Ashley Bourgeois, DVM, DACVD: I know we’ve been in my realm quite a bit. Moving into your realm. We do know that there are some dogs that truly lick and chew from anxiety. You’ve touched a little on this, but I want to dive a bit deeper. When will you consider treating anxiety as a cause of licking or chewing or some form of pruritus?
Christopher Pachel, DVM, DACVB, CABC: That’s a great question. Truthfully, if the animal is experiencing any degree of stress, fear, anxiety, or even the windup of arousal, that can start to create some very similar physiological changes within the body. If we have the sense that this is manifesting as licking or contributing to that. Even if we’re seeing a dual problem where the animal has an underlying skin disorder and when they’re experiencing a level of stress, they start licking now, which creates a layer of moist skin, which creates more maceration. Now we’re cruising downhill very quickly. For me, anytime I identify any level of stress, I’m asking the question, what are our options here?
I’m not saying that every level of anxiety or stress is pathological. We know that fear or anxiety—at least a minor degree—is a completely normal behavior when we have little episodic moments. That may be OK, but if we’re starting to see a recurrent chronic or severe manifestation of that, especially if we’re able to tie in with our history that when anxiety is higher perhaps, we see more gastrointestinal sensitivity. When stress levels are up, we see more licking or more likely to break with an otitis episode or something along those lines. Those are all indications for me that we’re probably looking multimodal, not just from the multiple ways of addressing the skin issue, but truly saying we probably need to address the skin and the behavioral issue.
Then we can start diving into the 3-pronged approach that we’re often referring to within behavior: How do we manage that scenario to avoid those triggers as best we can; how do we change the emotional response that the animal has to those triggers, or if we’re talking truly about anxiety and this sense of worry and apprehensive anticipation of threat; how can we provide, through training or behavior modification, a level of structure or predictability or a sense of control that we can give that animal within their surroundings that directly starts to target that anxiety? Is there a consideration for supplements for pheromones, for any of the pharmaceutical options that may be relevant for us, as a way of directly hitting that particular element, that may be feeding back in a negative way back on the original dermatologic condition that we’re trying to treat in the first place.
Ashley Bourgeois, DVM, DACVD: That’s awesome.
Transcript edited for clarity.