Medical Problems Disguised as Behavior Problems – Guest Post from Dr. V

I have mentioned Dr. V and her Pawcurious blog a few times. Her blog bridges the gap between entertainment and education in a way that I am still aspiring too match.

So, I am proud to bring you a guest post from Dr. V herself:

The veterinary behaviorist consulted her appointment schedule and pointed to the 2 o’clock appointment. “Aggression consultation- needs evaluation for homeowners insurance.” As the veterinary student rotating through the behavior service, my job was to take notes and observe.

In walked the family- an elderly Golden retriever, two parents, and three small children. “So what’s going on?” the behaviorist asked, consulting her notes. “Brandy bit a child on the face?”

“Yes,” the mother replied. “One of my daughter’s friends was over, and didn’t see Brandy as she was sleeping in the hall. She tripped over her, woke the dog up, and I guess she startled her by falling on her head.” We looked at Brandy, resting quietly on the floor as the three kids crawled all over her. “She told her parents that it was her fault, and they weren’t upset, but since she required a stitch the hospital was required to report it to animal control.”

The two year old pulled on Brandy’s lips, stretching them into a smile. “She was in quarantine at animal control for two weeks,” the mother said sadly. “And my homeowners insurance is considering dropping us.” Brandy thumped her tail happily as the toddler shouted, “WE MISSED HER” into her ear.

After a long period of questioning and a thorough exam, we came to two conclusions: 1. Brandy had arthritis that was undertreated, and 2. She did not exhibit any signs of aggression. All these years later, I never forgot that case. The dog didn’t need behavioral therapy! She needed Rimadyl!

Veterinarians and trainers work hand-in-hand on a daily basis to try and understand why our pets do the things they do. With time and experience, both experts learn the signs that clue us in as to whether a pet has a problem rooted in behavior or in medicine. Here are some classic examples:

1. My dog suddenly regressed on his potty training.

Dogs with a long history of being thoroughly housebroken that suddenly start having accidents are most commonly dealing with a medical issue. Some common medical causes of inappropriate urination can be diabetes, Cushings disease, cystitis, bladder tumors, incontinence, renal disease, or orthopedic disease. In fact, the number one cause of death in dogs with Cushings (an adrenal disorder) is euthanasia from owners who can no longer deal with the urinating in the house (a side effect of overproducing urine.)

2. My cat is suddenly peeing outside the box.

This one is a little trickier, as litterbox aversion is a common and complicated behavioral issue that can be challenging to differentiate from marking without expert guidance. In either case, one also needs to rule out the common urologic problems in cats: cystitis, diabetes, renal disease, or blockage.

3. My dog just had a major aggressive episode.

We recently had a case in our clinic with a very sweet 3 year old terrier who, without warning, attacked the other dog in the house, then the owner when he tried to break them up. The concerned owner went directly to their experienced trainer, who decided that something didn’t make sense when he got the full history. After some detective work and a consult with a neurologist, they learned that the young dog had a brain tumor, and began radiation therapy.

The challenge with behavioral issues is that there is often not a good way to definitively diagnose that problem. In most cases, diagnosis is made by exclusion- by getting a thorough history, and then ruling out the underlying medical issues that can masquerade as a behavioral one.

Any time there is a sudden onset of an unusual behavior, an abrupt change in a long-standing habit, it raises a red flag for me. When these types of situations arise, it’s invaluable to have both a vet and a trainer you trust, who can work together and with you to find out what’s going on with your pet.

You can find Dr. V at Pawcurious, where she blogs about her life as a vet, mom, and pet owner. As a matter of fact, I have a guest post over there today about thunderphobia.