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Medical aspects of elimination problems must be resolved. There is a close relationship between stress and [[Cystitis|FIC]] so that dealing with social and environmental stress is an important component in resolving this condition.
 
Medical aspects of elimination problems must be resolved. There is a close relationship between stress and [[Cystitis|FIC]] so that dealing with social and environmental stress is an important component in resolving this condition.
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==Environment and Social Issues===
 
Typically, it is possible to identify one or two environmental changes that have initiated the housesoiling/inappropriate elimination problem. This may be something as simple as a change of cat litter. However, it is very important not to treat the problem at this superficial level. If a single inconsequential change has caused the cat to house-soil then it is very likely that there are other underlying problems that also need to be addressed. Not to do so may mean consigning the cat to a life of stress and impaired welfare.
 
Typically, it is possible to identify one or two environmental changes that have initiated the housesoiling/inappropriate elimination problem. This may be something as simple as a change of cat litter. However, it is very important not to treat the problem at this superficial level. If a single inconsequential change has caused the cat to house-soil then it is very likely that there are other underlying problems that also need to be addressed. Not to do so may mean consigning the cat to a life of stress and impaired welfare.
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Overall '''resource levels should be increased''' and resources should be distributed so that individual cats and cat-factions can make use of them without coming into conflict with each other. This also helps to undermine the activities of feline despots who try to monopolise specific resources. Additional cat flaps may be needed if aggression between cats is preventing certain cats from using outdoor latrines.
 
Overall '''resource levels should be increased''' and resources should be distributed so that individual cats and cat-factions can make use of them without coming into conflict with each other. This also helps to undermine the activities of feline despots who try to monopolise specific resources. Additional cat flaps may be needed if aggression between cats is preventing certain cats from using outdoor latrines.
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The cats should be provided with a range of suitable latrines, inside and outside the house. Cats do not share latrine facilities so, in multi-cat households, the optimum number of latrines should be one per cat plus one extra. This number of cat litter trays is obviously a horrific prospect for the owner of a lot of cats. The answer is to provide cats with outdoor latrines in the owner’s garden. With the current fashion for hard landscaping, cats may have few opportunities to use good outdoor latrines and may have to travel across several gardens to find somewhere suitable. In winter, these toilets may become sodden or frozen, making them unusable. For this reason, many housesoiling problems are worse during the winter.
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The cats should be provided with a '''range of suitable latrines''', inside and outside the house, discussed on the [[Cat Latrines]] page.  
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GENERAL LATRINES
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'''F3 diffusers''' are traditionally used to treat [[Indoor Marking - Cat|spraying problems]], but can be used to make a latrine location more attractive. The diffuser is placed very close to the litter tray in a confined area. This can be effective for cats that choose to eliminate on piles of the owner’s clothing or on the owner’s bed because these locations are associated with increased security. F3 diffusers may also be used to reduce general social stress in the household. In this situation, the diffuser should be allowed to warm up for at least a couple of hours before allowing cats to have access to the room where the diffuser is installed.
Outdoor latrines are actually very easy to construct. These outdoor toilets should be hidden in flowerbeds behind shrubs and tall plants to give the cat privacy. These latrines are essentially self-cleaning but it is sensible to regularly use a litter scoop to remove faeces in the same way as with a conventional litter tray. The sandy part of the latrine should be dug out and replaced every six months. One outdoor latrine is unlikely to be enough, and different cats will have different preferences for location. At least two latrines should be provided.
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There are often concerns that other cats will come into the territory to use the outdoor latrines. This is a possibility but rarely causes a problem. In fact, the presence of nearby latrines tends to strengthen the boundary of the resident cat’s own territory.
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Conversely, '''inappropriate latrine sites should be made less appealing'''. There are a number of ways to do this, including changing the floor substrate to make it less pleasant to stand on, placing small bowls of food close to the location so that it becomes designated as a feeding station instead of a latrine. The best guide for how to modify a particular latrine site is the cat’s reason for choosing it in the first place. For example, a dark and secluded corner can be made a lot less discrete by moving furniture, putting in a loud radio close by or illuminating the corner with a bright spot lamp. Battery powered infra-red activated lamps can be bought very cheaply from hardware stores and can be installed in small corner, where it will switch on every time the cat approaches. This can act as an effective deterrent.
 
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Indoor latrines should be made as appealing as possible. They should be positioned in quiet locations and deep filled with a scent free mineral based litter. In some cases, soft sand or a mixture of soft sand and litter is attractive to cats, and the sand content can be reduced gradually once the cat has shifted its location preference to the designated litter tray.
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F3 diffusers are traditionally used to treat spraying problems, but can be used to make a latrine location more attractive. The diffuser is placed very close to the litter tray in a
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confined area. This can be effective for cats that choose to eliminate on piles of the owner’s clothing or on the owner’s bed because these locations are associated with increased security. F3 diffusers may also be used to reduce general social stress in the household. In this situation, the diffuser should be allowed to warm up for at least a couple of hours before allowing cats to have access to the room where the diffuser is installed.
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Conversely, inappropriate latrine sites should be made less appealing. There are a number of ways to do this, including changing the floor substrate to make it less pleasant to stand on, placing small bowls of food close to the location so that it becomes designated as a feeding station instead of a latrine. The best guide for how to modify a particular latrine site is the cat’s reason for choosing it in the first place. For example, a dark and secluded corner can be made a lot less discrete by moving furniture, putting in a loud radio close by or
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illuminating the corner with a bright spot lamp. Battery powered infra-red activated lamps can be bought very cheaply from hardware stores and can be installed in small corner, where it will switch on every time the cat approaches. This can act as an effective deterrent.
      
Altering inappropriate latrine sites to make them less appealing to the cat (this must only be done when a potential alternative has been made available)
 
Altering inappropriate latrine sites to make them less appealing to the cat (this must only be done when a potential alternative has been made available)
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* The same effect can be achieved using a small, battery powered infrared activated lamp, which will turn on each time the cat approaches [these are very inexpensive].
 
* The same effect can be achieved using a small, battery powered infrared activated lamp, which will turn on each time the cat approaches [these are very inexpensive].
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Cats that are inhibited, fearful and therefore unable to utilise improved resources because of their apprehension, may benefit from psychoactive drug therapy. Selegiline is not licensed for use in the cat, but it can be used for the treatment of specific fears, a condition for which it is licensed in the dog (in the UK). This drug increases confidence and exploratory behaviour, but takes 4-6 weeks to show efficacy. It should be continued until the cat is fully utilising resources and has not eliminated in the house for 8 weeks.
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===Psychoactive Drug Therapy===
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Cats that are inhibited, fearful and therefore unable to utilise improved resources because of their apprehension, may benefit from psychoactive drug therapy. '''Selegiline''' is not licensed for use in the cat, but it can be used for the treatment of specific fears, a condition for which it is licensed in the dog (in the UK). This drug increases confidence and exploratory behaviour, but takes 4-6 weeks to show efficacy. It should be continued until the cat is fully utilising resources and has not eliminated in the house for 8 weeks.
    
Where signs of chronic anxiety are apparent, despite the use of F3 diffusers, then an SRI or SSRI type drug, such as Clomipramine or Fluoxetine, may be appropriate.
 
Where signs of chronic anxiety are apparent, despite the use of F3 diffusers, then an SRI or SSRI type drug, such as Clomipramine or Fluoxetine, may be appropriate.
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CYSTITIS
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Trial treatments for [[Cystitis|Feline Idiopathic Cystitis]] have included polysulphated glycosaminoglycans and Amitriptyline. Response to glycosaminoglycans was variable, with some individuals responding extremely well and others less so. Treatment with Amitriptyline has produced good results, with the affects being attributed to the nor-adrenergic effects of the drug. Amitriptyline is 5:1 selective in favour of nor-adrenaline over serotonin reuptake inhibition, whereas Clomipramine is 5:1 selective in favour of serotonin reuptake. However, both drugs do have significant effects on nor-adrenaline reuptake and Clomipramine may be a suitable alternative if there are concerns over adverse effects with Amitriptyline.
Trial treatments for Feline Idiopathic Cystitis have included polysulphated glycosaminoglycans and Amitriptyline. Response to glycosaminoglycans was variable, with some individuals responding extremely well and others less so. Treatment with Amitriptyline has produced good results, with the affects being attributed to the nor-adrenergic effects of the drug. Amitriptyline is 5:1 selective in favour of nor-adrenaline over serotonin reuptake inhibition,
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whereas Clomipramine is 5:1 selective in favour of serotonin reuptake. However, both drugs do have significant effects on nor-adrenaline reuptake and Clomipramine may be a suitable alternative if there are concerns over adverse effects with Amitriptyline.
      
In all cases, psychoactive drug therapy should only be considered after reaching a specific diagnosis and taking into account the risks of disinhibition of aggression. Obstructive urinary tract disease should be ruled out before initiating therapy with SRI or SSRI drugs, which have a risk of increasing outflow obstructions through their effects on acetylcholine transmission.
 
In all cases, psychoactive drug therapy should only be considered after reaching a specific diagnosis and taking into account the risks of disinhibition of aggression. Obstructive urinary tract disease should be ruled out before initiating therapy with SRI or SSRI drugs, which have a risk of increasing outflow obstructions through their effects on acetylcholine transmission.
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