Aggression in cats is a complex problem that requires open and honest client communication and an understanding of when medication should be part of the treatment plan.
Cats are notorious for their aloof demeanor and sometimes feisty behavior. Most veterinarians can likely recall some of the more memorable feline patients that made it abundantly clear they did not want to be examined—and many have the battle wounds to prove it. When “cattitude” becomes violent, however, pet owners may find themselves at a loss for what to do, and relinquishment or euthanasia becomes part of the conversation.
Although it’s true that cats with aggressive behaviors can become a danger to people, other pets, and themselves, feline aggression may be a surface indicator of something deeper. Identifying the underlying causes of aggression and creating a treatment plan to ameliorate hostile situations may ultimately save patients’ lives. At the 2017 New York Vet conference in New York City, Lisa Radosta, DVM, DACVB, explained some of the complexities of dealing with feline aggression, including what clients may not realize are normal feline behaviors, the need to obtain a comprehensive patient history, and situations in which medications or supplements may—or may not—play a role.
The first step in treating a cat with a behavioral disorder is gathering an in-depth history, said Dr. Radosta, who owns Florida Veterinary Behavior Service in West Palm Beach. “For some reason, when veterinarians are faced with a behavior case, we freeze,” she said, “yet compiling as much detail as possible is as imperative for cases of feline aggression as for any other case that walks through your hospital door.”
Asking open-ended questions is vital to uncovering necessary information, Dr. Radosta said. Simply asking whether the cat is aggressive won’t establish the whole picture. Once in the examination room, many pet owners will forget important aspects or misjudge which details are relevant.
In most cases, gathering a comprehensive history means pressing the client for additional information. For example, if you ask whom the cat is biting, be prepared to probe for clarification to determine whether it’s just the client, his or her spouse, children, or other animals in the household. “A client may relay that the patient is biting her husband but forget to tell you that she has also been a victim of the cat’s aggressive behaviors,” explained Dr. Radosta. The client may also note that even though the cat bites her, the cat loves her. “The emotional aspects are not as important for diagnosis,” said Dr. Radosta. “You need the facts.”
For multicat households, veterinary teams must also determine exactly which cats are displaying negative behavior. The truth is, pet owners have favorites, Dr. Radosta said. A client may pin behavioral issues on the cat that has been labeled as the spouse’s when in reality more than 1 cat in the home is aggressive.
Be prepared for the true investigation to begin when you ask about the onset and evolution of negative behaviors, Dr. Radosta said. “You may find out that aggression started at 5 months, but the cat is now 5 years old,” she said. “Very often I ask ‘What brought you here today when this has been going on for a long time? What happened?’” Common reasons may include a new pregnancy or a new living situation in which someone in the home is less tolerant of the behaviors. “You need to know why there is an urgency now and how the behavior has progressed,” she added.
It’s also crucial to identify situations in which a cat is exuding aggressive or intimidating behaviors that the pet owner views as benign. Body blocking is a classic example. “Ask the client whether Teddy sits in the hallway to strategically block Fluffy from passing or whether Teddy spreads himself across the hallway to block access to the litter box,” Dr. Radosta said. Although not an outward attack, body blocking is a clear form of aggression.
Finally, Dr. Radosta explained that evaluating the risks associated with the situation is critical. Is the cat a threat to the public because it might bite a stranger who enters the home? Is this a welfare issue because the animal has a very poor quality of life? Is the owner considering relinquishment or euthanasia?
In her own practice, Dr. Radosta said she reviews an 8-page questionnaire with clients whose cats present with aggression or behavioral problems. Rather than implement the same lengthy form, Dr. Radosta encouraged veterinarians to create a simple yet detailed document with which they are comfortable. As a starting point, she offered a 2-page form on her practice website that other hospitals can use or model for their own patient history forms. It covers topics ranging from changes in behavior and lifestyle to rate of recurrence and suggested recheck dates.
It’s important to inform clients about the very natural reasons why their cats may be displaying signs of aggression. Many domesticated cats live in settings that are contradictory to their instinctual behaviors, and this can lead to aggressive tendencies and hostile relationships with other cats living in the home. Other than in companion animal relationships, cats don’t live in colonies with other unrelated cats.
“Studies have shown that cats who are related will live together, groom each other, and sleep together,” Dr. Radosta said. “It is unnatural for cats to live in a house or an apartment with another cat they’re not related to.” This information should be used to help pet owners understand that a big reason why their cats might be fighting is simply that the living situation is perverse. If cats are not sleeping in a pile or touching or even within 2 feet of each other, they are probably not friends, she said.
Socialization is another key contributor to aggressive behaviors within multicat households. “When cats are adopted, they typically never see another cat until the next one comes in,” she explained, and that situation in itself can be very jarring. “If I was raised by monkeys and then one day I saw a person, I’d be like ‘What is that strange thing, and why is it drinking out of my bowl.’” It is important for pet owners to understand that situations outside a cat’s normal socialization—which never before included another cat—are scary. Once pet owners begin to comprehend what is normal and abnormal for a cat, they recognize that introducing their cats to atypical situations, while never the intention, can induce aggression.
Dr. Radosta stressed that veterinarians should be less concerned with aligning their diagnosis with textbook definitions and instead make a concerted effort to provide a detailed summary of what the patient is experiencing and why. “You don’t have to be perfect. You just have to be able to identify what is happening,” she said.
As a rule of thumb, compile enough information so that any veterinarian, even one unfamiliar with the case, could pick up the file and have a clear understanding of what has happened, what the presenting signs are, and what the cat’s home life is like. With a comprehensive patient history, a veterinarian can create a strategic course of treatment that is tailored to both the cat and the client. When treating cats with behavioral issues, Dr. Radosta reminded veterinarians, there are some instances in which prescribing medications or supplements is beneficial and others when it is unnecessary.
Consider the period of time it takes the cat to recover after it has bitten someone or displayed another aggressive behavior, Dr. Radosta said. “If it’s a few hours or an entire day before the cat returns to a normal state, that is a long recovery,” she added, “and that animal most likely needs to be medicated.” On the other hand, if a cat bites but is playful and precocious again within an hour, the aggression is likely play induced and does not warrant medication.
Environment and Welfare Issues
Dr. Radosta also strongly recommends that veterinarians consider the cat’s welfare. If the owner shares that the cat spends long periods of time sequestered in a room with little to no positive interaction, it could be a sign that medication or a natural supplement is needed. Similarly, veterinarians must decide whether the cat’s environment is conducive to a positive outcome. “If there are children in the home, the answer 99% of the time is no. Children distract pet owners and keep them from doing what they’re supposed to for the cat,” she explained. “So, think about prescribing if there is a child in the home.”
The Compliance Factor
One key to successfully reversing aggressive feline behaviors is to create a relationship of honesty so that the owner understands that he or she is an integral part of the solution. “If you explain to the owner what steps need to be taken that do not include medications, but the owner admits he or she can’t comply, then you should think about prescribing,” Dr. Radosta said.
“It’s OK to be very clear to the client that you are prescribing medication because the client has been honest about the fact that there is no way he or she can do what the veterinary team is asking,” she said. It’s also important to let the client know that the response is acceptable. The end goal is to ensure that the cat can live safely and happily in the home environment that has been created.
Some pet owners can reasonably predict the hours of the day or the situations that will lead to aggressive behaviors. In those instances, the cat doesn’t need medication if the pet owner can learn to control interactions within those time periods by distracting the cat or removing triggers. If the cat randomly bites or the actions are predictable but the biting is deep and severe, a medication or supplement may be necessary to even out the cat’s neurochemistry.
Ultimately, judging the severity of the situation is subjective, Dr. Radosta admitted, but as long as a veterinary practice establishes a universal scale for all its feline patients, there will be a reliable measurement. “If you are faced with a severe or moderate to severe case, please consider adding medication to that pet’s plan,” she said.
More than anything, Dr. Radosta emphasized that it is vital to manage client expectations, a key component of which is informing clients about what medications and supplements are and are not capable of doing. “You can expect a 25% change from a supplement and about a 50% change from medication if it is to be called successful,” Dr. Radosta said. Choosing which to utilize is sometimes based on client preference or the cat’s preexisting conditions.
“You should opt for a supplement in a geriatric pet with renal failure and heart disease because you know you don’t want to add another medication,” she explained. Be honest with the owner about your reasoning. Make it clear that it may take 2 supplements given at the same time to achieve the same result as a medication, but the supplements are in the best interest of the pet.
Other times, clients may ask for a holistic approach. They don’t want their pet on medication, and that’s fine as long as they understand the difference in behavioral changes they can expect. “If their expectations are managed and they’re on board with supplements, I am on board too,” Dr. Radosta said.
Still, she added, even with supplements, medications, and enrichment activities, make sure all parties involved (veterinarians included) accept and understand that you’re not fixing the problem; you’re suppressing it. And if the client stops doing the things you’re recommending, the problems will come back. In this regard, remedying aggression is like treating food allergies. The problem is still present; it’s just being avoided.
“Treating cats with medications is nothing to be ashamed of,” she concluded. “You are keeping cats in their homes, they are no longer biting people, and they are alive. Don’t feel that if you don’t have a resource in your community to perform behavioral treatments that you can’t treat aggression, because you can.”