Fear Free: Helping You & Your Vet Think About the Connection Between Mental & Physical Health For Your Cat


Valarie Tynes, DVM, DACVB, is a board-certified diplomate in animal behavior and a member of the Fear Free board of advisors. Recently, she presented to the veterinary profession at the Western Veterinary Conference, Las Vegas, NV on the elusive behavior of cats & more relative to revealing their physical health in her latest presentation, “The Interactions of Feline Physical & Mental Health”.  The following article is a condensed version of her presentation for pet owners.

“Has the cat got your tongue?” is one of the more common idiomatic phrases that we often hear, but we don’t consider how it relates to the cat world. We humans sure know what we mean when we say it. It’s usually said in “jest” when someone hesitates to speak up on a particular issue or is unusually quiet. That sure also sounds like our feline friends who would rather quietly slink away rather than divulge their latest ailment to us. Could it be that they are suffering in silence, and even in fact, have anxiety added to their medical malady?

According to Valarie Tynes, DVM, DACVB, behavior changes are common with physical illness but veterinarians and pet owners alike should think in terms of how behavioral illness can affect physical health.

“Animals who live with chronic fear or anxiety can be placed at a higher risk of certain physical illness and living with chronic pain can increase anxiety so that a very complex interrelationship exists between behavioral and physical health,” she says.

An awareness of this complex relationship is critical to providing the best possible care for patients but requires that veterinarians first have a basic understanding of animal learning and behavioral development as well as an understanding of how physical illness, pain and discomfort effect behavior.

The Behavior of the Sick Animal

The behavioral responses to illness have been well documented and are relatively consistent across mammalian species. They generally include:

  • Reduced appetite
  • Reduced activity
  • Decreased water intake
  • Increased sleep
  • Decreased interest in social interaction
  • Decreased play
  • Decreased grooming

These behaviors have the cumulative effect of helping the animal to rest and conserve energy while its body “fights” the illness usually with the aid of an elevated body temperature.1,2

Cats in particular are notorious for hiding signs of illness but studies have shown that “sickness behaviors” such as decreased food intake, increased vomiting, elimination outside of the box and a complete avoidance of elimination will also increase when a cat is stressed.3

Stress can come from seemingly innocuous sources: changes in husbandry routines, unfamiliar caretakers, etc. but the studies suggest that monitoring of sickness behaviors in the cat may be an excellent additional means of evaluating feline welfare and that the cats’ behavior is a more reliable indicator of their level of stress than their physiological responses.3

The Role of Stress

Research continues to demonstrate the myriad ways in which stress can affect living organisms.  Stress for the purpose of this discussion can be defined as any chemical, physical or emotional force that threatens homeostasis of an organism.

You might also simply refer to these things as the stressor, but when the body attempts to maintain homeostasis in the face of the stress or stressors, and is unable to, for whatever reason, then the individual can be said to be suffering from distress.

Stress can arise from a variety of different sources, both physiological and psychological. Physical stress can be caused by:

  • Hunger
  • Thirst
  • Pain
  • Exposure to extreme temperatures
  • Disease
  • Illness
  • Sleep deprivation

Psychological stressors can arise from exposure to novelty, unpredictable environments, social conflict, and constant exposure to fear or anxiety provoking stimuli and situations leading to frustration or conflict. A lack or loss of control is another important psychological stressor. In fact, novelty, withholding of reward and the anticipation of punishment (not the punishment itself) have been found to be the most potent of all psychological stressors.4

Any single individual’s response to stress will vary as a result of several different factors such as genetics, temperament, experience, environment and learning. For example, cats not socialized to people have been shown to be more likely to experience high levels of stress when exposed to people in a shelter setting.5

Experiences during the first weeks of life have been shown to have profound effects on an animal’s ultimate ability to cope with stress.6 The individuals’ perception of stress, which will also vary based on experience, is ultimately the most important factor that influences the effect of stress.

When stressed, cats have been shown to display less play and active exploratory behaviors and spend more time awake and alert but attempting to hide.3

When cats are unable to hide, they experience more stress.3 Behavioral apathy, vocalization, escape behaviors and aggressive behavior have also been considered indicators of stress in kenneled cats.7

When cats are stressed, they may feel the need to re-mark territory through facial marking, urine spraying or scratch marking.

One method to reduce stress in cats is through the use of a product called Feliway. Feliway helps reduce the instinctual need for your cat to re-mark territory by diffusing calming pheromones in the environment.

To see how stressed your cat is, Feliway offers this Cat Stress test.

Behavior of Pain

Recognizing pain in our non- verbal patients may be difficult but because they are non-verbal recognizing their pain is critical! A number of problem behaviors can potentially occur in dogs and cats in response to pain. These can include irritability, aggressiveness, restlessness, excessive vocalization, changes in activity level, and an increase in anxiety related behaviors. Any abrupt changes in behavior can signal pain but they are especially noteworthy when occurring in a middle aged or geriatric animal.


“When a pet has a behavior change, one of the most important questions that must be asked initially is whether or not the behavior is truly a new behavior or an escalation of a previous behavior. Most behavior problems, especially those related to fear and anxiety, do not develop spontaneously in behaviorally normal adult pets (over 2-3 years of age),” says Tynes.

For the pet owner, your veterinarian is the best person to evaluate this. Your veterinarian will ask questions about the presence of other co-morbid behavior problems that can be helpful because animals with fear or anxiety related behavior problems usually have more than just one.

Many pets with behavior problems develop them at or around social maturity and then without intervention the problems will worsen gradually over the ensuing years so it can require some practice to learn to recognize the difference between new behaviors and behaviors that are a result of existing but escalating problem behaviors.

However, when presented with an animal that is middle-aged or older that is displaying a new behavior, medical differentials should be at the top of the list. Behavior treatment may be necessary as a part of the overall treatment plan but in these cases, it is often impossible to successfully change any unwanted behavior without first managing the underlying medical condition.

Conversely, it may be impossible to manage some medical conditions without first attending to the behavioral health of the animal.

“The most important rule in assessing the interaction of mental and physical health is don’t let “the cat get your tongue” for you or your cat. Ask questions about behavior and environment at home at every appointment. Don’t allow misconceptions about cat behavior to mislead you and prevent you from identifying the underlying mental or behavioral issues that may be contributing to a patient’s overall health and well-being. You can help your cat to achieve optimal health by working closely with your veterinarian and never forgetting the important role of mental or behavioral health to any individual’s overall state of health.” Tynes concludes.

  1. Hart BL: Beyond Fever: Comparative Perspectives on Sickness Behavior. In Breed M & Moore J, editors: Encyclopedia of Animal Behavior, vol. 1, Academic Press, 2010, pp 205-210.
  2. Hart BL: Behavioural defences in animals against pathogens and parasites: parallels with the pillars of medicine in humans.  Philos Trans R Soc Lond B Biol Sci 366: 3406-3417, 2011.
  3. Carlstead K, Brown JL & Strawn W: Behavioral and physiological correlates of stress in laboratory cats. Appl Anim Behav Sci 38: 143-158, 1993.
  4. McEwen BS: The neurobiology of stress: from serendipity to clinical relevance. Brain Res 886: 172-189, 2000.
  5. Kessler MR, Turner DC: Socialization and stress in cats (Felis silvestris catus) housed singly and in groups in animal shelters. Anim Welf 8: 15-26, 1999.
  6. Foyer P, Willsson E, Wright D, et al: Early experiences modulate stress coping in a population of German shepherd dogs. Appl Anim Behav Sci 146: 79-87, 2013.
  7. Kessler MR, Turner DC: Stress and adaptation of cats (Felis silvestris catus) housed singly, in pairs and in groups in boarding catteries. Anim Welf 6: 243-254, 1997.

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