My last patient on Saturday scared the heck out of me. No, it wasn’t the scratch marks on my arms (that itched like mad for the whole day) or the shallow bite marks on my hands (which, incidentally, did not break the skin but itched nonetheless).

No, my last patient was especially frightening because of the red-ringed scratch-mark scabs all over my diabetic, immunosuppressed client’s legs.

This client had recently undergone major intra-abdominal surgery only six weeks ago. Her children felt it would be sweet to provide their mother with a companion for her convalescence. A beautiful black and white kitten named Jax.

Jax was not exactly the companion she’d envisioned when she gleefully accepted the puffball. How precious! And how precocious—he loves to play with my rings!

One thing led to the next and Jax`s playful behavior became a game of stalk and kill. It would have been fine, according to the owner, but for the target: mom’s extremities. A diabetic cannot afford to have her kitten rack up damage points based on the depth of the limb wounds he inflicts.

And Jax`s behavior was worsening with age. He was now a large four-month-old kitten, and he’d taken to skulking behind doorways then launching himself at his owner’s fragile legs. She was wary each time she turned a corner in her own home. This was clearly a problem for the vet to solve.

The vet was suitably horrified. Puncture wounds on a diabetic can easily lead to limb amputation. The first words out of my mouth: You should consider rehoming this wonderful kitten. His play instinct, normal though it may appear, is out of control.

I was able to make this statement based on my first (and only) interaction with the kitten. At first he batted at my hands. When I held his paws to restrict their movement he playfully attacked my hand, as if it were a mouse. When I attempted to withdraw my hand he growled and bit down—substantially harder than he should have.

And now for an explanation: Kittens have a normal instinct to play. Their play is typically geared towards predator-prey role-playing games. When they play, usually with one another, they stalk each other and tussle on the ground, biting gently with claws typically withdrawn. Occasionally, you’ll hear them vocalize, but mostly this is a silent, benign pantomime of adult cat combat. When they lack a littermate or willing feline target, the closest human will suffice.

Some kittens, especially males who lack buddies to wrestle with, will occasionally yield to more extreme violence with their humans. They will stalk and roughly attack hands, arms and legs—even faces. It can get pretty out of control at times. Although annoying and sometimes dangerous, depending on the human target’s health, this type of behavior is absolutely normal.

Some owners, especially children (and men, in my experience), encourage this behavior by engaging the kitten in play and by roughhousing in response when the kitten stalks and attacks.

The ideal human response is to satisfy the kitten’s natural hunt-kill behavior with toys, particularly the interactive dangling ones. This allows for human-cat interaction without the behavioral implications (my human is just like my littermate; he’s on my same social level and therefore worthy of my scorn and abuse anytime I choose to inflict it). This kind of play also spares you the puncture wounds I’m sure you’d prefer not to sustain.

Another solution to this dilemma is to consider getting your kitty a playmate of the same age. This is the only situation in which I’d ever advocate the adoption of another pet for behavioral reasons. Some kittens just get too crazy without a constant outlet for their energy and natural excitability.

And now back to my terminator kitty: Jax`s behavior is out of control. He exhibits not only the extreme normal version of play aggression we commonly see, but also a form of dominance aggression that will sometimes emerge in a frustrated, high-energy kitten.

How do I know? Not only do I still have the marks to prove it, but Jax gave up his diagnosis on the first growl. Aggressive vocalization is almost never a part of play aggression. Growls and meowling don’t usually accompany normal kitten play. Extreme stalking, as his owner described it, isn’t usually part of the act, either. They’re usually the hallmark of dominance or territorial aggression. In this case, his in-hospital display coincided well with a dominance form of aggression. After all, he was on my turf now.

In spite of Jax`s violent behavior, his owner is loath to part with him. Much as she fears him her guilt won’t let her give him up so easily. So we discussed the playmate and toy alternatives along with immediate neutering and she agreed to follow up with those suggestions.

For my part, I made careful annotations in his record of my strong recommendation in favor of rehoming. My two cents? Pets are a wonderful addition to any household but the seriously ill cannot afford to keep kittens like this one. Ultimately, I hope he finds another home in which he can more safely vent his aggressions.