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Cat’s ills a diagnostic problem

Dear Dr. Spiegel, I have a neutered male cat who just turned two years. Last spring (`94), he was permitted to go outdoors. He loved it outside, but would run away to another home a couple of blocks away for some unknown reason most times when he was out. After awhile I decided to get him a companion as I didn't want him out anymore. I acquired another male cat who was about six months younger than he. After a short period both cats became compatible to each other. This new cat has also been neutered. I had both cats declawed five months ago. Neither cat seemed to mind the procedure. Now the oldest, "Teddy," has been straining to urinate and he also has urinated right in front of family members (on the floor) a couple of times. I brought him to the vet who gave him a prescription urinary tract cat food and valium pills to take. Unfortunately, the cat doesn't like the food. I am able to give him his pill twice per day. I do see a change in his attitude... more friendly toward everyone. I had tried to monitor his urine habits but after a few days gave up as nothing was showing in his litter box. I have searched the basement where I kept him for four days and had not found any urine. I finally let him return to the upstairs of the house figuring because of his change in attitude and his playing with his companion, he is feeling better. My concern is this urinary tract thing. What else besides special diet food can be done in a situation like this? My vet said sometimes it's just a behavioral problem and I'm hoping by keeping him on valium he will be okay. What other solutions are there? Sincerely, I. M., Wilmington

Dear I.M., For every problem there is a solution; but until you know what the problem is, any attempts at solving it is merely a guessing game. Accurately diagnosing elimination problems takes a significant amount of time (for me, usually 40-60 minutes). It must first be determined whether the problem is medical or behavioral. Behavioral causes of urination problems in cats is very common. However, ruling out an underlying medical problem is the best first step. This can usually be accomplished simply by having your veterinarian perform some laboratory tests collectively known as a "urinalysis" (short for urine analysis). History can also provide information to aid in this distinction. When urination problems in cats are behavioral, there typically is no change in the normal urinary frequency or volume. When there is an underlying medical cause, there is usually either an increase or decrease in urine volume and/or an increase or decrease in frequency of urination (depending on the problem). The sole exception of a behavior problem where such changes exist is with urine marking, in which case very small amounts of urine are produced (frequency can vary). Urine marking can, however, be easily recognized. These cats back up against vertical objects, remain in a standing position, lift their tails strait up, and shoot urine backwards against the object. The diagnostic fun does not end there, because this posture can also be taken by cats who have an aversion to one or more aspects of their litter box. Hence, diagnosing and ultimately deciding on effective treatment for elimination problems in cats is significantly more complex than the question that is typically posed to myself and most other vets, "My cat isn't using his litter box. What should I do?" In your particular situation, I.M, the cause of Teddy's problem is by no means clear from your letter. Much of the history, "recently going outside," and "new male cat in the house," might lead one to begin thinking of a urine marking problem. But probably more telling than all else was your choice of the word, "straining," which is usually characteristic of F.U.S. (feline urologic syndrome). This can be a partial or complete obstruction of the urethra, which causes cats to strain to urinate, and often occurs out of the litter box. When straining occurs with no urine being produced, this constitutes a medical emergency and immediate veterinary attention should be sought. Valium can be very effective in cats which urine mark. Specially formulated diets can be very helpful for some medical problems, including F.U.S., but these two treatments usually don't go together unless there are two concurrent problems. And while most medical and behavioral urination problems in cats are correctable through a variety of treatment modalities, accurate diagnosis must come first.