Litter Box Woes

By Teresa Garden, DVM

Most people are surprised to learn that in 10% of multiple-cat household there are problems of inappropriate urination or defecation. The incidence of this malady increases by 10% with each additional cat in the household. The bad news is that this is a serious problem that can ruin your bond with the offending cat as well as ruin your home. The good news is that you are not alone; it is a common problem and much research is being done to find ways to combat it.

The reasons for a cat not using the litter box are many and varied. There are physical and medical reasons as well as behavioral or emotional. The goal of the pet owner and the veterinarian is to work together as a detective team to figure out the exact underlying problem and then to treat that problem. Perhaps your cat has a bladder infection (cystitis). You will see bloody urine, straining, small urine puddles or drops of urine, and increased frequency of urination. The urine will be on horizontal surfaces in the house such as the floor, bedding, bath tub, or sink. Your vet can diagnose cystitis by a urinalysis. Treatment may include antibiotics and pain medications. At our practice we will focus on feeding canned natural diets two times daily and avoiding dry commercial food. Herbal supplements have been shown to be effective in combating chronic cases of cystitis.

Stress is probably the second most common reason for a cat to not use his litter box.

Stress is often overlooked or misunderstood by pet owner and veterinarian alike. Cats can become stressed out by a new move, new person or pet, missing a person or pet who has left, new furniture, carpet or drapes, and fighting between cats in the household. We see this type of problem occurring when owners go on vacation and during holidays. These cats will often spray vertical surfaces with urine or can develop bladder infections. At Animal Health & Healing we offer Bach flower remedies, homeopathy, Alpha-Stim, herbals, and Feliway as treatment options for stress. These modalities are safe, gentle, and often effective. Conventional western medicine may employ drugs such as Elavil or Prozac.

Litter box aversion will occur if your cat deems something is not quite right with his toilet or bathroom arrangements in general. The litter box may not be in a secluded or safe place, may be too small (especially if a cat is fat or very big), or may be too high or too far away( if the cat is geriatric). There may not be enough boxes in the household given the number of cats. Actual research has found the optimal number of litter boxes should equal the number of cats + 1. So if you have 3 cats you should have 4 litter boxes.

Some cats prefer hooded boxes while others do not. Hoods will trap odors inside the box so pay particular attention to keeping these boxes very clean. Cats are very clean and fastidious creatures who will often relieve themselves elsewhere if the box is “dirty”. Some cats will not use a box if another cat has already done so. Some cats will not use a box if there is any solid waste in it at all. So, clean, clean, clean is the message. Litter type can be extremely important to some of our precious felines. Recent research has shown most cats (not all) prefer soft, clumping litter, non scented, with activated carbon to control odor. Some cats do not like litter box liners so you may consider removing the liner and see if usage improves.

Pain can be a source of litter box aversion. Pain may interfere with positioning to urinate or defecate. Cats may then associate this pain with the litter box and, hence, avoid the box. Causes of pain may include infections, crystals, or tumors in the bladder; spine, hip or knee pain; overgrown toenails, colitis, or diarrhea. Constipation can be a common and painful affliction of our senior and geriatric cats. Symptoms of constipation are crying when defecating, blood in stool, or dry hard feces. Not having daily bowel movements could lead to a neurological condition called megacolon. The colon loses its ability to contract and pass feces. This results in the colon becoming big and flabby and full of large wide fecal balls that are extremely difficult or even impossible for the poor cat to pass. The solution is for your veterinarian to diagnose and treat the underlying physical problem that is causing pain. This is accomplished by performing a thorough physical exam, urinalysis, blood tests, and radiographs.

Supply adequate number of boxes (# cats + 1). Make sure to have boxes on each floor of your home. Elderly cats will often have difficulty navigating stairs and may be more urgent in their need to urinate or defecate. Try large plastic storage boxes for large cats. Try smaller/lower boxes for smaller/older cats. Make sure boxes are in quiet calm areas without foot traffic. Try hooded vs non-hooded boxes to see which your cat prefers. Clean boxes daily to minimize odor and make the box more attractive. Try different litter types-most cats prefer soft clumping litter but yours may prefer clay, crystals, or shredded pine. Try non-scented litters. The cat’s sense of smell is much more acute than ours and what smells pleasant to us may be overwhelming for our feline friends. Use a litter with activated carbon to help minimize odor. Consider using or not using a litter box liner. Add Cat Attract litter to litter box. This is a high quality clumping litter that contains natural herbs to attract your cat to the box. Cat Attract can be found in local pet stores.

Decrease stress in your household by using Feliway. This is a diffuser that will dispense feline pheromones into the air to calm your cat. Feliway creates “good zones” in the home and cats tend not to soil these “good zones”. Feliway is also helpful to those cats who overgroom and can decrease fighting among cats. Bach flowers such as Rescue Remedy can decrease stress and anxiety. The Bach flower Walnut can be helpful in decreasing stress due to a new home or new pet or person. Honeysuckle can be helpful if your cat may be mourning the loss of a previous owner or home or pet.

Treat soiled areas in your home with a stain removal and odor neutralizer product such as Zero Odor (914-764-1566) or Vet Solutions (sold thru vets). If treating carpeted areas remember to treat the carpet pad as well. Inspect your cat’s feet to make sure clumping litter is not getting stuck between toes and foot pads. This results in infection and pain and can cause your cat to avoid the box.
All parts of the above treatment program as well as your vet’s recommendations must be followed in order to have success in treating litter box aversion. The prognosis is worse if a stressor cannot be removed, if duration of the problem is longer than 1 month, and if there are many cats in the household. A real partnership between pet owner and veterinarian is needed to overcome inappropriate elimination problems in our feline friends. Patience, love, dedication, and knowledge are all essential in helping these cats become better pets.

Dr. Teresa Garden is chief veterinarian/owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. 314-781-1738.