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In a letter in 1998 we drew attention to the fact that there was no reference to Munchausen syndrome by proxy described in the veterinary literature.1 Recently Munro and Thrusfield from the Royal School of Veterinary Studies, University of Edinburgh have published a paper in the Journal of Small Animal Practice, documenting the first series of reports of suspected Munchausen syndrome by proxy involving pets as proxies.2 In the study, 1000 randomly selected veterinary surgeons received a questionnaire specifically asking for details of their perceptions and experience of non-accidental injury in animals. A total of 448 cases were described, six of which were described by the respondents as possible Munchausen syndrome by proxy. Three other cases were identified by the authors as possible Munchausen syndrome by proxy. The nine cases are all described and show similarity to child proxy incidents. Common features include frequent requests for clinical review (up to four times in one day in one case), and frequent change of veterinarian (“veterinarian shopping”). In some cases the mode of clinical presentation was similar to that seen in paediatric practice, for example, presentation with haematuria or uncontrolled fitting. In one case a dog owner was insistent that a neighbour had poisoned his dog, but he was later convicted for the attempted poisoning of his child; in court it was revealed that he had previously attempted to poison two other pets treated by other veterinarians. In another case a cat owner gave an incoherent history with regard to the cause of injuries, and postoperative trauma occurred to the intramedullary pin. Repeated problems arose until the cat was admitted.
The authors conclude that their findings should not only inform the small animal practitioner about a curious syndrome but also form the basis of broader debate in comparison between the experience of the veterinary and medical professions. Communication between child protection agencies, veterinary surgeons, and the RSPCA is beginning to occur in different parts of the country. Such liaison should be welcomed by paediatricians.
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