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Owner education is key to effective treatment, as they must be convinced to make permanent changes to the ways in which they interact with the cat.
 
Owner education is key to effective treatment, as they must be convinced to make permanent changes to the ways in which they interact with the cat.
 
Specific recommendations will depend on the individual case, but could include:
 
Specific recommendations will depend on the individual case, but could include:
*Train the owner to give '''eye contact''' and '''vocal greetings''' instead of physical contact or handling. The owner must resist the temptation to pick the cat up.
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*Teach the owner to interact with the cat in a manner that is acceptable to it; reducing physical contact and increasing verbal and visual signals for greeting. For example, using '''brief eye contact''' and '''high-pitched vocal greetings''' instead of touching the cat or picking it up.
 
*The owner must also be able to identify early signs of aggression and irritation, such as growling vocalisation, tail swishing and ears folded back.
 
*The owner must also be able to identify early signs of aggression and irritation, such as growling vocalisation, tail swishing and ears folded back.
*Identify the maximum amount (duration) and type of contact that the cat will tolerate before becoming aggressive. Owners should restrict physical contact to a maximum duration that is less than half of this value, in order to minimise aggressive responses.
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*Identify the maximum amount (duration) and type of contact that the cat will tolerate before showing the first signs of aggression or irritation. Owners should restrict physical contact to a maximum duration that is less than half of this value, in order to minimise aggressive responses.
 
*Introduction of physical contact should be planned, systematic and increased in response to the cat’s improved behaviour.  
 
*Introduction of physical contact should be planned, systematic and increased in response to the cat’s improved behaviour.  
 
*The owner should '''substitute appropriate play''' for times when they might otherwise try to handle or cuddle the cat.
 
*The owner should '''substitute appropriate play''' for times when they might otherwise try to handle or cuddle the cat.
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*Physical environmental enrichment should be introduced, including giving the cat free access to resources such as food, preferably through activity feeding, in order to reduce underlying stress.
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Owners may be reluctant to comply with these demands but this is made easier if the ethological basis is explained, and an analogy is drawn with acceptable human greetings in different cultures. Hugging and kissing are the norm in many societies, even when introduced to strangers, whereas in the parts of Northern Europe, especially the UK, this would be considered socially uncomfortable. Following the social conventions enables the individual to fit into a social group without causing offence or stress. This is also so with cats; forcing excessive physical contact is against [[Feline Social Behaviour|normal feline social norms]].  
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Owners may be reluctant to comply, but this is made easier if the ethological basis is explained, and an analogy is drawn with human greetings in different cultures. Hugging and kissing are the norm in many societies, even when a person is introduced to strangers, whereas in the parts of Northern Europe, especially the UK, this used to be considered socially uncomfortable. Following social conventions enables an individual to fit into a social group without causing offence or stress. The situation is similar with cats; greeting behaviour does not usually involve much physical contact, so forcing excessive physical contact is against [[Feline Social Behaviour|normal feline social norms]]. Owners should be taught to correctly reciprocate feline greeting behaviour, for example calling the cat’s name in a high-pitched voice, or making slow blinking eye contact. They must realise that the cat that sits in close proximity has already made its greeting and may not, on this occasion, have any desire to be touched. '''Physical contact should generally be restricted to times when the cat initiates it'''.
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Cats need to learn about social interaction with humans, and be conditioned to tolerate it. The situation is compounded once the cat has been forced to put up with interaction that it does not like, and this creates negative associations with the approach of a person, which must be overcome before touch contact can be reintroduced.
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Cats also need to learn about social interaction with humans, and be conditioned to tolerate it. The situation is compounded once the cat has been forced to put up with interaction that it does not like, and this creates negative associations with the approach of a person, which must be overcome before touch contact can be reintroduced.
    
Fortunately, clients who change the character of their interactions with their cats will often be rewarded with increased trust and a greater amount of affiliative behaviour so that future compliance is usually high. However, it is important that they do not attempt to re-establish a tactile relationship with the cat as soon as it begins to become more approachable, as this will undermine trust and the cat will regress rapidly.
 
Fortunately, clients who change the character of their interactions with their cats will often be rewarded with increased trust and a greater amount of affiliative behaviour so that future compliance is usually high. However, it is important that they do not attempt to re-establish a tactile relationship with the cat as soon as it begins to become more approachable, as this will undermine trust and the cat will regress rapidly.
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Interactions should be limited to very short, planned sessions and always terminated before agitation begins. The owner needs to learn how to '''read body language''' and '''predict when tension is increasing'''. Tail twitching, flattening of the ears, stiffening of the shoulders and legs and dilatation of pupils are all signs of increasing arousal and [[Feline Aggression - Overview#Aggressive Sequence|risk of aggression]]. If the cat begins to show aggression during handling it is important to avoid touching the cat’s abdomen, even if it rolls onto its back or side. Severe lacerations are possible if a hand or foot is rapidly pulled away whilst the cat is latched onto it. Struggling and sudden movements of the hand also drive the cat to hold on tighter or to bite more deeply.  
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Methods of conditioning may be used to re-establish tolerance of contact in cases in which the cat had begun to show avoidance when a person approaches. Owners may need to experiment with a wide range of food rewards in order to identify something that can be used as a reinforcer. Access to the chosen food reward is restricted to training sessions alone, as this helps to increase their perceived value.  
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Whilst it may be painful, the most appropriate response is to remain still and make no noise. It is therefore advisable for owners to wear protective gloves and thick sleeves during treatment sessions. The primary aim of treatment should be to gradually work towards the situation where the cat is on the owner’s lap unrestrained. Once this has been achieved it should be possible to gradually condition the cat to accept increasing levels of restraint and handling, and eventually to accept being lifted from the ground, but this may take some considerable time.  
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The cat can be classically conditioned to associate the presence of a person with a food reward (without any request for physical interaction). Once the cat is accepting this, it can be trained using instrumental conditioning, to accept increasingly direct contact from the person. It may help for the owner to be given a listed sequence of behaviours, which should be rewarded. The owner must not progress to the next step unless the cat shows no signs of stress, fear or anxiety.
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Food rewards may be used during training, but cats are rarely motivated to work for their daily food ration and the treats that are used will need to be of sufficient value so that they genuinely represent a reward. Owners may need to experiment with a wide range of food rewards in order to discover what the cat really likes. Access to the chosen reward is restricted to training sessions alone, as this helps to increase their perceived value.
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A typical sequence of actions might be as follows:
 
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*A person approaching
The first step is to condition a positive association with the presence of a person by offering a food reward without any request for physical interaction. As treatment progresses the cat should be rewarded for permitting increasingly direct contact from the person. It may help for the owner to be given a listed sequence of behaviours,which should be rewarded. The handler must not progress to the next step unless the cat shows no signs of arousal or distress.
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*A person sitting near to the cat without touching
 
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A typical sequence of actions might include:
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*Approaching person
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*Sitting on furniture close to person
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*Sitting unrestrained on person’s lap
   
*Tolerating brief stroking along the back
 
*Tolerating brief stroking along the back
 
*Tolerating brief restraint
 
*Tolerating brief restraint
*Tolerating and ultimately accepting increasing amounts of stroking and restraint
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*Tolerating increasing amounts of stroking and handling
 
*Tolerating being lifted briefly off the floor  
 
*Tolerating being lifted briefly off the floor  
*Tolerating and ultimately accepting being picked up
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*Tolerating being picked up
 
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This is another condition in which a permanent change in owner behaviour is vital for continued success. Clients should be taught to notice and appropriately respond to normal feline greetings:
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*Eye contact with slow blinking
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*Trills
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*Sitting close to the person without touching
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*Tactile contact
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Owners should be taught to reciprocate these kinds of greetings in a similar manner, for example calling the cat’s name in a high-pitched voice, or making slow blinking eye contact. They must realise that the cat that sits in close proximity has already made its greeting and may not, on this occasion, have any desire to be touched. '''Physical contact should generally be restricted to times when the cat initiates it'''.
      
==Prognosis==
 
==Prognosis==
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