The Chemical Language of Cats: Pheromones and Wellbeing

Join us as we discuss the fascinating world of feline communication, exploring howcats use chemical signals to interact with their environment and each other. Additionally, we shall shed light on a rational approach to using gastroprotectants in cats, providing invaluable insights for veterinary practitioners.

In Part One of our discussion, Dr Sarah Ellis and Dr Daniel Mills talk about thecomplexities of pheromone use in cats, emphasising the differences between scents and pheromones and their impact on emotional processing. They also highlight the importance of understanding pheromones in assessing feline behaviour. Part Two of their discussion will be available in next month's episode, so make sure you're signed up to Chattering With ISFM on your preferred podcast platform if you don’t want to miss out!

Following this, Dr Kelly St. Denis and Dr Katie Tolbert discuss Dr Tolbert's JFMS Clinical Spotlight article on the rational use of gastroprotectants in cats. They cover the risks of using these medications, especially the differences in how cats and dogs metabolise drugs, and the potential benefits of soluble fibres in preventing GI ulceration. They also address the careful use of gastric acid suppressants and gastroprotectants in clinical practice, with a focus on patient comfort and proper administration.

For further reading material please visit:

Pheromonatherapy: Theory and applications

Stress and Pheromonatherapy in Small Animal Clinical Behaviour

JFMS Clinical Spotlight Article: A Rational Approach To The Use Of Gastroprotectants In Cats

For ISFM members, full recordings of each episode of the podcast is available for you to listen to at portal.icatcare.org. To become an ISFM member, or find out more about our Cat Friendly schemes, visit icatcare.org

Host:

Nathalie Dowgray, BVSc, MANZCVS, PgDip, MRCVS, PhD, Head of ISFM, International Society of Feline Medicine, International Cat Care, Tisbury, Wiltshire, UK

Speakers:
Sarah Ellis, BSc, PGDip, PhD, Head of Cat Wellbeing and Behaviour at International Cat Care, independent feline welfare educator, writer and consultant.

Daniel Mills, BVSc PhD CBiol FRSB FHEA CCAB Dip ECAWBM(BM) FRCVS, Professor of veterinary behavioural medicine & RCVS, European and ASAB recognised specialist in clinical animal behaviour

Kelly St. Denis, MSc, DVM, DABVP (Feline), Co-editor of the Journal of Feline Medicine and Surgery and JFMS Open Reports, St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada

Katie Tolbert, DVM, Ph.D., DACVIM (SAIM, SA nutrition), Clinical Associate Professor in Small Animal & Comparative Gastroenterology & JFMS Author.

Creators & Guests

Host

Nathalie Dowgray

What is Chattering With ISFM?

Welcome to Chattering With ISFM, the official monthly podcast of the International Society of Feline Medicine, hosted by Nathalie Dowgray (Head of ISFM). Each month, we chatter about cats and cat-friendly practices with industry experts and contributors to The Journal of Feline Medicine and Surgery. Each episode contains highlights from our longer discussions and interviews, which are accessible to ISFM members at portal.icatcare.org. If you would like access to our full episodes, would like to become an ISFM member, or find out more about our Cat-Friendly schemes, visit icatcare.org.

Nathalie Dowgray: Hello, welcome to the
August episode of Chattering with ISFM.

I'm Nathalie Dowgray, Head of ISFM
and host of this month's podcast.

First up this month we have Dr
Sarah Ellis speaking with Dr Daniel

Mills on feline pheromone use.

And then we have AAFP's Dr Kelly St.

Denis speaking with Dr Katie Tolbert
on her JFMS Clinical Spotlight

Article, A Rational Approach To The
Use Of Gastroprotectants In Cats.

Sarah Ellis: So, Daniel, it's really
lovely to get a chance to speak to

you and on a topic that I know we're
both quite keen and interested on,

and that is the topic of pheromones.

There's so much terminology out there,
and I think sometimes that can be

quite confusing for people to navigate.

Is the word scent a better word
to use to simplify things, or

does that make it more difficult?

Daniel Mills: I think it is
useful to make a distinction

between scents and pheromones.

One of the problems for many
vets is we're not really taught

much about that at vet school.

They're chemicals in the air,
so aren't they all scents?

They're chemicals that are detected, but
they are detected by a variety of organs.

There's actually several chemo
detecting organs up your nose

and in your mouth as well.

We're familiar with what's on the
tongue versus on the nose, and we get

flavour from the integration of those.

But there's actually quite a few
organs, not just the main olfactory

epithelium, which detects odours,
as we might like to think about,

or scents, but there is another
structure called the vomeronasal organ.

The important thing about the vomeronasal
organ is that it's wired to parts of

the brain which are very much more
closely associated with emotion.

So, it's not just a information about
what the chemical balance is in the air,

it's actually processing information and
it says, this is emotionally important.

And for that reason, I think it is
worth distinguishing the pheromones

from the scents, because these are
such simple molecules, they're present

in so many things, but in certain
combinations they have real meaning.

So it's a bit like we've got
certain letters and we put

them together in a certain way.

If somebody shouts fire, then
we all react in a certain way.

If that combination is picked
up by the vomeronasal organ, it

gets fast tracked into the brain.

It's not just like hearing the word fire.

It's actually hearing the word fire and
somebody giving you a shot of adrenaline

at the same time, because your whole
body is reacting in that situation.

But I fully understand the skepticism that
some people have, because also as vets,

we're often trained to think about things
in terms of disorders and pathologies.

And this is a very different area.

It's a natural human tendency
also to think of things in

very black and white terms.

But when it comes to emotional
processing, pheromones, like any other

bit of information, they're part of
the wider picture, but they have a

particular weight in how we see things.

And when I started my career working
on emotions, it was driven very much

by trying to understand what it was
these pheromones were doing that was

different to other olfactory cues.

And it's trying to think, how
do animals process emotion?

What is the significance?

And emotions are personal judgments.

They're what give individual differences.

Now, I'm not saying that the pheromones
are about individual identity, but

it's about subjective judgments.

You and I both like chocolate.

If there's a chocolate bar there, I
might fight harder than you because

I like chocolate more than you do.

That's what makes me
slightly different to you.

These individual differences
are really important.

And as I said, at an emotional
level, we get enormous differences in

character as a result of differences
in those emotional processes.

Sarah Ellis: That makes complete sense.

Something that I often get asked,
is it a pheromone or is it an odour?

And the reality is the pheromones
will always exist where there's an

odour as well because of the very
nature and what they're deposited in.

Daniel Mills: Yeah, absolutely.

In some species the vomeronasal organ only
opens up when it's triggered to open up.

So there has to be something in the
olfactory message, usually, or you

could say that if there's a visual
mark, then that might trigger it.

But something has got to tell
the animal's brain to send a

signal to open up the vomeronasal
organ and start processing this.

They're not something
that work in isolation.

Again, people who are used to using
drugs for managing behaviour, they

expect it to treat the condition.

Whereas what we're doing with
pheromones is we're nudging the

animal to evaluate its environment
in a certain way and therefore

hopefully respond in a more acceptable
or appropriate way for the owner.

Sarah Ellis: So would you say
they aid that sort of emotional

assessment of their environment?

Daniel Mills: Absolutely.

I think they're integral to it.

We evaluate the world emotionally
in lots of different ways.

What resources are there?

What can be taken?

But that can always be overridden
by a fear message coming in.

Equally, are there barriers
to what I want to do?

Because if there are, then I've
gotta do something about them.

And that triggers the
emotions of frustration.

But it's not that you are either
scared or you're frustrated.

So for example, if you are a cat
and you can't get to safety, then

you're gonna be scared and then
you're gonna be frustrated and

it's sometimes useful to
anthropomorphise, and I would say that

might be more like a terror state,
if you want to put a word on it.

It's more than just fear, because
it's fear followed by frustration,

and I can't escape from it.

So I feel that much worse about it.

And this is how the emotions blend
into our conscious experience.

Whereas if you are frustrated,
and then scared, whilst you've got

frustration and fear again, they're
in a different sequence and so it

will feel like something different.

Sarah Ellis: I'm thinking about
the example in the vet clinic

where the vet offers food.

So you have that, they want the food,
they want to approach, but also there's

that avoidance piece because they're
not comfortable in those surroundings.

So you get those two
emotions, one after the other.

Daniel Mills: Yeah, so you'll
get a state of conflict there and

often, yes, a conflict will involve
quite often different emotions.

We often think about it in terms of
approach avoidance from a behavioural

point of view, but actually from
an emotional point of view as well.

And it's this that really guides
us what we do as individuals.

Sarah Ellis: Absolutely.

Nathalie Dowgray: And now over to Dr
Kelly St Denis and she's speaking with

Dr Katie Tolbert on her JFMS Clinical
Spotlight Article, A Rational Approach

To The Use Of Gastroprotectants In Cats.

Kelly St Denis: Why don't we just start
talking about some of the things that I

noticed in the article that probably will
affect other people in clinical practice.

I just do feline medicine, but I
noticed years ago when I was practicing

with dogs that oftentimes if we
were prescribing non steroidals,

we would often do medication to try
and protect them from GI ulceration.

And that's not recommended for cats.

And I wondered if we could talk
a little bit about why that is.

Katie Tolbert: Cats are not small
dogs, even though sometimes we like to

treat them as such, but the way that
they metabolise drugs is different.

We know that their nutrient
requirements is very different.

We know that cats are not as at
risk for GI ulceration as dogs.

In fact, when we do see GI ulceration
in the cat, more commonly, it's

related to a neoplastic disease
or something like lymphoma or

carcinoma or rarely gastronoma.

And if it's non neoplastic, it's usually
something like inflammatory bowel disease.

Although they can get GI
ulceration, it's just not very

common as compared to the dog.

We know that, actually, when you
use gastroprotectants in combination

with NSAIDs, just based on some
early work that we did in dogs and

then some work that's been done
in rats and humans, that it might

actually increase risk of ulceration.

Kelly St Denis: There's some
discussion around dietary fibre.

There were studies that looked
at the cat's stomachs in terms of

when they were on medications and
whether or not they had ulceration.

And it was noted that there were
changes in how they were going to

respond to different types of fibre.

We always think about fibre and diarrhoea,
or fibre and constipation, but not really

about what's happening in the stomach.

Katie Tolbert: Absolutely.

There are obviously a few different
characteristics of fibre that can

be beneficial for the GI tract.

And one of them is the fact that
soluble fibres can form gels.

So if they're viscous fibres, they
can form a protective layer in the

stomach and the intestinal tract.

And so there have been a couple of
studies actually, ironically enough

with NSAIDs and whether or not they
caught some GI bleeding in cats.

And in this case, they
used extremely high doses.

So doses that wouldn't be
necessarily therapeutic.

And what they found was that cats
that received soluble fibres actually

did have a benefit of those and in
preventing some of that ulceration.

Kelly St Denis: One of the things
in here, like you guys have

nicely divided up gastric acid
suppressants and your protectants.

And I just wondered if you
could talk about the difference?

Katie Tolbert: Yeah.

So we, yeah, divide them for
gastric acid suppressants.

So we have our histamine 2 receptor
antagonists being promoted in our PEPCID.

And then we have our
proton pump inhibitors.

Those are going to work directly
on the acid producing cell of the

stomach, which is the parietal cell.

So they're going to inhibit acid
secretion by two different mechanisms.

And then we have cytoprotectins.

So that would be things that are
like traditionally thought of as

coding agents, although they can
have some other benefits as well.

So something like sucralfate or
barium, for example, and then we

have our prostaglandin analog, so
that would be like misoprostol,

which is not used as commonly in
feline medicine, but that would be

the other one that we think about.

Kelly St Denis: And again, if we're
talking about quality of life and

how pain and emotion are so connected
that pain is a sensory and an

emotional experience, again, keeping
a patient comfortable is so important.

And I wondered if you could just elaborate
a little bit on the use of sucralfate.

Katie Tolbert: Sucralfate has this
interesting benefit in that it has

been shown to have some ability to
treat pain in the case of oesophagitis.

So it does seem to have some
antinociceptive properties.

And in fact, if you have really severe
oesophagitis and you have the option

of taking a protein pump inhibitor
or something like sucralfate, you'll

choose sucralfate every time because
it immediately ameliorates some of

that painful stimulus versus the PPI.

It takes a long time to take care
of the acid and decrease the acid.

So sucralfate is a really nice
drug to use in conjunction

with a protein pump inhibitor.

If you're feeling like whatever
disease that you're treating is

erosive, it's ulcerative and the
cat has pain associated with it.

Kelly St Denis: And the challenge
always being getting it into the cats.

Katie Tolbert: That challenge is real.

You want to make sure you have really
clear instructions for how to make

sucralfate slurries so they're doing
it appropriately, that you're giving

it in the way that it needs to be given
and that there's a real conversation

with the client about, it's okay if
you can't do that, then we think of

something else that we can try to help.

Obviously in cats that are very painful
sucralfate alone is not going to cut it.

It just has that added benefit.

Like maropitant, for example, we know
that in those studies that sometimes

animals needed less inhaling gas when
they were undergoing spay because

of the properties of maropitant on
helping with visceral induced pain.

And nobody would withhold an opioid
from a dog or cat undergoing a spay just

because they're getting maropitant..

So same with sucralfate.

You're just happy that it also
helps with some of the pain.

Kelly St Denis: Lately, a lot of my
lectures have been focusing on pain.

It's the fourth vital
assessment after TPR.

I think that's a big gap that a lot
of us experience when we're seeing

patients on a day to day basis.

We forget how that really
impacts the patient.

One of the things that we do
a lot with painful cats that

are older is dental surgeries.

And one of the things that comes up
in here is a reflex under anaesthesia.

And I know over the years, I have
heard people recommend to use

gastroprotectants in those cases.

And I know in this article you guys
suggest maybe that's not a good idea.

So I wanted to talk about why that
might be a consideration and why you

wouldn't recommend it as a routine thing
for an old cat undergoing a dental.

Katie Tolbert: This is the
section that I really went back

and forth on how to write it.

I want to be really careful
about the misuse of these drugs.

They come, obviously, also with the costs
to the clients so we want to be careful.

I think there are situations
in which I would recommend it.

For example, a patient, for whatever
reason, couldn't be fasted for

the length of period that you
want, I think it makes sense.

Because this is more of an evidence
based article, we don't have evidence to

suggest that giving them perioperative or
preoperative acid suppressants actually

decreases their risk of oesophagitis.

And so for that reason, we haven't
made a recommendation about it.

However, it would be
great to have a study.

In this case, I would give from famotidine
perioperatively and see if there's

a benefit to reducing oesophagitis
and oesophageal strictures in cats.

Kelly St Denis: So you wouldn't use
something like a proton pump inhibitor if

you were going to do it, like Omeprazole,
you would reach for famotidine.

And so why would that be?

Katie Tolbert: So famotidine works
very quickly when given injectably.

The PPI will be more effective.

But it has to be over time.

For example, if you had a client who
was very worried about it and you want

it to be doing everything possible,
then you would really want to,

especially in cats, you'd really want
to start the proton pump inhibitor,

like four days before the procedure.

Kelly St Denis: Wow.

Katie Tolbert: Yeah.

Based on our studies that, in cats, they
start to see max effect around day four.

And so just giving one dose, you're
missing the maximal efficacy.

So I would give famotidine
because it works within 30

minutes to an hour of injection.

Kelly St Denis: Right.

So if we do have those higher risk
patients, like brachycephalic,

you have, I think, hiatal hernia.

Katie Tolbert: Yeah, exactly.

Kelly St Denis: Yeah, instead of maybe
like diabetics, I'll have them give half

their meal in the morning with their
insulin because their stomach transit

time seems to be so quick in cats
anyways, but we don't fast them as long.

So those would be patients that
you might consider doing that with.

Katie Tolbert: Exactly.

And then I would just
wouldn't let your guard down.

You should do all those care
things that you would do otherwise

in a high risk patient or a
patient that you're worried about.

We know the consequences of a
ooesophageal stricture can be fatal.

You're suctioning out the oesophagus,
for example, or if you notice there's

a large volume of fluid pooled
into the oesophagus, suction it out

really well and maybe give a little
bit of a barium or a bicarb like

solution to help neutralise that.

Kelly St Denis: Great.

Those are great tips.

Nathalie Dowgray: Thank you for listening.

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