Feline Compulsive Behavior
July 2019
The most common compulsive behaviors exhibited by cats include wool sucking or fabric eating, over-grooming/hair-barbering or hair-pulling behavior (psychogenic alopecia), and possibly feline hyperesthesia. By far, oral behaviors such as wool sucking and psychogenic alopecia predominate in feline compulsive disorders.
Wool-Sucking:
“Wool-sucking” is expressed as repetitive and inappropriate sucking and chewing on fabric, usually woolen, synthetics, or cotton substrates such as sweaters, blankets, or carpets. Some cats suck on or ingest plastic substrates. Wool sucking may start as a displaced nursing behavior directed toward the queen or other cats coat. Such misdirected nursing may subsequently generalize to other fuzzy substrates. As the cat matures, sucking may progress to pica (consumption of inedible material), and the range of materials ingested may broaden to include a wide variety of fabrics and other inappropriate items such as shower curtains, rubber bands, shoe laces, and plastic bags. Damage can be quite extensive and costly and can impose health risks including intestinal blockage. Consequently, wool sucking can be dangerous to the cat as well as a nuisance to the owner. The onset of wool sucking is usually observed any time after weaning, especially during the first year of life, and frequently before 6 months of age.
Several predisposing factors have been suggested for this behavior, including persistence of kitten oral behavior following early weaning, heredity, inadequate environmental or social stimulation (feline separation anxiety), or a malfunction of neural control of appetitive behavior. Medical conditions that can trigger abnormal ingestion of inappropriate material include hunger, nutritional deficiencies such as anemia or inadequate dietary fiber, diabetes, or tumors.
Wool sucking is predominantly seen in oriental breeds, although other purebreds and cats of mixed origin as well as domestic long and short hairs exhibit this condition. Siamese cats appear to be particularly susceptible and account for ~50-65% of the affected population. Given the breed predilection, compulsive wool sucking is thought to have genetic underpinnings possibly related to the comparatively anxious and active temperaments of affected breeds.
Psychogenic Alopecia:
Cats normally groom as a displacement behavior when momentarily stressed, but in some cases the frequency and duration of grooming lasts longer than would be considered functional. In susceptible animals exposed to chronic stress, grooming may become maladaptive and be performed out of the normal context. Such grooming is repetitive, excessive, and inappropriate in frequency and intensity of occurrence. Excessive self-licking and chewing result in areas where hair shafts have been sheared, leaving stubble. Some cats may engage in the behavior more aggressively and 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 only accessible to the cat (abdomen, flank, back, chest, and legs). A stressful change in the environment often coincides with the onset and concurrent anxiety-associated behaviors such as hiding, anorexia, avoidance, and nervousness may be observed.
Medical rule-outs include allergies or hypersensitivity to parasites, food, dust, pollen, or mold. If a trial dose of steroids controls excess grooming, the condition is probably medical and not psychogenic in origin. Fungal infections should also be ruled out as a potential cause of hair loss. Other medical conditions causing discomfort but not associated with skin conditions can cause excessive grooming (cystitis, inflammation of anal sacs, hyperthyroidism, hyperadrenocorticism). Even if a medical condition triggers the onset and is subsequently resolved, a susceptible cat may continue to groom excessively.
In general, females appear to be more commonly affected than males. The onset of psychogenic alopecia may occur at any age but tends to occur around puberty. Psychogenic alopecia is thought to have a genetic basis because a) it appears to be a displaced grooming behavior which is hard-wired, and b) the condition is seen predominantly, but not exclusively, in purebred cats of oriental breeding and is usually associated with cats with anxious temperaments.
Feline Hyperesthesia:
Feline hyperesthesia is a complicated behavioral condition with some features that appear compulsive and others that appear frankly neurological. It is characterized by compulsive self-directed grooming/aggression, and affected cats episodically become abnormally sensitive to perceptual input. In some cases, the condition may progress to generalized seizures. Because of the overlap between symptoms, it is thought to possibly be a form of partial seizures with compulsive components. Alternatively, one group of scientists believes the condition is primarily medical. They identified intramuscular inclusion bodies in the epaxial muscles of five affected cats and suggested that feline hyperesthesia syndrome may result from a myopathy similar to inclusion body myositis in humans.
Symptoms characteristic of feline hyperesthesia include dilation of pupils, excessive skin rippling, and frenetic self-directed grooming which may result in hair loss. Grooming may be so intense it may manifest as self-directed aggression often focused on the tail, flank, or pelvis. Aggression may sometimes be explosive and directed at people. Affected cats may emit excessive and unusual vocalizations and appear to hallucinate (“act afraid of their tail”) and run away. They may appear “manic” (excited look, frantic running, jumping) and are frequently extremely sensitive to touch. Sometimes aggressive bouts are preceded by attention-seeking and enhanced affection to people. Affected cats are often anxious and restless, constantly wandering and pacing.
There is an apparent sensitivity to touch (episodes may be induced by stroking along the spine), which can trigger attacks and accounts for the name of this syndrome. Feline hyperesthesia is usually associated with heightened affect and aggression. Attacks appear to be more frequent in the evening or early morning. Aggression appears spontaneously and for no obvious reason, and the bouts can end as quickly as they appear. Following an episode, the cat often looks confused. The behavioral manifestation varies between cats and milder forms of feline hyperesthesia may be confused with psychogenic alopecia because of the common symptoms of excessive grooming that may result in hair loss.
The onset usually occurs in young to middle age cats between one to five years of age. The signs may last a few seconds to a few minutes and may vary in incidence from month to month. Episodes may occur every few days or almost constantly all day. Medical rule-outs include fleabite dermatitis, food allergy, intervertebral disc disease, vertebral trauma, infection, toxins, myopathy, or neoplasia.
Treatment for Feline Compulsive Behavior:
1.) Eliminate or reduce exposure to stressors or eliciting triggers: The first line of attack for treating anxiety-based disorders is to remove or reduce the source of conflict or anxiety. If this is not possible, then counter-conditioning and systematic desensitization techniques are the treatment of choice. Common eliciting triggers for feline compulsive behaviors are:
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Separation anxiety (owner’s absence, loss of companion animal)
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New animal or person in household
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New environment
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Restricted access to outdoors
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Inadequate social or environmental stimulation
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Seeing cats outside a window
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Resolved medical condition (tail injury)
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Stroking or petting cat on back
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Loud or high-pitched noises
If the cat sucks on fabric, restrict its access by picking up clothing and stuffed toys and preventing it from going in rooms where it 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 would seek fabric. If the cat suffers from feline hyperesthesia, advise the owners to avoid stroking their cat along its back as this can trigger attacks.
2.) Environmental enrichment to distract cat from compulsive behavior:
Climbing frames
Many cats enjoy climbing frames that make their environment more 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 it entertained. Some cats will even watch bird videos. Fish tanks are also entertaining for cats, but 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. Other cats can be redirected onto pieces of thin rawhide coated lightly with fish oil or cheese spread. Owners should offer the rawhide chews only when they will be directly supervising their cat.
Novel feeding opportunities
Have several different feeding stations so the cat will have to search for its 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 several 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. With this technique, the cat will have to hunt for its food. The goal is to keep the cat occupied and mentally stimulated for much of its active time.
3.) Exercise: Daily aerobic exercise helps decrease arousal. We recommend that the owner spend 10-15 minutes twice a day engaged in aerobic, interactive play with their cat. One way to accomplish this is to attach treats or furry toys to string and play “predator” games with the cat. Some cats prefer feather wands and will perform some amazing acrobatics while they try to catch their “avian prey”. Try several different types of toys and rotate them regularly so the cat does not tire of them.
4.) Diet: Prolonging feeding behavior can be helpful. For example, feeding a high fiber dry food ad-lib may help redirect the cat from sucking on fabric or over-grooming to eating. Putting large rocks in the food bowl can increase the difficulty of obtaining food and prolong the foraging effort. As previously mentioned, food puzzles are a great way to increase a cat’s activity level and prolong feeding.
5.) Predictable schedule: Having a set routine helps calm many cats. Regularly scheduled times for feeding, playtime, and attention are recommended.
6.) Restraint and punishment: Generally, treatment of over-grooming conditions by physical restraint (Elizabethan collars) is not recommended. Although it may prevent the cat from injuring itself, it does nothing to address the underlying anxiety issues that maintain the behavior. The cat should never be punished for any anxiety-based behavioral condition since punishment may contribute to the underlying conflict and increase the cat’s anxiety.
7.) Pharmacological treatment: Pharmacological treatment for cats with compulsive disorders is like that described for dogs. Selective serotonin reuptake inhibitors, like Prozac, form the basis of treatments.
Although we cannot always eliminate compulsive behavior, the treatment program outlined above for both dogs and cats is effective in reducing the incidence of compulsive behavior. To be effective, all phases of the program must be followed simultaneously and consistently. It is often helpful to have the owners keep a daily diary of their pet’s behavior. This helps them be more accurate in assessing the animal’s improvement and may help increase owner compliance. In addition, it will make your job easier in terms of having accurate information regarding which aspects of treatment are effective and which are not beneficial for each individual case. In difficult cases, weekly follow-up calls may also improve owner compliance and provide emotional support.