Chapter 1 Introduction to Feline Behavior
The earliest known ancestors of the Felidae date back 45,000,000 years. Carnivores are believed to have shared at that time a common forest-dwelling ancestor: the Miacidae. The cat was derived from a later subdivision, the Dinictis. Approximately 8,000,000 to 10,000,000 years ago, the feline branch with the cat’s closest relatives separated from that which gave rise to the modern large cats.34,150,240 Today it is generally accepted that the modern cat, Felis catus, is derived from Felis libyca, the Kaffir cat (also known as the small African bush cat, African wildcat, and Caffre cat), which was numerous in Egypt at that time. The role played by the European wildcat Felis silvestris in the development of the modern cat is uncertain, although it is known to have separated from the other small cat branch before F. libyca.240 Some contend that F. silvestris (formerly called F. catus) was crossed with the Egyptian cat to produce the modern F. catus (formerly called Felis domestica), whereas others give behavioral, cultural, and physical reasons to refute this theory. Another theory is that the two wild types are actually subspecies (F. silvestris silvestris and F. silvestris libyca), because the domestic and wild variations have identical karyotypes.33,186 Molecular studies show a close lineage between the domestic cat and five wildcats, including F. libyca.34,150,240
Through the ages the human’s relationship with the cat has been a curious one. This relation, more inconsistent than that between humans and any other domestic animal, has nurtured the behavior of the modern cat. It is not known when the cat was first considered domesticated. What is recorded is that by 1600 bc cats were domesticated in Egypt.
In ancient Egypt the cat was originally kept to control rodents on farms and in granaries. Later, cats were also used to fish and to hunt and retrieve wild birds. The Egyptian word for cat, mau, means “to see.” As time passed, the cat came to be associated with religion. The belief that a cat could see into the soul is tied to the fascination with cat eyes.138 Bastet (also called Bast, Bassett), the cat goddess, daughter of the sun god Re, represented the fertility of plants and women, as well as good health (Figure 1-1). As Bastet became the primary goddess, the cat became a prized animal—legally protected, mourned over at death by the owner shaving his eyebrows, and mummified for burial in special cemeteries.
Spread of the domesticated cat occurred slowly, possibly because of tight export restrictions, which limited emigration to the individual cat’s own travels.10,186,213,248 Eventually merchants and soldiers introduced F. catus to Asia and Europe, so between 300 and 500 ad the cat is known to have reached Britain. Evaluation of water trade routes and feline populations shows that water posed no problem to migration. The orange genetic allele, which originated in Southeast Asia and India, can be traced as it moved westward.138 Therefore, the cats probably traveled by ship, coming and going as they pleased.225 In the Orient, cats were revered for their ability to foresee storms at sea and Mi-Ke (calico) cats ensured a safe voyage as symbols of good luck.138
Because Mohammed’s favorite animal was the cat, it has always enjoyed favor in Islamic countries. Islamic teachings include specific references to punishment for the harsh treatment of cats and other animals.54 However, Christianity’s treatment of this animal has had a more profound effect on its course of behavioral development. When first introduced into Europe, the cat was believed to have protected the Christ child in the stable from the Devil’s mouse.10 As time passed, the independent nature of the cat and its prominent eyes led to its association with Diana, the moon goddess (Figure 1-2).96 Legend says she created the cat to mock the sun god Apollo.10 This association of cats with the moon led to the connection of the cat with the Devil and witchcraft.62,207 During the Middle Ages, not only were vast numbers of cats exterminated, but the same fate was met by individuals showing compassion for them. As the European Crusaders returned around 1600 ad, they brought with them an invasion of the brown rat, the plague, and a gradual reacceptance of the only effective rat-control method—the cat. They lived in monasteries to protect manuscripts from rodents. As a result of monk preferences in type, color, and coat, certain breeds were established, including the Korat and Chartreux.138 Introduction into North America came in the seventeenth century, probably because the cat served as the principal method of rodent control on British vessels bound for the New World. Along with the cat, however, came the witchcraft cult.62
When Pasteur discovered microbes in the 1800s, people became extremely conscious of cleanliness. By another twist of fate, the cat came to be considered the only clean animal and was allowed in food markets, acquiring a position of favor by merchants.62,178
Domestication is a process requiring several generations of selective breeding to produce physiologic, morphologic, and/or behavioral changes.66,109 It is not known how long this process might take. In foxes dramatic changes occurred in 20 generations135,142; however, 24 generations in cats did not result in significant differences in the reverse process.231 For F. catus the domestication process has been unique. There has been recent discussion about whether cats may have undergone “self-domestication.” This is, humans played little or no role in the changes except allowing cats near them for a better chance for survival and reproductive success. It is more likely humans did play a role that gradually became more significant. Except for the cat, breeding during domestication of most animals had been done by selection of behavioral characteristics, which are more quantitative than qualitative.179 Response thresholds are heightened, and the resulting behavior is generally an increase in gentleness or ease in training. The cat, however, was first brought into the home for religious reasons, not utilitarian ones.120,241 Cats followed the urbanization of human populations, so mating was a matter of proximity rather than human selection.207,226 Not only was it difficult to control mating in cats, but the religious connotation prohibited selective breeding. The date given of domestication varies from 100 bc to as early as 7000 bc, but several infer that even now the cat is not fully domesticated because it can revert to total self-sufficiency.138,186 The time from ancient Egypt to the present may represent as few as 4000 generations with a constant infusion of genes from uncontrolled populations. Only the small group of purebred cats had true selective breeding,20 and these are mainly for physical features.93 The first recorded planned feline breeding did not occur until 999 ad at the Japanese Imperial Palace. It soon became fashionable in that country to control cat matings and environments. With cats under tight control mice devastated the silkworm industry, so by 1602 Japanese cats were again released from these controls.178
Although the cat fell from favor and met with mass extermination in Europe, selective breeding was of course not practiced. Even with the Crusaders helping its return to favor, the atmosphere was one of tolerance rather than full acceptance. Historically, then, it took many years before the cat achieved a position in which selective breeding could help develop the behavioral characteristics desired in a domesticated animal.
In recent years there has been a dramatic increase in the number of cats, especially registered cats, in the United States, partly because of their adaptability to apartments and small homes. Exact population figures vary greatly and are inaccurate because of the wild population, but it has been estimated that the cat population numbers from 23,100,000 to 61,000,000.* In the United States 23% of households have at least one cat.220 Sixty-six percent of cat owners have only one cat,222 but associated figures estimate 1.4 to 2.2 cats for each house having cats, or 1 cat in every 3.2 single-family dwelling units.† Of this cat population less than 80% are seen annually by veterinarians.‡
The modern cat’s lifestyle tends to fall into one of four categories: (1) feral, independent “wildlife,” totally ignored by people; (2) feral and interdependent free-roaming or unowned with dependence to humans limited to food; (3) domesticated, interdependent, and free-roaming or loosely owned, such as abandoned pets; and (4) domesticated household pets.138 Of this owned group, only 14% of the cats are purebred,197 compared with 61% of owned dogs.222 The population is also relatively young, with 11% younger than 1 year, 49% being 1 to 6 years, 27% being 7 to 12 years, and 10% older than 12 years.197,222
The number of stray cats has been estimated at between 2% and 28% of the known population.72,133,147 Whereas 415 humans are born every hour in the United States, 100 to 2000 kittens are born per hour.55 The significance of this is that at least 30,000 cats must die per day just to maintain a stable population. At the end of a 1-year period 18% to 30% of cats are no longer in their original home.125,169,196 After 3 years two thirds are no longer in their first home.
An excess population comprises those animals that are available and adoptable but for which no home can be found.224 Each year as many as 20% of a city’s pet population may pass through its animal shelter.173 An estimated 4 to 9 million cats die each year in these shelters.7,94,127,151,170 Of all cats euthanized in shelters, 18% to 33% die because of behavior problems.71,125,137,193,227 At least 28% of cats relinquished to animal shelters are there because of behavior problems.192 The top four problems cited include housesoiling, problems between pets, aggression toward humans, and destructive behaviors.192 Interestingly, the presence of at least one other pet in the home dramatically increases the likelihood of relinquishment for behavior problems to approximately 70%, a trend that has been especially true if a new pet was added during the preceding year.192
The surplus cat population is related to the cat’s reproductive efficiency and cat owners’ attitudes. Although most of the U.S. population believes that something should be done about pet overpopulation, most cat owners claim their own litters “just happen.”94 Half believe controlling reproduction is the pet owner’s responsibility, but a lot of ignorance remains about the necessity of neutering. People who relinquish cats to animal shelters are significantly more likely to believe a female should have a litter before being neutered and to be ignorant about the estrous cycle compared with cat owners who keep their cat.148 They also are more likely to believe that cats exhibit behaviors for “spite,” to not understand normal play behaviors, and to feel the number of cats in a home does not relate to the incidence of problems.148
In 7 years one female cat can be responsible for the birth of up to 781,250 kittens.127,151,224 In 7.9% of cat-owning households at least one litter of kittens is born during the year and most of those are unplanned.169 By the time a queen is 3 years old, 74.4% will have had at least one litter,125,129,196 and many of the females that do have an ovariohysterectomy have already had kittens.184 The highest cat densities are found in the same areas that have the highest densities of people—a source of food.184 The presence of these cats indicates that there is a niche that will support that approximate number of cats, so migration and reproduction help replace any permanent losses. Removal of individual cats increases population turnover but does not significantly alter the total number of cats.247 The large stray feline population may be reflected in another statistic: Only 38% of male cats are castrated and 31% of females are spayed,242 although local differences are reported.146
Worldwide cat ownership is increasing, often in parallel to trends in the United States. In several European countries, the numbers for cats increased so much that they now outnumber dogs, as did the percentage of homes owning cats.130
In addition to surviving a varied history, the cat has survived many types of owners. Cat owners have been classified in several ways by different researchers, but they tend to be categories for those who have a weak attachment and those who have a strong one.102,242 The classification “low involvement owner” is applied to 59% of the 14,645,000 cat-owning households in one study of pet owners.242 Another study called this group “pet dispassionates” and suggested it comprised 41% of pet owners.117 These individuals devote little time to the care or company of the cat and seem to enjoy having a cat around more than really interacting with it. The animal may be a companion for someone else in the household. This lack of involvement with the pet is reflected in trauma statistics. Of 126 cats (89 males, 37 females) reported injured over slightly more than a year’s period, 16.3% were hit by a car, 14.7% were involved in animal interaction, and 39.5% received injuries from causes unknown to the owner.108 Although the average age for the general population is 3 years, that of the neutered cat is 3 to 5 years longer, and that of the traumatized cat is only 1.3 years.22,108,242 This is despite the average life span for a cat being 12 years, with ages of 20 years or older not uncommon.35,218 The current longevity record is 36 years.243 One study of roadkills indicated that most were kittens or young adults.31 Because of these low involvement owners, cat populations for the most part still fulfill the criteria of random mating.203
A subcategory of the low-involvement group might include owners described as the “pet-for-child people.”117 This group consists of 29% of owners. Here the pet is considered to belong to a child; the adult is not highly committed to the animal but usually ends up being the primary caregiver.
The second classification of cat owners, those with a strong attachment, has been subdivided. “Quality or status conscious owners” represent 21% of all cat owners. The pet is an expression of how this owner views himself or herself and reflects his or her good taste, as would other material possessions. These owners feel that the cat depends on them for love, affection, and care, and as a result, the animal is well groomed and only reluctantly left alone.58,242
“High involvement owners” compose the second subdivision of the strongattachment category.242 These owners have also been called “pet lovers” and make up 20% to 30% of pet owners.117,242 Unlike owners in the other two categories, these individuals rely on the cat to supply love and affection or to serve as an emotional crutch, such as a child substitute. Attachments to the cat are frequently described as those to a human family member, friend, or child.1,67 These people feel the cat enjoys humans, feed it specially prepared foods, have photographs of the pet, take it on vacation, and may celebrate the cat’s birthday.67,222 They estimate spending more than 3 hours a day with the animal, particularly on the weekend.177 Owners from this group are most likely to bury a deceased pet in a pet cemetery or mausoleum or to leave an estate to their cats. Just this kind of owner made two cats worth $415,000 in 1965 the richest cats in history.58,242
Cat owners with a strong attachment to their pets are often in the middle and upper socioeconomic levels and will spend billions of dollars each year on their pets. These individuals have a higher percentage of neutered cats and a preference for lighter-colored cats.32
Pets take on many roles in society, and these roles change as the needs of civilization change. Although individual animals can be shown to be unique, all cats are a product of species-specific characteristics.56 Reasons people have cats vary, but most people indicate that personality and appearance are important features.176 The cat still controls rodents, but closer contact with humans is now adding new dimensions of purpose. As a research animal, the cat has become invaluable for studies of aggression, neurology, anatomy, ecology, and aging.
Developing children derive significant benefits from having a pet, and the cat has long been important in this regard. The animal can assume different roles during a child’s maturation. A child may relate better to pets than to adults and with this friend may be better able to work out many of the normal problems of childhood. Caring for a cat teaches a sense of responsibility to the child, and watching the cat’s normal body functions results in self-understanding and a respect for life. The cat also provides companionship. Motivation for learning and creativity is also stimulated by a cat’s presence.58,121,123,219 Even the painful process of the death of a beloved pet can help prepare a child for the future loss of loved ones. It has been shown that especially in boys, and to a lesser extent in girls, interest in pets tends to decrease sharply when adolescence is reached.116,120,121
Cats and other pets are assuming an increasingly important role in maintaining the mental health of our society. The fast pace of modern civilization tends to isolate humans from each other, and the animal may be the only constant factor in a person’s environment to help maintain psychologic equilibrium. For most owners, a cat provides companionship, something to care for, motivation to exercise, and a feeling of being needed and safety.69,222,246 The role a pet plays within a family often varies with individuals. For a wife, petting the cat may represent affection for a child substitute or a safe expression of desire for sexual sensations, whereas the pet may represent an object of ego expression for the husband.63,121 The important role of emotional support has been documented for widows during the first year after the loss of their husbands and in cat owners in general.229
Serving as a catalyst and facilitator of human relationships, the cat has been especially helpful to the elderly and the young. The role of a dependent may be difficult to accept by an individual in either age-group, and the cat, as a subordinate, can boost the person’s self-esteem.40,118,122 The psychologic health of cat owners is significantly better than that of nonowners in terms of general responsiveness and being in touch with reality.246 To the elderly, cat adoption increases life satisfaction and occasionally has health benefits too.246 To an individual, a pet may serve as a living memory of a deceased spouse. Widows tend to preserve this memory at all costs, whereas widowers often destroy guilt-laden reminders of the past.120,122 Although it is generally believed that relationships like loving a cat promote good mental health, a minority opinion has been expressed that attachment to a pet is a symptom of alienation toward other humans.27 This is probably true in cases in which the attachment is pathologic.
Use of the cat has increased in psychotherapy sessions to stimulate communication, provide an object for affection, and allow the patient’s mastery of a situation. Cats have also been prescribed for home therapy, working 24 hours a day to draw individuals into an awareness of their surroundings or provide affection and emotional security where it might be lacking. Therapy in institutional settings for the emotionally disturbed and mentally retarded has also received a big boost when cats are part of the settings, because the animals increase the effect of the professional staff and provide continuity during staff turnovers.119
Pets often reflect the psychologic state of their families, even to the point of taking on the same neuroses as the family.215 The animal may receive the abuse that a parent would have otherwise directed toward the child or the abuse from a child mimicking his or her parents.77,87 The relationship between criminals convicted of having committed violent crimes and a childhood history of animal abuse is well documented. Even the cat’s name may indicate its role to the family. “Ugly” or “Shorty” may represent the low regard the owner has for the animal, whereas human names may be indicative of a peer ranking. In a study of cat owners who used veterinary services, 52% of the owners gave their cat a human name and another 26% had chosen a pet-related name.4 Nicknames were used by 56% of the owners.3
The veterinarian is in a unique position in the owner-pet relationship. He or she is privileged to be trusted with helping keep the cat healthy and to be sought out by 71% of cat owners for feline-related information.222 The increasing use of the cat as a mental health tool forces such patients into an increased dependency on the veterinarian, which necessitates the veterinarian’s awareness of human behavior, including methods of communication with affected individuals. In this regard, a special facility has already been established to study the human-animal interrelationship.128 There will also be the added role for the veterinarian of helping in the selection of pets, so he or she must be aware of characteristics that make each animal desirable or undesirable for a particular emotional or physical need.11,12,111,118 There are risk factors for cat relinquishment that can be changed through veterinary interactions with clients. Included in these are (1) owners who have specific expectations, (2) cats that can go outdoors, (3) sexually intact cats, (4) owners who never read a book on cat behavior, (5) daily or weekly bouts of housesoiling, and (6) inappropriate care expectations.170
If the trend toward pet dependence continues, if civilization continues to gather in suburban areas, and if pets take on neuroses from family members, then the veterinarian will have to be able to treat more and more abnormal behaviors in their feline patients. Although almost two thirds of pet owners believe their pet is well behaved, as many as 82% of cat owners will mention a specific behavior problem if asked.174 Problems most commonly cited are anxiety, clawing furniture (15% to 20%), climbing on furniture (16%), housesoiling (10% to 13%), bringing birds or mice into the house (8%), fighting (6%), biting people (6%), and destroying items (5%).86,174,222 As significant as the numbers and types of problems is the report that 24% of cat owners have not tried anything to stop the behavior and 68% have not resolved the problem.174
Each animal species has certain behavior patterns that are genetically programmed into all individuals of that species. These are the behaviors that are discussed throughout this book—behaviors that have resulted in F. catus through years of evolution. Individual variations resulting from environmental alterations are so inconsistent that they are essentially meaningless. To evaluate any behavioral problem, the veterinarian should decide whether the behavior pattern is objectionable to the owner but normal to the cat or whether it is both objectionable to the owner and abnormal for the cat.76 Fortunately, euthanasia is no longer the only alternative for a cat showing abnormal behavior.
There is a serious lack of knowledge about animal behavior on the part of pet owners leading to misconceptions about the behavior and inappropriate ways to resolve it.86,170,193 A behavior problem is often a “terminal disease,” so being able to help an owner can be important to saving the animal’s life.237 Prevention of a problem is usually easier than eliminating one, making the first kitten visits the most important. The entire veterinary staff should be educated about how to help new cat owners get started correctly. Handouts, books, and videotapes are good client education materials. Services that a clinic can make available to clients include preselection consultations, preventive behavior counseling by either the veterinarian or the veterinary technician, client education during “kitty kindergarten” classes, and preventive management products.111
Even with careful preventive measures, behavior problems can occur. One third of cats relinquished to animal shelters are there because of an unacceptable behavior.193 The risk is greatest for cats younger than 6 months, those that were free to the owner, those that are a mixed breed, those that spent most of the day in a basement or garage, those that had behavior problems, and owners who had sought behavior advice but did not try it or found the advice not helpful or impractical.170 Slightly more than half of pet owners have or would discuss a pet’s problem with their veterinarian.2,3,245 To help clients a veterinarian can first learn how to treat some of the most common behavior problems and gradually add others over time. Consulting with board-certified veterinary behaviorists or referring patients to them is an appropriate service for those more complicated cases. Housesoiling, damaging furniture, and aggression (particularly redirected or irritable aggression) are the most common problems.2,103,244,245
Behavior problems can be quite simple in their origins, such as pain-induced aggression when the cat’s tail is pulled, or they can be very complex, as with aggression resulting from abnormal neurotransmitter function. On the surface both behaviors appear the same. Only when we can understand the causes at all levels will we really understand these problems (Figure 1-3), and that still remains a future goal. Appropriate workup of a behavior case requires the establishment of a veterinarian-client-patient relationship to obtain all pertinent information. Although histories are important, information from appropriate physical examinations, including neurologic and orthopedic examinations, as well as interpretation of laboratory and special examination results, must be included in diagnostic considerations.
Figure 1-3 Levels of “causality.”
(Modified from Overall KL: Understanding repetitive, stereotypic behaviors: signs, history, diagnosis, and practical treatment. Paper presented at American Veterinary Medical Association meeting, Pittsburgh, July 8, 1995.)
Several methods can be used to classify feline behaviors, with the simplest being to determine whether the behavior is normal or abnormal and acceptable or unacceptable.15,17,106,239 Normal behaviors are those that are species specific. They may or may not be appreciated by the owner. Furniture scratching and urination (even outside the litter box) are examples of unacceptable normal behaviors. On the other hand, abnormal behaviors are those resulting from learning or from pathophysiologic processes. Psychogenic grooming and hypothyroid aggression would be included in this category. Not all individual cats will develop a behavior problem, much less the same problem behavior in the same environment. Environments are often blamed for stress or anxiety but serve to demonstrate that the threshold between normal and abnormal varies among individuals.44
Classification of behavior problems can also be done by the signs shown by the cat—descriptive classification. This scheme is currently the most often used because a problem generally falls into one of several categories. Examples include housesoiling-urination, excessive vocalization, and furniture scratching. Descriptive classification does not account for multiple causes of the same sign. As an example, “aggression” does not distinguish between fear-induced, intermale, and epileptic aggression.
Functional classifications are the most specific because they take environmental and physiologic factors into consideration. The list of specific problems becomes very long and difficult to keep in mind.17 Functional diagnoses can relate to a stimulus-response relationship such as separation anxiety; disease, as in seizure-induced aggression; physiologic states such as fear-induced aggression; or other factors such as genetics or developmental conditions such as malnutrition. From a clinical approach it tends to be most useful to minimize the number of major categories by using signs and to put a functional diagnosis as a subcategory.
Feline behavior problems can be broadly classified by function into four categories.14 Although these four categories could be applied to any animal, the frequency of each category varies among the species.
The largest factor causing primary problems for the cat is stress or “frustration,” which can be expressed in many forms for many reasons.9,144 This is the largest category of behavior problems and one receiving a lot of attention recently because of drug therapy. Even with all the current attention on psychopharmacology, behavior modification or environmental change to manage the stress can still be successfully used with or without drugs. In fact, drug therapy alone is generally not sufficient or long-lasting without environmental change or behavior modification. All animals are creatures of habit, and unless a change is gradual, a break in routine can be very upsetting. The introduction of a new pet or family member, inconsistent punishment, a change in litter brands, or a lack of proper exercise will result in increasing tension. Reactions vary between individuals and within individuals at different times. Unfortunately for the cat, as for other animals, there is no normal innate pattern for the release of these stresses. Because frustration cannot be reasoned away by the animal, the resulting behavior is a normal pattern expressed in an inappropriate situation. Examples include urine marking, housesoiling, aggression, or a psychosomatic condition. The cat is still relatively independent of humans; however, as society asks that F. catus change, particularly relative to close social interactions with humans and other cats, the number of behavior problems will rise.
Socialization is a process by which an animal learns to accept certain animal species, including its own, in close proximity, and it occurs most easily during a limited time span. Improper or inadequate socialization of a cat during its first few months of life can result in an individual that does not relate socially to other cats, the family dog, or people. The animal is handicapped in a social situation that is normal for most families and undergoes a great deal of stress if forced into such a situation.
An animal’s genetic makeup will affect behavioral inheritance. Fortunately, the cat’s history has been good in one respect: Genetic behavioral problems are minimal. For this species, the minimal use of selective breeding has allowed it to maintain a diverse gene pool. Only 7% of cats are pedigreed as compared with 51% of dogs, indicating that human intervention is still minimal.65,242 As cats undergo an increasing amount of selective breeding, the chances are good that the primary consideration will be for physical characteristics, not behavioral ones, as has occurred with dogs. This fails to produce cats that can better tolerate changes in society.
Abnormal behavior in a domestic animal is usually a result of an organic state of neurologic or systemic origin. An owner takes the cat to a veterinarian because of an observed change in the animal’s behavior, such as sneezing, lameness, or depression. The statement that “they just aren’t acting right” shows the importance of behavior to an owner relative to the animal’s overall health. Medical problems from leukemia to fever can present this way. Generally, a physical examination and some laboratory data are sufficient to provide a diagnosis. Just as frequent urination may indicate urinary calculi, interstitial cystitis, renal problems, or litterbox aversion, aggression may indicate thyroid dysfunction, local pain, generalized discomfort, or central nervous system abnormalities. In some cases it is easy to remember to connect a behavior and medical problem. Other times the medical relationship becomes a diagnostic challenge. Using the degenerative, anomoly, metabolic, nutrition/neoplasia, infectious/inflammatory, trauma/toxin (DAMN IT) scheme to consider differential diagnoses, every category has medically based conditions that must be included as causes of abnormal behavior.112 Although not always the highest priority in a differential list, medical problems should always be considered. Much is still unknown about abnormal behaviors related to medical conditions, but there have been significant advances.
The signalment and name of the cat can provide useful hints about particular behavior problems. As an example, inappropriate urination in a young cat is more likely to be related to a box that is remotely located than it is to diabetes. Intact tomcats spray urine significantly more often than castrated males, and Persians have a higher incidence of litterbox problems than other breeds. The name is interesting too because derogatory ones can indicate a negative attitude toward the cat and a higher probability of treatment failure.
For most behavior problems, the majority of information about the case will come from the history, so its importance cannot be overemphasized. The goal is to obtain an accurate description of all important aspects of the problems, including relevant information about the pet, the associated humans, and the environment.97,235,237 It is also important to identify the immediate consequences, developmental factors, and other related problems that may be present.238 The initial history-taking session, especially for chronic problems, will take more time than one for most medical problems, but it is crucial to the ultimate understanding of the behavioral complaint. Schedule an appropriate amount of time to devote to this owner and charge for your time.
One format used to take a behavioral history utilizes a list of specific questions, which can be useful to shorten the time of the initial assessment. A history form is one way to ensure that all pertinent data are obtained.15,97,105,163 Some owners prefer an open format in which the owner discusses his or her perspective first, followed by additional questions to fill in missing information. This necessitates that the veterinarian organize the information somehow.85 For the recently developed but less serious types of problems, the practitioner may be able to use a fairly structured questioning style. However, for the problem typically seen in a referral setting the owners want to describe the problem as they see it. Sessions should be structured enough so as to not miss important information, yet flexible enough to bring out the unexpected.97
The writing of the history for the patient’s record can tax even the fastest note taker, but this technique gathers a lot of information that might otherwise be missed, ensures the owner of the veterinarian’s interest in the pet, and helps the owner focus on specific events when more specific questioning follows. The history should include where the owners got the cat and if they know anything about its parents. Then fill in the details of its life history up to the present day. Some choose to ask about the latest episode first.45,235 Others want the descriptions to occur in the order of occurrence. Questions during the owner’s narrative can be asked but usually just for clarification of a point or two before the owner continues. After the owners have completed their segment, it is appropriate to ask for more details about specific episodes.235 A rating scale can help quantify the seriousness of various episodes to the owner.90 It should also be noted that different owners may have different perspectives about the problem or memories of the events. For this reason all the people involved should be present for this visit if possible.45 Owners may also use incorrect terms for an event, such as spraying for inappropriate urination, so be sure they describe the specific behaviors and not just give the perception of what happened or why.97
Four general questions should be answered in any history-taking session—what, where, when, and when.13,15 Based on the answers to these questions, many more specific questions help focus on the total scope of the problem.
This question should be first and may help determine whether the cat is clawing the furniture, spraying the house, or refusing to eat. Although the problem behavior is usually easy to define, “doing it all over the living room” will require multiple questions to actually define the “what.” The history may also reveal other maladaptations of which the owner is unaware or to which he or she has already adjusted.
For some behaviors, the where may be a simple answer such as on the Oriental rug in the dining room or on the owner’s ankle. Many times, however, the answer is “all over the house.” Careful questioning will often narrow down the location to one or two spots. To the owner the smell of urine or feces may be “all over” when the actual site of elimination is limited to one corner in the dining room.
The answer to where can also provide insight to causes. Events restricted to one area may indicate that a stressor is located nearby. The cat spraying near a window may be taunted by a neighbor cat that walks on the window ledge or that can be seen walking outside that window. Defecating next to the litter pan may indicate that a new type of litter is unacceptable to the cat.
This question is designed to determine how longstanding the problem is. For example, a 4-year-old cat that never used the litterbox will probably not start just because the owner is getting new carpeting. The “when did it start” questions might also help tie the start of a problem to another event occurring shortly before it. Acquisition of a new pet may initiate marking behavior by the resident cat, or aggression to the owners could begin after the birth of kittens. The length of time a problem has existed also helps from a prognostic standpoint of how long it will take to correct the behavior.
Many behavioral patterns have a precipitating event, such as aggression that occurs when the neighbor child pulls the cat’s tail. In this case the problem is associated only with the child’s presence. If an event occurs only while the owner is away, perhaps a friend or neighbor could be asked to see whether the event is occurring just after the owner leaves, throughout the owner’s absence, or immediately before the owner’s return. Some problems occur at certain times of the day. Others are related to either the presence or the absence of the owner. Additional information under this “when” heading will include frequency and duration of the average bout.155 Knowing the schedule of the cat and the owner helps put this information into perspective, and may explain variations in the pattern of frequency and intensity.155
Another important part of the history is to determine what the pet’s owners have already tried45 and how they went about it. The knowledge that a specific therapy has already been appropriately tried means it need not be done again. In some types of problem cases, it can also help rule out certain things on a list of differential diagnoses. If a therapy has been tried but was not done for an appropriate length of time or compliance to the accepted protocol was poor, that therapy can be tried again with emphasis on the correct methods.
After a complete history is obtained, the next step is a thorough physical examination. As is normally done, the animal is evaluated from body weight to temperature, respiration, and pulse. The abdomen is palpated and thorax ausculted. Particular emphasis may need to be placed on a neurologic evaluation, health of the eyes, musculoskeletal evaluation, skin lesions, and anal sacs. Physical problems should be noted and evaluated in the total context of the problem. Medical conditions can be common risk factors in cats presenting with behavior problems.15,98,143,167 Medical conditions usually must be considered in the list of differential diagnoses for various problems, as is shown in later chapters. Common sense is also necessary during an examination. Every practice has its very aggressive cats that cannot be carefully examined and a behavior practice seems to collect more than its share. Because the highest priority must go to human safety, it may not be possible to do a detailed physical examination on every animal.
With a behavior case the physical examination becomes broader in scope. It includes how the cat interacts with other cats, new humans, and the hospital environment. Subtle cues like excessive alertness, crouched postures, aggression toward anything that moves, tail and ear postures, owner-cat interactions, abnormal gait, and reluctance to break eye contact provide a wealth of information that complement other physical findings. Allowing a nonaggressive patient to roam the examination room can provide insight about how the animal behaves and how the owners react.45
Information from the signalment, history, and physical examination allow the problem to be narrowed to a list of differential diagnoses. For behavior problems, the list of differential diagnoses often combines medical and behavioral problems. For example, a list of differentials for a cat urinating in the house could include feline lower urinary tract syndrome, urinary tract infection, kidney disease, diabetes mellitus, diabetes insipidus, hyperadrenocorticism, psychogenic polydipsia, unavailability of access to normal eliminative locations, marking behavior, and separation anxiety.
In performing the workup for a behavior problem, the veterinarian will use selected clinical tests based on the differential diagnoses chosen. Disease-related causes of behavior problems may require that additional information be obtained through special tests, or the tests may be needed to be sure a certain medication is appropriate. A complete blood count, biochemical profile, and urinalysis are the most commonly used of these tests. They are appropriate for the geriatric patient, particularly one presented for housesoiling,98 or one to be placed on any of the human drugs currently used as extra-label treatments. Other tests for feline leukemia, feline immunodeficiency virus, or thyroid hormone levels might be appropriate. Radiographs with or without special contrast media, ultrasonography, electroencephalograms, electroretinograms, fundic examinations, cystograms, nuclear scans, computed tomography, and magnetic resonance imaging are needed in certain cases.
As with traditional medical problems, diagnoses can be ruled out based on the test results, with a resulting shift of the rank on the differential list. The veterinarian and client can work together to determine how far to look into a problem and in what order.
As with any medical condition, a behavioral diagnosis is determined after considering all the information gathered. The most commonly used diagnostic approach is a mixture of classification schemes. For example, separation anxiety is functional, but the urination, defecation, and prolonged sucking are descriptive. An appropriate course of therapy can be prescribed only after a diagnosis is made.
Owners want to know the prognosis for the behavior problem and how long it will take to be “cured.” Before a prognosis can be given or even a therapeutic plan devised, the veterinarian must determine the level of owner commitment.97,113 For that it is helpful to ask each person what his or her feelings are about the cat235 and what his or her goal is for the behavior program. If the therapeutic plan will involve a major commitment of time and effort, the owners need to know that up front rather than figure it out as they become discouraged. The more that is expected of the owner, the more difficult it will be and the more likely it is to fail.154 They must be both willing and able to make the program work.113 Several things have an impact on the prognosis of behavior therapy, including the etiology, duration, predictability, and type of problem; experience with the problem; danger; owner perception; owner compliance; ease of treatment; owner expectations; and response to therapy.25,154 In assessing the cause, the veterinarian knows that the easiest to treat will be normal behaviors or simple learned ones shown by an individual. The toughest will be the abnormal, complex unlearned problem involving several animals.
Etiology is important. Untreatable medical causes of behavior changes, such as feline leukemia, have a poor prognosis. A simple change like cleaning a litterbox more often usually means a happy ending.
The duration of the problem is often related to how long it takes to treat the problem. This is especially true when learning is involved, because the animal will have to unlearn the unacceptable behavior and relearn the normal behavior.
Patterns of a problem can affect the outcome of a treatment program. If an occasional problem can be predicted because of a cofactor, removing the relationship or changing its context can be helpful. Feces that is only on the carpet Wednesday, Thursday, and Friday suggests the box is cleaned on Saturday. The cat is willing to tolerate a few days of buildup but after a few days the odor is no longer tolerated.
The type of problem dictates how treatable the condition is. Certainly past successes dealing with similar problems gives the veterinarian a better chance to be successful and a better prognostic perspective. Also, the more simple the solution, the greater is the likelihood of an acceptable outcome. When owners become fearful, as often happens with aggression, they may never trust the cat again even though the actual type of aggression would otherwise be treatable. Client and public safety is a factor that must be considered, and euthanasia may have to be the only “treatment” that is appropriate.
Assuming a correct diagnosis is made, individual variation can affect an outcome, as can owner compliance. When the therapy is a pill a day, compliance is reasonable. The more involved a behavior modification plan becomes, the lower the overall success rate will be. Owner expectations are also important. Some people are grateful for a small improvement, but others expect miracles overnight.
For behavior problems case follow-up is important. Recheck visits or phone calls help confirm that the therapeutic plan is progressing as expected. They reassure the owner that the veterinarian cares and provide an extra incentive to keep up the effort. Following up with the owner also provides an excellent learning experience about responses to various therapies to increase the level of expertise for the various types of problems.
Once a diagnosis has been made for a behavior problem, an appropriate therapeutic regimen must be designed. Owners commonly want a magic pill or ultimate solution. Everyone wants a quick fix, but in the real world this seldom occurs. Primary influences on behavior include genetics, the environment, physiology, and experience.237 As a result, behavior treatments can consist of drug therapy, behavior modification, client education, environmental manipulation, or some combination. Drug therapy alone is often unsatisfactory over the long term,83 unless the main problem is primarily medical, such as hypothyroid aggression.
Because one category of cat-owner interactions can be normal behavior that is unacceptable to the owner, the veterinarian is often required to educate the owner about what is normal for a cat. An animal cannot change a normal species-specific behavior, so the owners may have to change their expectations or find an alternative that allows both to have their way.152 If a cat grooms itself at night, the owner may complain that the “slurping” noise is too loud. Because it would be difficult to get the cat to change its behavior, other alternatives may be acceptable. Some owners would learn to ignore the sound once they learned they could not make it stop. Others would not be willing to tolerate the noise and choose to keep the cat out of the bedroom. Teaching the client about what is normal for a cat provides a client service that can be particularly valuable as preventive and therapeutic.
Changing a behavior usually involves changing the environment too.28 This requires client education about how to make the necessary changes. It could mean it will be necessary to remove a chair that is the frequent target of clawing or change a time schedule for interactions between owner and cat. In any case, owner compliance will be dependent on good client education.