From POCUS to Pheromones: Applying Cat Friendly Techniques

I think if you're talking about cats and things like urine marking, then it's always important to clear up the urine in an effective way, either a commercial cleaner that has enzymes in it, or I still swear by using biological washing powder. Rinse it, followed by surgical spirit, lift off any fatty elements. I find that very effective.

And if you've got wooden floors and the cat's done it on the carpet, then potentially if it's sprayed the wall and it's run down into the carpet, you may have to lift the carpet and scrub those areas as well. That's one thing you have to be careful of though, if you do use those sorts of enzymatic sprays is that if you apply a pheromone spray over it, the enzymes may be active and can break it down. So that's one of the reasons why sometimes people say, I tried the product, didn't work.

So in those situations, the sprays are useful if you want to apply it tactically in particular areas. So we know that cats tend not to scratch, for example, where they face rub. So it can be useful, I think, using some of the sprays where the cats tend to be scratching, as long as you provide them with an outlet where to scratch. And I know that there has recently been a big clinical trial, which actually looked at the rate of scratching in cats.

And the classic Feliway does seem to reduce that as does the Feliway Optimum. When I first got in to this, we really knew very little and we were starting to probe and it's a new treatment modality for vets and other people and to try and understand it. And while some people will just embrace it and misunderstand it, they'll think about aromatherapy, but it's not relevant to them. For vets, it was very difficult for them to get their head around that this wasn't a drug. What was it exactly?

Was it just an odour? And I think in the first 10, 15 years, people were very skeptical because they didn't understand it. And were these products going to be successful? Clearly they are, they've been well adopted. And as long as people use them appropriately, they can be life changing for both the cat and for the owners. And now companies like Ceva are prepared to do those large RCTs.

And that was one of the criticisms I think that was made by some of the skeptics early on was, well, these aren't big RCTs. You wouldn't invest in a large RCT unless you're confident in your product and your product has got a big enough market share. And that's easy for a drug, but when you're talking about completely new treatment modality, it takes time. These sorts of trials cost a lot of money and you don't invest in them until you've got all the available information.

And over the years, we've accumulated through a number of small trials, but also some of the stuff that we've done outside of a clinical treatment setting to understand how these work and say, okay, these are the routes to go down.

Are they all the same thing made by different companies or are we actually dealing with different pheromone compounds here?

So, the first thing I would say to people is, regardless of what it says on the bottle, whether or not it's pheromones, and as we've already said, pheromones are different to odour therapy, and there are chemicals that have all sorts of effects on us as well, but look at the ingredients. I did look at the newer products and one of them says that it's particularly good because it's a unique blend. And I'm thinking, what does that mean?

A unique blend could actually have things that, rather than things that complement each other, when you put them together, they could antagonise each other. And I've already said that I've done a lot of work for Ceva and I should, for the sake of transparency, people need to be clear of that. But I am a traditionalist. I will stick with Ceva products because I know what's in them and I know that they're reliable.

It's an important part of veterinary medicine that you don't just switch because there's a new product. A new product doesn't necessarily mean a new class and if it's just another manufacturer. The reason why there has been an explosion, I think is partly because Ceva have been very successful in producing very effective products. So people have jumped onto that bandwagon and there is some unscrupulous advertising there. And secondly, the Feliway formula is now out of patent.

So other people can make generics. And so there is much more opportunity there, which means that potentially there are cheaper versions out there as well, which are just as effective. But because I deal with clinical cases, I'm not going to say there is this cheaper option and I'll recommend that instead. Now, if a client comes back to me and they say, I really can't afford that, then I might say, I don't know this product as well, but it's not going to be my first line.

My first line is going to be what I'm familiar with.

Are they doing two things trying to do the same thing? Does one plus one equal two? Or what's your thoughts on that?

I would start with those with the best evidence, and of all of those sorts of products, I would say that the pheromones are better than things.

There have been some trials published with Pet Remedy, I'm, I don't find the data that convincing, but I hear enough people telling me that it's really good that I do think that there is something there, but exactly what the indications are, just to flip back to what we were talking about earlier about the different parts of the territory and the emotional reactions. Personally, I don't think saying that something helps stress is terribly useful because stress is such a general term.

And my job as a behaviour clinician is to work out what emotions relate to that stress. As we've said, you've got fear, you've got frustration, they're different emotions. They have different solutions. So I could be cynical and say it's lazy to say stress, but people understand what the word stress means. But if you get the wrong type of stressor that product's not going to work. That doesn't mean that product is useless. It just means you've used it for the wrong indication.

And that's part of what my training is.

And I will still tend to use the individual Ceva products rather than the Feliway Optimum, unless I'm uncertain, or I think that there is a social element that needs to be included together with the physical, then I might recommend the Optimum, but to go back to answering your question, actually, we haven't got any evidence to suggest that, certainly, yeah, with things like pet remedy and some of the nutritional supplements, there's no reason to suppose that one should antagonise the other.

But some of the products that I'm starting to see labelled as pheromones, I struggle a little bit more with because some of the ingredients, they talk about calming scent with added catnip. Yes. And you're thinking, hang on.

It's more of a rapid, evidence based, non invasive, of course, repeatable, and specifically cage side or patient side sonographic examination. And in this article, me and the other authors have really tried to point out that POCUS can be done in a way where we really try to ask clinically driven questions without compromising the felines wellbeing.

So what you should start with is that you should part the fur until you see a bit of skin. And then you apply a little bit of alcohol and you put your probe on. And just having that coupling agent, a little bit of liquid between the probe and the skin, you will actually get quite a good picture. There's no point in just taking a cat, putting it on the table, spraying him down with alcohol because you won't see anything.

You really need to part that fur to actually get the alcohol between the skin and the probe. And then once you have quite a good contact, you will be surprised about how much you can usually move that probe around by taking your non ultrasound hand and moving the skin around and, in a cat on the thorax, most of the time you're able to scan almost the entire thorax in one go. It doesn't take a lot of practice, but you really got to be thorough with the parting and the spraying and so on.

If you would be charging an hourly rate, you know, POCUS should definitely cost less because you could do more in an hour and you don't really go into all the details, meaning you shouldn't pay as much. You might not need the necessary training in the same way as a sonographer. So, should the owners pay the same? Probably not. They should probably pay less because you can see it as an extension of your physical examination.

Are they kind of things that nurses or veterinary technicians could also be trained up to do in the hospital situation?

We'll see you again next month.