Can Dogs Be Victims of Munchausen by Proxy?
A Dogster editor recently drew my attention to a Dogster discussion forum thread about Munchausen by proxy in dogs. Here's a quote from the Dogster member who started the thread:
"I know this is a weird topic and I'm not definitely talking about anyone here since I never saw it here. But on other dog groups with several owners I get the feeling they enjoy the sympathy they get from having a sick dog -- plus, these same people never take advice. (I don't mean mine!) Or seems like they purposely give wrong medication or forget. They write every day about how awful it is having a suffering dog but they are not doing anything to help the dog. I think there's a disease like this with humans and their human children. Honestly, it seems like it happens in people with their dogs, too. Has anyone ever witnessed something like that?"
Other contributors to the thread quickly identified the syndrome: It is Munchausen syndrome by proxy. The condition, also known as MBP, is described by all-knowing Wikipedia as follows.
"Münchausen syndrome by proxy (MSbP or MBP) is a controversial term that is used to describe a behavior pattern in which a caregiver deliberately exaggerates, fabricates, and/or induces physical, psychological, behavioral, and/or mental health problems in those who are in their care. ... At times, they are also able to assume the hero role and garner still more positive attention, by appearing to care for and 'save' their child."
It need not be a child. Pets also can be the victims of MBP.
MBP is famous for being difficult to identify. People with the syndrome often don't know or acknowledge that they have the condition. As a veterinarian, I've probably dealt with cases of MBP that I failed to identify. And I can't prove that my suspected cases of MBP were, in fact, MBP. But I certainly have dealt with some suspicious cases over my career.
In fact, one of my first cases as a veterinarian probably was a case of MBP. I was just weeks out of vet school, and I was highly lacking in experience and confidence. A woman brought her Schnauzer to me and said that he wasn't behaving normally. When I asked her for details, she acted like I was crazy, stupid, or both.
"What do you mean," she spat. "Just look at him! That's not normal! Don't you know anything about dogs?"
In fact (and this was part of the problem), I knew very little at the time. I looked at the dog. He sat on the floor and looked back up to me. I didn't see anything wrong. I performed a physical exam. I could find nothing wrong. And, in hindsight, I realize that there was nothing wrong. His behavior was normal. He was normal. But at the time I lacked the experience to convince the client.
I told the owner that I did not see anything wrong. That did not satisfy her. I asked if she wanted me to run some tests. She said sure. We collected blood for diagnostics.
The next day I spoke with the owner to advise her that the tests were all normal. She said that her dog was still not acting right. We scheduled more tests, which again were normal. We took X-rays, which also showed nothing wrong. I was reluctant to prescribe medication for a dog with no clear medical problem. I recommended observation at home.
The next day, mercifully, was my day off. But the dog was still not better (I have since learned that an animal can't be made better if there's nothing wrong with it in the first place). And now the owner was mad. She called my boss and complained that she had spent money for tests and X-rays and I had not cured her dog. My boss evaluated the dog, saw nothing wrong, and gave the dog a steroid injection. The owner believed the dog was cured, at least temporarily, by the injection -- which is proof that the placebo effect occurs in veterinary medicine.
I have since avoided similar situations by polishing my client communication skills. However, I can remember two more recent cases in which there actually was something wrong with the dogs who came to me for attention. I can't prove they were cases of MBP.
The first occurred several years ago, when I was working at a general practice. A big commotion occurred in the waiting room of the practice. A dog with a hemorrhaging wound had been brought in. It would have to be squeezed in as an emergency.
The dog was a very nice Standard Poodle. The owners' daughter had come home and discovered that the dog's left rear leg was bleeding. The daughter had wrapped the wound and called the parents, and a short while later the dog was in the waiting room.
I unwrapped the leg. A one inch laceration was present in the thigh. The wound was deep. The technicians placed an IV catheter and administered pain killers and antibiotics. The dog was anesthetized so the wound could be humanely explored. It penetrated just behind the femur. No major vessels had been severed. No nerves appeared damaged. X-rays showed no injury to the femur. After thoroughly flushing and probing the wound, I sutured it without difficulty. The dog went home that evening, with a full recovery expected. The daughter was feted as a hero. It was theorized by the family that the dog had impaled himself on a sharp coffee table corner while running around the house.
Later that night I started to question the story. The injury seemed like a perfect knife stab wound. And I reflected: The daughter certainly seemed to enjoy being a hero. Might she have stabbed the dog in order to fulfill that role? It would be impossible to prove and would lead to exceptionally angry parents. I could not make an accusation based upon such a hunch. All I could do was make a notation in the file to monitor for any further unexplained injuries. Fortunately, none occurred.
The final case in this post was beyond suspicious. In fact, I'm not sure it was a case of MBP; it more likely was an awkward attempt to cover up outright physical abuse. A family brought a dog to my clinic after their son heroically found the dog unconscious in the bathroom. By the time I examined her, she was developing the characteristic bloodshot eyes and bruising around the neck of a dog who had been strangled.
I didn't even try to tickle the truth out of the owners. I was practicing in a jurisdiction with an excellent animal rescue and control department (sometimes it can be nearly impossible to report suspected animal abuse). They sent an inspector immediately, who confiscated the dog for rehousing.
Sadly, I do not believe the son faced any legal consequences for his actions, nor was he referred for psychiatric counseling. Animal abuse laws in the United States are woefully toothless. Let us hope that no pets (or children!) come into his life in the future.