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Inappropriate Elimination, Cat 533

Technician Tips Client Education SUGGESTED READING
• Wear gloves when handling immuno- Explain to the client that affected dogs will Tizard JR: Primary immune deficiencies. In Tizard
VetBooks.ir • Protect yourself from opportunistic zoonotic puppies of the same litter may be affected. AUTHOR: Jonathan F. Bach, DVM, DACVIM, DACVECC Diseases and Disorders
not be cured, the disease is heritable, and other
compromised patients.
IR, editor: Veterinary immunology, ed 10, St. Louis,
2018, Elsevier.
infections by wearing protective shielding.
Affected puppies are at an extremely high risk
• Use sterile saline when performing
ill animals.
nebulization. for secondary infections and should avoid other EDITOR: Jonathan E. Fogle, DVM, PhD, DACVIM
• Encourage patient appetite by warming
foods.

Inappropriate Elimination, Cat Client Education
Sheet

BASIC INFORMATION • Styles (covered) and placement (in closets) • Location preferences or aversions; location
that allow the cat using the litter box to be of area for elimination is key
Definition trapped by a child or another pet • Marking
• Use of inappropriate areas (locations or • Placement of boxes in locations cats ○ Nonspraying: elimination of small
surfaces) for elimination of urine or feces. cannot reach because of pain (e.g., arthri- amounts of urine or feces in areas that
As used here, this is a diagnosis associated tis), access (e.g., doors closed), or social have social, not tactile, significance
with an anxiety disorder. Otherwise, inap- factors (e.g., being chased by the new ○ Marking: spraying is part of a normal
propriate elimination is often elimination puppy) signaling repertoire in cats. The cat treads
that is normal for the species but undesirable • Poor ventilation resulting in entrapped odors on its front feet, raises its tail (quivering
to clients. (covered boxes) the tip), and sprays urine vertically. If the
• Urinary incontinence: passage of urine • Cystitis in offending cat (pain) or any cat is not backed against a vertical surface,
without awareness due to a medical problem; household cat (e.g., odorant changes) sprayed urine makes a linear pattern on
comparatively rare in cats. Risk factors for marking are based on social horizontal surfaces. Only cats willing to
• Marking: passage of urine or feces involving stress and distress; stressors: be seen raise their tails.
social interaction; very common in cats. • Addition or loss of another pet (including
Marking with urine may or may not involve visits by outside cat) HISTORY, CHIEF COMPLAINT
spraying. • Change in the composition of the human Clients find urine or feces in locations they
household consider unacceptable.
Synonyms • Change in the stress level of the household
Toileting problems, litter box problems, unde- (e.g., illness, changes in jobs) PHYSICAL EXAM FINDINGS
sirable litter box use, aversions/preferences to • Change of relationships between cats in the • Usually unremarkable
substrates/locations household (e.g., that are concomitant with • Findings suggesting lower urinary tract
social maturity) disease, gastrointestinal problems, arthritis,
Epidemiology • True intercat aggression or other nonbehavioral disorder warrant a
SPECIES, AGE, SEX diagnostic medical evaluation.
• Urine spraying: sexually intact animals > GEOGRAPHY AND SEASONALITY
neutered animals; possibly males > females Marking behaviors may intensify in spring, Etiology and Pathophysiology
• Marking behaviors (which need not involve when more animals are let outside and visit • Behavior can be normal for the species but
spraying) may develop at sexual maturity indoor animals and when scents aerosolize. unacceptable to clients.
(≈6 months) if about sexual advertisement Marking increases in frequency (female and • Behavior can be an anxiety disorder and
or at social maturity (≈24-48 months) if male, although males more readily noticed) comorbid with intercat aggression or other
about social stimuli, social anxiety, or stress when females enter estrus. behavioral conditions, such as comorbid
or distress inflammatory cystitis (p. 332).
ASSOCIATED DISORDERS • Association between crystalluria or anal sac
GENETICS, BREED PREDISPOSITION • Comorbid intercat aggression is common; disorders and periuria/perichezia (urinating/
Long-haired cats possibly overrepresented identifying relative victims and aggressors is defecating outside the litter box) remains
with substrate (surface used for elimination) essential to resolving the social conflict and speculative.
aversions fixing the toileting complaints.
• Medical issues may precipitate or worsen DIAGNOSIS
RISK FACTORS behavior issues due to pain and perceptual
Risk factors for elimination preferences and changes. Diagnostic Overview
aversions: Clinical Presentation It is important to use history (video record-
• Dirty litter and/or litter boxes ings in the home environment can be useful),
• Litter boxes that are too high for cats to DISEASE FORMS/SUBTYPES physical exam, and routine lab tests to differen-
enter readily (e.g., arthritic cat) Three classes of problems, all of which are tiate between behavioral and medical issues. For
• Litter boxes that are too small (<1.5 cat body normal behaviors in free-ranging cats: behavioral issues, you must determine whether
length) and discourage active digging and • Substrate (texture/surface) preferences or marking or substrate/location preferences/
exploration aversions; sensory aspects of substrate is key aversions are involved because management

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