Feline compulsive behaviors are based on natural behaviors that are somehow frustrated by management practices and/or restrictive environments. Compulsive behaviors may initially be expressed as displacement behaviors. For example, when a cat is torn between responding with aggression or running away, it may displace into a seemingly unrelated behavior, such as self-grooming, as a way of reducing emotional tension. If exposure to the anxiety-provoking stimulus continues, the cat may express the behavior repetitively and, finally, out of context.
In the end-stage condition, even when the behavior has adverse consequences for the cat (i.e. pain), it will continue to engage in the behavior. The level of stimulation required to trigger the behavior decreases over time so that the behavior occurs in response to any level of arousal. Certain breeds seem prone to compulsive disorders, so genetic influences are likely involved. Genetics may determine which individuals display compulsive behaviors and what those compulsions are.
The most common compulsive behaviors exhibited by cats include wool sucking (or fabric eating), over-grooming/hair-barbering or hair-pulling (psychogenic alopecia), and feline hyperesthesia. Oral behaviors such as wool sucking and psychogenic alopecia are the most prevalent feline compulsive disorders.
"Wool sucking" refers to the repetitive, inappropriate sucking and chewing on fabric, usually woolen, synthetics or cotton substrates (such as sweaters, blankets or carpets). Some cats even suck on or ingest plastic substrates.
The condition resembles displaced nursing behavior and may be the feline equivalent of thumb sucking. Wool sucking may start as a nursing behavior directed toward the coat of the mother or some other cat. Such misdirected nursing may extend to other fuzzy material. As the cat matures, sucking may progress to pica (consumption of inedible material) and the range of materials ingested may broaden to include a variety of fabrics and other inappropriate items, such as shower curtains, rubber bands, shoe laces, and plastic bags.
The damage inflicted can be quite extensive and costly. Worse, the behavior can pose health risks for the cat, including intestinal blockage. The onset of wool sucking is usually observed at any time after weaning, especially during the first year of life, frequently before 6 months of age. Several predisposing factors have been suggested for this behavior, including genetic factors favoring persistent oral behavior following weaning, early weaning itself, and inadequate environmental or social stimulation (feline separation anxiety).
Medical conditions that can trigger abnormal ingestion of inappropriate material include hunger, nutritional deficiencies, anemia, diabetes, and tumors. Wool sucking is seen predominantly in oriental breeds, although other purebreds and cats of mixed origin as well as domestic long- and shorthairs may also exhibit this condition. Siamese cats appear particularly prone to the condition and account for about 50 percent of all affected cats.
Compulsive wool sucking seems to occur in breeds that are more anxious and more active.
Excessive grooming is called psychogenic alopecia. Cats normally groom as a displacement behavior when momentarily stressed. In some cases, the frequency and duration of grooming lasts longer than it should.
In susceptible animals exposed to chronic stress, grooming may be performed out of the normal context. Such grooming is repetitive, excessive and inappropriate in frequency and intensity. Excessive self-licking and chewing causes hair shafts to become sheared, leaving stubble.
Some cats that engage in the behavior more aggressively actually bite and pull out patches of hair from their coat. Hair pulling and chewing may result in skin wounds and ulceration. Hair loss is typically noted on areas easily accessible to the cat (abdomen, flank, chest, and legs). A stressful change in the environment often coincides with the onset of the behavior. Other anxiety-related behaviors, such as hiding, anorexia, avoidance, may also be observed.
Medical causes should be ruled out before a diagnosis of psychogenic alopecia can be made. The most common medical look-alike condition is that of skin allergy, caused by hypersensitivity to parasites, food, dust, pollen or mold. If a trial dose of corticosteroids controls excess grooming, the condition is probably medical and not psychogenic in origin.
Other medical conditions causing discomfort can cause excessive grooming: e.g. cystitis, inflammation of anal sacs, hyperthyroidism. Even if a medical condition triggers repetitive licking, a susceptible cat may continue to groom excessively even after the medical problem has been resolved.
In general, females appear to be more commonly affected than males. Psychogenic alopecia may occur in any age of cat but tends to arise most often around puberty.
Feline hyperesthesia is a state of abnormally increased sensitivity to stimuli. It is a complicated behavioral condition with some features that appear compulsive and others that appear frankly neurological.
The condition is characterized by compulsive self-directed grooming/aggression. In some cases, the condition may progress to generalized seizures. Because of the overlap in clinical signs, we believe that feline hyperesthesia may be a result of a partial seizure disorder that manifests as a compulsive disorder.
Symptoms of feline hyperesthesia include:
- Dilated pupils
- Excessively sensitive skin (the skin literally jumps when touched. especially along the spine)
- Excessive grooming, which may result in hair loss
- Running away from an unseen foe
- Apparent hallucinations
The grooming associated with this condition may be so intense that it appears like self-directed aggression focused on the flank, lumbar area, or tail. Aggression may sometimes be explosive and directed at people. Such cats may make loud and unusual noises, appear to hallucinate ("act afraid of their tail"); and run around frantically as if fleeing from some unseen adversary.
They may look manic during bouts of this behavior – that may occur several times a day. Feline hyperesthesia attacks appear to be more frequent in the evening or early morning. The aggression appears spontaneously, and bouts can end as quickly as they appear. Sometimes aggressive bouts are preceded by attention-seeking behavior with enhanced affection to people. During a hyperesthetic bout, some cats appear anxious and restless, constantly wandering and pacing or even running away. Following an episode, cats appear confused.
The behavioral manifestation varies between cats, and milder forms of feline hyperesthesia may be confused with psychogenic alopecia (excessive grooming). Feline hyperesthesia occurs in young to middle age cats, often between 1 to 5 years of age. The signs may last a few seconds to a few minutes. Episodes may occur every few days or may occur almost constantly. Medical ruleouts include fleabite dermatitis, food allergy, intervertebral disc disease, vertebral trauma, infection, toxins or cancer. The condition may have a genetic basis since it occurs predominantly, but not exclusively, in purebred cats, especially Siamese or Siamese crosses.
Identify the Conflict
The first line of attack when treating any anxiety-based disorder is to remove or reduce the source of conflict or anxiety. If this is not possible, then counterconditioning (teaching the cat to perform a behavior that is incompatible with fearful behavior) and desensitization (gradually introducing the cat to the stimulus it fears and coupling this with a positive experience) are the treatments of choice.
Common Eliciting Triggers for Feline Compulsive Behaviors
- Separation anxiety (owners absence, loss of companion animal)
- New animal or person in household
- New environment
- Restricted access to outdoors
- Inadequate social or environmental stimulation
- Early weaning
- Resolved medical condition
- Stroking or petting cat on back
- Loud or high pitched noises
If the cat sucks on fabric, his access to it should be curtailed by picking up clothing and preventing him from going in rooms where he may suck on bedspreads or curtains. If the cat chews specific items, make these items aversive by coating them with bitter-tasting substances. Remember to provide acceptable alternative items for play and chewing and place them in the area where the cat normally seeks fabric. If the cat suffers from feline hyperesthesia, avoid stroking him along his back as this can trigger attacks.
Provide the cat with plenty of activities that he enjoys. A few ideas include:
Climbing frames – Many cats enjoy climbing frames that make their environment three-dimensional and allow them to express their natural tendency to climb trees.
Bird feeders, fish tanks – Placing a bird feeder near a window where the cat can observe the birds may help keep him entertained. Some cats will even watch bird videos. Fish tanks are also entertaining for cats; just be sure to place a cover securely on top of the tank to protect the fish.
Prey facsimiles – Toys attached to strings, feather wands, and fishing pole toys stimulate predatory behavior. Daily rotation of toys is recommended to keep the cat mentally stimulated.
Non-toxic grasses – Some cats respond well to fresh catnip or cat grass grown especially for them. Along the same theme, some cats also enjoy lettuce or green beans.
Novel feeding opportunities – Have several different feeding stations so the cat will have to search for his food. Some cats respond very well to "food puzzles" that they must bat around in order to obtain food. Food puzzles can be purchased in pet supply stores or crafted at home by taking an empty toilet paper roll and punching a number of holes in the tube. Make the holes large enough to release the kibble. Fill the tube with kibble and securely tape the ends to contain the food. The owner may need to show the cat how to roll the tube in order to obtain food. Make several food puzzles, fill with the cat's daily meal, and distribute them around the house. The goal is to keep the cat occupied and mentally stimulated for much of his active time.
Daily aerobic exercise helps decrease arousal. Spend 10 to 15 minutes twice a day engaged in aerobic, interactive play with your cat. Attach treats or furry toys to string and play "predator" games with the cat. Some cats prefer feather wands. Try several different types of toys and rotate them regularly so the cat does not tire of them. Exercising your cat outdoors on a leash and cat harness may be helpful in some cases.
Prolonging feeding can be helpful. For example, feeding a high fiber dry food over the course of the day may help redirect the cat from sucking on fabric, or over-grooming, to eating. Food puzzles are a good way to increase a cat's activity level and prolong feeding.
Having a predictable daily routine helps calm many cats. Regularly scheduled times for feeding, playtime and attention are strongly recommended.
Repetitive behaviors should be ignored if there is any indication that they are being performed to get the owners' attention. This will ensure that the owners are not somehow reinforcing the unwanted behavior. Be forewarned, though, the frequency of the behavior will increase initially as the attention-seeking cat attempts to regain lost attention. It is important to stick with the program – for a while at least. Continued lack of reward (constantly ignoring the behavior) will reduce the performance of the behavior in about three weeks if an attention-seeking component is involved.
Avoid Discipline and Restraint
Generally, treatment of over-grooming conditions by physical restraint (Elizabethan collars) is not recommended. Although it may prevent the cat from injuring himself, it does nothing to address the underlying anxiety issues that maintain the behavior. Cats should never be punished for engaging in these behaviors since punishment may actually contribute to the underlying conflict and increase the cat's anxiety.
Once the behavior becomes engrained, the cat may continue to display compulsive behavior even after the initiating stressors have been removed or attenuated. At this stage, the behavior may not respond to standard behavior modification techniques and management changes alone. Pharmacological intervention, in addition to management changes and behavior modification, is often required in the treatment of feline compulsive behaviors. This is especially true if the environmental triggers cannot be identified and eliminated.
Compulsive behaviors appear to involve changes in brain neurotransmitters. Serotonin involvement is suspected as instrumental because drugs that inhibit the reuptake of serotonin in the brain are the most helpful for treating compulsive disorders. Medications that inhibit the re-uptake of serotonin appear to normalize brain chemistry, minimize the impact of environmental stressors, and help stabilize the cat's mood. Typically, either clomipramine (Clomicalm®) or fluoxetine (Prozac®) are prescribed. A less anxious cat will be less inclined to engage in a compulsive behavior. Anticonvulsants, such as phenobarbital, are sometimes helpful in the treatment of feline hyperesthesia, possibly because of its partial seizure component.
Although we cannot always completely eliminate compulsive behaviors, the treatment program outlined above is often effective in reducing compulsive behavior to a more livable level for both cat and owner. To be effective, all phases of the program must be followed simultaneously and consistently. It is often helpful to keep a daily diary of their cat's behavior. This helps to be more accurate in assessing improvement and encourages continued observation and effort on the owner's part.