Cat behavioral problems can be divided into normal feline behaviors (management issues) that are unacceptable to owners (eg, climbing, scratching, and excessive nocturnal activity) or abnormal behaviors. The first type requires advice or resource material on normal behavior and learning principles so that the owner can ensure the pet's needs are being met, desirable behaviors are reinforced, and undesirable behaviors are prevented.
The second type requires a behavior consultation to determine the cause and prognosis, implement behavior and environmental modifications, and dispense drugs or supplements if indicated. The most common feline behavior problems involve elimination and aggression. Because aggressive encounters in cats may be subtle and passive, their frequency may be seriously underestimated.
For both prevention and treatment, it is important to meet the behavioral needs of the cat. Because a cat would normally spend time in hunting and feeding, exploration, social activities, rest, and sexual activities (which is reduced by neutering), cat owners should be advised on how each of these can be addressed. For example, cat food can be given in small portions throughout the day and placed inside toys that require some form of manipulation to release the food (batting, chasing, rolling). To add an element of hunting, the cat can be given opportunities to chase, pounce on, and bite toys that the owner dangles or pulls in front of the cat.
Play appears to be motivated by two mechanisms: an initial interest if the toy possesses appropriate characteristics (texture, small size) and rapid habituation. Owners should find a number of toys that interest the cat and play with several different toys until the cat's interest wanes. Cats may also be offered small toys for batting and chasing, boxes or containers to explore, and an occasional catnip toy (to which 50–75% of cats respond). Cat owners should also provide opportunities for climbing, perching, and scratching.
Teaching the basics of reinforcement-based training allows owners to focus on rewarding desirable behaviors (eg, where to eliminate, climb, scratch, or perch). Punishment should be avoided because it can cause fear and anxiety toward the owners or fear of handling and petting. At best, it will only stop the undesirable behavior when the owner is present. If all of the cat's needs are being met, the best approach to undesirable behavior is to prevent access to areas where problems might arise. Another alternative would be to teach the cat to avoid the area by making it unpleasant with a taste (eg, bitter apple), odor (eg, citrus), substrate (eg, upside down carpet runner, double-sided sticky tape) or perhaps a motion-activated device (eg, alarm, air spray).
Diagnosis and Treatment
Assuming all possible medical causes have been ruled out, a thorough history can help determine the cause, prognosis, and most appropriate treatment program. In cats, especially those with elimination and marking problems, it is particularly important to assess the environment either by visiting the home or having the owners diagram the home so that it can be determined how the environment affects the problem and how it might be modified to improve the situation.
Response substitution (training an alternative desirable behavior) can be a useful approach if the cat is reward trained with food or favored toys to respond to one or more simple commands (eg, come, sit). A leash and harness can be used as an aid in training as well as a means of preventing undesirable behaviors and ensuring safety. For fearful behavior, access to the stimuli should be prevented, at least in the short term. For example, if cats are fearful or aggressive with other cats or visitors, confinement away from the stimulus is an essential first step to ensure safety as well as to prevent further aggravation of the problem. This generally involves housing the cat in its own room with litter, toys, bedding, and food. When the cat is calm and comfortable, it might then be possible to introduce the cat using favored toys, treats, or food for counterconditioning during graduated exposure.
Drugs such as fluoxetine, paroxetine, or clomipramine, and natural products such as Feliway®, l-theanine or α-casozepine might reduce the level of anxiety for reintroduction. With inter-cat aggression, buspirone or a benzodiazepine might increase the confidence of the victim cat.
Before working on behavioral diagnostics and treatment, medical problems must first be ruled out, because any disease affecting urine volume, frequency, control, or ability to access the litter box can contribute to soiling. Evaluating the behavioral history is then the primary process for making the diagnosis, determining the prognosis, and developing a treatment plan. Important aspects of the history include whether the elimination is urine or stool, whether urine deposits are vertical (spraying) or horizontal (soiling), duration and frequency of the problem, signalment and temperament of the soiling cat, when and where the cat eliminates, litter box details (number, placement, cleaning, substrate, size), the cat's daily routine, and its home environment.
Urine Marking (Spraying)
Spraying is emission of a stream of urine onto vertical surfaces, usually accompanied by elevation and quivering of the tail and in some cases treading of the feet. Marking on horizontal surfaces (eg, owner's clothing, bedding, or countertops) is less common. Spraying is most common in intact males. Marking may be due to anxiety, such as might arise with changes in routine or schedule, the environment, or family (eg, addition or departure of people or pets, renovations, addition or removal of furnishings). Alternatively, marking may be a direct response to new or unfamiliar visual, auditory, or olfactory stimuli or may be a redirected behavior when the cat is unable to access the stimuli.
Treatment can include a combination of prevention, environmental modification, behavior modification, and medication. Providing more litter boxes, cleaning of the soiled areas with bacterial or enzymatic cleaners, and more regular cleaning of the litter box may reduce or eliminate marking in some cats. Neutering can reduce the problem in ~90% of intact males. Punishment is contraindicated as it increases fear and anxiety in an already anxious animal. The use of medications such as fluoxetine or clomipramine and/or natural supplements such as feline pheromones may also be necessary.
Soiling on horizontal surfaces with urine, stools, or both, occurs in males and females. Cats that consistently return to the same location or substrate may have a location or substrate preference. Cats that do not use their litter for urine, stool, or both may be avoiding the litter, box or location. A common cause of avoidance is any medical problem that might cause painful elimination, increased frequency, lack of control, or difficulty accessing the litter box. If medical problems have been ruled out or treated and the problem persists, the focus must then be on the behavioral history. Avoidance might arise because of aspects of the box (size, shape, hood), substrate (texture, depth, scent, cleanliness), or location that reduce appeal; unpleasant experiences at or near the box (eg, noises, pain due to medical problems, insufficient cleaning); or difficulty in gaining access to the box. Anxiety does not specifically play a role in soiling except when fear or anxiety-evoking events (eg, sounds, aggression, or threats from other pets or people) lead to litter box avoidance. Surface and location preferences may arise as a result of avoidance; however, some cats may be attracted to a particular odor, texture, or location.
Treatment should focus on providing a litter, box and site that is most appealing to the cat and reducing or preventing the use of soiled locations. This might be accomplished by blocking access to the area(s), using odor counteractants in the soiled area, making the area unpleasant, or keeping the cat confined away from the area (eg, small room, large crate) at times that it might soil. Cleaning the box more frequently, or changing the function of the location (eg, placing food, water, scratching posts, or play centers in the area) may decrease soiling.
Aggression Toward People
Aggression toward owners may be fear related or may be due to play or predation. Cats that bite during petting may have a low tolerance for physical contact, and some cats will bite to keep people from approaching or handling them when they are resting, sleeping, or eating (which may be a learned, fear, or social issue). Aggression may be particularly intense if the cat is approached when it is aroused. When the arousal is due to a stimulus to which the cat cannot gain access (eg, another cat outside, loud noise), the cat may redirect its aggression to any person that approaches.
Some cats display abnormal and out-of-context social responses including aggression when approached or handled. This may have a genetic component that is compounded by insufficient socialization, inadequate early handling, and fear-evoking or traumatic early experiences. However, at the time of presentation, most aggression will also have a learned component, because any unpleasant response on the part of the owner (eg, fear, punishment) will cause increased fear, while retreat of the owner negatively reinforces the behavior. Aggression toward strangers most often has a fear component.
Aggression Toward Other Cats
Cats may display aggression toward other cats due to play, predatory behavior, redirected behavior, fear, and perhaps as a status-related behavior in which cats use aggression to retain control of sleeping areas, common areas, or possessions. Ultimately, the relationship that develops between any pair of cats will be affected by learning because fearful responses by either cat can increase aggression, as will retreat of one of the cats (negative reinforcement). Aggression toward unfamiliar cats is most often a fear response but may have a territorial component.
Treatment of feline aggression is similar in principle and practice to that of canine aggression. The first step is to ensure that further injuries are prevented. Avoidance (physical, visual, and preferably olfactory separation of cats that are fighting) is paramount, and early intervention is best. Only after all cats are calm (which can take from a few days to several months), desensitization and counterconditioning with favored rewards can begin. Training one or both cats to wear a leash and harness can help to ensure safety and distance during reintroductions, while a bell on the aggressor can help the target to monitor its whereabouts. Providing more 3-dimensional space and sufficient resources can further decrease conflict. Punishment should be avoided as it increases fear and anxiety in cats. Drugs might also be indicated (see Treatment of Fears, Phobias, Anxiety, and Aggression).
Feline Compulsive Disorders
Feline stereotypic behaviors are derived from normal behaviors such as stalking, chasing, grooming, etc. These may be exacerbated by stress or anxiety such as alterations in relationships with humans or other cats, or may be inadvertently aggravated by the owners either reinforcing or punishing the behavior (increasing conflict and anxiety). If these behaviors occur out of context or in a frequency or duration in excess of that needed to accomplish the task, a diagnosis of compulsive disorder should be considered. Medical problems must be ruled out because they can be responsible for many of the same signs. For example, self-mutilation, excessive grooming, and/or self-directed aggression can be due to any condition that might cause neuropathic pain or pruritus such as adverse food reactions, atopic dermatitis, and parasitic hypersensitivity.
Cats that suck, lick, chew, or even ingest non-nutritive substances—including natural materials such as wool or cotton, synthetic fabrics, plastic, rubber, paper, cardboard, and string—may have a compulsive disorder if the problem becomes sufficiently frequent or intense; however, disease processes, in particular those that might affect the GI tract should first be ruled out. Oriental breeds develop pica, particularly sucking of woollen objects, more frequently than other cats. Hallucinatory and locomotory compulsive disorders are less common than in dogs; however, painful conditions and any disease process affecting the neurologic system first need to be ruled out.
Cats often improve with modifications to the environment that provide more control and predictability and increased enrichment, combined with medications that augment the amount of brain serotonin such as fluoxetine and clomipramine.
Hyperesthesia may not be a disorder but rather a sign of a wide range of underlying medical or behavioral problems. Most commonly the skin along the lumbosacral area may twitch or ripple. There may be excessive self-grooming, hissing or biting at the back or flank, and intensive tail wagging. Some cats cry, dash away, and even defecate. These episodes arise when the cat is highly aroused and may be incited by physical contact or external stimuli. A compulsive disorder is a consideration when the intensity, frequency, and duration of these problems is sufficiently severe. However, medical causes such as neuropathic pain, dermatologic conditions, myopathies, and complex partial seizures can also present with similar signs. Therefore, a therapeutic response trial for neuropathic pain, seizures, pruritus, or compulsive disorders might be part of the diagnostic process.
Fear may arise in cats as a result of genetic factors, lack of sufficient early socialization and exposure, or fear-evoking experiences. The fear may be of unfamiliar people, unfamiliar cats, dogs, noises, or places and situations such as car rides, veterinary visits, and unfamiliar environments. Some cats may also be fearful of familiar people and cats. This may be evidenced as threatening displays and overt aggression (see Aggression) or avoidance, withdrawal and hiding, and possibly spraying.
Treatment should begin with identification and avoidance of any situation, stimulus, approach, or handling that might lead to fear. When the cat is sufficiently calm, gradual improvement might be achieved with desensitization and counterconditioning. Drugs might also be indicated (see Treatment).
Aging and Cognitive Dysfunction
Aging and younger cats have similar behavior problems; however, the likelihood of a pathophysiologic underlying condition is higher in older cats. Many diseases, including those affecting the CNS, metabolic and endocrine systems (eg, renal disorders, hyperthyroidism), sensory decline, and pain (eg, arthritis), may present with behavioral signs. Once medical problems have been ruled out or treated, behavioral therapy may be required. Behavior problems in senior pets may be more difficult to resolve due to a decline in cognitive function, medical problems that cannot be entirely resolved, and drug contraindications or adverse effects.
Cognitive dysfunction syndrome (CDS) is less commonly reported in cats than in dogs. Yet in one study ~35% of cats >11 yr of age displayed at least 1 sign of CDS, and 50% of cats >15 yr of age showed ≥2 signs. Brain changes are similar to those seen in CDS in dogs (see Aging and Cognitive Dysfunction). There are currently no licensed drugs or diets for feline CDS, although selegiline and propentofylline have been used off-label and a number of supplements including Senilife® and Novifit® have feline label claims. Environmental enrichment and mental stimulation is paramount for the prevention and treatment of CDS.
Last full review/revision April 2012 by Gary M. Landsberg, BSc, DVM, MRCVS, DACVB, DECAWBM; Sagi Denenberg, DVM