Feline Housesoiling Problems
Part II. Urine and Faecal Marking
Article (c) and reproduced by kind permission of Dr.
Barbara Sherman Simpson, MS, PhD, DVM
Animal Behavior Service of the Veterinary Teaching Hospital, North Carolina
State University College of Veterinary Medicine,
Although unacceptable to cat owners, marking is a normal feline behaviour. The
most common form of urine marking is spraying, a stereotyped motor pattern with
consistent features among cats.' The cat orients to a vertical surface, raises
and quivers its tail, and directs a stream of urine caudally. Sniffing the
surface may precede this display. Typically, the amount of urine expressed is
small relative to that of normal voiding. If the owner does not witness this
stereotypic behaviour sequence, he or she may detect urine marks on upright
surfaces. Cats that urine spray usually continue to use the litterbox for normal
urination and defecation.2
Housesoiling problems may involve elimination outside the litterbox (discussed
in Part I) or marking behaviour, covered in this article. As described in Part
I, elimination outside the litterbox generally involves dissatisfaction with
some environmental or social feature associated with the litterbox or
conditioned avoidance. Inappropriate elimination may involve urine, faeces, or
both. Once the cat or cats responsible for the problem have been identified,
medical conditions that might be contributing to the behaviour problem should be
ruled out. A thorough behaviour history should be taken to detect environmental
or social factors that may play a role in the problem. After any medical
problems are addressed, behaviour therapy to systematically alter the cat's
environment is initiated. In some refractory cases in which arousal or anxiety
plays a role, pharmacologic approaches may be helpful; such therapy is discussed
in this article.
URINE MARKING (SPRAYING)
Urine spraying is more common in but not restricted to males. Maximal rates
reported for feral male cats are 62.6 sprays per hour versus 6.0 per hour for
females.3 Of male domestic cats castrated between 6 to 10 months of age, 30%
exhibited occasional urine spraying and 12% exhibited frequent (problem)
spraying.4 In contrast, 4% of females ovariectomized at the same age exhibited
frequent urine spraying.
In addition to sex differences, there are widespread individual differences in
the propensity to spray urine. This may be due to breeding or dominance status
or activity patterns.3 Aggressive interactions between cats have been proposed
to play a role.5 An individual farm cat may spray most frequently while
travelling from the centre of its home range, when hunting, or after an
agonistic encounter.6 It has been suggested that urine marks act as a "keep out"
signal (i.e., they are used by certain cats to communicate their presence so
that other cats will avoid using the same space at the same time), although
there is no evidence that cats sniffing urine marks change their route of travel
in response. The ability to recognize urine of familiar versus unfamiliar males
has been demonstrated.7 This recognition would permit a resident to monitor the
activity of other cats in a given area to avoid confrontation or competition for
Among house cats, urine marking is indicative of a high level of arousal, often
associated with the presence of other cats inside or outside the home. Urine
marking may be a form of "passive aggression" toward another animal or animals.5
The location of the urine mark may suggest the source of stimulation. Spraying
around doorways and windows indicates response to the presence of an outdoor cat
or cats. Spraying along internal walls and furniture suggests a response to cats
in the household, including a new cat. In fact, the probability of urine
spraying by at least one cat in a household increases with the number of cats in
Changes in the household can influence the incidence of spraying, possibly due
to anxiety.9 For example, a move to a new house can precipitate the behaviour in
some cats. The addition of a new cat to the household is a common stimulus for
urine spraying. It has been suggested that the presence of a cat's own urine
odours makes it more self-confident and comfortable in the face of
There is a tendency for some cats to repeatedly mark specific locations or
substrates. Stereo speakers and kitchen appliances are frequent targets, as are
objects impregnated with the owner's odour, such as shoes, clothing, or
briefcases.9 Novel or unfamiliar objects, such as a new piece of furniture or a
shopping bag, may be marked when first brought into the home. Moving the target
object to a new location and observing the cat's response differentiates between
location and substrate preference.11
Urine marking can occur on horizontal surfaces, confusing the dichotomy between
urine marking and inappropriate urination (discussed in Part I). The amount of
urine produced in this fashion is relatively large, as though the cat is
voiding. When horizontal marking occurs, however, there are specific substrate,
odour, and location preferences consistent with marking. The habit is very
situation-specific and is responsive to treatment or marking behaviour. Examples
include urine marking the bed of the owner or clothing left in an open suitcase
by a newly arrived house guest.
Urine marking is not usually associated with a medical condition; however, some
behaviourists have anecdotally noted an increase in spraying concomitant with
inappropriate urination in some cases of lower urinary tract disease," possibly
due to agitation associated with pain. In some cases, medical abnormalities have
been detected in cats that spray urine. Therefore a medical evaluation should be
made on any cat in which urine marking occurs, particularly when associated with
inappropriate (squat) urination or with medical abnormalities, such as hematuria.
FAECAL MARKING (MIDDENING)
Faecal marking among farm cats is suggested by their tendency to defecate away
from the farmyard at conspicuous "middening sites." Piles of exposed faeces
accumulate, suggesting communication of individual or sexual identity or a means
of assessing population density and animal movements.12,13 In contrast, faeces
are typically covered or partially covered at communal latrine sites in the
farmyard. The latter are in loose substratum, such as sand, tilled soil, gravel,
or hay. The occurrence of faecal marking has not been well documented among
house cats,1 but patterns of faecal deposition suggest it in some cases in which
conspicuous sites are repeatedly chosen.
As with inappropriate urination, there may be uncertainty regarding which cat is
urine marking in multiple cat households. Even if the owner has seen one cat
exhibit the behaviour, this does not rule out the possibility that more than one
cat is urine marking. To identify the "culprit," individual cats may be isolated
one at a time in a room to determine whether urine marking occurs in that room
or in the rest of the household in the absence of the isolated cat.
Unfortunately, because social interactions among cats may trigger marking
behaviour, isolating one individual may reduce the probability of marking by
that cat or others. Administering fluorescein dye to one cat and subsequently
checking urine for fluorescence using a Wood's light,14
as described in
can also be used to identify the cat that is urine marking.
Treatment of urine marking can be accomplished by environmental, behaviour,
surgical, and pharmacologic methods (Table I).15 Prior to treatment, the
behaviour history should attempt to identify stimuli for urine marking, such as
the presence of an outside cat, so that they can be removed to reduce the
incidence of the misbehaviour. If these environmental factors are not corrected,
the prognosis for successful pharmacologic control is poor.
for Treatment of Marking Behaviours in Cats
Restrict the cat from areas where spraying occurs by
closing doors or using motion detectors or
Block the indoor cat's view of outdoor cats by covering windows and
Reduce the number of cats outside or inside the house.
Make the location aversive to the
problem cat by spraying an odour deterrent (e.g., citrus spray) at sites
of urine marking, or spray synthesized
F3 facial pheromone at sites of urine
Use dedicated animal odour repellents outside the house to keep outdoor
cats away; refresh according to instructions.
Establish positive interactions with
the cat in scheduled play times each day.
Avoid punishment because it may increase the cat's anxiety and fear of
the owner and is rarely curative.
Decrease arousal by administering
Decrease anxiety by administering benzodiazepines or antidepressants.
Administer antiandrogenic hormone treatments.
Castrate intact males.
Perform olfactory tractotomy in cats refractory to all other treatments.
A new environmental treatment involves exposing the cat to a synthesized facial
pheromone (dubbed the F3 fraction) when urine spraying is problematic'16,17
or when cats are introduced to new households.18
The commercial product (Feliway™, Abbott Laboratories), previously available
only in Europe, is applied daily to sites of urine spraying and on prominent
objects in the home. Although the exact mechanism of action is unknown and
results of blinded trials among exclusively indoor cats are not yet available,
the product appears to reduce the incidence of urine spraying in some single and
An obvious benefit in multiple-cat households is that the positive identity of
the problem cat or cats is not required because the entire household is treated.
There are no reported side effects to this environmental treatment.
Behaviour modification consists of scheduling play or grooming time with the cat
to increase social interaction with the owner. Increasing the cat's focus on
pet-owner interactions has been assessed to be an effective component in the
treatment of marking behaviour.12,19
Punishment should be avoided. Punishment by the owner may deter the cat in the
owner's presence and encourage the cat to become more secretive, but it is
rarely effective at eradicating urine marking. In fact, punishment may worsen
the problem by creating an unpredictable environment for the cat. The owner
should know that urine marking is a highly motivated, normal behaviour. Control
is best achieved by decreasing the motivation to perform the behaviour.
Surgical treatment can affect the incidence of urine spraying. Studies of house
cats have shown that males castrated prepubertally or as adults are less likely
to urine spray than are intact males.20 After castration, approximately 80% to
90% of males that urine spray will show at least 75% improvement in the
behaviour immediately or within several months.21
For refractory cases in which euthanasia is imminent, olfactory tractotomy has
been shown to reduce urine spraying.21
After inappropriate defecation has been ruled out, faecal marking should be
treated as urine marking. Sites of faecal marking should be cleaned with an
and then treated with an olfactory deterrent, such as a citrus-scented spray.
There is no evidence to date that pheromone treatment of the household will
alter patterns of faecal marking. The same pharmacologic agents used in the
treatment of urine spraying to decrease anxiety and arousal may reduce the
incidence of faecal marking.
Pharmacologic treatment of urine spraying attempts to attenuate the cat's
arousal and/or anxiety in response to social or environmental situations (Figure
1). Openlabel trials of diazepam,23,24
shown that these drugs markedly reduce the incidence of urine spraying in 55% to
75% of cases. Double-blinded controls are needed to more accurately evaluate the
effectiveness of these treatments over placebo.9
Paroxetine and fluoxetine have shown promise in individual refractory cases .26
Pharmacotherapy plays an important role in the successful treatment of
elimination problems, particularly those associated with marking. At present,
there are no drugs approved by the FDA for the treatment of inappropriate
elimination in cats. The experimental nature of these treatments and the risks
involved should be explained to the client. Such a discussion should be
documented by a notation in the medical record or the use of a dedicated release
form.27 Prior to the
use of these agents, a medical evaluation, including complete blood count and
serum chemistry (with total thyroxine), is recommended to rule out underlying
conditions that may contraindicate or complicate their use.28
The use of psychotropic drugs should be initiated when the owner is present to
monitor the patient, and an emergency contact number should be given for
after-hours medication questions. Clients are often willing to assume some risk
in the treatment of the elimination disorders because the alternative to
successful treatment may be rehoming or euthanasia.
Many psychotropic drugs have human abuse potential. In particular,
benzodiazepines are controlled substances, and the tricyclic antidepressants can
cause fatal cardiac arrhythmias in cases of deliberate or accidental overdose.29
Sensible precautions should be taken to ensure that prescriptions for pets are
not abused by humans.
Familiarity with the medications should include knowledge of common side effects
and drug interactions. For example, tricyclic antidepressants and selective
serotonin reuptake inhibitors (SSRIs) can interact with drugs classified as
monoamine oxidase inhibitors (MAOIs). Concomitant use of SSRIs with the MAOIs
amitraz or deprenyl can lead to serotonin syndrome and should be avoided.30
Behavioural and physiologic characteristics of the drugs aid in their selection.
Certain pharmacologic agents reduce spraying in males more than in females. The
greater effectiveness in males may be due to antiandrogen effects or differences
in receptor sites. Bromocriptine is an ergot alkaloid that acts as a dopamine
agonist. In its injectable form, which is no longer available, a dose of 2 to 5
mg/cat subcutaneously was shown to reduce urine spraying in 85% (n=27) and 40%
(n=5) of male and female cats tested, respectively." The oral form may be used
twice a day for 4 to 8 weeks. A study of the effect of synthetic progestins on
the frequency of urine spraying concluded that it is effective in 55% of males
and 25% of females. 32
Choosing a specific psychotropic drug depends on a number of variables,
including side effect profile, dosing regimen, familiarity with the drug,
latency to effect, and cost. In general, if one drug causes unacceptable side
effects or lack of efficacy, a drug from another class should be utilized. Drugs
in each class share biochemical characteristics and mechanism of action.
Table II lists common classes of medications used to treat urine marking;
common and rare but potentially serious side effects are included.
Classes of Drugs Used for the Treatment of Feline Housesoiling
Latency to desired
Potential Side Effects
(may be immediate)
Idiopathic hepatic necrosis rare
Alterations in social
Cost may play a role. In the United States, benzodiazepines and tricyclic
antidepressants are available in generic forms, which are less expensive than
proprietary forms. The azaperones and SSRIs are not available in generic
formulations. Table III lists specific drug names and doses.
Drugs and Dosages Used to Manage Feline Housesoiling
Dosage for Cats (orally)
1.0-4.0 mg every
Sedating until tolerance develops
5-7.5 mg every 12hr
May affect social interactions among
2.5-7.5 mg every 24 hr
Give at bedtime to
manage sedation; bitter tasting
1-5 mg every 12-24 hr
Compounding to a 2.5
mg/ml solution facilitates dosing
1-2.5 mg every 24 hr
Available as an elixir;
give in the morning to avoid changes
in sleep cycle
1.25-2.5 mg every 24 hr
More sedating than fluoxetine;
taper dose over 1 wk to discontinue
Benzodiazepines act on specific receptors in the central nervous system by
facilitating y aminobutyric acid, a widely distributed inhibitory
neurotransmitter. Drugs in this class are used to treat fears and phobias as
well as states of anxiety and arousal. They have been shown to be useful in the
treatment of urine spraying in cats. Side effects in humans include sedation,
ataxia, muscle relaxation, increased appetite, paradoxic excitation, and memory
Abrupt discontinuation can lead to recurrence of the original problem or
the drug is discontinued, it should be slowly tapered. Once diazepam has been
discontinued, spraying can resume in up to 90% of cases.23
Although tapering the medication is often attempted after several months of
successful therapy, continued therapy is commonly required, depending on the
owner's success with environmental and behaviour regimens and the motivation
level of the cat.
Hepatic necrosis is a rare, idiosyncratic effect of diazepam therapy in cats. It
may be irreversible and fatal. It has been reported in apparently normal cats
within 7 days of oral therapy with generic and proprietary diazepam.34
It is not known whether other benzodiazepines will produce the same response
when their frequency of use approaches that of diazepam. It is recommended that
a biochemistry screen be conducted prior to oral diazepam use28
and after 3 to 4 days of therapy.
Azaperones have serotonergic and dopaminergic mechanisms. One azaperone,
buspirone, has been shown to be efficacious for the treatment of urine spraying.35
The drug has no potential for abuse and is not sedating. Buspirone may take 1 to
3 weeks to show an effect. Side effects include idiosyncratic changes in social
behaviour ranging from irritability to increased affiliative behaviour to the
owner. Mild gastrointestinal (GI) side effects have been reported. When tapered
off buspirone, cats tend to resume spraying behaviour in 50% of cases.
23 25 Buspirone appears to
be more effective in multiple-cat than in single cat households ,36
suggesting that buspirone influences social factors that mediate urine spraying.
The tricyclic antidepressants are drugs with a rang of behaviour activities and
have wide applicability to behavior treatment.37
Acting therapeutically on the nor epinephrine and serotonin neurotransmitter
systems tricyclic antidepressants also affect other receptors which explains
their antihistaminic and anticholinergi (atropine-like) side effects. Because of
the latter, cardio vascular abnormalities, glaucoma, and urinary or feu
retention are contraindications to the use of these agents.38
Due to the tendency of tricyclic antidepressants to exacerbate cardiac
conduction disturbances in human patients with underlying cardiac abnormalities
a screening electrocardiogram within 4 weeks of initiation of therapy with these
compounds is recommended
Selective Serotonin Reuptake Inhibitors
The SSRIs act selectively on the serotonin neuro transmitter system by blocking
the reuptake of serotonin and effectively increasing its bioavailability.37
They have been used in cats for the treatment of refractory urine spraying.
Because most of the serotonin receptors in the body are found in the GI tract,
common side effects include inappetence and other GI sign such as anorexia,
nausea, and diarrhea. GI side effect (which occur in up to 25% of humans) may be
avoid by starting at a low dose for I week and then increasing the dose over 2
weeks. Other side effects include idiosyncratic anxiety, irritability, insomnia,
or sedatior Fluoxetine may have 3 to 4 weeks latency to effect an a long
elimination half-life of the active metabolite. Response to paroxetine appears
to be more rapid in cats. Paroxetine has a shorter elimination half-life and
should be tapered when discontinued. When using any SSRI, cats must be carefully
monitored for water and food consumption, weight, and elimination habits
Because synthetic progestins have a higher incidence of side effects, including
obesity, diabetes mellitus, mammary hyperplasia and carcinoma, and blood
routine use has declined and is now reserved for cases refractory to first line
treatment with other psychotropic agents. They are not discussed further here.
Solving feline elimination problems requires a systematic approach. Realistic
expectations should be made regarding control of longstanding cases. Medical
differential diagnoses for elimination disorders must be ruled out before a
behavioral diagnosis is made. Marking behaviour must be differentiated from
inappropriate elimination because the motivating factors and specific treatments
differ. Prior to treatment, a baseline of the number of marking events occurring
each week should be established so that progress can be monitored. In general,
treatment consists of environmental control, behaviour modification, surgery,
and pharmacotherapy. In many cases, an aggressive approach is warranted-by the
time consultation is sought, the owner may have little patience left.
Therapeutic failure may result in the cat being euthanatized, rehomed, or
About the Author
Dr. Sherman Simpson is Director of
The Animal Behaviour Service of the Veterinary Teaching Hospital, College of
Veterinary Medicine, North Carolina State University, . She is a Diplomate of
the American College of Veterinary Behaviorists and is Certified as an Applied
Animal Behaviorist by the Animal Behavior Society.
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