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Inappropriate Elimination - Cat (view source)
Revision as of 16:11, 18 March 2014
, 16:11, 18 March 2014→Diagnosis
COMMON
COMMON
==Diagnosis==
==Diagnosis==
===Identifying the Culprit===
It is very important to properly identify the culprit[s] for the indoor housesoiling. Clients frequently blame a particular animal, usually because they have seen it eliminating in the house. However, other cats may also be involved. It is possible to use fluorescein dye to identify the urine of each cat in the household so that the identity of the soiling cat can be confirmed ''[see box below]''. ''Recent research has shown that the fluorescence of urine spots from fluorescein treated cats may vary with urine pH. The fluorescence of fluorescein varies with pH, such that it only strongly emits light under UV illumination when it is in a neutral or alkaline solution. In acidic solution it may hardly glow green at all. Spots should therefore be sprayed with a buffer solution of sodium bicarbonate [baking soda], which will produce a pH of around 8, before testing with a UV lamp. ''If faecal soiling is involved, then a small amount of indigestible material is added to each cat’s food for several
It is very important to properly identify the culprit[s] for the indoor housesoiling. Clients frequently blame a particular animal, usually because they have seen it eliminating in the house. However, other cats may also be involved. It is possible to use fluorescein dye to identify the urine of each cat in the household so that the identity of the soiling cat can be confirmed ''[see box below]''. ''Recent research has shown that the fluorescence of urine spots from fluorescein treated cats may vary with urine pH. The fluorescence of fluorescein varies with pH, such that it only strongly emits light under UV illumination when it is in a neutral or alkaline solution. In acidic solution it may hardly glow green at all. Spots should therefore be sprayed with a buffer solution of sodium bicarbonate [baking soda], which will produce a pH of around 8, before testing with a UV lamp. ''If faecal soiling is involved, then a small amount of indigestible material is added to each cat’s food for several
days and the faeces are inspected. Crushed sweet corn works very well because
days and the faeces are inspected. Crushed sweet corn works very well because
it is easy to identify in the faeces and does not upset digestion.
it is easy to identify in the faeces and does not upset digestion.
====Using Fluorescein to Identify Urine Marking or Soiling Cats====
* Fluorescein is available as sterile paper strips, for ophthalmic examination. These contain approximately 1 mg of fluorescein per tip, but this should be checked with the manufacturer.
* The tips should be torn off and rolled to fit into gelatine capsules, giving approximately 5 per capsule [5mg].
* This dose is given once daily for 3-4 days.
* Urine sites are checked daily.
* Lightly spray each site with a solution of sodium bicarbonate [baking powder], mixed in water [1 tablespoonful in 125ml water].
* A UV lamp is then used to check the site for fluorescence.
* It is vital to start by testing the least probable culprits first, working up to the most probable. Otherwise fluorescence marks left by one cat will obscure those of another. If it is certain that the culprit is a resident cat then the culprit may be identified by a process of elimination, which minimises the risk of leaving lots of fluorescent stains for the client to
clean up.
* A 5-day washout is left between testing of each cat, to make sure that each individual has excreted all of the dye before testing the next.
* Although fluorescein is water-soluble and can usually be removed with normal cleaning, this testing method may leave stains on fabric, carpets or wall paper and owners must be warned of this.
ELIMINATION
===Behavioural Diagnosis===
A behavioural diagnosis should only be attempted after medical underlying and contributory factors have been investigated. A diagnosis is reached after collecting a detailed history and making diagrams of the soiling locations. Causes of housetraining breakdown are many and varied and detailed history taking and in-depth consultations are essential to get an accurate picture. Post trauma breakdown is relatively common and examples of trauma can include a period of enforced confinement, fear of the litter tray due to administration of medication or negative associations with the tray as a result of medical problems. Inappropriate facilities may be at the root of inappropriate toileting problems and it is important to consider the type of litter used in the tray, the sort of tray that is being offered and also the location of that tray. The cleaning regime may also be relevant since most cats are reluctant to use trays that are dirty and some others will fail to bond successfully to their latrine if it
is cleaned too frequently. Other potential causes of a breakdown in house training include challenges to security in nervous individuals, overcrowding within a small-sized territory where there is competition over the resource of the latrines or access to the trays is controlled and manipulated by one individual within the household. There is also the issue of old age and debilitation.
ELIMINATION
==Typical Causes==
* '''Lack of privacy in latrine locations''': litter trays that are placed too close to feeding areas or cat doors, or sited in busy places where the cat does not feel safe to go to the toilet. A previously satisfactory location may become unacceptable if the presence of new pets or children constantly disturbs the cat. New cats in the neighbourhood may overlook the litter tray from outside, again reducing privacy.
* '''Inappropriate substrate''': Certain scented, pine or wood-pulp based litters are aversive to cats. When urinated on they may release odours that the cat finds repellent, especially if the litter tray is hooded or enclosed. Substrate depth is also important, with cats preferring a depth of around 3cm.
* '''Competition and excessive latrine use''': if several cats are using the same litter tray then it quickly becomes soiled and cats may be forced to find somewhere else. Cats may be forced to displace each other in order to gain access to the solitary household latrine. Cats prefer to use separate toilets for urine and faeces wherever possible.
* '''Despotic control of entry/exit points''': Feline despots may perch close to cat doors and threaten other cats as they come and go. Nervous cats may not have the confidence to go in and out so they cannot use outdoor latrines. Threatening of cats leaving or entering the litter tray may also occur from cats within the same household.
* '''Specific fears''': Cats that are moved to a noisy or stressful location may be unwilling to go outside to use latrines. They may stay inside and soil the house if not provided with a litter tray.
* '''Negative litter box associations''': If the cat has been attacked or disturbed whilst using a particular latrine, or if it has experienced pain on micturition, then it is likely to chose a different toilet location the next time it needs to eliminate.
* '''Inability to use/find litter trays''': Elderly or debilitated cats may be less willing to travel to find a latrine, so they may resort to soiling in the house. They may be unable to make use of high-sided or covered trays.
* '''Medical illness''': Cats with PU/PD, incontinence, FLUTD or recurrent/chronic diarrhoea are unlikely to maintain a normal or acceptable pattern of elimination.
* '''Punishment''': cats that have been punished for eliminating in the wrong place may refuse to go to the toilet in the presence of the owner. Litter trays tend to be placed in public areas like the kitchen or utility area, which means that the fearful cat ceases to use them for fear of being punished further.
CYSTITIS
Recent research has demonstrated a direct connection between psychosocial stress and feline lower urinary tract disease. Feline idiopathic cystitis [FIC] is a complex condition that involves neurological changes in spinal pain fibres and biochemical changes in the bladder wall. The precise aetiology is not fully understood but cats with an anxious personality are predisposed to FIC and it is proposed that the condition arises from a combination of physical and psychological factors. Black and white cats, and Persian cats are commonly affected and FIC may account for a significant proportion of FLUTD in cats. Urine samples of FIC cats may be sterile or may contain crystals, plugs or traces of blood. Diagnosis is confirmed by double contrast radiography or ultrasound imaging of the bladder to reveal mural thickening.
==Treatment==
ELIMINATION
Medical aspects of elimination problems must be resolved. There is a close relationship between stress and [[FIC]] so that dealing with social and environmental stress is an important component in resolving this condition.
HOUSESOILING
Typically, it is possible to identify one or two environmental changes that have initiated the housesoiling 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.
Treatment of housesoiling, therefore, involves dealing with general environmental and social issues that cause stress, as well as the specific aspects of latrine location and type. [[Aggression ]]between cats sharing a household is often overlooked because actual fights may be uncommon and most of the threatening behaviours between them are subtle.
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.
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.
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.
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.
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.
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
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.
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.
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.
CYSTITIS
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,
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.
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