Q: My 2 year old white boxer, Lola eats toilet paper, tissues, paper towels. Is this a vitamin or mineral deficiency? Just not sure what she might be lacking? She has had this problem since I took her home from the animal shelter. She was at the shelter for about 2 months. I do give her doggie dophilus and vitamin B-12 with folic acid. Hopefully you are able to help her out with a product to take. Thanks for your help.

A: Thank you for your question. The behavior Lola is exhibiting is called pica. Pica is the craving and ingestion of nonfood items. Pica is not usually (although it can be) an abnormality of the digestive system or a nutritional deficiency. It is most commonly a psychological abnormality. The diagnosis is made when a dog does not just eat an object once, but rather seems obsessed with consuming certain materials. In Lola’s case, it appears to be paper products. Pica is commonly diagnosed in dogs that have been crated or caged for long periods of time (you said Lola was at the shelter at least 2 months) or have other psychological or anxiety issues.

It is important that Lola be checked for some of the medical issues that can cause pica. These include:

• Primary gastrointestinal or digestive problems such as inflammatory bowel disease (IBD) and exocrine pancreatic insufficiency (EPI).
• Iron deficiency anemia. This can happen as a result of chronic intestinal bleeding, parasitism (intestinal or fleas/ticks), etc.
• Endocrine problems (although unlikely given her age) such as diabetes mellitus and cushings disease. These conditions cause polyphagia (increased appetite) and dogs often exhibit pica.
• Most often, however, pica is a behavioral problem.

I recommend the following to evaluate for the conditions above: CBC (to check for anemia), chemistry panel (to help evaluate proteins and other factors that can be low with intestinal malabsorption), urinalysis, fasted TLI (tests for pancreas insufficiency), vitamin B12/folate levels (as a crude measure of intestinal malabsorption), and fecal test for parasites.

If these tests (or others your veterinarian may recommend) are normal, pica is diagnosed as a behavior problem.

I believe all pets should receive a daily vitamin-mineral supplement as a bit of an “insurance policy” against nutrient deficiencies. Even if a dog is eating a high quality natural diet that is intended to achieve optimal health; picky or poor appetites, or competition in a multi-dog household may lead to one dog not getting quite enough. Supplements can also help counter the aging/degenerative process that goes on in all pets. I like to alternate the Halo Daily Greens with the Vitamin Mineral Mix to provide an excellent supplement of vitamins and minerals. For a fatty acid supplement (for great skin/hair and digestive health), the Dream Coat is excellent.

As far as Lola, if her lab work turns out to be normal (which I expect it will), the best “medicine” for her is avoidance. For example, locked lids on garbage cans to prevent access to paper products. There are behavior specialists and behavior modification treatments that you can also ask your vet about.

Good Luck. Keep us posted.
Dr. Donna Spector

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