Cats are considered perfect pets by many people because they're relatively self-sufficient. If we provide a few basics - like a clean litter box, fresh water and access to nutritious food - they share our lives without demanding constant care. However, this same benefit can sometimes create problems when things go awry. When a cat develops a behavior problem, pet parents are often at a loss as to how to solve it.

As with dogs, many behavior problems in cats can be resolved with a change in management of your pet or your pet's environment. For instance, litter box problems can often be dealt with by changing the presentation of the box, the litter or other factors associated with use of the box. (For a complete discussion of litter box problems and how to resolve them, please see our article on Litter Box Problems.) Problematic scratching can be fixed by providing suitable scratching surfaces for your cat (please see our article, Destructive Scratching), and overly rambunctious play can be channeled into appropriate activities (please see our articles, Cats Who Play Rough and Nighttime Activity in Cats).

However, sometimes cats develop behavior problems that pet parents can't reduce or resolve. For instance, problems may develop between multiple cats in a household, or a cat might stop using her litter box because of a physical problem that's no longer even bothering her, or a cat might groom herself excessively, to the point of pulling all her hair out.

When behavior problems like these develop in cats, help is available from qualified professional animal behavior experts, such as Certified Applied Animal Behaviorists (CAAB or ACAAB) or board-certified veterinary behaviorists (Dip ACVB). (Please see our article, Finding Professional Help, to locate a qualified professional in your area.) After reviewing the specifics of your cat's behavior problem and all the factors that influence it, a behaviorist can design a successful behavior modification plan to resolve the problem. In some cases, a behavior problem can be treated most successfully with a combination of behavior modification and behavioral medication.

Is Medication Necessary?
You might be reluctant to give your cat behavioral medication and prefer to find a solution that focuses on behavior modification or a change in your cat's environment. However, keep in mind that some problems can be resolved more quickly - and with less distress to both you and your cat - if medication is added to the treatment plan.

The most effective approach to treating a behavior problem in a cat is behavior modification. Behavior modification plans designed by knowledgeable, qualified professionals treat a problem behavior by:

• Changing the consequences of the cat's behavior


• Giving the cat an acceptable outlet for her natural behavior or an acceptable behavior to do instead of the problem behavior


• Using a combination of these solutions

Unfortunately, behavior modification can prove difficult in some situations. For example, natural cat behavior is sometimes at odds with a cat's environment. Many modern households have multiple cats. But cats are solitary hunters, and although they sometimes get along, it's also normal for them to avoid each other. Because living together isn't natural for them, it's sometimes necessary to help cats in a single household learn to accept each other. This can be accomplished through a kind of behavior modification procedure called desensitization and counterconditioning (DSCC). (Please see our articles, Introducing Your Cat to a New Cat and Desensitization and Counterconditioning, for more information.) Sometimes, however, cats are so excited and upset by the sight and smell of each other that DSCC isn't possible. In these cases, behavioral medication can reduce the cats' reactivity to each other enough so that DSCC can be carried out successfully.

Can You Use Medication Instead of Behavior Modification?
Behavioral medication alone isn't usually enough to resolve behavior problems. Medication serves to reduce the emotional part of a situation, but it doesn't resolve the behavioral component. Once medication gets your cat's emotional reactions under better control, behavior modification can be used to change her behavior. For instance, if your cat is afraid of another cat in your home, she might not use the litter box because of her fear. Medication can help your cat be less reactive to the other cat - but it won't help her learn to use the litter box again.

Which Medicines Are Best for What?
For the most part, four types of behavioral medicines are used to treat behavior problems in cats. These medicines are

• benzodiazepines (BZs),
• monoamine oxidase inhibitors (MAOIs),
• tricyclic antidepressants (TCAs) and
• selective serotonin reuptake inhibitors (SSRIs).

The following table shows different cat behavior problems that have been successfully treated with a combination of medicine and behavior modification:



Medicines for Treating Sudden or Severe Fear, or Aggression
Just like antibiotics need to be taken for a while before they begin to fight bacteria, most behavioral medications for cats need to be taken daily for several weeks before they produce results. In situations where your cat is acting aggressive at the slightest sight or smell of another cat or has some other severe reaction to a fear of something else, a few weeks can be too long to wait. Benzodiazepines (BZs) can reduce your cat's reactivity immediately. BZs produce results as soon as they're taken, so they can treat fear or aggression within a few hours.

Some common BZs are diazepam (Valium®), alprazolam (Xanax®), chlordiazepoxide (Librium®), lorazepam (Ativan®) and clonazepam (Klonopin®). BZs work by increasing the activity of a chemical in the brain that interferes with activation of the fear networks.

Dose Effects
You can only know if a drug is working if you have an idea of what effects to expect. The following list offers expected reactions in cats to different doses of benzodiazepines:

• At low doses, BZs decrease the intensity of excessive behavior and reduce excitability.
• Moderate to high doses of BZs can reduce anxiety and increase playfulness, but they can also produce impaired movement and thinking, including disorientation. BZs affect some of the same parts of the cells in a cat's brain as alcohol does in a human brain, and they produce similar effects. High doses can produce increased restlessness and anxiety, particularly when an animal is already stressed when given the medicine.

Side Effects
Benzodiazepines can increase appetite and sleeplessness. They can also interfere with learning and memory, so they aren't good choices for long-term use with DSCC.
Health Issues

Benzodiazepines are metabolized in the liver and excreted through the kidneys of a cat, so if your veterinarian advises you to treat your cat with BZs, he should check your cat's liver and kidney function with a simple blood test. If your cat has had problems with her kidneys or liver in the past, be sure to let your veterinarian know.

Medicines for Treating Ongoing Behavior Problems
Behavior problems that involve day-to-day household issues, such as problems between multiple cats within a household, or ongoing problems, such as excessive grooming, are best treated with medicines that are given long term, such as TCAs, MAOIs and SSRIs.

Tricyclic Antidepressants
Tricyclic antidepressants (TCAs) were first used to treat depression in people. They work primarily by increasing serotonin and norepinephrin - two neurotransmitters that are involved in regulation of emotional activity. They also affect other neurochemicals involved in emotional reactivity. The TCAs prescribed most for cats are amitriptyline (Elavil® or Tryptanol), clomipramine (Anafranil® or Clomicalm®), doxepin (Aponal®), imipramine (Antideprin or Deprenil), desipramine (Norpramin® or Pertofrane) and nortriptyline (Sensoval). Every cat is unique behaviorally and physiologically, so while one TCA might not work well for your cat, another TCA could have excellent results.

Although TCAs were originally intended to treat depression in people, they can also reduce anxiety, manage compulsive behavior and help people with anger problems. They've been used successfully in cats to help treat compulsive behavior problems like excessive grooming, reduce reactivity to other cats in the household and treat anxiety problems.

Dosage Schedule
TCAs are prescribed for use every day. If the medicine isn't taken every day, it won't work to treat the behavior problem. TCAs are not usually effective the first day - or even the first few days - that they're taken. Because at least some of their effectiveness comes from the changes they make to the brain, TCAs must be taken for at least two to three weeks before they produce results. Treatment should continue for at least two months before a decision is made regarding the success of the drug.

Health Issues
TCAs are metabolized in the liver and excreted through the kidneys of a cat, so if your veterinarian advises you to treat your cat's behavior problem with a TCA, he should give your cat a simple blood test to make sure these organs are working well before beginning treatment. If your cat has had problems with her kidneys or liver, be sure to let your veterinarian know. It's recommended that a recheck blood test be done every year (twice a year for older cats) to ensure that the medicine hasn't damaged the liver or kidneys.

TCAs should not be used with MAOIs because the combination of these two types of drugs can increase serotonin to unhealthy levels.

Side Effects
TCAs can increase water retention, and water retention produces dry mouth. As a result, some cats might foam at the mouth, and they might also be extra thirsty. Because they're thirsty, they might drink extra water. Water retention can also lead to constipation and even diarrhea. All of these effects can lead to house-soiling problems. TCAs can also cause a sudden increase in heart rate.

Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors (MAOI) work on similar neurotransmitters as TCAs, but they work differently and with less selectivity, so they have a more general effect on the brain. Selegiline (Anipryl®) is an MAOI that seems to mostly affect the neutrotransmitter dopamine. It's used to treat cognitive dysfunction in older cats, and studies indicate that it can slow aging of the brain.

Health Issues
Some MAOIs can have dangerous side effects when cheese is eaten. Selegiline doesn't fall into this category, but because some humans have reactions to cheese when taking it, pet parents should avoid giving their cat cheese when she's taking selegiline.

MAOIs should not be used with SSRIs because the combination of these two types of drugs can increase serotonin to unhealthy levels.

Selective Serotonin Reuptake Inhibitors
SSRIs affect the brain chemical called serotonin. Common SSRIs are fluoxetine (Reconcile® or Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

SSRIs like fluoxetine and sertraline have been successfully used to treat a number of anxiety-related behavior problems, such as fearful avoidance of the litter box, fear of other cats in the household or aggression toward other cats. SSRIs are also useful in reducing compulsive behaviors, such as excessive grooming.

Health Issues
SSRIs are metabolized in the liver and excreted through the kidneys. Even if your veterinarian does a pretreatment blood test to check liver and kidney health, be sure to let him know of any medical problems your cat has or has had in the past. It's a good idea to have your cat's liver and kidneys rechecked each year if she's kept on an SSRI.

SSRIs shouldn't be used with MAOIs because the combination of these two types of drugs can increase serotonin to unhealthy levels.

Dosage Schedule
SSRIs need to be taken every day to be effective. If the medicine isn't taken every day, it won't work to treat the behavior problem. SSRIs are rarely effective the first day and, in fact, can increase anxiety in some cats before they begin to have therapeutic effects. Because SSRIs create changes in the brain, they must be taken for at least six weeks before they produce results. Treatment should continue for at least four months before a decision is made regarding the success of the drug.

Because SSRIs take a few weeks to take effect, some people also treat their cat with another medicine, such as a benzodiazepine, when they begin treatment with an SSRI.

Serotonin (5-HT) Agonists
Buspirone (BuSpar® or Bespar) is the only 5-HT agonist that's used regularly in companion animal behavior treatment plans. It's sometimes used in conjunction with SSRIs and TCAs when treatment begins, but it's also sometimes used by itself.

Dosage Schedule
Like other medicines that act on serotonin, buspirone needs to be taken every day to be effective. If the medicine isn't taken every day, it won't work to treat the behavior problem. Buspirone usually takes about three weeks to produce therapeutic effects, although this period might be shortened if the medication is taken in addition to an SSRI.

Giving Your Cat Her Medicine
If you decide to use a behavioral medication to help your cat overcome a behavior problem, you might run into a challenge when you try to give her medicine. It can be difficult to get cats to swallow pills, and some cats get so upset by the pilling process that they start avoiding their pet parents altogether. To learn how to give your cat the medicine she needs in the least stressful way possible, please see our article on Giving Your Cat a Pill.

Seek the Advice of an Experienced Professional
This article is intended to help pet parents understand common behavioral medications used for cats. It is not intended as a guide to choosing behavior medications. If your cat suffers from fear, anxiety, compulsive behavior or any other behavior problem for which you're considering behavioral medication, be sure to first consult a Certified Applied Animal Behaviorist (CAAB or ACAAB) or a board-certified veterinary behaviorist (Dip ACVB). These qualified animal behavior experts can evaluate your cat's behavior problem and help you develop a treatment plan, give you advice on suitable medications, and work with your veterinarian to maximize the success of your cat's treatment program. Please see our article Finding Professional Help to locate one of these experts in your area.

Used with permission of the ASPCA, © 2009 ASPCA. All Rights Reserved.

Related Topics:

• Pet Health: The Veterinarian Is In
• WebMD Healthy Pets Newsletter - Behavior and health tips for cats & dogs

Labels: ASPCA, behavior, cat, cat training, medication

The word "compulsive" describes the repetitive, irresistible urge to perform a behavior. Most compulsive behaviors are normal activities, such as eating, grooming, moving around or sexual behaviors, but they occur in the wrong contexts and to such an extent that they interfere with normal functioning. The most common compulsive behaviors in cats are wool sucking or fabric eating (a form of pica) and excessive licking, hair chewing or hair pulling (called psychogenic alopecia). When performed compulsively, these behaviors can be harmful to a cat. Cats who eat fabric can suffer intestinal obstruction, and cats who over-groom can develop skin wounds. Sometimes a cat becomes so compelled to engage in a compulsive behavior that it interferes with her ability to lead a normal life and impairs her relationship with her pet parent.

What Causes Compulsive Disorders?
Compulsive behaviors often develop when a sensitive cat is frustrated or stressed. Initially, the cat performs a displacement behavior. She wants to do one thing but she can't, so she gets frustrated and does something else. For example, when a cat sees another cat outside the window, she might want to attack - but she can't get out, so she performs a seemingly irrelevant behavior instead, like licking herself. If stressful situations like this happen repeatedly, the cat may continue to engage in the displacement behavior. At first, she'll do it only in stressful situations, but she may eventually do it even when there's nothing frustrating going on. At this stage, the behavior has become repetitive and compulsive.

While it's not been confirmed, some experts believe that kittens who were weaned too early might be susceptible to developing compulsive disorder later in life.

Facts About Compulsive Disorders in Cats

• Cats are usually less than two years of age when they develop compulsive disorders. Kittens may be as young as three to four months old when they start wool sucking, for example.


• Although any cat can develop a compulsive disorder, Oriental breeds, such as the Siamese, are particularly prone to developing them. It's likely that the breeding practices necessary to create and maintain these purebred cats also concentrate genes associated with compulsive disorders.


• Female cats are more commonly affected with psychogenic alopecia. There is no known sex bias for other compulsive disorders.


• Compulsive disorders occur most often in cats who live exclusively indoors, presumably because indoor cats get less mental stimulation and physical exercise. Indoor cats are also more likely to face stressful situations, like fighting with other cats in the home.


• Significant disruptions in a cat's life, like moving to a new house, home remodeling, or the addition of a new pet or family member to the household, can cause stress and trigger the development of compulsive behavior.

Check with Your Veterinarian First
Don't assume that your cat has a compulsive disorder just because she's licking herself or eating non-food items. Some medical conditions can cause these behaviors, so it's crucial to have your cat thoroughly examined by her veterinarian before doing anything else. A cat who licks herself excessively might be suffering from allergies or fungal infections, or she could be experiencing pain in the area she licks. A cat who eats non-food items, such as fabrics, could be suffering from a nutritional deficiency. If you have more than one cat and they all share a food bowl, it's also possible that your cat simply isn't getting enough to eat.

It's important to understand that behaviors originally caused by medical problems can become compulsive. Your cat might continue performing a behavior, even after you've resolved its medical cause.

Identifying the Cause
Once you've ruled out medical issues, the next step is to figure out what's causing your cat to feel stressed and, if possible, get rid of it. Some of the most common factors that contribute to the development of compulsive disorders include the following:

• Separation anxiety, particularly if someone in the family is absent for a lengthy period of time, or if a person or pet in the family has died or left the home


• A new person or pet in the household


• A move to a new home


• Restricted access to the outdoors


• Inadequate social or environmental stimulation due to an exclusively indoor life


• The presence of cats outside the windows of the home


• Loud or high-pitched noises


• Attention seeking

Obviously, some of these factors can't be eliminated or avoided. However, if you can't remove the source of your cat's stress, there are still ways to help her cope.

Helping Your Compulsive Cat
If your cat reacts to a specific sight or sound, you can expose her to the thing that upsets her at such low levels that she remains calm. At the same time, you'll be associating the thing with something your cat enjoys, like treats or play. For instance, if she gets stressed when you play the piano, start by teaching her that she gets tasty salmon every time you play a very quiet tune. As she demonstrates that she's comfortable with this, take several weeks to gradually expose her to louder music. Each music session should be accompanied by her favorite foods. For more information about this kind of procedure, please see our article, Desensitization and Counterconditioning.

Cats who are stressed by the presence of other cats outside the home can be discouraged from watching out windows. Remove your cat's favorite resting spots by windows, and make other places more appealing. If necessary, cover the windows with curtains, blinds or even an opaque material like cardboard. Please see our article, Keeping Cats Out of Your Yard, to learn about ways to deter outside cats from coming around.

If your cat lives exclusively indoors, enrich her environment so that she has plenty of things to do. Make sure you have structures for climbing and perching, bird feeders, fish tanks or Kitty TV for watching, and interesting toys for playing. Spend 10 to 15 minutes at least once a day playing interactive games with your cat. Some cats even enjoy a daily walk outdoors on a harness and leash. (Please see our article, Enriching Your Cat's Life.

Some cats engage in compulsive behaviors because they get attention from their pet parents. It's important that you don't unintentionally reward your cat with attention when she's engaging in a compulsive behavior. If you do, she might learn that eating fabric, for example, makes you follow her around everywhere, or that licking herself makes you come over and stroke her. It's best to interrupt your cat without interacting with her. Simply remove the item she's chewing, or clap your hands to distract her from licking.

If your cat is having a hard time adjusting to a dramatic change in her life, such as a move or the loss of a family member, medication might help her. Anti-anxiety medications, such as fluoxetine (Prozac^®) or clomipramine (Clomicalm^®), are often helpful in treating compulsive disorders. Please see Behavioral Medications for Cats for more information and Finding Professional Help for a referral to a veterinary behaviorist.

Specific Tips for Fabric Eating and Wool Sucking

1. Keep desirable items out of reach, and prevent your cat from going into rooms where she can access bedspreads or curtains. If she sucks or chews specific items, spray them with a deterrent to make them taste bad. Please see our article, Using Taste Deterrents, for information about products designed for cats.


2. If your cat sucks or chews but doesn't ingest fabric, provide furry mice and soft toys as acceptable alternatives. If your cat eats fabric, provide toys made of rubber or plastic. Scatter the toys in areas where your cat would normally go to look for fabric items.


3. Some cats will chew on fresh catnip and cat grass as safe alternatives to fabric. A few even like to eat lettuce and green beans.


4. Some cats enjoy chewing pieces of thin rawhide lightly coated with fish oil or cheese spread. Others prefer to chew on raw chicken wings. Make sure they're raw - cooked bones can splinter and choke or injure your cat. Only give your cat rawhide or chicken wings when you're able to closely supervise her.


5. Use your cat's feeding times as enrichment opportunities. Hide small dishes of her food around the house so she has to hunt for them. You can also see if she'll eat from a food puzzle toy. You can use toys made for small dogs, such as the KONG^® or the Tricky Treat™ Ball. Alternatively, you can make a toy by punching holes in an empty toilet paper roll. Make the holes large enough for the pieces of kibble to fit through. Cover one end of the roll with tape, dump some kibble or other semi-hard treats inside, and then cover the other end, too. Set the toy down in front of your cat and roll it so that she sees the food fall out of the holes.


6. Speak with your cat's veterinarian about feeding her a high-fiber, low-calorie diet. She'll be able to eat more of this kind of food, which will keep her occupied for longer periods of time.

Can a Compulsive Cat Be Cured?
It's often not possible to completely cure compulsive disorders in cats. However, behavior modification, drug therapy and changes to your cat's environment can be effective in reducing the frequency and intensity of her compulsive behavior, making it more tolerable for you and for her. It may help you to keep a daily diary of your cat's behavior so that you can see whether your efforts are helping. If they are, seeing it on paper will encourage you to continue with the treatment program.

What NOT to Do

• Do not punish your cat for engaging in compulsive behavior. Punishing her will increase her stress, and she'll probably do even more compulsive licking, sucking or chewing as a result.


• It's usually not helpful to physically prevent your cat from engaging in compulsive behavior. For example, making her wear an Elizabethan collar probably won't work. While restraint can be helpful in the short term to keep your cat from harming herself, it's important to find a long-term solution to address the source of the underlying anxiety.

Used with permission of the ASPCA, © 2009 ASPCA. All Rights Reserved.

Related Topics:

• Pet Health: The Veterinarian Is In
• WebMD Healthy Pets Newsletter - Behavior and health tips for cats & dogs

Labels: ASPCA, behavior, cat, cat training, compulsive