Excessive grooming (overgrooming) in cats

What is overgrooming?

Cats normally groom themselves extensively, but in overgrooming a cat licks, bites or pulls at the coat so intensively that bald patches (alopecia) occur — typically on the belly, inside of the thighs, flanks or lower back. Owners often only see the hair loss, because the excessive licking takes place at night or out of sight [3].

Psychogenic or medical?

The term psychogenic alopecia is quickly used, but research shows that in 76% of cats with a presumed psychogenic problem a medical cause proved to be the real explanation [3]. Diagnosis is always a diagnosis of exclusion: the veterinary surgeon must first rule out flea allergy, food hypersensitivity, atopic dermatitis, ringworm, mites and pain before overgrooming is labelled as a behavioural problem.

What does the evidence say about additional options?

Environmental adjustments and behaviour modification

This is the only approach with broad consensus in the literature, although controlled studies are lacking. Consider:

• Environmental enrichment — scratching posts, hiding places, hunting toys, window perches
• Predictable routine — fixed feeding and play times reduce chronic stress
• Removing stressors — conflicts with housemate animals, moving house, new residents
• Never punish — punishment increases stress and worsens overgrooming behaviour

Pharmacological agents (off-label)

Fluoxetine (SSRI) and clomipramine (TCA) are used in veterinary practice, but the evidence is weak. In the only published RCT (n=25), clomipramine showed no significant advantage over placebo in reducing grooming episodes or hair growth [2]. A systematic review confirms that the evidence is insufficient to make a strong recommendation [1]. Both agents are used exclusively in combination with behaviour modification and are not a standalone solution.

Phytotherapy and supplements

There are no controlled studies that have specifically investigated herbal preparations, CBD oil, melatonin or other supplements for overgrooming in cats. Anecdotal reports from owners are not evidence of efficacy. Use of such agents without veterinary consultation is not recommended, partly due to possible adverse effects and interactions.

Pheromone therapy

Synthetic cat pheromones (F3 fraction, such as Feliway) are recommended as a stress-reduction agent. Evidence specifically for overgrooming is lacking, but the safety profile is favourable and it fits within a broader stress-reduction approach. Additional, never replacing medical investigation.

Summary of options

When to see the veterinary surgeon?

Overgrooming is always a reason to consult a veterinary surgeon — certainly in the case of a first episode. Self-diagnosis as 'stress' misses the actual cause in the majority of cases [3]. Additional measures are an addition to, never a replacement for, veterinary diagnosis and treatment.