Page 927 - Small Animal Clinical Nutrition 5th Edition

Feline Lower Urinary Tract Diseases 959

VetBooks.ir Box 46-7. Behavioral Management for Cats with Inappropriate Urination.*

Cats that urinate and/or defecate outside the litter box can do so for a variety of reasons including disease, communication (e.g., marking)
and toileting preferences/aversions. Sometimes the medical problem can be an initiating factor for toileting problems. For example, med-
ically triggered urgency to urinate causes the cat to select a convenient location like the bed; but even with resolution of the medical prob-
lem, the new behavior persists. These cats develop a new preference for toileting. (e.g., the bed is convenient, nicely absorbent and is
cleaned readily) or have such negative associations with the litter box (e.g., painful urination when they were ill) that they persist in using
a new, alternative, inappropriate site. Issues that should be addressed in cases of inappropriate elimination are listed below.

Resources Recommendations Explanations/consequences
Number of litter boxes Number of litter boxes = Too few litter boxes may result in problems that cause a cat to seek
number of cats +1 alternative toileting sites. These problems may include: volume of
excrement in the litter box; box occupied by another cat; box
being guarded by another cat.
Location of litter boxes Should be spread throughout Clustering litter boxes in one location may create access problems.
environment in easily accessible These problems may include: guarding by another cat and physical
locations challenges (e.g., stairs/distance) with getting to the litter box location.
Litter box style Large Boxes that are too small may be uncomfortable for cats to use,
causing them to seek out other sites.
Uncovered Boxes that are covered may trap odors, creating an unpleasant
environment and causing the cat to seek other toileting sites.
Litter Clumping (sand-like) Although individual preferences exist, the majority of cats prefer
Unscented unscented clumping (finely particulate matter–similar to sand) litter.
Litter box hygiene Daily litter box scooping Cats tend to be fastidious and prefer clean toileting locations.
Complete litter box cleaning/ Frequency of full box cleaning (wash/new litter) will depend on litter
change every 1 to 4 weeks type; clumping type litters that allow owners to remove urine may
require less frequent changes.
Scratching posts/pads Multiple, sturdy, tall, Scratching is a form of marking behavior. Encouraging scratch
prominently located marking on appropriate targets may reduce the likelihood of other
forms of marking and prevent destruction of household items.
Resting perches Multiple, single cat sized, Creative use of vertical space in the home can reduce
elevated, upholstered surfaces inter-cat tension/aggression. Cats tend to prefer upholstered surfaces
over slick surfaces but individual preferences may exist.
Feeding/water stations Number of stations = Providing adequate resources spread throughout the environment
number of cats allows cats to self-segregate; this may help to reduce social tension
in multi-cat households.
Play/social interaction At least 2 to 3 daily short Cat age and personality may affect type and duration of interaction
sessions (5 to 10 minutes) but it is important to recognize that domesticated cats are social and will
often benefit from play/interaction. Indoor-only cats can especially
benefit from owner-initiated activity such as play with toys for overall
stress reduction and exercise. Play activity also enhances the family-
pet bond and is useful for overweight cats.
*Adapted from Neilson JC. FLUTD: When should you call the behaviorist? In: Proceedings. Hill’s Symposium on Feline Lower Urinary Tract
Disease, 2007: 20-28 (www.hillsvet.com/conferenceproceedings).

Despite evidence for effectiveness of nutritional management veterinary teaching hospital (Lulich et al, 1993a; Lulich and
for dissolving struvite uroliths, many veterinarians still prefer to Osborne, 2007).
surgically remove uroliths because of perceptions that surgical
management is more effective, is less expensive overall when Assess and Select the Food
considering monitoring and aftercare, controls clinical signs Table 46-24 provides nutrient information about foods com-
quicker and will not be associated with urethral obstruction as pared with recommended levels of key nutritional factors for
uroliths decrease in size, especially in male cats. Although sur- dissolution of struvite uroliths. Generally the food that most
gical removal of uroliths has not been critically evaluated in closely matches the recommendations should be selected; how-
cats, a retrospective study of 37 dogs and 29 cats with urinary ever, only two foods f,g have published clinical evidence of
bladder uroliths revealed that four cats (14%) and eight dogs effectiveness.Treatment with a struvite dissolution food is con-
(22%) had incomplete removal of uroliths by cystotomy in a traindicated in growing kittens, reproducing queens and