Behavioral problems, especially fear and aggression in dogs and elimination in the house in both dogs and cats, are a major reason for people to give up or euthanize their pets, so they represent a serious medical condition. There are many methods of treating such disorders with behavioral modification, and medications can sometimes be helpful, though our understand of which medications might help for which problems in which patients is very poor. However, the sad truth is that we have very limited success in alleviating many of these problems.
In the face of serious medical problems for which there are not strikingly effective scientific therapies, more questionable methods can become widely used. Some, like Bach flower essences, such as Rescue Remedy, or homeopathic treatments are clearly useless nonsense. Others are plausible scientifically, but not really shown to work in definitive ways. One such treatment is the use of pheromones.
Pheromones are chemicals animals produce that can affect the behavior of other members of the same species. They are believed to be common and important in coordinating social behavior in animals, especially mammals. The role, if any, that they play in human behavior is less clear, though they may be involved in the synchronizing of menstrual cycles in women living together. In any case, it is clearly reasonable that such substances might have an impact on the behavior of dogs and cats and so might be useful in managing behavior problems. Notice all the “mights” in that statement? The devil, of course, is in the details
It has become quite common for veterinarians to recommend use of synthetic pheromone analogs, that is chemicals made to be structurally natural pheromones, to help treat behavioral problems. The most common products are Feliway, and analogue of the facial pheromone cats leave behind on furniture and people the rub their faces against, and DAP, short for Dog Appeasing Pheromones, a pheromone nursing mothers release which is believed to calm puppies. These are sold with dramatic claims of efficacy for a wide range of conditions, but of course the claims of folks selling the product have to be viewed as perhaps less objective than other forms of evidence.
In the most recent issue of the Journal of the American Veterinary Medical Association, a systematic review was published which evaluated the research evidence for the use of these products.
Frank,D. Beauchamp,G. Palestrini,C. Systematic review of the use of pheromones for treatment of undesirable behavior in cats and dogs. J.Am.Vet.Med.Assoc., 2010, 236, 12, 1308-1316.
The purpose of a systematic review is to evaluate all the published data on the basis of quality, and then evaluate the results of studies that meet a reasonable minimum quality. In this review, studies were excluded that did not meet minimum quality standards or that were conducted by researchers working for the company selling the product under study. This left a total of 14 studies, 7 in cats and 7 in dogs.
In general, as is too often the case in veterinary medicine, the methodological quality of the studies overall was lower than expected in human medicine, with no studies reaching the highest standards. But as the authors wisely note, imperfect information is better than no information, so we must make our judgments based on the best available evidence even if it is prone to errors that better studies would avoid. I will spare you the interesting but complex details of the various study designs and their strengths and weaknesses, though reading the full review is recommended for anyone interested. Having read through the full report, I am convinced that unlike others I have reviewed, the conclusions of the authors of this systematic review are supported by the methods and results they detail elsewhere in the paper.
Of the 7 cat studies, none provided convincing evidence of a benefit. Some decrease in urine spraying occurred in some cats, but the significance of this was muddied by failure to follow up on cats which dropped out of studies, which were probably cats who didn’t improve with the treatment, and other methodological flaws in the studies reviewed. Pheromone therapy also was not clearly of benefit in cats with interstitial cystitis (a condition in which irritation in the bladder causes symptoms much like those of a bladder infection). The pheromone also did not seem beneficial in calming cats in the hospital or facilitating the stressful process of placing IV catheters in hospitalized cats.
In dogs, one study found some evidence that pheromone therapy might reduce anxiety in puppies during training. Other than that, no convincing evidence of benefit was found for anxiety associated with veterinary care, anxiety in shelter dogs, or barking and elimination indoors by recently adopted dogs.
The limitations in the quality of the evidence mean we cannot definitively declare that pheromone therapy doesn’t work. What we can say is that based on the best evidence to date, it does not appear to have a benefit. Further study is certainly reasonable, but as always I question the wisdom and the ethics of widespread sale and use of products which, despite years of testing, don’t seem to have much evidence that they work. These products appear harmless, and if clients wish to spend money rolling the dice on a treatment that is not well supported by the limited clinical research available that is certainly up to them. But when veterinarians recommend such products, it does tend to convey the impression that they are legitimate, validated therapies, and I think we do a disservice to our clients if we make such recommendations without a clear statement of the limitations in the evidence. Thanks to this paper, it is now easier to make such a statement.
It would be interesting to see the studies you are referring to.
As for veterinarian recommendations, I suspect they are recommending based mostly on clients’ anecdotal experience, rather than product representation. Add to that, the very high-priced product that when found in the veterinary clinic, are marked up considerably, making it cost-prohibitive. The product sold in retail stores is high-priced as it is, for the very small amount of product that must be used on a consistent, repeat basis for effectiveness, as claimed by the manufacturer.
I’ve seen many vets claim Feliway works in the clinical setting, but I don’t know how they can measure effectiveness when cats in general hide their anxiety, pain and stress anyway. I wonder if the cat would react the same if they were released in a timely manner and did as well at home (as is usually the case when the condition/recovery can be managed at home). Then there will always be the cat(s) who surprise you with resiliency despite the stress or condition so it is difficult to truly gauge effectiveness of the product.
Purely anecdotal of course: I have a cat who started urinating in odd places, did the health workup and rule-outs, investigated the environment, and several other things involving behavioral modification. I decided to give Feliway a shot. In the course of two months of using the products as the manufacturer recommends, there was absolutely no improvement beyond the first week. (the manufacturer recommends up to 3 months of continued, consistent use). I will continue to the 3rd month but just to say I did, I do not expect improvement from the product, rather I expect improvement from my diligence in working with the cat in behavioral conditioning.
So, perhaps it’s just my cat who doesn’t respond to Feliway. Yet, I have a multi-cat household and none of the other cats have responded favorably or unfavorably either. Perhaps no cat responds to the product.
There are literally thousands of testimonials and reviews on the net in favor of the product, but of course, all anecdotal. I recently heard somewhere that the “active”, “essential oil” ingredient is valerian (or maybe it was lavender, I can’t recall which). Either way, it’s pricey and I believe totally ineffective. My personal experiment with Feliway failed miserably.
What branch of government is regulating Feliway? I cannot find any FDA or USDA claim along with their all natural anecdotal ones. I also cannot find a cheap knock off competitor. When what you sell does not need to work it should be easy for the competition to make a similar product that does not work.
VT,
I haven’t been very impressed with Feliway myslef, having suggested it to owners in the past with a “who knows?” level of endorsement. If you’re interested in reviewing the specific studies, they are listed in the references section of the original paper.
Art,
I haven’t been able to find any regulatory information on these products either. EPA regulates pheromones used in pest control, and this (http://apvma.gov.au/publications/gazette/2007/10/gazette_2007-10-07_page_15.pdf) is the approval for use granted by the Australian Pesticides and Veterinary Medicines Authority, which sounds like a hybrid of the EPA and FDA’s CVM.
I would guess it’s under EPA jurisdiction, but I’m still looking.
There seems to be some confusion for classification, I assume it would fall under aromatherapy, and according to the FDA, anything actually applied to the body would be regulated by the FD&C Act (for example, perfume). Since Feliway and DAP are not applied to the body, neither are they drugs or cosmetics.
Since it is not applied to the body as would a pesticide containing an essential oil or solvents etc, I assume it is not regulated by the EPA.
So far, I could only find on the FDA’s website regarding aromatherapy:
http://www.fda.gov/Cosmetics/ProductandIngredientSafety/ProductInformation/ucm127054.htm
Should the CPSC regulate it because one product is a plug-in device and another product is a pump spray?
Art, maybe they already have competitors, in essential oil marketers. Pet owners are using essential oils in various ways for behavior problems in pets. (in diffusers, in collars, even directly on the pets’ fur – despite the dangers and no evidence of effectiveness).
would be interested in seeing what if any country has good consumer protection regulations that keep it from being sold. OZ?
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Hello,
If anyone would like a copy of the 35 peer reviewed published papers looking at the practical application and efficacy of the pheromone products (DAP and Feliway) and / or an overall summary giving the exact stats please e-mail lucy.brett@ceva.com or visit feliway.co.uk or dayfordogs.co.uk.
Alternatively, I am happy to answer and questions you have if you would like to send me an e-mail.
Lucy Brett
CEVA Animal Health
Sure, I would love copies of those papers. Of course, the systematic review discussed in this post looked at the 14 papers that met minimum standards of methodologic quality and concluded that the evidence was weak, so I’m not sure how they missed what you seem to feel is definitive proof of the value of your product. But as I did with a recent study of DAP, I am happy to look at the papers in detail and see if they support your company’s claims. Please e-mail them to skeptvet@skeptvet.com.
Thanks.
Lucy,
I’m still waiting for the evidence you offered to provide.