Can dog appeasing pheromone ameliorate stress behaviours associated with anxiety in mature domestic dogs?

PICO question Does use of dog-appeasing pheromone reduce the frequency and/or severity of non-specific stress behaviours associated with anxiety in domestic dogs, older than 6 months, when compared with no treatment?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Eight controlled trials were appraised. Four were randomised and four were either non-randomised or did not clearly describe the method of allocating subjects into treatment groups. Strength of evidence Weak Outcomes reported There was no evidence that any dog appeasing pheromone (DAP) formulation (spray, diffuser, or collar) was superior. There was moderate evidence that DAP could reduce some behavioural manifestations of fear and/or anxiety stemming from thunderstorm noise and weak evidence that it could ameliorate some non-specific stress behaviours in hospitalised patients. In shelter dogs, there was mild evidence that DAP could reduce barking intensity and increase some behaviours associated with relaxation. When behavioural changes occurred, most were observed during exposure to DAP and there were minimal residual effects post-treatment. Conclusion The evidence for using DAP to manage stress behaviours associated with anxiety in dogs over six months of age remains weak. Until there is a stronger evidentiary basis, clinicians should be aware that a true clinical benefit is undetermined. Nevertheless, DAP is unlikely to cause harm and may still provide some therapeutic benefit. Therefore, DAP may still be employed in a multimodal management plan for some behaviour cases and may exert a placebo effect. However, if an owner’s financial resources are restrictive, clinicians should not prioritise pheromone therapy at the omission of other therapies that have established clinical effects   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.