Use of pheromones to reduce stress in sheltered cats

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JFMS CLINICAL PRACTICE 829
L E T T E R S
Dear Editors, – My colleagues and I read with interest the
recent article in JFMS from the European Advisory Board
on Cat Diseases (ABCD), ‘Prevention of infectious diseases in
cat shelters’.
1
Within the ‘stress reduction recommendations’
section, just after the overall guidance on environmental
enrichment for a shelter housing system, the authors
included a paragraph on ‘Pheromones’. This did not
surprise us as we know how common it is for many shelters
and big catteries in the world to routinely use feline facial
pheromones in their facilities, to provide those cats with a
sense of safety and security. For example, Wood Green (one
of the leading UK charities, which rehomed more than 2500
cats last year) systematically includes Feliway spray in each
cat unit and Feliway diffuser in its vet check rooms, as stated
in its ‘procedures for feline welfare’ at intake. Indeed, cats in
a shelter environment do not find their familiar marks, and
have to cope with a new and unknown environment, which
is potentially stressful. Even cats staying for a while in a
shelter, which might be considered as accustomed to this
environment, have the territorial marks they spread in their
environment (while rubbing their face against walls, doors,
provided enrichment devices, etc) regularly removed during
cleaning processes (as do hospitalised cats in a vet practice
environment). The removal of those familiar marks (which
cats in private homes are less subjected to) is believed to
lead to an increase in anxiety in cats.
For all these reasons, providing cats with synthetic
pheromones, which reproduce the familiar marks they
naturally deposit into their environment when they feel safe,
will help them feel confident at the shelter.
In addition to the catteries and shelters routinely using
pheromones, several behaviourists and veterinarians
working with catteries also recommend their use. For
example, the Maddie’s Shelter Medicine Program at Cornell
University College of Veterinary Medicine states in its ‘stress
reduction protocol’ for cats: ‘Feliway has been shown to
reduce anxiety in cats. A plug-in diffuser should be used in
each cat room. Additionally, the spray can be used to help
individual cats who continue to exhibit signs of stress. To use
the spray properly, spray the cat’s bedding when the cat is
not in the cage or spray a washcloth and place it in the cage
with the cat.’
2
Use of synthetic pheromones (Feliway diffuser
or spray) as an enrichment means for cats has also been
recommended to those attending an international congress
on shelter medicine.
3
In the recent JFMS article, we were thus surprised that the
paragraph on pheromones stated that there was insufficient
evidence of their efficacy, a statement based solely on a single
reference.
4
This completely disregarded the clinical trials
(14 in 2013)
5
performed with Feliway and published in
reputable scientific journals or presented at international
conferences. No other stress-relieving product available on
the market for use in cats relies on so many published trials
to support its efficacy. Most of them do not have even one.
The article referred to in that reference, by Frank et al,
although presented as a ‘Systematic review of the use of
pheromones for treatment of undesirable behavior in cats
and dogs’, does not comply with the recommended
guidelines for conducting a systematic review. The authors
only focused on the material and methods described in each
trial, and did not evaluate the outcome parameters such as
mean and median efficacy rates. As has already been pointed
out in a further publication in JAVMA,
6
this article is
incomplete, inaccurate and misleading (for example, it falsely
claims that Valeriana is present in all formulations and
therefore may explain the efficacy). Also, according to the
guidelines for conducting a systematic review, only
comparable papers should be included for analysis (eg, all
publications on the different treatments available for one
particular disease). Here, we can question the scientific
appropriateness of including studies that assessed one
single product but in a variety of situations and for different
indications. Moreover, we can question the inclusion of
studies whose objectives were not in accordance with the title
of the paper: neither idiopathic cystitis nor IV catheterization
can be considered ‘undesirable behaviors’.
Aside from the scientific content of Frank et al’s review,
the tone used was consistently negative rather than impartial.
Systematic review guidelines emphasize the importance of
respect for selected publications. All the trials quoted have
been published in reputable, peer-reviewed, scientific
journals, and although not perfect, they can inform an
evaluation of efficacy. The review failed to highlight the lack
of good evidence, according to the authors’ own standards,
for the management of most of the conditions evaluated
(beyond the use of Feliway) and thus ignores the inevitable
conclusion that some evidence is better than none. Thus, as
written, the Frank et al review offered no constructive advice
for readers.
In summary, using the Frank et al review (with its flawed
methods and debatable conclusions) as the basis for
evaluation of, and advice on, the efficacy of pheromone
therapy in cat shelters is very regrettable. We would urge
readers to take a broader view and evaluate the primary
literature for themselves before making a judgement.
We believe that there is much more evidence that can be
highlighted already, but also that this is an area that deserves
further field trials in the future.
Alexandra Beck DVM
Companion Animals Behavior Technical Manager
CEVA Santé Animale, Libourne, France
References
1 Mostl K, Egberink H, Addie D, Frymus T, Boucrat-Baralon C,
Truyen U, et al. Prevention of infectious diseases in cat
shelters. ABCD guidelines. J Feline Med Surg 2013; 15:
546–554.
2 Anon. Stress reduction protocol for cats.
http://www.sheltermedicine.vet.cornell.edu/Resources/
Use of pheromones to reduce stress in sheltered cats
Journal of Feline Medicine and Surgery (2013) 15, 829–830
at ISFM on August 27, 2013jfm.sagepub.comDownloaded from

Letters may be shortened for publication
documents/StressReductionProtocolforCats.pdf (accessed
July 16, 2013).
3 Griffin B and Levy J. Feline-friendly sheltering. Proceedings
of the North American Veterinary Conference; 2010 Jan
16–20; Orlando, Florida.
4 Frank D, Beauchamp G and Palestrini C. Systematic review
Re-shedding of Toxoplasma gondii oocysts
Dear Editors, – Jitender Dubey proved 18 years ago that cats
reinfetcted with T gondii 6 years after initial infection re-shed
oocysts.
1
And yet, we still see statements like the following
which was recently published in a consensus guidelines
article by the ABCD in JFMS:
2
‘Thus, cats that have
antibodies to T gondii no longer shed oocysts, and do not
pose a risk to humans.’
How long will this myth continue to be perpetuated?
Nate Bauer DVM
MS College Station, Texas
DOI: 10.1177/1098612X13500882
of the use of pheromones for treatment of undesirable
behavior in cats and dogs. J Am Vet Med Assoc 2010; 236:
1308–1316.
5 Complete references on file.
6 Beck A. Questions study on the use of pheromones in dogs
[Letter]. J Am Vet Med Assoc 2010; 237: 493–494.
References
1 Dubey JP. Duration of immunity to shedding of
Toxoplasma gondii oocysts by cats. J Parasitol 1995; 81:
410–415.
2 Hartmann K, Addie D, Belak S, Boucraut-Baralon C,
Egberink H, Frymus T, et al. Toxoplasma gondii infection
in cats. ABCD guidelines on prevention
and management. J Feline Med Surg 2013; 15: 631–637.
DOI: 10.1177/1098612X13500883
830 JFMS CLINICAL PRACTICE
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