Behavioral Urinary Tract Problems

Question 1

What are some causes of house soiling?

Answer 1

• Stress (environmental, social factors)
• Marking - not out of spite or anger towards owners
• Medical illnesses (bacterial cystitis, neoplasia, IBD, GI lymphoma)
• Feline Idiopathic Cystitis

Question 2

Define barbering

Answer 2

Pulling out tufts of fur (stress form of self-grooming) usually along tail-head

Question 3

What are some diagnostic options for urinary house soiling?

Answer 3

• Urinalysis (+/- culture)
• Radiographs (r/o urinary calculi)
• Abdominal ultrasound
• Fecal float (if diarrhea present)
• CBC/Chem/T4

Question 4

You perform a urinalysis with culture, radiographs, and bloodwork on a cat that is house soiling and they are all within normal limits. What can you conclude?

Answer 4

Medical causes of house soiling unlikely, but P could still have FIC

Question 5

What are some signs of marking?

Answer 5

• Standing, tail up, & twitching
• Small amount of urine on vertical surface (occasionally horizontal)
• Fixed or vacant stare
• Normal voiding in litterbox otherwise

Question 6

What are the 4 types of marking behavior?

Answer 6

1. Scratching
2. Rubbing
3. Urine spraying
4. Middening (deposition of feces; least common type)

Question 7

How many litter boxes would you recommend an owner have?

Answer 7

1 for every cat + 1 more

Question 8

T/F: Pellets, scented, & organic litter is best for cats

Answer 8

F, this just pleases the owner; the cat couldn’t care less

Question 9

Describe the ideal litter

Answer 9

Fine, sand-like, non-scented, clumping, & at least 1.25 inches deep (avoid liners, powders, or slotted grills)

Question 10

Is it okay to use automatic litter boxes?

Answer 10

Yes, but you need to desensitize the cats to it first!

Question 11

What are the 5 pillars of a healthy feline environment?

Answer 11

1. Provide a safe place
2. Provide multiple, separated key environmental resources
3. Provide opportunity for play & predatory behavior
4. Provide positive, consistent, & predictable human-cat social interactions
5. Provide an environment that respects the importance of a cat’s sense of smell

Question 12

What pharmaceuticals can you use for behavioral urinary problems?

Answer 12

Fluoxetine, Buspirone, Alprazolam

Question 13

Which pharmaceutical should you avoid in aggressive patients with behavioral urinary issues and why?

Answer 13

Alprazolam - may increase aggression

Question 14

What are the potential adverse effects associated with Fluoxetine?

Answer 14

• Increases risk for serotonin syndrome
• Can cause urine retention
• Can take up to 8 weeks to know full effect
• May see inappetence at higher doses (V/D too but that is rare)

Question 15

What are some medical causes of house soiling?

Answer 15

• Feline idiopathic cystitis
• Neoplasia
• Osteoarthritis
• Incontinence
• Kidney/bladder disease
• Hyperthyroidism
• Diabetes
• Cognitive dysfunction

Question 16

What is FIC

Answer 16

Multifactorial condition with one or more FLUTD signs (hematuria**, pollakiuria, periuria, stranguria, dysuria) where a single underlying cause cannot be determined

Question 17

What are some pharmaceutical options for FIC?

Answer 17

• Prazosin (alpha antagonist; caution with cardiac patients)
• Amitriptyline (do NOT use with Fluoxetine)
• Fluoxetine (SSRI, probably most common)
• Alprazolam (Benzodiazepine; caution with aggressive patients)
• Buprenorphine or Gabapentin

Question 18

When should owners come back for a recheck for FIC?

Answer 18

2-3 months initially (i.e. after starting medications)