Florida Veterinarian Ebook Continuing Education

litterbox, without any changes in substrate or to the box itself, the problem can be diagnosed as an aversion to the area where the litterbox was previously located 22 . These aversions often relate to fearful or painful situations, for example a cat who was injured by the door of the room leading to the litterbox, a cat who was startled in the litterbox by the noise of the washer or dryer, or a cat who was tormented in that room by a child or the family dog 18 . Location aversions are a simple fix in many homes, because the problem can often be resolved by moving the litterbox to another room. In multi-cat homes, hostility between cats can often trigger location aversions. Certain locations make it easier for a dominant cat to bully other cats in the home, for example if the litterbox is in a confined room with only one entrance and exit 22 . Relocating the litterbox often solves the inappropriate elimination piece of this puzzle, but the client may also wish to seek help for the intercat aggression issues to prevent other behavioral problems. Older cats and cats with subclinical arthritis may find it difficult to go up or down a flight of stairs to get to the litter box. In these cases, owners should consider placing a litterbox on each floor of the house, in order to provide easy access for these pets 4 . Substrate preference Cats may develop a preference for a variety of alternative substrates, including cloth, wood floors, linoleum, bathtubs, etc. These preferences are often very specific, with cats eliminating only on their preferred substrate. The preferred substrate is usually something soft (for example sheets or bath rugs), but this is not always the case; some cats prefer open, reflective areas 18 . Treatment of inappropriate toileting As with urine marking, the prognosis for treatment of inappropriate toileting will depend on the correct identification of the underlying cause, the duration of the problem, and the owner’s level of commitment to treatment. Managing inappropriate toileting involves a four-pronged approach. First, owners must thoroughly clean the soiled areas. Next, they should make the litterbox environment as appealing as possible; the cat’s optimal litterbox should be found and utilized. Third, owners should use environmental management to decrease conflict and anxiety. Finally, veterinarians and owners should consider drug therapy if the cat is demonstrating significant signs of anxiety. Clean soiled areas thoroughly As with cases of urine marking, the first step to manage inappropriate toileting is to thoroughly clean of all surfaces to remove odors. The smell of urine and feces remains present for extended periods of time, which will continue to attract elimination in these areas, if aggressive cleaning is not performed. Washable items, such as bedding and soiled laundry piles, should be washed using hot water and bleach 4 . Carpets should be cleaned with an enzymatic cleaner, and tile/wood surfaces should be cleaned aggressively. In homes with a more chronic issue, carpets, carpet padding, and tile may need to be removed and the subfloor should be sealed. Contaminated concrete flooring (such as on patios or in garages) should be sealed or painted over 1 . It is essential that owners understand the importance of this step. Additionally, owners should limit the cat’s access to previously sprayed areas. They can accomplish this through the use of physical barriers, such as closed doors, or through the use of more creative means such as bowls of potpourri placed at previously soiled areas 14 . Owners may also wish to change the function of the marking area through the use of food and water bowls, beds for sleeping, catnip, or a scratching post 8 . All of these measures are designed to break the habit of urine marking, when combined with the other methods discussed below.

Substrate preferences are often, but not always, associated with substrate aversions. As the cat develops an aversion to its regular litter, it finds a new, preferred substrate for elimination 1 . Illness can also be associated with the development of a substrate preference. For instance, cat with cystitis or diarrhea may eliminate on the floor because it cannot make it to the litterbox, and then discover that it likes carpeting for elimination 18 . Approximately one-third of cats with substrate preferences who show a poor response to treatment have occult UTIs. Therefore, veterinarians should consider repeating urinalysis and urine culture in these patients, even if they obtained negative results during the initial pre-treatment medical workup 18 . Location preference Cats may prefer an alternative location for elimination, especially in situations where intercat conflict exists within the home. For an anxious or timid cat, a covered box in a quiet area of the house may actually be preferred to the open, accessible litterbox that most cats use 1 . Most cats prefer a litterbox that is located in the core area of the home, where they spend most of their time 6 . If a cat consistently eliminates in one specific location within the house, this can suggest a location preference issue; relocating the litterbox to this location can confirm the diagnosis 1 . If this move is successful and the cat again begins to use the litterbox regularly, the litterbox can then be gradually moved (1–2 inches per day) towards a slightly more appropriate location in the same vicinity 1 . If multiple areas are involved, owners should place the litterbox on the most commonly used area and cover the other soiled areas either with food and water bowls or other non-mobile objects 1 . If none of these measures are effective, owners should use aluminum foil to cover previously soiled areas and prevent access. This aluminum foil should be secured with masking tape, and left in place until the elimination problem has been resolved 4 . Make the litterbox appealing Two key factors help to make the litterbox as appealing as possible. Owners should remember that these cats are not eliminating outside of the box for marking purposes, but because they have found a better toilet. Therefore, resolution of inappropriate toileting relies upon making the litterbox as appealing as possible so that it can be the cat’s preferred toilet. This means not only keeping the box impeccably clean, but also designing a litterbox that meets the cat’s preferences in In order to encourage cats to use the litterbox, and thus make the litterbox more appealing, owners must keep the litterbox and litter very clean. Veterinarian professionals may ask clients – “Would you want to use a dirty restroom with a toilet that had not been flushed, or would you look for somewhere else to go to the bathroom?” Litter should be scooped at least once daily, ideally twice daily (or more frequently in a multi-cat home). Clay litters should be emptied fully every three to four days, while clumping litters can go as long as one week between full litter changes. When the litterbox is emptied, the box should be thoroughly disinfected, with care taken to ensure that no chemical scent remains on the litterbox 16 . Additionally, the level of litter in the box should always be kept at least 3–4 inches deep, to allow room for scratching and burial of waste 14 . In multi-cat homes, owners must provide at least one litterbox per cat, and these litterboxes should be distributed throughout the home, not all in one room 14 . Litterbox trial other ways as well. Litterbox hygiene Owners should offer a variety of litter types, as cats vary in their preferred substrate. Many cats prefer litters that have activated carbon added as an odor preventive (Fresh Step™ Scoopable

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