Compulsive Disorders

Canine compulsive disorder (CCD) is characterized by repetitive, ritualized behaviors that are out of context and interfere with normal functioning. The dog is difficult to interrupt and may show signs of distress when prevented from performing the behavior.

Common presentations:

• Tail-chasing: Often Bull Terriers, German Shepherds
• Fly-biting: Snapping at invisible flies; may be compulsive or seizure-related
• Acral lick granuloma: Repetitive licking of carpus/tarsus → alopecia, ulceration, lichenification
• Flank-sucking: Common in Dobermans; may be self-soothing
• Shadow/light chasing: Often triggered by moving light sources

Neurologic:

• Focal seizures: Fly-biting, episodic tail-chasing, trance-like states. May have autonomic signs (salivation, urination). Video is essential. If episodic and stereotyped, consider MRI + CSF analysis.
• Head trauma / forebrain lesions: Can cause repetitive behaviors.

Dermatologic / Orthopedic:

• Atopy / food allergy: Pruritus leads to licking → secondary compulsive licking.
• Orthopedic pain: OA or soft-tissue injury → licking at painful site.
• Foreign body / neoplasia: Chronic irritation.

Endocrine: Hypothyroidism can contribute to behavioral changes and skin issues.

Behavioral:

• Interrupt and redirect early in the sequence
• Increase physical exercise and mental enrichment
• Remove or control triggers (e.g., block access to light reflections)
• Teach incompatible behaviors (settle on mat, target training)

Pharmacologic:

• Fluoxetine: 1–2 mg/kg PO daily (first-line)
• Clomipramine: 2–3 mg/kg PO daily (TCA alternative)
• Naltrexone: 2 mg/kg PO for acral lick (opioid antagonist)

Physical management: Elizabethan collar, bandages, topical barriers for acral lick; address primary dermatologic/orthopedic cause if present.