ABSTRACT: When presented with a pet animal showing a particular set of clinical signs, it is all too easy to rush in and make a diagnosis without necessarily taking into account the wider picture. Inappropriate elimination in cats is such a case in point, in which medical, environmental and behavioural aspects may all have a part to play. The author takes readers through a typical case history in order to illustrate a logical, step-by-step holistic approach.

Presenting problem behaviour

Depositing urine in the owner’s house. 

Differentials

Cats have a generally well-deserved reputation for being naturally clean animals that readily learn to use a litter box.1 However, the most common feline behavioural problems involve inappropriate elimination behaviour. 2'3>4&5 They tend to be caused by medical disorders, litter box avoidance, unacceptable elimination site preferences, territorial marking and stress.6 This normal behaviour can take the following forms; eliminative urination and urine marking.

Abnormally, elimination problems can occur as the result of various medical conditions. A complete medical work-up is, therefore, essential for all cases of feline elimination disorders, to rule out somatic causes. This should include a clinical examination, urinalysis, an assessment of mobility, cognitive function and sensory perception and further investigation through haematology, biochemistry or imaging techniques.7

If the behaviour problem persists after the medical condition has been treated, it will then be necessary to carry out behaviour modification to resolve the problem. For example, cats may develop a litter tray aversion if they have experienced pain on elimination, while using the tray.

History

Mr & Mrs Client are a married couple in their 50s, living in a spacious detached house with a large garden. Sasha also lives with a 12-year-old, neutered, male Siamese cat (Merlin). Sasha was obtained by Mr & Mrs Client at eight weeks of age, from a breeder. The kittens were reared in a domestic environment and were handled frequently by the breeder and her family.

Mr & Mrs Client did not meet Sashas father but did meet his mother and reported that she interacted with them in a friendly manner. Mr & Mrs Client ensured that Sasha had contact with various people and was frequently handled after they obtained him, so Sasha was well socialised with people during the critical period of two to seven weeks of age, and beyond.

Sasha was reported as generally being a healthy and friendly cat, although he had always had a tendency to be nervous. Mr & Mrs Client have lived at the property for two years and had no problems with Sasha during the first year.

His daily routine involves being fed at 9am when he then has free access to the downstairs and, until recently, had access to the garden via a cat flap in the back door of the kitchen. His owners reported that he does not venture out frequently and spends much of his time sleeping in the study downstairs. The cats are then fed again at 4pm.

At night, the cat flap is shut and the cats are confined to the kitchen with two open litter trays next to each other, opposite the back door. During the day, one litter tray is located in the dining room, and the other in the kitchen. Both litter trays are cleaned on a daily basis. Mr & Mrs Client reported that Sasha and Merlin co¬exist happily together.

The presenting problem began approximately a year before the consultation and Mr & Mrs Client stated that it had become a lot worse over the last three to five months. Prior to then, Sasha had always used the litter facilities provided. The onset of the problem seems to have coincided with the appearance of a neighbouring cat at the back door, which is situated in the kitchen.

The cat in question frequently stares into the kitchen through the glass back door. As far as Mr & Mrs Client are aware, the cat has not actually entered the property. They noticed that each time Sasha saw the cat at the back door, he would exhibit flight behaviour and he also reacts fearfully if he observes a neighbouring cat in the garden, from a window.

They then noticed that instead of using either of the litter trays when confined to the kitchen at night, he would urinate in a corner of the kitchen (lino floor) away from the back door. He then began to urinate in the corner of the dining room (carpeted), behind the dining table during the day, instead of using the litter tray. The urine was always deposited on a horizontal surface in large volumes.

He has stopped using the kitchen litter tray completely but will still use the dining room litter tray intermittently and will sometimes eliminate outside. Soiling tends to take place approximately three or four times a week, both during the day and at night, and tends to occur more frequently in the dining room – and always in the same location. The litter used is clay-based and is the same litter that has been used since Sasha was a kitten.

To try to resolve the problem, Mr & Mrs Client have blocked up the cat flap in an attempt to make Sasha feel more secure in the home. They also attempted to move the litter trays to areas that have been previously soiled, but instead of using the tray, he urinated next to it. Sasha has not been punished for urinating in the home, as his owners are aware that this would be detrimental to the resolution of the problem, especially as Sasha is of a slightly nervous disposition.8

During the consultation, Sasha was nervous initially but then jumped on the authors, lap and remained there for the rest of the consultation.

Assessment

Sasha has developed a negative association with using the litter tray, owing to the presence of a fear-eliciting stimulus (neighbouring cat) in close proximity to the tray.9 This has led to the performance of inappropriate urination in the home. The urine is found in large puddles on horizontal surfaces in only two locations, and occurs in corners rather than in prominent locations, suggesting that the urine is deposited for elimination purposes rather than marking.

Most elimination problems of cats can be successfully treated if the problem is logically pursued.4 To resolve this problem, it will be necessary to remove stressors, break the habit, increase Sashas sense of security in the home and make the litter tray the most obvious and appealing choice.

Behaviour modification programme

Treatment of this problem will involve dealing with the general environmental and social issues that cause stress to Sasha, as well as the specific aspects of latrine location and type." This can be achieved by removing stressors (neighbouring cats), increasing Sashas sense of security in the home, determining his latrine preferences and by discouraging further use of the soiled areas by carrying out an effective cleaning regimen and by changing their function.

1.   Deter other cats from coming into the garden

This can be achieved by squirting any cats entering the garden, with a long- range water pistol. This will remove the initiating and a maintenance factor.4

2.   Block visual and olfactory access to neighbouring cats

Mr & Mrs Client will need to ensure that blinds are closed so that Sasha is unable to see any neighbouring cats that enter the garden. The glass back door and clear plastic cat flap (which should remain blocked off) should also be covered by using solid coloured paint. Windows and doors should also be kept closed.

Denying Sasha visual and olfactory access to neighbouring cats and keeping the cat flap closed will
ensure that there is a clear distinction between the safety of indoors and the vulnerability of the outdoors.4 This will help to increase Sashas sense of security in the home. It also removes the opportunity for neighbouring cats to use visual threats (posture, eye contact) to intimidate Sasha in his own home.7

3.   Provide various resting areas around the home

Mr & Mrs Client should obtain more cat beds and place them in various locations around the house, preferably high up. Providing a greater choice of resting areas will increase Sasha’s well-being in the home.7

4. Install a Feliway diffuser in the home

Mr & Mrs Client should install an F3 diffuser (Feliway, CEVA Animal Health) in the kitchen.

This product contains a synthetic analogue of feline cheek gland secretions and is designed to reassure cats in stressful situations relating to the environment.2 It has been shown to be effective at reducing reaction.10 It should be located in the kitchen, as this is the area of greatest challenge.

5.   Confine Sasha to the study

Sasha should be confined to the study for a week, but can be allowed out when supervised.11 He should be provided with food, water, toys, a cat bed and litter facilities. If Mr & Mrs Client wish to confine the cats at night after this period, Sasha should be confined to the study rather than the kitchen.

Confining Sasha for a week will help to break the habit of inappropriate urination by denying access to previously soiled areas unless supervised. The study is an ideal location as this is a favoured resting area of Sasha’s. He should then be given gradual access to other parts of the house and outdoors.12 Sasha should be confined to the study rather than the kitchen at night as he is more relaxed in this location.

6.   Determine Sasha's litter preference

Provide several litter trays, each with a different type of litter – clumping, non-clumping, clay-based, sand-based, paper-based and topsoil. Litter trays should be filled to a depth of 3cm and cleaned on a daily basis.11

This will identify Sashas litter preference, which will encourage him to use the litter tray on future occasions. Changing to a sandy, clumping litter, which most cats prefer, will encourage cats to use the litter tray.1 Cats prefer to use a clean litter tray with a litter depth of 3cm.7

7.   Determine Sasha's tray preference

When the litter preference has been determined, provide Sasha with two litter trays during the confinement period; one open, one covered.6 This will indicate Sasha’s tray preference which will encourage him to urinate in the tray on future occasions.

8.   After confinement, place trays in quiet, secluded areas

Litter trays should be relocated to quiet secluded areas such as corners of the study, dining room and lounge.7 This will provide Sasha with a safe place to eliminate, which should make the litter tray a more attractive latrine.

9.   Change the function of soiled areas

Place small bowls of food and jam jars containing dry food (with holes in the lids) so that the latrine sites become feeding stations. Feeding close to the undesired toileting area can help to repel this behaviour as cats are usually reluctant to urinate near sources of food.7 

10.   Change the cleaning regimen

A 10% solution of biological washing powder in warm water should be used to clean the areas that have been previously soiled. When dry, it should be sprayed with surgical spirit.

The biological washing powder will remove the protein and bacteria in the urine as well as removing the odour. Surgical spirit will remove any fatty deposits that remain.13

Removing all traces of urine will reduce the likelihood of Sasha using these areas as his latrine on future occasions. Ammonia is a constituent of urine and its scent may attract Sasha back to the same place to soil.14 Therefore, cleaning products containing ammonia should not be used.

11.   Reward use of litter tray

Mr & Mrs Client should reward Sasha with a favoured food treat when he uses the litter tray. 11 This may help to reinforce usage.6

12. Use additional trays

After the confinement period, Sasha should be given access to at least four trays.

Cats often prefer to urinate and defecate in different latrines; therefore, as there are two cats in the household, each cat should be provided with at least two trays.3 

Author

Dawn Turner BSc (Hons) MSc

Dawn began practising as an animal behaviourist in April 1999 after obtaining a Degree in Environmental Biology and a Masters in Applied Animal Behaviour and Animal Welfare. She is also a member of the Association of Pet Behaviour Counsellors (APBC). Dawn sees cases on referral from veterinary practices and carries out expert witness work for the RSPCA.

To cite this article use either

DOI: 10.111l/j.2045-0648.2010.00043.x or Veterinary Nursing Journal Vol 26 pp161-l64

References

1.   BORCHELT, P. L 11991) Cat elimination behaviour problems. Vet Clin North Am Small Animal Practice 2112): 257.

2.   OVERALL, K. 12002) Feline Aggression: Associations with Elimination Disorders and Complex Neurochemistry. WSAVA Congress Proceedings.

3.   HOUPT. K. A. 11991) House-soiling: Treatment of a common feline problem. Vet Med 86: 1000.

4.   VOITH, V. L 11993) Behaviour Problems in Cats. Tijdschrift voor Diergeneeskunde 118111: 589.

5.   DODMAN. N. H. 11994) Pharmacological treatment The most common feline behavioural problems involve inappropriate elimination behaviour. They tend to be caused by medical disorders, litter box avoidance, unacceptable elimination site preferences, territorial marking and stress. 99 of behavioural problems in cats. Veterinary International 4: 13-20.

6.   LANDS8ERG. G.. HUNTHAUSEN. W. and ACKERMAN. L. I2003I Handbook of behaviour problems of the dog and cat. 2nd edition. London, Saunders.

7.   BOWEN. J. and HEATH. S. 120051 Behaviour Problems in Small Animals: Practical Advice for the Veterinary Team. Elsevier Saunders.

8.   HOUPT. K. A. and REISNER, H. R. 11995) Behavioural Disorders. In: Textbook of Veterinary Internal Medicine. 4th edition.

9.   APPLEBY. D. 11995) How to Have a Contented Cat. The Pet Behaviour Centre, Worcestershire.

10.   PAGEAT, P. and GAULTIER. E. [20031 Current research in canine and feline pheromones. Vet Clin Small Anim 33: 187-211.

11.   SIMPSON, B. 119971 Tr
eatments of Separation- Related Anxiety in Dogs with Clomipramine. Proceedings of the First International Conference on Veterinary Behavioural Medicine. Universities Federation for Animal Welfare,

12.   HART, B. L. (1994) Feline behavioural problems. Vet Int 4: 3-12.

13.   O'FARRELL. V. and NEVILLE. P. 11994) BSAVA Manual of Feline Behaviour. British Small Animal Veterinary Association. Gloucestershire.

14.   NEVILLE, P. 119901 Do Cats Need Shrinks? Sedgewick and Jackson. London.

Further reading

HART, B. L. and HART, L. A. 11985). Canine and Feline Behavioural Therapy. Philadelphia: Lee & Febiger.

• VOl 26 • May 2011 • Veterinary Nursing Journal