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Applied Animal Behavior > Compulsive disorders > Flashcards

Compulsive disorders Flashcards

1
Q

What is a compulsive disorder?

A
  • Involves abnormal, repetitive behavior resulting from anxiety or stress without an apparent inciting trigger and when other physical or behavioral causes have been ruled out
  • Difficult to disrupt
  • May be self-reinforcing and difficult to interrupt without physical intervention
  • often disrupts daily functions due to the intensity and frequency
  • The diagnosis for 2-5% of patients seen by veterinary behaviorists
    • May actually be higher number as thought to be under-reported
  • Owners often don’t seek help until symptoms are severe
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2
Q

What are the clinical characteristics of Compulsive disorders?

A
  • Categories for dogs are very diverse range of behavior
    • Locomotor
    • Visual/hallucinatory
    • Oral
    • Self-directed
  • Breed predilections
    • Flank-sucking Dobermans
      • Altered function in the subcortical region of the brain
  • Affects serotonergic and dopaminergic regions
    • Affected dogs have lower serotonin-receptor binding
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3
Q

What are the Locomotor Compulsive Behaviors?

A
  • Circling/spinning
  • Tail chasing
  • Pacing
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4
Q

What are the visual/hallucinatory compulsive Disorders?

A
  • Light or shadow-chasing
  • Fly snappers
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5
Q

What are the oral compulsive disorders?

A
  • Pica
  • Licking
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6
Q

What are the self-directed or self-injurious compulsive disorders?

A
  • Flank sucking
  • Hind checking
  • Acral like dermatitis
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7
Q

What is the Pathophysiology of Compulsive Disorders?

A
  • Likely multifactorial
  • Learning
    • can be part of the inciting cause and perpetuation of CD
    • Owners may inadvertently reinforce
    • Over time, the behavior becomes so engrained that it continues, even the inciting cause is no longer there
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8
Q

What are the history and clinical signs of compulsive disorders?

A
  • Symptoms in dogs often start prior to a year of age
    • Median <1 year for tail chasing and flank sucking
    • Median >1 year for acral lick dermatitis
  • Owners often don’t present dogs until they are older for treatment
  • Concurrent behavioral issues often present in 75% of dogs with CD
    • Separation anxiety
    • Aggression
    • Generalized anxiety
    • Attention seeking disorders
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9
Q

How are compulsive disorders diagnosed?

A
  • Diagnosis of exclusion
  • PE and diagnostic testing may show abnormalities secondary to behaviors associated with chronic CD
  • A thorough history is needed
    • Description/video of the behavior
    • Initiating factors
    • Situations where behavior will likely occur
    • Owner response
    • Attempted treatments and success
  • Behavior history forms are useful
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10
Q

Are all repetitive behaviors compulsive?

A
  • NO
  • alternative causes must be ruled out
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11
Q

What is displacement behavior?

A
  • Normal behavior displayed at inappropriate times, or out of context, in response to anxiety-provoking events
  • EX: dog licking paw when alone
    • Occurs during stressful situations
    • Remains linked to the anxiety-provoking situation
    • Can evolve into CD with repetition or additional stress
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12
Q

What are differential diagnosis for repetitive behavior?

A
  • Displacement behavior
  • Redirected behavior
  • Vacuum activity
  • Stereotypy
  • Audience-responsive behavior
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13
Q

What is redirected behavior?

A
  • Behavior incited by one target but directed at another
  • EX:
    • Pruritic dog that licks inside of an Elizabethan collar when it cannot lick itself
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14
Q

What is Vacuum activity?

A
  • Behavior performed in absence of normal stimuli required for that behavior
  • Ex:
    • Border collie that runs laps when not exercised
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15
Q

What is stereotypy?

A
  • Repetitive, unvarying behavior with no apparent goal or function displayed by captive animals lacking appropriate enrichment or outlets
  • EX:
    • Dog confined to a small kennel without toys or social contact that jumps on the door in an invariant pattern
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16
Q

What is Audience-responsive behavior?

A
  • Operant-conditioned behavior performed to solicit interaction with humans and in the presence of a human and has past reinforcement
  • Ex:
    • Light-chasing dog that stops when owner leaves and has historically been offered a toy when it chased lights
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17
Q

What are the Key components of Management and Treatment of Compulsive Disorders?

A
  • Client education
  • Minimizing repetitive behavior
  • Reinforcing alternative behaviors
  • Alleviating patient stress
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18
Q

How does Client education affect Compulsive disorders?

A
  • Punishment based training
    • Can increase aggression
    • Can increase likelihood o injury
    • Can increase anxiety
    • Exacerbate CD
  • Educated owners are less likely to use punishment-based training when they are informed that CD is due to anxiety and NOT due to dominance behavior of lack of training
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19
Q

How does Minimizing Repetitive Behavior affect Compulsive Disorders?

A
  • Treatment should focus on behavior prevention
    • The more a dog performs the repetitive behavior, the more ingrained it becomes
    • Pet owners should try to identify situations that invoke compulsive behavior and try to avoid them
  • Owners need to prevent unintentional reinforcement
    • Don’t provide or take away positive reinforcements while the repetitive behavior is occurring
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20
Q

How dos Reinforcing Alternative Behaviors affect Compulsive Disorders?

A
  • Dogs should be taught an alterative behavior that can be cued or reinforced whenever repetitive behavior is likely to occur
    • Dogs that pace
      • try to get them to fetch
    • Shadow Chasers
      • reward for lying down with chin on the floor
    • Pica behavior
      • feed from puzzle toys
    • Owners should use cue-response-reinforcement patterns
      • Give a cue
      • God needs to respond
      • Give a treat/toy/praise if responds appropriately
    • When undesirable behavior is demonstrated
      • Attention should be withdrawn
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21
Q

How does alleviating patient stress affect Compulsive Disorders?

A
  • Pharmacological intervention to address anxiety
    • Clomipramine
    • Fluoxetine
  • Higher doses of medications may be needed for CD
    • Be careful of side effects
    • There are no FDA approved medications for CD
  • Owners should not be inconsistent with their interactions
    • Can cause:
      • Anxiety
      • Frustration
      • Confusion
    • Predictable interactions help to mitigate stress
22
Q

What is Cue-response-reinforcement?

A
  • Give a cue
  • Dog needs to respond
  • Give a treat/toy/praise if responds appropriately
23
Q

What environmental modifications and physical restraint can be used for Compulsive Disorders?

A
  • Opaque privacy film on reflective surfaces (light chasers)
  • Walk on leash to eliminate (yard pacers)
  • Barriers (baby gates, tethers, pens/crates) o prevent access to trigger environments and restrict movement
    • minimize repetitive locomotor behavior
  • Self-inflicted trauma
    • E-collars
    • Bandages
    • Muzzles
24
Q

What pharmacological interventions are used to address anxiety in CD?

A
  • Use drugs that affect Serotonin levels
  • Clomipramine
    • Common drug choice for CD
    • Tail chasing in terriers
    • 1-2mg/kg PO BID
  • Fuoxetine
    • Effective as clomipramine for tail chasing
    • More effective than placebo for acral lick dermatitis
    • Owners more apt to report decrease in severity of CD but not in frequency or duration
      • 1-2 mg/kg PO SID
25
Q

Are there pharmaceutical treatments for CD?

A
  • No FDA approved medications
  • Get informed consent from client, especially if higher doses are used
  • Side-effects: Bradycardia and arrhythmias
26
Q

What is the Prognosis of CD?

A
  • Guarded to Fair
  • Owners need realistic goals and expectations
    • Reduction of severity and duration is the goal
    • Treatment is unlikely going to be able to be stopped
  • Focus treatment on Quality of Life
    • Distraction from repetitive behavior
    • Limit self-trauma
    • Enjoyable activities and interactions with owner
  • Preemptive intervention has best chances for success
27
Q

What additional steps need to be taken to manage CD?

A
  • Frequent communication with owner is necessary
    • monitor patient’s response to treatment
    • Make adjustments to therapy, if needed
  • Communicate to owners that stressful situations may exacerbate or trigger a relapse of CD
  • Compulsive behaviors can be managed and quality of life can be improved for all
28
Q

What causes Feline CD?

A
  • Physical and environmental stressors have be implicated
29
Q

What triggers wool-sucking?

A
  • Stressful events
    • being left alone for extended durations
  • Early weaning (<7 weeks of age)
    • Increase that risk for wool-sucking and overgrooming
    • Has not been associated with n increased risk for pica
  • Medical issues
    • cardiovascular disease, neoplasia, allergies
30
Q

What breed predilections have been identified in Feline CD?

A
  • Several breed predispositions have been identified
    • Suggests Genetic factors may play a role
  • Over-grooming: Siamese, Burmese, Oriental cats
  • Wool-sucking: Siamese, Birman, Crossbreed house cats
  • Pica/Oral behavior: Bengal, Burmese-type, Siamese
31
Q

When does Feline CD start?

A
  • Mean age ~2 years
  • Breeds that are predisposed to CD may exhibit signs at a younger age
    • Mean age for wool-sucking in Siamese and Birman cats was 41.6 and 67.6 weeks
32
Q

What is Feline overgrooming?

A
  • Tends to be directed at:
    • Abdomen
    • Flanks
    • Back
    • Thorax
    • Medial aspects of the thoracic limbs and thighs
  • In some cases, excoriation of the underlying skin may be present
  • Over-grooming in these areas is not pathognomonic for psychogenic alopecia
    • Physical causes of over-grooming can result in the same pattern
33
Q

What is Feline Pica behavior?

A
  • Cats with Pica may chew on, suck on, or ingest various objects
  • Pica may be directed at one or several objects
    • Shoelaces
    • Threads
    • Plastic
    • Fabric
    • Rubber
    • Paper
    • Cardboard
    • Wood
  • Cats that suck on fabric are more likely to also ingest fabric
34
Q

How is Feline CD diagnosed?

A
  • Diagnosed by exclusion
  • There could be a medical cause for the behavior
    • After presumptive medical causes have been identified and treated, the repetitive behavior may persist to the same or lessor degree
      • Can indicate that the physical ailment was either not the primary inciting factor OR
      • Medical and behavioral comorbidities were present
  • Thorough behavior history
35
Q

What should be gathered for history to diagnose Feline CD?

A
  • Description (ideally including video) of the behavior
  • Initiating factors situation in which the behavior is likely to occur
  • Pet owner’s response
  • Previous treatment attempts and their degree of success
36
Q

What are the categories of Feline CD?

A
  • Self-directed; Self-injurious
  • Oral
  • Locomotor
  • Vocal
  • Visual; Hallucinatory
37
Q

What are the self-directed/self-injurious Feline Compulsive Behaviors?

A
  • Overgrooming / Psychogenic alopecia
  • Hyperesthesia Syndrome
  • Feline Behavioral Ulcerative dermatitis
  • Chewing feet/claws
  • Feline orofacial pain syndrome
38
Q

What are the Oral Feline compulsive behaviors?

A
  • Pica
  • Wool-sucking
39
Q

What are the Locomotor Feline Compulsive disorders?

A
  • Pacing
  • Tail-chasing
  • Hyperesthesia syndrome
40
Q

What are the Vocal Compulsive Behaviors?

A
  • Excessive vocalization
41
Q

What are the Visual/hallucinatory compulsive Behaviors?

A
  • Chasing unseen prey
42
Q

How is Feline CD treated?

A
  • Educating owners
  • Minimizing the repetitive behavior
  • Reinforcing alternative behavior
  • Alleviating stress
    • Environmental enrichment
    • Anxiolytics
43
Q

Should Negative punishment be used to treat Feline CD?

A
  • NEVER use negative punishment
  • Verbal or physical punishment
    • Repetitive behavior often originates from stress or frustration
      • Use of harsh verbal or physical punishment that increases the cat’s anxiety
      • May exacerbate the disease
  • Cats may learn to avoid punishment** and perform it **out of the owner’s sight
  • Use remote punishment that is not associated with the owner’s presence to stop CD behaviors
    • Dropping a book to make a noise out of the cat’s sight
    • Tossing a pillow across the cat’s line of sight to break its concentration
44
Q

How can Minimizing the repetitive behavior affect Feline CD?

A
  • Reduces opportunities for reinforcement of the behavior
  • May be necessary for the health and welfare of the cats
  • May increase stress in some instances
  • Preventing situations that trigger the repetitive behavior or preemptively engaging the cat in another activity before the CD behavior occurs is ideal
  • Attempts to distract the cat with food, toys, or attention while it is engaged in the repetitive behavior may inadvertently reinforce the behavior
45
Q

How can reinforcing alternative behavior affect Feline CD?

A
  • Positive reinforcement
    • Teaches alternative behavior
    • Creates pleasurable associations with previously stressful situations
46
Q

How can stress be alleviated in cats with CD?

A
  • Environmental Enrichment
  • Anxiolytics
47
Q

How can the environment be enriched for cats with CD?

A
  • Feline environmental enrichment provides a means to:
    • Avoid stressful situations
    • Mental and physical stimulation
    • Opportunities to engage in normal, species-typical behavior
48
Q

What Anxiolytics are available for cats with CD?

A
  • Pheromones (feline facial and appeasing)
  • Supplements
    • a-casozepine
    • L-theanine
  • Pharmaceuticals - response is highly variable
    • TCA - clomipramine
    • SSRI - Fluoxetine
    • No FDA approved drugs for Feline CD
49
Q

What is the prognosis for Feline CD?

A
  • Fair for reduction in the frequency or intensity of CD behavior
  • Poor for complete resolution or cure
  • Owners should be informed that the goals of treatment are to improve the cat’s welfare and quality of life by:
    • Limiting the risk for self-injury
    • Increasing the amount of time engaged in pleasurable activities rather than the compulsive behavior
50
Q

What additional considerations are there when treating Feline CD?

A
  • Affects the well-being of both the cat and its owners
  • May result in Relinquishment or Euthanasia of the pet if not addressed
  • Ongoing communication with the owner is essential to increase the likelihood of compliance with the treatment plan
  • Because treatment response depends on many factors nd may be unpredictable, Frequent consultation may be needed to adjust the treatment plan

Applied Animal Behavior (13 decks)

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