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===Pheromones===
 
===Pheromones===
A number of studies support the use of pheromonotherapy for the treatment of indoor marking in cats(Mills 3).
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A number of studies support the use of pheromonotherapy for the treatment of indoor marking in cats<ref name="Mills3">Mills, D.S., Redgate, S.E., Landsberg, G.M. (2011) A Meta-Analysis of Studies of Treatments for Feline Urine Spraying. PlosOne. 6(4), 1-10.</ref>.
The product Feliway contains a synthetic analogue of the F3 fraction of the facial marking secretion of cats(Mills 1).
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The product Feliway contains a synthetic analogue of the F3 fraction of the facial marking secretion of cats<ref name="Mills1" />.
 
The presence of this chemical signal deters spray marking on a specific spot, and the general concentration of the chemical signal in an environment may reduce stress and interact conflict that underlie spray marking.
 
The presence of this chemical signal deters spray marking on a specific spot, and the general concentration of the chemical signal in an environment may reduce stress and interact conflict that underlie spray marking.
Current evidence suggests that Feliway diffusers or sprays need to be used for a minimum of 4 weeks in order to produce a reduction in spray marking (Mills 3).
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Current evidence suggests that Feliway diffusers or sprays need to be used for a minimum of 4 weeks in order to produce a reduction in spray marking<ref name="Mills3" />.
    
===Psychoactive Drug Therapy===
 
===Psychoactive Drug Therapy===
Medication can be very effective; a study by Landsberg & Wilson found that 20 out of 25 cats treated with [[Clomipramine|clomipramine]] at a mean dose of 0.54mg/kg showed a reduction in spraying within 4 weeks<ref>Landsberg, G.M., Wilson, A.L. (2005) Effects of clomipramine on cats presented for urine marking. J Am Anim Hosp Assoc. 41(1), 3-11.</ref>. In a meta-analysis of the effectiveness of treatments used for indoor spray marking both [[Fluoxetine|fluoxetine]] and clompiramine were found to reduce spraying by at least 90%<ref name="Mills3">Mills, D.S., Redgate, S.E., Landsberg, G.M. (2011) A Meta-Analysis of Studies of Treatments for Feline Urine Spraying. PlosOne. 6(4), 1-10.</ref>.
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Medication can be very effective; a study by Landsberg & Wilson found that 20 out of 25 cats treated with [[Clomipramine|clomipramine]] at a mean dose of 0.54mg/kg showed a reduction in spraying within 4 weeks<ref>Landsberg, G.M., Wilson, A.L. (2005) Effects of clomipramine on cats presented for urine marking. J Am Anim Hosp Assoc. 41(1), 3-11.</ref>. In a meta-analysis of the effectiveness of treatments used for indoor spray marking both [[Fluoxetine|fluoxetine]] and clompiramine were found to reduce spraying by at least 90%<ref name="Mills3" />.
    
Psychoactive drug therapy is often prescribed for cats with indoor marking problems. However, to be successful, the '''underlying reasons for the indoor marking must also be addressed'''. Medication does have a role in longstanding cases where the number of marked sites is large, or when marking has become habitual, or there is an emotional problem that may benefit from temporary drug support. Analysis of the general emotional state of the animal is important. SRI/SSRI drugs such as fluoxetine and clomipramine are beneficial for cats that are habitual indoor markers, or show a pattern of anxious, reactionary spraying. [[Selegiline|Selegiline]] benefits behaviourally-inhibited cats that will not explore their environment, or that display fearful reactions followed closely by reactionary spraying when they see certain cats lurking outside the home. These drugs will not help confident cats that show no signs of anxiety or fear and are merely using spray marks, albeit inappropriately, as part of a calmly considered strategy to control territory in the house. Hormonal preparations have no role in the treatment of indoor marking.
 
Psychoactive drug therapy is often prescribed for cats with indoor marking problems. However, to be successful, the '''underlying reasons for the indoor marking must also be addressed'''. Medication does have a role in longstanding cases where the number of marked sites is large, or when marking has become habitual, or there is an emotional problem that may benefit from temporary drug support. Analysis of the general emotional state of the animal is important. SRI/SSRI drugs such as fluoxetine and clomipramine are beneficial for cats that are habitual indoor markers, or show a pattern of anxious, reactionary spraying. [[Selegiline|Selegiline]] benefits behaviourally-inhibited cats that will not explore their environment, or that display fearful reactions followed closely by reactionary spraying when they see certain cats lurking outside the home. These drugs will not help confident cats that show no signs of anxiety or fear and are merely using spray marks, albeit inappropriately, as part of a calmly considered strategy to control territory in the house. Hormonal preparations have no role in the treatment of indoor marking.
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==Prognosis==
 
==Prognosis==
The prognosis for cats with indoor spray marking appears to be enhanced by the use of drug (fluoxetine, clomipramine) and pheromone (F3 fraction of facial mark, Feliway®), with these treatments significantly increasing the probability of a cessation or 90% reduction in spraying (Mills 3). 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. Studies suggest that a period of 8-16 weeks is required to establish efficacy of either of these drugs. Feliway produced no significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking in less than 4 weeks, but improvements were significant for treatment durations of more than 4 weeks(Mills 3). This suggests that a combination of pheromone and pharmaceutical interventions, with environmental modifications, is most likely to produce a rapid response and good outcome.
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The prognosis for cats with indoor spray marking appears to be enhanced by the use of drug (fluoxetine, clomipramine) and pheromone (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. Studies suggest that a period of 8-16 weeks is required to establish efficacy of either of these drugs. Feliway produced no significant increase in the proportion of cats showing a cessation or 90% reduction in spray marking in less than 4 weeks, but improvements were significant for treatment durations of more than 4 weeks<ref name="Mills3" />. 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.
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