Animal Behavior for Shelter Veterinarians and Staff. Группа авторов
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(not self‐licking), sucking, pica, gulping, and lip‐smacking behaviors may all be associated with gastrointestinal disorders. However, some partial motor seizures may also be associated with similar behaviors. Many gastrointestinal disorders can manifest with unusual behavioral signs. In one recent study where 19 dogs were examined due to frequent surface‐licking behaviors, 14 of the dogs were determined to have some form of gastrointestinal disease (Bécuwe‐Bonnet et al. 2012). These included conditions such as delayed gastric emptying, irritable bowel syndrome, gastric foreign body, pancreatitis, and giardiasis, to name a few. The unusual behavior of fly biting, considered by some to be a compulsive disorder, has even been found to be associated with gastrointestinal conditions such as gastroesophageal reflux (Frank et al. 2012).
4.6.4.1 Pica
Pica is the consumption of non‐nutritive items such as fabric, paper, and plastic. There is little research available involving companion animals and pica. However, a literature search for pica as a clinical sign links it to a variety of disease processes, including portal caval shunts, iron‐deficiency anemia, pyruvate kinase deficiency, ehrlichiosis, gastrointestinal disorders, neurologic damage, feline infectious peritonitis (FIP), and other medical conditions (Thomas et al. 1976; Black 1994; Goldman et al. 1998; Marioni‐Henry et al. 2004; Kohn et al. 2006; Kohn and Fumi 2008; Bécuwe‐Bonnet et al. 2012; Berset‐Istratescu et al. 2014). Both cats and dogs can be affected. Pica has also been described in horses, cattle, sheep, and other domestic species (Houpt 2011). In rats and mice, pica has been associated with gastrointestinal disturbances and may be an adaptive mechanism used to cope with gastrointestinal upset (Takeda et al. 1993; Yamamoto et al. 2002). In a recent case report, a 5.5‐year‐old dog with a 4.5‐year history of pica (eating rocks) resolved when diagnosed and treated for mild hip dysplasia (Mills et al. 2020).
There is some indication in the literature that oriental cat breeds (Burmese and Siamese) may be represented in numbers higher than the general hospital population, suggesting the possibility of an underlying genetic predisposition for pica (Blackshaw 1991; Bradshaw et al. 1997; Overall and Dunham 2002; Bamberger and Houpt 2006). To date, the evidence for a genetic basis is purely correlative.
Underlying medical causes for pica should always be investigated and ruled out through appropriate diagnostics. A behavioral diagnosis of an abnormal repetitive disorder is made by excluding all possible medical conditions. If financial constraints limit testing, a clinical trial with appropriate gastrointestinal protectant drugs is indicated prior to using any kind of psychoactive substance. Behavioral enrichment is indicated, and behavior modification can be attempted (Blackshaw 1991). There is a single documented case study that successfully used behavior modification to diminish the occurrence of pica in a cat (Mongillo et al. 2012).
4.6.5 Dermatological Disease
In humans, the relationship between skin disease and mental health has received much attention in the past decade. The skin and the central nervous system are both derived from the embryonic ectoderm, and they share many of the same hormones, neuropeptides, and receptors. Many of these substances are involved in neurogenic inflammation, pruritus, and pain sensation, and stress can alter their release. A substantial number of chronic dermatoses in humans are heavily influenced by stress. It has been estimated that in as many as one‐third of the humans with skin disease, the condition is complicated by significant psychosocial and psychiatric morbidity. Patients with atopic skin disorders also have a higher prevalence of anxiety, depression, excitability, and suicidal ideation and a decreased ability to cope with stress.
While many of these emotions may be impossible to confirm in our non‐verbal patients, it is logical to assume that stress has the potential to cause similar pathophysiologic responses that perpetuate the itch‐scratch cycle. Cases of dogs with pyoderma and pruritic skin disease associated with psychogenic factors have been reported (Nagata et al. 2002; Nagata and Shibata 2004). Newer research supports the likelihood that chronic skin disease, especially that which causes pruritis, can lead to stress and subsequent behavior change (Harvey et al. 2019; Yeom et al. 2020; McAuliffe et al. accepted for publication). Harvey et al. (2019) found that dogs with chronic atopic dermatitis demonstrated problematic behaviors such as mounting, chewing, hyperactivity, coprophagia, begging for and stealing food, attention seeking, excitability, excessive grooming, and reduced trainability. The frequency of unwanted behaviors increased when the degree of pruritis was more severe. In another study (data not yet published), dogs with higher levels of pruritis were found to have significantly higher levels of aggression, fear, separation‐related problems, attention‐seeking behaviors, excitability, and sensitivity to touch (McAuliffe et al. accepted for publication). While the exact relationship between these problem behaviors and atopy have not yet been determined, chronic atopy and pruritis is known to result in reduced quality of life; therefore, the potential for chronic anxiety and stress is clear. For that reason, the clinician should remain aware of two important things. First, many skin conditions may be exacerbated in the stressed shelter animal. Second, animals with chronic skin conditions may be more likely to exhibit problem behaviors—and these behaviors might be reduced by treatment that improves their skin condition.
4.6.5.1 Overgrooming
When placed in situations of frustration or conflict, some animals will show displacement behaviors, and grooming is commonly seen as a displacement behavior in many species. Psychogenic alopecia is a term often used to refer to a skin condition of cats in which irregular patches of hair are removed, presumably by licking and chewing. Some have suggested that oriental cat breeds (Siamese, Burmese, Abyssinian) may be at higher risk of developing this problem (Sawyer et al. 1999). Hair may be missing over the flanks, abdomen, front legs, or virtually anywhere on the body. This condition may occur secondary to anxiety or environmental stress but is a diagnosis of exclusion because many pathophysiological conditions can contribute to feline overgrooming. One case series that examined cats with a presumptive diagnosis of psychogenic alopecia found that 76% of the cats had medical conditions causing pruritus (Waisglass et al. 2006). A painful sensation may cause cats to overgroom as well, so radiographs may be helpful in some cases. Regrowth of hair and resolution of the overgrooming, after treatment with pain medication, is suggestive of pain as an underlying cause for the behavior.
While less common, dogs can also overgroom areas of their body due to environmental stress or anxiety, although, as is the case with cats, painful sensations may also lead to overgrooming in the dog. When overgrooming behavior occurs primarily as a response to anxiety or conflict, it has the potential to develop into a repetitive disorder, generalize, and eventually occur even in the absence of the original stressors. Some have referred to this as a compulsive disorder. Regardless of the terminology applied, if the animal is believed to be overgrooming due to stress or anxiety, the primary treatment approach must be aimed at relieving the anxiety through a combination of environmental management, behavioral modification, and anxiety‐relieving medications.
4.6.5.2 Acral Lick Dermatitis
Acral lick dermatitis (ALD), also sometimes referred to as acral lick granuloma, is primarily a dermatological syndrome that is a result of self‐trauma. While some individuals may begin licking a leg to excess due to anxiety, frustration, or conflict, studies have found that many other underlying causes for these lesions are possible (Denerolle et al. 2007). Pruritus due to allergies, orthopedic pain, trauma, neoplasia, bacterial pyoderma, and fungal infections are just a few possibilities.
Once a dog begins to lick and causes an open lesion, the dog will continue to lick it, no matter the original cause. When presented with a patient with ALD, a complete medical workup aimed at identifying the underlying cause is ideal. Long‐term treatment with appropriate antibiotics will almost always be required. Treatment may also include ancillary medications to break the itch‐scratch cycle (e.g., glucocorticoids, antihistamines). Physically preventing the dog from licking the lesion may be necessary to ensure resolution. This may be accomplished with the use of e‐collars, bandages, socks, body suits, or leggings, depending on what the individual patient tolerates.
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