Genetic of OCD and CD

• Human OCD can run in the family
• People who have first degree relatives with OCD have nearly 5 fold increase in life time prevalence of OCD (Nestadt et al, 2000; Lougee et al, 2000)
• Breed predisposition
• German shepherd :tail chasing
• Doberman : flank sucking
• Bull terrier : spinning
• Large breed dogs : acral lick dermatitis

Pharmacological Response in animals

• Tricyclic antidepressant (TCA)
• Clomipramine for canine acral lick dermatitis (Rappoport et al, 1992)
• Clomipramine for other types of CDs (Hewson et al, 1998)
• Clomipramine for excessive licking/chewing in rabbits
• Selective serotonin reuptake inhibitor (SSRI)
• Fluoxetine (Rappoport et al, 1992, Wynechack, 2000) for canine acral lick dermatitis
• Fluoxetine for all types of CD (Irimajiri et al, 2005)

Others for animals
Opioid antagonists: effective for tail chasing dogs (Brown et al 1987, Dodman et al 1988)

Serotonin and Dopamine Interaction

• 5-HT innervation of dopaminergic cell bodies and terminals regulate DA neuronal firing and DA release (Quist et al, 2001)
• Opioid System
• Naltrexone, Naloxone, Nalmefen reduced stereotypies in sows (Cronin et al. 1985)

» Effect mostly on mu opioid receptors

• Nalmefene suppressed cribbing in horses (Dodman,1987)

Diagnosis

• There is no definitive diagnostic test
• Exclusion of medical causes
• Physical exam, CBC, serum chemistry, other special examinations
• Behavior history
• Observation of the behavior

• Treatment
• Identify and remove cause of conflict and desensitize to stress inducing situation
• Reduce general stress in the environment
• Interact with dog with predictable and calm fashion
• Provide consistent routine
• Avoid punishment as much as possible unless the punishment can meet the 3 rules of punishment (appropriate, consistent, immediate)
• Provide sufficient exercise and activity
• Medication-See paper for Serotonin and norepinephrine reuptake inhibitors to treat behavior problems
• All medications are extra label use.
• None are 100% effective
• SRI (serotonin reuptake inhibitors) will not show their effect for about 4 to 8 weeks

Behavior Modification

• Desensitization and counter-conditioning
• Identify the stress and make it non-stressful
• When supervised, as soon as the animal performs the compulsive behavior, distract the behavior,
• give a command that the animal knows, reward with food for responding to a command
• Training with food reward
• Basic obedience training
• Structured game (hide and seek, etc)
• Clicker training
• Treatment Summary

Identify and remove cause of conflict and desensitize to stress inducing situation

• Reduce general stress in the environment
• Medication
• Behavior modification

Prognosis

• Owners are often frustrated. It is important to have follow up calls and follow up visits frequently.
• Medication will reduce the frequency and the duration of the behavior but will not cure the animal. Inform the owner that behavior modification is important
• If there is no improvement 4 to 6 weeks after starting the treatment, changing or giving additional medication may be recommended
• If there is no improvement, ask how much they have been trying behavior modification, training and management

Crowell-Davis SL and Murray T 2006. Veterinary Psychopharmacology. Blackwell Publishing.