help him!