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Pathologic self‐mutilation has been studied much more in humans and non‐human primates than in domestic animals. In non‐human primates, it is believed by many to be a maladaptive coping mechanism. Rearing in a suboptimal environment, and specifically social isolation, is considered a risk factor (Dellinger‐Ness and Handler 2006). Stressors such as relocation have also been known to lead to self‐injurious behavior (SIB) in some primates (Davenport et al. 2008). SIB in dogs and cats is often but not always associated with tail chasing, circling, and subsequent tail tip mutilation. Self‐mutilation is most likely to be associated with pain, dysesthesia, or paresthesia. One case has been documented of a 30‐month‐old Labrador retriever that presented with acute onset tail mutilation (Zulch et al. 2012). Radiographs of the tail revealed some soft‐tissue swelling and a mineralized ossicle in one intervertebral space that may have caused discomfort. Administration of analgesics led to complete resolution of the behavior. Self‐mutilation has been documented in several other species secondary to nerve injury, pain, and altered sensation, so self‐mutilation behaviors should always lead to a thorough physical exam and imaging, if possible, to rule out underlying medical causes. Empirical treatment with analgesics or anti‐inflammatories may be warranted in some patients before determining that self‐mutilation is a primary behavioral problem. Box 4.5 lists some of the most important medical rule‐outs for common repetitive behaviors (often referred to as compulsive disorders) in dogs and cats.