Page 1005 - Problem-Based Feline Medicine

46 – THE CAT WITH AGGRESSION 997

Treatment ● Benzodiazepines, such as diazepam (0.2–0.4 mg/kg
PO q 12 h – average 1–2 mg/cat PO q 12 h), may be
It is inadvisable to approach any highly aroused cat,
necessary for the victim. Care as it can lead to
especially to try to calm or reassure it. The cat should
hyperexcitement and has been associated with
be left alone until it is calmer. This may be 24 hours.
hepatopathy.
If another cat is involved, then the cats should initially ● Azaperones – Buspirone has been reported to
be separated regardless of whether it is the victim or be helpful in some cases (0.5–1.0 mg/kg PO q
the instigator (the thwarted one). 8–12 h).
● They should be placed in separate rooms so that ● Blood biochemistry analysis should be done prior
they can hear and smell each other, but no visual to medication to determine a baseline especially
contact occurs. for liver and kidney parameters as all are meta-
● The cats should be rotated around all the rooms bolized by the liver and excreted through the renal
until they have distributed their scent in all rooms. system. These parameters should be checked every
● While separated a regular routine should be 6–12 months depending on the age and general
established with each cat so that feeding and play- health status of the cat.
ing occur at a set time each day. Ideally the cats are ● The cats may require medication for a prolonged
fed 5–6 small meals each day. period – up to 6–12 months – and then should be
slowly weaned off.
Treatment then involves slowly reintroducing the cats
to each other (the same way a new cat is introduced The synthetic pheromone, Feliway®, can also be bene-
into the household). ficial. It should be sprayed on 4–6 prominent objects in
● The aim is for them to have a positive association each room at cat nose height for a period of 30–45 days
with each other. This essentially means that “good” and is said to decrease anxiety. A Feliway® diffuser
things such as play or feeding only happen in the plugged into the room in which the cat spends most of its
presence of the other cat. time can also be very helpful. Treatment should continue
● The cats are then slowly reintroduced. Initially they for at least 1 month.
are only in the same room during meal times and
If aggression is directed towards a person, the cat
are separated at other times. They are placed in
should be avoided in all stimulating circumstances.
cages (or on a cat harness and lead) at opposite ends
● Whenever the cat is calm desensitization and
of the room and are fed at this time. This should
counter-conditioning can be used. This means
create a positive association with food and the pres-
rewarding the cat (this may involve feeding or
ence of the other cat.
playing) for being relaxed in the person’s presence
● If no hissing or spitting occurs and the cats eat the
and walking away if the cat starts to become
food, the cages are gradually brought closer and
aroused.
closer to each other over a period of days and meals.
● Punishing the cat will exacerbate the problem as
This may take several weeks or even months.
it may lead to even greater arousal.
● Then one cat at a time is allowed out of its cage
to explore and if no aggression occurs then both are
allowed to interact under supervision.
● The re-introduction needs to be slow. Prognosis
Anxiolytic medication may also be needed to treat one Generally good if it is a single event and people can
or both cats. recognize the initiating stimuli and avoid them.
● Tricyclic antidepressants (TCAs) such as
Poor if the aggression is intense, of long duration
amitriptyline (0.5–1 mg/kg PO q 12–24 h, average
and there are multiple stimuli that cannot be identified.
5–10 mg/cat PO q 24 h) or clomipramine (0.5 mg/kg
PO q 12 h) or selective serotonin re-uptake Even though the aggression is of sudden onset it may
inhibitors (SSRIs) such as fluoxetine (0.5 mg/kg take weeks, or even months, for the cats to be success-
PO q 24 h) may be useful for the aggressor. fully reintroduced.