All About Cat Anxiety

An anxious cat will let its humans know loud and clear that something is wrong. However, it’s easy for humans to misinterpret the signs and miss the underlying cause of telltale behaviors. 

Anxiety is relatively common in cats. Symptoms of anxiety—like spraying outside the litter box, incessant meowing, aggression, or hiding—can be as distressing for humans as they are for the suffering cat. Untreated anxiety can lead to more serious health problems, like skin and gastrointestinal issues. 

Fortunately, veterinarians and animal behaviorists understand the link between feline stress, behavior, and medical issues better than ever before. Here is what you need to know to spot the signs of anxiety, de-escalate problem behaviors, and return to a happy, healthy cat. 

What Is Cat Anxiety?

When a cat senses a threat in her environment, the normal, healthy short-term stress response automatically kicks in, preparing her to fight or flee. With anxiety, this fight-or-flight response is prolonged, and the cat’s mind and body are stuck in a state of anticipating a dangerous or unpleasant situation. Over time, anxiety can interfere with the cat’s physical health and overall well-being.

There are two main types of cat anxiety—situational and generalized. With situational anxiety, anxious behavior occurs only in specific contexts, like being left home alone, traveling in the car, or going to the veterinary clinic. Separation anxiety is the most common of these, says Dr. Sara Ochoa, a small animal and exotic veterinarian at Whitehouse Veterinary Hospital. “Cats are stuck to their owners like velcro when they are home, always following them around the house and trying to be near them,” she says. “Then, when their owners are gone, they are maybe hiding, destroying furniture, or excessively licking themselves.” 

Cats with generalized anxiety, however, are in a constant state of stress, and the anxious behaviors take place regardless of where they are or who they are with. 

Cat Anxiety Symptoms

Anxiety usually shows up in abnormal behaviors such as peeing or pooping outside of the litter box, clinginess, or vomiting. Anxious cats may be fearful and hide often, or they might become aggressive toward other pets and people in the house—even their favorite humans. 

Repetitive behaviors like pacing, excessive grooming, or tail-chasing can also signal anxiety.  

Many of the behaviors associated with anxiety are also associated with pain, illness, or medical conditions. All three are serious and warrant medical attention to discover the underlying cause.  

Other symptoms of cat anxiety include:

• Failure to use the litter box
• Increased vocalization
• Withdrawal and hiding
• Trembling
• Destructive or aggressive behavior
• Cat spraying
• Becoming less active
• Trying to escape
• Diarrhea 
• Pacing
• Sores or hair loss resulting from over-grooming
• Change in appetite
• Changes in sleeping patterns

In cases of separation anxiety, these behaviors occur when home alone. While in the presence of their owner, the anxious cat is either clingy or appears completely normal.

Dr. Megan Teiber has counseled countless clients concerned about their cats’ troublesome behaviors at Indian Prairie Animal Hospital in Aurora, Illinois, and notices that people often think these common symptoms of anxiety are a cat’s way of retaliating against her owners. “For example, if the cat urinates on the bed, their human may incorrectly assume the cat is angry with them and soiled the bed due to spite or hatred,” she says. “It is unlikely that cats reason this way, and more likely, there is underlying anxiety to explain their behavior.”

What Causes Cat Anxiety?

Just as there are many causes for human anxiety, there are numerous factors that can cause anxiety in cats.  

Topping the list of common triggers for anxiety in cats are: 

• Separation from their favorite human
• The addition of a new person or pet to the home
• Moving to a new home or rearranging furniture
• Changes in household routines 

Older cats seem to be slightly more prone to anxiety due to the effects of aging on the brain.

To understand why cats experience anxiety, it can help to take a step back to look at their big cat ancestors. In the wild, they were “independent and concerned more with the security of their territory than with their attachments to humans or other cats, exactly the opposite of dogs,” says Dr. John Bradshaw, an animal behavior expert and author of the New York Times bestseller “Cat Sense.” 

For modern, domesticated cats, living indoors can sometimes lead to behavior problems, especially when they perceive a threat to their territory or security. 

In general, cats are susceptible to changes in their environment. Triggers such as a move or a new baby are usually easy for humans to recognize. But sometimes, changes that seem insignificant to humans—like changing the curtains or moving the litter box by a few feet—can be stressful to cats, particularly in multi-cat households. 

Other causes of cat anxiety include stress and/or fear stemming from former abuse or trauma, an aging brain, or underlying pain or illness. A lack of socialization during kittenhood is also a common theme among chronically anxious cats. When kittens aren’t exposed to new people, pets, and surroundings during the first two to three months of life, they are more likely to be fearful and anxious as adults. 

Here is a list of factors that might cause ongoing anxiety in cats:

• Confined environment or the inability to roam
• Particular noises
• Traveling
• Veterinary visits
• Litter box problems (position, number of litter boxes, type of litter)
• Lack of early socialization with new people, places, and animals 
• Age-related changes to the brain, dementia
• Traumatic events or injuries
• Pain or illness

Diagnosing Anxiety in Cats

Your veterinarian will perform a full physical exam on your cat and ask you questions about her behavior and any recent changes in diet or environment. 

There is no test to diagnose anxiety in cats. However, your veterinarian may order radiographs, blood tests, or urine tests to rule out any underlying medical conditions that carry the same symptoms as anxiety. For example, bladder or gastrointestinal diseases may lead to abnormal litter box habits; overgrooming can signal a skin allergy, or thyroid disease may cause increased vocalization. A cat who is in pain will often show signs of anxiety, too.

If no medical condition is detected, the doctor can begin to make recommendations to help reduce your cat’s anxiety.  

Cat Anxiety Treatment

There are a few ways experts treat anxiety in cats, including behavior training, medication or supplements, and environmental enrichment, or a combination of these approaches. Your veterinarian will work with you to come up with an individualized treatment plan based on what will be the best fit for you and your cat. 

If you can pinpoint what is causing your cat’s anxiety, the most straightforward remedy is to remove the trigger, if possible. For example, if your cat is anxious because a feline housemate is bullying her, separate the cats until you can get a handle on their behavior. 

A trainer or behaviorist can recommend positive reinforcement techniques such as play, treats, or praise, to reduce the unwanted anxious behaviors and reward desired behaviors. Training techniques vary based on the type of anxiety. In general, the treatment process involves exposing the cat to a weak version of the trigger and then rewarding them for remaining calm. Over time, the strength or duration of the trigger increases, and the rewards continue each time the cat remains calm. 

Veterinarians and behaviorists universally warn against punishing a cat for problem behaviors related to anxiety. Negative consequences will only confirm that she had something to be anxious about and will make circumstances worse by reinforcing the unwanted act.  

Veterinarians may suggest prescription medications or over-the-counter supplements to help cats relax enough to respond to a behavior plan.  

Supplements and medications can cause side effects such as drowsiness or diarrhea, or they may not work at all for some cats. There may be a period of trial and error with your veterinarian to find what works best. There is rarely a cure to anxiety, but oftentimes it can be well managed. Finding the best management plan for your anxious cat can take months and a lot of hard work. Continue discussing your concerns with your veterinarian.

Over-the-Counter Supplements to Treat Anxiety in Cats

Synthetic Feline facial pheromone: Feline facial pheromones are a natural option designed to help cats with stress and anxiety by mimicking the calming scents produced when a cat rubs against a person or object, to mark it as a safe and reassuring part of its territory. 

Available without a prescription, this pheromone is available in the form of a collar, a diffuser, or a spray. The diffuser works well in small enclosed rooms. The spray is to be used on cloth items to help calm your cat, such as the towel in a travel carrier. 

L-theanine: L-theanine is an over-the-counter dietary supplement that has been shown to help cats and dogs deal with separation anxiety and environmental stressors. L-Theanine is an amino acid associated with muscle relaxation, better sleep quality, reduced blood pressure and heart rate, and cognitive benefits. It is available without a prescription as a pill or as an ingredient in specially formulated cat food or treats. 

L-tryptophan: L-tryptophan is an over-the-counter dietary supplement that can promote calmness in some cats. L-tryptophan is an amino acid associated with reducing repetitive behavior, vocalization, clinginess, and aggression. It is available without a prescription as a pill or as an ingredient in specially formulated cat food or treats.

Alpha-casozepine: Alpha-casozepine is an over-the-counter dietary supplement used to reduce fear, anxiety, and aggression in some cats. A peptide related to milk, alpha-casozepine is available without a prescription as a pill or as an ingredient in specially formulated cat food or treats.

Complementary therapies like massage or acupuncture are used to treat cat anxiety. There is little if any specific evidence that they work for this problem in cats, but they are safe and can be helpful.   

Treatments containing cannabidiol (CBD) are becoming increasingly available, but scientific research on its use in cats is lacking. When considering any dietary supplement, ask your veterinarian about reliable brands and formulations, since supplements are not well-regulated.

Prescription Medications to Treat Anxiety in Cats

Amitriptyline (Elavil, Levate): Amitriptyline is a type of drug known as a tricyclic antidepressant (TCA) and is used to treat generalized anxiety and separation anxiety and behavior disorders in cats and dogs. This drug should always be used under the supervision of a veterinarian and in conjunction with a behavior-modification program.

Clomipramine (Anafranil, Clomicalm): Clomipramine is a type of drug known as a tricyclic antidepressant (TCA). Clomicalm is FDA approved to treat separation anxiety in dogs. This drug should always be used under the supervision of a veterinarian and in conjunction with a behavior-modification program.

Fluoxetine (Prozac): Fluoxetine, better known as Prozac in humans, is a type of drug known as a selective serotonin reuptake inhibitor (SSRI). Reconcile is an FDA-approved fluoxetine product to treat separation anxiety in dogs. This is the most frequently prescribed medication for urine elimination outside of the litter box, and generalized anxiety in cats. It should always be used under the supervision of a veterinarian and in conjunction with a behavior-modification program.

Gabapentin: Gabapentin is an anti-seizure and neurologic (nerve) pain medication that is sometimes prescribed by veterinarians to help relieve certain types of pain or short-term anxiety in cats, such as travel or medical treatment. It should always be used under the supervision of a veterinarian.

Alprazolam (Xanax): Alprazolam, better known as Xanax for humans, is a type of drug known as a benzodiazepine, which acts on the brain and nerves to produce a calming effect. Though it is FDA-approved only for human use, veterinarians sometimes prescribe alprazolam short-term to treat anxiety or phobias in cats and dogs. This drug should always be used under the supervision of a veterinarian and in conjunction with a behavior-modification program.

With all treatment plans, patience is important. Most behavior problems can take time to solve. But the sooner the issue is addressed, the better the chance for a positive outcome. Untreated anxiety can lead to more serious health problems, like skin problems and gastrointestinal issues. Anxiety and stress can also lead to urinary issues, including infections, bladder inflammation, or in more severe cases, urinary blockages.

Cost to Treat Anxiety in Cats

The cost of treatment for anxiety in cats depends on what is causing the anxiety, the treatment plan prescribed, and what tests are needed to rule out other illnesses. 

Cats that suffer from anxiety can incur fees for exams, medications, and behavioral training in the hundreds of dollars. 

• Medical exam: $50-$75
• Diagnostic testing: $25-$300
• Medication: $30-$60 per month
• Behaviorist or trainer: $50-$300 per session
• Miscellaneous supplies: $25-$200

How to Prevent Anxiety in Cats

The best thing you can do to prevent anxiety from plaguing your cat is to create an environment that allows her to act on her natural feline instincts and behaviors: eating, hunting, drinking, elimination (“going to the bathroom”), security, play and exploration, climbing, perching, and scratching.

Providing indoor cats with enough enrichment and stimulation promotes well-adjusted and appropriate behavior. Make sure cats have dedicated playtime and exercise daily. During playtime, drag or dangle toys for them to chase or pounce on to simulate hunting. Give them their food in small portions throughout the day and use puzzle feeders that require some batting, chasing, rolling, or pawing to release the food. Satisfy their need to climb, perch, and scratch with appropriate furniture such as scratching posts and cat trees.  

Being territorial creatures, cats are also very particular about resources—food and water, litter boxes, and beds.  

“Each cat in the household should have space to relax, eat, and eliminate without interference from other cats or people in the home,” advises Teiber. “They are very sensitive to changes around the house, so special care needs to be taken when moving, bringing in new family members, changing diets or litter, or even rearranging furniture.” 

If you have a kitten on your hands, make sure to socialize her to new people, animals, and places during her first few months of life. Make sure you build in opportunities for positive reinforcement during these new experiences. For example, show her that getting inside the cat carrier means she will get a treat and that new people in your apartment means a chance to play. 

Related Conditions

• Feline idiopathic cystitis (FIC), formerly known as feline lower urinary tract disorder (FLUTD)
• Urinary tract infection
• Arthritis
• Thyroid disease
• Skin allergies
• Gastrointestinal disorders