The negative associations with cats, such as links to paganism and witchcraft, had a significant impact on their treatment during the Middle Ages. Cats were often viewed with suspicion and fear due to these beliefs, leading to mistreatment and even persecution. This resulted in some cats being killed, especially during times like the Black Death when they were wrongly associated with spreading disease through their supposed connection to the devil. The negative perceptions of cats influenced how they were regarded in society and affected their overall well-being.