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FELINE ELIMINATION PROBLEMS

Urine marking and inappropriate elimination are the most common feline behavioral problems seen by veterinarians.  Before making a behavioral diagnosis, a comprehensive medical work-up is needed to reveal any underlying medical disease.  Some diseases of the gastrointestinal tract that are associated with increased urgency to defecate, straining to defecate (tenesmus), diarrhea and abdominal pain also need to be considered.  Among the numerous diseases that need to be ruled out are:

  • Cystitis (inflammation of the bladder)
  • Urinary tract infection
  • Bladder stones (urolithiasis)
  • Kidney (renal) disease
  • Diabetes mellitus
  • Hyperthyroidism
  • Psychogenic polydipsia (drinking too much water)
  • Hyperadrenocorticism
  • Obstipation/constipation
  • Intestinal parasites
  • Inflammatory bowel disease or any other condition that leads to diarrhea or loose stool

If the medical work-up does not reveal an underlying disease, then a behavioral diagnosis can be pursued.  Inappropriate urination must be distinguished from urine marking.  Information about the frequency, location and quantity of accidents needs to be examined.

URINE MARKING

Urine marking (urine spraying or squatting) is a form of communication.  Cats may be communicating information about identity, stress, territory and sexual status.  Anxious cats may urine mark to create a familiar scent around themselves, thus decreasing some of their anxiety.  Social friction between indoor cats and reaction to outside cats can result in territorial urine marking.   A cat exhibiting urine marking behavior will usually continue to use the litter box for urine and fecal elimination.  Targets are usually doors and windows or items with a person’s scent on them.

Urine spraying is done in a standing posture, hind legs straight, tail up and quivering while the cat alternately steps with the back legs.  Squatting urine marking is done on a horizontal surface and has the same context as spraying;  common targets are the owner’s bedding or clothing.  About 5% of spayed females and 10% of neutered males will urine mark. 

INAPPROPRIATE ELIMINATION

In inappropriate elimination, the cat changes its toilet area to another part (or parts) of the house.  Inappropriate elimination is often triggered by medical causes, aversions (dislike of litter or box), preferences or anxiety.  The cat will have decreased or absent litter box usage.  In most cases, the elimination is found on horizontal surfaces and the cat will often tend to return to a specific substrate or location.  The problem may be with urine, feces or both.

Possible triggers for urination outside the box are:

  • Poor litter hygiene (the box is not cleaned/emptied enough)

  • Dislike of litter used or a change in preference

  • Litter box location (especially too close to food)

  • Size or type of litter box (too small, doesn’t like covered or open)

  • Stressful changes in the household (change in owner routine, visitors, new pets, etc)

  • Social friction between cats in the household (not enough boxes)

  • Underlying medical problem

  • Pain associated with urination/box

Possible triggers for defecation outside the box are:

  • Poor litter hygiene

  • Some cats prefer separate boxes for urination and defecation

  • Colitis, inflammatory bowel disease, irritable bowel syndrome

  • Constipation

  • Arthritis

  • Intestinal parasites

  • Other metabolic disease

  • Pain associated with defecation/box

DIAGNOSING THE PROBLEM

The minimal diagnostic work-up for a cat exhibiting elimination problems includes the following:

  • Complete physical examination

  • Urinalysis

  • Fecal examination

  • CBC, chemistry panel, thyroid

  • Other diagnostics as determined by physical exam and test results.

A complete history is essential for proper diagnosis and treatment.  The history should include the following information:

  • Frequency and pattern of elimination

  • Location of elimination

  • Substrate in litter box (boxes)

  • Behaviors associated with elimination (e.g. attempts to cover)

  • Litter box history and location

  • Owner’s response, previous attempted treatment

  • Social and environmental history

  • Cleaning strategies

  • Diet and medical history

  • Any changes in the household that could contribute to stress

PREVENTION AND TREATMENT

Neutering cats will decrease marking behavior.  Ninety percent of intact males show a significant decrease in urine marking after castration.  Try to discourage stray cats and neighborhood cats from entering front and back yards.  Create multiple feeding, sleeping and elimination areas to decrease interaction with other cats.  Spend a certain amount of time each day petting or playing with the cat.

The minimum number of litter boxes should be one per cat plus one.  Litter boxes should be scooped at least once daily.  This is critical.  The frequency of complete litter changes/box cleaning depends upon the type of litter used and the number of cats.  A good rule of thumb is changing clay litters once weekly and scoopable litters once every other week.  Litter boxes need to be the correct size.  A large cat may need an alternative such as a larger plastic storage box.  The litter boxes should be placed in easily accessible locations.  For those cats regularly eliminating in certain places, we recommend that you place a box at that site.  After the cat has been using the box regularly, slowly move the box back to its desired location, moving it no more than an inch at a time every 2 days.  Offer the cat a choice of litters.

Some cats will need to be confined to a small area (such as a bathroom) with food, water and a litter box until the cat is using the box regularly.  The time needed will depend upon the length of time that there has been a problem.  For a cat that has been urinating elsewhere in the house for 4-6 months, that cat may need to be confined to a bathroom or utility room for 3-4 months.  Slow re-introduction to the rest of the house is recommended after the cat has begun using the box regularly.

Soiled areas need to be properly cleaned with an enzymatic cleanser.  Do not use ammonia!  Make these areas less desirable by placing aluminum foil, rubber mats, or potpourri (make sure your cat does not ingest this!) at the site.  For vertical surfaces, we recommend placing a strong smelling stick-up (deodorizer) at the marked area.  You can also place the cat’s food and water at the soiled site.

Feliway is a synthetic facial pheromone that has been used with some success. Apply this to previously marked surfaces on a daily basis. Some herbal remedies have also been helpful with this problem. Ask your Doctor for details.

As a last resort, drug therapy may be needed while trying behavior modification.  A proper diagnostic work up needs to be done before prescribing medication.  Currently no medication is labeled for use in cats for treatment of inappropriate elimination.

Recommended Diagnostics:

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Recommended Treatments:

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Note: This article is provided by Claws & Paws Veterinary Hospital® for informational purposes only.