Think outside the litter box

Kitties can produce some odoriferous tinkles and sprinkles and drizzles and downpours that leave their owners with less than affectionate feelings toward their furry felines. The good news is that I believe people are beginning to understand cats that eliminate inappropriately might have a behavior problem. So they take action. And this might also be the bad news.

Some cat owners might ask a cat expert friend, even if that friend lives with eight cats in a house that reeks of cat pee. Due to the myriad of traditional media and Internet stories—including my own—people become instant experts themselves and take action based on what they've read, perhaps adding another litter box or changing the brand of cat litter.

At first cheek rub, this sounds good—but it's not. As you know, no advice is going to help with a cat when its accidents are a result of diabetes, hyperthyroid disease, interstitial cystitis, osteoarthritis, kidney disease, feline cognitive dysfunction syndrome, or any other medical problem. So it's vital for you to place yourself in the chain of communication so you can discuss these medical problems with pet owners.

Inappropriate elimination is the No. 1 behavior issue reported for cats. If you wait until clients speak up, you may never find out. Or you might learn about the problem when the cat's very life is in the balance. An absolutely desperate owner says, "I have a week to fix this problem, or the cat goes!"

Uncover litter box issues

The first hurdle is to explain that litter box issues may not be behavioral in the first place. For example, you might start by explaining diabetic cats might always be thirsty. And with increased water intake, sometimes diabetic cats just can't make it to the box. Or their once pristine box quickly becomes too dirty to tolerate. Of course, these cats benefit far more from insulin than a new and trendy cat litter—and cat owners will understand once you explain their pet's condition. Just remember, even if you're treating a medical condition in some cases you may also need to use behavior modification to resolve the pet's problem.

Some cat owners are simply too embarrassed to talk about their cats' accidents. So this is where a trusting relationship may not only save a client, but also a cat's life.

Many cat owners just don't think of you as a resource for behavior problems. So, the right time for a conversation about all behavior problems is the very first moment the client appears with a new kitten or cat. Don't be afraid to bring up the topic and ask questions. For example, "Tell me about the litter box. Does your cat have good aim?" Even if you include behavior questions on a questionnaire, it's a good idea to ask them verbally and watch for the client's response, which might be hesitant at first.

As the veterinarian works to identify any underlying health issues that may contribute to the problem, you can offer support and advice that will complement the cat's care—and, with persistence, possibly bring the cat back to appropriate litter habits.

Make your mark

Clients often say, "My cat is spraying." Well, technically there are two categories of cats thinking outside the box. One is spraying or marking. The second is voiding or house soiling. Let's examine each and discuss some solutions you can offer to help pet owners address this issue.

Spraying or marking is the feline version of spray painting: "This is my territory. I'm here!" Urine sprays as the cat quivers, tail lashing and often vocalizing, and then it drips from a vertical surface. Voiding or house soiling occurs on flat surfaces and is often caused by a physical problem, anxiety-related issue, aversion to litter or the box, or any combination of these.

For cats that spray or mark, start by asking these questions:

• Is the cat neutered?

• Is the cat seeing or smelling outdoor cats, or even other animals, causing a territorial response?

• In multi-cat homes, is there a new feline addition? Are cats getting along?

• Is there new furniture in the house the cat is spraying on?

• Is cat spraying against the wall in an apartment or condominium where another cat is living on the other side?

Once you've discussed these issues with the client, it's time to take action. Consider these actions to help resolve the issue:

• Recommend a veterinary exam to rule out a contributing physical explanation.

• Neuter the cat.

• Pull down shades and close blinds to prevent seeing outdoor cats.

• Suggest a motion detector sprinkler or another humane deterrent to dissuade outdoor cats.

• Confine the spraying cat to a part of the house where outdoor cats can't be seen, heard, or smelled when it's unsupervised.

• Cover any new furniture to protect it from spraying.

• Add an additional litter box near where the cat sprays.

• Use a synthetic pheromone product, a nutritional supplement, or a psychopharmaceutical to decrease anxiety, if recommended by the veterinarian.

Finally, remember if it's a cat vs. cat situation, the client may require hands-on help to broker peace from a veterinary behaviorist, certified cat behavior consultant, or a member of the American Veterinary Society of Animal Behavior. Your veterinarian can offer a referral.

If the pet is voiding or house soiling, consider corrective measures. The first step is a veterinary exam to rule out FLUTD, including idiopathic cystitis, urinary bladder stones, a urinary tract infection, or any other physical cause.

Some of your response depends on where the cat is urinating. Cats that piddle next to the litter box aren't complaining about the location of the box—otherwise they may piddle in another room. Instead they may have an aversion to the litter or the box itself.

A cat urinating on a counter might prefer that location because it's an excellent lookout. Perhaps it's worried about being ambushed while in the litter box by another cat, the family dog, or well-meaning toddlers. This is a red flag that cats aren't getting along—at least not all the time, even if the owners don't notice subtle signaling.

Offer a helping paw

When you're dealing with an issue like inappropriate elimination, it's important to offer these general tips:

• Offer an abundance of all resources, including litter boxes, to minimize stress. The rule is to have one more litter box than cats. So if a client has four cats, ideally that means five boxes.

• Pinpoint the culprit. In multi-cat homes, determining the culprit can be challenging. A veterinarian can prescribe fluorescein dye, which is given to one cat. Urine outside the litter box during the next 24 hours can be checked for fluorescence using a Wood's lamp. If urine doesn't fluoresce, administer fluorescein to each cat until the one responsible is found. And remember, a positive test doesn't eliminate the possibility that more than one cat has accidents.

• Offer tips to protect furniture. Remind clients that it's reasonable to deter their cat's actions by making the object less appealing. You may recommend a variety of helpful products, from a motion detector that alarms and sprays harmless citronella, to double-stick tape, rug runners, or car mats nubby side up. Place a litter box near the furniture the cat currently uses. Once the cat begins hitting the target, gradually move the box to a more preferred location.

• Support your veterinarian's medical recommendations. To diminish anxiety, the doctor may recommend a synthetic pheromone or chewable tablets containing L-Theanine, an amino acid that has demonstrated particular success for cats with FLUTD or interstitial cystitis.

• Check litter box habits. Remind clients to scoop daily. If the owner has switched cat litters recently, return to a previous brand. Most cats prefer clumping unscented litter.

If the litter box is more than a year old, replace it. And remind clients that most cats prefer uncovered boxes. Obese cats that may also be arthritic may struggle to step into and maneuver inside the box. Suggest an extra large plastic storage container—the kind you'd store under a bed. Advise pet owners to look for low sides that make it easy to walk in and out. It's also important to offer information about weight loss and consider supportive care for pain for these cats. And if the cat litter itself is suspect, allow the cat to choose using a litter trial, lining up the boxes as a buffet.

When clients choose the locations of the boxes, they should consider the relationships of various cats in the household. Feline signaling may be covert, and cats that appear to be friends in one context may sometimes also have agonistic associations in another context. Explain that boxes should be distanced from commotion. Cats seek privacy but also don't want to feel trapped. Remind clients to avoid basements and other places with potential loud, sudden sounds. They should place litter boxes in various locations, not all in one room. Make an exception for cats that prefer to two toilets next to one another—one to do No. 1 and a second for No. 2. And when accidents occur, make sure pet owners clean accidents with an enzymatic cleaner.

For cats that develop a substrate preference for carpet, you may suggest placing a carpet remnant inside the box. If the cat begins to use the box, gradually add litter while the remnant is cut away.

An important reminder: Make sure you tell clients to never rub a cat's nose in the mess or physically punish. This only heightens anxiety in an already anxious cat and creates mistrust. And don't forget to mention it's important to still provide litter boxes for cats that spend time outdoors.

While relegating the cat to a small room, such as a bathroom, may re-train a cat having accidents to the box, the inappropriate elimination is likely to return unless the underlying cause is dealt with. Explain that enriched environments are particularly important for indoor cats. Enrichment-deficient cats are more susceptible to stress, which may lead to inappropriate elimination, frequently linked to idiopathic cystitis.

Finally, keep in mind that pharmacological interventions will not help cats with aversions to litter, litter boxes, or location; the drugs do potentially help cats with anxiety problems, including inter-cat relationship issues, in conjunction with behavior modification.

Offer support for success

Your patients' life may depend on you developing a trusting and easygoing relationship with the client. It's tempting to roll your eyes when you hear there are eight cats sharing one litter box—no wonder there's a problem! Try to be open and nonjudgmental, and clients may even bring up behavior problems without your prompting.

Other clients may be more savvy, and behavior problems aren't so easy to figure out. You need to let these clients know together, with advice from trusted websites and expert bloggers, you'll find a solution. After all, clients need to think of you as an experienced resource as well.

What's most important is to communicate at each visit that you're interested in the pet's behavior. And if clients experience that funny feeling that something's wrong, something probably is amiss. Getting a jump on that instinct may be lifesaving—and it highlights one of the many benefits of twice annual visits. After all, it's difficult to solve problems you don't know about.

Steve Dale, CABC, writes a twice-weekly syndicated newspaper column for Tribune Media services and is a contributing editor at USA Weekend. He is also host of two nationally syndicated radio shows, "Steve Dale's Pet World" and "The Pet Minute," and is heard on WGN Radio. Please share your questions or comments at dvm360.com/community.