compulsive behavior in dog and cats

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Proceeding of the LAVCLatin American Veterinary Conference

Oct. 25-27, 2010 Lima, Peru

Next LAVC Conference:

Oct. 24-26, 2011 Lima, Peru

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Compulsive Behavior in Dog and Cats

Terry Marie CurtisDVM, MS, DACVB

College of Veterinary MedicineUniversity of Florida

(352) 294-4397

[email protected]

An Obsessionis a persistent idea, thought, impulse, or image that is experienced as intrusive andinappropriate and that causes marked anxiety or distress. A Compulsion is a repetitive behavior ormental act the goal of which is to prevent or reduce anxiety or distress. In most cases the person feelsdriven to perform the compulsion to reduce the distress. Obsessive-Compulsive Disorder (OCD) is ahuman psychiatric diagnosis. In animals, it is impossible to confirm the obsession, although it probablyoccurs. The only compulsions we can be certain of are those that manifest as overt behaviors.

When discussing OCD, it is important to discuss other related and sometimes, predisposing behaviors. With Redirected Behavior the animal is motivated to perform an activity toward anappropriate target. If the animal is interrupted or prevented from reaching that target the behavior can bedirected toward a less appropriate target. For example, Fluffy sees another cat outside in his yard.

Fluffy becomes very aroused and cant get to this cat. Instead, he attacks his housemate and/or hisowner. Redirected behaviors can develop into stereotypic behaviors. With Displacement Behavior theanimal is motivated to perform two behaviors that are in conflict with each other. For example, the cat isuncertain whether to approach a strange person or retreat, or it may be uncertain whether to attack a newcat in the household or retreat. In either case, it does neither, and begins to groom itself. Just like withredirected behaviors, displacement behaviors can also develop into stereotypies. With Vacuum Activit ythere is an instinctive behavior performed in the absence of the stimulus to which it would normally bedirected. It appears to have no apparent useful purpose and can also develop into a stereotypy. Anexample would be a cat that sucks on a blanket or on its owner that was not allowed access to realnursing on its queen.

A Stereotypy is a specific behavioral pattern that is a repetitive action, which is constant in form, whichhas a predictable sequence, with no obvious goal or function. Stereotypies have been reported in mostdomestic species, captive wild animals, and humans. Stereotypy Compulsive Disorder. Somestereotypic behaviors in animals resemble human OCD. Not all stereotypies are compulsive disorders.For example, an animal may continually pace back and forth when in a small cage, but cease doing sowhen released into a larger environment. A Compulsive Disorder involves behaviors that are out ofcontext, exaggerated or excessive, repeated in stereotyped manner, directed toward unnatural stimuli,continue even when source of stress or conflict is removed, and may interfere with normal functions. Forexample, that same animal that paces back and forth when in a small cage continues to do so even whenit is released into a larger environment.

The exact causeof Compulsive Disorder (CD) is unknown and is probably multifactorial. CD can evolveover time and probably involves neurotransmitter changes which is important to understandingtreatment. Acquired causes include, but are not limited to, conflict, frustration, stress, inappropriateenvironments, high or low state of arousal, attention-seeking behavior with owner-reinforcement, and

physical lesions which may have healed. There are also genetic causes of CD. Certain genetic strainswithin species appear to be more predisposed to develop compulsive disorder in response to givenenvironments. In cats, the Oriental breeds appear to be predisposed to wool sucking and fabric eating:Siamese, Burmese, and Birman.

The diagnosis of CD involves getting a thorough behavioral history, observation of the behavior, and thevery important exclusion of medical causes. When preparing a history of the behavior for yourveterinarian, it is important to get an accurate description of behavior, the amount of time spent onbehavior, the onset, duration and progression of the behavior, the genetic history of the pet, any knownprecipitating events, any past treatments (and if so, results), and the owners response to behavior (is the

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behavior dependent on the owner being there?) Important questions include Can the pet be interrupted?If so, how? It is also important to get a description of owner-pet interactions and a description of a typicalday in the life of the pet.To help rule-out seizure activity, and animal with CD is fully conscious and aware of its surroundings. Thebehavior can usually be interrupted, and there is no post-ictal phase.

Other possibilities for these types of behaviors include acute conflict behavior/anxiety, attention-seeking

behavior, operantly-conditioned behavior (pet is rewarded in some way for engaging in the behavior), anda neurologic disorder.

Compulsive behaviors are classified according to the following categories:LocomotionGroomingOral or IngestiveVocalization

AggressionHallucinatory

Locomotionbehaviors include freezing, circling, whirling, and tail chasing; pacing and fence running,jumping in place, floor scratching, and digging; and shadow chasing which playing with pen light may

predispose to.

Grooming behaviors include chewing self (legs, feet), self-licking, and excessive grooming: psychogenicalopecia; flank sucking, self-mutilation, chewing, sucking, or licking objects, and hyperesthesia

Ingestive behaviors include increased eating (polyphagia) and increased drinking (polydipsia), woolsucking and wool chewing, pica, and fabric eating it is important to rule out other causes.

Vocalization behaviors include howling, crying, and self-directed vocalization.

Aggression behaviors include self-directed aggression - growling at self, hyperesthesia?? and attackinginanimate objects.

Hallucinatory behaviors include staring, fly chasing, and searching for imaginary prey.

The neurophysiology suggests that the different behaviors rely on different neural pathways, which mayexplain the differential responsiveness of various forms of OCD to different medications.

The treatment of CD/OCD is multifactorial. It is of utmost importance to rule out medical problems thatmay cause or contribute to the behavior. It is also important to treat any concurrent and/or ongoingmedical conditions. Environmental modification will involve identifying and removing any apparent causeof conflict to reduce the environmental stress. It is important to decrease any sources of arousal whileproviding sufficient stimulation. Consistent exercise and play schedules are important, as is providing apredictable environment. Providing distraction and relaxation is the ultimate goal. Behavioralmodification involves highly structured interactions and avoidance of all forms of owner-administeredpunishment. It is important to avoid reinforcement of any undesirable behaviors and to desensitize thepet to stress-inducing situations. Response substitution involves teaching behavior that is incompatible

with stereotypic behavior using positive reinforcement. The stereotypic behavior is interrupted and thepet is redirected to an alternate behavior.

Medications can be very effective in the treatment of CD/OCD and include the Selective Serotonin Re-uptake Inhibitors (SSRIs) such as fluoxetine (Prozac

), paroxetine (Paxil

), and sertraline (Zoloft

), and

the Tricyclic Antidepressants (TCAs) such as clomipramine. In some cases Narcotic Antagonists can beeffective. This is based on the theory that endogenous morphine-like substances are involved in themanifestation of the compulsive behaviors. There is a possibility that there is a release of endogenousopioids that stimulate the pleasure center which cause the behavior to be inherently reinforcing. Anewer, anti-convulsant, gabapentin (Neurontin

) can also be very effective especially if theres a




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neuropathic or hyperesthesic component to the behavior (such as with over-grooming). As more of a lastresort, Antipsychotics/Neuroleptics may be necessary. In any case, all of these medications are extra-label use and require informed consent on the part of the owner. Also, it is important that none of thesemedications are 100 % effective in all patients for all compulsive behaviors.



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