Behavior or Medical problem - Litterbox and Elimination


Behavior or Medical problem - Litterbox and Elimination


Cats may transmit Toxoplasmosis through their stools. This can cause serious problems if a woman is infected during pregnancy and can lead to neurological disease or eye damage in humans. Toxoplasmosis is more commonly acquired from eating undercooked infected meat but there is no reason to take any risk - avoid contacting cat feces directly and wash your hands (or the children's hands) thoroughly if contact occurs.


Question: Dear Dr. Richards,

I have three cats that live in our home (2 females and 1 male) and a fourth female stray that we take care of (she winters in our garage.)

Recently, our neighbor acquired a new cat and it likes to visit our garage in search of food. We chase it away, but now our male cat has started spraying the inside of the house door that leads to the garage, and I'm wondering if he now feels that he has to mark his territory because of the scent of the neighbor's cat.

All of our cats are permitted outdoors, but are kept in at night. All have been spayed/neutered and this is the first time that the male (6 yrs. old) has exhibited this behavior (he did mark our Christmas tree once a couple of years ago, but nothing since.)

I'm worried that this behavior will spread to the entire house! Is there something that I can purchase to spray on the door to deter him? Help!

Sincerely, S. K.

Answer: S.-

We have had pretty good success lately with a product called Feliway (Rx), which is a synthetic reproduction of a natural phermone of cats that helps to inhibit spraying. We have recommended this mostly for indoor only cats who spray, at this time, but we have had one client try it for a situation like yours and it seemed to help. It is important to follow the directions.

It sometimes helps to stop letting cats outside when spraying occurs in a situation like yours, but that may not be practical or you may not find it to be an acceptable solution. It doesn't always work, so that has to be a consideration in deciding to make a change, too.

If you want to keep the other cat away and it has limited access routes to your house, several of our clients have been able to deter neighborhood cats by using the soaker hoses that produce a fine mist and stretching them across the areas that the cat comes into the yard from. Obviously, this works best if that is a small area.

Medications sometimes help with this problem, too. Anti-anxiety drugs like diazepam (Valium Rx), buspirone (Buspar Rx), amitriptyline (Elavil Rx) and others will sometimes help to reduce the anxiety level to a point where the cat won't spray. Obviously, this has its shortcomings, since the pills have to administered and they do have effects like sedation or decreased activity.

We really like Feliway and feel that it is worth a try. It is a little expensive but if you don't let that deter you it may be a good solution.

Good luck with this.

Mike Richards, DVM 12/2/99

Fecal incontinence, Renal failure and litterpan habits

Q: Dear Dr. Michael, My cat is 19 years old. She has been very healthy except for her kidneys beginning to fail the last four years. Our vet says the kidneys are not good and they're not real bad yet. She is on the kidney prescription diet, but will only eat dry food. Anyway, recently she started having bowel movements on our bed instead of the cat box. Our vet feels this is a behavioral problem and she is upset about something. I was following that line of reasoning until recently. She was squatting to go in the cat box. She kept digging and squatting. As I watched, her hind legs collapsed and she tipped over in the cat box. She tried to get out only her hind legs kept tipping over. When she got to our bed, she sprang up without any problem, pranced across me to the pillow next to me and had a bowel movement on the pillow. She looked perfectly healthy and following that she had no other behaviors that would indicate anything was wrong.

When I look at her she looks perfectly healthy and more energetic than usual. I resist taking her to the vet because the blood test bills are adding up and I don't see any benefit to them. Our vet says it helps us monitor her situation. I know she's getting old. I wonder if she is having some kind of seizure. She is constipated but I understand that is because the kidneys are failing.

She looks too healthy to put to sleep. We're controlling her behavior by keeping her in a very large cage. Have you ever heard of this kind of thing before. I saw your note about the article in Veterinary Medicine and I will contact our vet office to get a copy of it.

A: It is not that unusual for older pets to develop fecal incontinence. In this case most cats do not get into the posture normally associated with having a bowel movement and usually do not strain. Pets experiencing fecal incontinence do sometimes have "accidents" when doing anything strenuous because this sort of activity seems to encourage the stool to move out of the rectum. This is a possible problem but my impression from your letter is that she does seem to know when she is going to have a bowel movement and that she is probably having it in a normal manner. If that is so, then incontinence is not very likely. It is a good idea to think about how the stool is being produced, though, just in case.

There are a couple of things that have nothing to do with the inappropriate defecation that I would like to address a little.

I have mixed feelings about labwork for cats with chronic renal failure. The need to monitor labwork varies depending on the stage of the disease and the medications being used for treatment.

There are five lab tests that I use routinely to help monitor renal failure. The first is specific gravity of the urine. If a cat can't concentrate urine when it is dehydrated, the situation is more serious than if a cat can concentrate urine but has minor variations in other labwork. I like to monitor potassium levels because cats with kidney failure are prone to developing low serum potassium levels. This can lead to a decrease in appetite and to muscular weakness. Supplementing potassium when it is low is very helpful. We monitor phosphorous levels because rises in serum phosphorous interfere with treatment with calcitriol when we are using it and because they also indicate that kidney failure is getting worse. Serum or blood urea nitrogen (SUN, BUN) levels rise fairly early in renal failure and can give a rough estimate of how bad a cat might feel, although the levels associated with inappetance and with discomfort vary a lot from cat to cat. Serum creatinine levels rise a little slower and take a little longer to disappear during a kidney disease crisis and this can be helpful in gauging the state of the illness. An additional concern is blood pressure. Many, perhaps most, vets do not directly measure blood pressure in cats since there isn't yet an accurate, inexpensive and easy to use method of doing this. It is possible to keep a high degree of suspicion for this condition and to watch for clinical signs, though.

Labwork does help with monitoring the progress of renal failure. What I can't figure out is how often to run various tests. I would much rather put money into preventative measures or treatment than into labwork, if I have to make a choice between them. When finances are not a concern and the cat seems unfazed by drawing blood, I try to check the basic lab values once or twice a year if the cat is doing well and anytime that there is evidence it is not doing well. If the blood values indicate a problem when the cat is not feeling well I will usually monitor the BUN and/or creatinine every 48 hours or so until I am convinced the cat is responding to treatment. Most of the time this means that we draw blood two or three times for every episode of illness related to the renal disease. If finances are a problem or if I wonder if the cat is going to die from stress every time we draw blood, I just use the clinical response to treatment to evaluate how things are going. It isn't as accurate but most of the time it works out OK.

I guess that I have avoided your underlying question long enough.

Many cats change their litterpan habits because of medical problems. It is very likely that your cat has done this. I can't say for sure what was causing the weakness or pain that leads to her hind legs not working well. It may be low potassium levels, it might be arthritis, it might be a spinal problem, it might have been a seizure or just enough pain on having a bowel movement to catch her off guard and cause an episode of odd behavior. But something seems to have happened. It would help a lot to figure out what it was.

Constipation can lead to changes in litterpan behavior. If your cat is having a lot of dry stools, it may be time to consider using subcutaneous fluid replacement therapy. We teach clients to do this at home but some vets are uncomfortable doing that. If this resolves the dry stool/constipation problem it is the best approach. If not stool softeners can help, too. My personal favorite is lactulose (Chronulac Rx) but your vet might like another medication that works well for him or her. I really think it would be worthwhile to ask your vet about this. In addition, a good physical exam may reveal a cause for the weakness or pain in the rear legs. If an episode of pain occurs while a cat is in a litterpan the cat may associate the pain with the litterpan and decide not to use it anymore. If the pain is only associated with bowel movements the cat may continue to use the litterpan to urinate. If this is the problem, getting a second litterpan may resolve the problem, especially if you use a softer litter in the second pan (like the clumping type litters).

In the April, 1998 issue of Veterinary Medicine, Dr. Karen Overall points out that a cat that stops using the litterpan for any reason has to find another place to defecate or urinate. This leads to a period of exploration in which the cat tests the various surfaces in the house for one that feels right to defecate or urinate on. Some cats choose soft surfaces, leading to defecation on bedspreads, carpets or other soft textured places. It is important to correct the underlying problem that is making the cat avoid the litterpan and to provide an acceptable alternative soft texture to use for elimination behaviors. While this is a great simplification of what Dr. Overall said, it sums up the process that you face -- find out why your cat has suddenly changed its habits and try to provide an alternative to the new chosen spots that you can live with. After 19 years of not using your bed for defecation I think it is reasonable to start with the assumption that there is likely to be a physical cause for the behavioral change. I hope that you are able to find what it is and provide your cat with enough relief for her to comfortable and reliably use her litterpan consistently in the future.

Mike Richards, DVM


Q: I have a question about a new drug called feliway for cats that have box problems do you know about this and if so where can my vet get this. thanks so much. Joyce

A: Feliway (Rx) is not approved in the United States, to the best of my knowledge, although that sort of thing can change pretty quickly these days. It is a synthetic phermone product that is supposed to deter cats from spraying by putting the phermone odors on objects the cats sometimes spray. I am not exactly how this works, behaviorally, but apparently it does, based on the limited information on this that I have seen.

Mike Richards, DVM

UPDATE: It is a synthetic product. The phermones in this case are calming to cats and work to make them think that they are in "friendly" territory, making them feel less of a need to urine mark. It is reported to be very effective.

Subject: your write up on Feliway

Q: I was horrified to read Dr. Mike's description of Feliway as a product made of pheromones from cats Exactly how would someone commercially harvest pheromones from cats without killing or harming the cats???? The product description says it contains an "analogue" of feline facial pheromones; I have called the distributor, Abbott Laboratories, who have confirmed that this is a synthetic product. Conversely, if you know that Abbott is lying, which I doubt, why not speak up on that issue. (By the way, the product now is available in the U.S. through at least one pet supply catalog.) Thank you. Joann

Q: Dear Joann-

I am sorry. I did not mean to imply that this is a product that is somehow harvested from cats. It is a synthetic product. The phermones in this case are calming to cats and work to make them think that they are in "friendly" territory, making them feel less of a need to urine mark. It is reported to be very effective.

Once again, I apologize for the confusion over this issue.

Mike Richards, DVM

Clumping/scoopable litter

Q: I recently was told by my vet that the new clumping/scoopable litter will stick to the cats feet; and turn to cement in the stomach & intestines. He said there is new research suggesting this. I have 4 cats, and a Big litter box that I use the antibacterial clumping litter. I love it, and they prefer it as well. Have you heard any news about problems with this? Any suggestions? Thank you, Rhonda

A: Rhonda- If you could obtain from your vet the references for this information I would genuinely appreciate it. This has been a persistent rumor but I have not yet seen a scientific study supporting the claim. I have not personally seen a case of this and I have not spoken with any veterinarians who have treated patients with this problem. At present, I suspect that it is not a valid concern. Your vet may have access to information I do not, though.

Mike Richards, DVM

Litterpan or Elimination Behavior Problems

Litterpan problems are very common in cats. It helps to think about this problem from the cat's point of view sometimes when trying to deal with it. Cats like to have a clean, inviting place to defecate and urinate. Remember some of the dirty bathrooms you have had to decide whether to use or not, and you can relate to this feeling. So it is very important to make the littepan as attractive as possible for use.

Keep it very clean. Use a litter that the cat likes. The clumping type litters are the most commonly preferred litters in surveys of cat preference. If you are not using this type and your cat has a problem, it can help to switch.

The litterpan should be in a convenient, but private or at least semi-private site.

It helps very much to have one more litterpan than you have cats. In multicat households where this is impractical, it can help to give the problem cat access to the litterpan, alone, for several minutes twice a day.

When a cat is using a place in the house other than the litterpan to urinate or defecate, the opposite is also true. You want to make these spots unattractive. Cleaning the area with an enzymatic cleaner so the cat is not drawn back to the same site helps. Putting plastic or aluminum foil over the area, if possible, can be very helpful. Putting the litterpan at the site the cat prefers, then very gradually moving it to a site you like can be helpful.

Cats may not be using the litterpan because they are ill. Cystitis (a bladder infection or inflammation) is a common problem that can lead to litterpan aversion. One theory is that the cat associates the litterpan with the painful sensation or urinating with this disease and avoids it. Some anatomical defects can lead to an increased need to urinate frequently. Diseases that increase the need to urinate, like diabetes and hyperthyroidism should be ruled out if that seems appropriate. Disorders that might affect a cat's ability to get to the litterpan, like low potassium levels in the bloodstream or arthritis need to be considered. If there are no medical problems and good litterpan maintenance is in place, then the problem is more likely to be behavioral .

Some cats are not using the litterpan because they are marking territory. This can occur in either male or female cats. It is more common in cats in multi-cat households, especially if there are five or more cats. It can occur when an inside cat is bothered by frequent appearances of an outside cat at the windows. In this case, limiting access to seeing the other cat can help. If a cat is not neutered, this should be done first. Neutering is often helpful, even after urine marking (spraying) behavior is established. Currently, it is estimated that 80 to 90% of cats will stop urine marking within a couple of months after neutering. When neutering alone does not work, urine marking behavior is often responsive to medical therapy with medications like diazepam (Valium) or buspirone (Buspar). It can be responsive to megestrol acetate (Ovaban), but this medication has signficant side effects that must be considered. It should be a last resort medication. Your vet can help you decide that best approach to this problem.

Mike Richards, DVM

Just can't get the litterbox habit

Q: Dear Dr. Mike: I am the proud owner of six wonderful cats who are indoor-only, have four litter boxes (two jumbo-size), eat only Iams dry and an occasional shared can of Fancy Feast. I scoop each litter box twice a day and use a premium scoopable litter. My cats who are two males and four females ranging in age 1-10 all get along remarkably and are all very healthy. My problem is my caboose, a one-year old Cornish Rex who we have fallen in love with, however she cannot get the litter box habit down pat. She will defecate in any box, but urinates where-ever and when-ever she desires. I have tried confining her during the day with one litter box of her own. She urinates in it once, and then urinates on the top of the box, in front of the box and behind the box. She does not just do this here, when she is out in the rest of the house, as I said, it is just when-ever and where-ever. She was spayed the first week in March when we obtained her from a breeder. She really has added a spark to our household and we want to make this work. However I know that it is just a matter of time before the others pick up on her bad habits. I have been especially blessed by having only occasional accidents in the past. Please offer any advise before I have to give her up. Unfortunately, it would have to be her that would go as seniority rules. She does not seem at all a nervous cat, and is very much loved by everyone in the house. Thanks - P.

A: You are doing the right things to prevent litterpan problems. It might help to provide a different litter material for this cat, just in case she is being overly sensitive. Using a litter that masks the wet feel might work (pelleted litters may do this a little better).

It is really important with this sort of behavior pattern to make sure that there is not a medical cause. Many cats with cystitis or feline lower urinary tract disorders will use the litterpan sporadically or develop aversions to litterpans because of pain on urination.

This might be a variation of urine marking behavior even though she doesn't seem to be spraying. The medications used for this may help if that is the case. It is best to determine this to the best of your ability first. That may take working with your vet or an animal behaviorist to try to confirm this as a cause of the problem.

If she does not have a medical problem that your vet can find and changing the litter type doesn't help and urine marking seems unlikely after consulting more with your vet and/or a behaviorist, then it is possible you can discourage her by making urinating outside of the box unpleasant. If you see her (this only works if you see her) making a very loud noise right as she starts urinating can be disturbing enough to startle her and make her stop. Something like an airhorn works best but if that isn't practical (most people have neighbors) then other loud noisemakers of a slightly lower decibel range like a whistle, might work.

Hope this helps.

Mike Richards, DVM

Litterpan problems

Q: Dear Dr. Mike, I'm desperate, my precious persian is about to be evicted. She is almost 6 years old and had been using her litter box without a problem. About a year ago, she refused to defecate in the litter box but will urinate in the box. I have not changed the brand of litter but we did acquire a new dog two years ago. The dog does not go into "her room", rather, he stays in a specific area no where near the litter boxes. The cats (I also have a tonkinese) have the run of the house. I have used various products to remove the odor but she is relentless. She goes right outside the litter box on the carpet. In a strange way, I feel that she does this intentionally. Have you any experience with this type of problem???? She does see her vet regularly and is not ill. Please, please help. My fiance is really about to give her the boot! Thnx. GG

A: GG-This is not likely to be a spiteful situation. Since it appears that you have more than one litterpan already it may help to separate them or to allow your Persian to have some "private time" with the litterpan. In some cases, anti-anxiety medications like diazepam or buspirone will help for stool problems. In long haired cats it can help to shave to the hair back from around the rectum. Once in a while it seems to hurt for stool to get hung up in the hair and cats may "blame" the litterpan for the pain and avoid it.

Mike Richards, DVM

Last edited 01/30/05


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...