Sometimes, fear and anxiety can make it difficult for a cat to cope with her daily life. Perhaps there has been a change in the environment – a new cat or dog comes to live in the home or a new born baby comes home one day.

A diligent owner tries to adapt the environment to accommodate the cat and the newcomers.   Sometimes, the resident kitty remains upset, hiding under the bed and not the using the litter box regularly. 

So, off to the vet for kitty. The vet may prescribe a behavior medication for a cat to reduce anxiety and allow the cat to start to acclimate to the changes in her world (Reference 1).

Can Behavior Medication for a Cat Help?

Daily behavior medications may be prescribed for cats due to:

  • anxiety
  • fearful behavior or aggression
  • inter-cat aggression
  • urine marking
  • overgrooming due to anxiety or other psychological reasons

How Does a Daily Behavior Medication for a Cat Work?

Most of the daily drugs prescribed for feline behavior problems involve the neurotransmitter serotonin.

Serotonin is a neurotransmitter, a chemical that transmits signals from a nerve to another nerve, muscle cell or gland. In humans, serotonin regulates behavior, mood, memory and metabolic processes in the intestines (Reference 3). Serotonin is thought to perform a similar function in cats, inducing feelings of happiness and calmness.

The most common drugs used to treat feline behavior problems include:

  • fluoxetine (human analog is Prozac)
  • clomipramine
  • buspirone


Fluoxetine is a Sustained Serotonin Re-uptake Inhibitor (SSRI). It works by blocking the “reuptake” of serotonin, interfering with the metabolic “recycling” of serotonin and, consequently, serotonin actively transmits its messages for a longer period of time.

Time to full effect
Initially, there is an excess of serotonin due to the medication. Serotonin receptors are overwhelmed and you may see side effects such as decreased appetite and activity, and decreased grooming. But over 4-6 weeks, most of the receptors become less sensitive to the excess serotonin and the side effects abate (Reference 2).

Fluoxetine is the “go-to” daily behavior medication for a cat for most cases of feline anxiety, aggression, and house-soiling.


Clomipramine not only blocks the reuptake of serotonin, it also blocks reuptake of norepinephrine, a neurotransmitter responsible for the emotions underlying the “fight or flight” response. Most of the benefits of clomipramine are due to the action of serotonin, although norepinephrine also regulates anxiety and behavior.

Clomipramine has an antihistamine effect that contributes an additional calming effect similar to the sleepiness you may experience when taking allergy drugs such as benadryl.

Clomipramine reaches full effect in 4 weeks. There is more of a tendency toward side effects such as sedation, dry eye, dry mouth, urine retention, and constipation when compared with fluoxetine (Reference 2).

Clomipramine is typically used for canine separation anxiety and urine marking in cats. However, it has seen use to calm “bully” cats that pick on their more timid housemates (reference 4), due to its antihistamine effect.


Buspirone is another drug used in cat behavior. This drug binds directly to serotonin receptors to reduce anxiety and promote boldness (Reference 2).

Buspirone reaches full effect in 1-2 weeks. Cats on Buspirone are more friendly and socially assertive. Because the drug promotes boldness, it can make aggressive cats more aggressive. It is primarily used to treat fearful, non-aggressive cats for urine marking and in cases of inter-cat aggression (Reference 2).  Victim cats on buspirone are bolder and are less likely to behave like “prey” when around more aggressive cats.

How do I know if the drug is working?

To determine if the drug is working, you must “measure” the behavior regularly and compare it to the behavior you observed before starting the medication (Reference 1).

Before Starting the medication

  • Identify the problem behavior.
  • What are the characteristics of the problem?
  • How often does this occur?
  • Where does it occur?
  • Can you assign an intensity to the behavior? 10 for very intense, 0 for calm, relaxation?
  • How long does an episode last – how long before the cat becomes calm again?

It can be helpful to draw a house map and note on it where the behavior occurs.

House Map
A house map showing areas where house-soiling has occurred.

Once the medication starts…

Maintain a daily diary of the behavior. Look for trends showing that the behavior is not as frequent, not as intense or prolonged (Reference 1).

Keeping a Diary

Back to our cat who had her world turned upside down with a new dog or baby. She is hiding and not always using her litter box.



The owner can record how often and/or how long the cat hides under the bed.


In this case, monitoring involves checking the house for soiled areas and noting if the cat has soiled these areas.

The number of house-soiling/hiding incidents should decline if the drug is working once there has been enough time for it to reach full effectiveness.

Serotonin Syndrome

Too much serotonin can be fatal. Watch out for:

  • accidental overdose
  • combining two or more medications that act on serotonin
  • combining supplements that boost serotonin levels with medications such as fluoxetine, clomipramine and buspirone.

Signs of serotonin Syndrome

  • agitation, restlessness, aggression
  • tremors, ataxia, seizures, coma
  • vomiting, diarrhea, lack of appetite

Seek emergency treatment immediately if your cat takes a behavior drug and you see these signs!

A daily behavior medication for a cat can help reduce anxiety and aggression to a level where the owner can start a behavioral modification program. Even in cases where the owner is already following a behavioral modification program, medication can help improve the effectiveness of the program. These drugs, under a veterinarian’s supervision, are safe and can improve feline welfare. Maintaining a daily diary of behavior incidents is an important part of assessing the drug’s efficacy.


  1. Denenberg S, Dubé MB. Tools for managing feline problem behaviours: Psychoactive medications. Journal of Feline Medicine and Surgery. 2018;20(11):1034-1045. doi:10.1177/1098612X18806760
  2. Herron, M. Integrated Care: Feline Psychopharmacology, Nutrition, & Supplements. Presented at: 2022 American Association of Feline Practitioners Conference, Pittsburgh, Pennsylvania. October 27-30, 2022
  3. Bamalan OA, Moore MJ, Al Khalili Y. Physiology, Serotonin. [Updated 2023 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:
  4. Capuzzi, Joan. Medicine to Ease the Feline Mind. dvm360.February 2023 Vol. 54 , Issue 2, p. 16 January 4, 2023. Viewed 5/2024.
Art by Kal Meyer

Imagine being suddenly snatched up by a giant from your favorite chair. You are lifted up into the air, your legs flailing as you try to maintain your balance. Scary, huh?

Some of the more exciting scenes in fantasy movies include the hero or heroine being snatched up and taken away. In the Wizard of Oz, a troop of flying monkeys swoop down and grab up Dorothy and her dog, Toto, taking them to the castle of the Wicked Witch of the West. A giant ape carries Ann Darrow up the Empire State Building in the movie “King Kong”, as the audience shrieks and squeals.

Picking up your cat can be frightening for him. He often has little warning before he is airborne. He feels helpless and scared. But, you say, I pick my cat up all the time and he does not seem to mind.  In certain circumstances though, he might redirect his fear as aggression and  bite or scratch you, if you try to pick him up, say, to move him away from the vacuum cleaner.

Okay, so maybe you can coax him to go where you need him to by using treats or a target stick. But there still will be times when picking up your cat is necessary – for example, you may need get him out of the way of a car. What can you do?

Picking Up Your Cat Step-by-Step

The “Pick Up” behavior was a by-product of training Gus, a feral cat caught in a live trap when he was three years old.

When you picked Gus up, he often would thrash and flail in your arms, biting and scratching. He responds well to clicker training so I wondered if I could teach him to be picked up, in the same way he learned to sit and target.

We broke the behavior of being picked up into the following steps.

  1. Kneel next to him on the floor and touch him where I would if I were going to pick him up. Give the verbal cue “UP”, then, click and treat.
  2. Slide my arms around him like I was going to pick him up. Give the verbal cue “UP”, then, click and treat.
  3. The next step was to actually to start to pick him up briefly, lifting him off the ground, with the cue “UP”. Click then treat.
  4. Finally, I would pick him up off the ground for a few seconds while saying “UP”.  I would click when he was off the ground, then treat him when I placed him back on the ground.
  5. I “shaped” the behavior by picking him up and holding him longer and longer, always rewarding him afterwards.


Unlike most of the time we train our cats, “UP” does not require the cat to actively choose to do something. It involves a passive response. The click marks that the cat is being lifted up and will be rewarded in the near future. But, the “click” can also make your cat feel good.

Like Pavlov’s dogs, who salivated when they heard a bell, the “click” is a classically conditioned response.   Once the click has been consistently associated with food or another reward, it ultimately triggers the same pleasurable emotions as the reward.

The “Pick Up” command was so successful that I taught all my cats this. Gus still squirms sometimes when the hold is taking him somewhere he does not fancy going… but, the biting has stopped! And he is rewarded for his patience with treats or head rubs when we arrive at our destination.

Although your cat is not in control of the situation when being picked up, if he hears the cue and the click, he knows what is going to happen, and can anticipate something good which should reduce his fear and anxiety.


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Art by Kal Meyer

“Music has charms to soothe the savage beast” is actually a misquote of the poem, The Mourning Bride, by William Congreve in 1697. The word “beast” is commonly substituted for the original word “breast”.  But perhaps Congreve actually meant “beast” – a similar reference to “savage beasts” and music is found earlier with the Roman poet Lucan, whose work was translated into English by Thomas May in the 1620’s.

“…Whose charming voice and matchless musick mov’d

The savage beasts, the stones, and senseless trees…”

Music can arouse strong emotions in people – it can help instill a martial spirit, make us happy but also make us melancholy and sad. It clearly effects our mood.

Researchers at the University of Wisconsin set out to find music that would affect the moods of our cats. Snowden, Teie and Savage created music for domestic cats that would calm the cats. They observed the responses of cats to the “cat music” and compared these with the cats’ responses to classical music that humans find calming.

Human Emotions and Features of Music

Specific features of music induce particular emotions in humans:

  • Slow tempos, a narrow frequency range, decreases in pitch, longer sounding of the notes are characteristic of “sad” music
  • “Joyful” music features fast tempos, increasing pitches and notes tend to be more staccato and not held very long.
  • “Angry” music is louder and has a higher fundamental frequency; “fearful” music also has a higher fundamental frequency but notes are not held as long.

Snowden and Teie hypothesized that music with the features described above would affect cats in the same way as people, as long as the frequencies and tempos are the same as what is found in natural cat communication.

Cat Music vs Human Music

The “cat music” used in this study had an average pitch that was 2 octaves higher than the human music; it was also 1 octave higher than the fundamental frequency of natural cat communication  (“meows” and “howls” were excluded).

The “cat music” also included elements at lower frequencies for the listening pleasure of the cats’ human friends. One piece contained a pulse rate of 1380 bpm, similar to purring, with melodic sliding frequencies; another had a pulse of 250 bpm, similar to kittens suckling, also with melodic sliding frequencies.


Do cats like cat music?

Snowden, Teie, and Savage’s study compared the reactions of 47 spayed and neutered cats to the “cat music” with the cats’ reactions to the human music. Researchers watched for the following responses:

orient/approach behavior

  • orient head toward speaker playing music
  • move toward speaker
  • rub speaker
  • purring

Avoid/fearful behavior

  • leaving the room
  • hair on end
  • growling
  • hissing
  • arched back


Cats showed more Orient/Approach responses to the cat music than the human music. They also approached the source of the cat music more quickly than the human music. There were few Avoidance/Fearful behaviors (9 out of 94 trials – same for both types of music).

Cats were more interested and responsive to music that was designed for them. These pieces were also composed to be calming, so perhaps it is not surprising that there were few “negative” behaviors seen in the cats’ responses to the music.  So, when choosing music for your cat, consider the features of the music and what emotional state they may induce.  Just randomly picking some classical music to play for your cat may not achieve the goals that you are looking for. 

Trying Out Cat Music

In 2019, the cat music was tested in the veterinary clinic at Louisiana State University. Twenty one cats completed the study. The cats presented for 3 examinations, two weeks apart. Each cat was exposed to one of three soundtracks : silence, cat music or classical human music. Each session included an examination and blood draw. The chosen soundtrack was played throughout the session, until the cat was placed back in her carrier.

Cat Stress Scores (CSS) were measured when the cat arrived, during the exam and at the completion of the blood sampling. A Handling Score (HS) was also measured during the examination.

The CSS and HS were not very different comparing cats exposed to silence and classical music; however, CSS and HS were significantly lower for cats exposed to the “cat music”.

cats prefer species specific music

Art by Kal Meyer

Cat music can help reduce stress-related behaviors.  I have found “cat music” useful to calm my kitties

  • when work is being done on my house
  • when I am transporting my cats in the car.


The cat music developed for the studies above can be purchased at

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Cats are not only predators, they are also prey for larger carnivores like coyotes. A predator will target a weak or injured prey animal so it is important that prey animals hide their pain, so they don’t become some else’s snack. Cats are no exception and are masters at hiding pain. As a veterinary technician, I have found clients often do not give pain medication that we send home because “he didn’t seem painful”.

Painful cat?

how do I know if my cat is painful?

It is hard to assess pain in animals and young children.  They can’t tell you how it hurts. There has been interest in  developing methodology for computer assessment of pain in human children using facial expressions. Humans have expressive faces, with 42 facial muscles; there is a universal “pain face”, with lowered eyebrows, eyes squeezed together, nose wrinkled, raised upper lip and open mouth.

Like us, cats also have a “pain face” but it takes some practice to become attuned to it. The Feline Grimace Scale (FGS) was developed to give veterinary professionals an easy-to-use tool to assess whether a cat needs pain medication. With some practice and attention to your cat’s environment, you can tell if your cat is painful.

The FGS focuses on 5 facial features:

  1. position of the ears
  2. shape of the eyes
  3. shape of the muzzle
  4. attitude of the whiskers
  5. position of the head

Each feature is assigned a score of 0, 1 or 2.

“0” = no pain

“1” = moderate appearance of pain

“2” = obvious appearance of pain

The highest pain score with this system is 10; a score of 4/10 indicates the need for pain medication.

The Kitty Pain Face

scoring The Ears

  • Score = 0  Ears are up and facing forward
  • Score = 1   Ears are not facing forward and further apart; they are a little “flat” 
  • Score = 2   Ears are flattened and rotated out, like the wings of an airplane

scoring the eyes

  • Score =0     Eyes are open
  • Score = 1     Eyes partially closed
  • Score =2      Eyes are “squeezed shut”

scoring the muzzle

  • Score = 0    Muzzle is relaxed and round in shape
  • Score = 1     Muzzle is tense and starting to become flatter
  • Score = 2    Muzzle is tense and elliptical in shape

scoring the whiskers

  • score = 0   Whiskers are relaxed and curved downwards
  • Score = 1    Whiskers are beginning to straighten, as the muzzle becomes tense
  • Score = 3    Whiskers are straight or forward

scoring the head

  • Score = 0  The head is up and above the line of the shoulders
  • Score = 1  The head is in line with the shoulders
  • Score = 2   The is below the line of the shoulder

Using the FGS

The FGS was developed for veterinary staff to monitor hospitalized patients.  In the validation studies, cats were observed undisturbed for 30 seconds.  This could be a challenge in the home, where the cat is not in a kennel and can move around.

Pain causes anxiety and stress. The expressions making up the cat’s  “pain face” overlap with the body language of stress. How can you eliminate environmental stress when scoring your cat for pain?

getting a valid score for your cat

Don’t have 30 seconds?

If you’re having trouble watching your cat for 30 seconds, try scoring your cat, then score him again in 15-20 minutes and see if you get the same results as before.

Pain or environmental stress?

Reduce the effect of the environment on your cat. Don’t have someone hold him or rub his head. Try to observe him when there is not a lot of activity in the house – try guiding him to a quiet room and let him settle down before you try to score him.  Don’t interact with him – he may respond by hiding his pain.

If your cat is grooming, eating, or vocalizing, wait until she is finished before assessing her. If sleeping, wait until she is awake. 

practice telling if a cat is painful

Using the FGS can be challenging but it can help you decide sometimes if your cat needs veterinary treatment. Practice observing cats that are painful or not painful to give yourself a mental map of the cat’s face and demeanor.

  1. Go to, and download the FGS manual.
  2. Using the FGS manual, practice your skills with the series of 11 cat photos on the website.
  3. Compare your results with those of the researchers.


Other indications that your cat is painful

  • she is hiding or you find her in a place she usually does not frequent
  • she is more subdued than usual
  • there is a decrease in appetite and activity

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Secure Base test for cat

The stereotype of the aloof, independent cat is being challenged. Do our cats bond with us, their human caregivers? How does this attachment affect the well-being of our cats?

Studies into animal cognition suggest that cats show attachments to their caregivers, similar to those exhibited by human children and dogs.

Researchers at Oregon State University tested a group of cats and caregivers using The Secure Base Test. This test was developed to evaluate attachments to caregivers in apes and dogs; a variant is used with human children.

secure and insecure attachments

In the Secure Base Test for cats,  a cat and his owner were placed in a strange room for 2 minutes. After 2 more minutes, the owner would leave and the cat would be alone. The owner would return in another 2 minutes.

Cats were described as “securely” attached and “insecurely” attached. About 2/3 of the cats were “securely” attached. These cats were willing to explore the room with their owners present and continue to explore after the owners left.  When the owner returned, a “securely” attached cat would greet his owner but would continue to explore and play.

“Insecurely” attached cats were reluctant to explore and sat with their owners or hid in a corner. On return of the owners, some of these cats wanted physical contact with their owners while others avoided contact and did not seem to know what to do.

This makes me think of children at their first day of school – some kids are adventurous while others cling to their parents. So, it seems that our cats bond with us much like dogs and children.

Our personalities and our cats

Another study looked at how owner personality can affect a cat’s well-being. Over 3000 cat owners responded to a survey asking questions about the their personalities and how they characterized their cats’ behavior and health.

Owner personalities were evaluated using the Big Five test. The Big Five test assigns a score for each of the five traits below to describe an individual’s personality.

  1. Openness – willingness to embrace new experiences
  2. Conscientiousness – how responsible and organized a person is
  3. Extroversion – how social and outgoing you are
  4. Agreeableness – how cooperative, kind and trusting you are
  5. Neuroticism – prone to anxiety and depression


  1. Owners scoring high in the anxious (neurotic) category were more likely to have cats with medical and behavioral problems; these cats were often more aggressive, anxious or fearful
  2. Owners scoring high in openness, conscientiousness, extroversion, and agreeableness often had cats that were less fearful and anxious, and more friendly.

These results parallel human studies: Less anxious, open, and agreeable parents are able to provide their children with guidance and limits, without a controlling, authoritarian bias. Children are happier, cooperative, and have fewer behavior problems.


  • We can’t change who we are but we need to remember that because our cats bond with us, our moods and behavior, especially when we are stressed and anxious, can affect them. 
  • We need to avoid micromanaging our cats and let them be cats, doing the things cats do.
  • We need to try to see the world from the “feline purrspective”.


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cat found in swamp

For a time, I lived in the Florida Keys, about 50 miles north of Key West. Half of the island where we lived was owned by the Nature Conservancy and was a natural habitat of mangrove swamps, alligators, snakes and raccoons. There were some feral cats in the Conservancy reserve.

One summer, there was a litter of 4-5 kittens that we saw playing with their mother near the side of the road. In a few weeks, these cats had disappeared with the exception of one little female kitten, who continued to return to the side of the road. We used a Havaheart trap to bring the small kitten home. It was October so we named the orange and black kitten Pumpkin.

Throughout her life, Pumpkin was prone to bouts of bloody urine and not using the litter box. Antibiotic treatment was palliative at best; x-rays and ultrasounds did not reveal any medical causes. She was affectionate but she did not like the other cats. She seemed happiest when my son took her with him when he moved.

Cats’ health and stress…

Veterinary medicine for cats has advanced in the past few decades. If Pumpkin were alive today, she might be diagnosed with FIC, or Feline Idiopathic Cystitis. Idiopathic means that although we recognize the condition we don’t know the cause of it; cystitis refers to inflammation of the bladder.

Cats that suffer from frequent FIC episodes handle stress differently than other cats – they do not release stress hormones such as cortisol in the same way “normal” cats do.

Cats prone to FIC

  • have lower levels of cortisol in their bloodstreams compared to “normal” cats.
  • have higher levels of the “fight-or-flight” hormones.

Like interstitial cystitis in humans, stress contributes to flare-ups of FIC, making a cat sick from stress.

 Cortisol is a potent anti-inflammatory hormone – the lack of cortisol can result in increased inflammation in the body, in this case, the bladder.

Ways to Reduce your cat’s stress at home…

Cat napping on dresser
Gus takes a break on a blanket on a dresser.

Make sure each cat has a safe place – a place that is secure and secluded, a hiding place to retreat to.

Safe Place

Feeding stations for cats
Gus is much more relaxed when eating away from the other cats.

Have several feeding stations, water stations, and litter boxes spread through out the house or apartment.

House map cat resources
A simple sketch of your house can help with locating litter boxes.

Draw the paths a cat must take to get to her food, water and litter boxes in your house. Is there plenty of room for cats to pass other pets and humans?

cat with wand toy
Zelda plays with a toy mouse on a wand toy.

Good kharma with humans.

  • Greet your cat before handling him or her.
  • Have a daily routine for grooming and play.

Positive cat-human interactions

Marley marks the corner wall at the top of the stairs.

Cats communicate  by smell.

  • Use pheromone diffusers in the safe places.
  • Don’t use of strong smelling cleaners.
  • Scoop litter boxes daily.

The Colony Scent

Outside the home – what can make a cat sick from stress

Your cat may view neighborhood cats or other animals coming to the windows and into the yard as threats to his territory. Territorial threats can make your cat sick from stress. Consider…
  • A cat fence can keep other cats from entering the yard
  • Have scratching posts at doors and windows so that the resident cats can mark their territory.
  • A motion-activated sprinkler can help deter animals from coming into your yard.
There is no substitute for appropriate and timely medical care. However,  increased stress contributes to flare-ups of not only FIC,  but other conditions such as chronic diarrhea and overgrooming.

Pumpkin lived to be 17 years old. She was euthanized due to complications of chronic kidney disease. I wish I knew then what I know now – her life may have been less stressful and more comfortable.

Do cats have feelings?

Let’s say that a feeling is “an emotional state or reaction”.  We humans experience many feelings, among them fear, anxiety, joy.  Like us, cats are mammals and have many of the same brain structures we do.  Brain imaging studies of humans and other mammals have linked different areas of the brain to positive and negative emotional states. Cats certainly have feelings.

What kinds of feelings do cats experience?

Cats likely experience fear, anxiety, pain, and frustration, as well as pleasurable sensations that give rise to positive feelings. They do not experience more complex emotions, such as guilt and spite. Happiness for cat is different than for a human – the cat certainly will not be writing poetry and singing songs about how good he feels but he may purr or knead a blanket with his paws.

How do cats experience these feelings?

The neurological pathways are thought to be the same for all mammals. Outwardly, how the animal feels is expressed by his behavior. Different individuals may behave differently while experiencing the same emotion. Two cats may both be feeling frustrated while waiting to be fed. One cat might pace and meow; the other cat may swat at the first cat.

How do I know what my cat is feeling?

Observe your cat’s posture (body language) and behavior.

  • Is she relaxed (calm, confident) -OR- tense, and hunched into a ball (anxious)?

Look at your cat's posture

  • Does he approach you with tail in the air, crooked at the end (confident, happy) -OR-  is his tail twitching rapidly back and forth, tucked tightly (agitated, anxious)?



  • Are his ears up and listening (calm) -or- are they flattened out (anxious, unhappy)?



  • Is she vocalizing – hissing (distressed)? purring (calm and happy)? meowing loudly(frustrated)?



What can I do to make my cat feel good?

Make sure that your cat’s environment is rich, emotionally and physically.

  • Each cat needs place of his own, where he feels safe
  • Have several feeding and watering stations and scratching posts
  • Have more than one litter box in quiet, easily accessed places
  • Have toys available that encourage play and hunting behavior
  • Play and interact with your cat daily
  • Cats have a very sensitive sense of smell – avoid using strong smelling household cleaners, air fresheners, perfumes.