“Look at Me” can often be done with a chin rub and slow eye blinks.

When behavior problems arise, your vet may recommend drug therapy and environmental changes for your cat. These interventions work best when coordinated with a behavior modification plan.

What is behavior modification? What does behavior modification for cats involve?

Behavior modification for cats – more than just training and medication


Behavior modification is a type of behavior therapy. It has its roots in the work of B. F. Skinner in the 1930’s. Skinner was psychologist who believed behavior is a response to an organism’s environment and is not a consequence of mental states (beliefs, memories, desires, plans) (Reference 1).

Skinner came up with the theory of operant conditioning. In operant conditioning, reinforcement and punishment are used to encourage or discourage behaviors (Reference 2).

Reinforce the Behavior – Make It Happen Again!

Add Something “Good” Take Away Something “Bad”
If you reward your cat for sitting with his favorite treat, he is more likely to sit the next time you ask. If you stop trimming your cat’s nails every time she growls or hisses, you are reinforcing her behavior of hissing and growling at nail trims by “removing” the unpleasant nail trim.

Punish the Behavior – Make It Stop Happening

Add Something “Unpleasant” Take Away Something “Good”
If you spray your cat with water when she jumps on the counter, she may be less likely to jump up on the counter. Your cat claws at your hand for a treat. If you put the treat behind your back, the cat learns that the treat goes away when she swats at your hand.

Operant conditioning forms the basis of many training methods.  It appears to be pretty straight-forward: can we just reward the cat for using the litter box and spray her with water if she doesn’t? 

Problem behaviors involve more than just a stimulus and a conditioned response.  Operant conditioning  does not take into account the emotional state of an animal. It may be difficult to positively reinforce or punish an animal that is fearful.

To modify or change problem behaviors, the animal’s emotional state must be addressed. Teaching a cat or dog a substitute behavior for the undesired behavior or medicating him does not teach him how to respond to other stressful situations in his life.

Christine Calder, a member the American College of Veterinary Behaviorists, describes a five step process in working with problem behaviors in dogs (Reference 3).

  1.  Avoid all the things that cause the behavior.
  2. Open the lines of the communication – learn body language; stop punishment.
  3. Build a toolbox of known behaviors such as voluntary eye contact, touch, or a chin rest.
  4. Teach the animal to relax.
  5. Systematic desensitization and Counter Conditioning (to what triggers the behavior).

 Behavior modification for cats can follow this five-step plan.

You may have gotten a new dog or your young nephew comes to stay with you.  Your cat finds these new additions terrifying so she hides under the bed to be safe.  She does not use her litter box because she is afraid the dog or the child will be there. You try to adapt the environment to accommodate your cat and the newcomers but your cat remains fearful. 

Behavior Modification for Cats- More Than Just Training and Medication


  1. Avoid Triggers: We offer the kitty the sanctuary of a room or place in the house off-limits to the dog or child. This area has all the cat’s resources: litter box, cat tree, food and water.
  2. Establishing communication: Spend time with your cat, coaxing her to come to you; brush or pet her if she likes it. Learn her body language so that you know when she is done interacting (see “How to interact with your cat” ). Have your nephew also learn cat body language. Stop punishment: no spraying with water bottles; speak to your cat quietly with a pleasant tone.
  3. Toolbox of known behaviors: For a cat, these may be targeting on your finger or a stick, and learning to pay attention to you through eye contact.
  4. Teach the cat to relax: A cat who is relaxed is calm. She is able to devote more of her energy to learn how to cope with new situations. When the cat can relax on cue, she is able to choose a calm state. We can work up to asking for calm behavior when the dog or child is nearby.
  5. Desensitization: In this case, we introduce the cat to the dog or child in a safe situation. The dog or child is separated from the cat (use a barricade as needed) and the cat can come or go as she pleases. Gradually the distance between the cat and the dog or child is decreased.
  6. Counter-Conditioning: Previously, the cat associated the dog or child with being anxious or fearful. If she can be calm when dog  is on the other side of the barricade, we can start to form some new associations using high-value treats or other things the cat likes, such as being brushed.  With supervision, your nephew may be able offer your cat treats or brush her.

Behavior modification for cats is more than just substituting a desirable behavior in place of a problem behavior.  For the intervention to work, the emotional state of the cat has to be considered.  We need to give the cat a break from the stressful situation, then establish communication with cat.  We need the cat to trust us and look to us for guidance. Teaching the cat to relax and getting accustomed to what triggered the behavior are the final steps of the behavior modification plan.  The services of a cat behavior professional can be helpful in these situations.

references

  1. B.F. Skinner (1904-1990) Advocacy of Behaviorism and its Application to Psychology and Life
    Operant Conditioning and the Law of Effect.  https://psychology.fas.harvard.edu/people/b-f-skinner Viewed 5/2024.
  2. Cherry, Kendra. What is Operant Conditioning? February 24, 2023. https://www.verywellmind.com/operant-conditioning-a2-2794863  Viewed 5/2024.
  3. Calder, Christine D. Behavior Modification for Dogs. Behavior Bytes. December 28, 2022. https://cattledogpublishing.com/blog/behavior-modification-for-dogs/ Viewed 5/2024.

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A cat and dog relax together

Although the expression “fight like cats and dogs” refers to people who are always arguing and fighting, cats and dogs can coexist in peace and harmony.  A slow, gradual introduction provides a foundation for positive and predictable interactions between dogs and cats.

The owner’s role in introducing dogs and cats


Slow, Gradual Introduction – Off to a Good Start


It is wise to be pro-active when introducing dogs and cats.  There are two styles of introductions (Reference 1):

Owner-led introductions

  • Owner uses strategies that prevent dogs from being aroused around the cat.
  • Strategies include distractions such as food treats and encouraging calm behavior.

Pet-led introductions

  • Owners put the pets together expecting them to “work it out”.
  • Behaviors indicative of stress in cats (aggression toward the dog, vocalization, hiding) are common.
  • Risk of injury to either pet is more likely.

How to Lead when Introducing Dogs and Cats


Introducing dogs and cats is surprisingly similar to cat-cat introductions in terms of swapping scents, no visual contact initially, and supervised visits with a barrier in between.  Experts recommend a multi-stage process rewarding both the cat and the dog for calm behavior (Reference 2):

Stage One – the New Pet Arrives

  • Set up a dog zone and a cat zone before bringing the new pet home
  • Allow the resident pet to become comfortable in his or her “zone”.
  • “New” cats do better if confined to a small space initially (see Moving with Your Cat).
  • Keep the dog and cat separate at first for a few weeks. Exchange bedding daily during that time so that each animal gets accustomed to the other’s scent.

It takes a dog about 3 weeks to destress and start settling into their new home and new routines (Reference 2).

Stage Two – Initial Visitations

  • Have two people – one to manage the cat and one to manage the dog.
  • Always use a barrier between the two pets.
  • Don’t force the cat to come to the barrier – wait until he is resting somewhere you can bring the barrier and the dog to him.
  • Consider using a free-standing accordion-style baby gate as a barrier.
  • Allow the cat to leave the area if he/she desires.
  • Have the dog on a leash.
  • Reward calm behavior by both pets with tasty treats.

Stage Three – Intermediate Visitations

  • Remove the dog’s lead and continue to use the barrier.
  • Reward the dog and the cat for calm behavior.

Stage Four – Advanced

  • Remove the barrier but keep the dog on a leash.
  • Continue to reward both the cat and the dog for calm behavior.
  • Gradually increase the duration of the face-to-face time as long as both pets are calm.
  • Be sure to supervise the dog and cat when the leash is removed.

Always make sure the cat has escape routes to safe places – these can be high cat trees, cat flaps in doors to closets or other rooms, the tops of bookcases or high closet shelves (Space Cats Vertically).

This cat can CHOOSE to go higher or to another room if he wants to avoid strange people or animals.

 

Remember that it is natural for dogs to chase cats – buried under the layers of domestication is an animal that chased down small prey to eat and survive. It is also natural that cats will run when threatened by a large predator, trying to reach a safe zone, like a tree.  In Owner-led introductions, the chase sequence is interrupted. These introductions tend to be more successful than pet-led introductions.

 

 

Rewarding calm behavior


When your dog first sees the cat, click (if using a clicker) or say “good” and see if he will take a treat. If he  is whining, barking, stiff, tense or staring at the cat, walk him away from the barrier until you reach a distance where he is relaxed and calm. Reward him with a treat when calm.

Watch your cat for signs of stress – if she is crouched and slinking away, hissing, growling, try to lure her to a place where she is more comfortable, say a high cat tree, where she can observe the newcomer from a safe place. Reward with a high value treat.

Introducing dogs and cats can take weeks to months, depending on the pets.  After your new dog or cat is settled in, you can start slow, gradual introduction. Be sure to monitor the pets’ body language and don’t hesitate to return to an earlier step if things are not going well.

 

A Useful Behavior

Dog owners will find it useful to teach their dogs to ignore food on the ground, other dogs, and small animals (such as cats). This is a useful behavior when introducing dogs and cats.

“Leave It!” is more than just having the dog ignore the food or other animal. One of the key points in this behavior is when the dog focuses his/her attention on you instead of the food or other animal. He is looking to you for guidance.

This behavior is trained in stages but usually starts as follows (Reference 3):

  • Place a treat on the floor and put your hand over it.
  • Have a higher value treat behind your back or in your pocket.
  • Your dog will most likely try to get the treat, sniffing and pawing at your hand.
  • Say “Leave It!”
  • When she stops trying, click with a clicker or say “good”.
  • Offer a higher value treat as she looks up at you.

This behavior can be generalized to include small animals, people or other dogs. In the case of introducing dogs and cats, you can use “Leave It!” to direct your dog’s attention away from the cat to yourself.

references

  1. Kinsman, R.H.; Owczarczak-Garstecka, S.C.; Casey, R.A.; Da Costa, R.E.P.; Tasker, S.; Murray, J.K. Introducing a Puppy to Existing Household Cat(s): Mixed Method Analysis. Animals 2022, 12, 2389. https://doi.org/10.3390/ani12182389
  2. Introducing Your New Dog to an Exisiting Cat. December 5, 2023. https://www.battersea.org.uk/pet-advice/dog-advice/introducing-your-new-dog-existing-cat. Viewed 4/2024
  3. Gibeault, Stephanie. “Leave It” Command: Training Your Dog to Ignore Food and Other Items.  March 14, 2024. https://www.akc.org/expert-advice/training/learning-the-leave-it-command/.  Viewed 4/2024.
Needs of Domestic cats

What do cats need to be healthy and happy? Whether you are a new cat owner or someone who has owned a number of cats, this is a question that needs some careful thought.

Your cat is not human; he/she is a different species. After all, if you were going to have a tiger as part of your household, you would need to learn something about how tigers live in the wild to set up an appropriate habitat. Zoos have found that providing an environment that allows animals to engage in behavior typical of their species reduces mental and physical health problems.

This post was originally published on 7/4/2021.  It has been rewritten and updated with new references on 2/17/24.

What do cats need – Healthy Feline Environments


Let’s start with ourselves. Many philosophers and psychologists have come up with answers to what humans need for a happy and fulfilled life. One of the simpler models is that proposed by the psychologist Abraham Maslow in 1943 (Reference 1).

Needs and motivation


Maslow postulated that people are motivated by five types of needs (Reference 1):

  1. Physical needs (food, water)
  2. Safety
  3. Love/belonging
  4. esteem
  5. self-fulfillment (be all that you can be)

Maslow's hierarchy of needs

As an individual satisfies needs in one of these categories, he is motivated to tackle the next level.

  1. What motivates behavior at the most basic level is the need to survive. We need to eat and drink to stay alive.
  2. Having satisfied these needs, the next step is to ensure that we will continue to have food and water. We need shelter and a job.
  3. Once fed and secure, we can address the need to be part of society – to belong to a group.
  4. The next level of needs is esteem: we need to value ourselves and feel that other people value us.
  5. We are now at the top of the pyramid. We can work on reaching self-imposed goals: maybe become a writer or artist, nurture extended family, or climb mountains.

There is flexibility in this hierarchy- some needs are met at the same time; for some individuals, reaching your full potential may be more important than the esteem of others.

Let’s apply this thinking to cats. We’ll start with the wild cats – those secretive, un-owned cats that populate neighborhoods and barns.

what do cats need? wild cats


  • A wild cat’s needs begin with having prey to eat.
  • Once fed, he will find a safe place where he can sleep, eat and retreat from danger – like a den.
  • He must establish his territory where he can hunt regularly and have access to food.
  • A well-fed wildcat who hunts successfully has good prospects for mating. 
  • As far as Nature is concerned, the wildcat has reached his or her full potential once he or she has ensured that there will be another generation to hunt and mate, continuing the species.What does a wildcat need?

 

When food is plentiful, some cats will group together in colonies near the food source. The colony forms around breeding females with some unrelated male cats in the colony that help with kitten care and protection. A colony fulfills safety and belonging for a wild cat.

what do cats need? Domestic cats


Things are a bit different for the cat who lives with humans. Hunting and establishing a territory have become separate from getting enough food; our house cats are spayed and neutered, so do not have a drive to mate and reproduce. We can construct a hierarchy showing what do cats need for the cats that live with us.

the 5 pillars of a healthy feline environment


The American Association of Feline Practitioners (AAFP) list five things that make a healthy environment for a cat (Reference 2).

  1. A safe place
  2. Multiple and separated key environmental resources
  3. Opportunity for play and predatory behavior
  4. Positive, consistent and predictable human-cat social interaction
  5. An environment that respects the cat’s sense of smell and other senses

 

We can assemble these needs into a pyramid diagram:

  • At the bottom of the pyramid are the needs for survival: food, water, and litter boxes.
  • The next level ensures that these essential resources are available to each cat to use safely, without fear of competition or interference from other cats, pets or humans. The cat owner should provide multiple and separated feeding, watering stations and litter boxes.
  • One of the AAFP requirements is an environment that respects the cat’s sense of smell and other senses.  Such an environment is the cat’s territory. Cats will mark walls and furniture in the home with facial pheromones and scratching posts with pheromones released when scratching. Your cat belongs to his territory.

Thinking about cats as aloof and independent would most likely consider the cat’s needs are met at this point.

Needs of Domestic cats

 

 

the cat-human bond


Our cats share basic physiological needs with their wild relatives. But the domestic cat has chosen a different path and has some different needs because of his bond with his human caregiver. The two final levels of the pyramid are 4) positive and predictable human interaction and 5) the opportunity for predatory play.

  • Human Interaction: To truly feel safe and secure in her territory, a housecat needs to know how the humans in the house will behave: when will she be fed? Will they approach quietly and greet her? Will they swoop down on her and pick her up when she least expects it and hold her dangling in the air?
  • Predatory Play: The need to hunt defines who your cat is – this is what he was born to do.  We need to provide our cats with an opportunity to hunt – whether it is fishing kibble out of a food puzzle or chasing a stuffed mouse at the end of a wand toy.

These last two needs bring us to the heart of the cat-human bond.

Positive and predictable interactions  allow us to communicate with our cats; predatory play helps us recognize the cat’s nature as a born hunter and allows us to share this essential part of his life.

We are one of the “5 Pillars of a Healthy Feline Environment”.

In return for helping our cats satisfy their needs, we humans enjoy the pleasure of our cats’ company, better heart health and reduced stress and anxiety. 

references

  1. Taylor S, St Denis K, Collins S, et al. 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines. Journal of Feline Medicine and Surgery. 2022;24(11):1133-1163. doi:10.1177/1098612X221128763

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An elevated perch allows this cat a good vantage point to survey her surroundings for other cats and people.

Pandora Syndrome refers to cats suffering from multiple medical ailments that do not resolve with appropriate medical treatment. Instead, the symptoms are chronic, waxing and waning in response to environmental stressors. These cats also share a history of traumatic experiences and exhibit an abnormal stress response, partly due to epigenetic changes resulting from the stressful events in their lives (Reference 1).

Pandora syndrome is an “anxiopathy” – a condition resulting from chronic activation of the central stress response system (Reference 1).

Treating Pandora syndrome in cats: the environment


Careful modification of the Pandora cat’s environment (in additional to medical therapies) can reduce the severity and frequency of the cat’s symptoms (Reference 1). One of the first studies to demonstrate the efficacy of MEMO (Multimodal Environmental Modification) studied the response of 46 cats with Lower Urinary Tract Symptoms (LUTS) to MEMO. Cat owners were asked to reduce environmental and social stressors using the following suggestions (Reference 2):

  • avoid punishing the cat
  • change to canned food
  • change to unscented, clumping litter
  • improve litter box management
  • provide climbing structures, viewing and resting perches
  • provide audio/visual stimulation when the owner was gone
  • increase interaction with the cat
  • identify and resolve conflict in multi-cat homes

The most commonly followed MEMO suggestions were:

  • increasing the amount of time interacting with the cat
  • changing to a canned diet
  • adding another litter box

During the 10 months of follow-up, no signs of LUTS were observed in 70-75% of the cats. Owners also reported reduction in fearfulness, nervousness, respiratory signs, aggressiveness, and lower intestinal tract signs (Reference 2).

Treating Pandora Syndrome in cats: MEMO


Environmental modification for the Pandora cat needs to:

  1. increase the security of the environment
  2. allow the cat to feel in control of his environment

Treating Pandora syndrome in cats: choosing the memo that suits the cat


The basic blueprint for cats’ environmental needs can be  found at https://catfriendly.com/cat-friendly-homes/what-your-cat-needs-to-feel-secure/.  Treating Pandora syndrome in cats will be most successful when MEMO is tailored to the individual cat.  Here is some additional information to consider once the basic environmental needs are satisfied.

The Fearful, Nervous Cat that Prefers to Stay Alone

For these cats, MEMO will focus on providing safe places and positive, predictable interactions with humans.

  • make plenty of hiding places available – these can be the top shelves of closets or boxes in the bottom of closets
  • increase the number of “vantage points” through the use of shelves, perches and cat trees (Reference 3)
  • increase the security of the floor space: minimize wide open spaces by positioning furniture to create places where cats can rest and hide (Reference 3)
  • use baby gates to limit the access of potential stressors such as dogs or small children to the cat’s area (Reference 3)
  • allow the cat to choose to interact with humans (https://www.felinepurrspective.com/touch-not-the-cat-interacting-with-cats/)

Treating Pandora Syndrome in Cats in the Multi-cat home

In a multi-cat house, Pandora cats may show aggression or become ill when threatened. Successful MEMO requires identifying the social groups of cats in the house and ensuring that plenty of resources are spread throughout the house. Be prepared to intercept aggression when necessary (https://www.felinepurrspective.com/managing-aggression-in-the-multi-cat-home/) – keep the peace!

Separation Anxiety

Some Pandora cats were orphans or abandoned. These cats may exhibit some separation anxiety due to a strong attachment to the owner. For example, some of these cats follow the owners around like a dog (Reference 1). MEMO can be adapted for these cats.

  1. Encourage Kitty to spend “alone time” in an enriched room or space (don’t force – maybe coax her into the room with some treats). Enrichment can be elevated perches near windows, a play tunnel with toys in it, food puzzles with snacks. Cats have a great sense of hearing and many like music – choose music designed for cats when you are not there.
  2. Establish a routine – help your cat to have control of his environment by knowing what is going happen and when it will happen (https://www.felinepurrspective.com/routines-help-cats-reduce-stress-and-anxiety/).

Many cats cope with environments that are not optimal. However, Pandora cats have suffered traumatic events in their lives resulting in epigenetic changes. These cats exhibit an abnormal response to environmental stress. Consequently, they do not cope as well as other cats with changes in their environment and develop chronic illnesses. MEMO allows these cats to feel safer and more in control of their environments, reducing their stress, and, in turn, reducing the frequency and severity of their symptoms.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Buffington CAT, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. Journal of Feline Medicine and Surgery. 2006;8(4):261-268. doi:10.1016/j.jfms.2006.02.002
  3. Ellis SL. Environmental Enrichment: Practical Strategies for Improving Feline Welfare. Journal of Feline Medicine and Surgery. 2009;11(11):901-912. doi:10.1016/j.jfms.2009.09.011

 

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Some of the Signs that May Indicate Pandora Syndrome

The term “Pandora syndrome” was coined by Tony Buffington of Ohio State University to describe cats with chronic clinical symptoms suffering from health issues involving multiple organ systems. Buffington initially studied a group of 200 cats that had “incurable” urinary tract symptoms (bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts). These cats had other health issues in addition to the urinary tract disease.  Curiously enough, the cats’ symptoms resolved after living in an enriched environment (Reference 1).

Early studies linked the urinary symptoms to diets containing too much magnesium, causing formation of urinary stones. However, dietary changes did not resolve the cats’ urinary issues and they continued to suffer from bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts, frequently in the absence of stones (Reference 1).

diagnosing Pandora Syndrome in cats


What “Pandora Cats” have in common (Reference 2):

  • history of traumatic experiences such as abandonment, orphaning, infection
  • having more than one disease at once
  • clinical symptoms that wax and wane in response to changes in the environment

More About Pandora syndrome in cats


Genetic makeup and traumatic events are thought to contribute to Pandora syndrome in cats. Our genomes (cats and humans) contains the DNA that makes us unique. DNA is made up of 4 building blocks that can be assembled in different orders. The sequence of the DNA building blocks in a gene provides the code for a particular trait such as eye or hair color (Reference 3).

However, there is more to growth and development than just genes that code for a particular trait. The science of epigenetics studies modifications to our DNA that don’t change the order of the DNA building blocks. The epigenome refers to chemical compounds that are attached to your DNA. Exposure to pollutants, what you eat, and stress are some things that can result in certain molecules attaching to your DNA and turning particular genes on or off. This is why genetically identical twins may have different skills, health, or behavior (Reference 3).

The epigenome is reset when the genome is passed on from parents to their offspring at conception. Maternal stress during pregnancy, traumatic events such as abandonment, orphaning, and infection can subsequently affect the epigenome. While many cats recover from these things, others may develop chronic illnesses or behavioral abnormalities (Reference 2).

Pandora cats are inherently “sensitive” cats who have difficulty coping with challenges presented by their environment.  They have a heightened stress response that increases the likelihood of them becoming ill.

Why the name “Pandora” syndrome?
Pandora is a figure from Greek mythology. She was a human woman made by the gods from clay.  She was endowed with many attributes, such as beauty, charm, cleverness, and curiosity. Before sending her to earth, the gods gave her a box, that she was told NEVER to open. Pandora’s curiosity got the best of her one day and she opened the box, releasing evils to plague mankind – disease, violence, greed, old age, death… However, all was not lost. Hope was also in the box to help people survive and cope with the evils in the world.

Like Pandora’s box, “Pandora cats” have multiple problems (“evils”).

diagnosing pandora syndrome in cats


A diagnosis of Pandora Syndrome is a diagnosis of exclusion – the symptoms may respond to medical therapies but then recur. Diagnostic procedures do not reveal a root cause. Diagnosis requires an extensive review of the cat’s life history, medical history and home environment. Some sample questions are below. (A more complete history form can be found in the supplementary materials of Reference 2).

Life History

  • where did the cat come from? from a shelter? was he/she a stray? an orphan?
  • are other cats/pets in the house?
  • how many people in the house?
  • indoor only? outdoor access?
  • is your cat fearful? friendly?

Medical History

  • vomiting? diarrhea? coughing? sneezing?
  • using litter box?
  • history of medical problems- e.g. allergies, heart problems?

Environmental Resources

  • safe and secure resting places?
  • multiple, separated litter boxes, feeding stations, water bowls?
  • can the cat interact with people and other pets on his/her own terms?

treating pandora syndrome in cats


Pandora syndrome is treated with medical therapies and MEMO (multimodal environmental modification).   MEMO aims to reduce the cat’s perception of threat and increase his/her perception of control of his/her environment. There is no cure for Pandora syndrome but medical therapies and MEMO can reduce the cat’s clinical signs and increase the time between episodes of symptoms (Reference 1).

The goal of MEMO is to create an OPTIMAL environment for the individual cat.  This will be the subject of the next post.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Tony Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora syndrome: Where are we, how did we get here, and where to now? Journal of Feline Medicine and Surgery. 2014;16(5):385-394. doi:10.1177/1098612X14530212
  3. National Human Genome Research Institute; Epigenomics fact sheet 8/16/20. Viewed on 1/6/24. https://www.genome.gov/about-genomics/fact-sheets/Epigenomics-Fact-Sheet.

 

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Cats staring
The direct stare is not a friendly behavior.

It is increasingly common for people to own more than one cat. With more than one cat in the home, conflict between cats of the same household is also increasing.

managing aggression in the multi-cat home


It can be challenging to identify aggressive behavior. Cats play roughly and what looks like play might be a fight in progress. Subtle signs like staring and tail twitching are hard to recognize from across the room – overt behaviors such as chasing, wrestling and vocalizing are more likely to catch our eye and ear and alert us to trouble. [Reference 1]

Things to keep an eye/ear out for:

aggression


  • vocalizing: growling, hissing, long drawn out meowing
  • chasing where one cat is the “chaser”
  • offensive postures: stiffened legs, stiff tail
  • defensive postures: crouching, tucked head  [References 1, 2]

play


  • Frequent and long-lasting wrestling/chasing
  • You may hear occasional short, soft meows or chirrups [Reference 2]
  • Reciprocity – cats take turns being on top or chasing

things in-between


There are interactions that combine both play and aggression but do not result in a fight [Reference 1].

  • One cat wants to play and the other does not, responding with a swat and hiss to end the play sequence.
  • Cats of different social groups may need to pass each other. There may be some hissing but body postures are not stiff nor crouching.

interventions – Managing Aggression in the multi-cat home


When you hear yowling/hissing/growling or see stiff or crouching postures, it is time to investigate. Intervention may just consist of opening a door wider so that both cats can pass through. If things are a bit more serious, separate the participants using noise or a barrier. See Managing the Indoor Cat Fight

It is important to identify the social groups in the house.  A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources most likely will not require intervention [Reference 1].

Gus and Marley tolerate each other with the occasional spat.

 

PLAY can become AGGRESSION


  • A cat becomes too exuberant and begins to scratch and bite harder.
  • Reciprocity stops – cats are no longer taking turns.
  • Hissing, growling increases as the other cat tries to end the play sequence.

 

 

Decreasing aggressive play towards other cats

By reducing the desire to play, cats will play less, decreasing the chance that aggressive play happens [Reference 2].

  • Provide play-time for the whole group at predictable times: scatter toys around the room for the group to interact with; play with the aggressive/energetic cats with a wand toy or other interactive toys.
  • These more active cats can also benefit from play time away from the other cats in a separate room [Reference 2].

non-play aggression


Play aggression starts with positive, friendly emotions, whereas non-play aggression arises from fear, anxiety, and frustration [Reference 2].

Common scenarios include cats blocking other cats from accessing resources, or trapping another cat in a place that has no escape route. And there are those “bully” cats that “pick on” timid or shy cats, who respond with crouching down and scooting away.

  • Have plenty of resources spread out through the house (a cat can’t block two places at once).
  • Have multiple, separated play/resting/observation areas.
  • Monitor “bottlenecks”: provide places for cats to avoid each other, e.g. a high cat tree near a doorway, offering an escape from another cat passing through.
  • Enrich the “bully” cat: give him time away from cats not of his social group with access to food puzzles and novel toys.
  • Enrich the “victim”cat: give him or her time away from the bully and his buddies.
  • Put a collar with a bell on the “bully” so that other cats know he or she is coming.  [Reference 2]

redirected aggression


Something happens that frustrates or frightens a cat, and the cat strikes out at whomever is closest. The cat cannot strike out at the cause of the arousal – it may be out of reach or too risky to confront.

A frequent scenario is a strange cat appearing at a window. The cat indoors cannot engage the stranger and redirects her frustration and anger at another cat nearby. Other triggers include high-pitched or loud noises, unusual odors, or visitors in the house.

Dealing With Redirected Aggression [Reference 2]

  • Separate the cats and reintroduce gradually.
  • Desensitize the aggressor cat to whatever stimulated the aggression: if it was a noise – play this sound (or something like it) when the cat is around. Start with a low volume and gradually increase to full volume while offering high value treats.
  • Visitors in the house: train the cat to go to a safe place when visitors come in.
  • For more information, see Redirected Aggression in Your Cat – When It Becomes a Problem.

other interventions – managing aggression in the multi-cat home


  • Medication may be helpful for very timid cats, highly aggressive cats, or to manage redirected aggression where the cat will continue to be exposed to the trigger [Reference 2].  See Dealing with Anxiety and Misbehavior in Your Cat.
  • If conflict continues, you may need to set up a time-sharing plan and have different social groups use critical areas in shifts. See How Cats Get Along – Timesharing.
  • Rehoming the aggressor cat with his social group or the victim cat with her social group may be viable alternatives [Reference 2].

Managing aggression in the multi-cat home requires careful observation of how the resident cats interact with each other.  Knowledge of the social groups in the home can help in deciding whether intervention is needed.  The cat owner must also be willing to respond to problems by adapting the environment, providing opportunities for cognitive enrichment, such as group and individual play time, and separating and reintroducing cats, when necessary. 

Managing aggression in the multi-cat home is essential for the health and happiness of the feline and human occupants.

references

  1. Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1
  2. Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204

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Gus greets Miso

Social Groups of cats in the multi-cat home


This post was originally published 8/29/20. This newer version has been edited to incorporate new material and references.

If there is plenty of food around, free-roaming cats tend to form groups called colonies. The core of the cat colony are the females, typically a mother, her sisters, and her daughters. These females share the care of the kittens – they nurse each others’ kittens and even help each other give birth.

Male kittens are driven off by their mothers at maturity to avoid inbreeding. They can become solitary hunters like their wildcat ancestors or become attached to an unrelated colony if accepted by the females.

Smaller social groups of cats often form within the larger social group of the cat colony.   These groups of 2 or more cats typically

  • sleep snuggled together
  • groom each other
  • rub against each other
  • “play fight”.

These cats are comfortable sharing resources: food, water, litter boxes, sleeping and resting places.  Often these are cats that grew up together but that is not always the case. 

social groups of cats indoors -managing the multi-cat home


In the multi-cat home, some cats also prefer to stay together. Identifying the social groups of cats in the home can aid in allocating resources and reduce conflict among the resident cats [Reference 1].

Identifying the social groups of cats


Members of the same social group mayCat sharing a basket

  • sleep snuggled together
  • groom each
  • rub against each other
  • engage in mutual social play.

There are no hard and fast rules to affiliation: some cats will not snuggle together, but will groom each other and play together.

A Multi-Cat Household and its Social Groups


There are 3 social groups in this 4 cat household.

Social Group 1

Athena forms her own social group.  She is a 15 year old spayed female. She recognizes her housemates but prefers to spend time by herself or with her owners.

Social Group 2

Marley (14 yr neutered male) will hang out with 4 year old Zelda. They will rest together and  “share” snacks. They will occasionally “play fight”.

Social Group 3

Zelda and Gus (3 yr old neutered male) groom each other’s heads and play together occasionally.

Gus and Zelda also go on walks together with their owners.

Allocating resources in the multi-cat home to reduce conflict


One of the keys to harmony in the multi-cat home is to provide multiple resources and spread them throughout the house.  The goal is to ensure that all cats have access to litter boxes, food and water without having to compete with another cat. Here is a simple diagram showing the location of litter boxes on the second floor of a multi-story home [Reference 1].

When locating resources, watch for “bottlenecks” such hallway doors where cats may have to pass each other. Try and place litter boxes, water stations… away from these areas.

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

tips for managing resources in the multi-cat home


  • # litter boxes =  # social groups + 1
  • Feed cats individually and out of sight of each other.
  • Have daily play time for each cat
  • Have multiple sleeping, resting places – have secluded and elevated choices

monitoring interactions between cats to manage conflict


Once the social groups in the house are identified, it important for the cat owner to monitor how the cats are getting along and intervene, if necessary, to prevent conflict [Reference 1].

  • A cat fight can result in injuries to the fighting cats and the humans who try and manage the fight.
  • Aggression does not need to cause physical injury – psychological stress resulting from one cat guarding resources from another can result in illness and undesirable behaviors such as house-soiling.

signs of conflict – signs of play


It is important to be aware of potential conflict in the multi-cat home.  Signs of conflict not only include chasing, running away, howling and hissing, but also more subtle, seemingly harmless behaviors such as staring and blocking doorways.  To make things more confusing, chasing and running away can be play behaviors! For more information, visit “How Do Your Cats Get Along – Conflict Behaviors”.

 Cats are socially flexible and can form social groups with unrelated cats, although the strength and intensity of these social bonds can vary.  A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources may not point to a deterioration in their relationship [Reference 2].  However, cats whose affiliation is weaker and whose inter-cat interactions are frequently punctuated with hissing and growling may warrant a call to your veterinarian or a cat behaviorist. 

The next post will look at identifying aggressive behaviors in more detail and what interventions are available to the cat owner.

references

  1. Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204
  2. Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1

 

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Cats have many more odor sensitive cells in their noses than we humans do. They also have a vomeronasal organ (VNO) in the roofs of their mouths to process odors. Cats communicate by smell.

cats communicate by smell


This post was originally published May 2, 2021 and has been updated to reflect new content.

For a cat, odors can be associated with a particular place or individual animal, identifying that place or animal.

Another way cats communicate by smell is through semiochemicals. Odors can contain semiochemicals, molecules that carry “messages” from one organism to another. The organism receiving the “message” responds with a change in physiology or behavior. For example, there are insect traps that use hormones that simulate the type of scent produced by the female insect. Male insects are lured into the traps, preventing them from mating.

Semiochemicals that carry “messages” between members of the same species are called pheromones. For cats, pheromones are used to mark territorial boundaries, advertise that a cat is ready to mate, or send greetings. Lactating mother cats also produce a blend of “appeasing” pheromones,  that make kittens feel safe and reassured when their mothers are nearby.

Cats release pheromones from glands in their bodies. These glands can be found in…

  • the lips
  • the cheeks
  • the pads of the feet
  • at the base of the tail
  • the area surrounding the teats in females.
Glands producing pheromones
Locations of the glands that produce pheromones in the cat.

 

Cats communicate by smell -pheromones


When your cat rubs his cheeks against furniture or that corner wall, he deposits pheromones there. Researchers have separated secretions from the sebaceous glands in your cat’s face into 5 pheromone-containing fractions. The “F3 fraction” is thought to be a friendly greeting, marking the area as safe.

Cat Appeasing Pheromone (CAP) is released when the mother cat nurses her kittens. It is a message to the kittens that they are safe and secure – after all, mom is there!

Cats also release pheromones when they scratch, marking territory with another pheromone, FIS or feline interdigital semiochemical. The cat making the scratch marks also leaves behind his own individual scent, giving the next cat who comes along an idea of who left the pheromone message. As time goes on, the pheromones/scents decay. This change in pheromones/scents  notifies the incoming cat when the previous cat was there.

using pheromones to communicate with your cat


It is not surprising that synthetic versions of the F3 fraction of the facial pheromones and CAP have been made with the intention of calming cats and reducing conflict in multi-cat households. These products are available as diffusers or sprays.

Facial Pheromones F3 Fraction


  • Diffuser: place in areas you want your cat to identify as safe and secure, for example, sleeping areas.  You may not need to use the diffusers all the time – after all, your cat or cats are most likely marking these areas themselves. However, the diffuser could give an added boost in times of increased stress, such as home renovation.
  • F3 spray can help with  urine marking. Clean the marked spots with enzyme cleaners (eg. Tide), followed by rubbing alcohol. When dry, spray the spot with one of the F3 sprays.
  • The F3 spray is also useful to discourage scratching. Try spraying the area you DON’T want scratched with the F3 spray and place a scratching post nearby.
  • BSerene spray features the F3 fraction combined with catnip oil to promote calm behavior.

Cat Appeasing Pheromone


  • Diffuser
  • This product can be useful in multi-cat households when introducing a new cat. Place the diffuser in the common areas where all the cats will congregate.
  • You may not need to use this diffuser all the time but it can give a boost during times of stress, for example, when one cat returns from a veterinary visit.
  • The BSerene brand offers a diffuser that contains both F3 and CAP.

A product called Feliscratch contained a synthetic version of FIS. Feliscratch was applied to the scratching post to encourage cats to use it.  This product has recently been pulled off the market due to flagging sales.

No Feliscratch?

  • Make scratchers appealing with treats or catnip
  • If your cat will knead a small fleece blanket, it is possible that this blanket may have FIS deposited on it.
  • Placing the blanket near a new scratching post may attract your cat to the scratcher.

Feliway Optimum – one size fits all?

Feliway Optimum is the result of computer simulation and features a single product designed to address urine spraying, scratching, fear, and inter-cat conflict. It is a proprietary blend of specific pheromones that bind to receptors in the VNO in cats. It comes in a diffuser (Reference 1).

 

How effective are pheromones in communicating messages to cats?


The idea of managing cat behavior using pheromones is appealing. There are no pills to give and you can treat all your cats at once. However, studies aimed at determining whether these products work or not have mixed results (Reference 2).

How receptive an individual cat is to pheromone signals may depend upon her experience (Reference 2).  A free-roaming cat or cat who is a member of a multi-cat household will use pheromone signals more than an indoor cat who lives alone.  A kitten bottle-fed by humans will not be exposed to CAP like kittens nursed by a feline mother.

In my own experience, cats with a feral background respond more strongly to the pheromone products than cats raised in a human household.

You can think of pheromones as those signs in the library asking you to KEEP QUIET or the NO SMOKING signs – there is always someone who is talking or smoking. Compliance is never 100%.

Since cats communicate by smell, synthetic cat pheromones allow us to add some basic messages when we are trying to change a cat’s behavior. Do these products work? The efficacy of these products may depend on the experience of the individual cat.  Consequently, pheromones are best used in conjunction with other behavior modifications.

references

  1. De Jaeger, Xavier & Meppiel, Laurianne & Endersby, Sarah & Sparkes, Andrew. (2021). An Initial Open-Label Study of a Novel Pheromone Complex for Use in Cats. Open Journal of Veterinary Medicine. 11. 105-116. 10.4236/ojvm.2020.113006.
  2. Zhang Lingna, Bian Zhaowei, Liu Qingshen, Deng Baichuan. Dealing With Stress in Cats: What Is New About the Olfactory Strategy?. Frontiersin.org/articles/10.3389/fvets.2022.928943, DOI=10.3389/fvets.2022.928943 

 

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Introducing a new cat to an established group of resident cats can be challenging. Most experts recommend a slow, gradual introduction, similar to how wild cat colonies accept new members.

introducing a new cat


Wild cats recognize members of their own colony. Unfamiliar cats will be greeted with aggression if they try to approach and enter the group. This is not to say that non-members don’t join the colony from time to time. If these “outsiders” are persistent in their attempts to join the group, they may be accepted after a gradual process that involves many interactions (Reference 1).

I am in the process of introducing a new cat to my household. The introduction process is still ongoing but here is my progress so far.

Miso is 2 year old male domestic shorthair who had been frequenting the porch where my veterinarian employer leaves food out for the community cats. Miso behaved more like a stray cat and tried to get into the house. So, he was coaxed into a carrier, neutered and had dental treatment at the veterinary clinic where I work.

Miso is friendly toward humans and other cats. Although he is quite a bit younger than my cats, I thought it was worth a try to bring him into my group.

At the time of the introduction, there were 4 cats in my household and two social groups:

  1. Athena, aged 18 years, forms her own social group. She tolerates the other cats but does not snuggle, groom or otherwise interact with them.
  2. Marley, a 17 year old neutered male, 7 year old Gus, and 7 year old Zelda form the second social group. Zelda and Marley will snuggle together particularly when it is cold. Gus and Zelda allogroom; Gus and Zelda also groom Marley.

Getting Ready

 

Introducing a new cat starts with scent exchange. A few weeks before I brought Miso home, I brought home a blanket he slept on and left it in the kitchen area. All four cats carefully smelled it and there was some hissing but that waned over a week.

I made a barricade of closet shelving to close off the downstairs from my resident cats and set up a room downstairs for Miso to stay in with a litter box, scratching posts and food station.

 

Week 1

Miso is calm and confident and asks to go out of his room. He goes out into the catio downstairs. We set up a system of time-sharing the catio, allowing Zelda and Athena to occupy it in the morning while Miso is closed in his room. Miso has the catio in the afternoon.  At night, Miso is closed in his room.

Miso chooses to eat at the top of the stairs next to the barricade. The other cats are fed out of sight in the kitchen.

At the end of the week, I apply a mousse shampoo to Miso and wash his bedding, thinking that he might smell like the vet clinic.  I also put a multi-cat pheromone diffuser downstairs and 4 more on the upstairs floor.

Week 2 – Zelda gets sick

Zelda has diarrhea which I think may be due to the stress of having a new roommate.  The diarrhea  resolves with a few days of probiotics.  

The resident cats frequently hiss while passing Miso at the barricade but they now ignore him and continue on their way. We start to allow Miso upstairs while the other cats are in the catio.

At the end of the week, we allow Miso to have free run of the downstairs and not be closed in his room at night. The barricade is still up.

Week 3 – A Behavior Change for Gus

Miso was trained to harness and leash when at the vet clinic. I officially bring Miso upstairs on a leash and we have our first friendly interaction with the residents – Miso and Gus touch noses and there is no hissing.

Gus greets Miso

Miso is assigned a feeding station (a cat carrier) to eat in and is fed with the other cats. I get a little push back from Gus, who refuses to eat at his feeding station.  I offer him his food on his cat tree which he accepts.

Miso starts doing the evening food puzzle and treat toss with Zelda and Marley. Again, Gus prefers not to participate and does his food puzzles on his cat tree. The barricade is opened during the day near the end of the week.

 

Week 4 – Aggression from Athena

Athena swats Miso and we separate them temporarily, closing Athena in the bedroom. I put a broom near the door way with the water fountain so that I can herd Miso away in case he blocks Athena on her way to water.

There is still plenty of hissing going on but everyone’s body language is neutral. There are still 4 multi-cat pheromone diffusers on the upper floor.  Miso is allowed out in the catio with the other cats.  Everyone keeps their distance.

At the end of the week, Miso is allowed upstairs at night and chooses an empty carrier to sleep in.

Although the cats are sharing common areas now, the process of introducing a new cat is far from over. It will take many more months before all the cats are accustomed to the new resident and the changes in the daily routines.

Introducing a new cat into an established household is stressful for the incoming cat as well as the residents. Even with a gradual introduction, stress-induced illness, changes in routine, and displays of aggression are not uncommon. It is important to monitor the body language of all the cats, accommodate changes in behavior and be ready to separate cats if there is a scuffle.

references

  1. Crowell-Davis SL, Curtis TM, Knowles RJ. Social organization in the cat: a modern understanding. J Feline Med Surg. 2004 Feb;6(1):19-28. doi: 10.1016/j.jfms.2003.09.013. PMID: 15123163.

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A cat enjoys the scents of a summer night from his window seat.

I remember visiting the zoo as a young child. Back then, the animals’ enclosures were not the large, landscaped areas that you see today. The animals were behind iron bars with a few hides to go into, water, and maybe a tree or two. It was not uncommon to see the tigers or lions pacing repetitively back and forth along the walls of their enclosures or the giraffes continually licking the chain link fences.

These repetitive behaviors are referred to as ARB’s, abnormal repetitive behaviors. In the past few decades, zoos have found that changing captive animals’ environments to allow more natural behaviors reduces ARB’s significantly. Expressing species-specific behaviors allows an animal to control and modify its environment, ensuring survival and reproductive success. Creating a den (safe place) is an example of how an animal controls and modifies its environment (Reference 1).

Environment and cat behavior


Many cats live predominately indoor lives. Our homes are quite different than the territory of a wild cat. The indoor cat often has little opportunity to engage in typical cat behaviors such as hunting and climbing trees. It is not surprising that some domestic cats indulge in ARB’s to reduce the stress of being unable to predict and control their environment.  Overgrooming, where a cat licks or scratches her fur so much that the area becomes inflamed and bald, is one of the more common ARB’s shown by domestic cats.

Of course, a good, solid medical workup may uncover a cause for overgrooming and itchiness – perhaps kitty has a food allergy or skin infection. But it is not uncommon for some of these cases to be “idiopathic”, meaning we don’t know what the cause is.

environment and cat behavior: ARB’s


The wound on this cat’s neck comes from repeated scratching.

A study published in 2018 (Reference 2) investigated the link between the environment and cat behavior. The study followed thirteen cats who had been diagnosed with Idiopathic Ulcerative Dermatitis (IUD).  IUD presents as a crusted, non-healing ulcer on the neck, head or between the shoulders. Medical therapy including surgical excision is rarely successful. The cat scratches at the wound frequently; the wound will heal if the cat cannot scratch it, say if she wears a collar or bandage. Once the collar or bandage is removed, the cat will scratch the area again and the wound reappears. (Reference 2)

 

The research team asked the owners of the 13 cats to institute the following environmental changes:

  • Leave closets open to allow cats to use them as a hideout
  • Free access to food and water (add a fountain if the cat prefers running water)
  • Free access to a garden or balcony/window – a cat door was recommended
  • Provide access to a secure area where each cat can sleep, eat, use the litter box without competing with other cats (some cats were separated from their house mates)
  • Regularly offer new toys to the cat
  • Stop interactions initiated by owner such as carrying the cat, petting the cat. Allow the cat to initiate the interaction.

As soon as environmental changes were set up, the ARB of scratching stopped within 2 days. All cats except one healed – for this cat, the owners were not able make the environmental changes. Oral medication was given to this kitty for two months but the neck wound did not heal. The other twelve cats did not receive medication.  The research team followed these cats for two years and no relapses were noted in that time.

The environmental remedies in this study aimed to give the cat control over her environment by allowing her to exercise typical “cat” behaviors.  These are in line with the AAFP* recommendations for a healthy feline environment (Reference 3):

  • Provide a safe place <> leave closets open to allow the cats to use them as a hideout
  • Provide multiple and separated key environmental resources<>secure area for eating, sleeping and using litter box
  • Provide opportunity for play and predatory behavior <> offering new toys to the cat
  • Provide positive, consistent and predictable human–cat social interaction <> emphasize interactions initiated by the cat
  • Provide an environment that respects the cat’s sense of smell <>  access to a garden/balcony/window exposes the cat to outdoor scents and smells

Although our cats are a domestic species and have lived alongside humans for over 10,000 years, life in our homes sometimes reduces their opportunity to express behaviors typical of their wild relations. The environment and cat behavior are intertwined.  Improving the cat’s environment to encourage species-specific behaviors can reduce a cat’s stress and, in some cases, cure disease.

Note: I don’t agree with free-feeding cats even in such a situation – I think it is better to meal feed and use feeding as a positive interaction with humans. Using food puzzles and tossing kibble for the cat to hunt down allows cats opportunities to engage in foraging and hunting behaviors.

* American Association of Feline Practitioners

references

  1. Joseph P. Garner, “Stereotypies and Other Abnormal Repetitive Behaviors: Potential Impact on Validity, Reliability, and Replicability of Scientific Outcomes”, ILAR Journal, Volume 46, Issue 2, 2005, Pages 106–117, https://doi.org/10.1093/ilar.46.2.106
  2. “From Feline Idiopathic Ulcerative Dermatitis to Feline Behavioral Ulcerative Dermatitis: Grooming Repetitive Behaviors Indicators of Poor Welfare in Cats”, Titeux Emmanuelle, Gilbert Caroline, Briand Amaury, Cochet-Faivre Noëlle. Front. Vet. Sci., 16 April 2018 Sec. Veterinary Dermatology and Allergy Volume 5 – 2018 | https://doi.org/10.3389/fvets.2018.00081
  3. Ellis SLH, Rodan I, Carney HC, et al. AAFP and ISFM Feline Environmental Needs Guidelines. Journal of Feline Medicine and Surgery. 2013;15(3):219-230. doi:10.1177/1098612X13477537

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