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Facial pheromone spray in cats with non-obstructive lower urinary tract disease

Clinical Scenario

Ben is a 7 year old male neutered domestic short hair (DSH) who is showing signs of cystitis for the third time in 6 months. You have undertaken urinalysis and performed contrast radiography and have found no underlying cause for the thickened bladder wall and macro-haematuria. In the past you have given non-steroidal anti-inflammatories to manage the clinical signs and Ben is now on a completely wet diet. You are considering using Feliway but your client has a limited budget you wonder if it will be helpful in alleviating the clinical signs of the lower urinary tract disease...

3-Part Question (PICO)

In [cats with non-obstructive lower urinary tract disease] does the use of [feline facial pheromone spray in the environment compared to placebo] [decrease the severity of clinical signs]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(cat.mp. OR cats.mp. OR feline.mp. OR felines.mp. OR felis.mp. OR felidae.mp. OR exp Cats/ OR exp Felis/ OR exp Felidae/)

AND

(FLUTD.mp. OR feline lower urinary tract disease.mp. OR cystitis.mp. OR FUS.mp. OR feline urologic syndrome.mp. OR bladder disease.mp. OR bladder inflammation.mp. OR exp Cystitis/ OR exp Urinary Bladder Diseases/)

AND

(feline facial pheromone.mp. OR feliway.mp. OR pheromone.mp. OR pheromones.mp. OR pheromonatherapy.mp. OR exp Pheromones/)

CAB Abstracts 1910 to Present using the OVID interface

(cat.mp. OR cats.mp. OR feline.mp. OR felines.mp. OR felis.mp. OR felidae.mp. OR exp cats/ OR exp Felis/ OR exp Felidae/)

AND

(FLUTD.mp. OR feline lower urinary tract disease.mp. OR cystitis.mp. OR FUS.mp. OR feline urologic syndrome.mp. OR bladder disease.mp. OR bladder inflammation.mp. OR exp cystitis/ OR exp bladder diseases/)

AND

(feline facial pheromone.mp. OR feliway.mp. OR pheromone.mp. OR pheromones.mp. OR pheromonatherapy.mp. OR exp pheromones/)

Search Outcome

MEDLINE

  • 2 papers found in MEDLINE search
  • 0 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 2 total relevant papers from MEDLINE

CAB Abstracts

  • 11 papers found in CAB search
  • 1 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 8 papers excluded as they are review articles/in vitro research/conference proceedings
  • 2 total relevant papers from CAB

Total relevant papers

2 relevant papers from both MEDLINE and CAB Abstracts

Comments

Of the 2 relevant papers found, one was included as part of the other (which was a systematic review) so only the original article has been included in the summary of evidence.

Summary of Evidence

Gunn-Moore and Cameron (2004) UK

Title:

A pilot study using synthetic feline facial pheromone for the management of feline idiopathic cystitis.

Patient group:

12 cats with recurrent feline lower urinary tract disease (FLUTD)

Study Type:

Randomised controlled trial (crossover design with placebo)

Outcomes:
  • Owner-reported signs including frequency of urination, straining or crying on urination and macrohaematuria
  • Owner-reported changes in behaviour and cats' 'overall health'
Key Results:
  • There were no statistically significant differences between clinical outcomes in cats treated with feline facial pheremone (FFP) compared with a placebo
  • Some trends towards a reduced number of clinical signs and episodes of FLUTD during FFP treatment; also trend towards association between FFP use and diminished friendliness and increased appetite, but not statistically significant
  • 56% of owners said their cats' 'overall health' was better with FFP whilst 44% noted no difference
  • Recurrence of cystitis was seen in 4/7 (57%) during the 4 months of the study
Study Weaknesses:
  • Very small sample size
  • The results begin by talking about 12 cats, then describe 3 dropping out, then finish talking about 7 cats so some lack of clarity on dropout
  • No sample size calculation; power calculation unclear
  • Blinding and randomisation methods unclear
  • Raw data regarding differences between groups prior to treatment not shown
  • Measurement criteria not standardised between samples and potentially subjective
Attachment:
No attachments.

Comments

The two relevant papers found comprised a randomised controlled trial (Gunn-Moore et al.) and also a systematic review (SR). The SR concerned the use of pheromone therapy in treatment of behavioural problems in dogs and cats. Although FLUTD is physiological, not behavioural, the SR did consider the question of feline facial pheromone use in FLUTD. However, the only paper found in the SR was Gunn-Moore et al. Therefore the systematic review was excluded from the BET to avoid duplication. Due to the weaknesses described above it is not possible to infer any benefit in the use of FFP for the treatment of FLUTD. However, the trends in the study may suggest that a more robust and powerful study (e.g. larger sample size) could provide greater insight.

Bottom line

In cats with non-obstructive lower urinary tract disease, there is no evidence to suggest that feline facial pheromone spray in the environment will decrease the severity of clinical signs compared to a placebo.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Gunn-Moore DA, Cameron ME (2004) A pilot study using synthetic feline facial pheromone for the management of feline idiopathic cystitis. Journal of Feline Medicine and Surgery 6: 133-138.

Frank D, Beauchamp G, Palestrini C (2010) Systematic review of the use of pheromones for treatment of undesirable behavior in cats and dogs. Journal of the American Veterinary Medical Association 236: 1308-1316.

About this BET

First author:
Jenny Stavisky
Second author:
Rachel Dean
Institution:

CEVM, University of Nottingham

Search last performed:
2018-04-15 15:45:33
Original publication date:
2013-09-13 15:45:33
Last updated:
2018-04-15 15:45:33
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