Psychology and Physiology: Does Your Cat Also Have a Medical Issue?
“Speak English! I don’t know the meaning of half those long words, and I don’t believe you do either!”
—The Eaglet, Alice in Wonderland
CATS’ BEHAVIOR IS A PRODUCT OF THEIR GENES, THEIR ENVIRONMENT and social development, and their health. Many behavior problems are medical in origin and should first be treated by a veterinarian. But even medically related behavior problems should be referred not just to a veterinarian but also to a cat behaviorist (or this book). In my experience with thousands of clients and their vets, vets are great at dealing with medical problems, but they are rarely as successful at dealing with behavior problems, particularly those that have become habitual. Let’s look now at your cat’s physical health and behavior and the intersection between them.
Good Veterinary Hygiene
Did you know that cat owners take their cats to the vet less often than they take their dogs, not to mention less often than dog owners take their dogs? In fact, over the last two years, the disparity has gotten even worse. I recommend that you take your cat to a vet for medical checkups and teeth-cleanings as often as your vet recommends, but at least once a year, and certainly any time your cats begin to exhibit any unwanted or abnormal behaviors.
One possible reason that people don’t take their cats to the vet as often as they probably should is that cats hide their illnesses more effectively than dogs. For example, it’s been estimated that nearly a third of cats over the age of eight suffer from painful arthritis, but you’d never know it. Cats don’t show it by limping, as dogs or horses do. Cats rarely even vocalize their pain; in fact, if they’re not feeling well, they may even purr, because purring can be a form of self-soothing. Although a cat may also signal an illness by a sudden unwillingness or inability to jump or eat, or by sleeping more, and playing and hunting less, other signs that something is wrong—say, sudden aggression, spraying, or inappropriate elimination—may be misunderstood as signifying behavioral rather than medical problems. Hyperthyroidism, for example, is just one of many possible physiological causes of aggression. And I can’t tell you how often an abscessed tooth has been to blame for all the cat fights within the home.
When was the last time your cat had a dental exam? The stress of a painful tooth or sore gums can transform the dynamics of the entire household—and not for the better! Poor oral health leads to pain or discomfort, which leads to stress, which leads to tension among cats.
Original Medical Causes Versus Habituated Behaviors
Because unwanted behaviors sometimes have a physiological basis, among the first actions you should take to cure behavioral problems is to make sure you’ve identified and dealt with any medical causes. For most of the behavior issues in this book, I’ve included a sidebar called Medical Alert, which will give you an idea of possible medical causes you should consider consulting a vet about.
A visit to the vet will usually reveal any medical cause, and lead to effective medical treatment. However, as successful as that treatment is, it may not be able to change any behavioral habits that formed in response to the medical problem. The unwanted behavior now has another, separate cause: It’s become habituated. For example, I often work with clients whose cats’ urinary tract infections or crystals were cleared up prior to the owner consulting with me. But the cats are still urinating inappropriately because (1) they have associated the litter box (or substrate or location) with the past painful urination, and (2) they’ve developed a habit of urinating somewhere else, like on the sofa. Both association and habit can develop very quickly, resulting in a preference for a new location and a different material.
Our goal in this book will be to make sure you remedy both the original, medical cause of the behavior problem with your vet, and the habituated and environmental causes, all while we undo any negative associations and attract and retrain your cat to more desirable behaviors. Perhaps you can now see why one-note remedies, such as curing a urinary tract infection or adding more litter boxes to your home, are often insufficient.
Another possible catalyst for undesirable habits that aren’t medical in nature is psychological trauma. If you yelled at or spanked your cat near her litter box, or forced her into it, she may associate the litter box with the painful or negative experience of your anger. Here, too, we must reverse an ingrained association.
Better Living Through Chemistry? Don’t (Automatically) Drug That Cat!
Let me say, up front, that psychoactive drugs can save cats’ lives and work where nothing else does. Sometimes it’s the most responsible and even humane decision. However, I am concerned here with over-prescription of medication for normal and easily solved cat behavior issues. Just as pediatricians (sometimes with the complicity of parents) may overprescribe ADHD drugs for kids who are just, well, being kids, cats are often overmedicated for exhibiting natural and easily solved behaviors such as spraying or clawing.
To a person who loves cats, the results of unnecessary medication can be tragic. An unnecessarily medicated cat is a cat that may lose its catness. Go to your medical vet or a vet behaviorist, but go armed with empowering knowledge. While psychoactive drugs have a useful place in solving some behavior issues, there are a number of reasons to adopt a more skeptical stance toward medication than most cat owners do.
First, depending on their application, even the most effective medication for your cat’s behavior issue may have a success rate of only 50 percent or so. The most effective medications for spraying, for example, have success rates of around 75 to 90 percent1—a lower rate than I achieve. (And that’s assuming that the medication is actually the right one. It may take several trips back to the vet, either to modify the dosage, or to find a different drug that works better than the first one that was prescribed.) My clients who have been medicating their spraying cats are usually able to use my methods to remove the underlying cause of the spraying and take their cats off the medications.
Second, even when drug therapy works, it usually works only as long as the animal is medicated. (One exception is when medication has been used to defuse cat-to-cat social conflict; the results may be lasting.) For example, cats who are put on and then taken off medication for spraying tend to resume spraying at rates of 75 to 95 percent.2 Without a behavior plan, your cat may revert to her unwanted behavior once you stop the medication.
Third, medications may be prescribed in error. I’ve seen many cases in which a vet, sometimes pressured by the cat owner, prescribed an antianxiety medication (like most cat drugs, one first sold to humans) for a behavioral problem—while, ironically, overlooking the underlying medical issues for the problem, such as a bladder or kidney stone.
A VET’S VIEW: DRUG THERAPY FOR CATS
Dr. James Shultz, DVM
For about the first ten years of my career as a small-animal veterinarian I must have counseled thousands of pet owners on canine behavioral issues. For these clients the options were almost endless. Dog trainers, behaviorists, puppy whisperers, and animal psychics, all at their disposal and ready to help. Group training, individual training, in-home training, and doggy boot camps that would last three or more months and most certainly cost as much as a small SUV were the norm. Then there were the products: citronella collars, shock collars, spiked collars, pinch collars, tracking collars, muzzle leads—the list went on and on.
But what about cats? Cats were a whole other story. Clients would come in frustrated. Like most vets I know, I was not trained in cat behavior, but I did my best: We would rule out any purely physiological cause and then try a few things like changing the number and location of the litter boxes, changing the substrate in the box, and maybe we’d try enriching the cat’s environment with a few toys. If none of this worked, the cat owner had but a few options: make the cat a “barn cat” or “outdoor cat” or try one or more medications. Since few if any behavioral medications are specifically designed for cats, it usually meant trying a human medication on the cat and then trying to find a dose that worked.
These medications worked about half the time, to some extent. In a few cases they made all the difference and the owner was elated, and so was I. Too often, though, there were problems, and lots of them. To start, how do you get cats to take the medication? We tried pills, tuna-flavored liquids, flavored treats containing the medication, and even transdermal gels. And not always successfully.
Then there was the cost. Nearly all of the cases treated, if successfully managed with medications, were only managed while the cat was medicated. In other words, there was no way to get the patient off of the drugs. On top of this, clients were reporting that not only were the medications lightening their wallets, but that there were other unwanted side effects as well. Even on some of the newer drugs, clients would note that the cat had lost his or her “personality” or seemed “out of it” most of the time—side effects not that different from those noted by humans taking these medications. (Note that with some medications it is common for cats to seem dazed for a couple of weeks, but once their bodies adjust to the medication, they often seem to normalize.) Since cats don’t metabolize these drugs in the same way as humans (for whom the drugs were originally designed), it makes sense that undesirable side effects would be common.
Some variation on the above treatment plan was basically how we treated these cases until we met Mieshelle. What was so exciting about her methods is that she could consistently identify and correct the underlying cause of the unwanted behavior. This meant in most cases usually no medications were required at all, and when we did utilize them in conjunction with her methods it was only for a short period of time. By identifying the cause of the unwanted behavior (example: spraying), Mieshelle resolves the problem for the life of the cat, without the need for long-term medications, and without banishing your cat to the garden shed forever.
All that being said, there’s no question that drugs are sometimes not only helpful but necessary, and even lifesaving. And sometimes drugs must be used when the problem has no medical basis but is as purely behavioral as it’s possible for a problem to be. Imagine a cat that presents a danger to himself, another cat, or a person. Medicating a cat under those circumstances is certainly a better solution than abandoning or killing him.
But for problems that have no medical basis, I firmly believe that we should explore natural solutions before resorting to drugs. Based on my experience and a high success rate in solving unwanted behaviors through behavioral techniques and environmental modification alone, I believe most medication of cats with unwanted behaviors is unnecessary. It makes no sense to drug a cat against anxiety when the source of the anxiety can be easily spotted and removed from the environment. Medication is rarely enough by itself. There’s a reason the behavior started to begin with, and it wasn’t because the cat was missing Prozac in her diet. Just as a cat behaviorist should not hesitate to recommend the services of a veterinarian when a cat appears to have a medical problem, I consider it unethical to medicate a cat for a behavioral problem without first seeking behavioral expertise.
Now, are you ready for some fighting? We’ll start with a common and challenging behavior of cats: aggression.