veterinary medicine


What ‘Bad Dogs’ Can Teach Humans About Compulsive Behavior

Casey was diagnosed with canine compulsive disorder. He’s now on Prozac. (Courtesy)

Casey was diagnosed with canine compulsive disorder. He’s now on Prozac. (Courtesy)

When Casey, a 6-year-old German Shepherd, gets anxious, she chases her tail.

But it’s not the kind of endearing, once-around-and-it’s-done kind of tail-chasing we’ve all seen. Left unchecked, Casey circles around and around, pursuing her tail until she can bite it. Then, even when the blood starts flowing, the dog is driven to continue the chase.

“It’s upsetting,” says Paula Bagge, a Hopkinton, Mass. business owner who has been living with Casey since puppyhood. “And it’s damaging. She hurls herself around the house, and it’s like a big bloody paintbrush spraying the walls.” Once, Bagge tied the dog’s leash to a coffee table in an attempt to control the chasing. But Casey, who weighs about 85 pounds, just started dragging the coffee table around with her. Now, she’s on Prozac.

Dogs, it turns out, can have obsessive-compulsive disorder, just like people. And in a new study, Dr. Nicholas Dodman, a professor of clinical sciences at the Cummings School of Veterinary Medicine at Tufts University, found that structural brain abnormalities in dogs, in this case Doberman pinschers, with canine compulsive disorder (CCD) are similar to those of humans with OCD.

In an earlier study, Dodman, a leading researcher on repetitive behavior in animals, found a specific gene associated with canine OCD.

Studying anxiety disorders in dogs, Dodman says, may ultimately help scientists come up with better therapies and medications to treat OCD and related conditions in people. Current drugs for OCD, such as SSRI’s (or for dogs, a beef-flavored form of Prozac) are notoriously ineffective for many sufferers. Indeed, Dodman says, only around 43 to 60 percent of people suffering from OCD show a postive response from an SSRI; the average reduction of symptoms in people taking these drugs is only about 23 to 43 percent. “Certainly not a panacea,” he says.

So, to further this research, Dodman spends time thinking about bears who pace obsessively, for instance, or parrots unable to stop preening and picking their feathers and beagles who overeat to the point of exploding,

Dodman calls the latest dog-brain imaging study, conducted in collaboration with researchers at McLean Hospital, in Belmont, Mass., “another piece of the puzzle, another brick in the wall.”

He says while more research must be done, it’s becoming increasingly evident that dogs with OCD are a great model for exploring human psychopathology: they show similar behaviors, respond to drugs in comparable ways and now, at least in this small study, seem to have the same brain abnormalities as people with the condition. “When you know what your dealing with it’s much easier to create targeted approaches,” to treatment, Dodman says. “If you don’t know what you’re dealing with it’s just kind of like going with your sense of smell.”

OCD afflicts about 2 percent of the population and often goes untreated or undiagnosed. People suffering from the disorder, marked by intrusive thoughts and repetitive behaviors such as hand washing, locking and unlocking doors, counting, or repeating the same steps, feel these impulses as uncontrollable. And the compulsive rituals, often triggered by stress or trauma, can be incredibly time-consuming, interfering with daily life.

Famously, Lena Dunham, the star and creator of the HBO series “Girls” came out with her own OCD on air, with repetitive tics, obsessive counting and painfully compulsive use of Q-tips. Continue reading

Treating Fluffy: Health Care Lessons From Our Pets

In the past few months I’ve seen enough stories comparing human health care to pet health care to declare it an official genre: the lessons we learn from the pets we treat. In many cases, the pets come out on top, like in this essay by Ken Farbstein, “My Dog Gets A Print Out From His Doctor, Why Don’t I?” and this piece, “How A Veterinarian’s Experience Influenced Her View On Assisted Suicide.”

The latest pet vs. man piece, published in the Journal of the American Medical Association makes a somewhat different — but equally important — point: it suggests that whether you’re a vomiting cat or a woman with reflux, figuring out the best course of treatment can be infuriatingly difficult, even for the most savvy patient.

Comparing pet care to human care

Comparing pet care to human care

In the JAMA piece, Nancy Kressin, PhD, director of the Healthcare Disparities Research Unit and associate professor at Boston University School of Medicine compares her own experience with gastroesophageal reflux disease to her cat’s vomiting and weight loss. She notes that while the diagnostic path for each case varied substantially — in cost, risk and time — ultimately the two treatments were similar, involving a fairly cheap, readily accessible medication to ease symptoms. So, Kressin writes, “why was it so hard for this patient/client to negotiate her way to obtaining enough, but not too much, information to address these symptoms?

“Patients are increasingly being encouraged to take an active role in understanding their physician’s thinking about diagnostic testing, to express their own preferences, and potentially decline or postpone tests with limited value or excessive risks or costs. Yet it remains exceedingly difficult for even the most informed patient to do so….” Continue reading

How A Veterinarian’s Experience Influenced Her View On Assisted Suicide

shelley fitzgerald

Veterinarian Shelley Fitzgerald with her friends, Eddie and Jackie Parlee.

One of the most fascinating aspects of the debate over Question 2, the Massachusetts “Death With Dignity” ballot measure on assisted suicide, is the outpouring of personal stories about our encounters with death and dying that it has brought. We don’t like to talk about dying. But suddenly, we’re doing a lot more of it than usual.

The stories that have arrived in the comments section of this recent post are moving, sometimes heartbreaking, always thought-provoking. One particular recent comment prompted me to ask the writer to expand. She had written:

The issues raised by this ballot question are faced by veterinarians every day. I can only speak for myself but I can say I have never enjoyed euthanising a client’s pet. However, I am glad the option is available. The word euthanasia means ‘good death.’ Perhaps veterinarians’ experiences could provide some clarification.

That rang so true that I asked for more. But first, an emphatic preface: This is a veterinarian sharing her thoughts and experiences, but that by no means implies that she is equating putting a pet to sleep with physician assisted suicide in humans. So please hold those objections. She is, rather, offering an insider’s valuable perspective on hundreds of experiences in which families choose to hasten the end of a beloved pet’s life. And facing head-on an issue that vets don’t talk about much, either. Deepest thanks to Westford veterinarian Shelley Fitzgerald for sharing this:

Roxie was a friendly and exuberant two-year-old Afghan hound cross who came into our clinic in 2003 for a small swelling on her cheek. The most likely causes were an insect bite, an infection or trauma. However, the swelling increased in size despite being treated with antibiotics, antihistamines and steroids. Roxie continued to be happy and eat well, but we and her owners were dismayed.

Ultimately the cause of the swelling was determined to be an aggressive form of cancer. We all knew Roxie and her family well, and everyone in our clinic cried when Roxie was euthanized because she could no longer eat.

I have performed hundreds of euthanasias myself and witnessed many more. After nine years, the details of Roxie’s case are still clear and painful. Yet I would not have wanted to see her live in her condition. I was grateful then and still am now that the option to end Roxie’s suffering in a peaceful and painless way was available. Continue reading