Cat w/ increased anxiety and aggression - worsened by meds?

[dkb817]

Simon has spent the last roughly 3.5 weeks being treated with 1/4 of a pill of Fluoxetine once per day for some separation anxiety issues. It worked a little, but some of the problematic behavior still existed - which the vet warned me could happen. We were hoping that between the meds and several months of behavior modification, we could successfully manage the anxiety and eventually ween him off the Fluoxetine altogether (This was more something the vet was pushing; I was fine with him staying on the meds forever, if it meant he was more comfortable and less anxious)

Well, over the last couple of weeks, Simon developed fits of aggression. It was almost like he’d forget who I was - his eyes would widen and become laser focused on me, the ears would go back, and he would launch himself at me in fits of violence - but as soon as the incident passed, he would go back to being the sweetest cat you've seen. Most of the time, I was able to sort of dodge these attacks until I could get him into his crate, where he could calm down (As I've said in other posts, it's a large dog crate with his litterbox and water fountain, so it's not like I was keeping him in a tiny carrier long term). Our vet thought maybe the aggression was coming from the bladder crystals or Giardia - but no longer thinks that since we've now successfully treated both. Last night was his worst attack yet - he took large gouges out of my leg, and when I scruffed him to get him off of my leg, he latched onto my arm (and I mean latched; I had no idea he had that kind of strength in him, to be honest, as he's always been relatively gentle with me). In the process of getting his jaws to release my arm, he went after my face and managed to get a few swipes in before I was able to get him into the crate. None of these wounds required stitches thankfully, and I was careful to clean them up with peroxide, hibiclens soap (which is what they use before surgical procedures), neosporin and a few bandages until they have sufficiently scabbed over - but this terrified me. I had never seen him so aggressive and violent before. I called the vet as soon as the office opened this morning with every intention of having Simon euthanized today because I cannot and will not live in a state of fear in my own home, and know that most rescues/shelters will not adopt out cats with combination of separation anxiety and aggression issues. I hated the idea of putting a cat to sleep when he could be so sweet, but also can't run the risk of the next attack being even worse or even having him tear off after my nieces or nephews (I do try to keep them separated, but y'all have cats and know that if they're determined, there's no keeping them out of or away from something)

When the vet returned my call, as worried about the change in personality as I was (even stated that he had previously had to do the same thing with a cat of his own), I asked if this was something we needed to adjust the prozac for, perhaps change meds, or if this was the end of the line. The vet said that increasing the prozac likely wouldn't do anything, but that we needed to have Simon off of the SSRI for a couple of weeks before we switched him to a new one, just to give his system a chance to adjust. So, for now, we're going to try two weeks off of the medications to see how things go. If he stays relatively calm, we won't have to put him back on any meds - but if the separation anxiety flares again, we will likely have to try a different med.

Have any of y'all dealt with this increase in aggression/violence when putting your cats on medication? Any experience with anxiety meds other than the fluoxetine/prozac?

 

[Furballsmom]

How are things now?

 

[dkb817]

Well, after each episode passes, he calms back down to normal. Right now, he's singing me the song of his people because I'm approx. 18 minutes late with his breakfast He curled up on my lap and fell asleep a couple of times last night, which is such a stark contrast to his episodes that you'd get whiplash.

Like I said, we're going to try and tough it out sans-fluoxetine for two weeks and go from there.

 

[Furballsmom]

 

[Norachan]

dkb817 I'm including a link to you previous thread about Simon here, so people can refer to it.

Aggressive/Violent Cat - starting to face reality, needing advice/experience

How long have you had Simon?
Is this relatively new behavior? Was he OK before his health problems started?

It does sound like it could have been redirected aggression caused by the pain of his crystals. Cats can sometimes have pain when urinating even after their crystals appear to have cleared up. Is he on a diet specifically for Flutd cats?

The only anti-anxiety med I've used with my cats is a very mild https://www.vetoquinolusa.com/content/zylkene I have some rather nervous former ferals, but none of them are aggressive at all. Has Simon always had separation anxiety?

 

[Caspers Human]

Agitation and aggression is a known side effect from Fluoxitine. (Prozac)
It can happen in humans or animals.

Remember that Fluoxitine is a stimulant as well as an antidepressant. Sometimes Fluoxitine can stimulate a cat too much, especially cats that are already anxious, to start with. The thing is that you can never tell whether Fluoxitine will cause this problem unless you try it.

The way to deal with this problem is to either adjust the dosage or discontinue the meds. Maybe a lower dose will stop the problem. Maybe you need to cut it off. It's hard to know which.

Another problem with Fluoxitine is that it takes time to start working. It takes a couple of days to kick in when you start taking it and it takes a couple of days to taper off, as well. It can take a couple of weeks to a month to start taking full effect and it takes the same amount of time to wear off when you stop.

I think that antidepressants are good things when they are necessary but I also think that they have become a "fashionable" drug to take and I think that too many doctors prescribe them too much and that people are too willing to take them without asking questions.
This includes giving Fluoxitine to pets, too. Many people assume that, if it's good for them to take it must be good for their pets, too.
That isn't always the case, however.

It can be difficult to get the right dose. It takes a long time to start working and that makes it hard to know whether any bad effects are being caused by the meds.

I agree... If your cat is having such a bad reaction to his meds, I think it's best to take him off.

If your vet wants to put him on something else, I suggest you ask lots of questions and get as much information about the new stuff as you can before you give the go-ahead.

 

[Tobermory]

My experience with cat aggression may not be the least bit relevant or helpful, but just in case...

Several years ago, I was awoken in the night by a strange noise. I went to investigate and found 11-year-old Max (neutered male) preparing to attack four-year-old Iris. Four-year-old Lily was in the room, too, but he was ignoring her. They had all always gotten along.

This was not your typical “I’m going to pounce on you and chase you around, having a great time in the process.” This was scary “I’m a predator, and I’m going to kill you” body language. I had never seen him look or behave like that, and it was unsettling. I snatched Iris up just as he attacked.

His threatening behavior continued toward Iris, and I had to separate them, alternating them in and out of a spare room. Max continued to completely ignore Lily. I took Max to the vet, and the vet couldn’t find anything wrong. He recommended that I try the Feliway diffusers (the Classic calming version). It took three months, but Max finally returned to normal.

So what was it? The only thing we could figure out was that Max was reacting to the stress in my life. My father was dying of cancer, and I was gone a lot. I was also in a bad situation at work with the Boss-from-Hades. Max actually tore my leg open at one point when he went after Iris and I picked her up just in time.

Just a thought. They can be extraordinarily sensitive, and if there are physical issues combined with some external stress, it could be a trigger. I’ll keep you and Simon in my thoughts and hope you find a solution.

 

[dkb817]

Delayed response - but after a week or so without fluoxetine, we made the executive decision to put him back on to the med as his anxiety went up DRAMATICALLY. I’m sure it’ll take a few more days to regulate his body again, but we are getting there.
as far as the aggression episodes, we are going to monitor and see if we can figure out a method of dealing with those as they happen

 

[Caspers Human]

In humans, it can take a month, or longer, for Fluoxitine to work and for a person to completely stabilize after starting to take it.

During that time, it is quite possible to see symptoms of agitation and/or aggression. Those symptoms usually decrease and go away after the person has fully stabilized.

I don't know how long it takes a cat to stabilize after taking Fluoxitine. It might take less time but... I don't know. It could take longer.
Out of an abundance of caution, I would assume that it takes up to a month for a cat to stabilize, just like humans.

 

[dkb817]

That’s what we figure now, since when I was on the med (albeit a significantly higher dose), my dr told me it took 4-6 weeks to build to a therapeutic level in my system

 

[Caspers Human]

Remember, it's not the drug, itself, that's doing the heavy lifting.

When you take Fluoxitine it inhibits the reuptake of serotonin in the synapses between nerve cells.

As your nervous system works, the neurotransmitter, serotonin, is released from the end of one nerve cell and is collected by the next. That's how signals travel through the nervous system. It's just chains of nerve cells releasing the correct chemicals to pass signals from one place to another.

Well, now, you've got molecules of serotonin hanging around in the synapses between nerves. If it stayed there, it would signal nerve cells to keep firing. That wouldn't be good. To stop that, our body has a way of taking serotonin away, preventing unwanted firing of nerve cells. This is called "reuptake."

Fluoxitine inhibits that serotonin reuptake. It causes more of the neurotransmitter to be present in the body and enhances firing of certain nerve cells. That's what we believe causes the mood elevation when you take Fluoxitine. (Nobody is 100% sure that this is the reason Fluoxitine works but this is the best explanation we have... A pretty good one, IMHO.)

During the stabilization period, it's not the drug that is stabilizing. It's the serotonin in your system that is stabilizing.

That's why some people have adverse reactions to Fluoxitine. Suddenly, there is more serotonin than they are used to. Since serotonin increases nerve activity, a person who has more of it in their system will be more active and have a more positive mood. Well, if a person's serotonin levels suddenly shoot up, it can cause their mood to increase too quickly.

It's just like if you suddenly floor the accelerator pedal in your car. You'll feel like you are driving out of control until you get used to the way the car drives at higher speeds.

I think that is the best analogy for what happens when a person takes Fluoxitine.

Now, imagine giving Fluoxitine to a cat that doesn't have the ability to understand what's happening.

All of a sudden, her body feels like it is going crazy but she doesn't know why.

Cat goes... "Mm-ee-YEOW!!!"