Stress Behaviours and Illness in Cats

In the last of our topical blogs, we discuss stress behaviours and illness in cats. 

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In the last of our topical blogs, we discuss stress behaviours and illness in cats.

Inappropriate elimination

It is important to acknowledge that what we perceive as ‘inappropriate’ scent marking is actually normal behaviour. If a cat starts spraying, urinating or defaecating in the house, the cat is expressing stress-related behaviour; crying out that things are not good, help is needed! Although intuitive, the worst thing we can do in that situation is to punish the behaviour. This is only going to increase stress levels and aggravate the situation. What we need to do is identify the underlying problem and instigate appropriate environmental changes or behavioural modification techniques. This may take time, and it is easy to get frustrated and annoyed (inappropriate urination/defaecation is not the easiest thing to tolerate), however, it is important to take a step back; the end results will hopefully be worth the wait.

There is also a tendency to assume that inappropriate urination is a sign of urinary tract infection. In a few cases this is true, however, urinary tract infections are very uncommon in cats, and usually only occur in cats with underlying predisposing conditions such as chronic kidney disease or diabetes. There are many other causes of inappropriate urination that are much more likely, most of them a result of stress or a suboptimal environment.

A good place to start is to ask ‘is this somewhere I would want to go to the lavatory?’ For example:

  • Is the tray in an acceptable location?
    • Is the tray located in a quiet area of the house?
    • Can the tray be used without the worry of being interrupted?
    • Is the tray located right next to sleeping or feeding areas?
    • Has something changed in the vicinity of the tray that that has become off putting?
  • Is the litter substance acceptable?
    • Individual cats have different preferences for litter type but, in general, clay is a popular choice.
    • Cats like to bury their urine and faeces to conceal their whereabouts and supplying deep litter (>3cm) helps them to maintain this behaviour inside.
  • Is the tray clean?
    • Faeces should be removed daily and the tray should be emptied and disinfected at least once a week.
  • Does the litter tray have an off-putting smell?
    • Strong disinfectant smells are disliked by cats and should be washed away effectively before the tray is replaced.
    • Deodorisers and fragrant litters may be more pleasant for us but can be off putting to cats.
  • Preference for the type of litter box
    • Does the cat prefer a covered litter tray or an open one?
    • Is the tray large enough for the cat to display normal scratching/covering behaviour after defaecation?
    • Is the tray large enough to enable and un-impinged route out of litter box after elimination without having to soil their feet?

Another problem might be the complete lack of a litter tray. Many cats routinely urinate and defaecate outside and, in that case, a litter tray in the house may not have been needed previously. However, there are various situations in which a cat may suddenly decide they no longer want to urinate or defaecate outside. This may be due to a change in the environment. Maybe the usual place of defaecation has been unknowingly covered up or changed in some way. Maybe the surrounding environment has changed or there are strange news noises (e.g. building work). Or maybe a new cat has moved into the neighbourhood; this can be very threatening and, if a cat is fearful, he may not feel brave enough to eliminate outside. A similar problem is an inadequate number of litter trays in a multi-cat household. If the tension in the household mounts, certain cats may no longer feel confident enough to use a particular litter tray. In that case, provision of an additional tray may be helpful. In general, the number of litter trays should be at least one more than the number of cats in the house. A converse problem is when cats start defaecating in appropriate places outside. Unless being used as specific scent markers, cats like to bury their urine and faeces in order maintain cleanliness and to hide their smell from potential intruders. They therefore like to defaecate on easily raked substances. This means that gravel, wood chipped surfaces and sand make attractive latrines and we should be careful when considering where to position these substrates in our gardens. For example, we should not be surprised when a cat choses a child’s sand pit as its latrine. This is hard to avoid and should be factored in before installation (i.e. use of a cover is usually essential).

Stress and Illness

Environmental stress is by far the most common cause of inappropriate urination and defaecation, however, once these factors have been excluded, the final question to ask is ‘is there a medical problem?’. Maybe the cat is simply not able to use the litter tray anymore. This is a particular problem in older cats with arthritis. Arthritis is not uncommon in older cats, who may resort to eliminating outside of the litter tray if climbing in and out of the tray has become too painful. Alternatively, disease of any sort can be stressful and thus result in altered elimination habits. In extreme cases, stress is even severe enough to cause specific urinary tract disease. Stress-induced cystitis is the most common cause of cystitis in cats. It results in bladder inflammation leading to pollakiuria (increased frequency of urination), stranguria (straining during urination) and haematuria (blood in the urine). It is an uncomfortable condition and the mainstay of medical treatment is anti-inflammatory pain killers. Although it presents in a very similar way, infectious cystitis is extremely uncommon in cats, and antibiotics are rarely indicated. Instead, the most important ‘treatment’ is to identify and resolve the underlying cause of stress, in order to minimise the risk of recurrent episodes.

Summary of Litter Tray Problems

  • Inappropriate litter tray placement
  • Preference for tray type
  • Aversion to litter tray smell
  • Unpleasant experience (dirty litter)
  • Removal of usual latrine facilities outside
  • Bullying by other cats outside or tension within multi-cat household
  • Inadequate number of litter trays in multi-cat household
  • Pain on urination (arthritis?)

As well as inappropriate urination and cystitis, stress can also lead to other ‘illness behaviours’ such as vomiting and reduced appetite. Such problems should always be investigated in case there is a medical problem requiring specific treatment. However, if no medical explanation is found, or if response to medical therapy is suboptimal, the possibility of an environmental trigger should be considered and addressed.


Cats are naturally clean animals and, in the wild, groom to help them remain in the tip-top condition needed for hunting. Grooming removes parasites, potentially toxic substances, and anything else that might degrade their natural coat quality and smell. It enables them to remain as undetectable as possible to both predators and prey, while at the same time, it enables them to retain their own unique smell which is so important for maintaining social relationships. Lastly, but not least, it is used as a comforting behaviour which is why many cats will over groom during times of stress.

Domestic cats retain a strong drive to groom and spend around 8% of their waking time displaying this activity. Poor coat quality can be a result of primary skin disease or systemic disease. Disease conditions resulting in lethargy or generalised weakness may reduce grooming behaviour but some diseases, such as hyperthyroidism, can also have a direct affect on coat condition. Poor coat quality may be caused by an inability to groom. For example, conditions such as arthritis or dental disease may mean that grooming is painful, or obesity may make it impossible to reach less accessible areas of the body. Older cats may also chose not to groom due to cognitive dysfunction. Grooming has a calming effect so over grooming is often seen as a displacement behaviour in times of anxiety. In addition, localised areas of over grooming may suggest the presence of pain in that region (for example cystitis or arthritis). In summary, poor coat condition should not be ignored. It is a signal that something is not right, and has a variety of causes requiring very different interventions.

If you have any questions on our series of topical cat blogs, please call your local practice.


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