Can we tell the difference between when behavioural problems cause skin problems and when skin problems cause behavioural changes?
In human medicine, the influence of stress on the onset or worsening of medical problems has been extensively studied. One of the most widely discussed relationships is that between stress and skin problems. Does the same thing happen in our cats?
There are skin lesions that can be directly related to behavioural problems. Excessive licking, nail biting, or scratching with the nails can be substitute behaviours.
But what are substitute behaviours?
When our cat finds itself in a situation where it does not know how to respond correctly, it may start to perform a different activity to reduce its anxiety. This activity has nothing to do with solving the problem, but it makes them focus on something else and feel good. Licking is one of these activities.
This gesture becomes a routine that always starts the same way: they may stop to observe, sniff and then start licking, scratching or biting, and they may continue like this for a long time, perhaps not stopping until we distract them in some way.
The problem with these behaviours, apart from the injuries they cause, is that they do not allow them to adapt to situations; they have no meaning or function. At first, they were related to the situation that caused them particular stress, but little by little they become detached from that moment and can appear several times a day, in any situation, interfering with normal life activities.
The origin and causes can be very varied.
We must know and analyse our cat well. There are risk factors related to their genetic predisposition, temperament, age, physical stimuli (e.g. a wound or injury), and environmental conditions. Let’s look at some examples:

Some cats, due to the environment in which they were raised, are more fearful than others when they have to live in different conditions. If we place a fearful cat in a place where it has no means of avoiding the stimuli that frighten it, it may begin to exhibit this type of substitute behaviour.
On other occasions, the trigger is a change in routine: moving house, changing furniture or schedules, having to live with a new pet, a new member of the family or the loss of one of them. Sometimes cats begin to warn us of their stress by spraying urine, but if we scold them because we misinterpret their warning signs, the problem can worsen.
It may also be due to a lack of visual stimuli or lack of activity. Consult your vet.
Some behavioural changes may start out very subtly: they may groom themselves more than usual or, conversely, start grooming themselves less. But if we let time pass, these can become serious health problems. They can lead to patches of broken hair, bald spots, chafing from licking, or wounds from scratching and biting, which can then become infected.

The vet will need to make a thorough diagnosis to determine whether it is a behavioural problem or a different problem that manifests itself as a change in behaviour. We should not rule out medical problems in advance, thinking that our cat has a ‘habit’ of scratching… as there may be dermatological problems, allergies (to certain foods, fleas…), neurological problems… We need to know what is behind their behaviour.
If it is a behavioural problem, we will have to treat both the skin problem and the behavioural problem. And if there is a different problem that was the cause of the change in behaviour, we will also have to treat both issues at the same time.
How to prepare for the visit to the vet?
It is important to review what we know about our cat:

Where it was raised, what it usually does, what the house it lives in is like, what its routines and schedules are, what has changed recently (think about small or big changes, from moving house, building work in the neighbourhood, to the type of food we give it, etc.).
When did the behaviour start, what was the situation like when we noticed it, when does it do it now, what have we done to prevent it…
What other changes in behaviour have we seen (urine marking, scratching, using the litter tray less, eating more, etc.)?
The details are important and help when it comes to making a good diagnosis!
Feliway can help by reducing the anxiety that is causing the behaviour, or by calming the anxiety caused by itching or a medical problem.

Depending on the cause, the vet will suggest different solutions:

Feliway facial pheromones will reduce anxiety.
In addition, we must help them regain control over their environment: for example, enabling them to escape from situations that worry them.
If they have conflicts with family members or other pets, we will need to check whether they have enough escape routes if they want to be alone and safe. Can they avoid encountering those who worry them when they need to go to the litter tray, eat, rest, etc.? We can establish predictable schedules and predictable social contacts: times for eating, playing, etc.
We know that some cats prefer to play by jumping and catching feather toys in flight, while others prefer to run after their toys… Variety is important, and we should change them so that they don’t get bored.
(Original article owned by Feliway Spain (CEVA Animal Health Group)