Is It Behavior… or Pain? The Hidden Medical Reasons Behind Cat Behavior Problems

When a cat starts missing the litter box, acting aggressively, or withdrawing from family life, it’s easy to assume it’s a behavior issue.

But what if it’s not?

What if your cat is actually trying to tell you something is wrong?

In this episode of Cat Talk Radio, I sat down with veterinarian Dr. Kevin Toman to talk about one of the most important—and most misunderstood—aspects of feline care: the connection between chronic medical conditions and behavior.

Cats are masters at hiding discomfort. In the wild, showing weakness makes them vulnerable, so they’ve evolved to mask pain incredibly well. Unfortunately, that means many health issues go unnoticed until they show up as behavior changes.

And those changes are often misinterpreted.

Common “Behavior Problems” That May Be Medical

Some of the most frequent concerns cat guardians have are:

• Litter box avoidance

• Aggression toward people or other pets

• Overgrooming or barbering

• Hiding or withdrawal

• Changes in appetite or activity

While these can absolutely have behavioral roots, they are also very commonly linked to underlying medical issues like:

• Chronic pain (especially arthritis)

• Gastrointestinal discomfort or constipation

• Urinary tract disease

• Dental pain

• Chronic conditions such as heart disease

The Subtle Signs Cats Are Struggling

Unlike dogs, cats rarely cry out or limp dramatically. Instead, their discomfort shows up in quieter ways:

• Less jumping or hesitation before jumping

• Sleeping more or in unusual places

• Decreased grooming—or overgrooming

• Increased irritability

• Avoiding interaction

These small changes are easy to miss—but they matter.

Why This Matters

When we mislabel a medical issue as a behavior problem, we risk:

• Delaying necessary treatment

• Increasing the cat’s stress and discomfort

• Damaging the human-animal bond

The good news? Once the underlying issue is addressed, many of these “behavior problems” improve—or even resolve completely.

What You Can Do

Dr. Toman emphasizes a few key takeaways for cat guardians:

• Pay attention to changes, even subtle ones

• Prioritize hydration and diet, especially for GI health

• Don’t wait—if something feels off, check with your veterinarian

• Advocate for your cat, because they can’t explain what they’re feeling

At the end of the day, behavior is communication.

And when we learn to listen more closely, we can give our cats the care—and comfort—they deserve.

Listen to the full podcast here.