Contributing Factors

In many cases, inappropriate elimination is caused by a medical problem. Therefore, improvement can be expected when the medical problem has been successfully treated. Since there is no definitive way to diagnose a behavioral cause, it is imperative to rule out all medical possibilities first.

Medical causes include any illness that: a) makes elimination uncomfortable, b) increases the amount of urine produced, or c) compromises the pet's ability to "hold it." These include, but are not limited to: urinary tract infections, diabetes, kidney disease, or hormonal diseases.

In other cases, elimination disorder is primarily a behavioral problem. Multiple cats within a single household significantly increases the risk of elimination disorder. One study found that, for every cat present, there is an additional 10% chance that one will exhibit an elimination disorder. This means that if there are 6 cats in a household, there is a 60% chance of inappropriate elimination occurring.

Prevalence

A recent study performed by an animal behaviorist at the University of Pennsylvania reported that 40% to 75% of all cats presented with behavior problems had an elimination disorder. It appears that longhaired cats are over-represented as compared to short-haired cats.

Behavioral Causes

After medical causes have been ruled out, inappropriate elimination is considered a behavioral disorder. Behavioral causes fall into two general categories: dislike of the litterbox or stress-related misbehavior.

One reason the cat may avoid the litterbox is that it has somehow become objectionable to the cat. This usually occurs because it is not cleaned frequently enough or because the cat objects to the type of litter used (substrate aversion). Sometimes, the cat dislikes the location of the litterbox (avoidance of location), but substrate aversion is by far more common.

Stress-related causes can include:

	A new person (especially a baby) in the house
	A person leaving the house (permanently or temporarily)
	New furniture or new configuration of existing furniture
	New drapes or carpet
	A new house
	A new pet in the house
	A pet leaving the house
	A new neighborhood cat that can be seen by the indoor cat
	A neighborhood cat in heat
	A new neighborhood dog that can be seen or heard by the indoor cat

Therapy

Most successful treatments rely on a combination of behavior modification techniques and drug therapy.

Behavior modification therapy utilizes a dual approach involving aversion and attraction therapies. The former repels the cat from the inappropriate location, and the latter encourages the cat to choose the appropriate location.

The purpose of aversion therapy is to make the area of inappropriate urination or defecation undesirable to the cat. There are many ways to do this, but the following steps have proven successful in a high percentage of cases:

Use a product designed specifically to neutralize the odors of urine or stool in places where inappropriate urination or defecation has occurred. Several products are available for this purpose. When using any of these products, always test it in a hidden area (closet, etc.) to be sure it does not discolor your carpet. Although many products do a good job, none will undo months or years of repeated soiling. The sooner the affected area is treated, the better. If the objectionable location is carpeted, it is important to treat the carpet and the pad below, because most of the odor will be in the pad. This usually means soaking the carpet with the neutralizing product so it penetrates into the pad.

If your cat is eliminating in the soil of your potted plants, place a lemon-scented air freshener at the base of the plant. This will usually repel the cat, but in some cases the plant may need to be removed.

Cover the area(s) of inappropriate elimination with aluminum foil secured with masking tape. Most cats will not walk on this surface.

The purpose of attraction therapy is to make the litterbox more desirable than the inappropriate site(s). The following steps are usually successful:

Purchase a new, non-hooded litterbox. Even well-cleaned litterboxes absorb odor deep within the plastic, and although we like our privacy, most cats find a hooded litterbox undesirable (presumably because it traps odors inside).

Put non-scented clumping litter in the new litterbox. Even if your cat has not been using this type of litter, it will usually find it more desirable than clay types. Cats prefer these newer litters because they have a more "natural" feeling on their paw pads. Some behaviorists theorize that the new litters are more reminiscent of the cat's ancestral elimination substrate - desert sand.

Place the new litterbox near the area of inappropriate elimination until it is used for several days, and then move it 2-3 feet per day until it's in the desired location. Eventually, there will be two litterboxes side-by-side.

Keep the existing litterbox in the normal location in case the aversion therapy causes your cat to return to it.

Medicinal therapy usually involves one of three types of medications:

Anti-anxiety drugs like amitriptyline or buspirone

Tranquilizers like diazepam or phenobarbital

Hormones like megestrol acetate and medroxyprogesterone acetate

An aerosol spray called Feliway is also available for use in cases of inappropriate elimination. It contains a synthetic derivative of feline hormones, called pheromones, which have a calming and comforting effect on some cats. The product helps in decreasing - though not totally eliminating - inappropriate elimination in cats. It is available at Valley View as a spray and via electric diffuser (plug-in).

Prognosis

The prognosis for improvement is more likely if several of the following apply:

	Your cat's elimination disorder is less than 1 month old when treatment begins
	There are only 1-2 locations in the house that the cat uses for inappropriate elimination
	It is possible to identify and relieve the stress-causing situation
	It is possible to neutralize the odor caused by the urine or stool
	You have only one cat