Inappropriate Elimination - Cat

Introduction

Inappropriate elimination is a common problem for owners. It is sometimes confused with indoor marking behaviour and at times, these two types occur together. Even though the resultant problem is very similar to the owner, the underlying motivation is different and it is therefore important to differentiate between inappropriate elimination and indoor marking, which is discussed on the general housesoiing page.

Once the initial history taking has been completed and the case has been categorised as one of elimination, it is important to spend time investigating the potential trigger factors which lead to the onset of the behaviour. Only once the underlying reasons for the alteration in toileting behaviour have been identified can effective behavioural therapy be instituted and the cat taught to return to more acceptable patterns of elimination.

In some cases, the cat may never have achieved a state of successful house training but these are relatively uncommon. In the past, a belief that kittens needed to observe their mother’s eliminatory behaviour in order to learn how to toilet appropriately was thought to be supported by the over representation of certain breeds, such as Persians, and the occurrence of house soiling issues within familial lines in those breeds. However, research suggests that observational learning is not involved in this process and that a lack of opportunity to explore and experiment with suitable substrates early in life is more likely to influence a failure to house train successfully. Obviously this access to suitable litter is going to be influenced by the mother’s behaviour since kittens will follow her when she goes to use the tray and will thereby come into contact with an acceptable substrate. Kittens from mothers with poor toileting skills are therefore likely to have less interaction with a suitable substrate and may develop problems as a result but, even when the mother is a very clean individual, lack of suitable facilities near to the nest will have a similar effect. Failure to provide suitable substrate can also lead to the development of undesirable substrate associations.

Diagnosis

It is very important to properly identify the culprit[s] for the indoor housesoiling.

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.

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 polyuria/polydipsia (PU/PD), incontinence, feline lower urinary tract disease (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.

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

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.

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.

Treatment of housesoiling/inappropriate elimination, 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.

GENERAL LATRINES 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.

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)

• Cover the location with thick polythene: urine will then drain towards the cat’s feet when it is standing on the sheet.
• Cover the location with a large sheet of silver foil: some cats do not like to stand on this.
• Apply strips of double-sided sticky tape to either of the above to make them even more repellent.
• Place small bowls of food on top of the latrine sites, so that they become feeding stations. Cats are usually reluctant to urinate near sources of food.
• Illuminate dark corners with a bright spot lamp so that any privacy is taken away.
• 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].

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.

Treatment of Inappropriate Elimination
General environmental and social issues:	Increase resources available to the cat and strategically locate them for easy access by the various cats and factions within the household. Give the cats indoor-outdoor access with an electronic coded cat door. Switch feeding to activity feeding. Provide more choice of resting and hiding locations. Install F3 diffusers, to reduce anxiety and improve inter-cat relationships in the house. Use scent swapping to improve group odour. Consider temporarily isolating and then reintroducing cats if there are problems of aggression.
Latrine number, location and substrate:	Latrines should be relocated to quiet areas. Litter trays should be deep filled [3cm] with a mineral-based or clumping litter [not pine or wood-pulp based or scented]. In some cases using pure sand or a 50% mixture of litter and sand as a substrate in trays, is attractive to cats. A mixture of covered and open litter trays may be trialled. Additional outdoor toilets should be provided. Total latrine number may need to be as many as one per cat plus one extra. A specific latrine location may be made to feel more secure by locating an F3 diffuser [Feliway] next to it.
Owner behaviour:	Stop punishment of inappropriate elimination.
Psychoactive drug therapy:	Selegiline: specific fear with behavioural inhibition that limits normal behaviour Clomipramine/Fluoxetine: chronic anxiety [concomitant signs of stress such as over grooming]. Clomipramine/Amitriptylline: FIC

Prognosis

The prognosis for cats with house-soiling problems is good, as long as owners can accept that there may be brief relapses in the future. Even if the domestic indoor and outdoor environment is optimised and relationships between cats in the household have been improved, there is always the possibility that new cats to the neighbourhood may upset the situation.

Cats with a history of inadequate housetraining, or inappropriate substrate or location preference are likely to relapse on occasion during periods of stress, or if the owner makes changes to existing toilets. These cats may always be a short step from reverting to using their own preferred toilet sites so it is important to stick to environmental modifications that work.