Regarding Pooh

Your authors are free to diagnose the psychosocial problems of Christopher Robin,1 but diagnosis of the other inhabitants of the Hundred Acre Wood requires a licence to practise veterinary medicine. Diagnosis and treatment of both physical and behavioural problems in animals, including animals used as aids for humans,2^,3 require appropriate training to understand the interaction of physical, behavioural and environmental factors that might contribute to the apparent abe(a)rrant behaviour.

In some cases, the clear physical deformities of the inhabitants of the Hundred Acre Wood account for their behaviour. High-level tail loss in Eeyore may have resulted in damage to the cauda equina, with subsequent chronic pain and a depressive demeanour. By brown bear standards, Pooh is a dwarf with pica. Congenital panhypopituitarism and secondary endocrine dysfunction, including hypothyroidism, explain a lot about Pooh. Meanwhile, Tigger is simply exhibiting catlike behaviour that does not appear to need intervention (unlike attacking, spraying, inappropriate voiding and self- mutilation). Finally, Piglet, Kanga and Roo are also exhibiting species-appropriate behaviour.

None of the medications mentioned is licensed for use in the species under discussion. The Health Protection Branch would probably frown upon the off-label usage recommended by the authors.

In the future I would encourage Sara Shea and colleagues to consult with a qualified veterinarian to avoid misdiagnosis.

I look forward to future analyses from these authors. How about Alice in Wonderland (schizophrenic?) and Dorothy in The Wizard of Oz (post-traumatic stress disorder?).