Treating the challenging cat


During her lecture at the 2022 American Association of Feline Practitioners conference, Sarah Heath, BVSc, PgCertVE, DECAWBM (BM), CCAB, FHEA, FRCVS, explained the causes, and diagnosis possibilities, behind the challenge cat case at your practice.

cat at vet / Africa Studio

Africa Studio /

At the veterinary clinic, it is not uncommon for teams to come across a client with a challenging cat. Whether that cat is soiling outside the litter box, scratching furniture, or acting harmful toward others, it is an issue that frustrates clients and possibly is a deeper medical issue for felines.

Presenter Sarah Heath, BVSc, PgCertVE, DECAWBM (BM), CCAB, FHEA, FRCVS, dove into the emotional motivation behind common challenging behaviors, what factors can be involved, and more, during the 2022 American Association of Feline Practitioners (AAFP) in Pittsburgh, Pennsylvania.

Underestimating cats

With cats, there is a common misconception that they do not really pose a threat to anyone because of their size. However, as most veterinary professionals know, cats can cause significant damage to anyone, especially children, the elderly, and the immunocompromised.

“We really must remember that when [cat attacks] happen, it can be very serious and it's of course complicated by zoonosis. So, the fact that we have an animal who has very high levels of bacterial contamination, through things like Pasteurella and other pathogens, and a cat is an individual thing [that] bites with penetration and that's part of their natural behavior. Of course, they do, they have to do it, they bite to kill their prey, which involves a lot of pressure. So, when they bite, they bite with serious penetration and that's just like injecting pathogens really into muscle tissue,” explained Heath.

Because of this risk, seeing a veterinary professional about this behavior is crucial to both the pet and the owner. Health urged attendees that when they first get the call that a cat attacked someone else, it is crucial not to punish them. She explained that even if you punish the cat at the time of the incident or later, it can escalate the situation. This can also push the cat from the repulsion branch to an avoidance or inhabitation branch” which means the problem has not been fixed, it has just been shifted into a different format. After the incident, the cat and its target should be separated.

“First of all, do not punish don't do that anything that could escalate the tension. The other thing is [to] prevent the cat from coming into contact with the target, particularly if that target is vulnerable in any way, we need to take it seriously because of the potential we've seen for Zoonosis and some serious injury. And if it's not possible to supervise them, then isolate them. And isolation needs to be in the interest of the cat. So, I'm not saying when I say put them in an indoor pen, or suitable hideout, I would prefer to use another room. What I'm not talking about is putting them in a restricted pen, so we're not putting them in a cat carrier or putting them even in a dog pen, probably that's not big enough, either. We just need the cat to be safe and everyone to be safe as the immediate plan,” she explained.

History of the patient

An important part of dealing with a challenging cat case is to look at what happened in a chronicle way. Heath explained that knowing what triggered the pet to act the way it did can help solve why it happened, and how to help in the future.

“We want to go right back to the beginning if we can about this individual and know about its development and its subsequent learning. We want to know the context of the behavior, social and physical. So where was it physically, and who was there?” said Heath.

When taking the history, be sure to get the physical elements of the case as well. Is it an outdoor cat? Is the cat indoor only? If so, does it show interest in the outside world? Also, ask about any medications the pet is on. Painting the picture of the patient's history can help understand why the events occurred when they did.

Once the team gathered all the information, create a timeline. Heath told attendees to literally write the timeline down. Begin your timeline when the cat was first brought to the house and end it with the incident that brought the cat into the clinic. She recommends writing the medical history at the bottom of the line and the history at the top line.

"Why do I do that? Because I'm looking for clusters of events. So, if I've got a timeline, and then start to see oh, hang on a minute, that incident, a new moving house, or that instant of the cat having been diagnosed with renal failure and being hospitalized for three days, they actually are correlated with each other, you're looking for these events clustering around on your timeline,” clarified Heath.

She cautioned that when trying to get as detailed of a history as possible if it escalated to a serious confrontation, they might have issues recalling when it started.

Common diagnoses

Now that all you collected all you could, there are multiple causes behind these issues. Heath cited fear, anxiety, desire—sometimes talked about as misdirected—predatory behavior, and social planning. Desire seeking and social play have positive emotions with them, but they can cause confrontation. Fear and anxiety are causing repulsion, which comes with a desire to remove the thing that causes them to feel this way.

Desire seeking and social play have positive or engaging emotions, but cause confrontation, whereas fear anxiety causes repulsion. The difference is repulsion has the desire to remove the thing, whereas confrontation doesn't. Heath gives her clients the example of a dog chasing a squirrel up a tree and barking at the bottom.

“Explain this to clients who've got a dog at the bottom of a tree barking and growling and squirrel, it's not repulsion. They actually want the squirrels to come back down the tree so they can eat it. It's frustration, of desire, seeking desire, seeking to chase as we're all frustrated because the squirrel was up the tree, and frustration of anything of the other emotional systems is associated with increased intensity, increased speed, and confrontation,” concluded Heath.


Heath S. The Challenging Cat. Presented at: 2022 American Association of Feline Practitioners Conference, Pittsburgh, Pennsylvania. October 27-30, 2022.

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