The interplay between emotional and physical health

Question 1

Give an example of a disease which demonstrates the link between physical and emotional health.
(The disease occurs due to the animal experiencing stress in its environment)

Answer 1

FIC - feline idiopathic cystitis

ALD - acral lick dermatitis

Question 2

If you’ve taken a chronological history looking at behavioural and physical changes but still can’t determine the origin of the behavioural change, what further investigations can be carried out?

Answer 2

• Neurological exam
• Haematology
• Biochemical
• Urinalysis
• Diagnostic imaging

Question 3

What are the four possible categorisations of links between physical disease and behavioural changes?

Answer 3

• Developmental
• Intermediate
• Learned
• Emotional

Question 4

How can physical influence in the first few weeks of life affect an animals behaviour?

Answer 4

• Isolation from adequate socialisation and habituation
• ## Negative associations with certain forms of handling due to medication and nursing intervention

Question 5

Explain how inappropriate learning in early life may lead to physical disease

Answer 5

• Essential for successful development of stress control mechanisms (HPA axis)
• predispose individuals to physical disease later in life

Question 6

Describe an immediate link between injury or physical disease and behavioural change

Answer 6

Cases where underlying physical disease is directly responsible for the behavioural change - the behavioural change is a symptom of the physical condition

Question 7

Give some examples of obvious links between current disease and behavioural change

Answer 7

o Acute pain and “aggressive” defensive behaviour – the dog or cat that hisses and scratches when its fractured limb is manipulated
o House soiling as a result of polydipsia and polyuria from a medical cause – the diabetic that is obviously drinking excessively

Question 8

Give some examples of subtle links between current disease and behavioural change

Answer 8

• Onset of anxiety as a result of endocrine imbalance e.g. hyperthyroid cat, Cushings, etc
• Relationship between hypertension and behavioural change
• Gastrointestinal function effect on neurotransmitter availability – dysbiosis effects on serotonin

Question 9

Give some examples of non-aggressive responses to pain

Answer 9

o Chronic pain leading to limitations of mobility may result in issues of indoor toileting
o It can also lead to anxiety related behaviours, avoidance strategies, decrease in play and social interaction

Question 10

Describe the learned association between physical disease and behavioural change.

Answer 10

Onset of “aggressive” responses to stimuli, such as people or dogs, which have been linked with pain through association
With time, a process of generalisation may lead to expression of ‘aggressive’ behaviours in decreasingly obvious contexts

Question 11

Describe the emotional association between physical disease and behavioural change.

Answer 11

Any emotional disorder resulting in physiological stress can be a predisposing factor for physical disease

Likewise, any physical disease that leads to irritation/debilitation is a risk factor for alteration in emotional state/arousal

Question 12

Outward manifestation of behavioural change is dependent on which 3 factors?

Answer 12

• threshold of response to stimulus
• salience of stimulus
• emotional state of individual (emotional arousal)

Question 13

What presentations of physical disease indicate the potential of an emotional component?

Answer 13

• Recurrent physical illness
• Diseases associated with breakdown of mucosal integrity (e.g. FIC, IBD)
• Infectious diseases (e.g. FIP, flu)
• Pain-related conditions (increased perception of pain in an anxious state)
• Dermatological conditions (stress-related grooming / repetitive licking)

Question 14

What is the pattern of stress-related grooming?

Answer 14

Repetitive/extreme grooming of normal areas

=> bilateral alopecia

Question 15

What is the pattern of repetitive licking?

Answer 15

Unlike stress-related grooming, repetitive licking is focused on the same spot (also suspect pain)

Question 16

What effect can physiological stress have on physical disease?

Answer 16

Pre-disposing factor for physical disease

Can prevent treatment working effectively

Question 17

How do cats with feline idiopathic cystitis present?

Answer 17

• Overweight, sedentary
• Alopecia on ventral abdomen & medial HL (due to over-grooming in response to pain)
• Increased display of displacement behaviours
• Straining to urinate / house-soiling

Question 18

How can the environment effect the emotional state and also influence physical disease in an animal?

Answer 18

• When environments do not cater for species specific behavioural needs this leads to negative emotion
• Human misperceptions may lead to presentation of water in ways that make it unattractive to the cat
• Restricted water intake can be a factor in renal disease
• Multi-cat households

Question 19

The potential for an underlying physical health issue being the reason for the behavioural change should not be ignored, especially in what circumstances?

Answer 19

Behavioural signs are sudden in onset

Signs show an unexpected form of progression

Poor response to conventionally accepted forms of behavioural modification

Question 20

The potential for an underlying emotional health issue being the reason for the physical health change should not be ignored, especially in what circumstances?

Answer 20

Physical disease is recurrent

Patient shows concurrent alterations in behavioural responses

Poor response to conventionally accepted forms of medical therapy