How to identify, treat self-injurious patients
Self-traumatizing disorders, such as self-inflicted barbering or hair removal and abrasions or ulcerations of a body part, can occasionally start as a behavioral pathology. When presented with an apparently pruritic patient—or any patient that has caused damage to itself with its teeth, tongue, claws or even an external object—perform a thorough history and medical workup to search for the underlying cause. Endocrine, neurologic, musculoskeletal, infectious, immune-mediated, neoplastic, inflammatory, traumatic, dermatologic and behavioral causes can all play a part in an itching, scratching and chewing pet.
After two weeks, the dermatophyte culture results remain negative, and the owner reports that topical and systemic medications have not changed Morris' signs. The results of a complete blood count, serum chemistry profile, urinalysis and thyroid profile are normal.
After using a thorough protocol to help identify patients with allergic and endocrine-type skin disorders, the medical team determines that Morris does not appear to be afflicted by either of these conditions. They now must look to other possible causes of his chronic behavior.
Pruritic or other self-mutilatory disorders seen in the behavioral specialty can include compulsive disorders, displacement activities and stereotypic, attention-seeking and other anxiety-related behaviors. These are classified as primary behavioral disorders, with any skin manifestations occurring secondary to the self-induced trauma.