Changes

====Drug Therapy====

====Drug Therapy====

Psychoactive medication is indicated in cases of "compulsive" over-grooming, or over-grooming that is leading to self-mutilation, or over-grooming with a strong underlying aspect of anxiety. Serotonergic medication such as the serotonin reuptake inhibitor (SRI) drug [[Clomipramine]] or the selective serotonin reuptake inhibitor drug fluoxetine have anxiolytic and anti compulsive effects. Fluoxetine can also improve impulse control in impulsive individuals. With clomipramine, cats may show adverse effects of lethargy and anorexia at higher doses, so treatment should start with a lower dose, increasing if there is no effect after 4-6 weeks. Clients should record the number and severity of self-grooming bouts seen during the 7-14 day period before treatment, as a baseline. Minimum treatment period is usually 6-8 months, with treatment being withdrawn once the cat's coat is fully restored and there has been a period of 6-8 weeks without signs of over-grooming or self mutilation. The withdrawal period should be 1 week per month of treatment, with withdrawal in three stages (75%, 50% and then 25% of therapeutic dose). Successful drug therapy should produce around 70% reduction in the behaviour and an increase in normal activity as a substitute.

Psychoactive medication is indicated in cases of "compulsive" over-grooming, or over-grooming that is leading to self-mutilation, or over-grooming with a strong underlying aspect of anxiety. Serotonergic medication such as the serotonin reuptake inhibitor (SRI) drug [[Clomipramine]] or the selective serotonin reuptake inhibitor drug fluoxetine have anxiolytic and anti compulsive effects. Fluoxetine can also improve impulse control in impulsive individuals. With clomipramine, cats may show adverse effects of lethargy and anorexia at higher doses, so treatment should start with a lower dose, increasing if there is no effect after 4-6 weeks. Clients should record the number and severity of self-grooming bouts seen during the 7-14 day period before treatment, as a baseline. Minimum treatment period is usually 6-8 months, with treatment being withdrawn once the cat's coat is fully restored and there has been a period of 6-8 weeks without signs of over-grooming or self mutilation. The withdrawal period should be 1 week per month of treatment, with withdrawal in three stages (75%, 50% and then 25% of therapeutic dose). Successful drug therapy should produce around 70% reduction in the behaviour and an increase in normal activity as a substitute. If there is a relapse, psychoactive drug treatment can be reinitiated. However, anecdotally, the response to successive courses of the same SRI or SSRI drug may diminish, so that it is sometimes better to treat relapses with a different psychoactive drug from the same class.

 

If specific events or stimuli are associated with signs of [[Feline Fear and Stress|anxiety, fear]] or directly with bouts of excessive grooming, then these may be desensitised and counter-conditioned. Relapses are common, but may be managed effectively using the same methods as for initial treatment. Response to successive courses of the same SRI or Selective Serotonin Reuptake Inhibitor (SSRI) drug may diminish, so that it is sometimes better to treat relapses with a different psychoactive drug from the same class. Any additional underlying factors that may have initiated another period of self-mutilation should then be identified and resolved.

====Summary of Treatment for Grooming Disorders====

====Summary of Treatment for Grooming Disorders====