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Psych/behavioural AP > General info > Flashcards

General info Flashcards

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1
Q

What are the categories of psychodermatological conditions?

A
  1. Psychophysiologic
  2. Primary psychiatric disorder
  3. Secondary psychiatric disorder
  4. Cutaneous sensory disorder
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2
Q

What does psychophysiologic means?

A

skin disorder exacerbated by emotional stress (cAD, acral lick dermatitis)

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3
Q

Define primary psychiatric disorder?

A

-primary behavioural problem with self-induced secondary skin manifestations

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4
Q

What are tought to be primary psychiatric disorder in dogs?

A

Dogs:
1. acral lick dermatitis
2. flank sucking
3. tail chewing-chasing
4. foot-nail -chewing-licking

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5
Q

What are tought to be primary psychiatric disorder in cats?

A

Cats:
1. psychogenic alopecia
2. hyperesthesia syndrome
3. tail sucking
4. feet-nail chewing

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6
Q

What are tought to be primary psychiatric disorder in dogs and cats?

A

D&C
1.self-directed attention- seeking behaviour
2. psychogenic pruritus?

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7
Q

Define secondary psychiatric disorders?

A

when skin diseases adversely affect the normal behavioural patterns and social functions

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8
Q

Name cutaneous sensory disorders:

A
  1. Allodynia
  2. Hyperalgesia
  3. dysesthesia
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9
Q

What is allodynia?

A

experience of pain from non-noxious stimuli

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10
Q

What is hyperalgesia?

A

exaggerated response to painful stimuli

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11
Q

What is dysesthesia?

A

behaviours in response to or to avoid unpleasnt stimuli
-feline hyperesthesia syndrome

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12
Q

What are self-injurious behaviours?

A

-volitional behaviour resulting in self-damage that appears repeatedly, consistently in the absence of any dermatological or physiologic condition

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13
Q

What are obessions?

A

persistent ideas, impulses or images
-inaapropriate and causing anxiety
-cannot be confirmed in animals

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14
Q

What are compulsions?

A

-repetitive behaviours with the goal to prevet or reduce anxiety
-stereotypic behaviours that interfere with normal function

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15
Q

What are stereotypic behaviours?

A

-sequence of movements
-serve no obvious purpose
-occur repetitively or with excessive duration
-usually they derive from behaviours that are part of normal behavioural repertoire
-most are not compulsive

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16
Q

What are etiopathogenesis of OCDs?

A
  1. Breed predisposition
  2. Lifestyle
  3. Individual animal
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17
Q

Name psychogenic skin disease in dogs?

A
  1. Acral lick dermtaitis
  2. Tail bitting, chewing, chasing
  3. Tail dock neuroma
  4. Flank sucking
  5. Self-nursing
  6. Anal licking
  7. Foot licking, nail licking
  8. Preputial licking
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18
Q

What are psychogenic skin diseases in cats

A
  1. Psychogenic alopecia-dermatitis
  2. Tail sucking
  3. Self-nursing
  4. Nail biting, foot chewing, nail chewing
  5. Head and neck excoriations (idiopathic ulcerative dermatitis)
  6. Indolent ulcer-like lesions, erosions on the nasal planum
  7. Feline hyperesthesia syndrome
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19
Q

What are psychogenic skin diseases in horses

A
  1. Psychogenic self-mutilation
  2. Neurological self-mutilation
20
Q

Name trcyclic antidepressants

A

amitryptiline, imipramin, doxepin, chlomipramine
cADi or ICAD

21
Q

What is MOA of tricyclic antidepressants

A

incerased serotonine and norepinephrine

22
Q

Name recommended psychological drug therapy

A
  1. Trcyclic antidepressants
  2. SSRI (fluoxetine)
  3. Opiate antagonists (naloxone, naltrexone)
  4. Anxiolytics (benzodiazepines)
23
Q

Treatment of psychogenic itch (Olivry, 2019)

A

single drug at recommended dose → escalate dose until side-effects → combine drugs → escalate doses
1) Treat dermatologic (inflammatory itch): glucocorticoids (oral ± topical), oclacitinib, perhaps lokivetmab
2) Add or replace with gabapentin (C: 5-10 mg/kg BID or TID; 50-100 mg/cat BID)
3) Add or replace with antidepressants: amitriptyline, clomipramine, fluoxetine, perhaps mirtazapine, perhaps carbamazepine
4) Add or replace with mu-opioid antagonist: naloxone, naltrexone

24
Q

What are ddx for canine psychogenic dermatoses

A
  1. Psychomotor (partial complex) seizures (e.g. tail biting in dogs)
  2. Abnormal movements: myoclonus
25
Q

Causes of acral lick dermatitis

A
  1. Phychogenic causes: always or almost always even if there is an underlying organic disease
  2. Allergic causes: it can be the only manifestation of adverse food reaction
  3. Neurologic causes
26
Q

What neurologic causes can cause acral lick dermatitis

A
  1. Distal sensory axonal neuropathy
  2. Lesions in ventral spinal cord motor nerve roots
  3. Peripheral nerve sheath tumors: type I are characterized by hyperesthesia (nerve irritation) without neurologic deficits; usually in front legs
  4. Cauda equina syndrome, sciatic nerve inflammation
27
Q

What is the most common place for acral lick dermatitis and rare locations

A

Rare location: tail, stifle, hip, lateral elbow
Site preference: left forelimb

28
Q

How dg of acral lick dermatitis can be made

A
  1. Owner may be unaware of self-traumatic behaviour
  2. Dx from normal self-grooming: in normal grooming licking pauses and breaks and there are changes in the posture and the area groomed.
  3. Dx from pain or irritation: in cases with pain or irritation there is also chewing
  4. Clue in favour of psychogenic component: newly licked area when the original lesions has been covered by a bandage or wrap
  5. Biopsy selection: non-ulcerated area
  6. Histopathology
29
Q

Histo changes of acral lick dermatitsi

A

follicular elongation, plasmacytic periadnexal inflammation, vertical streaking fibrosis, traumatic furunculosis; dilatation, hypertrophy, inflammation and occasional rupture of sweat glands

30
Q

What is the atb treatemnt for acral lick dermatitis

A

Antibiotic treatment:
1. Frequency: bacteria isolated in 97% of the cases
2. Selection: based on deep tissue culture due to frequent isolation of multiple drug resistant organisms and to differences from the results of superficial cultures
3. Empirical treatment: enrofloxacin or potentiated sulfonamides (based on deep cultures)

31
Q

What is the psychogenic treatment for acral lick dermatitis

A
  1. Desensitization, counterconditioning
  2. Drugs: tryciclic antidepressants, SSRI, benzodiazepines, phenobarbital, hydroxyzine, endorphin blockers, endorphin agonists, progestins.
    -Trial periods of 5 weeks which drug is more effective.
    -Selegiline= treatment of choice for chronic lesions
32
Q

What are recommended treatments for the lesion of acral lick dermatitis

A
  1. Mechanical prevention of licking
  2. Repellents
  3. Topical glucocorticoids, DMSO, inj glucocorticoids
  4. Surgery
  5. laser
  6. cryosurgery
  7. Radiation
  8. Acupuncture
  9. Oclacitinib
33
Q

What are causes to tail biting or tail chasing and spinning

A
  1. Genetics: autosomal recessive in bull terrier
  2. Psychogenic: excessive endorphin release
  3. Association with lethal acrodermatitis-Zn
  4. Psychomotor seizures: abnormal EEC in all dogs examined
  5. Lipids: increased serum cholesterol, HDL and LDL
33
Q

What dog breed are predisposed to tail biting or tail chasing and spinning

A
  1. bull terrtier, GSD
34
Q

DDX to tail biting or tail chasing and spinning

A

1) infection-trauma,
2) lumbosarcal stenosis-cauda equina syndrome,
3) tail dock neuroma,
4) anal sac disease

35
Q

Causes of flank sucking

A
  1. Trichuriasis (not confirmed)
  2. Psychomotor epilepsy: treatment with phenobarbital or primidone
  3. Bacterial folliculitis
  4. cAD, food allergy
  5. Psychogenic (compulsive)
36
Q

What age of onset, triggers and associtaed behaviours are seen with flank sucking

A

-Age of onset: median 8.5 months
-Triggers: inactivity > increased arousal
-Associated behaviors: fabric sucking, acral lick dermatitis, pica

36
Q

Name recommended tretamemnt for self- nursing

A
  1. Spaying
  2. Sedation, psychological training
37
Q

What causes anal licking

A
  1. Anorectal disease: inflammatory bowel disease, proctitis
  2. Anal sack disease, Malassezia anal sacculitis
  3. Malassezia dermatitis
  4. cAD, food allergy
38
Q

DDX for psychogenic alopecia and dermatitis

A
  1. FLUTD,
  2. nephritis,
  3. anal sac diseases,
  4. internal parasites
38
Q

Clinical DDX for psychogenic alopecia and dermatitsi

A

-based on distribution
1. FAD: caudal abdomen, medial-caudal thighs
2. fAD, AFR: more generalized, less symmetrical. AFR was the most common cause of the syndrome (at least for cats referred to a behaviorist)

39
Q

Treatment for psychogenic alopecia and dermatits

A
  1. Glucocorticoids: for short-term (2-4 weeks) in case of neurodermatitis
  2. Flea control: always
  3. Expression of anal sacs: always
  4. Clomipramine: not effective
  5. Haloperidol
40
Q

MOA and side effects of haloperidol

A

=dopamine antagonist
-may desensitize a-noradrenergic receptors;
-initial dose 1mg/kg BID and 1 week hospitalization;
-evaluation of response at 2 months;

side effects: hallucinations, ataxia, limb twitches.

41
Q

Causes of feline hyperesteshia syndrome

A
  1. Dermatologic: FAD, atopic, food, skin infection, pansteatitis
  2. Neuromuscular: epilepsy, brain tumor, spinal cord disease, myopathy, toxoplasmosis
  3. Abnormal sensation: hyperesthesia, allodynia, alloknesis
  4. Behavioral: stress; compulsive, displacement behavior
42
Q

What are clinical manifestations of feline hyperesthesia syndrome

A
  1. Estrus behavior: increased activity, rolling, elevation of perineum, vocalization
  2. Excessive licking, plucking, biting or chewing: flank, lumbar, anal, tail
  3. Self-mutilation: inflicted over a short period of time; tail, flanks, forelegs, paws
  4. Rippling of the skin, muscle spasms or twitches: dorsally
  5. Hard to distract the cat to stop the behavior or only temporal disruption
43
Q
A

Psych/behavioural AP (1 decks)

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