spraying/medical vs. behavioral

[Jen]

I have 14 cats. 2 have been caught spraying. (Jim and Sterling for reference)
Jim had a urinalysis on July 6th, came back with good results but since he had a fever we did antibiotics. Still spraying. On Aug 25 he had another urinalysis. Found a small amount of blood. Back on antibiotics and started amitriptylin for behavior. Was cage confind from Aug 25 to Sept 1 when he went to confinement in one room. I allowed Jim in the whole house yesterday and a new pee spot was found on the carpet. (Sterling is the only non-suspect, he was still in confinement).
Sterling had a urinalysis on Aug 25. Found conciderable blood. On antibiotics and also amitriptylin. Cage confined for about 4 days and room confined until Sept 3 when I gave him a trial run in the whole house. (with Sterling I was assuming it was LESS behavioral than medical)(Jim was in confinement) Found a new pee spot so he went back into confinement and had a follow up urinalysis on Sept 5. MUCH imptroved so we are upping the dose of amitriptylin assuming it is more behavioral than medical.
I should add that Jim and Sterling are sharing a room for these almost 2 weeks and no accidents were found in this room or in the other part of the house with the other cats.
Now for the questions:
1) what other medical problems should we look for before assuming it is 100 % behavioral? (I have had Sterling for 3 years with no problem although new cats have come into the house recently....fosters)
2) Has anyone actually had success using amitriptylin for this problem?
3) are there other medications I should ask to try?

[Traci]

I never recommend behavioral medications unless it is an absolute last resort (i.e, owner considering giving up cat)....least of all, amitriptyline. Seems it was too easy for your vet to prescribe it for both cats???!! And why would you want to up the dose simply based on response? The appropriate thing to do would decrease or taper/cease the meds until a persistent favorable response is noted.

Start by looking into the environment and defining stress factors. You said you bring in fosters (do you keep them seperated?)...what other changes in the environment have occured within the last year? What about changes in your own routine and/or stress level?

Because the two of them are not marking in the room they are confined in, and because they seem to do ok together in that room, chances are there is some other environmental influence affecting their behavior. It may not even be behavioral at all, since both have had urinary tract infections.

[Guest]

As I understand it, the higher dose was suppose to reduce their stress levels to the point that they would not care that there are many other cats around them. How would I as a non-medical professional even consider to question this? It seemed logical.
The fosters were 100 % separate for quite a while, but after the mom cat weaned her babies and the babies were adopted, I allowed the mom cat out. It is possible that this was the beginning of the behavior although I ended up finding old pee spots that could have pre-dated this event. But either way, we are going on the assumption that if this is behavioral, than THIS was the trigger.
If you would not prescribe a behavioral modification medicine but the problem was NOT medical, what WOULD you have the owner do? I want to be able to keep my cats but I also want to be able to keep my sanity.
Bonnie (the mom cat foster whom I adopted) seems to truly have issues with Jim but adores the ground Sterling walks on. She is young and playful and might be a bit too exuberant for his tastes (as she is for some of the others) but Sterling has never had a problem adjusting to ant other new addition before. Jim on the other hand was the last cat adopted until Bonnie came along so I understand his need to show some sort of dominance.
Would you have me simply give up Bonnie in the hopes that if she were not here the problem would go away? (the other fosters CAN be separated in one room if need be) After all, you said to locate the source of the stress and if that source is Bonnie than do I need to let her go? (something I do NOT want to do. She is not very adoptable and would probably spend her whole life in a prison cell).
What other medical conditions should I be looking for? I don't want to have either one of them suffering from anything medical because everyone is assuming it is behavioral.

[Traci]

As I understand it, the higher dose was suppose to reduce their stress levels to the point that they would not care that there are many other cats around them.

One reason I don't recommend them, I wouldn't want my cats on a drug that altered their natural moods, behavior, and amitriptyline can and does cause adverse effects in some cats (i.e., some turn more aggressive, some are half-sedated)

How would I as a non-medical professional even consider to question this? It seemed logical.

I simply stated my reasons/preferences for not prescribing amitriptyline unless in last resort cases. I found it odd that your vet was quick to put both cats on the medication without discussing other potential stress factors that may or may not be inducing the marking behavior. Perhaps you did discuss that with him, but I don't know anything other than what you post.

If you would not prescribe a behavioral modification medicine but the problem was NOT medical, what WOULD you have the owner do? I want to be able to keep my cats but I also want to be able to keep my sanity.

With 14 cats, you would first investigate the environment, find potential causes of stress, reduce or rectify those concerns, and consider watching every single cat for signs of problems. One cat doesn't appreciate another, another cat is aggressive toward another, yet another might be intimidated by another, etc etc etc. Multi-cat environments are not an easy task sometimes, and sometimes, the clues are as obvious, just have to look for them. There are various things one can do without resorting to behavioral medications. Confinement of the suspect, reducing obvious stress in the environment, strategic litterbox placement (and type), providing another box in the area of the accidents and slowly moving it to a more preferable location, slight changes in their routine if it means getting down to the problem, and your comittment to the task.

I'm not saying you are not doing the right thing for your situation, I'm simply saying I would not resort to medications unless a health condition warranted it or if it meant you were so discouraged you were thinking of giving up a cat.

Bonnie (the mom cat foster whom I adopted) seems to truly have issues with Jim but adores the ground Sterling walks on. She is young and playful and might be a bit too exuberant for his tastes (as she is for some of the others) but Sterling has never had a problem adjusting to ant other new addition before. Jim on the other hand was the last cat adopted until Bonnie came along so I understand his need to show some sort of dominance.

This might be an area where you might consider spending more time with whichever cat most needs your attention at that time. Try aversions, with toys, catnip, time spent with them playing, get them actively involved with each other during playtime, grooming, etc. Provide one more scratching post in a new area for a diversion, etc. I don't know your cats' individual needs or personalities, but you do, you have to do whatever works best for them and you.

Would you have me simply give up Bonnie in the hopes that if she were not here the problem would go away? (the other fosters CAN be separated in one room if need be) After all, you said to locate the source of the stress and if that source is Bonnie than do I need to let her go? (something I do NOT want to do. She is not very adoptable and would probably spend her whole life in a prison cell).

I would never suggest such a thing, and I was completely unaware of Bonnie and the potential cause of the problem.

What other medical conditions should I be looking for? I don't want to have either one of them suffering from anything medical because everyone is assuming it is behavioral.

Behavioral, in the sense of stress or the previous UTI's. That is what you need to focus on. Cats with UTI's often may have a reoccurance, leading to increased infection, or that the recovery process is lengthened simply due to stress. With FLUTD for example, or those cats with persistent, chronic infections, crystal problems, etc, stress is the number one cause (other than improper diet) for reoccurance. Keeping stress minimized at all costs is essential to both the recovery and behavior.

Again, I would simply like to see owners more focused on their environments rather than accepting medications unless it is a last resort incidence. Amitriptyline can be used effectively in some cases, but it is not a cure-all, nor does it come without potential side effects (dry mouth, increased thirst, rapid heart rate, sedation ---- and higher doses can cause life-threatening cardiotoxicity), which is one reason I would not upthe dose under any circumstance unless based strictly on an agressive behavioral case or a need that absolutely necessitates the use of this drug.

[Jen]

Sorry, I completely forgot that I posted that last message from a different computer.

OK, if I am to look at the environment and find the stress factor(s) what if they turn out to be either Bonnie or my other fosters? On the chance that it IS the fosters causing the stress, the foster kittens have been kept completely separated from my own cats since the time that I let Jim and Sterling back into population after THEIR confinement period. But is my current success (no peeing in the house) because of the lack of "extra" cats or because of the amitriptylin? And what if Bonnie causes Jim or Sterling to spray? How will just knowing that fact make me able to stop the behavior?

The spraying was done in too many places to try the litter box trick (putting it where they pee). As a matter of fact, I was the target of one of the spraying incidents.

I am hoping that with the fact that we went through a period of confinement, that the fosters will stay separate and the medicine (which we will be weaning them off of each on their own schedule) will do the "trick".