Changes

==Introduction==

==Introduction==

Tolerance of human contact is learned as a '''result of early experience''' during the [[Feline Socialisation|sensitive period]]. For example, without appropriate handling between two and seven weeks of age a cat may grow up to be wary of people and to have a predisposition towards defensively aggressive behaviour, especially if it is placed in a situation where it feels threatened. Early traumatic experience has been found to be associated with increased aggress in cats<ref name="Ramos"/>.  

Tolerance of human contact is learned as a '''result of early experience''' during the [[Feline Socialisation|sensitive period]]. For example, without appropriate handling between two and seven weeks of age a cat may grow up to be wary of people and to have a predisposition towards defensively aggressive behaviour, especially if it is placed in a situation where it feels threatened. Early traumatic experience has been found to be associated with increased aggression in cats<ref name="Ramos"/>.  

In the absence of positive experience with people, cats will avoid contact with them. However, if this is not possible and the cat is forced to remain in contact with people that it is afraid of, [[Feline Aggression - Overview|defensive aggressive behaviour]] can become an effective strategy for maintaining distance from them. With repeated negative experience in which escape and avoidance are impossible, cats may shift from an avoidant strategy to offensive aggression. By the time some of these cases are brought to the attention of the veterinary practice or referred for specific professional advice the initial fearful motivation for the behaviour may be obscured by the cat’s overt hostility and offensive behaviour. Aggression toward unfamiliar people is comparatively uncommon in cats, with the majority being defensive in nature<ref name="Fatjo"/>.

In the absence of positive experience with people, cats will avoid contact with them. However, if this is not possible and the cat is forced to remain in contact with people that it is afraid of, [[Feline Aggression - Overview|defensive aggressive behaviour]] can become an effective strategy for maintaining distance from them. With repeated negative experience in which escape and avoidance are impossible, cats may shift from an avoidant strategy to offensive aggression. By the time some of these cases are brought to the attention of the veterinary practice or referred for specific professional advice the initial fearful motivation for the behaviour may be obscured by the cat’s overt hostility and offensive behaviour. Aggression toward unfamiliar people is comparatively uncommon in cats, with the majority being defensive in nature<ref name="Fatjo"/>.

Cats that are exhibiting fear-related aggression toward people will often adopt characteristic postures and use threatening vocalisation prior to a defensive swipe, which is intended to drive the threat to a greater distance. The response of the person may be significant in the progression of the problem behaviour and it should be remembered that the owner’s attempts at reassurance often intensify fear and aggression by increasing pressure on the cat removing its ability to carry out an avoidance behaviour (for example, picking the cat up to comfort it). In situations where owners try to deal with the aggressive behaviour by punishing the cat, an anticipation of the owner’s apparent ‘aggression’ may increase the cat's fear further and lead to an escalation of the problem.

Cats that are exhibiting fear-related aggression towards people will often adopt characteristic postures and use threatening vocalisation prior to a defensive swipe, which is intended to drive the threat to a greater distance. The response of the person may be significant in the progression of the problem behaviour and it should be remembered that the owner’s attempts at reassurance often intensify fear and aggression by increasing pressure on the cat removing its ability to carry out an avoidance behaviour (for example, picking the cat up to comfort it). In situations where owners try to deal with the aggressive behaviour by punishing the cat, an anticipation of the owner’s apparent ‘aggression’ may increase the cat's fear further and lead to an escalation of the problem.

==Prevalence and Risk Factors==

==Prevalence and Risk Factors==

Despite a number of studies having been carried out, including surveys of referral populations and cat owners, and reports from veterinary surgeons <ref name="Bradshaw>Bradshaw, J.W.S., Casey, R.A., MacDonald, J.M. (2000) The occurrence of unwanted behaviour in the cat pet population. In: Proceedings of the Companion Animal Behaviour Therapy Study Group Study Day; Birmingham, England.</ref> <ref name="Fatjo">Fatjo, J., Ruiz-de-la-Torre, J.L., Manteca, X. (2006) The epidemiology of behavioural problems in dogs and cats: a survey of veterinary practitioners. Animal Welfare. 15, 179-185</ref> <ref name="Amat">Amat, M., Ruiz-de-la-Torre, J.L., Fatjo, J., Mariotti, V.M., van Wijk, S., Manteca, X. (2009) Potential risk factors associated with feline behaviour problems. Applied Animal Behaviour Science. 121, 134-139.</ref> <ref name="Ramos">Ramos, D., Mills, D.A. (2009) Human directed aggression in Brazilian domestic cats: owner reported prevalence, contexts and risk factors. Journal of Feline Medicine and Surgery. 11. 835-841.</ref>,there is no consensus on the prevalence of feline aggression problems.

Despite a number of studies having been carried out, including surveys of referral populations and cat owners, and reports from veterinary surgeons <ref name="Bradshaw>Bradshaw, J.W.S., Casey, R.A., MacDonald, J.M. (2000) The occurrence of unwanted behaviour in the cat pet population. In: Proceedings of the Companion Animal Behaviour Therapy Study Group Study Day; Birmingham, England.</ref> <ref name="Fatjo">Fatjo, J., Ruiz-de-la-Torre, J.L., Manteca, X. (2006) The epidemiology of behavioural problems in dogs and cats: a survey of veterinary practitioners. Animal Welfare. 15, 179-185</ref> <ref name="Amat">Amat, M., Ruiz-de-la-Torre, J.L., Fatjo, J., Mariotti, V.M., van Wijk, S., Manteca, X. (2009) Potential risk factors associated with feline behaviour problems. Applied Animal Behaviour Science. 121, 134-139.</ref> <ref name="Ramos">Ramos, D., Mills, D.A. (2009) Human directed aggression in Brazilian domestic cats: owner reported prevalence, contexts and risk factors. Journal of Feline Medicine and Surgery. 11. 835-841.</ref>,there is no consensus on the prevalence of feline aggression problems.

In a Brazilian study the commonest situations that elicited aggression toward the owner were when the cat was petted or put onto a lap, during play, when startled, when observing an unfamiliar animal, when in the presence of unfamiliar people and when protecting food or territory<ref name="Ramos"/>. Aggression when petted or put on the lap was the most common. The authors found that aggression was associated with an early traumatic event and outside access. Cats that did not like being stroked or did not get on well with other animals that they had contact with were more likely to show aggression in general. However, a range of other factors, including age, sex, neuter status, accommodation, origin, and social contact with people and other cats were not significantly associated with increased aggression. However, the population of aggressive cats in this study was small (107 cats). A spanish study of 336 cats referred to a behavioural clinic found that 17.2% involved a complaint relating to aggression toward people<ref name="Amat"/>. 43.1% of human directed aggression involved play, and 39.6% involved petting, with a significant overlap. With respect to aggression toward unfamiliar people, 70% of cases involved defensive and only 30% offensive aggression.

In a Brazilian study the most common situations that elicited aggression towards the owner were when the cat was petted or put onto a lap, during play, when startled, when observing an unfamiliar animal, when in the presence of unfamiliar people and when protecting food or territory<ref name="Ramos"/>. Aggression when petted or put on the lap was the most common. The authors found that aggression was associated with an early traumatic event and outside access. Cats that did not like being stroked or did not get on well with other animals that they had contact with were more likely to show aggression in general. A range of other factors, including age, sex, neuter status, accommodation, origin, and social contact with people and other cats were not significantly associated with increased aggression. However, the population of aggressive cats in this study was small (107 cats). A Spanish study of 336 cats referred to a behavioural clinic found that 17.2% involved a complaint relating to aggression toward people<ref name="Amat"/>. 43.1% of human directed aggression involved play, and 39.6% involved petting, with a significant overlap. With respect to aggression towards unfamiliar people, 70% of cases involved defensive and only 30% offensive aggression.

==Investigation==

==Investigation==

A range of information is required for a proper investigation of the cause of aggression toward people, including:

'''A range of information is required for a proper investigation of the cause of aggression towards people, including:'''

*Information about the rearing circumstances and age of homing of the cat.

*Information about the rearing circumstances and age of homing of the cat.

*History of the cats reaction to human contact, including any changes that have been seen over time (for example, a switch from avoidant behaviour to defensive and then offensive aggression).

*History of the cats reaction to human contact, including any changes that have been seen over time (for example, a switch from avoidant behaviour to defensive and then offensive aggression).

*Detailed description of events in which aggression has been observed (including context, triggering events/stimuli, the cat's behaviour and the owner's reaction).

*Detailed description of events in which aggression has been observed (including context, triggering events/stimuli, the cat's behaviour and the owner's reaction).

*Full investigation of health problems, particularly those likely to cause pain.

*Full investigation of health problems, particularly those likely to cause pain.

*Assessment of the cat's physical and social environment (including resource availability and distribution, conflict with ether animals in the home, and the range of opportunities available to support avoidance and escape responses).

*Assessment of the cat's physical and social environment (including resource availability and distribution, conflict with other animals in the home, and the range of opportunities available to support avoidance and escape responses).

'''Fear-related aggression is a motivational diagnosis and it can be associated with a variety of contexts'''. In some cases it may therefore be beneficial to add a contextual label as part of the diagnosis. For example, a cat that is aggressive when handled by the owner may be diagnosed as displaying "aggression associated with handling" that is fear motivated and a cat that is fearful of strangers and shows aggression to the owners when visitors are present may be diagnosed as a case of "redirected aggression", which is motivated by frustration of the fear response. In both cases "fear-related aggression" is the underlying motivational diagnosis and treatment of the cat’s underlying fear is crucial to the success of treatment but the contextual labels help the owner to understand when the behaviour may occur and to take steps to avoid it.

'''Fear-related aggression is a motivational diagnosis and it can be associated with a variety of contexts'''. In some cases it may therefore be beneficial to add a contextual label as part of the diagnosis. For example, a cat that is aggressive when handled by the owner may be diagnosed as displaying "aggression associated with handling" that is fear motivated and a cat that is fearful of strangers and shows aggression to the owners when visitors are present may be diagnosed as a case of "redirected aggression", which is motivated by frustration of the fear response. In both cases "fear-related aggression" is the underlying motivational diagnosis and treatment of the cat’s underlying fear is crucial to the success of treatment but the contextual labels help the owner to understand when the behaviour may occur and to take steps to avoid it.

It is unusual for fear-related aggression towards people to be a problem outside the home environment (other than during a visit to the veterinary clinic). Fear-related aggression towards people in the home is treated using '''desensitisation and counter-conditioning procedures''', often supported by '''[[Pheromonotherapy - Cat|pheromonotherapy]]'''.  

It is unusual for fear-related aggression towards people to be a problem outside the home environment (other than during a visit to the veterinary clinic). Fear-related aggression towards people in the home is treated using '''desensitisation and counter-conditioning procedures''', often supported by '''[[Pheromonotherapy - Cat|pheromonotherapy]]'''.  

The general method employed is:

'''The general method employed is:'''

*Detail the characteristics of the target(s): age, height, hair colour, types of movement, clothing/appearance. List all of the features which affect the cat’s response so that they can be introduced during training.

*Detail the characteristics of the target(s): age, height, hair colour, types of movement, clothing/appearance. List all of the features which affect the cat’s response so that they can be introduced during training.

*Identify a way to present targets in a graded manner, starting with people with an appearance that is least likely to evoke any reaction. For example, some cats are more aggressive towards men or children and may react differently according to their clothing, what the person is carrying or how they are moving.

*Identify a way to present targets in a graded manner, starting with people with an appearance that is least likely to evoke any reaction. For example, some cats are more aggressive towards men or children and may react differently according to their clothing, what the person is carrying or how they are moving.

====Clicker Training====

====Clicker Training====

In some instances clicker training may be an effective way of training cats to respond appropriately to the presence of people. The is trained to associate the sound of a click with the delivery of a small food reward. This is achieved by clicking and then dropping a piece of food approximately 20-30 times until there is some sign of positive anticipation on the part of the cat. Clicks are then only given when the cat carries out a specific behaviour, such as sitting. Once the cat is reliably sitting to get a click this behaviour can be ‘named’. Just as the cat is about to sit, the trainer says the command word that is intended to cue the behaviour: for example saying ‘sit’. After doing this a further 20-30 times most cats will be reliably trained to sit on cue (although often their responses are quite slow).

In some instances clicker training may be an effective way of training cats to respond appropriately to the presence of people. The cat is trained to associate the sound of a click with the delivery of a small food reward. This is achieved by clicking and then dropping a piece of food approximately 20-30 times until there is some sign of positive anticipation on the part of the cat. Clicks are then only given when the cat carries out a specific behaviour, such as sitting. Once the cat is reliably sitting to get a click this behaviour can be ‘named’. Just as the cat is about to sit, the trainer says the command word that is intended to cue the behaviour: for example saying ‘sit’. After doing this a further 20-30 times most cats will be reliably trained to sit on cue (although often their responses are quite slow).

Cats that have already begun to associate the presence of visitors with the availability of food treats may be instructed to sit and then repeatedly clicked and treated whist they stay sat. Alternatively, the cat may be clicked and rewarded repeatedly throughout the period while it remains present with the person. The limitation to this kind of training is that the sound of the click may produce a startle response that increases fear and anxiety and cats can sometimes be very difficult to motivate with food rewards.  

Cats that have already begun to associate the presence of visitors with the availability of food treats may be instructed to sit and then repeatedly clicked and treated whist they stay in a sitting position. Alternatively, the cat may be clicked and rewarded repeatedly throughout the period while it remains present with the person. The limitation to this kind of training is that the sound of the click may produce a startle response that increases fear and anxiety and cats can sometimes be very difficult to motivate with food rewards.  

====Pheromonotherapy====

====Pheromonotherapy====

====Psychoactive Medication====

====Psychoactive Medication====

In some cases of fear-aggression, the use of psychoactive medication may be useful to support behavioural therapy. '''Selegiline''' may be used to '''reduce apprehension'''. It is licensed for the treatment of behavioural problems with an emotional origin in dogs, but is not licensed for use in cats. The effect of this drug is to increase exploratory behaviour and confidence in fearful situations. It can also enhance the perception of reward, and thereby improve responses to counterconditioning procedures. However, by encouraging the animal to move closer to the target of the fear-related aggression there is an increased risk of injury if the person startles the cat by making a sudden noise or movement. This appears to be worst during the initiation of treatment (the first 4-6 weeks of medication).  

In some cases of fear-aggression, the use of psychoactive medication may be useful to support behavioural therapy. '''[[Selegiline]]''' may be used to '''reduce apprehension'''. It is licensed for the treatment of behavioural problems with an emotional origin in dogs, but is not licensed for use in cats. The effect of this drug is to increase exploratory behaviour and confidence in fearful situations. It can also enhance the perception of reward, and thereby improve responses to counterconditioning procedures. However, by encouraging the animal to move closer to the target of the fear-related aggression there is an increased risk of injury if the person startles the cat by making a sudden noise or movement. This appears to be worst during the initiation of treatment (the first 4-6 weeks of medication).  

Serotonergic drugs such as '''Fluoxetine''' and '''Clomipramine''' may be used to '''reduce aggression where anxiety of frustration are underlying factors'''. It may also be used to reduce impulsiveness, thereby making attacks less sudden and unsignalled. However, with all psychoactive medications that alter anxiety and fear, there dis a risk of disinhibition. Drugs can only be used safely and effectively after a thorough assessment of the case, and in combination with a well organised behavioural therapy plan and management to reduce risk of injury. No drug is currently licensed for the treatment of feline fear-related aggression, so informed consent must be obtained at the time of prescribing.

Serotonergic drugs such as [[Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine)|'''Fluoxetine''' and '''Clomipramine''']] may be used to '''reduce aggression where anxiety or frustration are underlying factors'''. They may also be used to reduce impulsiveness, thereby making attacks less sudden and unsignalled. However, with all psychoactive medications that alter anxiety and fear, there is a risk of disinhibition. Drugs can only be used safely and effectively after a thorough assessment of the case, and in combination with a well organised behavioural therapy plan and management to reduce risk of injury. No drug is currently licensed for the treatment of feline fear-related aggression, so informed consent must be obtained at the time of prescribing.

==Prognosis==

==Prognosis==

The owners expectations for the outcome of therapy should be part of the investigation, and unrealistic expectations will need to be managed. For example, in most cases previously fearful are only ever likely to become tolerant of people. Cats that wish to avoid contact with certain visitors should be allowed to do so, because this represents a safe and normal response to fear, which is far more desirable than an aggressive attack.

The owners expectations for the outcome of therapy should be part of the investigation, and unrealistic expectations will need to be managed. For example, in most cases previously fearful cats are only ever likely to become tolerant of people. Cats that wish to avoid contact with certain visitors should be allowed to do so, because this represents a safe and normal response to fear, which is far more desirable than an aggressive attack.

If clients can be satisfied with this kind of situation, then the prognosis is generally good. However, cats that have already inflicted injuries without any apparent provocation are potentially an ongoing danger. For example, those which hide and then attack without warning may be impossible to manage safely. This is why it is very important to differentiate motivations such as [[Misdirected Feline Predatory Behaviour Towards People|misdirected predatory play]] from genuine fear-related aggression, because the two often have different treatments and outcomes.

If clients can be satisfied with this kind of situation, then the prognosis is generally good. However, cats that have already inflicted injuries without any apparent provocation are potentially an ongoing danger. For example, those which hide and then attack without warning may be impossible to manage safely. This is why it is very important to differentiate motivations such as [[Misdirected Feline Predatory Behaviour Towards People|misdirected predatory play]] from genuine fear-related aggression, because the two often have different treatments and outcomes.