Today's Veterinary Practice

SEP-OCT 2018

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PEER REVIEWED 36 SEPTEMBER/OCTOBER 2018 todaysveterinarypractice.com diets (Association of American Feed Control Officials [AAFCO]-labeled) fit their personal preferences and then offer the cat a few samples of these at mealtime so the cat can express its preferences. I recommend this approach to minimize the effects of perception of diet on the activation of the CSRS of both the client and the cat. A detailed discussion of the pros and cons of diet therapy for all manifestations of Pandora syndrome is beyond the scope of this article. If a diet change seems appropriate, to reduce the risk of inducing a learned aversion to the new food, I recommend implementing it only after the cat has returned home and is feeling better. Pharmacotherapy. Choices for drug therapy, if any, depend on the individual cat's manifestation(s) of Pandora syndrome. A variety of drugs have been recommended for use in cats with "feline idiopathic cystitis." 23 However, to my knowledge, no studies comparing their effectiveness with that of MEMO have been published. There also are hazards associated with drug therapy for cats, which include the aversion of many cats to chronic administration of oral medications and potential adverse effects. With regard to drugs that target anxiety in general, a recent review of behavioral psychopharmacology in cats reminds us that "There are no approved behavioral drugs for cats. Using any of the previously mentioned medications for purposes other than the indications listed on the label and the use of any psychoactive medication not listed previously is considered extralabel use and falls under the rules of the Animal Medicinal Drug Use Clarification Act of 1994 and its implementing regulations." 24 The review goes on to speculate that maropitant citrate ( cerenia.com ; zoetis.com ) "has the potential for many additional uses including as an adjunct medication for the treatment of pain and as a mediator of the stress response during handling and hospitalization." Unfortunately, there is no published evidence to support this speculation with regard to cats, and studies in other species suggest that effectiveness in the situations described is highly unlikely. 25 One (manufacturer-funded) 4-week study 26 evaluated use of alpha-casozepine in anxious cats, but the statistics reported leave one skeptical of the results. To my knowledge, no randomized controlled trials of use of alpha-casozepine in cats with Pandora syndrome have been conducted. In fact, the role of anxiolytic drugs in the treatment of many manifestations of Pandora syndrome remains an open question. Treating the Environment: MEMO If cats with Pandora syndrome have a sensitized CSRS, then the treatments most likely to be effective are those that reduce cats' perception of threat and increase their perception of control. Environmental conditions are known to affect the behavior and health of animals, 27 particularly captive animals. 28,29 Effective MEMO creates conditions that permit the patient to feel safe and to have unrestricted access to species-appropriate novelty, activity, and interactions with other animals (including humans). Effective MEMO for cats means provision of all necessary resources, refinement of interactions with the clients, an intensity of conflict that is tolerable, and thoughtful institution of change(s) to the cat's environment (its territory). It extends the "1+1" rule traditionally applied to litter boxes (1 for each cat in the home, plus 1 more) to all pertinent resources (particularly resting areas, food bowls, water bowls, and litter boxes). e components of MEMO are as follows: Space. Each cat needs a safe refuge: a cozy bed in a desirable (to the cat) location in the home and outfitted for the cat's comfort. A good refuge is a cat carrier, with the added benefit that habituating the cat to the carrier also facilitates crating the cat for medical care and other travel. Cats also interact with the physical structures in their environment; they need opportunities to scratch (both horizontal and vertical surfaces), climb, hide, and rest, preferably in multiple locations in the home. A study reported that for some cats, enrichment can be enjoyed in the form of scents (e.g., catnip, silver vine, Tatarian honeysuckle, and valerian [a constituent of Feliway spray 30 ]). 31 Another study reported the following preferences indicated by domestic cats: social Effective MEMO creates conditions that permit the patient to feel safe and to have unrestricted access to species- appropriate novelty, activity, and interactions with other animals (including humans).

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