Article

Gastrointestinal disorders in dogs with excessive licking of surfaces

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  • Centre hospitalier vétérinaire de l'Université de Montréal (CHUV)
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... To further complicate matters, as diagnostic capabilities continue to improve, new evidence is arising that suggests that many of these problems may arise from underlying medical conditions. 11,12 Although stereotypic behavior may be a component of obsessive-compulsive behaviors, the 2 terms are not interchangeable. Within psychiatry, a diagnosis of OCD is distinct from a diagnosis of stereotypy and other body-focused repetitive disorders such as trichotillomania. ...
... However, recent research supports the likelihood that in many cases, gastrointestinal disease leads to behaviors such as surface licking and fly snapping or air biting. 11,12 A working definition of CDs in animals was proposed by Hewson and Luescher 45 in 1996 and reads as follows: ...
Article
Abnormal repetitive behaviors (ARBs) represent a diverse group of behaviors whose underlying mechanism is poorly understood. Their neurobiology likely involves several different neurotransmitter systems. These behaviors have been referred to as compulsive disorders, obsessive compulsive disorders and stereotypies. Underlying medical conditions and pain can often cause changes in behavior that are mistaken for ARBs. A complete medical work-up is always indicated prior to reaching a presumptive diagnosis. The frequency of ARBs can be reduced but not always eliminated with the use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) in conjunction with behavior modification and environmental enrichment.
... In a recent study of dogs with excessive licking of surfaces, gastrointestinal disorders were identified as a cause in at least half of the dogs. 22 House soiling is often considered a behavior problem but is often precipitated by medical problems. In a retrospective study of cats with problem elimination behavior, 60% of the cats had a history of feline urological syndrome/feline lower urinary tract disease. ...
Article
Physical signs of old age may be obvious, but mental and cognitive changes require more careful observation. Changes in behavior may represent the earliest indications of medical problems, or disorders of the central nervous system, and these may be bidirectional. Cognitive dysfunction syndrome is underdiagnosed and affects a substantial portion of aged companion animals. This article describes potential treatment regimens to address age-related behavioral problems, as well as a framework for investigating differential diagnoses. Early identification of changes in behavior is essential for the adequate treatment and management of medical and behavioral problems, and for monitoring outcomes.
... Life iii in kennels can have significant negative effects on the welfare of dogs causing physiological (9) and behavioural changes (10,11,12) contributing to the development of potential CD (13) conditions. Pica should be considered primarily as a nonspecific sign that may be the consequence of several clinical conditions, including behavioural disorders (14). ...
Article
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The present report describes a case of pyloric wall leiomyoma in a shelter dog with a history of vomiting, pica, licking and chewing the walls of the kennel. The clinical, radiological, ultrasound, hematological and blood chemistry examinations showed no abnormalities. A compulsive oral disorder was diagnosed and treatment with behaviour therapy instigated. The compulsive oral behaviours stopped following behaviour therapy, however, the vomiting persisted, suggesting the need to proceed with further diagnostic exams. The ultrasound examination, repeated after 6 months, had revealed the presence of a hypoechoic mass (3.52 cm) in the pyloric-antrum obstructing the gastric outfl ow. Following gastric dilatation the mass was surgically excised. Histological examination revealed a pyloric leiomyoma. In clinical practice this case highlights the importance of gastrointestinal diseases in the development of behaviour changes related to pica.
... Unanswered questions include how many and which repetitive behaviors could in fact be nonspecific signs of strictly medical conditions and not an OCD/CD. Studies on "psychogenic alopecia" in cats, repetitive licking of surfaces in dogs, and "fly biting" in dogs are showing that these conditions labeled as OCD/CD are in fact often secondary to medical conditions (17)(18)(19). In 1998, Hewson (20) had already written that dogs with repetitive licking behavior (self or objects) were different from other "CD" cases and that this behavior was possibly symptomatic of another condition. ...
... A recent study evaluating gastrointestinal disorders in dogs with excessive licking of surfaces found similar courses of disease, with dogs responding to the combination of diet and famotidine. 26 In retrospect, it would have been desirable to exclude food-responsive enteropathy first, but it is the authors' experience that dietary compliance increases considerably in cases in which a comprehensive investigation of the animal's problems has been performed. Secondly, because all patients underwent upper gastrointestinal endoscopy for evaluation of their clinical signs, we included capsule placement in the diagnostic evaluation to avoid a second anesthesia. ...
Article
Background Although gastroesophageal reflux (GER) often is assumed to be causative for upper gastrointestinal and respiratory signs in dogs, no attempts have been made to verify this assumption.Objectives To monitor esophageal pH with the Bravo pH system in healthy dogs and client-owned dogs displaying signs commonly attributed to GER.AnimalsSeven healthy and 22 client-owned dogs.Methods After routine esophagogastroduodenoscopy, radiotelemetric pH capsules were placed in distal esophagus for continuous pH recording. Reflux was defined as single pH measurement <4. At discharge, owners were instructed to press individually predefined clinical sign-buttons on the receiver whenever indicated. Results between groups were compared using Mann–Whitney U-test.ResultsThe median (range) number of refluxes in client-owned and healthy dogs, respectively, was 17 (1–205) and 10 (1–65), the number of refluxes >5 minutes in duration was 1 (0–14), and 1 (0–4), duration of longest reflux (min) was 10 (0–65) and 8 (0–27), and fractional time pH <4 (%) was 0.76% (0.01–6.28), and 0.3% (0–3.1). No differences were found between groups. The median of 7 (1–35) clinical sign-button pushes were recorded in 21 dogs. Median of 12.5% (2.8% [1/35]–50% [2/4]) reflux-positive clinical sign-button pushes was found in 10 dogs with reflux-positive pushes. Five (22.7%) dogs had increased esophageal acid exposure, and mild esophagitis was noted in 1 dog.Conclusion and Clinical ImportanceDespite evidence of increased GER in some dogs, the clinical sign-reflux association remained poor. Future investigation should focus on dogs with esophagitis.
... Together, there is growing evidence for a genetic contribution to canine stereotypic behavior; however, no clear biological mechanism has been identified. More recent research investigating some forms of excessive licking may be associated with undiagnosed gastrointestinal disorders (Bécuwe-Bonnet et al., 2012). These results suggest that there are likely biological contributions to canine stereotypic behavior but leave open the question whether environmental factors may also play a causal role in the development and or maintenance of canine stereotypic behavior. ...
... Other abnormal behaviors in dogs such as excessive licking of surfaces, lip smacking, and fly-biting, although listed by some authors as obsessive-compulsive disorders, have been associ-ated with gastrointestinal (GI) disorders (3,4). In one study, dogs exhibiting fly biting (appearing to be watching something and suddenly snapping at it) (4,5), were consistently extending their neck and raising their head prior to jaw snapping (4). ...
Article
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A Yorkshire terrier dog was presented for episodes of "star gazing" behavior expressed as upward raising of the head and neck extension with subsequent staring at the ceiling or sky. Erosive gastritis with reflux esophagitis was diagnosed. Treatment of these conditions was associated with resolution of the behavior, suggesting a causal link.
... type of communication [125][126][127] or experience with dogs [91,128,129], must be taken into consideration as well. Lastly, the dog's health can also affect how a dog behaves [130][131][132]. Those factors most frequently reported in the literature were included in this study. ...
Article
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In humans, the personality dimension ‘sensory processing sensitivity (SPS)’, also referred to as “high sensitivity”, involves deeper processing of sensory information, which can be associated with physiological and behavioral overarousal. However, it has not been studied up to now whether this dimension also exists in other species. SPS can influence how people perceive the environment and how this affects them, thus a similar dimension in animals would be highly relevant with respect to animal welfare. We therefore explored whether SPS translates to dogs, one of the primary model species in personality research. A 32-item questionnaire to assess the “highly sensitive dog score” (HSD-s) was developed based on the “highly sensitive person” (HSP) questionnaire. A large-scale, international online survey was conducted, including the HSD questionnaire, as well as questions on fearfulness, neuroticism, “demographic” (e.g. dog sex, age, weight; age at adoption, etc.) and “human” factors (e.g. owner age, sex, profession, communication style, etc.), and the HSP questionnaire. Data were analyzed using linear mixed effect models with forward stepwise selection to test prediction of HSD-s by the above-mentioned factors, with country of residence and dog breed treated as random effects. A total of 3647 questionnaires were fully completed. HSD-, fearfulness, neuroticism and HSP-scores showed good internal consistencies, and HSD-s only moderately correlated with fearfulness and neuroticism scores, paralleling previous findings in humans. Intra- (N = 447) and inter-rater (N = 120) reliabilities were good. Demographic and human factors, including HSP score, explained only a small amount of the variance of HSD-s. A PCA analysis identified three subtraits of SPS, comparable to human findings. Overall, the measured personality dimension in dogs showed good internal consistency, partial independence from fearfulness and neuroticism, and good intra- and inter-rater reliability, indicating good construct validity of the HSD questionnaire. Human and demographic factors only marginally affected the HSD-s suggesting that, as hypothesized for human SPS, a genetic basis may underlie this dimension within the dog species.
... Female rats are prone to developing signs of anxiety after iatrogenic gastritis (Luo, 2013). In addition, some behavioural problems, such as excessive licking of surfaces, are associated with gastrointestinal disorders in dogs, without, however, being associated with anxiety (Bécuwe-Bonnet et al., 2012). ...
Article
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Anxiety in a population of dogs with chronic gastric disease was evaluated to determine whether there is a potential link between certain chronic gastric disorders and behavioural disorders. This preliminary study compared anxiety scores in a cohort of 20 dogs with chronic gastric disorders and a control group comprised of an equal number of healthy dogs. The control group included dogs without digestive disease, age-, breed-, and sex-matched with the ill dogs. Clinical, biochemical, and endoscopic exams were performed for each of the dogs with chronic gastric disease. The Evaluation of Emotional Disorders in Dogs scale (EDED, or ETEC in French) is used to score anxiety in dogs. The average age of the dogs included in the study was 5.7 years, and 75 % were male. Yorkshires, Labradors, and poodles were numerous in our study. Smaller breeds were better represented than large or average breeds, but the small sample size did not allow us to identify any significant difference. Small breeds were better represented than large and average-sized breeds. Smaller dogs often live in closer contact with their owners than do large dogs. It is possible that vomiting or dyspeptic episodes go unnoticed if a dog lives primarily outdoors. Yorkshire terriers, Poodles, and Labrador retrievers were the breeds that were most represented in our study (45%). However, when this distribution is compared to the distribution of breeds within the French canine population, it appears that these were the three most common breeds in France at the time of the study. In the group of dogs with chronic gastric disease, 85 % had an EDED score between 17 and 35, three dogs scored less than 17, and no dogs scored over 35. Only one of the control dogs had an EDED score great than 17, and could thus be classified as having anxiety. The ill animals primarily exhibited vomiting (75%). The average EDED score of dogs with dyspepsia was 23.2, compared to 19.6 for dogs who exhibited vomiting. The average EDED score in the ill dog group was 20.5, and the median was 20.5 with a variance of 21.8. For the control group, the average was 11.5, the median was 11, and the variance was 6.25. The Wilcoxon test yielded a p-value of 0.00023, indicating a very significant difference between the two groups. The animals with chronic gastric disease had significantly higher EDED scores than the control animals. There was no significant difference between the scores obtained for the dogs with dyspepsia and those who exhibited vomiting. The differential diagnosis for chronic gastric disease should include anxiety, and not only as an exclusion diagnosis. Scoring chronic and relapsing dogs on an EDED scale can save time. Treating anxiety improves the outcome of these dogs.
... When follow-up was prolonged to 6 months, the improvement went up to 76% of dogs. Interestingly, even if some dogs did not have a gastrointestinal disorder identified, the excessive licking of surfaces decreased following a course of hypoallergenic diet, antacid, and anti-emetic, suggesting nausea or possibly the discomfort/pain associated with hyperacidity could be a potential cause [45]. ...
Article
Full-text available
We argue that there is currently an under-reporting of the ways in which pain can be associated with problem behavior, which is seriously limiting the recognition of this welfare problem. A review of the caseloads of 100 recent dog cases of several authors indicates that a conservative estimate of around a third of referred cases involve some form of painful condition, and in some instances, the figure may be nearly 80%. The relationship is often complex but always logical. Musculoskeletal but also painful gastro-intestinal and dermatological conditions are commonly recognized as significant to the animal’s problem behavior. The potential importance of clinical abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed by clinicians in general practice, even when they are common within a given breed. In general, it is argued that clinicians should err on the side of caution when there is a suspicion that a patient could be in pain by carefully evaluating the patient’s response to trial analgesia, even if a specific physical lesion has not been identified.
... Other authors concluded that grass-eating should be regarded as a normal behaviour of dogs [22][23][24]. Excessive surface or object licking was found to be a behavioural change associated with gastrointestinal abnormalities [25]. Currently it is unknown to which extent such non-specific signs are associated with early or advanced gastric mucosal pathology in dogs. ...
Article
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Background Gastric carcinoma (GC) is uncommon in dogs, except in predisposed breeds such as Belgian Shepherd dogs (BSD) of the Tervuren and Groenendael varieties. When GC is diagnosed in dogs it is often late in the disease, resulting in a poorer prognosis. The aim of this prospective clinical study was to investigate possible associations of gastric mucosal pathologies with clinical signs, laboratory test results and GC in BSD. An online survey gathered epidemiological data to generate potential risk factors for vomiting as the predominant gastric clinical sign, and supported patient recruitment for endoscopy. Canine Chronic Enteropathy Clinical Activity Index (CCECAI) score and signs of gastroesophageal reflux (GER) were used to allocate BSD older than five years to either Group A, with signs of gastric disease, or Group B, without signs. Findings in the clinical history, laboratory tests and gastric histopathology of endoscopic biopsies were statistically analysed in search of associations. Results The online survey included 232 responses. Logistic regression analysis recognized an association of vomiting with gagging, poor appetite and change in attitude. Recruitment for endoscopy included 16 BSD in Group A (mean age 9.1 ± 1.8 years, mean CCECAI = 3.1 ± 2.2 and signs of GER); and 11 in Group B (mean age 9.8 ± 1.4 years, CCECAI = 0, no signs of GER). Seven (25.9%) of the 27 BSD (Group A 4/16, Group B 3/11) had leukopenia. Serum C-reactive protein tended to be increased with more advanced GC (P = 0.063). Frequency of GC, mucosal atrophy, mucous metaplasia, or glandular dysplasia did not differ between groups. GC was frequently diagnosed (6/27), even without clinical signs (2/11). The odds ratio for vomiting (OR = 9.9; P = 0.016) was increased only when glandular dysplasia was present. GC was associated with mucous metaplasia (P = 0.024) and glandular dysplasia (P = 0.006), but not with mucosal atrophy (P = 1). Conclusions GC can develop as an occult disease, associated with metaplasia and dysplasia of the gastric mucosa. Suggestive clinical signs, notably vomiting, should warrant timely endoscopy in BSD. Extensive endoscopic screening of asymptomatic dogs remains, however, unrealistic. Therefore, biomarkers of mucosal pathology preceding clinical illness are needed to support an indication for endoscopy and enable early diagnosis of GC.
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Chapter
Cognitive dysfunction syndrome (CDS) is a diagnosis of exclusion given that there is no specific diagnostic test or tool and that medical disorders can cause the same set of signs. The veterinary surgeon must first identify that signs are present, collect a full history and then perform a full physical examination and relevant diagnostic tests to rule out medical causes for the signs including blood and urine analysis, radiographs and diagnostic imaging such as magnetic resonance imaging (MRI) where indicated.
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The quality of histopathology slides of endoscopic biopsies from different laboratories varies, but the effect of biopsy quality on outcome is unknown. The ability to demonstrate a histologic lesion in the stomach or duodenum of a dog or cat is affected by the quality of endoscopic biopsy samples submitted. More endoscopic samples are needed to find a lesion in poor-quality tissue specimens. Tissues from 99 dogs and 51 cats were examined as clinical cases at 8 veterinary institutions or practices in 5 countries. Histopathology slides from sequential cases that underwent endoscopic biopsy were submitted by participating institutions. Quality of the histologic section of tissue (inadequate, marginal, adequate), type of lesion (lymphangiectasia, crypt lesion, villus blunting, cellular infiltrate), and severity of lesion (normal, mild, moderate, severe) were determined. Sensitivity of different quality tissue samples for finding different lesions was determined. Fewer samples were required from dogs for diagnosis as the quality of the sample improved from inadequate to marginal to adequate. Duodenal lesions in cats displayed the same trend except for moderate duodenal infiltrates for which quality of tissue sample made no difference. Gastric lesions in dogs and mild gastric lesions in cats had the same trend, whereas the number of tissue samples needed to diagnose moderately severe gastric lesions in cats was not affected by the quality of tissue sample. The quality of endoscopically obtained tissue samples has a profound effect on their sensitivity for identifying certain lesions, and there are differences between biopsies of canine and feline tissues.
Article
Stress parameters that can be measured noninvasively may help to identify poor welfare in dogs that live in private homes and institutions. Behavioural parameters are potentially useful to identify stress, but require further investigation to establish which behaviours are appropriate. In the present study, behaviours were recorded and analysed for signs of acute stress in dogs. Simultaneously, saliva cortisol and heart rate were measured to support the interpretation of the behavioural data with regard to stress. Ten dogs of either sex, different ages and various breeds were each subjected to six different stimuli: sound blasts, short electric shocks, a falling bag, an opening umbrella and two forms of restraint. Each type of stimulus had been selected for its assumed aversive properties and was administered intermittently for 1 min. The stimuli that could not be anticipated by the dogs, sound blasts, shocks and a falling bag, tended to induce saliva cortisol responses and a very low posture. The remainder of the stimuli, which were administered by the experimenter visibly to the dog, did not change the cortisol levels but did induce restlessness, a moderate lowering of the posture, body shaking, oral behaviours, and to a lesser extent, yawning and open mouth. Pronounced increases in the heart rate were nonspecifically induced by each type of stimulus. Heart rate levels normalized within 8 min after stressor administration had stopped. Saliva cortisol levels decreased to normal within the hour. Correlations between behavioural and physiological stress parameters were not significant. From the present results, we conclude that in dogs a very low posture may indicate intense acute stress since dogs show a very low posture concomitant with saliva cortisol responses. Dogs may typically show increased restlessness, oral behaviours, yawning, open mouth and a moderate lowering of the posture when they experienced moderate stress in a social setting. The nonspecific character of canine heart rate responses complicates its interpretation with regard to acute stress.
Article
In this study the anxiety-related components of rhesus monkey infant behavior at an early stage of social development were examined. Eight rhesus infants (age 30-40 weeks) belonging to 3 captive groups were administered with an anxiogenic drug (beta-CCE; 0.2 mg/kg) and an anxiolytic drug (midazolam; 0.2 mg/kg). Saline solution was used as placebo. All infants were tested twice with each drug (four times with placebo) and their behavioral interactions with their mother and other social companions were recorded in 1-hr observation sessions. No convulsant or sedative effects of the drugs were observed. beta-CCE was associated with an increase in time spent by the infant with its mother and a concomitant reduction in proximity with other individuals and in social play. Midazolam did not affect the mother-infant interaction but increased the infant's locomotor activity away from the mother and its proximity and social play with juveniles and subadults when compared to peers. These results suggest that, although infant anxiety can be experimentally induced, it is not a major component of the mother-infant relationship. Infant anxiety, however, might affect the formation of other social bonds and play a part in the development of avoidance responses toward other individuals.
Article
Colonic mucosal samples were obtained every 4 weeks for 13 months from 6 clinically normal dogs and from 47 dogs with a clinical diagnosis of chronic inflammatory bowel disease. All samples were graded on a scale of 0-5, based upon the quantity of lymphocytes and plasma cells in the lamina propria, epithelial changes, and the presence of ulcers and erosions. A grade of less than or equal to 2.0 was considered normal and was assigned to 77 of 78 samples from clinically normal dogs and 28 of 48 samples from dogs with diarrhea. A transient increase in cellularity was noted in 1 sample from 1 control dog. Nineteen dogs with clinical disease had obvious histologic abnormalities. The grading scheme described provides the pathologist with an objective criterion for the microscopic evaluation of colonic mucosal samples obtained by endoscopic techniques and offers clinicians a method of assessing the dog's progress and response to therapy.
Article
OBJECTIVE--To compare histologic lesions in the stomach and duodenum of dogs and cats with and without lymphocytic-plasmacytic enteritis (LPE). DESIGN--Case-control study. ANIMALS--20 clinically normal dogs, 40 dogs with LPE, 10 clinically normal cats, and 20 cats with LPE. RESULTS--Unevenness of the mucosal surface was detected in the stomach of 4 of the 20 (20%) clinically normal dogs and 10 of the 40 (25%) dogs with LPE. Mucosal friability was detected in the duodenum of 16 (40%) of the dogs with LPE and 10 of the 20 (50%) cats with LPE. Histologically, clinically normal dogs and dogs with LPE had various degrees of fibrosis in the gastric lamina propria. All of the clinically normal cats and the cats with LPE had slight gastric fibrosis. Clinically normal cats had infiltrates of inflammatory cells similar to those seen in the clinically normal dogs. Significantly more plasma cells and lymphocytes were seen in the duodenal lamina propria of dogs and cats with LPE than in the duodenal lamina propria of clinically normal animals. CLINICAL IMPLICATIONS--LPE should be diagnosed by counting the number of inflammatory cells in the duodenal lamina propria and then comparing that number with the number seen in clinically normal animals.
Article
The development of laboratory rodent models for elicitation and measurement of a range of defensive behaviors raises the question of the relationship between defense in these animals and those of their wild congeners. To evaluate this relationship for mice, defensive responses to an anesthetized rat were compared for fourth-generation laboratory-bred wild mice and Swiss CD-1 (Swiss-Webster derived) laboratory mice in a Mouse Defense Test Battery. Wild mice showed enhanced levels of both freezing and flight, fleeing from distant approach of the predator in several situations and fleeing more quickly than the Swiss mice. However, Swiss mice did flee upon contact with the rat and also showed levels of several other defensive behaviors (risk assessment, defensive threat, and attack) that were often reliably higher than those of the wild mice. However, when wild mice were prevented from fleeing, their levels of defensive threat and attack were as high as, or at very short prey-predator distances higher than, those of the Swiss mice. These findings suggest that flight and freezing are the major defensive behaviors reduced in Swiss mice and that these reductions allow the appearance of higher levels of additional defensive behaviors in the laboratory animals. However, although Swiss mice do show lower levels of flight and freezing, their patterns of defensive behavior are sufficiently similar to those of wild mice that they provide adequate subjects for research on the biologic bases of defensive behavior. A final experiment indicated that when wild mice are familiarized with a chamber providing a place of concealment, they flee directly to this chamber on presentation of a rat, indicating that flight is a targeted response and not simply an abrupt increase in forward locomotion. Over 10 rat presentation trials with a blocked chamber entrance, however, this response declines.
Article
To assess the efficacy of clomipramine for treatment of canine compulsive disorder (CCD). Randomized, placebo-controlled, double-blind, balanced AB-BA crossover clinical study. 51 dogs with CCD. Dogs were given clomipramine (3 mg/kg [1.3 mg/lb] of body weight, PO, q 12 h) for 4 weeks and placebo for 4 weeks. At the end of each treatment each owner rated the severity of their dog's behavior, using 2 validated rating scales. Statistical analysis was made by ordinal regression. Compliance, adverse effects, and the effectiveness of masking were also assessed. Each dog's behavior was reevaluated 1 to 2 years after completing the study. Behaviors included spinning (n = 17) and self-mutilation by licking (acral lick dermatitis, 12). Both rating scales demonstrated a treatment effect. Compliance was satisfactory, and masking was effective. Sedation and reduced appetite were reported more commonly when dogs were given clomipramine than when they were given placebo. Forty-five dogs available for follow-up evaluation still had their behaviors; 6 dogs were lost to follow-up evaluation. Results suggest that clomipramine was effective in dogs with CCD and was not associated with serious adverse effects. However, treatment for 4 weeks was not curative. Behavior modification is likely to be necessary to manage CCD.
Article
Immunohistochemistry and computer-aided morphometric analysis were used to define populations of leucocyte subsets in the intestinal tract of an outbred population of dogs with no evidence of gastrointestinal disease. In the small intestinal lamina propria, B cells and plasma cells (IgA+, IgM+ and IgG+) were prominent in peri-crypt regions, with a significant trend for a reduction in the number of cells towards the villous tip (P < 0.0001). By contrast, lamina propria T cells (CD3+) and T-cell subsets (CD4+ and CD8+) were present in greatest numbers at the tip of the villus, with significantly decreasing numbers towards the crypt regions (P < 0.0001). In the lamina propria, CD4+ cells outnumbered CD8+ cells (P = 0.05), but the opposite was true of the epithelial compartment (P < 0.001). The distribution of CD5+ lymphocytes was similar to that of CD3+ cells, in both the lamina propria and epithelial compartments. The numbers and distribution of cells expressing MHC class II, L1 and CD45 were recorded. Numerous eosinophils were present in the lamina propria, and an intra-epithelial population was also noted, especially in the crypt epithelium. Mast cells, which were mainly found in the subepithelial lamina propria, were also present within muscle layers, and cells expressing IgE had a similar distribution. Similar populations of cells were recorded in the colonic lamina propria and epithelium. The quantitative and qualitative data from this study will enable comparisons to be made with dogs suffering from inflammatory bowel diseases.
Article
To compare the antiemetic effectiveness and safety of oral granisetron plus dexamethasone with those of oral ondansetron plus dexamethasone administered before emetogenic chemotherapy. Randomized, prospective, multicenter, open-label study. University-teaching hospital and veterans health care system. Sixty-one chemotherapy-naïve patients scheduled to receive emetogenic antineoplastic agents. A single-dose oral granisetron 1 mg and dexamethasone 12 mg or single-dose oral ondansetron 16 mg and dexamethasone 12 mg was administered before chemotherapy. Twenty-four hours after administration patients were contacted to assess nausea, emesis, and adverse events. There were no statistical differences in frequency of nausea or emesis between groups. Seventy-six percent and 82% of patients receiving ondansetron and granisetron, respectively, experienced no emesis 24 hours after chemotherapy. Complete protection from nausea occurred in 58% and 46% of patients receiving the drugs, respectively. Adverse events were similar between groups. Oral granisetron 1 mg and ondansetron 16 mg plus dexamethasone are safe and effective in preventing nausea and vomiting related to emetogenic chemotherapy.
Article
The aim of this paper is to explicate what is special about emotional information processing, emphasizing the neural foundations that underlie the experience and expression of fear. A functional, anatomical model of defense behavior in animals is presented and applications are described in cognitive and physiological studies of human affect. It is proposed that unpleasant emotions depend on the activation of an evolutionarily primitive subcortical circuit, including the amygdala and the neural structures to which it projects. This motivational system mediates specific autonomic (e.g., heart rate change) and somatic reflexes (e.g., startle change) that originally promoted survival in dangerous conditions. These same response patterns are illustrated in humans, as they process objective, memorial, and media stimuli. Furthermore, it is shown how variations in the neural circuit and its outputs may separately characterize cue-specific fear (as in specific phobia) and more generalized anxiety. Finally, again emphasizing links between the animal and human data, we focus on special, attentional features of emotional processing: The automaticity of fear reactions, hyper-reactivity to minimal threat-cues, and evidence that the physiological responses in fear may be independent of slower, language-based appraisal processes.
Article
To evaluate the efficacy and tolerance of a treatment protocol for obsessive-compulsive disorder, separation anxiety and noise phobia in dogs. A study was undertaken to assess clinical responses in 24 dogs diagnosed with one or more of three behavioural disorders stated above to a treatment regimen that included clomipramine and behaviour modification. A detailed behavioural and clinical history was obtained for each dog. Obsessive-compulsive disorder was diagnosed in nine cases: primary presenting complaints were tail-chasing, shadow-chasing, circling and chewing; one case was diagnosed with concurrent separation anxiety. Separation anxiety was diagnosed in 14 cases: presenting complaints included destruction, vocalisation and escaping in the absence of the owner; four cases also exhibited noise phobia. The study also included one dog diagnosed with noise phobia only and another with inappropriate fear responses. Clomipramine was administered orally twice daily. The starting dose was 1 to 2 mg/kg bodyweight. The dose was increased incrementally to a maximum of 4 mg/kg if needed. A behaviour modification program was designed and the owner instructed on its implementation. Dogs continued medication for at least 1 month after clinical signs disappeared or were acceptably reduced, then withdrawal of medication was attempted by decreasing drug dosage at weekly intervals while behaviour modification continued. The presenting clinical sign was largely improved or disappeared in 16 dogs, 5 demonstrated slight to moderate improvement and the behaviour was unchanged in 3. Clomipramine withdrawal was attempted in nine cases: this was successful in five. Clomipramine was effective and well-tolerated in controlling signs of obsessive-compulsive disorder and/or separation anxiety and/or noise phobia in 16 of 24 assessable cases, when used in combination with behaviour modification, and improvement in clinical signs was noted in 5 others.
Article
To evaluate quality of duodenal tissue specimens obtained endoscopically from dogs and cats and submitted to 1 of 2 diagnostic laboratories for evaluation. Case series. Slides from 50 consecutive canine and 50 consecutive feline endoscopically obtained duodenal tissue specimens submitted to laboratory 1 and 49 consecutive canine and 46 consecutive feline specimens submitted to laboratory 2. Slides were examined independently by 3 investigators, and each tissue piece on each slide was classified as clearly inadequate, questionable, or clearly adequate on the basis of 4 criteria. An overall score was then assigned to the slide. Slides from laboratory 1 were more likely to be scored as clearly adequate and less likely to be scored as clearly inadequate than slides from laboratory 2. Clearly adequate slides from laboratory 1 had a higher number of clearly adequate pieces of tissue than did clearly adequate slides from laboratory 2. Slides scored as clearly adequate had a higher number of individual tissue pieces than did slides scored as clearly inadequate. Results suggest that the quality of endoscopically obtained duodenal tissue specimens submitted to laboratories can vary, possibly because of differences in experience of individuals collecting biopsy specimens. Results suggest that at least 8 individual tissue pieces should be submitted when performing endoscopic biopsy of the duodenum in dogs and cats.
Article
To determine whether substantial interobserver variation exists among diagnostic pathologists for descriptions of intestinal mucosal cell populations and whether histopathologic descriptions accurately predict when a patient does not have clinically evident intestinal disease. Comparative survey. Sample Population-14 histologic slides of duodenal, ileal, or colonic tissue from 10 dogs and 3 cats. Each histologic slide was evaluated independently by 5 pathologists at 4 institutions. Pathologists, who had no knowledge of the tissues' origin, indicated whether slides were adequate for histologic evaluation and whether the tissue was normal or abnormal. They also identified the main infiltrating cell type in specimens that were considered abnormal, and whether infiltrates were mild, moderate, severe, or neoplastic. Quality of all slides was considered adequate or superior by at least 4 of the 5 pathologists. For intensity of mucosal cellular infiltrates, there was uniformity of opinion for 1 slide, near-uniformity for 6 slides, and nonuniformity for 7 slides. Five dogs did not have clinical evidence of intestinal disease, yet the pathologists' descriptions indicated that their intestinal tissue specimens were abnormal. Substantial interobserver variation was detected. Standardization of pathologic descriptions of intestinal tissue is necessary for meaningful comparisons with published articles. Clinicians must be cautious about correlating clinical signs and histopathologic descriptions of intestinal biopsy specimens.
Article
The clinical course of inflammatory bowel disease (IBD) in dogs is characterized by spontaneous exacerbations and remissions, which makes assessment of disease burden difficult. The objectives of this study were to develop a scoring system for evaluation of canine IBD activity and to validate this scoring method by correlating it to objective laboratory and histologic indices of intestinal inflammation. Fifty-eight dogs with IBD were evaluated prospectively and compared to 9 disease-free control dogs. Clinical disease activity was quantified by a simple scoring system, the canine IBD activity index (CIBDAI), and compared to serum concentrations of C-reactive protein (CRP), haptoglobin (HAP), alpha-acid glycoprotein (AGP), and serum amyloid A (SAA), as well as histology scores derived from endoscopic biopsy specimens. Forty-six dogs were available for a reevaluation of the CIBDAI, CRP HAP, and AGP, and 34 dogs had repeat analysis of SAA performed after medical therapy. Serum concentrations of CRP were significantly (P < .02) increased in dogs with CIBDAI scores > or = 5 (mild disease activity or greater) compared to controls. Among IBD dogs, the CIBDAI showed good correlation (r = 0.82, P < .0001) to both histology and HAP scores, but CRP also was a strong co-correlate of disease activity. The IBD dogs showed significantly (P < .0001) decreased CIBDAI and CRP values but significantly (P < .0001) increased HAP concentrations after medical therapy compared to pretreatment values. We conclude that the CIBDAI is a reliable measure of inflammatory activity in canine IBD and that CRP is suitable for laboratory evaluation of the effect of therapy in these patients.
Article
Nausea and vomiting are amongst the most common symptoms encountered in medicine as either symptoms of diseases or side effects of treatments. In a more biological setting they are also important components of an organism's defences against ingested toxins. Identification of treatments for nausea and vomiting and reduction of emetic liability of new therapies has largely relied on the use of animal models, and although such models have proven invaluable in identification of the anti-emetic effects of both 5-hydroxytryptamine(3) and neurokinin(1) receptor antagonists selection of appropriate models is still a matter of debate. The present paper focuses on a number of controversial issues and gaps in our knowledge in the study of the physiology of nausea and vomiting including: The choice of species for the study of emesis and the underlying behavioural (e.g. neophobia), anatomical (e.g. elongated, narrow abdominal oesophagus with reduced ability to shorten) and physiological (e.g. brainstem circuitry) mechanisms that explain the lack of a vomiting reflex in certain species (e.g. rats); The choice of response to measure (emesis[retching and vomiting], conditioned flavour avoidance or aversion, ingestion of clay[pica], plasma hormone levels[e.g. vasopressin], gastric dysrhythmias) and the relationship of these responses to those observed in humans and especially to the sensation of nausea; The stimulus coding of nausea and emesis by abdominal visceral afferents and especially the vagus-how do the afferents encode information for normal postprandial sensations, nausea and finally vomiting?; Understanding the central processing of signals for nausea and vomiting is particularly problematic in the light of observations that vomiting is more readily amenable to pharmacological treatment than is nausea, despite the assumption that nausea represents "low" intensity activation of pathways that can evoke vomiting when stimulated more intensely.
Article
Man should strive to have his intestines relaxed all the days of his life. Moses Maimonides, AD 1135–1204 A good set of bowels is worth more to a man than any quantity of brains. Josh Billings (Henry Wheeler Shaw), AD 1818–1885 For centuries, physicians and historians have recognized that it is common for maladies to afflict the intestinal tract, producing symptoms of pain, nausea, vomiting, bloating, diarrhea, constipation, difficult passage of food or feces, or any combination.1When these symptoms are experienced as severe, or when they impact on daily life, those afflicted often attribute the symptoms to an illness and seek medical care. Traditionally, the physicians caring for these patients will search for inflammatory, infectious, neoplastic, and other structural abnormalities to make a specific diagnosis and offer specific treatment. Yet as has been common in medical practice,2 when no structural etiology is found, the patient is diagnosed as having “functional” symptoms and is treated symptomatically. Until recently, the limited scientific knowledge about the pathophysiology of these symptoms, and the need to diagnose by excluding “organic” disease, has led physicians to feel uncertain about the legitimacy of these symptoms as bona fide disorders.3 Some have felt insecure in their ability to manage patients with these conditions, and might even avoid caring for patients with these complaints. But over the past two decades, two important processes have occurred to legitimize these conditions, and to increase attention toward the research and clinical care of patients with functional gastrointestinal disorders (FGID). The first has been a shift in conceptualizing these disorders from a disease-based, reductionistic model, where the effort is directed toward identifying a single underlying biological etiology, to a more integrated, biopsychosocial model of illness.4 5 The latter model allows for symptoms to be understood as physiologically …
Article
The past 20 years have seen notable advances in our understanding of the physiology and pharmacology of the emetic reflex leading to the identification of the anti-emetic effects of 5-hydroxytryptamine(3) (5-HT(3)) and neurokinin(1) receptor (NK(1)) antagonists. The introduction of 5-HT(3) and NK(1) receptor antagonists into the clinic has had a major impact in alleviating the nausea and vomiting associated with the treatment of cancer and the sequelae to anaesthesia and surgery (post-operative nausea and vomiting, PONV). Despite these advances there are major gaps in our understanding. Interestingly, one of these is the relatively poor ability to treat nausea. Additional gaps in our knowledge are highlighted to provide a framework within which directions for research can be proposed. Particular attention is drawn to: lacunae in knowledge of some currently used anti-emetics such as the source of dopamine required to initiate emesis; the theoretical assumptions and mechanisms underlying the concept of a "universal anti-emetic"; the variety of receptors at which agonists act to have anti-emetic effects (GABA (B), CB(1), 5-HT(1A), ghrelin, opioid); issues of translation from animals to humans and the relationship between the pathways involved in emesis and certain gastrointestinal disorders such as dyspepsia and gastroesophageal reflux, with the latter being of particular interest as some agents affecting reflux are also anti-emetic. Together, the unmet clinical need to adequately control nausea, possibly by new drugs acting within the brainstem, and the significant gaps in understanding key aspects of the emetic reflex, suggest an important need to focus and re-direct research into the distressing and sometimes life-threatening symptoms of nausea and vomiting.
Article
Nausea and vomiting are commonly seen in the critically ill patient. While these symptoms are not often the cause for admission to critical care, they complicate and may extend the length of stay as well as the patient's feelings about his or her hospitalization. As with all care provided in critical care, we should strive to implement interventions supported by evidence whenever possible. The article includes definitions, a general description, and the pathophysiology of nausea and vomiting. As well, an evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with nausea and vomiting is outlined, using levels of recommendation based on the strength of available evidence. A case study is presented to allow for clinical application: case study commentary reviews the salient points of care.
Article
Nausea and vomiting are important as biological systems for drug side effects, disease co-morbidities, and defenses against food poisoning. Vomiting can serve the function of emptying a noxious chemical from the gut, and nausea appears to play a role in a conditioned response to avoid ingestion of offending substances. The sensory pathways for nausea and vomiting, such as gut and vestibular inputs, are generally defined but the problem of determining the brain's final common pathway and central pattern generator for nausea and vomiting is largely unsolved. A neurophysiological analysis of brain pathways provides an opportunity to more closely determine the neurobiology of nausea and vomiting and its prodromal signs (e.g., cold sweating, salivation).
Article
This article discusses the presenting signs, diagnosis, and differential diagnosis of compulsive disorder. Problems with the diagnosis and heterogeneity of the condition are discussed. Likely causes, development, and pathophysiology of the condition form the basis for the clinical approach to the treatment of the condition. Treatment includes environmental and management changes, behavioral modification, and drugs.
Stereotypic and compulsive disorders
  • G Landsberg
  • W Hunthausen
  • L Ackerman
Landsberg, G., Hunthausen, W., Ackerman, L., 2003. Stereotypic and compulsive disorders. In: Handbook of Behavior Problems of the Dog and Cat. Saunders Ltd, Toronto, ON, Canada, pp. 195-225.
Handbook of Small Animal Gastroenterology
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DeNovo, R.C., 2003. Diseases of the stomach. In: Tams, T.R. (Ed.), Handbook of Small Animal Gastroenterology. Saunders, St Louis, MO, pp. 181-186.
Veterinary Endoscopy for the Small Animal Practitioner. Elsevier Saunders
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Guilford, W.G., 2005. Upper gastrointestinal endoscopy. In: McCarthy, T.C. (Ed.), Veterinary Endoscopy for the Small Animal Practitioner. Elsevier Saunders, St. Louis, MO, pp. 279-321.
Fear and anxiety: animal models and human cognitive psychophysiology
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  • M Davis
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Lang, P.J., Davis, M., Ö hman, A., 2000. Fear and anxiety: animal models and human cognitive psychophysiology. J. Affect. Disord. 61, 137-159.
Textbook of Veterinary Internal Medicine, 6 Ed
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Twedt, D.C., 2005. Vomiting. In: Ettinger, S.J., Feldman, E.C. (Eds.), Textbook of Veterinary Internal Medicine, 6 Ed. Saunders, St Louis, MO, pp. 132-136.