Cats living today have essentially the same brains and behavioral repertoire as their wild ancestors; they have just learned how to form social attachments to people when kept in confinement with them.¹³² Cats benefit from safe and predictable environments that permit their perception of control to exceed their perception of threat. Such environments include the people to whom cats are bonded. Cats respond to human communication and emotional cues, particularly when expressed by their owners. Significant differences in feline threat response system activity have been found when attending to human “happiness” or “anger” emotional signals.

For these reasons, effective chronic pain management plans include consideration of the human-cat bond as well as the effectiveness of medical interventions. Research in other species has shown that positive environments and emotions decrease pain behaviors and that negative ones have the opposite effect.¹³³ Thus, the treatment plan must minimize negative interactions with owners and caregivers, such as unpleasant-tasting medications or unskilled handling for administration.

The benefits of any treatment should be weighed against the potential costs to the cat’s comfort, including any treatments that require restraint or repeated trips to the veterinarian. For example, whereas therapeutic laser treatments may be a tolerable and effective form of therapy, the necessity for repeated transportation for treatment may limit their effectiveness for many cats. For medications, alternative formulations like compounded liquids, very small tablets, or preferred flavors may help reduce the difficulty of administration. The value of treatments that cause anxiety, fear, or frustration when administered must always be weighed against their negative consequences on the human-cat bond.

Conversely, humans initiating and maintaining contact with cats in their homes in ways that result in positive emotional states can reduce pain-related behaviors and improve animal welfare. Predictable interactions with humans reduce the cat’s perception of threat. And the ability to choose likely permits cats to increase their perception of control.¹³⁴ Choice in the timing and duration of play sessions and activities such as petting, grooming, or training, combined with high-value treats, should ideally be planned for predictable times of the day and can reduce pain-related behavior.¹³⁵

A cat’s perception of threat also can be reduced by increasing opportunities to express feline-specific behaviors, such as exploration and play, by providing stimulating feeding strategies, and by reducing or eliminating conflict. Humans are part of this, whereas unrelated cats are not. Cats also rely more than humans do on smell, hearing, and touch to experience the world. For example, cats commonly use scent to mate, mark territory, bond, and communicate. Thus, odors preferred by cats, such as catnip, silvervine, or a pheromone, can add to enrichment. Additionally, cat-specific music has been shown to reduce blood pressure in cats,¹³⁶ and preferred bedding materials, fabrics, and scratching surface textures can enhance tactile experiences. Effective chronic pain treatment plans should always include environment and emotional enrichment as integral components.