Pet Forum / Miscellaneous / Animal Health / April 2006

Its starting to warm up up here, but its Calgary so you never know (it has
the tendency to get cold again really fast).

Do you think it could be diet related? Frankly the food he's getting is
pretty low quality (No Name, Super Store Special in the Yellow bag), but its
hard to tell them that the food they've been feeding him for the last 13
years isn't very good. I was kind of hoping he would run out of food while
they were away, then I could get him a bag of some good stuff, and hopefully
they would notice a difference.

Its hard because I know they really love him to pieces, but they are pretty
'old school' in what they do for him.

Absolutely. He's such a sweet guy.

Dale

HOWEDY paula,

dale is a lyin dog abusing punk thug coward active acute chronic long
term incurable mental cse like the other respondents to this thread.

You've been HOODWINKED by irresponsible greedy
ignorameHOWESES with university books quotin other
lemmings thoughts <{) ; ~ (  >

Your veterinarian AIN'T GOT NO CURE for SELF MUTILATION.

Yeah. Most of them are PSYCHOTIC.

Would't it make more sense to treat the PSYCHOSIS in KNOWN abused
critters and if THAT don't work look for an underlying medical
condition.

You mean the NEURO TOXIN your VETERINARIAN SELLS?

There's many EFFECTIVE NON TOXIC ways to CON-TROLL fleas.
Perhaps you should read Dr. Pitcairn's book on Natural Heelth Care?

He's feedin cheap commercial garbage as opposed to the
EXXXPENSIVE COMMERCIAL GARBAGE your vet SELLS.

That so?

"Luck is for SUCKERS. Never make a SUCKERS' bet," The
Puppy Wizard's DADDY <{) ; ~ ) >

                     Behavioral Dermatology:
          Acral Lick Dermatitis, Psychogenic Alopecia,
               Hyperesthesia, & Related Conditions
                        Vint Virga, DVM,
             Dipl. ACVB Behavioral Medicine for Animals
                  SM Veterinary Healing Arts, Inc.
                       New York / Newport

HOWEDY Mari,

Here's The Puppy Wizard's Syndrome. CAVEAT: The Amazing Puppy
Wizard DOES NOT CONDONE or ENDORSE the good Doctor's METHODS
for treating STRESS INDUCED AUTO-IMMUNE DIS-EASE aka The Puppy
Wizard's Syndrome.  He's ONLY a veterinarian and there's ONLY THREE
CURES for it and HE AIN'T GOT 'em.

Here's WON of 'em:

                  <{#}: ~ } >8< { ~ :{@}>
           <{#}: ~ } >               < { ~ :{@}>
   <{#}: ~ } >                               < { ~ :{@}>
   <{#}: ~ } >                               < { ~ :{@}>
   <{#}: ~ } >  http://www.tinyurl.com/7bl5u < { ~ :{@}>
   <{#}: ~ } >                               < { ~ :{@}>
   <{#}: ~ } >                               < { ~ :{@}>
           <{#}: ~ } >               < { ~ :{@}>
                  <{#}: ~ } >8< { ~ :{@}>

                     Behavioral Dermatology:
          Acral Lick Dermatitis, Psychogenic Alopecia,
               Hyperesthesia, & Related Conditions
                        Vint Virga, DVM,
             Dipl. ACVB Behavioral Medicine for Animals
                  SM Veterinary Healing Arts, Inc.
                       New York / Newport

Introduction

The practice of behavioral dermatology encompasses the diagnosis
and management of a etiologically diverse set of disorders which
phenotypically manifest with dermatologic presentations. Not only
are primary behavioral etiologies included, but also primary
dermatologic conditions with secondary or contributory behavioral
components. It is not uncommon, for example, for veterinary or human
patients to experience anxiety, tension, or stress secondary to chronic
or acute dermatologic conditions. Ultimately, it is the interplay
between neurosensory, dermatologic, and behavioral components
which contribute to the manifestation of clinical signs associated with

psychocutaneous syndromes, including:

Self injurious behaviors

Compulsive disorders

Stereotypic behaviors

Displacement activities

Other anxiety related behaviors

Attention seeking behavior

Sensory Neuropathies

Psychotic Illnesses

A diagnosis of self-injurious behavior in small animals must
meet the criteria of barbering or removal of hair and/or abrasion,
petechiation, or ulceration of any body part using the teeth,
tongue, claws, or an external substrate (e.g. rubbing against
a wall).

A condition for a diagnosis of SIB is that these behaviors must
be demonstrated repeatedly and consistently in the absence of
any primary dermatologic or physiologic condition.

In veterinary behavioral medicine, compulsive behaviors may be
defined as sequences of movements which serve no obvious purpose
or function and which occur repetitively, out-of-context or at
an excessive frequency or duration, and in a relatively unvaried
ashion. In most cases they are derived from behaviors which are
part of the animal's normal behavioral repertoire.

While such behaviors in animals have been traditionally referred to
as stereotypies, to establish a diagnosis of a compulsive disorder,
the behavior must occur outside of its normal context or at a frequency
or duration which exceeds that necessary to achieve a real or potential
goal and must interfere with the patient's ability to function normally
in its social environment.

Considering these criteria, it is evident that some patients presenting
to the small animal practitioner may meet the conditions for both self-
injurious behavior and compulsive disorder. Compulsive behaviors
associated with dermatologic signs are most commonly classified as
grooming compulsive disorders, although some may be neurotic in
origin. In canine patients these may include acral lick
dermatitis/granuloma
(ALD/ALG), flank sucking, tail chewing (which may or may not be
associated
with tail chasing), excessive chewing of the feet and/or nails, and
excessive
scratching.

Other compulsive behaviors observed in canine patients may be
classified as hallucinatory (e.g. fly/light chasing, prey searching,
staring); locomotor (e.g. circling, tail chasing, fence running)
eating/drinking (e.g. fabric sucking, psychogenic polydypsia,
some picas); vocal (e.g. rhythmic barking, barking at food or
inanimate objects); or neurotic (e.g. vicious self-biting,
spontaneous aggression to humans).

Attention-Seeking Behavior

A significant percentage of cases referred for evaluation of compulsive
or self-injurious behaviors are ultimately diagnosed as
attention-seeking
behaviors. Animals can readily learn that not only disruptive behaviors
(e.g. barking, jumping, pawing, nuzzling), but also less directly
demanding behaviors (e.g. limb/foot/preputial licking, chewing,
scratching,
sucking, pawing) often effectively get the client's attention. The
clients may
have historically tried a variety of approaches to discourage such
behaviors;

often such attempts include: varying degrees of physical and verbal
corrections, comforting the patient with physical touch and verbal
reassurances, banishment with physical and social isolation, and
ignoring the behavior to varying degrees.

As the animal persists in the behavior, clients typically report that
they eventually provide some form of attention; in so doing, the
behavior can quite effectively be reinforced. It is important for the
client to recognize that any form of attention, even physical
punishment,
may serve to reinforce the problem behavior.

In establishing a diagnosis of attention-seeking behavior, a careful
review of the history should reveal that the patient will only
demonstrate
the problem behavior in the immediate presence or close proximity of
the client.

Observation of the patient at the time of consultation should reveal
the
behavior is dramatically reduced or non-existent when the clients (or,
in some cases, all parties including the clinician) are absent.

Canine Acral Lick Dermatitis/Granuloma

While acral lick dermatitis (ALD/ALG) may be organic or psychogenic
in origin, this discussion will limit consideration to psychogenic
considerations.

A strong association appears to exist between licking and anxiety in
dogs. Other psychogenic associations include inadequate social
interaction, environmental stimulation, and opportunity for aerobic
activity. As with over-grooming in cats, ALD may also be associated
with displacement grooming in response to social or environmental
stressors.

Compulsive behavior or states of anxiety may contribute to ALD in
some patients. As with feline psychogenic alopecia, the occurrence
and incidence of correlative behaviors to ALD in feral and wild canines

is not known.

Among domestic dogs, certain breeds appear to be over-represented -
Labrador retrievers, Great Danes, Doberman pinchers, German shepherds,
and some northern breeds - with some evidence of familial inheritance.
This may be reflective not only of a genetic component, but also
selection
pressures placed on these breeds reflecting their affiliative work and
social relationships with humans.

Other Presentations

Other behaviors focusing on specific body parts which may be of
psychogenic origin include tail biting, flank sucking, preputial
licking, self-nursing, licking in the anal region, and foot licking.
Based on the evidence to date, these conditions represent the result
of a heterogeneous array of underlying conditions, rather than specific

dermatologic or behavioral diagnoses.

Attention seeking, displacement, self-injurious, compulsive, and other
anxiety-related behaviors may lead to the establishment of these
behaviors.
Seizure activity involving the amygdala and ventro-medial hypothalamus
can
result in stereotypic, self-directed, aggressive behaviors.

The physiological sensation of pruritus may share common biochemical
origins with some anxiety states, which support consideration of
neuropsychodermatological etiologies.

Clinical Management

Considering the heterogeneous and potentially multifactorial origins of
compulsive, self-injurious, and anxiety-related behaviors, clinical
management should incorporate consideration of environmental stimuli,
social stimuli, the motivational state of the animal, and underlying
neurophysiological mechanisms in developing a treatment plan. A
hypothesis incorporating the above, which can account for the
patient's dermatological and behavioral manifestations, provides a
rational starting point from which a program of environmental,
behavioral, and pharmacological management can be based.

Environmental Management

Since the patient's environment may frequently contribute to the
establishment of OCD, SIB, and anxiety-related behaviors, it is
important to manipulate the environment so as to eliminate stressors
and conflict-producing stimuli. If this is not possible, systematic
desensitization should be employed to minimize the effect of the
environment.

Client resistance is often encountered and creativity is often
needed when proposing environmental changes. The client must be
committed to proposed changes in the environment before employing
behavioral and pharmacological management.

Behavior Modification

Counter-conditioning and desensitization provide the framework of
behavior modification. Counter-conditioning consists of teaching
the patient new behaviors which are incompatible with the problem
behavior. Since SIB, compulsive disorders, and related behaviors
are often based in anxiety, it is often most effective to select
for behaviors which encourage relaxation.

Desensitization consists of reinforcing the selected new behaviors
while very gradually introducing provocative circumstances and
environments. Clients commonly wish to progress more rapidly than
the patient can effectively accept. Patience, consistency, and
commitment on the part of the client are critical for success to
effectively support performance of the new behaviors in the face
of increasingly provocative stimuli.

For desensitization to be effective the patient must accept the
direction and leadership of the client.

Deference to the client can be established through routine and regular
reinforcement of leadership on a daily basis. This can be effectively
and gently achieved through asking the animal to sit for all routine
interactions with the client (i.e. receiving attention, love, meals and
treats; grooming and petting; interactive play; going outdoors / coming

inside).

Withdrawal of attention is an effective, gentle correction for failure
of deference. In all phases of counter-conditioning and
desensitization,
appropriate responses are effectively supported with encouragement and
small food rewards as positive reinforcement. Rewarding the patient at
any time when he/she is not exhibiting the problem behavior and is
relaxed can further support counter-conditioning. Massage therapy, when
the patient is relaxed, can further facilitate relaxation and encourage
appropriate interaction between the animal and client.

The above techniques are not limited to application in dogs, but can
be effectively employed with cats and other species with appropriate
modification.

Client responses to the patient, particularly when they are performing
the problem behavior, can be problematic. Despite their history and
experience of the problem behavior, the client should never express
their frustration in any way in the presence of the patient. Doing so
may reinforce any anxiety which the animal may be experiencing. Neither
should the client provide any measure of comfort - verbal, physical, or
emotional - to the patient while performing the problem behaviors.

Attention-seeking behaviors are based on the response of the client
or, in some cases, other people. Attempts to distract the behavior
or even aversive responses may be preferred by some animals and may
reinforce the observed behavior.

Interactive activity and opportunities for aerobic exercise can be
critical components of behavioral modification. Exercise and mental
stimulation in cats can be encouraged with a bit of creativity.

Opportunities for environmental and social enrichment may include:
augmenting accessible three dimensional space; adding window perches,
sisal wrapped scratching posts, and "kitty condominiums"; varying the
location and availability of limited resources (e.g. resting places);
providing an ample variety of both purchased and homemade toys;
scattering food into small portions throughout the house or employing
intermittent feeding devices; playing with clients utilizing "fishing
lure" type toys, laser pens, and other stimulating games; and training
"trick" behaviors through shaping with a secondary reinforcer (e.g.
clicker).

Agility, fly ball, and freestyle provide dogs the opportunity for
interactive, aerobic activity with the clients beyond traditional
activities such as field work, sheep herding, Frisbee tossing, ball
retrieving, and running / jogging.

Interactive exercise can facilitate desensitization to anxiety
producing situations by expose the dog to a variety of potentially
provocative stimuli while providing something else on which to focus.
Interaction with the dog in such activities also provides something
to which he/she can look forward, encourages mental and physical
agility, and serves to enhance the relationship between the dog and
the client.

Pharmacologic Support

Rational use of pharmacologic support can substantially enhance the
effects of behavioral and environmental modification in patients with
anxiety-related behaviors, compulsive disorders, and SIB. Management
of patients diagnosed with attention-seeking behavior should be limited
to behavioral and environmental modification unless the underlying
motivation is based in anxiety.

Pharmacotherapeutic agents should be selected to specifically address
the motivational state of the patient and a proposed underlying
neurophysiological mechanism of action. With few exceptions, the
application of psychotropic medications to veterinary behavioral
medicine constitutes extra-label use.

It is important to note that extra-label use requires compliance with
pre- medication data bases routinely used in human medicine. Hepatic
metabolism and renal clearance of these compounds further supports pre-
medication assessment of serum biochemistry, CBC, and thyroid function.

Psychotropic medications, as a category, may affect thyroid hormone
concentrations, potentiate cardiac arrhythmias, potentiate epileptiform
seizures, and increase hepatic enzyme activities (particularly SAP).

Practitioners are well advised to become familiar with the specific
indications, contraindications, side effects and pharmacodynamics of
psychotropics which they wish to employ.

Amitriptyline (Elavil®) and doxepin (Adapin®, Sinequan®) are
tricyclic antidepressants (TCA's) which are utilized in human and
veterinary medicine as an anxiolytics. Both exert their primary
clinical effects by inhibiting the pre-synaptic reuptake of serotonin
and norepinephrine to varying degrees. Both have antihistaminic
properties brought about by their ability to block H1 and H2 receptors.
Amitriptyline equally affects H1 and H2 receptors while doxepin is much
more selective for H1 receptors. These medications, particularly
amitriptyline, also effectively block muscarinic cholinergic receptors
resulting in anticholinergic side effects. Additional reported side
effects include weight gain, transient sedation (particularly in cats),
gastrointestinal disturbances, potential cardiac conduction
disturbances and a suggested role in sick euthyroid syndrome at higher
doses.

Contraindications may include hepatic, renal, or cardiac disease.
This class of drugs should not be administered concurrently with
MAOI's, selegiline (Anipryl®), or L-tryptophan. Amitriptyline
is a first choice medication for anxiolytic therapy because of the
relative cost and rate of clinical response relative to most
psychotropic medications. It has distinct disadvantages of having a
particularly bitter taste and a narrow therapeutic index associated
with a high rate of toxicity with overdose. For patients in which
dermatitis, neuralgia, or pain is associated with an anxiety related
condition, the antihistaminic properties of these compounds combined
with their noradrenergic effects (and the potential role of
norepinephrine in managing neurogenic inflammation) can prove to be
quite effective in managing clinical signs.

Clomipramine (Clomicalm®) is a TCA which is relatively more
serotonergic and less anticholinergic than previously mentioned
medications. Clomicalm® has been approved by the FDA for use in dogs
in the management of separation anxiety and may be an effective aid in
the management of other anxiety-related behaviors. Clomipramine is also
the only TCA which has documented efficacy in the management of
compulsive behaviors in both humans and animals. As a tricyclic
antidepressant, potential side effects and contraindications of
clomipramine are similar to those of other medications in that class.

Fluoxetine (Prozac®) and paroxetine (Paxyl®), as selective serotonin
reuptake inhibitors (SSRI's), share a common mechanism of action of
being serotonergic without substantially affecting the reuptake of
norepinephrine or dopamine. The relatively specific action of SSRI's
is associated with fewer side effects. Adverse effects reported with
SSRI's include increased anxiety, restlessness, insomnia, weight
loss, gastrointestinal disturbances, and alterations in cardiac
conduction. Despite the relative serotonin specificity of SSRI's
compared to clomipramine, they appear to be equally effective in the
management of OCD. As with TCA's, SSRI's should not be administered
concurrently with MAOI's, selegiline, or L-tryptophan.
Contraindications may include hepatic, renal, or cardiac disease.
Paroxetine is the most potent SSRI available, but it does have some
anticholinergic effects. Metabolism of paroxetine is unique in that
almost no active metabolites are produced. This feature may favor the
administration of paroxetine in elderly patients or animals with liver
or kidney disease.

Table 1: Important Considerations in the Behavioral History Detailed
description of the patient's behavior immediately prior to, during,
and after eliciting problem behavior Chronology, incidence, and
progression of problem behavior. Ease with which problem behavior may
be interrupted and tendency for return to behavior Locations,
circumstances, and potential eliciting stimuli associated with the
problem behavior Review of other problem behaviors Review of home
environment including all persons and animals in household.

Presence of the client(s), other people, and other animals in relation
to animal when behavior occurs Responses of the client(s), other
people, and other animals in relation to the problem behavior
Patient's background including adoption source, familial history,
early temperament/behavior of patient, and history of obedience work.

Interactions with familiar and unfamiliar household guests Dietary
history including consideration of who feeds patient and review of
feeding schedule Daily routine of patient in relation to other human
and animal members of household Specific types, amount, and frequency
of exercise Specific form, duration, and frequency of interaction with
client(s) and other people Notation of sleeping location and favorite
resting places Review of medical history with notation of any current
medications being administered

Table 2: Potential Environmental & Social Stressors Inadequate mental
stimulation Inadequate aerobic exercise Inadequate interaction with
family or other pets Limited access to essential resources Social
Isolation Overcrowding Status-related conflicts Territorial-related
conflicts

Addition or loss of family members or pets Changes in health status
of family members or pets Changes in daily routine of family members
or pets New home / environment Changes in physical environment Boarding
Hospitalization.

In feline patients compulsive behaviors associated with grooming
include psychogenic dermatitis, feline hyperesthesia syndrome,
and excessive chewing of the feet and/or nails. Other compulsive
behaviors noted in feline patients may be categorized as in canine
patients as hallucinatory (e.g. prey chasing or searching, air
batting),
locomotor (e.g. paw shaking, head shaking, pacing), vocalization (e.g.
repetitive howling / crying), or neurotic (e.g. vicious self-biting,
spontaneous aggression to humans).

A diagnosis of self-injurious behavior may be established independent
of compulsive behavior. In the author's experience, a significant
percentage of cases referred for consultation on potential compulsive
grooming behavior do not meet the criteria for compulsive disorders.

Behavioral conditions presenting with dermatologic signs exclusive of
compulsive disorders include some attention-seeking behaviors, feline
hyperesthesia, and certain anxiety-related behaviors.

Anxiety may be defined as an apprehensive anticipation of future danger
or misfortune accompanied by a feeling of dysphoria and/or somatic
symptoms of tension. Anxieties may be internally or externally focused
and may be in response to real or perceived stimuli. Anxiety may result

from motivational states of conflict (the tendency to simultaneously
perform
more than one type of activity) or frustration (engagement in a
sequence of
behaviors which cannot be completed because of physical or
psychological
obstacles).

Because of contributory factors of stress, pain, and pruritus
associated
with many lesions, a primary diagnosis of a behavioral disorder should
only be made after thorough dermatologic and medical evaluation. Even
with a presumptive behavioral diagnosis, after medical causes are ruled
out, secondary dermatologic sequelae may develop as a result of chronic

trauma to the skin.

Neurochemistry

Although anxiety, panic, and phobia disorders are related, different
neuroanatomic models have been proposed for each. Complex neurochemical
mechanisms involving dopaminergic, serotonergic, GABA-ergic,
noradrenergic,
and opioid systems may be involved in the manifestation of these
disorders.

Numerous clinical studies and case reports have explored
pharmacological
manipulation of the above neurotransmitter systems in patients with
anxiety-related conditions with varying results. Differences in
responses
to pharmacotherapy may be reflective of individual variations in
neuroanatomic
and neurochemical function. Therefore, it is important that the
clinician
consider the underlying motivational state and possible neurochemical
correlates when assigning behavioral diagnoses and recommending
pharmacologic and behavioral management.

Clinical Presentations

Evaluation of patients presenting for dermatological conditions with
suspected psychogenic components or origins should incorporate not only

a broad-based medical work-up but also a careful review of the
behavioral
history and direct observation of the patient. Table 1 provides a list
of
important considerations to address in the behavioral history. A
videotape
of the patient exhibiting any relevant problem behaviors recorded by
the
owner can provide valuable clues to the practitioner.

Stressful Environmental Conditions

It is not uncommon for both veterinary clients and practitioners to be
concerned about "boredom" as a cause for compulsive, self-injurious, or
anxiety related behaviors. While an assessment of boredom is
anthropomorphic and most likely an oversimplification of the stresses
a patient may be experiencing in relation to its physical and social
environment, it is important and frequently contributory to the
patient's
presentation.

Stressors, which may contribute to the manifestation of
anxiety-related,
compulsive, and self-injurious behaviors, are noted in Table 2.
Behaviors
that may be elicited in response to stress include changes in appetite,
grooming behaviors, elimination patterns, social interaction, and
activity.

Feline Psychogenic Alopecia (Over grooming)

Psychogenic alopecia is characterized by excessive self-grooming that
is initiated or intensified by non-organic causes, or which persists
beyond resolution of an organic cause. The predominant clinical sign
is alopecia -particularly in the area of the medial forelegs, caudal
abdomen, inguinal region, tail, and/or dorsal lumbar areas - in which
medical causes have been ruled out. Because cats may groom reclusively,
excessive licking, biting, scratching, or rubbing may or may not be
observed by the client.

Barbering and/or frank alopecia may be the only dermatologic signs.

In other cases, self-mutilation with possible secondary bacterial
infection may be evident. Symmetrical alopecia of the caudomedial
thighs and ventrum may be observed. Lichenification and
hyperpigmentation may develop in chronic cases. A dermatitic form
(atypical neurodermatitis) characterized by bright red, elongated,
oval streaks or plaques may result from extensive grooming behavior.

Physical examination reveals: (1) short, broken hairs which are readily
palpated by stroking the affected area against the normal angle of hair
growth; (3) remaining hairs do not epilate easily; (4) microscopic
evaluation of hairs reveal broken shafts; (5) hair re-growth occurs
normally and lesions heal with placement of an Elizabethan collar,
(6) significant amounts of hair upon fecal examination.

Licking of the hair and skin, nibbling, biting, facial rubbing of the
forepaws, and scratching may all be observed in cats exhibiting
normal grooming behavior.

Although they regularly self-groom, specific times and percentages
relative to other behaviors are unknown for household cats. Beyond
such basic purposes as cleansing, removal of parasites, and
thermoregulation, grooming in cats may occur as a displacement
behavior (an activity that

is performed out of context as a result of frustration) in response
to social or environmental stressors.

Displacement grooming may be rooted in anxiety and may serve
to lower arousal, deflect aggression from other individuals, or
provide some distraction for the cat.

While the occurrence of such behavior in feral or wildcat species
is not known, incidences of psychogenic alopecia have been noted
in captive wild cats. Psychogenic alopecia is reported to be more
prevalent in strictly indoor cats. A possible common variable in
both captive wild cats and indoor cats predisposing them to psychogenic
alopecia may be limited environmental stimulation. A seasonal
incidence, even in indoor cats, can result as a result in changes in
environmental and social stressors (e.g. accessibility / visibility of
other cats).

Feline Hyperesthesia Syndrome

Feline hyperesthesia syndrome refers to a complex of behaviors which
may include: (1) behaviors similar to those observed in estrous females
(e.g. increased motor activity, rolling, crouching with elevation of
the
perineal region, vocalizations); (2) excessive licking, plucking,
biting,
and/or chewing, particularly at the tail, flank, anal, or lumbar areas;

(3) rippling of the skin, muscle spasms, or twitches (especially
dorsally), which may be accompanied by vocalization, running,
jumping, possible hallucinations, or self-directed aggression.

Affected cats tend to be difficult to distract from the behavior, or,
if successfully distracted, remain so for only a short period of time.

As with feline psychogenic alopecia, environmental and social
stressors have been associated with this disorder. The cues or
changes precipitating the behavior may be endogenous. Cats
may present with clinical signs consistent with hyperesthesia
without evidence of alopecic or other dermatologic lesions.

Review of the behavioral history may further support a lack of
excessive grooming. Such cases support the hypothesis that this
complex of behaviors may represent a number of discretely different
phenomena. While not currently discussed in the veterinary literature,
based on clinical syndromes observed in human patients, it may be
worthwhile to consider hallucinatory, rheumatologic, or neurogenic
origins in future research.

Hi,

Sorry about the delay in getting back to you. After his bath he seems to be
doing much better. Maybe it was related to the change in seasons?

Just to follow up:

Nope he isn't on any flea medication that I know of. We don't really have a
problem with fleas around here (except out on the indian reservation, which
we aren't on). Also my two guys who have been in close contact with him
haven't been showing any symptoms, so probably nothing contagious.

The food he's on is... well crap (no name brand). But he's been on it for a
long time, and as he's not my dog I don't have a choice in the matter.

Thanks for the ideas,

Dale

P.S. Checked out my unfiltered newsfeed, to see what Jerry's been saying.
Few points bear replying to in what he said...

1. I don't think its self mutilation, I haven't caught him showing any
interest in the effected areas.
2. As far as learning things from books, yep I'm guilty of that too. I don't
have anything like enough time to make all the mistakes myself. I do however
know how to evaluate what I read critically. I believe very little I read
purely 'on faith'. If it doesn't make sense, I check in to it.
3. Interesting paper you quoted. Got through most of it, but if you had read
and understood what I wrote, and read and understood what was written in the
paper, the symptoms indicated aren't consistent with what is quoted in the
paper. I also find it interesting that you should quote an academic source
in the same post as you critique another for getting their information from
books :).

So, about 1/2 a bottle

...........You are a very nice person!  Am glad he took to it well.
Hopefully the owners will notice the difference in his coat and try to give
him a little brushing once in a while.  Nothing like getting out all that
old dirt and hair.  Bet he feels a million times better!

buglady
take out the dog before replying