Page 228 - Problem-Based Feline Medicine

220 PART 4 CAT WITH URINARY TRACT SIGNS

Pathogenesis Diagnosis

House-soiling problems are the most common behavior Underlying medical problems must be ruled-out
complaints made by cat owners. for a diagnosis of a behavioral problem, although
behavioral urination problems may occur in conjunc-
Urine house-soiling problems include inappropriate
tion with or following an underlying medical condition.
urination and urine marking.
● Inappropriate urination involves elimination of A behavioral history should be performed once medical
urine outside the litter box at locations unaccept- problems have been eliminated.
able to the owner. ● The owner should be asked to keep a daily record of
– Inappropriate urination usually occurs on the number of eliminations in each litter box and
horizontal surfaces outside the litter box. the number of eliminations outside the litter box
– Any age, breed or gender cat may be affected. with the location noted.
– Location of inappropriate urination is variable. ● Information should also be obtained concerning the
– Inappropriate urination often results from a care of the litter box by the owner.
problem with the litter box including, unwill- ● It is beneficial to ask the owner to make a map of
ingness by the cat to use certain types of litter, the interior of the home, with sites of elimination
infrequent cleaning, change in litter consistency and litter boxes marked so patterns can be visually
or amount and a deterrent to using the litter box identified.
because of other cats in the household. ● If multiple cats are in the household or if it is
● Urine marking involves the use of urine in the uncertain as to where a cat may be urinating
act of olfactory communication, which may inappropriately, fluorescein dye (0.3 ml SQ, 0.5 ml
occur independent of the act of urination. PO, or six fluorescein strips in gel capsules given
– Urine spraying occurs more frequently in PO) may be administered; any urine that is found
males than in females, and in intact animals outside the litter box during the next 24 hours can
compared with neutered animals. be checked for fluorescence using a Wood’s light.
– Urine marking may act as a means for cats to
Urine marking is typically characterized by a cat passing
communicate their presence so that other cats
small amounts of urine in different places (“spraying”).
will avoid using the same space at the same time.
● Owners may or may not observe this behavior.
– Urine marking may be indicative of a high level
● In a multi-cat household, more than one cat may
of arousal, often associated with the presence
exhibit this behavior.
of other cats inside or outside of the house.
● Although isolation of cats in a household may iden-
– Urine marking often involves surfaces other
tify the individual, urine marking may cease when
than horizontal ones (such as drapes, walls
separated from housemates.
and furniture); however, it may involve hori-
● Fluorescein dye as described before may also be
zontal surfaces similar to inappropriate urination.
used to identify offenders.
– Urine marking is not usually associated with a
medical condition.
Differential diagnosis
Clinical signs Inappropriate urination may or not occur second-
ary to a medical disorder.
Inappropriate urination occurs when the cat urinates a
● Diseases associated with polyuria, such as renal
normal amount of urine assuming a normal posture
failure and diabetes mellitus, may result in inap-
consciously outside of the litter box; inappropriate
propriate urination, because the cat finds the litter
fecal elimination may also occur. Urinalysis may or
excessively wet.
may not be normal.
● Causes of lower urinary tract disease, such as
Urine marking involves passing small amounts of urine on urolithiasis or idiopathic disease (non-obstructive
surfaces other than horizontal to mark a territory that a cat FLUTD or interstitial cystitis), result in inappropri-
inhabits or is passing through; urinalysis is normal. ate urination.