This behavior is actually not uncommon. It is called feline non-recognition aggression and it refers to one cat behaving in an uncharacteristically aggressive manner toward a companion cat in the household after a period of separation (the period of separation could be anything from a few hours to a few days or more). While it is sometimes the case as with my client's cats that it is just one cat who behaves aggressively, in some homes the cat who has been gone may not simply flee or freeze, but actually fight back, creating an even bigger problem. While this situation isn't completely understood, we do have a pretty good idea of where the problem arises. Most likely the change in the relationship is rooted in smell. The cat who has been gone smells different and therefore foreign; perhaps the cat who has been gone smells like a sick animal, like anxiety, or simply like the disinfectants used in the veterinary hospital where they received their care. If the cat coming home is also behaving differently (e.g. sluggish, tired, or wobbly), that may be triggering the cat left at home to think this isn't their companion cat, but an unfamiliar. It may also be the case that the cat who has been gone for the day is emitting pheromones which cannot be detected by humans, but are sensed by other cats and result in aggressive behavior. For example, the cat who has been gone may have expressed their anal glands due to stress and that odor is causing the other cat to respond with aggression. All of this makes sense when you acknowledge that cats recognize each other based on scent much more than on visual cues or appearance.
There are no easy fixes for this problem, and it is certainly the case that some cats are predisposed to behave in this manner and if they've done it on one occasion, it will happen again the next time the cats are apart. There isn't really anything cat owners can do in advance of a veterinary visit, or that your vet can do during the vet visit to potentially avoid this issue. If you know your cat will behave this way, then keeping the cats separate for however long it takes for them to become amenable to one another again is what has to occur. For some cats, bathing, at a minimum the cat who has been to the vet's office, can help as it gets rid of the hospital smell. After the bath, rub the cat with something that has their previously familiar smell. Hopefully, that will help the cats recognize each other. For other cats, it's even better to bathe them both; that way neither cat smells like themselves, both smell like fresh, clean slates when reintroduced. It goes without saying that you never want to bring two cats together if one is still feeling the effects of their vet visit and is dopey, painful, etc. Finally, if your vet is amenable to it, you may just want to send both cats to the vet at the same time; the cat not receiving the dental procedure can simply board there for the day. That way, both cats return home smelling like a vet hospital!
First and foremost, do not let your cats "fight it out." Cats don't resolve their issues this way like many dogs do. Interrupt any aggression you see by clapping your hands/stomping your feet, squirting water or compressed air at the aggressor cat. Try to move the aggressor cat into a separate room (NOT the cat being aggressed) where he/she can decompress. They may need to be in this room for several hours to several days, so make sure this room is set up for them with litter boxes, climbing perches, food and water, etc. If you have to pick up the aggressor to move them, throw a towel or blanket over them BEFORE you try to pick them up to make the situation safer for you both. Resist the urge to try to placate either cat; just let them both be so that they can calm down on their own. Remember that a cat when upset can redirect aggression at anyone in their vicinity, so make sure your aggressor cat is alone in that room (no other pets, and make sure than any humans entering the space are aware that they need to ignore this cat for safety reasons).
Gradual introductions will be needed, with cats on opposite sides of closed doors, screens, or gates working up to cracking the door open, to opening the door and supervising their time together. A good place to start is by placing each cat's food bowl near the shared door or gate so that they are eating together. You want to aim for them ignoring one another (best case option, actually) and hopefully over time work toward them tolerating one another, and then becoming friends again. In some homes, pheromones can help with the reintroduction phase, so Feliway spray and plug-ins can be used. In other homes, giving CBD oil to the aggressor cat can help with their underlying anxiety and stress. Realistic expectations are key, however, as some cats never return to being friendly with one another, in spite of everything you do. And remember that this is likely to happen again if it's already happened once; the next time a cat in your home has to be gone for any period of time, confine the other cat to ensure that the aggression doesn't happen again from the outset.
Non-recognition aggression is unique to cats and not something we see in dogs. Most likely this is the case because cats rely more on smell for identifying each other, while dogs use visual markers and past experiences more than scent recognition.
As always, if you have questions about your pet's behavior, you know where to find me.
Cats are sociable and quite capable of forming friendships and alliances with other cats, and even dogs. Age is definitely a factor, as is personality. And how cats feel about each other can change over time, and not always for the better!
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