Feline elimination quiz

Eliminating inappropriate feline elimination

SASKATOON, SK – Of the tens of thousands of cats that are euthanized or surrendered to shelters in North America each year for behaviour problems, between 40% and 75% have an elimination disorder involving urination or defecation, explained Margie Scherk DVM, DABVP (feline), speaking at the Saskatchewan Association of Veterinary Technologists Conference. In addition, many cats present with clinical signs of lower urinary tract disease (LUTD).

Inappropriate elimination is always a message: either the cat is conveying that a physical problem is present or that they are distressed.  A minimum of a urinalysis is required if the problem is inappropriate voiding.  A complete blood count and serum biochemistries, and vaginal examination may also be needed. If a cat is defecating inappropriately, a rectal examination, anal sac assessment, and fecal evaluation may be advisable.

Dr. Scherk noted that there are several “foolers”: some cats with hyperthyroidism defecate outside of their litterbox without showing other, more classic signs of this disorder. A cat with abdominal alopecia may be licking due to pain from cystitis (or inflammatory bowel disease).  Thus, in the case of a cat with a bald belly or flanks one should consider the need to conduct a urinalysis. Idiopathic cystitis may cause LUTD with hematuria as the only abnormality on urinalysis.  If the bladder or bowel appears unremarkable on abdominal ultrasound or plain and contrast radiography, then medications that address pain may be indicated.  As far as the patient is concerned, whether the inappropriate urination is due to pain, or the anxiety caused by the pain, is irrelevant. 

Identifying the cat that is eliminating inappropriately can be confusing in a multicat household.  For urination problems, fluoroscein can be administered subcutaneously, or six large fluorescein dye strips in a gelatin capsule can be administered orally.  An enhanced bright yellow-green fluorescent urine will be eliminated for 24 hours after administration when viewed with a fluorescent black light. Clients should be cautioned that fluoroscein stains some fabrics.  Remember though that there may be more than one cat exhibiting the unwelcome behaviour.

Once the clinician has ascertained that it is a behaviour-based problem, a thorough, detailed behaviour history should be taken. The history should include all relevant information regarding the source and age of the cat at adoption, age at surgical altering, prior behavioural problems, daily routine, indoor/outdoor status, feeding patterns, other family pet illnesses, family and household structure. Then the problem behaviour itself should be explored, including the three most recent incidents. 

For elimination histories, the types of litterboxes and litter and how the cat uses the box should be ascertained. Much of this can be done having the client fill in/check off history forms. Also, the client-cat interaction should be observed.

Aversions and preferences


Cats may come to associate their litter with pain or fear; this may occur when they experience cystitis, colitis, or post declawing.  They may dislike the smell of the litter or the state of the box, clean or soiled. In general, the finely grained, disposable, clumping, silica cat litters are preferred by most cats.  The easiest way to determine the preferred litter type, once a substrate preference has been identified, is to offer a buffet of litter boxes with several types of litter.


Aversions to certain locations are associated with the presence of an undesirable cat and may be precipitated by the scent of other cats, physical exclusion or victimization by other cats, people, other animals or objects. Generally, moving the box to an area lacking those factors will be diagnostic.

Dr. Scherk said that in situations where the cat uses several spots to eliminate in, rather than one, it is helpful to counter-condition the cat by placing food bowls over the spot after thorough use of an odour eliminator.  If this exercise isn’t successful, then placing a plant or a solid piece of furniture over that location may be required.  For this to be successful a new box should be left in the new location for two weeks of no failures in elimination location before starting to relocate it.  The box should be moved no more than 1-2 inches per day in the direction of the preferred final location. 


Nonspraying marking

Rather than being a behaviour of only dominant cats, this may be a form of expression by anxious underlings wanting to claim territory without fighting for it. 

Spraying marking

Spraying to mark is a very normal behaviour in cats, indicative of either bold cats announcing their presence or timid cats trying to claim a niche. Commonly cats spray near windows and doors to the outside if the perceived threat is outside. Females as well as males may spray.

Treatment of elimination disorders

All layers of the affected area need to be cleaned or replaced. After removing these materials, cleaning and using odour eliminator, heavy gauge insulating plastic should be taped down securely to avoid further penetration of new urine/feces, as well as to change the tactile sensation and make it less pleasant for the cat.  Ideally, isolate the cat to a different area with a selection of a number of litter boxes with different substrates.  It is critical that clients do not use vinegar or ammonia-containing bleach for cleaning up the soiled locations. Dr. Scherk noted that Urine-Off (www.urine-off.com) is very effective; it can be purchased with a black light to identify where the urine residue is.

Next, the cat should be provided with a variety of substrates, and multiple litter boxes of various styles in a number of locations; the general rule of thumb is one more than the number of cats. It is important that these boxes be placed in different rooms rather than all in one location.

Boxes should be scooped at least once a day and emptied and washed out once a week if the litter is not a clumping, scoopable kind. Because cats dislike disinfectants and deodorizers it is best to avoid scented litters. Boxes should be at least twice the length of the cat.

Pheromone use

FeliwayTM is thought to increase emotional stability, however its effectiveness at reducing inappropriate urination is not known.

A daily application on soiled areas is necessary until the cat is seen to exhibit facial rubbing on the site.  If the cat does not exhibit facial rubbing, then daily application to the environment should be continued for one month.

Pharmacological intervention

This must be viewed as adjunctive therapy, to be used with behavioural and environmental modification.  Drugs that are appropriate for certain situations and personality types are the benzodiazepines, tricyclic antidepressants, non-specific anxiolytics, and progestins (as a last resort). Dr. Scherk stressed the importance of becoming familiar with the mechanisms of action of all pharmacological agents that affect behaviour. 

She said that in elimination problems involving a substrate or location preference or aversion, either a tricyclic antidepressant or a non-specific anti-anxiety drug may be most effective. However, the cat’s litterbox also has to be a pleasant, safe place and social issues within the home need to be addressed if treatment is to be successful.

For most cats, drugs will be needed throughout life, however, after a minimum of 2-4 months have passed without incident, gradual weaning to the lowest effective controlling dose is advisable.

Dr. Scherk concluded by saying that if environmental, behavioural, and pharmacological therapies have been instituted, and the problem persists, medical evaluation and tests should to be repeated.  Bacterial urinary tract infections may be undetected until numerous urinalyses and cultures have been run.  Clients should also be made aware of the fact that elimination problems are more challenging and have a lower success rate in multi-cat households.CVT 

The American Association of Feline Practitioners has created many sets of guidelines.  These include the recent development of Behaviour Guidelines which can be downloaded and printed from the website: