One of the questions my clients often ask is, Does my cat need drugs? Naturally, I inquire in turn, Whatever prompted you to ask? As it turns out, there is a vast assortment of responses.
A major reason why people inquire about the use of medication is that they hope to find a drug that will cure their cats tendency to urinate or defecate outside the litter box. Other reasons include fighting among household cats, aggression toward people in the household and destructive behavior. Sometimes, people hope that giving their cat a drug will allow them to get a good nights sleep.
Unfortunately, it is not so simple. For one thing, there are few behavioral conditions that will absolutely resolve following the administration of a pill. Secondly, even though many types of behavioral conditions do improve considerably following the appropriate use of medication, in nearly all cases a successful outcome requires that additional measures be taken. Otherwise, maximum improvement will not be seen, and any resolution may not be sustained. In fact, most cases require a careful combination of behavioral and environmental modification to ensure control.
So the first answer to the inquiry is a conditional yes: If you are experiencing behavior problems with your cat, then medication may be beneficial. The corollary to that statement is that, for some conditions, medication is not indicated at all and may actually be contraindicated. That is why it is absolutely essential that a diagnosis be established before any behavior problem is treated, particularly when the use of any drug is being contemplated.
Lets look at the cat that eliminates outside the litter box. This behavior is a clinical sign. That sign alone is not a diagnosis. There are many reasons why a cat might leave a puddle on your bed. An analogy might be made to a person who goes to the doctor with a complaint of a swollen toe. All swollen toes are not treated the same way. The swelling might be secondary to trauma. The doctor might ask, Did someone step on your foot? In that case, she might prescribe medication to reduce pain and perhaps suggest cool or hot soaks, depending on the specific nature of the injury.
What if there is no injury? An infection might cause a painful, swollen toe. In that case, an antibiotic or even surgery might be indicated. The list of diagnoses goes on: a fracture, a circulatory problem, an immune-mediated disease and even an allergic response are among the myriad causes that might lead to the clinical sign of swollen toe. And all of these conditions are treated rather differently. Clearly, proper treatment demands a specific diagnosis.
Back to the cat world. You call your veterinarian and complain that your cat just urinated on the bed. Understanding that the behavioral complaint is not a diagnosis, your veterinarian requests a urine sample and discovers that the urine sediment contains red blood cells. This inappropriate behavior may have occurred because of the discomfort of the urinary tract infection. Psychotropic medication would have minimal to no effect on this condition. Instead, antibiotics may be prescribed.
Lets take another scenario. Perhaps your cats litter box was overflowing since the sitter forgot to change it all week. The clean, absorbent comforter seemed a better choice than a dirty box. In that case, the diagnosis might be litter box aversion. Again, psychotropic medication would not be a very helpful tool. Treatment would demand attention to litter box hygiene.
What if the sitter was diligent? Suddenly you recall that the last three times you traveled, you returned to a puddle on your bed. Well, maybe your cat suffers from separation-related anxiety. And, yes, that condition does indeed respond to anxiety-reducing medication. Of course, the treatment plan would also include environmental and behavioral modification.
Rule Out Health Problems First
For every behavioral complaint, there is a list of diagnostic rule-outs. The strategy for treating a behavior problem is no different from treating a medical problem. A careful history is needed to learn about the nature of the problem. A physical examination will rule out a medical basis for the behavior. And diagnostic tests will be performed to support or confirm the diagnosis.
Then, with a diagnosis established, an appropriate treatment plan can be created. It is possible that the plan will include the use of a psychotropic medication. Your veterinarian can explain the risks of any given medication for your cat. Naturally, there are potential side effects to any drug, including the exacerbation of an underlying behavioral problem. Fortunately, with the assortment of effective, safe drugs on the market, it is more likely that your cat will not experience any adverse events.
Remember: diagnosis before drugs.