Changes

A treatment programme will include a combination of:

A treatment programme will include a combination of:

* Client education

* Client education

* Provision of avoidance and escape opportunities

* Provision of avoidance and escape opportunities

* Psychoactive medication

* Psychoactive medication

* Pheromones

* Pheromones

Facial and flank pheromones are used by cats to mark their core territory; an area in which cats do not expect to encounter hostility from conspecifics. Behavioural therapy involving controlled exposure is best performed in an environment where the cat already feels secure, such as within its core territory. The use of synthetic analogue of F3 (Feliway) may enhance this core territory effect, to help provide a setting within which behavioural therapy can take place. However, studies have indicated that the "calming" effect of the synthetic pheromone does not necessarily increase tolerance of handling and other procedures<ref>Kronen, P.W.,, Ludders, J.W., Erb, H.N., Moon, P.F., Gleed, R.D., Koski, S. (2006) A synthetic fraction of feline facial pheromones calms but does not reduce struggling in cats before venous catheterization. ''Vet Anaesth Analg". 33(4):258-65</ref>, so behavioural therapy must still respect the tolerance limitations of the individual cat.

Facial and flank pheromones are used by cats to mark their core territory; an area in which cats do not expect to encounter hostility from conspecifics. Behavioural therapy involving controlled exposure is best performed in an environment where the cat already feels secure, such as within its core territory. The use of synthetic analogue of F3 (Feliway) may enhance this core territory effect, to help provide a setting within which behavioural therapy can take place. However, studies have indicated that the "calming" effect of the synthetic pheromone does not necessarily increase tolerance of handling and other procedures<ref>Kronen, P.W.,, Ludders, J.W., Erb, H.N., Moon, P.F., Gleed, R.D., Koski, S. (2006) A synthetic fraction of feline facial pheromones calms but does not reduce struggling in cats before venous catheterization. ''Vet Anaesth Analg". 33(4):258-65</ref>, so behavioural therapy must still respect the tolerance limitations of the individual cat.

There is some evidence that a synthetic analogue of the F4 fraction of feline facial marking pheromone [[Pheromonotherapy - Cat|(Felifriend)]] may improve tolerance of approach and handling by people when applied to them<ref>Mills, D.S., Dube, M.B., Zulch, H. (2012) Stress and Pheromonatherapy in Small Animal Clinical Behaviour. Wiley-Blackwell.</ref>. However, it appears only to be effective when the cat has not already accumulated a number of aversive experiences involving the particular person and situation. These cats may experience dissonance between the visual stimulus associated with threat and danger, and the pheromone cue that signals familiarity. Pheromones like F4 should only be used in conjunction with sensitive handling and behavioural techniques<ref>Mills, D.S., Dube, M.B., Zulch, H. (2012) Stress and Pheromonatherapy in Small Animal Clinical Behaviour. Wiley-Blackwell.</ref>.

There is some evidence that a synthetic analogue of the F4 fraction of feline facial marking pheromone [[Pheromonotherapy - Cat|(Felifriend)]] may improve tolerance of approach and handling by people when applied to them<ref>Mills, D.S., Dube, M.B., Zulch, H. (2012) Stress and Pheromonatherapy in Small Animal Clinical Behaviour. Wiley-Blackwell.</ref>. However, it appears only to be effective when the cat has not already accumulated a number of aversive experiences involving the particular person and situation. These cats may experience dissonance between the visual stimulus associated with threat and danger, and the pheromone cue that signals familiarity. Pheromones like F4 should only be used in conjunction with sensitive handling and behavioural techniques<ref>Mills, D.S., Dube, M.B., Zulch, H. (2012) Stress and Pheromonatherapy in Small Animal Clinical Behaviour. Wiley-Blackwell.</ref>.

If the cat has already shown different levels of fear according to the appearance of the people it has encountered, then a list should be made of the features of appearance the cat tolerates least. Typically, animals least like tall people wearing dark clothing, hats or hoods, because these make them seem more threatening. This enables therapy to start with people who dress and behave in the ways that the cat is most likely to accept. A good starting point is to start with female volunteers sitting down and wearing light coloured casual clothing. Cats that show signs of fear when they hear unfamiliar voices may be desensitised to these noises using recordings or radio programmes.

The level of fear shown by a cat will vary with the type of person, their appearance and their actions. A detailed list should be made of theses features, so that a gradient of exposure can be created, with stimuli listed in order of the level of fear they elicit. For example, animals often find tall people wearing dark clothing, hats or hoods, and moving quickly or noisily the most threatening. Controlled exposure should start with people who dress and behave in the ways that the cat is most likely to accept. For example, starting with female volunteers wearing light coloured clothing and sitting down. Cats that show signs of fear when they hear unfamiliar voices can be desensitised to these noises using recordings or radio programmes.

The benefit of using '''desensitisation''' and '''counterconditioning''' procedures for cats with a fear of people is that, with some co-operation, we can control many aspects of the person’s behaviour whilst in the presence of the cat. The cat can be desensitised or habituated to a variety of different human appearances using different clothes and other paraphernalia such as walking sticks, hats and glasses. This means that only a relatively small number of volunteers is needed.  

Desensitisation to the presence of a person will be most rapid if that person can remain as still as possible without watching the cat at all. This effectively makes the person inanimate and without any intention towards the cat.

Cats often respond best to desensitisation based approaches best. Counterconditioning is difficult as cats rapidly lose interest in appetitive stimuli (like food) when anxious or fearful.

As the cat becomes confident with several different people dressed on different occasions in a wide selection of clothes, the next stage is for the cat to encounter these same people while they are standing up. This will make them appear larger and therefore more dangerous. In successive stages the volunteers should begin to move about slowly, then more rapidly, but always remaining disinterested in the cat.

Desensitisation should follow distinct stages, moving on from one stage to the next only when it is clear that the cat is coping well.

* One person, sitting down and dressed in a manner that is least likely to provoke a reaction, ignoring the cat and staying still and quiet.

* Additional people, sitting down and dressed and behaving in the same neutral manner as above.

* The same people dressed with different types of clothing, gradually moving toward an appearance that is more fearful (e.g. dark clothes).

* One person, dressed in a non-provocative manner, standing up.

* Additional people, dressed in a non-provocative manner, standing up.

* The same people moving around.

Psychoactive medication may be useful if the cat shows generalised signs anxiety or inhibition, or a delayed recovery after a person has left. Cats that are generally anxious and hesitant may not have the confidence to explore and use environmental enrichments or discover hiding and escape opportunities that have been set up for them. Drugs, such as fluoxetine and clomipramine, that reduce anxiety can be a useful adjunct in these cases. Selegiline reduces specific fearfulness and increases exploratory behaviour, and can be used to treat specific fears. None of these drugs has a UK license for the treatment of behavioural problems in the cat.

* Make a list of the types and appearances of people that the cat is fearful of, placing them in order of the degree of fear elicited.

* Prepare a quiet and familiar environment for training, allowing the cat to get used to this in advance of training. Provision of F3 diffusers in this environment will increase the perceived sense of security. The cat should have resting places and boltholes where it can avoid contact if it wishes.

* Desensitise or countercondition the cat to elements of the stimuli it fears separately: sight, sound, smell and movement of the animal.

* DO NOT CARRY THE CAT INTO A TRAINING SITUATION AS THIS MAY TRIGGER AGGRESSION. Instead, bring it in in a carry box, or allow it to enter from another room on a harness and extending leash.

==Prognosis==

==Prognosis==