Changes

===Pharmacological Therapy===

===Pharmacological Therapy===

Treatment of specific fears of inanimate objects may be augmented with psychoactive drug therapy, although no drug is specifically licensed for this use in the cat. Extreme care must be taken in using these drugs when the cat also has a number of other [[Feline Fear and Stress|fear]] or [[Feline Aggression|aggression]] problems involving people or other animals, because anxiolytic psychoactive drugs carry a risk of producing disinhibition. [[Selegiline]] is the first choice for specific fears, as it is licensed for the treatment of this condition in the dog. It can be used in cats if the client’s informed consent is obtained. The onset of efficacy may be 4-6 weeks or more, and it is important to warn owners not to try to progress too quickly with behavioural therapy during the induction period with this drug, as the cat’s increase in confidence and reduction in apprehension are relatively fragile until the drug is in full effect. Attempts to take advantage of the cat’s growing confidence during the induction period can backfire, with the cat becoming even more uncertain of human contact. This is temporary but very disheartening for owners when it happens. Selegiline is most appropriate for fearful cats that also show a high degree of inhibition of normal behaviour, such as:

Possible indications for the use of psychoactive medication for the treatment of fears of inanimate stimuli include:

* Reduced self-maintenance behaviour (grooming, eating)

* Failure to utilise resources

* Perpetual hiding and avoidance

* When welfare has been impacted: cats with significantly inhibited patterns of behaviour.

* Frequent freezing behaviour in even mildly fear-eliciting situations

 

No psychoactive medication is specifically licensed for the treatment of fear problems of this kind in cats. [[Selegiline]] is licensed for the treatment of behavioural problems of an emotional origin in dogs, including specific fears and phobias. Under CASCADE, selegiline the therefore the first choice treatment for this problem in cats.  

 

Selegiline is appropriate for fearful cats that also show a high degree of inhibition of normal behaviour, such as:

* Reduced self-maintenance behaviour (grooming, eating).

* Failure to utilise resources.

* Perpetual hiding and avoidance.

* Frequent freezing behaviour in even mildly fear-eliciting situations.

Apart from increasing exploratory behaviour and confidence and reducing apprehension, selegiline also increases the rewarding nature of reinforcers and improves cognitive function so that it may be of benefit in improving responses to counterconditioning procedures.

Apart from increasing exploratory behaviour and confidence and reducing apprehension, selegiline also increases the rewarding nature of reinforcers and improves cognitive function so that it may be of benefit in improving responses to counterconditioning procedures.

Serotonergic drugs like [[clomipramine]] or [[fluoxetine]] are more suited to cases in which the cat shows chronic and generalised signs of anxiety in an environment that is generally devoid of specific fear-eliciting stimuli. These are cats that anticipate harm although no threat is actually present. They may be appropriate if there are signs of excessive self-appeasement or displacement behaviour such as [[Feline Grooming Disorders|overgrooming]].

However, selegiline produces only weak anxiolytic effects; if a cat shows significant signs of anxiety or signs of panic reactions then a serotonergic drug would be indicated. Serotonergic drugs like [[clomipramine]] or [[fluoxetine]] are more suited to cases in which the cat shows chronic and generalised signs of anxiety in an environment that is generally devoid of specific fear-eliciting stimuli. These are cats that anticipate harm although no threat is actually present. They may be appropriate if there are signs of excessive self-appeasement or displacement behaviour such as [[Feline Grooming Disorders|overgrooming]].

Deciding when to use psychoactive medication for fears of inanimate objects or sounds<br>

The onset of efficacy for all of these drugs is at least 4-6 weeks, and much longer in some cases. They are generally well tolerated but can cause lethargy, sedation and inappetance, which can interfere with counterconditioning procedures. Typical duration of treatment is 6-8 months, or until a period of 6-8 weeks without significant clinical signs has elapsed.

* Widely-generalised fears and phobias, especially when the range of fear-eliciting stimuli is expanding

* Longstanding cases where many fear-related associations have already formed

* When welfare has been impacted: cats with significantly inhibited patterns of behaviour

==Prognosis==

==Prognosis==