Lily had just finished putting away her groceries when she walked past Omar, her 2 year old Ragdoll cat. This good lady relied on her fuzzy house mate for more than she might readily admit. They lived alone together in a normal house on a normal street. She seldom went out; Omar never did.

As Lily headed toward the bedroom she glanced at her cat as a way of getting a read on his mood. She loved Omar but he could be impetuous. At times his postures and demeanor signaled his discontent with an outdoor scent or sound. There was the occasional rippling of his skin. Maybe there was a person approaching the house or a feral creature in the yard. Often Lily couldn’t relate her expressive cat’s visage to anything in particular. Omar was a bit of a puzzle.

Sometimes Lily checked in with Omar specifically because of his volatility. At times he was a sweetheart but he could bite – hard. Omar had left a few holes in his person. Sometimes he reacted while being brushed but on a few occasions Lily just absently walking past him could trigger serious aggression. On a few occasions Omar had lunged at her ankles, wrapped his arms and legs around her calf and dug in.

The utter shock of these unpredictable assaults was destabilizing for Lily. Thinking her own thoughts and minding her own business in her own house, to be suddenly the victim of a ruthless attack by someone so close was really unnerving. Didn’t this damned cat know how good he had it? Someone else would have provided him a one way trip to the local shelter with her shoeprint still fresh on his rear end.

Following the most recent of these diabolical outbursts, as the echoes of Lily’s shrieks faded, she walked backwards into her bedroom. She watched her feline felon with one eye while searching for a household item that could serve as a makeshift shield with the other. After closing the door and taking a few big lungfuls of air she fired up her iPad and Googled: Cat behavior Albuquerque.

There are some really sweet kitties who love to be with their people. They may rub against you or bump you with their head. They’ll hop into your lap and curl up for the kind of snuggle time we cat lovers crave. This is the normal heart-warming behavior we expected when we took that lithe and furry little athlete into our lives. And, as long as most organ systems in that feline body remain healthy, that’s what you can plan on enjoying for 15+ years. Sadly, not everything goes as planned.

Advanced mammals like cats and humans are jammed with an enormous array of interrelated moving parts. The brain, where all behaviors originate, is the most intricate and complex component in the whole system. As more research advances our knowledge it’s becoming clear that a doctor cannot afford a narrow focus on their singular area of expertise. In the body, everything affects everything.

There are diagnostic challenges that are unique to veterinary medicine. The utter failure of nonhuman animals to speak in complete sentences is part of the conundrum. That’s important because understanding all aspects of an unhealthy behavior is essential to lasting improvement.

A comprehensive diagnosis and treatment plan would be essential to a good outcome for Omar. A thorough evaluation of his skin, GI tract, his joints and bones, actually anything that could cause him to feel irritable, painful, or aggressive had to be suspected of influencing his outbursts. Between Omar’s behavior and Lily’s trepidation there was real distress in his home. There was one more thing that these two would need: all the kindness I could muster.

Omar’s history included violent reactions when his person brushed him. Lily provided a video that made a big difference in my understanding of her cat’s motivations. After propping her smart phone on a shelf and touching the start button she sat next to her cat and started grooming him. Omar’s early postures indicated enjoyment but it was Lily’s 5th or 6th stroke that triggered a swat. Believing that more brushing might help Omar accept her well-meaning stewardship she pressed on. It was the 8th stroke that unleashed an aggressive lunge at her arm. Omar was conflicted. He enjoyed the attention but his skin just couldn’t handle it. He meant well but his threshold for impulse-control had been exceeded.

When I observed Omar in my consultation room I recognized his guarded affect. At the start of my exam the minor stimulus of my gently touching his hair caused his skin to crawl ever so slightly. When I petted him, front to rear over his back, his head turned quickly toward my hand. This was not a happy kitty.

The video of Omar being brushed was diagnostically priceless. Careful observation of his body signals indicated advancing tension that Lily simply did not recognize. I slowed the video down for her as I explained Omar’s building frustration and discomfort. At the start of the grooming session Omar watched the brush approach, causing him to lean away ever so slightly. Each stroke triggered an incremental increase in his tension until he’d finally had enough. What had seemed to Lily to be a spontaneous act of aggression was actually the result of escalating and finally overwhelming skin discomfort.

There are important reasons for bad behaviors. Cats are not tricksters intent on messing with our minds, lying in wait to pounce for their own amusement. (Well, actually, that can happen but I’ll address that later.) Omar struck hard because he was being driven mad. He knew from experience that his person would not recognize his body signal communication. This cat’s message needed to be loud and clear. He had really painful skin.

The majority of pets with behavior disorders are otherwise physically healthy. But10% of them suffer from problems that can be manifest as depression, anxiety, aggression, and even self-mutilation. Joint pain, nausea, low thyroid, liver or dental disease, and skin discomfort, often due to itching, are common contributors. 10% may not sound like a lot but if it’s your cat or dog it becomes a 100% problem at your house. We can’t afford tunnel vision.

Omar‘s skin was difficult to examine because any touch could trigger a reaction. His at-home skin rippling was clear evidence that this poor guy’s misery required no stimulus at all. To reduce his angst I prescribed a medication called gabapentin. Gabapentin helps reduce anxiety, it’s valuable in controlling itching and, at generous doses, it has a sedative effect. Sprinkled on a cat’s food, it even tastes good.

One hour following 100 mg of gabapentin mixed in Omar’s food I discovered a relaxed Ragdoll cat, camped-out like a sphinx in the lower half of his carrier. The dreamy look on his cute face made it clear that he’d go along with just about anything. A full exam, a skin evaluation, a scraping to check for mange and fungal elements, and a blood draw for serum chemistries were risk-free for both of us. Ruling-out internal problems that may lurk below the surface is always worth the effort. Sedation can be a very good thing; rodeo’s and firm restraint are never necessary or appropriate for thorough medicine.

As it turned out Omar had severe food allergies causing him to be a wildly itchy, unhappy cat. A special prescription diet helped enormously. This boy’s disposition has improved but he can still be a mischievous little devil. He feels a lot better now and accepts Lily’s brushing but he is still prone to setting up an ambush. Funny, right? Not if your legs are the target of predation.

A feline reality check: Cats, while a legitimately domesticated species, are still largely wild animals we keep as pets. Their brains are genetically programmed to spend much of their time in hunting mode. They don’t eat salads and potatoes and they don’t forage for road kill. Our fuzzy sweet kitties are obligate predators by nature. They are supposed to stalk and ambush and consume living creatures. Without ready access to rodents or other legitimate prey, the moving legs of a quiet, unsuspecting lady can trigger the natural impulse to lunge with silent and deadly intent. That wrapping of feline arms and legs around Lily’s calf and the sinking of teeth into warm flesh, well, a cat’s got to do what a cat’s got to do.

The impulse for most normal people would be to come completely unglued when viciously attacked. You want to punish that horrible behavior right here, right now. But, of course, this was not a human event. It was the acting-out of the normal behavior of a creature who is different. Omar is not a little person in a furry suit; he doesn’t aspire to be like his person. He is and will always be – a cat. Instead of trying to correct innate behavior we must make it possible for our kitties to satisfy their primal needs while keeping us safe from their predatory proclivities. We want our little snuggle bunnies to be all that they can be – cats: satisfied, well-adjusted cats.

None of this is meant to diminish the entertainment value of sharing your life with a cat. Way back in the day, shortly after opening my very own veterinary clinic, I found a white kitten limping across the road one evening as I drove home from work. My roadside physical exam revealed one painful rear leg. Door-to-door neighborhood canvassing garnered only complaints about the occasional and irresponsible dumping of stray cats. This little orphan would need a new home.

The next day I took x-rays that showed damage to the kid’s kneecap, an injury that responded nicely to corrective surgery. Having invested in this little guy, who turned out to have a rather endearing personality, my entire staff of three claimed him as our own.

Our startup group had also gotten attached to a white-haired elderly gentleman named Mr. Frank Lindsey, who printed and delivered our office stationery. Pretty soon our new white kitty had a namesake. There was now a second Mr. Lindsey.

The wily young feline trickster, Mr. Lindsey, often lurked around corners in the clinic hoping to stir up trouble. This caused me to recall my Mom’s timeless admonishment, “If you go looking for trouble you’ll find it”. Of course, she was right.

Among the loyal client following of my nascent veterinary practice were the Felician Sisters who lived in a nearby convent. I always knew how much they appreciated our care for their pets although that bond may have been influenced by the fees we asked of them. (Prayers only, thank you.)

One after noon I stood on my side of the exam table while Sister Mary held the convent’s small dog on the other. As I was writing her pet’s history in the medical record I glanced up and spied Mr. Lindsey’s little white head slowly peering around the corner of the partially closed door. Quick as lightning that little feline menace leapt across the room in one bound and disappeared up Sr. Mary’s dress. This good woman and I could each have earned an Oscar for our performances. Facial expressions revealed nothing. One second later Mr. L exited the scene as fast as he had entered. Poker faced, the good nun and I continued our discussion of her little dog’s medical malady. Being a wild and crazy youngster, well, that’s just normal feline behavior too.

I hope you’ve found this information helpful. You’re welcome to share this blog with any of your cat-loving friends. Each week I share a short video, a podcast, or a blog to help bring out the best in pets and their people. You can sign up at no charge on my website www.drjeffnichol.com. And when you do, I’ll send you my free at-home pet first aid and CPR guide. I’m Dr. Jeff Nichol.