What are the Health Benefits to the Dog?

There are several health benefits to neutering. One of the most important concerns the prostate gland, which under the influence of testosterone will gradually enlarge over the course of the dogs life. In age, it is likely to become uncomfortable, possibly being large enough to interfere with defecation. The prostate under the influence of testosterone is also predisposed to infection, which is almost impossible to clear up without neutering. Neutering causes the prostate to shrink into insignificance, thus preventing both prostatitis as well as the uncomfortable benign hyperplasia (enlargement) that occurs with aging. It is often erroneously held that neutering prevents prostate cancer but this is not true.

Other health benefits of neutering include the prevention of certain types of hernias and tumors of the testicles and anus. Excessive preputial discharge is also reduced by neutering.

What Behavioral Changes can be Expected after Neutering?

The only behavior changes that are observed after neutering relate to behaviors influenced by male hormones. Playfulness, friendliness, and socialization with humans are not changed. The behaviors that change are far less desirable. The interest in roaming is eliminated in 90% of neutered dogs. Aggressive behavior against other male dogs is eliminated in 60% of neutered dogs. Urine marking is eliminated in 50% of neutered male dogs. Inappropriate mounting is eliminated in 70% of neutered dogs.

What Exactly is done Surgically?

An incision is made, generally just forward from the scrotum. The testicles are removed through this incision. The stalks are tied off and cut. Castration is achieved. If the testicles are not removed, the desirable benefits listed above cannot be realized. The skin incision may or may not have stitches.

What can I Expect upon Discharge from the Hospital?

The scrotum is often swollen in the first few days after surgery, leading some people to wonder if the procedure was really performed. If the dog is immature at the time of neutering, the empty scrotum will flatten out as he grows. If he is mature at the time of neuter, the empty scrotum will remain as a flap of skin. Sometimes the incision is mildly bruised. Most male dogs are eager to play by the day after surgery but, to keep the incision intact, it is best to restrict the dog from boisterous activity.

At what Age can Neutering be Performed?

Neutering can be performed at any age over age 8 weeks provided both testicles have descended. Dogs neutered before puberty (generally age 6 months) tend to grow a bit bigger than dogs neutered after puberty (testosterone is involved in causing bones to stop growing, so without testosterone the bones stop growing later). The same behavior and prostate health benefits can be realized no matter what age the dog is. (In other words, a dog does not become "too old" to obtain the same health and behavioral benefits of neutering.)

The traditional age for neutering is around 6 months of age and many veterinarians still recommend neutering at this age.

Will he Become Over-Weight or Lethargic?

Activity level and appetite do not change with neutering. A male dog should not gain weight or become less interested in activity post neuter.

Will he still be Interested in Females?

His interest will be reduced but if he is around a female dog in heat, he will become aroused by her. Mounting behavior often has roots in the expression of dominance and may be expressed by a neutered male in a variety of circumstances that are not motivated by sexuality.

What if a Dog has an Undescended Testicle?

Undescended testicles have an increased tendency to grow tumors. They may also twist on their stalks and cause life-threatening inflammation. For these reasons, neutering is recommended for dogs with undescended testicles. This procedure is more complicated than a routine neuter; the missing testicle can be under the skin along the path it should have descended to the scrotum, or it may be inside the abdomen. Some exploration may be needed to find it, thus there is often an incision for each testicle. The retained testicle is sterile and under-developed. If there is one descended testicle it will be fertile, but since retaining a testicle is a hereditary trait, it is important that the male dog not be bred before he is neutered.

Is Neutering Legally Required?

In some areas, neutering may be required as municipalities attempt to prevent pet overpopulation. Check with your local city or county officials.

CITY OF LOS ANGELES, CALIFORNA: Starting April 2008 (grace period until October 1), the City of Los Angeles has adopted mandatory spay/neuter for all dogs and cats. On February 12, 2008, the City Council of Los Angeles gave final approval to a new law that requires all cats and dogs in the city to be spayed or neutered after the age of four months, with some specific exemptions allowed. The Mayor signed the ordinance into law February 26, 2008. Violations are subject to three levels of increasing penalties, starting at $100. After the third violation, non-compliance is a misdemeanor.

Exemptions to the spay/neuter requirement are:

• Is a breed approved and registered with a registry or association approved by the Animal Services Commission, and does or will actively show or compete.
• Has earned or is in the process of earning a special title (i.e., agility, herding).
• Is used as or is in training to be a guide, signal or service dog.
• Is a dog trained or in training, for use in law enforcement, military or rescue activities.
• Has a letter from a licensed veterinarian certifying that the animal should be temporarily or permanently deferred due to age or health.
• Has a valid breeding permit issued to the owner pursuant to existing city ordinance.
• Additionally, all intact dogs must have an intact dog license from the city.

Feline Spay FAQ

Spaying your cat is an important part of basic cat health care. Spaying at a young age prevents mammary cancer and spaying at any age prevents unwanted kittens, noisy heat cycles, and possibly even urine marking in the house. The following is a list of frequently asked questions gleaned from years of veterinary practice as well as from answering questions online. We have found that even though the cat spay is a routine and a commonly performed procedure, many pet owners still have questions. Hopefully, this FAQ will be helpful.

What is actually removed during spaying?

Spaying is an ovariohysterectomy, which means that both the ovaries and the uterus are removed. The cervix is tied off, leaving the vagina to end in a blind sac. Since it is the ovaries that are responsible for the heat cycles, possible mammary tumor development, and behavior problems, it is crucial that the ovaries be removed intact; some veterinarians will leave the uterus behind, though, it is generally regarded as best to remove the entire tract, uterus included.

Feline reproductive tract after removal. Note the uterus as two horns forming a Y shape. The ovaries are located at the end of the arms of the Y. The cervix is at the base of the Y.

How long will my cat stay in the hospital?

Our hospital prefers to keep surgery cases overnight so that they can have bed rest in a properly confined area. We believe that this first night of confinement helps the incision in healing. Some hospitals and most spay clinics will release the cat on the same day as surgery so that she may be observed at home in case of problems. Either way is legitimate and largely depends on the preference and philosophy of the doctor in charge of setting policy.

Will she have stitches?

Some veterinarians always place skin stitches. Some veterinarians never place skin stitches and prefer to close the incision with buried stitches that are internal. The spay incision is closed in several layers (the abdominal muscles, the tissue under the skin, and the skin itself may all be closed separately). Skin stitches necessitate a return visit for a recheck, which is always a good idea after an abdominal surgery. Obviously, it may be more convenient for the owner not to have to make a return trip and it may be simpler not to have to worry about the cat pulling out her skin stitches and causing herself injury. My hospital employs both methods although aggressive or feral cats almost always receive buried sutures so as to eliminate possible bite injury to the staff at suture removal.

What can I expect regarding recovery period/incision care?

One of the advantages of keeping cats overnight after spaying is that they usually go bouncing out of the hospital as if nothing has happened. Some cats will not eat for the first day or so but if she does not seem back to normal by the day following discharge, we would like to know about it.

Cats discharged on the same day as surgery may experience more soreness if not confined to a small area. Food and water are generally withheld until the next day or late that night and she should be kept quiet and not allowed outside. Cats should not be discharged while still groggy in any way from anesthesia as they are a danger to themselves and to their human handlers.

Later in the recovery period, it is not unusual to notice swelling at the incision site. Cats often react this way to internal sutures and this kind of swelling is common and resolves spontaneously. Such swellings are firm and there is no fluid drainage or bleeding from the incision. They generally resolve in 3 to 4 weeks.

Any fluid drainage from the incision is abnormal and if possible the cat should be rechecked by the veterinarian who performed the spay.

What if she is in heat at the time of spay?

Some female cats are disruptively annoying when they are in heat, yowling and carrying on, and they are spayed to end the heat quickly. Other cats are spayed in heat randomly when the owner does not realize that the cat is in heat. Either way the spay is slightly more difficult due to the engorgement of the tissues and larger blood vessels. Spaying in heat does not carry a significant risk to the cat but, since extra surgery time is frequently required, an extra charge may be incurred.

What if she is pregnant at the time of spay?

Spaying can be performed at any time during the course of pregnancy. Often, the owner is unaware that the cat is pregnant. If there is any question, make it clear to your veterinarian what your wishes are should your cat be found pregnant. The incision can be closed and the pregnancy can proceed or the spay can proceed and the developing kittens will be removed along with the rest of the uterus. Due to extra work and surgery time, most veterinarians will charge an extra fee for spaying a pregnant animal. Some veterinarians will not knowingly spay a pregnant animal after a certain stage of pregnancy. At my hospital, we are commonly asked what to do about newly adopted stray cats thought to be pregnant. As we work with numerous rescue groups, we are keenly aware of the pet over-population problem. We encourage spaying of strays or newly adopted female cats regardless of pregnancy. There are simply too many kittens without homes as it is.

Whats the difference between spaying in a hospital versus spaying in a low cost spay clinic?

This question may have a very regional answer depending on what sort of low cost facilities are available in a given area. Most areas have some sort of low cost spay/neuter option (consult your local animal shelter for more information). There are some general principles that tend to hold true.

Low cost spay/neuter facilities operate on a tight budget in order to provide a low cost service and still be able to pay for supplies and staff. This means they use cheaper materials for suture and anesthesia, often have limited hours, and may not have state of the art monitoring equipment or capabilities in case of emergency. Probably most important is the fact that in order to stay in business, a low cost clinic must perform a high volume of surgeries each day. This limits the individual attention a patient can receive if an assembly line approach is used. Often these are the situations where only the ovaries are removed and the uterus is left behind so as to save time or where the entire spay is performed through a tiny incision only a half inch or so long so as to save time closing (and sacrifice inspection of the abdomen for bleeding). Most of the time, the end result is the same: a spayed happy female cat and, of course, cost can be an important factor. It is a good idea to know what one is paying for, however. It may be a good idea to have a tour of your local spay/neuter facility and see what they have to offer.

A full service hospital tends to have more nursing care (such as a technician tableside monitoring anesthesia throughout the procedure), monitoring technology (EKG, pulse oximeter, blood pressure monitor, respiratory monitor etc.), fluid support, all day (sometimes all night) patient observation, safer anesthetics (which tend to be more expensive), less reactive suture materials (which also tend to be more expensive), and most importantly individual attention to each patient. As a prominent member of the surgery board once said, Speed is not a legitimate goal in surgery. Doing a careful, meticulous job is the real goal.

It should be noted that many full service hospitals have some low cost options. Sometimes there are special arrangements for rescue or shelter dogs, people with multiple pets, senior citizens or even an annual special. Check with your vet to see if you qualify for any special programs.

Will spaying affect her personality?

The female cat spends at least half the year with her reproductive tract dormant (cats only cycle seasonally, primarily in the spring and summer). This means that, behaviorally speaking, she acts spayed most of the time and no personality change should be noted. This said, it is important to realize that a cycling cat can be extremely solicitous of affection. This kind of playful, flirtatious behavior will stop with spaying.

How long after having kittens can she be spayed?

The mammary (breast) development that comes with nursing can make the spay surgery more difficult. Ideally, a month after weaning allows for regression of this tissue and spaying can proceed. Unfortunately, it is possible for a female cat to become pregnant during this waiting period if her owner is not careful.

At what age can my cat be spayed?

Will she get fat and lazy after spaying?

Estrogens have a natural appetite suppressing effect and the loss of estrogens may lead to an increased appetite. Further, sterilization surgery has been shown to slow a cat's metabolism. Depending on the cat's age and activity level at the time of surgery, a diet change to a "lite" diet may be in order. Ask your vet if you are not sure.

Can she still come into heat after spaying?

Without ovaries, she should be unable to come into heat. Occasionally, a remnant of ovarian tissue is left behind by mistake. This can lead to some annoying behaviors as the female cat comes into heat (though she would be unable to get pregnant if her uterus has been removed as is customary with spaying). Special testing or even surgical exploration may be needed to determine if there is an ovarian remnant.

Got a question we missed? Please go to the homepage of VeterinaryPartner and find the Ask a Vet feature to ask a question. Once again, spaying is an important part of cat ownership and one of the most significant steps in health care that a cat owner can provide for their female cat.

This month we would like to dedicate our feature article section to our feline companions. The following aritcles outline three of the most common feline ailments that are presented to us, including; diabetes, hyperthyroidism, and urinary/renal issues. While specific diseases can only be diagnosed through the experitise of the doctor and thourough diagnostics, these articles provide a basic understanding of common symptoms of these diseases. We highly recommend wellness bloodwork on all of our senior cats ( 7 years of age or older) on a yearly basis to catch these problems early, when overall prognosis is best. If you have any questions, please don't hesitate to make an appointment with Dr. Singh. Our staff is here for your peace of mind.

Feline Diabetes Mellitus

Signs, Symptoms and Diagnosis of Hyperthyroidism
By Wendy C. Brooks DVM, DABVP

Clinical Picture of Feline Hyperthyroidism

There are many clinical signs associated with feline hyperthyroidism. The hallmark sign is:

weight loss despite excellent appetite.

In the normal cat, the lobes of the thyroid gland cannot be felt with ones fingers. In the hyperthyroid cat at least one lobe is usually prominent and may be detected by your
veterinarian during a physical exam.

HYPERTHYROIDISM IS GENERALLY A DISEASE OF OLDER CATS. THE AVERAGE AGE AT DIAGNOSIS IS ABOUT 13.

A blood panel is often ordered in the diagnostic work-up of any significant clinical signs. The blood panel surveys hepatic, renal, hematologic, and other body systems. Although there are multiple changes which fit hyperthyroidism, mild increases in liver enzymes are most commonly observed indicating mild (usually clinically insignificant) damage to the liver. The elevated T4 level forms the basis for diagnosis; there can be no other diagnosis in such a case.

If T4 is markedly elevated, the diagnosis is clear. Some cats have borderline results and require further testing.

When T4 Levels are Borderline

In older cats, the normal range for T4 is much lower than it is for young adult cats and thus sometimes it is not obvious whether a cat is truly hyperthyroid. Further, T4 levels are readily reduced by other disease states and there is some normal (but unpredictable) fluctuation in T4 throughout the day.

The easiest tests for your veterinarian to perform are called the T3 SUPPRESSION TEST and the EQUILIBRIUM DIALYSIS FREE T4. To do the T3 suppression test, the owner must be able to give the cat a pill three times a day for two days and return to the vets office for a blood test on the third day. In other words, some specific scheduling is necessary and the cat must be able to take pills.

The pill given is a T3 pill, active thyroid hormone. After two days of exposure to this medication, a normal thyroid will respond by reducing its T4 production. In a hyperthyroid cat, this negative feedback mechanism is not operating and the T4 level will not drop. Even borderline cases can be sorted out.

The Equilibrium Dialysis Free T4 represents a special form of thyroid hormone, the part that is not bound to blood proteins (as measured by a laboratory technique called equilibrium dialysis.) Unlike T3 and total T4 measurements, the Equilibrium Dialysis Free T4 is not as subject to the influence of non-thyroidal illness. For example, it is normal for total T4 levels to drop when one is sick; however, the free T4 portion remains unchanged. In this way, a hyperthyroid cat that is sick from another disease might have a T4 in the normal or borderline range but the Equilibrium Dialysis Free T4 would still be high enough to confirm the hyperthyroid condition. The Equilibrium Dialysis Free T4 is a simple blood test that can be run on any serum sample, though sometimes it must be sent to a special laboratory, thus requiring a few days for results.

Of course a nuclear medicine scan will also identify a hyperthyroid cat readily.The equipment necessary is only available in a limited group of radiotherapy facilities.

Thyroid x ray Scan of cat with normal thyroid glands

Thyroid gland x ray Scan of hyperthyroid cat, showing enlarged thyroid glands

What Causes Hyperthyroidism?

Hyperthyroidism is caused by a benign growth in the thyroid gland that is over-producing T4. It is important to realize that these tumors are almost always benign and represent a form of goiter rather than a form of cancer. Less than 3% to 5% of hyperthyroid cats have a cancerous thyroid growth.

Many people want to know what caused their cats thyroid gland to grow a tumor, benign or otherwise. A study published in the Journal of the American Veterinary Medical Association in March of 2004 shows some interesting information. There is a strong correlation between eating canned food and developing hyperthyroidism later in life; in fact, cats who eat only canned foods from pop-top type cans have five times the risk of developing hyperthyroidism relative to cats who eat only dry food. Cats whose diet is 50% canned food have 3.5 times the risk of developing hyperthyroidism relative to cats who eat only dry food. It has been speculated that pop-top type aluminum cans are lined with a substance called Bisphenol-A-diglyciddyl ether, which is transferred into food containing oils or fats. In areas of the world where this type of can is not used for cat food, hyperthyroid is not a common disease. Still, it is important to realize that a good 25% of hyperthyroid cats have never eaten canned foods in their lives, so there is clearly more than one factor at work.

Another study by Dye et al. looked at exposure to bromated flame retardants (polybromated diphenyl ethers specifically) as a factor in the development of feline hyperthyroidism. These chemicals have become largely ubiquitous in the home in the last 30 years, about the same time that feline hyperthyroidism went from being an extremely rare disease to an extremely common one. They looked at PBDE levels in young cats, older normal cats, and older hyperthyroid cats and while they readily found PBDE in the blood samples tested, they did not find any difference in levels between cats with or without hyperthyroidism. We mention this study as it received a great deal of press attention when it first came out leading many people to read just the "headline" that PBDEs were being investigated as a cause of hyperthyroidism in cats and to miss the conclusion that no significant difference in groups was found. It should be mentioned that indoor lifestyle is definitely correlated to increased chance of a cat being diagnosed with hyperthyroidism. This has led to assorted speculations as to why this is:

• Is there a chemical in cat litter involved?
• Is there some other household chemical involved?
• Do indoor cats simply have a greater likelihood of reaching the age at which hyperthyroidism develops? (While this is certainly true, we do not know if this is the whole story about why indoor cats have an increased rate of diagnosis.)
• Are indoor cats more likely to see the vet and have diagnostic testing while outdoor cats simply go undiagnosed?

Purebred cats, especially the Siamese and Himalayan breeds, appear to have a decreased incidence of hyperthyroidism (meaning they are less likely to develop this condition). This implies that there are genetic factors at work as well.

Why is it so Important to Treat Hyperthyroid Cats?

Hyperthyroid cats frequently experience reduced quality of life through weight loss, muscle deterioration, chronic vomiting or chronic diarrhea. Not all cats experience these signs at the time of diagnosis but there are less visible reasons to treat: heart disease and high blood pressure. These problems can result in heart failure, sudden blindness, or sudden death and all can be prevented with timely treatment for thyroid disease.

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Feline Lower Urinary Tract Disease (FLUTD)
By Wendy C. Brooks DVM, DABVP

(The disease formerly known as FUS)

Feline lower urinary tract disease, or FLUTD, is the term that describes the following group of clinical signs:

• bloody urine
• straining to urinate (can easily be mistaken for straining to defecate)
• urinating in unusual places
• urinary blockage (almost exclusively a male cat problem)
• licking the urinary opening (usually due to pain)

Some veterinarians may still be using the older term feline urologic syndrome, or FUS, or simply cystitis (meaning literally inflamed bladder). Because the syndrome can have many possible causes, it was renamed to discourage the perception that the clinical signs seen represent one disease with one cause. It was becoming too simple for medical professionals to diagnose FUS, prescribe a treatment, and look no further for a diagnosis, writing off recurrence to the classical course of the syndrome. Even less accurately, this condition is frequently referred to as a bladder infection, which it usually is not, in an attempt to simplify its description.

In fact, the key to treatment is the determination of a cause if this is possible (and it frequently is not). This web site attempts to answer the questions that cat owners have about this syndrome, its possible causes, and rational treatment plans to alleviate it.

What Causes FLUTD?

Central to treating a cat with FLUTD is determining which of many possible causes is present. It turns out that different diseases are common in different age groups of cats with this syndrome.

The average age of a cat with FLUTD is 4 years. Of all cats with FLUTD:

• 50% will not have a cause that can be determined despite extensive testing
• 20% will have bladder stones
• 20% will have a urethral blockage
• 1%-5% will have a true infection
• 1%-5% will have a urinary tract cancer
• 1%-5% will have had trauma to the urinary tract (i.e., have been hit by a car etc.)
• 1%-5% will have a combination of a bladder stone and an infection

If one looks only at cats over age 10 years of age, the likely possibilities are completely different. In this older group:

• 50% will have true urinary tract infections
• 10% will have bladder stones
• 17% will have a combination of infection and bladder stone
• 7% will have urethtral blockage
• 3% will have urinary tract cancer
• 5% will not have a cause tht can be determined despite extensive testing.

Further:

• 66% will be in some stage of kidney failure
• 5% will have urinary incontinence

How Can These Possible Causes Be Sorted Out?

In younger cats, there is a 50% chance that testing will be fruitless. Given this, testing beyond an examination and urinalysis may not be performed unless the syndrome is recurrent.

In older cats, it is more important to look for a diagnosis. A blood panel, urinalysis and urine culture will detect the 50% of cats who have urinary tract infections and the 66% that are in kidney failure. Radiographs will pick up any bladder stones.

What Is a Reasonable Approach to Treatment?

Obviously, the approach depends on which diagnosis has been reached. The following list shows areas regarding causes of FLUTD:

• If your cat has a documented urinary tract infection
  
• If your cat has bladder stones
  
• If your cat has a urethral blockage or partial blockage
  
• If your cat is in kidney failure
  
• If your cat seems to urinate in inappropriate locations for behaviorial reasons
  
• If testing cannot reveal any specific cause
  
• If your cat is diagnosed with interstitial cystitis
  
• If your cat has struvite urinary crystals without urethral blockage
  
• If your cat has oxalate urinary crystals

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Feline Chronic Renal Failure

• Polycystic Kidney Disease (PKD) is inherited and is most common in Persians and crosses between Persians and Domestic Shorthairs. In PKD, normal kidney function is lost due to the development of cysts in the renal medulla and cortex. PKD can also be acquired rather than congenital.
• Renal Aplasia occurs when one or both kidneys are not present at birth.
• Renal Dysplasia occurs when one or both kidneys develop abnormally.
• Renal Hypoplasia occurs when one or both kidneys have a decreased number of nephrons that work properly.

• Amyloidosis occurs when amyloid, a protein substance, is deposited in the kidneys. Familial amyloidosis is common in Abyssinian cats and the cause is unknown.
• Chronic Interstitial Nephritis is probably the most common cause of CRF in cats and it may be because it is often the end result of other kidney diseases. The kidneys become shrunken and normal kidney tissue turns into dead scar tissue.
• Glomerulonephritis is an inflammatory disease resulting from an antigen-antibody reaction that damages the glomeruli.
• Hydronephrosis occurs when an obstruction prevents normal urine outflow.
• Pyelonephritis is a bacterial infection of the kidneys.
• Renomegaly is the enlargement of one or both kidneys, caused by any number of conditions.

Diagnosis

There are several conditions, which exhibit symptoms similar to those seen in CRF. The only way to know for certain is to have your veterinarian perform some clinical tests. Urinalysis will be done to determine if the cat's urine is dilute; this indicates that the kidneys are not passing waste materials. Blood tests will determine the levels of creatinine and BUN (blood urea nitrogen) as well as other components of the blood. An elevated creatinine level is the most certain sign of loss of kidney function.

Treatment

There is no cure for CRF but the condition may be managed for a time. The cornerstone of CRF management is to control the amount of waste products that are sent through the kidneys. Since the remaining nephrons are limited in their ability to process waste, the idea is to reduce the amount of waste to a level that the nephrons can accommodate. This is done through a combination of diet, medication, and hydration therapy (diuresis).

There are current research projects targeted at slowing the progression of CRF with ACE inhibitors and calcium channel blockers. These medications dilate the blood vessels thereby decreasing blood pressure while facilitating a non-damaging increase in blood flow that doesn't tax the kidneys. The results so far have been encouraging, but the studies are not yet complete. Kidney transplantation and dialysis are also now possible. A kidney transplant should be viewed not as a cure, but as an option for the treatment of feline CRF. For more information on transplants, see the Transplant section of this site. For more information on dialysis, see the Dialysis subsection of the Management of CRF section.

Prognosis

CRF is a terminal disease. The only questions are how long and how well the patient will live until the end. With proper treatment, the cat may have from months to years of relatively high-quality life. As the cat's caregiver(s), it is up to you to determine when the quality of life has decreased to a point at which prolonging life no longer has value.

As CRF progresses and toxin levels rise, cats become more uncomfortable with an overall sensation of feeling unwell. Human patients with a similar condition don't report "pain" but describe their condition as feeling poorly. Dehydration, in particular, can make the patient very uncomfortable. Aggressively treating CRF, especially with subcutaneous fluid therapy, should not be thought of as "prolonging the agony" as there is no significant pain associated with kidney failure until the end-stage. Even then, unless the patient convulses, the chief symptoms will be malaise, weakness, nausea and discomfort.

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Feline House Soiling

When Good Cats do Bad Things

Tips on Feline House Soiling

Despite the cats reputation for fastidious cleanliness, house-soiling is the number one behavior problem of our feline friends. Many cats are turned outside, given away, or even put to sleep for this behavior problem, and it behooves the veterinary profession to address it.

Urinating in odd places can mean either a behavior problem or a medical problem and sometimes the difference is not clear cut. Cats often urinate in unusual places to get their owners attention when they are feeling unwell. Further, cats often urinate in unusual places in an effort to reassert their claim to territory, this need often arising from psychological stress and psychological stress can easily lead to a disease state. Some cats have purely behavioral motivations without illness. Some cats simply have litter box aversion.

Should the Approach Be Medical?

Feline lower urinary tract disease (also called "Feline Idiopathic Cystitis" and formerly referred to as Feline Urologic Syndrome) involves straining to urinate, genital licking/discomfort, bloody urine, and often urinating in unusual places. There are many causes for this syndrome, including psychological stress. It may be hard to determine if a cat urinating outside the litter box has this syndrome and it is important to observe for the signs listed in addition to inappropriate urination. Cats with this syndrome often (but not always) receive a medically oriented approach addressing inflammation in the bladder. Your veterinarian should evaluate your cat before you conclude that the problem is behavioral and you embark on a long-term behavioral approach.

Urine Marking/Territorial Anxiety

Cats use urination and defecation as a means of communication with other cats. By leaving their mark, they are telling other cats I was here on this date at this time. Other cats may then know this land has been claimed (or has not been recently claimed) and may act accordingly. Psychological stress, such as the presence of other cats, prolonged absence of the owner (who is usually viewed as a parent by the pet cat), or other problems may create a need for a cat to reassert a territorial claim. Signs that this kind of stress is causing the problem might include some or all of the following:

1. Spraying on an upright surface.
   
2. Urinating in the litter box sometimes and sometimes urinating elsewhere (as opposed to never using the box at all).
   
3. Defecating in the cat box but urinating outside the box.
   
4. The cat (either male or female) is not neutered.
   
5. There has been a change at home leading the cat to feel he/she must reassert his/her territorial boundaries. (Examples: a new pet has been added, a new roommate has been added, a recent move to a new home, remodeling, the owner recently returned from a vacation, other neighborhood cats are visible or smellable in the yard.)
   
6. The area marked is near a door or window.
   
7. The problem did not start until new furniture was added or the furniture was rearranged.
   
8. The cat appears to be responding to a punishment for another behavior.
   
9. The area marked involves the owners bed or laundry.
   
10. The area marked is the same each time.

If any of these scenarios seem to fit, anti-anxiety medications may be tremendously helpful if these source of stress cannot be identified or cannot be altered.

Medications commonly used as anti-anxiety treatments for inappropriate urination include:

AMITRIPTYLINE This medication is also a neurotransmitter blocker. Statistics are not available regarding the success of this treatment but many veterinarians report success. This medication is inexpensive and generally only requires once a day administration. There are some heart related side effects and it is useful to check an EKG prior to treatment with to ensure that no untoward side effects are likely.

CLOMIPRAMINE This medication has been helpful in the treatment of obsessive-compulsive disease and depression in humans and has been approved for canine separation anxiety. It has come to be the first choice of many behaviorists for urine marking cats. It has shown effectiveness similar to that of Buspar and in most cats requires only once a day dosing. The problem is that clomipramine is not available in a convenient dosage size for cats and will probably require compounding (creating a custom-made formulation with a special pharmacy).

FLUOXETINE This medication is more commonly known as Prozac®. It has been used for feline urine marking and has been found of comparable efficacy to clomipramine. At least 8 weeks of treatment was required to achieve results in over 90% of cats and as long as they took the medication, they did not mark. If the medication is discontinued, marking may resume but is just as likely to respond a second time if the initial treatment was successful.

ODOR ELMINATORS SHOULD BE USED IN MARKED AREAS TO DISCOURAGE THE CATS TENDENCY TO RETURN TO THESE AREAS.

A Word on Female Hormone Treatments

In the past, female hormones (common brand names: Megace, Ovaban, and depoprovera) have been used to control inappropriate urination. These treatments have not shown as wide success as the newer medications listed above plus they have been fraught with serious side effect potential (mammary cancer and/or induction of diabetes mellitus). We recommend that these hormones be used only as an alternative to euthanasia.

Feliway Spray

Feliway

Recently a new alternative treatment has become available in the approach to territorial marking. Feliway spray is a spray for the area rather than a medication administered to the cat. The spray consists of feline pheromones of the type that cats deposit when performing facial marking (i.e., rubbing their face/cheeks on things to scent mark). These pheromones have a general calming effect that helps neutralize the urge to urine mark.

A recent study was conducted involving 57 households with urine spraying cats. These cats marked on either vertical surfaces only or a combination of vertical and horizontal surfaces. Feliway spray was used twice a day on the urine marked areas for a one month period. In one-third of households, urine marking stopped completely. In 57% of the households, urine marking was reduced and in 9.3% of households marking was unchanged.
Hunthausen, W. Evaluating a feline facial pheromone analogue to control urine spraying.Veterinary Medicine, Feb 2000, p 151 - 155

If Feliway spray is used, it cannot be expected to work if it is casually used. It should be used twice daily for at least one month before determining if