Old kitty going outside the box...

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wren
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Old kitty going outside the box...

Post by wren »

Hi All,

My cat Guido, who has had a series of ailments the past year or so, is having a problem with urinating outside his box. He tries to get to the box, sometimes makes it ... sometimes not, but even when he does make it, more often than not he misses the box and it ends up on the floor.

I brought him to the vet 2 weeks ago, and his tests came back fine.

We tried making a bigger box (higher walls), and that has helped on the occasions that he makes it to the box. But, for the times he doesn't quite make it to the box, on the floor it goes.

Part of the problem is that he is blind. Part of the problem (squirting over the side of the box) is because he has arthritis and isn't lowering his back end enough.

That said, if anyone has a suggestion or two on how to help Guide "hit" the box more regularly I'm all ears.

If there's is anything else I should be asking the Vet about, I'm all ears for that too. Guido is scheduled to go for a shot for his arthritis tomorrow evening and it would be a perfect time to ask for more help.

Thanks
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Traci
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Re: Old kitty going outside the box...

Post by Traci »

What tests were done last week? Full bloodwork? Urinalysis?

Why injections for the arthritis, did your vet discuss with you the possibility of using Cosequin for Cats? Have xrays been done to rule out degenerative joint disease?

What are the "series of ailments"?

Is he clinically blind, or just losing sense of sight? Has he had a thorough optical exam?
..........Traci
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Tambrey
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Re: Old kitty going outside the box...

Post by Tambrey »

Guido might have trouble actually getting INTO the box, especially if you got one with higher sides still....

I have found that the BEST litterbox is a storage tote!! I get a fairly large one, and cut a hole in one end, large enough for a cat to get into and high enough from the floor so litter does not get scooped out....
I use a serrated knife that I heat over a flame to do the cutting, so edges are smooth...

You can cut even a bit lower for Guido to step into the box and do his thing...

If he has trouble making it to the box, you may need to "decorate" your house with litterbox/storage totes....

get one for each room he is a frequent inhabiter of and make sure he is aware they are there...
wren
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Re: Old kitty going outside the box...

Post by wren »

Guido has a long list of ailments, and has been seen regularly the vet for the past year. He's had full bloodwork recently because of ongoing health issues.

She did not run a urinalysis (not sure why, I can ask tomorrow). I told her about his urinary problems, and she said that because of his age (14), when he has to go, he has to go, and if he's too far away from his box to make it, he's going to go where ever he is. It doesn't help that he's moving a little slower than he used to because of his arthritis, and of couse, being blind isn't helping matters either. I've put boxes on each level of the house, but it doesn't seem to help.

As far as his ailments... here's what I can remember off the top of my head:

. fleas
. ear mites
. ensephilities (sp?)
. clinically blind (detached retinas)
. broken toe
. broken tail
. lump removed from back (benign)
. allergic reaction to topical from surgery, that resulted in him licking himself raw and creating scab. Need antibiotics.
. possibly a stroke (was acting "lost")
. broken blood vessel in the eye, with blood pooling in detached retina
. arthritis

I don't have the name of the shot he is taking with me at work, but I'll tell you the procedure, and hopefully you'll know what it is (I do know that she said that is a new drug): Shot once a week for 6 weeks, then a shot every-other week for 12 weeks, then a shot once a month. I'm also giving him one Cosequin pill a day mixed with wet food. Both of these (once a month shot and the one Cosequin pill a day are life long treatments).

Before the treatment, his arthritis became so severe he was limping. With in 3 days of getting his first shot, he was walking again (no limp).

I've probably forgotten something ... but I think those are the key things he's been through in the past 1-1.5 years.

So you don't have to ask: Guido is an indoor cat only, always has been. The reason he got fleas/mites is because I made the mistake of taking in a stray BEFORE I brought the stray to the vet for a check-up ... and unluckily, not only did the stray bring in fleas and ear mites, she was pregnant! Not smart I know, but I didn't know better at the time. I just thought I was doing something good by trying to provide a home for a little kitten.

Sorry for the long winded post, but I wanted to give you as much history as possible.
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Traci
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Re: Old kitty going outside the box...

Post by Traci »

What type of litter are you using? If unscented, maybe he can't smell where his litterbox is. If he is losing sight, he will rely a great deal on his other senses to navigate his environment.

Try providing a runner in front of the box. You can even pick up linoleum squares at any local hardware or home improvement store, place them in front of the box so he starts associating the feel of the runner, thereby associating the runner leading to the box.

As Tambrey said, cut out an opening in the front of a large litterbox or rubbermaid tote box, smooth the edges, and see if this will help. Use a litter that he likes, but not too deep.

Just because he's 14 doesn't mean he can't hold his bladder and the vet's comment on that is a little questionable. Yes, if he is arthritic, it may be more painful for him to travel a wide berth to get to the litterbox, so make sure each box is easily accessible for him, and in locations he is already familiar with. She should have done a urinalysis, since this is a vital part of the senior wellness exam, combined with full bloodwork.

I don't know if she's using corticosteroids, adequan, or pain medication, find out. Repeated use of some of these things can actually do alot of damage, for this reason it's imperative his bloodwork is checked frequently to monitor drug levels in his system and to make darn sure his kidney and liver is not affected by long-term use. Corticosteroids can also cause immunosuppression if used long-term, another critical reason bloodwork needs to be re-evaluated every several months, or sooner if problems or changes in health occur.

Detached retinas are painful, was/is he ever treated for that? Has the vet also ruled out glaucoma or cataracts?

Don't change anything in his environment, don't move furniture, etc, and keep stress to the barest minimum, blind cats rely on consistency and their environment unchanged for navigational ability.

Encephalitis, from what??? Is he being regularly monitored for this? What tests did the vet do to differentiate? Rule out viral, bacterial, parasitic, fungal disease?

And what led her to believe a stroke? What diagnostics and/or treatment was persued?
..........Traci
wren
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Re: Old kitty going outside the box...

Post by wren »

I'll answer in detail tomorrow ... have to run right now (sorry!) ...

We're using a mutli-cat clumping litter. I'll have to see if it's scented or not.

But very quickly, the "higher wall box" I original mentioned is exactly what Tambery had suggested ... as did our vet. It's a storage bin. My husband used a saw and then rimmed the edge so it's nice and smooth. Guido is still getting used to going through the opening ... but it works well once he's in there.

On the medical stuff ... I'll get back to you all tomorrow, and will get the name of the drug she is injecting. It was my understanding that it's is for his arthritis and it's supposed to help rebuild the cartilage.

And, yes, he has cataracts too.

More to come...
wren
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Re: Old kitty going outside the box...

Post by wren »

OK, I'll try to respond to the questions that I have answers for, and will get the remaining answers from the vet this evening:

1. Just had blood work done (less than 2 months ago), but I can ask her to redo if it makes sense.

2. I'll ask for a urinalysis.

3. Yes, we treated eyes, but that was over a year ago, so I'm not 100% sure what we did. I know that I was putting ointment in his eyes for quite some time, but I'm not sure if I was giving him oral medicine too (he was getting oral medicine but I can't remember if it was for his eyes or one of his other ailments).

4. I'll get the name of the medicine he's receiving for his arthritis. I'm concerned with your statement on long term use, since the vet said this is going to be a life long treatment (once a month after initial ramp up).

5. The house has remained stable, and he's navigating pretty well. Our vet told us that it was important not to move anything, and that if we had to, that we should acclimate him to the new environment.

6. Encephalitis: He had ear mites. We treated him for the ear mites, and did the follow-up treatment too. But, the vet said that sometimes ear mites can be stubborn, and that they must have survived the original treatments. Anyway, they were festering in his ear and created an ear infection. I didn't know that he had an infection until it festered for quite some time, and I started noticing that his eyes looked funny. That's when I took him in. She said the ear infection escalated to Encephalitis, and was putting pressure on the optical nerves. When examining/treating him for the above, she told me that he had cataracts too. He was on medicine (oral) and ear drops. I believe he was on antibiotics and steroids. He was at the vets for 4 days until he was stable enough to come home. Some of the details are a little fuzzy as this occurred about a year ago or so.

7. Stroke ... My husband seemed to think it was a stroke, but the vet said that it wasn't a stroke. He was acting discombobulated, like he didn't know where he was. That seemed to go away, it lasted for a couple of days (sporatically at that) ...

New: Guido licked some fur off his back paw. Is it possible that he is having an allergic reaction to the litter? We've been using the same brand (it's the multicat formula Fresh Scent Scoop from PetSmart) for quite some time.
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Traci
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Re: Old kitty going outside the box...

Post by Traci »

Licking fur to the point of baldness could be anything from a skin condition to pain response (either external or internal).

What limb(s) is the arthritis limited to? Did the vet ever xray, and followup with xrays each year? Is it the rear legs, hips, pelvis or all the limbs? Did she rule out degenerative joint disease, luxating patellars, other bone problems? Did he ever have a previous trauma (like a bad fall, hit by car, etc)?

The diagnosis of encephalitis doesn't make sense to me, did you ever seek a second opinion or see another vet? Mites don't survive treatment, meaning the treatment she used was more than likely inappropriate, or that treatment was not done successfully or followed up on.

Did the vet ever refer you to a feline opthamologist?
..........Traci
wren
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Re: Old kitty going outside the box...

Post by wren »

I'll have her take a look at his paw during his treatment this evening.

Arthritis is his front legs (actually I guess it would be considered his shoulders). This is a recent diagonsis... he started getting treatment for the arthritis 12 weeks ago. She made a house visit because he was walking like he was 100 years old, and started limping ...he was barely putting weight his right front paw. She said that he probably came down on it wrong when getting down from his favorite chair, and that it aggravated the area. No x-rays were taken, she manipulated the legs and said she could feel the arthritis in his joints. A few days after the initial shot, he was walking normal again. He's never been hit by a car, or any thing like that.

Given that he's walking fine again, do you think he should still get an x-ray?

No, she did not refer me to a feline opthamologist. And, no I've not brought Guido to another vet for a second opinion. I'm partial to this vet because she's been treating my cats for many, many years, and because she is a feline only vet. If I were to get a second opinion, what area(s) should the new vet review? Eyes and arthritis, or ???

Update: I just called the vet to get the name of the drug she's been injecting: Adequan. The receptionist said that it's typically used for dogs and horses, but that it's gaining acceptance in treating cats.
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Traci
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Re: Old kitty going outside the box...

Post by Traci »

Yes, get xrays, you and the vet need to know the extent of the arthritis, and rule out other factors (i.e, DJD vs something else), and xrays should be done yearly or twice yearly to monitor for progression.

Adequan does not rebuild cartilage, it can however, help to slow the progression. Alsol, frequent blood monitoring is necessary while on this medication.

Ask your vet about maybe adding a proper fatty acids supplement with the diet. What are you feeding him? Is he overweight? Are you attempting to encourage slight exercise? Did your vet teach you how to gently massage the limbs, provide a proper bed, etc? (a kitty warming bed for example could be helpful when he sleeps at night or if he sleeps for long periods in the day)

I question the encephalitis "diagnosis", and why I asked if you ever got a second opinion on that. Just because you've been seeing this vet for several years, does not make her the expert. A feline opthamologist is exceptionally knowledgeable on eye diseases, and better equipped on how to treat them more effectively (to either slow progression, or to treat painful problems, prevent worsening of the condition, knowledge of effective treatments, etc -- followups are crucial).

Broken toe, broken tail, and limping. I have to ask, is his environment safe?
..........Traci
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