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Litter Box Issues and House Soiling




Contributing Factors
Prevalence
Causes
Making the Box More Attractive
Preventing Return to Soiled Area
Additional Suggestions
Prognosis

The term "elimination disorder" is used to describe cats that do not use their litter boxes for urination and/or defecation; instead, these cats eliminate somewhere in the house. Elimination disorders are the most common behavioral problem of cats. Because most owners take pride in their homes, house soiling by the cat can strain the owner-pet relationship to the breaking point. Unfortunately, in some cases, frustrated owners give up their cat to an animal shelter or elect for euthanasia. As frustrating and aggravating as it may be to live with a cat that deposits urine outside the box, it is important to recognize that this behavior, although deemed 'inappropriate' by people living with the cat, is absolutely normal behavior for the feline species.  Our task, as veterinarians and as owners, is to attempt to redirect this normal behavior to a more acceptable location (the litter box). Doing so often requires time, patience, and an understanding of normal cat behavior and why cats do what they do.  Only then will we be able to fix what we have defined as a problem but which the cat does not!

Contributing Factors
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In some cases, a medical problem can be related to inappropriate elimination. When this is the case, improvement can be expected if the medical cause can be successfully treated. In many cases, however, inappropriate house soiling is primarily a behavioral problem. The more cats there are in a household, the greater the chances that inappropriate elimination will occur.

When presented with a cat with this history, there are multiple possible causes - and possibly more than one cause. Although we may discuss and make behavioral/environmental management suggestions even on the first patient visit, we always FIRST seek to rule out medical causes of inappropriate urination.

Medical causes of inappropriate urination include:

  1. Feline lower urinary tract disorder (usually associated with blood in the urine, pain when urinating, usually no infection involved)
  2. Urinary tract infection
  3. Arthritis (may make it difficult for the cat to get into or out of the box - or get up the stairs to his or her only litter box - or to position comfortably to eliminate)
  4. Pododermatitis (foot pad infection - again making it painful for the cat to get into or out of the box because the litter irritates the cat's paw pads)
  5. Hyperthyroidism (because it can cause personality/behavior changes in general)
  6. Incontinence/involuntary loss of bladder control (age-related, or associated with feline leukemia virus or other neurologic disorders)
  7. Diabetes/kidney failure (because cats with these conditions have to urinate bigger volumes and more often, and because these two conditions are more often associated with true urinary tract infections)
  8. Generalized weakness due to anemia, electrolyte disturbances, etc.
  9. Hypertension (high blood pressure)

In general any cat who doesn't feel well for whatever reason may occasionally not use the box not because they're "being bad" or "trying to tell their owners something" - but rather as a stress reaction to their not feeling up to par (we liken this to people who get irritable and cranky when they're not feeling well - they may snap at their spouse, or lose their temper more easily; in cats, their stress more often manifests as personality or behavior changes - one of which is inappropriate elimination).

This is why it is so important that a history, physical exam, and laboratory work are done on all cats with this "problem" - even if the owners feel "there's nothing wrong with my cat - I know he/she's just doing it to spite me." Half the time or more, there is in fact a medical problem that is at least a factor, if not the only factor, involved. (And the medical problem sometimes may not even involve the "guilty" cat!)

Prevalence
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Inappropriate elimination, especially urination, is the most common behavioral disorder in cats.

Causes
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As mentioned above, after medical causes of these problems have been ruled out, the source of the problem is considered a behavioral disorder. If "behavioral" factors are suspected, these may include:

  1. Material/substrate preference (cat prefers one type of litter vs. another, or prefers a carpeted surface, laundry basket full of clothes, etc. versus the litter)
  2. Litter box aversion (for whatever reason, the cat doesn't find the box acceptable - not clean enough, wrong litter, location, etc.)
  3. Other factors - such as social conflicts between household cats, stress-related "misbehavior," inadequate number of litter boxes, improper placement or maintenance of the litter box(es) - and there may be more than one category that applies

While ruling out/treating medical problems, we're also very tuned into the behavioral or possible behavioral aspect. A detailed map of the home can be extremely helpful, especially in long-standing cases, and should include information on box location(s), size of box(es), age of box, whether or not the box(es) in each location(s) has a hood, where inappropriate urination is found, type of surface in that location, etc. Pictures of the litter box area(s) and/or videos may also be very helpful.

Normal cats eliminate (urinate) 5 times daily.

Most cats, if content with their litter, litter box size, litter box locations, etc., and they're medically healthy, will spend some time in their litter box digging around for "the perfect spot" prior to eliminating. They may or may not then spend time after eliminating covering their excrement. Cats that "straddle" the litter box (not all four feet in the box when eliminating) often are doing so because the litter is not acceptable to them, the box is too small, etc. Cats that get in the box, and quickly get in and out (especially if associated with straddling their feet on the sides of the box or outside the box) usually are not content enough with the box or the litter to stay in the box long enough to exhibit normal litter box behavior. (Some cats, too, if concerned about being "attacked" by another household cat while exiting the litter box, may want to get in and out as quickly as possible.)

Spraying (or "marking") versus horizontal urinating (inappropriate toileting) is often determined first, because the treatment strategies may be different with spraying versus horizontal urinating:

  1. Vertical or horizontal with marking, versus usually just horizontal with toileting
  2. Quantity small with marking, moderate to large with toileting
  3. Feces usually absent with marking (though a small percentage of cats may use feces to mark)
  4. Substrate varies with marking, may be consistent with toileting (i.e., always carpet, etc.)
  5. Target location with marking usually carries "social significance" with toileting, the inappropriate area is, to the cat, an "acceptable alternate toileting option"
  6. Position for marking usually standing; versus squatting or straining with toileting
  7. Uses box most of the time with marking; MAY use most of the time with toileting
  8. Number of cats - may affect problem with marking (aggression and conflict); increased numbers of cats in the home almost always increases likelihood with toileting problem (number of boxes, location of boxes, cleanliness of boxes, access or aggression)

Multiple questions need to be answered in cases of inappropriate elimination that is not totally medical in cause, especially if long-standing, to help us in determining if the cat is spraying versus "toileting"; and if the cat may have an aversion to the box, a preference for some other type of surface, or if there are other household factors that may need to be addressed:

  1. Number of litter boxes - historically, veterinarians recommended that the number 'should be one more than the number of cats'. More importantly, as we have learned more about feline behavior, at least one acceptable litter box should be available for each 'social group' of cats in the home, and it should be placed within that social group's core territory (or 'safe space' for that social group). (Cats in the same social group will groom one another, rub on one another/touch noses, play with one another, etc.  Just because cats reside in the same home does not mean that they are in the same 'social group'. A home with five cats, for example, may have anywhere from one to five social groups, depending on the individual cats in the home. A complicating factor is that some individual cats may be members of more than one social group).
  2. Type of litter (non-scented clumping is preferred by most, though not all, cats)
  3. Where are boxes located throughout home? (quiet, non-intimidating locations?)
  4. Hood(s)? (most cats prefer no hood)
  5. Size of box(es) - (a lot of big cats need big boxes - often even the "jumbo" litter boxes in pet shops are too small, especially for many of our cats these days that top 13-14 pounds; alternatively, a large plastic tote from a discount store may work quite well!)
  6. How old are boxes? (really old boxes may retain urine odor, even if cleaned)
  7. Depth of litter? (some cats prefer a thin layer of litter, others want a real deep "sand")
  8. Which one/ones do the cat(s) use? (and what is different or potentially attractive about the box that is most used? its location? lack of hood? hood? type of litter?)
  9. How often scooped? (should be a minimum of twice daily)
  10. How often completely dumped and changed? (depends on litter - see below)
  11. Has brand of litter changed?
  12. Location of box changed?
  13. Box near laundry machine or dryer? (i.e., where the "buzzer" may have gone off while the cat was in the box - frightening the cat and now he or she is hesitant to use it?)
  14. Box in high traffic area? (and thus a shy cat may be intimidated about eliminating?)
  15. Low traffic area? (and thus a sociable cat, who likes to eliminate with the owner or others around, doesn't find the location acceptable?)
  16. Who is urinating inappropriately? Just one cat? More than one cat? Are you SURE? (confinement trials may be necessary, and/or use of markers)
  17. Personality of cat? Skittish? Friendly?
  18. Gets along well with other cats? Social relationship between cats?
  19. Pecking order of cats?
  20. Behavior of "guilty" cat(s) when they ARE in litter box?
  21. Where are inappropriate urinations occurring? Soft surfaces (clothes, rugs/carpet)? Hard surfaces (countertops, sinks, etc.)?
  22. How often are they occurring?
  23. Will the cat sometimes or usually use the box, but not reliably?
  24. History of recent stressful events/any triggering factors? (new baby, new husband, new box, guests in home, new pet, person who has recently left house, cat in heat in the neighborhood, new cat or dog in neighborhood that can be seen by indoor cat, etc.)
  25. Is cat who is inappropriately urinating being attacked when he/she gets out of box? Being stared at while in box by another cat (a very potent form of aggression in cats)?
  26. Room fresheners in the area? (cats tend to dislike these, and may avoid areas where they sense their presence)
  27. Quantity of urine produced by "guilty" cat? How often is cat frequenting the box and/or the inappropriate area?
  28. Does cat use box for stool? (many cats like to use separate boxes for urine and stool)
  29. Position of cat while urinating when outside box, and when inside box? (Is the cat "straddling" the box, as some will do if they don't like the litter, or the box is too small? Is an arthritic cat associating the litter box with the discomfort associated with trying to position to urinate or defecate?)

We always recommend when problems exist (even in many cases when there is a known medical problem - as medical problems can lead to behavioral problems; and sometimes medical problems can be caused by the stress of social conflicts, moving of box, changing litters, etc.) that owners

  1. Make the litter box more attractive
  2. Make 'inappropriately used areas' unattractive or inaccessible
    Sounds fairly simple - but remember we must make the litter box attractive to the cat, and determining what the cat may consider "attractive" can be challenging for many owners. It often involves close observation of behaviors of all cats in the home, along with a keen understanding and appreciation of normal cat behavior and appropriate identification of social groupings of cats in the home.

First and foremost, neuter any unneutered males or females.

Making the box more attractive:
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  1. Purchase new non-hooded litter boxes. Even well cleaned litter boxes, especially if old, have odor deep in the plastic
  2. Having said that, never completely eliminate every option that the cat currently has available now - this may backfire (i.e., if you want to try a different type of litter or box to see if that helps, be sure to leave at least one old box available with the old litter - it may be that your cat actually likes the old litter or the old box best - and that his or her inappropriate elimination isn't related to the type of litter at all)
  3. Number of boxes, at a minimum, should always be equal to the number of cats plus one, so providing additional boxes may be necessary
  4. Scoop soiled litter at least twice daily - and even more often if high volume of urine in box (for example, if a diabetic or kidney insufficiency cat resides in the home, or if multiple cats are using the box, etc.). It is astounding the number of cats who are not using the box because it is not cleaned to their satisfaction! (Would you want to use a toilet that hadn't been flushed?). After scooping, "top off" with fresh litter in between complete litter changes
  5. Place boxes in additional locations - boxes should be in quiet, non-intimidating locations
  6. Completely dump and change litter weekly (or every 4-7 days) - i.e. be meticulous about keeping the box clean (again, would you want to eliminate in a toilet that hasn't been flushed?). For the clumping litters, the boxes don't usually need to be dumped and changed this often (usually every 2-3 weeks is fine) - but as soiled litter is removed, always replace with a layer of fresh litter
  7. Never use ammonia, bleach, or citrus-scented cleaners to clean the box. (The latter is objectionable to cats; the former two exacerbate the urine odor.) Instead, use detergent and hot water
  8. Don't put boxes side by side - different rooms best
  9. Vary depth of litter - usually 1' - 3' (some cats prefer just a thin layer of litter, others like it much deeper)
  10. Consider large plastic tote versus a more traditional litter box, especially for larger cats
  11. Monitor which box cat(s) use most - and note the type of litter there, depth of litter, etc.
  12. Carpet/substrate preference item in box (i.e., piece of carpet in box if cat is urinating on carpet?, empty but clean box, etc.)??? - sometimes helps
  13. Temporarily move box to soiled area, then slowly move it (1-2 feet/day) away to a location more preferable to the owner - sometimes works
  14. Litter boxes available on all levels of home, especially if geriatric or arthritic cat(s)
  15. If cat is arthritic, use boxes with shallow sides
  16. Use non-scented clumping litter - this is the litter most likely to be accepted by most cats - these clumping litters have a more natural feeling to the feet
  17. No hoods (almost always - rarely we'll suggest trying a box with a hood, but only if non-hooded are available options for the cat too, or if we have a history of the owner telling us that the only box that the cat will use is hooded). As a general rule, most cats prefer a non-hooded box. Hoods may "hide" the litter box odor from the owner, but remember then that same odor is concentrated under the hood, making it less attractive to the cat! Additionally, hooded boxes, if multiple cats are in the home, may make it more likely that the cat using the box will be 'ambushed' when exiting the box - a perfect reason in the eyes of the cat to want to avoid using that box again!  Keep the box impeccably clean and odor shouldn't be a problem, even without a hood. If you or your cat insist on using a box with a hood, and especially if you have a cat who "sprays" the inside of the hood when urinating, it is very important that you clean the inside of the hood daily with mild detergent. This applies as well to the grooves into which the hood fits onto the base of the litter box. Alternatively, as mentioned above, a large plastic tote with high sides can be used in those homes with cats who like to spray" in the box - cleaning the sides of the box is easier and usually more effective with the plastic tote versus the hooded box
  18. Praise, praise, praise the cat when he or she uses the box - never punish unless you catch the cat in the act of inappropriate elimination - and even then, don't punish by scolding and then putting the cat in the box (cat associates punishment with the box - not what you want!) Instead, consider using a squirt gun filled with water or shaking a can full of coins, etc.
  19. Again, it is recommended that each social group of cats in the home have their own set of resources (food, water, litter box, play area, sleeping area) and that those resources be in that social group's defined territory within the home where the cats in that group feel comfortable and safe using those resources.

Preventing Return to Soiled Area/Making Inappropriately Used Area Unattractive or Inaccessible:
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  1. Block access to soiled area (closed doors, baby gates)
  2. Feliway (synthetic pheromone available through veterinarians, pet shops) sprayed frequently in the area of inappropriate elimination - may work best if the cat who is urinating inappropriately is "marking their territory" (versus other reasons). This pheromone is thought to have a calming and comforting effect on some cats. Feliway may decrease, though probably not completely eliminate inappropriate urinations in cats
  3. Other scent deterrents (citrus room fresheners aren't popular with cats - putting one of them near the area that the cat is inappropriately urinating may help)
  4. Other deterrents (such as "Sticky Paws," which is double-sided adhesive tape - may work to make the soiled area less appealing) - if soil in potted plants is being used as a litter box, "Sticky Paws for Plannts" is a good solution
  5. Use of enzymatic cleaner in adequate amounts (Nature's Miracle/Anti-Icky Poo) to clean soiled area - these products work to neutralize the odor of urine or stool. However, especially in cases where soiling has gone on repeatedly for months or more, these products cannot remove the odor entirely. The sooner the affected area is treated, the better. If the objectionable location is on carpet, it is necessary to treat the carpet and the pad below (or completely change it all), because most of the odor will be in the pad. This usually means soaking the carpet with the neutralizing product so that it penetrates into the pad or completely replacing the carpet
  6. Change function of soiled area (use for play or feeding)
  7. Cover soiled area (piece of furniture, plastic, tarp, aluminum foil)
  8. Confine cat when unsupervised

Additional Suggestions:
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  1. Add "vertical territory" into home (cat trees, condos, etc.) - cats love heights and it definitely expands the available "cat territory," which in turn may decrease tendency for some cats to spray/mark or inappropriately urinate
  2. Give cat his or her own "safe" space (separate conflicting cats)
  3. Additional litter box(es) when owner out of town - pet-sitters may not be as meticulous about keeping the boxes as clean as the owner does and/or they may not clean it as often
  4. Visit www.litterboxguru.com for additional tips. This website was put together by Michigan feline specialist, Dr. Tammy Sadek. It is an excellent resource.

If "Environmental Management" fails, and medical problems have been aggressively ruled out or resolved:

  1. Other "psychotropic" drugs to reduce aggression or anxiety (Prozac, Elavil, Clomiprimine) - need to determine who is the aggressor, versus the cat being "picked on" first - and tailor drugs accordingly; the goal is 90% improvement - we rarely see 100% improvement for long-time offenders
  2. Feline House-Soiling, Useful Information for Cat Owners" for additional points. The brochure was developed by the American Association of Feline Practitioners and can be viewed by going to catvets.com and selecting the Feline House-Soiling brochure.
  3. New home for cat - though it may be difficult to find an owner willing to take a cat with a history of inappropriate elimination, we have found that the offending cat's problem will often be "cured" if put into a low-stress (as defined by the cat!) home with clean, adequate-size litter boxes, etc.
  4. Referral to board-certified veterinary behaviorist
  5. Euthanasia - last resort only

Prognosis
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The prognosis for improvement is more likely if several of the following are true:

  1. The duration is less than 1 month when treatment begins.
  2. There are only one or two locations in the house that the cat uses for inappropriate elimination.
  3. It is possible to identify and relieve the stress-causing situation.
  4. It is possible to neutralize the odor caused by the urine or stool.
  5. You have only one cat.
  6. You are effectively able to identify 'social groups' among your cats (cats that may groom or rub one another, play with one another, etc.) so that proper resource allocation is assured (i.e., again, all necessary resources - food/water/litter/sleeping area/play area - readily available for each social group's core territory or 'safe space'). It is important to understand that while cats may exist under the same roof, this alone does not mean that they belong to the same social grouping. Fundamental behavioral requirements for each social group of cats sharing the same territory or 'safe space' (which does not mean the same home!) include the following for each social group: free and immediate access to important resources when required (food, water, litter), the provision of privacy, the ability to escape from or avoid potential stress from cats belonging to other social groups.
  • In some homes, these basic feline requirements are simply not met. Cats in multi-cat households may be subject to chronic low grade stress as a result. Overt aggression is certainly a manifestation of this situation in some cases, but more subtle effects may be evident and problems relating to freedom of movement around the house (and/or no well defined core territory for either timid or bully cats) and thus to indoor deposition of urine are not uncommon. If multiple cats living under one roof do not have key resources within each social group's core territory (even if one bedroom or small area of the home), the result may be a life of low grade stress and anxiety for many of those cats. Addressing these issues alone can make for happier cats with far less stress in their lives, and increased litter box usage by cats in the home is often a nice bonus as well!
  • The more dedicated the owner is to learning about and observing normal cat behaviors in the home, and the more willing the owner is to make any changes necessary to help resolve the problem, the more likely the problem will be resolved.


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