What makes a cat a healthy pet?

dvm360dvm360 October 2021
Volume 52
Issue 10

Cats' inherent behaviors explained, plus pointers to share with clients for keeping them healthy.

What makes a cat a healthy pet? Maintaining a healthy weight and exhibiting behavior that is acceptable to their human caretakers is a good start. Veterinarians must be sure they are communicating clearly to cat owners about how to keep their cats physically and behaviorally healthy.

One thing is sure: We have an epidemic. In America, 59.5% of cats are overweight or obese, according to the Association for Pet Obesity Prevention (APOP).1 Our cats’ bodies are overfed, while their predatory souls are starving. While debates rage on about what food to feed a cat, the most important health crisis facing cats has gotten almost no attention. The No. 1 cause of death for cats is being unwanted due to behavior problems.2

Much discussion and research has been done on the effect of diet on the physical health of cats. Only recently has feeding behavior and its effect on physical and behavioral health become an area of focus. We now know that, “Cats are solitary predators that consume small prey, and they prefer to eat often and alone. Their prey is of low caloric density, necessitating several kills per day (for which they expend large amounts of energy) to meet their basic nutritional requirements.”3 In short, multiple small frequent meals that cats must seek out, find, catch, kill, and eat is the natural feeding behavior of cats.

Outdoor life is inarguably dangerous for cats, but it also allows cats to live their lives according to their natural instincts, such as what and how to eat. What is on the menu and how it will be served becomes controlled by humans when we close and lock the door. In fact, it has been documented that behavioral problems are more common in cats without access to the outdoors.3 There is a clear, proven, direct correlation between understanding and providing for cats’ innate behavioral needs and their physical health. Stress has physiologic consequences. It activates the central stress response system,4 which has an impact on nearly every body system, and plays a role in the most common health problems that cats face. Research of exactly how to minimize cats’ stress and meet their behavioral needs, specifically their feeding behavior needs, is in its infancy.

A study released this summer from researchers at the University of California, Davis, School of Veterinary Medicine examined the likelihood of cats to contrafreeload. Contrafreeloading was defined as the preference of an animal to work for food when equivalent food is freely available.

This study looked at 17 cats to see if they were more likely to forage from a stationary tray with various obstructions creating a food puzzle or instead to choose to eat from a similarly sized tray with no obstructions. To prepare for the study, the cats were given 4 to 12 days to acclimate to eating from this food puzzle. During the study period, the cats were given 30 minutes to eat from the puzzle and tray for each trial, at which point both were removed and the recording was stopped. No mention was made if the administrators of the test remained in the room during the 30 min or if the cats were left alone. “Cats ate more food from the free feed tray than the puzzle (t (16)=6.77, P<.001). Cats made more first choices to approach and eat from the tray. There was no relationship between activity and contrafreeloading, and there was no effect of sex, age, or previous food puzzle experience on contrafreeloading” Investigators surmise that most domestic cats choose to eat from a tray rather than from this food puzzle.15

The question asked in this study is are cats contrafreeloaders. Before arriving at a conclusion, we must evaluate a few of the methods in this study. Foraging from a stationary food puzzle was evaluated as compared to eating from a similarly sized tray. For an animal to contrafreeload, does the work to obtain the food need to in some way mimic the way the animal would work to obtain food in nature? In nature, cats can naturally spend half of every 24 h looking for and obtaining food.3 The search for food is the most time consuming behavior of the hunt, catch, play, eat cycle. Additionally, cats are solitary predators that consume small prey, and they prefer to eat often and alone. Their prey is of low caloric density, necessitating several kills per day (for which they expend large amounts of energy) to meet their basic nutritional requirements.16

Searching alone and untimed for a portion/ calorie controlled small meal that the cat must then interact with is superior to being served a stationary puzzle and then fishing out a large portion of food while possibly being watched for thirty discrete minutes when it comes to replicating a cat’s natural feeding behavior.

Additionally, cats acclimate to new things more slowly than dogs or people. I would submit that four to twelve days is only a fraction of the time necessary for a cat to be comfortable acclimating to a change in the way they receive food—even when the change is more in line with their instincts.

Let’s be clear on what this study is solving for: Are cats contrafreeloaders? Do they prefer to work for their food or to be served? In this study, “Most cats in our study did eat some food from the puzzle but none ate more food from the puzzle than the tray. Thus, although we have evidence for some willingness to work for food when freely available food is present (weak contrafreeloading), there is no evidence that cats preferred to work for food.”15

How then does eating solely from puzzles, or better yet a series of hunting feeders day and night, impact a cat’s behavior? Their weight? These two pieces of information have the biggest impact on how the veterinarian should direct their clients on the feeding health and welfare of cats.

Physical and behavioral manifestations of stress go hand-in-hand. Short-term stress in cats has immediate effects on a cat’s body. The heart rate, respiratory rate, blood pressure, and body temperature increase. In the bloodwork we see a decrease in lymphocytes and an increase in neutrophils, monocytes, and blood glucose, which can spike so high that it mimics diabetes. Long term stress causes a variety of illnesses, behavior problems, urinary disease, cardiovascular disease, endocrine disease, dermatologic disease and gastrointestinal disease. Many cats experience a combination of these over a lifetime.7 We call these comorbidities.6

The good news is, we know the solution to this problem and it is not difficult. Cats’ behavior, social needs, and environmental needs are clearly understood and relatively simple to provide.

Fixing this problem requires one very important missing component. You. You see, reaching cat parents to educate them is much more difficult than reaching dog parents. Dog parents have lots of contact with educators, such as veterinarians, trainers, groomers, dog walkers, doggie day care workers, and friends at the dog park and on dog play dates. In fact, half as many cats as dogs see a veterinarian annually for wellness exams.8 It is entirely possible that a cat parent can spend a lifetime without interacting with an educator. Here is what you need to know.

What makes a cat a cat?

What is the essence of a cat? When we understand what motivates a cat’s behavior, we understand what to expect from a cat as a human companion and a companion to other cats in the confinement of our homes.

With this information, we can rethink the criteria for a minimally satisfactory physical living space in the confinement of our homes. Well-being for all living things begins with basic survival. How do cats survive and stay safe? How do they eat, drink, and sustain themselves? What are the threats to a cat’s safety, and how are they innately programmed to protect themselves from these threats? How do cats communicate and interact with the world, and each other? This is basic survival for a cat.

Just about everything you need to know about cats comes down to one thing: hunting.

Cats in the wild

Cats are exquisite hunters. They need to be. One cat needs to hunt, catch, kill, and eat 8-12 mice every single day to stay alive. It takes about 80% of a cat’s waking hours to accomplish this. Nature gave cats a strong innate drive to hunt to ensure they stay alive, even if there is plentiful food.9 A cat’s stomach is only the size of a ping-pong ball, just right for a mouse-sized meal, 1 at a time. Mice do not hang around in groups all day waiting to be eaten. They hide from cats, and scurry around alone, usually at dawn and dusk when the darkness can help protect them. So, cats are instinctively driven to hunt at dawn and dusk. They do not rely on their sight, like you and I do. Cats use their sense of smell, hearing, and perception of movement to locate their prey.

So much about a cat’s feeding behavior dictates the rest of their lives too. Mouse-sized meals are not enough to share, so cats hunt and eat alone. You don’t see a group of house cats working together to bring down a deer and dining on the carcass together. One cat hunts, kills, and eats one mouse at a time.

If a location has more cats than meals, cats starve. Eight to twelve mice every single day is a lot of mice, so cats are careful to protect their food sources. The result? Cats are extremely territorial. And if you are going to have to hunt and eat alone, you had better be able to depend on yourself to stay safe.

And that is exactly how cats evolved. Cats are solitary survivors. They do not defend each other, protect each other, or count on each other to sustain life. If they are sick, hurt, or have a need, no other cat is coming to help them. This is not malicious, vengeful, or unkind, it is simply the way nature made them. Therefore, it is of no benefit to them to show that they are sick, hurt, or have a need. Showing this vulnerability will not bring assistance, but is highly likely to tip off a predator that they are easy prey.

Groups of related mothers and kittens may live together, if there is enough food and safe shelter to meet all of their individual needs and the needs of the group. These mother cats grew up together, have lived together, and smell like each other. They are not receptive to new cats entering the group.10

If it comes down to a territorial fight between two cats, it is highly likely that one or both of the contenders will be injured or killed. In the wild, injury from fights often leads to death. So, nature designed cats to do everything that they can to avoid conflict and even interacting with the competition. So, cats find ways to communicate with each other without being present.

To avoid unwanted interactions, cats leave lots of communication around their territory. Often one “sign,” like urine marking or leaving claw marks on a tree, communicates in many ways, including smell, pheromones, and visual cues.

Cat’s have a keen sense of smell. In addition to smell, cats have a sophisticated chemical messaging system using pheromones. Pheromones are odorless chemicals produced by specialized glands on a cat’s cheeks, under the chin, at the base of the tail, on the foot pads, and around the anus, genitals, and mammary glands. Cats deposit these messengers when they do things like rub their cheeks on things, urinate/defecate and when they scratch things. The receiving cat actively has to draw the air containing pheromones into the roof of their mouth in an act called flehmen into an organ called the vomeronasal organ to detect the message. Only another cat can perceive these pheromones and when they do, the receiving cat has a specific, innate response.

Cats depend on the smell and pheromones. In short, if it smells like me, it is safe. Cats deposit their smell and pheromones throughout their home and on the other cats they choose to live with by rubbing on and grooming each other. Cats also use scent and pheromones to communicate fear, danger, and territory without having to be physically present.

Urine and feces contain waste material, and odor and pheromone information. There are times when a cat wants their urine and/or feces to communicate a message. We call this urine or fecal marking. Most of the time, a cat simply needs to eliminate and is careful to bury their urine or feces so as not to tip off a competitor or predator of their location. Outside, a cat chooses when and where to urinate and defecate to accomplish all of these goals, and to keep themselves safe.

Cats are a preferred meal for coyotes, foxes, large reptiles, hawks, owls, and other birds of prey. In fact, nature made cats keenly aware that their life is constantly in danger. Cats innately climb to the highest point available and choose a perch not much bigger than their body or squeeze into a small space to stay safe.11

Cats in our homes

As solitary survivors, cats are designed not to communicate their needs and vulnerabilities. In the absence of information, we presumed cats were aloof and vengeful tiny little hairy people that were very difficult to get along with.

Now that we know what makes a cat a cat, we understand what motivates our cat’s behavior. The next step is to use that knowledge to provide for their needs in our homes. Instead of working against our cats and forcing them to make do in a world that does not suit their nature, we can work with them so we can both live in happiness. And it’s easy.

Well-being for all living things begins with basic survival—stay safe, and eat. Cats are hunters and the hunted. This is what motivates their behavior. Providing for these needs should be the baseline minimum of care, not considered enrichment above and beyond.

To feel safe, cats need to know that they have places to climb and hide, even in the relative safety of our homes. When cats know that they have the option to escape any situation by climbing and hiding in their living space, they can relax and are more likely to engage in and enjoy human company.

Many cat parents are unaware of their cat’s behavioral needs. It is up to the veterinarian to educate the cat parent what cat’s need and how to meet those needs in the home. For instance, cat parents should provide their cat(s) with commercially available cat trees and shelves, or even an old bookcase for climbing. Beds can be store-bought, cat caves and cat beds, or a cardboard box with a towel inside. When cats choose to spend time resting on their high perch or inside of their cozy bed, leave them alone. Parents should let them know that these spaces are truly safe.

Cats are hunters. Seeking out food, catching it, and playing with it is their mental engagement and their physical exercise. It is their reason to be awake. We know that their stomach is only the size of a ping-pong ball and that they hunt and eat at least 8 to 12 times in a 24-hour period, mostly at dawn and dusk. We know that they are solitary survivors that hunt and eat alone. So, why are we feeding them from a bowl and taking away the most important activity in their life? Removing this natural behavior is making our cats bored and fat and sick.

Without a way to express their hunting instinct, cats can become aggressive or destructive.9 Nature is telling them to hunt, so they are finding a way. It is common for them to wake their person in the early morning hours to be fed, even if there’s food in the bowl. Cats are programmed to hunt at dawn, and without prey, they are getting their hunting interaction by hunting you, and then eating that food in the bowl.

Despite decades of fighting over what a cat should eat to be healthy, our cats are getting fatter and fatter. Now 60% of cats in America are overweight and obese. That number is going up every year.1 And, cats are still experiencing lower urinary tract disease. The answer to these uncomfortable, and sometimes deadly problems is unlikely to be found in the bag or the can or in anything that you put in the bowl. Research shows that idiopathic urinary disease is caused by stress, not food or water intake. The stress is reduced or solved with places to climb, places to hide and ways to hunt for lots of tiny meals in different locations around their environment many times over the day and night.

Pet parents could release 8 to 12 mice in their house every day. But mice also come with parasites and, you know, they are mice. So, what is the answer? Hunting feeders and puzzle feeders. Hunting feeders are mice that have a fabric covering for cats to use their teeth and claws, and a plastic inner container to hold the food. On the top of the mouse is an adjustable opening, so that the food dispenses easily or can provide more of a challenge. A cat’s complete hunting cycle is met when you fill and hide at least 3 mice during the day and three mice overnight around the house. Puzzle feeders are food containers that your cat must interact with to get their food. They may need to move a flap, spin a container, or reach into a hole to extract the food.

When a cat is exposed to a new feeding solution, they may reject it entirely, which makes pet owners feel frustrated and disappointed when they feel that they wasted their money. Slow down. It is not a waste. Remind pet owners that cats are hunters AND are also hunted. A prey species is on high alert for danger and reluctant to engage with new things. We also know that cats communicate by smell and are more likely to engage with things that have their smell and their pheromones. Use this information to educate your pet parents on helping their cat feel safe. They can gently wipe a towel over their cat’s cheeks and face while they are happy being petted or eating a snack, and then wipe the towel on the new thing. Pet parents can entice cats with new food and treats and even catnip to overcome their natural reluctance. And, we know that cats are solitary hunters. Pet parents should give their cat time alone with their new feeding solution to interact and explore. Soon enough, the bowl will be a thing of the past.11

Litter box

Urinating outside of the litter box is the most common and most undesirable cat behavior problem.13 Pet parents mistakenly refer to the entire syndrome of urinating outside of the litter box as a “UTI.” UTI stands for urinary tract infection: “Urinary tract infection (UTI) refers to the adherence, multiplication and persistence of an infectious agent within the urogenital system that causes an associated inflammatory response and clinical signs.1 In the vast majority of UTIs, bacteria are the infecting organisms.”14

In fact, bacterial UTI’s are uncommon in cats, with only 1% to 2% of cats suffering from a UTI in their lifetime, and are most common in female cats older than ten years old.14 A UTI is diagnosed only with a culture of a urine sample taken directly from the bladder, and not based on clinical signs of urinating outside of the litter box or painful urination.

So, what DOES cause cats to urinate outside of the litter box? The list is long and should start with a thorough veterinary examination to rule out medical conditions, including diabetes, kidney disease, hyperthyroidism, bladder stones, cancer, and many other conditions. If a cat gets a clean bill of health, the next step is to evaluate litter box hygiene and placement.

Indoors, a cat has limited options for where to eliminate. As far as people are concerned, there are two choices, in the litter box and outside of it. A cat is more likely to use a clean litter box, so educate pet parents to scoop out the liter box at least once a day. Cats need to be able to move around in their box, and dig and cover their urine or feces. They need a lot of room to do all of that. Cats prefer a box that is 1½ times the size of a cat with about 2 inches of litter inside. Different cats like different litter and some may only use one particular kind. Your cat needs to be able to get to the box, and get in and out of it. This may seem obvious, but your cat may have arthritis that makes it difficult to climb basement stairs or get into or out of a box. If pet parents have all of that correct, it could be stress that is causing their cat to urinate outside of the box.

How cats interact with other cats in their homes

Let’s review. The natural state of the cat is as a solitary hunter. Cats may live in social groups of related mothers that have grown up together and their kittens only if there is ample and constant food and shelter. Cats will establish a territory based on food and shelter and then protect it. As conflict avoiders, cats will use messages like urine marking, and clawing to communicate their territory in an attempt to resolve conflict without a fight. This is how cats are designed to experience the world. Without an abundance of food, water, litter boxes and safe resting places, distributed throughout their living space, cats are unable to avoid each other to get what they need. The fact of this alone increases each cat’s stress level all day every day. This stress level will spike when a direct interaction occurs over a shared resource.

Cats are not innately designed to accept a stranger cat into their territory. Full stop. As solitary survivors, cats do not “need a friend” like people do. People are communal animals, cats are not. We must educate cat parents that it is realistic to expect that the resident cat will not accept a new cat in their home. People who want more than one cat should be advised of this risk and encouraged to adopt sibling cats, kittens of a similar age, or a pair of cats who have been living together in harmony.

To best facilitate a new cat relationship in the home, go back to the natural state of the cat. Cats are most likely to live with other cats if there is ample food to hunt and safe shelter. To feel safe in their home, each cat needs separate places to climb and hide in the rooms where they spend time. Each cat is a solitary hunter, designed to hunt and eat alone, and a conflict avoider. A big bowl of cat food in the kitchen not only denies each cat their hunting behavior, but is forcing them to share a space to eat. Provide multiple feeding and water stations around the house. Better yet, feed with hunting feeders and puzzle toys in separate locations around the house. With this style of feeding the cats can fulfill their hunting needs, and their need to hunt and eat alone. They can interact only when they choose to and avoid interacting under stress.

Cats communicate through smell and pheromones and feel most at ease with things that smell like them. Pet parents can use this to help their cats get along. When cats are feeling happy and safe, parents can rub a towel on them and then repeat with their other cats. They can swap beds between the two cats as well. Pet parents can also buy commercially made cat pheromones to put on objects or into the air that convey the message of acceptance and calm between cats.

Many cats in a house need many litter boxes. Cats need a choice of locations throughout the living area to find a litter box. The rule is the number of cats, then one more, in different locations of the home.


Play is a great way for pet parents to bond with their cats and give them a healthy way to express their hunting instincts. Two five-minute play sessions every day is all it takes to meet this need. Here’s some recommendations for your pet parents: grab the cat’s fishing pole toy and get busy. Play with one cat at a time. Use the toy to mimic prey. This is harder than it sounds. Prey does not launch itself at a cat. Prey is near a cat and then flees with jerky, unpredictable movements in the air or on the ground. A jerking object that is moving away from a cat is what stimulates them to chase and play. Remember the hunt, catch, play, eat cycle? Pet owners can finish the play session by letting their cat catch the prey, then give them a treat and the cat will be content.

Cats need our help. Veterinarians have a unique opportunity to educate cat parents, both new and experienced, about the behavioral needs of cats, and how this impacts their physical and mental health.

Understanding and providing for basic survival should be the minimum standard of care for all cats, not the fortunate few. You can help reframe for cat parents what is reasonable to expect from a cat as a human companion and a companion to other cats in the confinement of our homes. You can help cat parents rethink the criteria for a minimally satisfactory physical living space in the confinement of their home. When the minimum standard for cat care is the norm and not the exception, behavior incompatible with the human-animal bond is minimized, relinquishment to shelters becomes unnecessary, and the gruesome truth that euthanasia is the leading cause of death for cats will become a part of a shameful past.

Armed with this knowledge and the materials offered with this article, you can educate each cat parent that walks into your office. A cat’s life just might depend on it.

About Basepaws

Basepaws is a leading innovator in pet biotechnology and is committed to research and discovering new knowledge that will help veterinary professionals provide better care for their patients. Basepaws helps veterinary professionals to set standards for health and wellness and provides the necessary tools to empower proactive health interventions and true preventative health care. Learn more at www.basepaws.com.

(This article was adapted with permission for reprint from Cats: In Crisis originally published by Pet Professional Guide. Cats: In Crisis was originally published in BARKS from the Guild (#44), September 2020, pp.12-19, https://issuu.com/ petprofessionalguild/docs/bftg_september_2020/12 )

Further reading

  1. American Association of Feline Practitioners. (2004). Feline Behavior Guidelines. Available at: https://catvets.com/public/PDFs/ PracticeGuidelines/FelineBehaviorGLS.pdf.
  2. Buffington, C.A.T., Westropp, J.L., & Chew, D.J. (2014). From FUS to Pandora syndrome: where are we, how did we get here, and where to now? Journal of Feline Medicine and Surgery, 16(5): 385-394. Available at: https://journals.sagepub. com/doi/abs/10.1177/1098612X14530212?journ alCode=jfma.
  3. Lund, H.S., Sævik, B.K., Finstad, Ø.W., Grøntvedt, E.T., Vatne, T., & Eggertsdóttir, A.V. (2015). Risk factors for idiopathic cystitis in Norwegian cats: a matched case-control study. Journal of Feline Medicine and Surgery, 18(6): 483-491. Available at: https://journals.sagepub. com/doi/10.1177/1098612X15587955.


  1. Association for Pet Obesity Prevention. 2018 Pet Obesity Survey Results: U.S. Pet Obesity Rates Plateau and Nutritional Confusion Grows. 2019. https:// petobesityprevention.org/2018
  2. Alley Cat Allies. Cat fatalities and secrecy in U.S. pounds and shelters. Alley Cat Allies. www.alleycat.org/resources/ cat-fatalities-and-secrecy-in-u-s-pounds-and-shelters/
  3. Rodan R. Importance of feline behavior in veterinary practice. In: Rodan I and Heath S (Eds), Feline Behavioral Health and Welfare. 2016. Elsevier: 1-11.
  4. Bradshaw, J.W.S, Casey, R.A., & Brown, S.L. (2012). The Behaviour of the Domestic Cat, 2nd Edition. Boston, MA: CABI: 16-40.
  5. Buffington, C.A.T. (n.d.). Pandora Syndrome in Cats: Diagnosis and Treatment. Today’s Veterinary Practice. Available at: https://todaysveterinarypractice.com/ feline-medicine-pandora-syndrome-in-cats-diagnosis-andtreatment/.
  6. Buffington, C.A.T. (2011). Idiopathic cystitis in cats--beyond the lower urinary tract. Journal of Veterinary Internal Medicine, 25(4): 784-796.
  7. Karagiannis, C. (2016). Stress as a Risk Factor for Disease. In Rodan, I., & Heath, S. (Eds.), Feline Behavioral Health and Welfare. St. Louis, MO: Elsevier: 138-147.
  8. American Association of Feline Practitioners. (2013, July). Bayer-AAFP study reveals half of America’s 74 million cats are not receiving regular veterinary care. (News release.) Available at: https://catvets. com/public/PDFs/PressReleases-Media/AVMABVCUS3PressRelease.pdf.
  9. iCatCare. (2019). Understanding the Hunting Behavior of Pet Cats. January 15. Available at: https://icatcare.org/ understanding-the-hunting-behaviour-of-pet-cats-anintroduction/.
  10. iCatCare. (2018b). The Social Structure of Cat Life. October 5. Available at: https://icatcare.org/advice/ the-social-structure-of-cat-life/.
  11. Bradshaw, J.W.S, Casey, R.A., & Brown, S.L. (2012). The Behaviour of the Domestic Cat, 2nd Edition. Boston, MA: CABI: 16-40.
  12. iCatCare. (2018a). Feeding Your Cat or Kitten. July 24. Available at: https://icatcare.org/advice/ feeding-your-cat-or-kitten/.
  13. Ellis, S.L.H, Rodan, I., Carney, H.C., Heath, S., Rochlitz, I., Shearburn, L.D., Sundahl, E., & Westropp, J.L. (2013). AAFP and ISFM feline environmental needs guidelines. Journal of Feline Medicine and Surgery, 15(3): 219-230.
  14. Dorsch, R., Teichmann-Knorrn, S., & Lund, H.S. (2019). Urinary tract infection and subclinical bacteriuria in cats: a clinical update. Journal of Feline Medicine and Surgery, 21(11); 1023-1028. Available at: https://journals.sagepub. com/doi/full/10.1177/1098612X19880435.
  15. Delgado, M.M., Han, B.S.G. & Bain, M.J. Domestic cats (Felis catus) prefer freely available food over food that requires effort. Anim Cogn (2021). https://doi.org/10.1007/ s10071-021-01530-3
  16. Sadek, T., Hamper, B. Horwitz, et al. D. Feline feeding programs: Addressing behavioural needs to improve feline health and wellbeing, Journal of Feline Medicine and Surgery, 20(11); 1049-1055 https://doi. org/10.1177/1098612X18791877
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