That depends on the generalist.  Remember, primary care veterinarians have to know everything about every spe​cies.  They even have to know a fair amount about human medical and psychological issues.  Many primary care vets have their favorite topics within all of the things they do.  If veterinary behavior is one of them, any primary care veterinarian can learn the details about psychoactive medications including side effects.  However, they may or may not have time or the inclination.  Most veterinarians are very honest about their skill sets, thankfully, and many are eager to refer if needed and if a veterinary behaviorist is close.  

That depends on the dog and the symptoms.  We always start with a CBC, chemistry, urinalysis, and thyroid assessment if the clients will let us, and a physical examination if the patient will let us.  If a pheo needs to be ruled out, an abdominal ultrasound is rational.  If seizure disorder is suspected and toxins are ruled out, then a consult with a veterinary neurologist, MRI/CSF tap, and/or empirical medication trial are options.  Every patient is different, and that's why having a great relationship with a skilled primary care veterinarian is so important.  Not everyone will have access to a veterinary behaviorists, but these medical differentials can be assessed in a primary care setting.  

Great question!  The best way to get more information on medications it to get at least one great textbook on veterinary behavior.  Behavior Problems of the Dog and Cat 3rd Edition​ by Landsberg, Ackerman, and Hunthausen is a good one.​

That depends.  I use them in many of my patients with anxiety disorders even if GI signs aren't overt, because of the interesting research in humans.​ This topic has been discussed in past VetVine offerings: Small Animal Roundtable on Nutritional Considerations & the Use of Supplements How Probiotics can Influence Behavior

Hi Marta, Great to hear back from you!   It's really difficult when the cats exposures to each other can't be controlled.  It allows so many negative interactions that it can be hard for other work to be successful.  We often do complete separation and reintroduction, but it can be so helpful to do partial separation to give everyone a break.   Regarding the dosing of the paroxetine.  In cats, I often use paroxetine once daily.  In dogs, I split the dose.  Cats metabolize medications incredibly differently from people and dogs, so they often get their own special dosing schedule.   In this type of case, if all other things were being addressed appropriately, then I might consider changing medications.  However, I would need a lot more information.  And, of course, I can't comment on these specific cats.  Info I would be looking for would include any improvements in frequency, duration, intensity, distractibility, resiliency, etc of each cats total suite of behaviors (not just the ICA).  Once I know about side effects and any improvement parameters, I would be able to move forward. In general, 1 mg/kg of paroxetine per day is actually a pretty good dose for a cat.  So other options may need to be explored.  They may also need combination therapy.   And then, of course, there is the "square peg, round hole" issue.  If one has two cats who are extremely distressed by each other, is it ethical to continue to encourage/attempt co-habitation in a species that would normally disperse if given the opportunity in this situation?   Cats with ICA can be difficult to rehome and obviously it's heart-breaking for the families, but sometimes it is absolutely the most ethical, humane choice.   And, of course, this is assuming all medical rule outs have been truly and completely assessed.   These are complicated cases that really require a lot of team work between very skilled people.  The clients are lucky to have both you and the veterinarian on their side.  If you are in Israell, what about calling Noa and seeing if she can support the vet through telemedicine?  Dr. Noa Harel.   Good luck!