Changes

==Prognosis==

==Prognosis==

The prognosis for cats with indoor spray marking appears to be enhanced by the use of drug (fluoxetine, clomipramine) and synthetic pheromone treatments (F3 fraction of facial mark, Feliway®), with these treatments significantly increasing the probability of a cessation or 90% reduction in spraying<ref name="Mills3" />. In a meta-analysis of treatment effect, fluoxetine appeared to be the most effective medication, but sample sizes in both of the included studies was small. Both drugs produced a large and significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking (primary outcome measure). Studies suggest that a period of 8-16 weeks is required to establish efficacy of either of these drugs. In the same meta-analysis, treatment periods of 4 weeks with Feliway produced no significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking (primary outcome measure). However, a large effect was detected when comparing the number of cats that reduced spraying compared with baseline (secondary outcome measure)<ref name="Mills3" />. The authors indicated that synthetic pheromones do reduce the overall incidence of spraying only after 4 weeks. This suggests that a combination of pheromone and pharmaceutical interventions, with environmental modifications, is most likely to produce a rapid response and good outcome.

The prognosis for cats with indoor spray marking appears to be enhanced by the use of drug (fluoxetine, clomipramine) and synthetic pheromone treatments (F3 fraction of facial mark, Feliway®). In a meta-analysis of treatment effect, fluoxetine appeared to be the most effective medication, but sample sizes in both of the included studies was small. Both fluoxetine and clomipramine produced a large and significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking (the primary outcome measure for the meta-analysis). Studies suggest that a period of 8-16 weeks is required to establish efficacy of either of these drugs. In the same meta-analysis, treatment periods of 4 weeks with Feliway produced no significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking (primary outcome measure). However, a large effect was detected when comparing the number of cats that reduced spraying compared with baseline (secondary outcome measure)<ref name="Mills3" />. The authors indicate that synthetic pheromones do reduce the overall incidence of spraying only after 4 weeks. This suggests that a combination of pheromone and pharmaceutical interventions, with environmental modifications, is most likely to produce a rapid response and good outcome.

   

   

However, cats with a history of indoor marking are likely to relapse at some point in the future, because this behaviour is normal and situations outside the owner’s control may create the conditions for a new bout of marking. Typical times when marking may re-emerge are after major home redecoration or reorganisation, after a house move, or the introduction of a new stressor (new baby, new pet). Spring and summer are times when cats seek to re-establish territorial boundaries, and are therefore a time when there is an increased risk of conflict and stress between cats.

However, cats with a history of indoor marking are likely to relapse at some point in the future, because this behaviour is normal and situations outside the owner’s control may create the conditions for a new bout of marking. Typical times when marking may re-emerge are after major home redecoration or reorganisation, after a house move, or the introduction of a new stressor (new baby, new pet). Spring and summer are times when cats seek to re-establish territorial boundaries, and are therefore a time when there is an increased risk of conflict and stress between cats.