Page 229 - Problem-Based Feline Medicine

14 – THE CAT WITH INAPPROPRIATE URINATION 221

● Incontinence associated with a congenital or – Make the location where the cat marks aversive
acquired anatomical problem may be interpreted as to the problem cat.
inappropriate urination. – An odor deterrent such as citrus spray may be
effective.
Urine marking must be differentiated from inappropri-
– Spray synthesized facial pheromone (the F3
ate elimination.
fraction) at the site(s).
● This can usually be accomplished on the basis of
● Behavior modification consists of positive interac-
historical information and a good behavior history.
tions with the cat in scheduled play or grooming
● Underlying medical problems rarely result in
times.
urine marking.
– Avoid punishment because it may increase the
cat’s fear and anxiety.
● Pharmacologic treatment of urine marking attempts
Treatment to attenuate the cat’s arousal and/or anxiety in
response to social or environmental situations.
The goal of treatment of inappropriate urination is to
– Benzodiazepines have been used for their anxi-
enhance the appeal and accessibility of the litter box
olytic property.
and to decrease the availability and appeal of alter-
– They may not only decrease anxiety and fear, but
nate sites.
they produce mild sedation.
● The litter box should contain a litter that is pre-
– Dosage of diazepam is 1–4 mg/cat q 12–24 h
ferred by the cat and kept clean.
PO.
● A litter box may be used in the area where inap-
– Side effects include sedation, muscle relaxation,
propriate urination has occurred.
increased appetite and paradoxical excitation;
– Once the cat begins to use this litterbox, it may
hepatic necrosis has been reported to occur
be moved slowly to a site more acceptable to the
rarely in cats.
owner.
– Other benzodiazepines have not been thor-
– Deterrents such as an unacceptable substrate,
oughly evaluated in cats.
e.g. plastic covers or odor may be used at the
– Alprazolam may be given at 0.125–0.25 mg
inappropriate site.
PO q 12 h or 0.05–0.1 mg/kg PO q 8 h.
● Positive reinforcement when the cat uses the
– Dosage for clonazepam is 0.016 mg/kg PO q
appropriate litter box is better than negative rein-
6–24 h.
forcement when the cat inappropriately elimi-
– Clorazepate dosage is 0.55–2.2 mg/kg PO q
nates.
12–24 h.
● Pharmacologic therapy is not usually necessary;
– Flurazepam has been used primarily as an
environmental therapy is much more effective
appetite stimulant at 0.2–0.4 mg/kg PO as
with behavioral inappropriate urination.
needed.
● Owners’ compliance can be a problem, and owners
– Triazolam may also be tried at 0.03 mg PO q 12 h.
should maintain records of the cat’s elimination
– Azaperones have serotonergic and dopamin-
patterns; owners also need positive reinforcement.
ergic mechanisms.
Treatment of urine marking can be accomplished by – Buspirone has been shown to be efficacious
environmental, behavior, surgical and pharmaco- for the treatment of urine marking.
logical methods. – Dosage is 5–7.5 mg PO q 12 h, or 2–10 mg PO
● Environmental treatment involves deterring the cat q 12–24 h, or 0.5–1 mg/kg PO q 12–24 h.
from urine marking. – The drug has no potential for abuse and does not
– Restrict the cat from areas where spraying cause sedation.
occurs. – It may take 1–3 weeks to show an effect.
– Block the indoor cat’s view of outdoor cats. – Side effects include idiosyncratic changes in
– Reduce the number of cats outside or inside the social behavior and mild gastrointestinal side
house. effects.