Could Fido’s fleas be all in your head?



In everyday practice, veterinarians may encounter pet owners with psychological disorders that can impact negatively on their animal’s welfare.

At last week’s Unusual Pet and Avian Veterinarians (UPAV) and Association of Avian Veterinarians (AAVAC) Combined Annual Conference in Brisbane, focusing on current and emerging issues in the veterinary care of unusual pets and birds, Dr Deborah Monks, from the Brisbane Bird and Exotics Veterinary Service, discussed the impact one condition, in particular, has on pets.

“Human delusional infestation is a psychiatric condition in which a human patient believes that they are infested with parasites or inanimate objects,” said Dr Monks.

“At this practice in the past six years we’ve seen at least three cases of delusional infestations by proxy. This is when the affected individual believes that their pet is infested, usually with parasites—tapeworm and fleas—when, in fact, the animal is not.

“There are a number of complexities surrounding the handling of these cases and they usually have an impact on everyone involved from the client and patient to the veterinary staff,” said Dr Monks.

Even if a vet has a high suspicion of delusional infestation, it is important to do diagnostic testing to thoroughly exclude parasitic disease.

“Being able to confirm parasite infestation is critical,” said Dr Monks. “Any veterinary action could worsen the problem for the client and reaffirm their perception of infestation, so anti-parasitic medications or any type of treatment should only be provided if parasitic disease is confirmed.”

Clients with delusional infestation are likely to frequently call or visit their veterinarian. This can be challenging for all veterinary staff because clients are likely to be in a distressed state, convinced that their pet has an undiagnosed infestation.

“For a veterinarian, the duty of care is to the animal. Our primary concern is for the safety of the pet and if an owner’s mental illness is having a negative impact on a pet’s health, then vets can report mistreatment to organisations that can investigate. Administering unnecessary medication to a pet is a form of mistreatment,” said Dr Monks.

“It’s also important to encourage the pet owner to get help via their GP. There aren’t any guidelines to help us in these sorts of situations, so it really comes down to each practice to decide how to respond.”


  1. Formication is the term given to the condition whereby people feel as if insects are crawling along their skin. It may be a manifestation of a systemic disease, especially a parasthesia of the nervous system. Symptoms may be relieved by HRT in post menopausal women.

    My strategy is to discuss formication in general terms as a possibility to be investigated by family doctor, who are not usually familiar with the condition, with a responsible family member, a tricky conversation.

    In the few cases I have encountered my efforts have been appreciated. Need to be alert for complaints about flea products not working.

  2. I hope there’s not too many pet owners that are like this! I would fear that the animal would be given too much medication that would lead to other health problems down the road.


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