First, a veterinarian is needed to rule out potential medical look-alikes. For instance, some dogs have a neurological problem instead of a compulsive disorder. “We’ve had a number of cases where the dog that has been circling has a brain tumor diagnosed on MRI rather the compulsive disorder,” states Luescher. Similarly, Luescher recalls a horse with repetitive leg movements like those of the America’s Funniest Home Videos dog. “It turned out to be a partial seizure due to a brain tumor.”He adds, “In another case, a dog presented with possible compulsive disorder, and it was actually due to Ehrlichia, an infectious agent that attacks the nervous system.”
Other instances can be related to dermatologic conditions. Dodman in particular recalls one case.“We had a Golden Retriever with a lick granuloma…not responding to medications for compulsive disorders. A closer dermatologic examination and blood work revealed that [the dog] had a deep-seated skin infection in just that one region, plus low thyroid levels. Treatment with antibiotics and thyroid medications cured the dog.”
Once other causes are ruled out, compulsive disorders can often be treated successfully with a combination of drug therapy (Reconcile® or Clomicalm®) and behavior modification. Up to 70 percent of patients do well on the combination of drug therapy and behavior modification, says Luescher. “These dogs have far fewer compulsive bouts, and when they do have the bouts, they can easily be redirected toward other activities, and will stay with these new activities.” He adds,“Some are treated successfully with behavior modification alone, too. It usually takes longer, though.”
Despite the success with drug therapy, all of those interviewed emphasized the need for concomitant behavioral modification. As Luescher observes, “Drug therapy alone does not make sense, since the environmental cause is still there.” Moon-Fanelli adds, “If the cause is conflict or stress, then even with the neurochemistry changes brought about by medications, you need to teach the animal to cope with the stress.” Behavior modification involves a combination of tactics: maintaining a predictable schedule, increasing exercise, interrupting the compulsive behavior and redirecting it by rewarding alternative relaxed behaviors (such as performing tricks), and improving the bond by participating in reward-based sports such as agility. Occasionally, a complete change of environment can have a dramatic effect.With Jake, the New York City dog who spun so much he couldn’t eat or drink, “I treated him with medications for years,” says Dodman.“It only got better when the couple split up and the dog was taken to live on a farm upstate.”The new owners were a couple with children, and they were able to get Jake’s attention and redirect his behavior.
All four behaviorists interviewed warned strongly against punishment, which is sometimes recommended by traditional dog trainers such as Cesar Millan on Dog Whisperer. Says Dodman, “I saw Cesar Millan put a choke chain collar on a dog with compulsive disorder and pop it. This is about as sophisticated as electrifying the taps [faucets] with an OCD hand-washer. This would stop the behavior, but the anxiety would still be there and could erupt in a more anxious behavior.”
Moon-Fanelli gives an example of one such redirection of anxiety. “I had a client with a spinning Bull Terrier and we were working on a treatment plan. The owner called up and said she had enlisted the help of a trainer who recommended a shock collar. She happily reported the shock collar had worked. The dog was no longer spinning, but I could hear her yelling to her dog, ‘Suzie, stop that.’When I asked what Suzie was doing, she said that Suzie was pacing around the kitchen.” The consequence, as Moon-Fanelli points out, was that “the tail spinning had evolved into pacing.”