For years we managed our lovable but anxious cat’s behavior in ways that, looking back, seem silly. Pepper, an indoor cat, would become upset if she looked through the sliding glass door in our kitchen and saw another cat passing through our backyard. As she began to growl, we would hastily retreat. We knew that, thwarted by the glass, Pepper might soon turn all her cat-directed fury at us. My husband would move behind a chair for protection, and I would rush out the front door to chase the intruder from our yard.

Pepper, a black and white cat, sits in a shoe box.
Anti-anxiety medication helped Karen Lange’s cat, Pepper, become calmer.
Karen Lange

It worked until she was 9. But one night, I was sitting in the darkened kitchen, focused on my computer. I did not see a cat enter our unlit yard or realize that Pepper had moved into the room. Unable to get at the cat invading her territory, she directed her aggression at my leg, tearing open my ankle with her claws and teeth. Shocked, I staggered to the bathtub to put pressure on the wound and stop the bleeding. It would take four months and multiple visits to a wound center before my leg healed.

“You should put her on fluoxetine,” said my husband’s cousin, a veterinarian, after he heard the story. “Fluoxetine?” I asked. Like many, I had heard of Prozac being used to treat anxiety and depression in humans but wasn’t familiar with its generic name and didn’t know it’s been prescribed to treat anxiety in cats since the mid- to late 1990s. That’s a common reaction, says Dr. Anna Delabar, a Missouri state representative for the Humane Society Veterinary Medical Association. Delabar, one of the founders of the Pet Wellness Alliance, a nonprofit veterinary clinic in Columbia, Missouri, says pet owners worry fluoxetine will change their pet’s personality.

Rather than “drugging” cats, though, fluoxetine simply reduces anxiety. This allows cats who might otherwise spend their days under a bed to emerge from hiding, stops compulsive behavior such as overgrooming and resolves behavioral issues that might make it difficult for people to keep their pets, says Delabar. Sometimes cats take the medication, which should only be given after consulting a veterinarian, for a short time. Often they take it for the rest of their lives. “It’s addressing their emotional and behavioral health,” Delabar says.

Veterinarians who went to vet school years ago may not be familiar with fluoxetine, says Dr. Nicholas Dodman, an HSVMA member, chief scientific officer at the Center for Canine Behavior Studies (which also covers cats) and pioneer in the use of anti-anxiety medication for cats. But today, it’s the “new normal” for treating feline anxiety, which has been on the rise since cats were brought indoors, he says. Some anxiety is a survival mechanism. It’s when instincts are frustrated that it becomes a problem, Dodman says, noting the importance of giving indoor cats windows to look out, high places to perch on, play that takes the place of hunting and time outdoors in catios or on leashes. That way cats can be kept safe and live longer, as indoor pets do, while also engaging in natural behaviors they enjoy.

Jimmy, a black and white cat lays in a blue chair.
Jimmy sprayed and urinated outside the litter box after joining his new home. With medication, he stopped that behavior.
Beth McNulty

When community cat Jimmy was brought indoors to live after being neutered, he quickly adapted to his new owners, sleeping between them at night, says adopter Beth McNulty, operations manager at the Humane Society of the United States. But the challenge of living with McNulty’s two other cats stressed Jimmy, causing him to spray and pee outside the box. After determining there were no medical issues, a veterinarian prescribed fluoxetine. Once McNulty started giving him a chicken-flavored, chewable form of the medication (at first wrapped in lunch meat, then mashed into food), she says the peeing outside the box and spraying dropped in frequency. Within a month, the behavior stopped completely.

Fluoxetine simply reduces anxiety, stops compulsive behavior such as overgrooming and resolves behavioral issues that might otherwise make it difficult for people to keep their pets.

A man mixing cat medication into wet food.
Lange’s husband, Stuart Gagnon, mixes the medication into wet food.
Karen Lange

More than three years after attacking my ankle, Pepper is a calmer, happier cat. She doesn’t become agitated when other cats walk through the yard and has stopped licking the fur off her belly (another sign of feline anxiety). She’s been taking fluoxetine every day since June 2020—we break open the capsule and mix the powder into her wet food. Pepper doesn’t notice the addition to her dinner, and we can all finally relax together in the kitchen.

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Cover of All Animals Magazine Summer 2024 Issue showing a dog outside.