Litter Box Laments

One of the most common problems people experience with their feline companions relates to use of the litter box. Or more specifically, non-use of the litter box! Many people automatically assume that urination or defecation outside the designated litter box indicates a spiteful behavior change in their cat. On the contrary, many toileting problems in cats stem from medical conditions. In fact, the only way to prove litter box avoidance is a behavioral problem is to rule out systemic disease.

Posture of a cat straining to urinate,
a medical condition requiring
urgent attention.

Today's blog is not about litter box avoidance due to urinary tract infections, bladder inflammation caused by crystals or stones, irritable bowel syndrome, or systemic disease (such as kidney failure or diabetes). These often treatable conditions are diagnosed by urine, stool or blood tests and imaging studies (e.g., "x-rays," ultrasound) and should always be considered if a previously well-trained feline starts "having accidents" around the house.

So what if your cat truly has a behavioral condition that causes him to abandon the litter box? Cats are fastidious creatures. If something about their litter box is not to their liking they may simply stop using it. My clients often protest that they "haven't changed a thing about the litter box yet suddenly their adult cat won't use it!" A veterinarian professor of mine put it like this: a toddler in toilet-training has no qualms about dropping her pants on the side of the road to use her potty chair when the urge hits, but a teenager wouldn't dream of it! Likewise many cats will tolerate less than ideal litter box setups for years before one day demonstrating that "enough is enough" by peeing or pooping in a preferred location.

Unfortunately what seems like a great litter box set up to the pet owner may be repugnant to the kitty. Consider the following:

Hiding a litter box in a planter seems like a good idea to a
person but breaks Cat Rule Number 1.

1. Your Personal "Porta-Potty." Would you really accept a "Porta-Potty" as a replacement for your home's spacious bathroom complete with ventilation fan? A covered litter box is the equivalent of a public portable toilet. Your meager human sense of smell recoils at the ammonia odor trapped inside. Just imagine how your feline's exceptional sniffer responds!

2. Grand Central Station. For some reason whenever I think about overflowing litter boxes I recall Weird Al Yankovic singing about cleaning "all the bathrooms in Grand Central Station with [his] tongue" in his anti-love song "One More Minute". I'll bet some of you have backed out of a filthy public restroom with a full bladder. I've even met people who won't use an otherwise clean but unflushed public toilet! Is it any wonder then that your cat would rather urinate on a rug than in a litter box that has old waste in it? Litter box waste should be scooped at least daily. The entire box may need to be emptied, cleaned and refilled every one to two weeks.

3. A Very Brady Bathroom. Imagine six kids sharing one bathroom. The inherent conflict is the stuff of which classic Hollywood sitcoms are made! Why then do we think six cats should be forced to share one litter box -- even uncovered and kept immaculately clean? The rule of thumb for litter boxes is "one litter box per cat plus one." Therefore, if you have two cats you should have three litter boxes. And if you're doing the math that means a single cat household should have two litter boxes! To reduce potential inter-cat drama these multiple litter boxes should not be lined up in a row like stalls in a high school lavatory. Also, try to place the boxes on different levels of the home. After all, how would you like to trek from your upstairs bedroom to the basement bathroom in the middle of the night?

Admit it. The basement can be a scary place.
Even for cats -- especially if their only bathroom
is right next to a hissing water heater.

4. Location, location, location. Toilets do not belong in the kitchen. Avoid placing your cat's litter box right next to where you feed him or where he sleeps. (A possible exception to this rule is for the cat who is being nursed through a weakening illness or post-surgical recovery.) A popular spot for the litter box is the basement or mechanical room.  All it takes is the sudden whoosh, whir, or clunk of a furnace, washing machine or other appliance to scare the bejeezus out of a cat settling down to business, and there you have it -- a future litter box avoider.

5. More on the Super Sniffer. Pysch's Burton Guster is not the only one with an exceptional sense of smell. Scent-sensitive people abound. I've had clients whose pet's file was flagged with the note "Remove air fresheners from room prior to appointment! Allergic!" The average cat's sense of smell is said to be about 14 times as strong as the average human's. The "extra fresh" odor controlling kitty litter that appeals to you may knock the socks off your cat. Research shows that most cats prefer soft, sandy litter with no added smells. In fact, any change in litter away from what your cat prefers can cause litter box avoidance. You can skip plastic pan liners (most cats hate them) but make sure you keep 1 to 1-1/2 inches of litter in the box (more is not better here).

6. It's a Cat Thing. When we put ourselves in our cat's "shoes" it is easy to see how the cleanliness and location of litter box can positively or negatively affect his willingness to use it. But some litter box problems stem from feline feelings with which it is hard to identify. For example, most of us do not urinate on objects to claim ownership of them. Nor do we tend to urinate in odd places just to get someone's attention. Territorial scent marking, especially by intact male and female cats, can flare up with the introduction of a new pet, with changes within an established feline family's social structure, or even with the visitation of an outdoor stray merely seen, heard or smelled outside the window! Some cats reportedly urinate or defecate outside the box while staring pointedly at their person as if to say, "Hey, there is something wrong here. Get me some help." It's hard not to get mad, but take a second and listen to your cat when this happens. Then call your veterinarian on his behalf.

An entertaining and enlightening resource for additional litter box management tips is The Fastidious Feline: How to Prevent and Treat Litter Box Problems by Patricia B. McConnell, Ph.D.

How to Choose a Puppy

Preparing to welcome a new dog to your family is an exciting time. Regardless of whether you will be searching shelters or interviewing breeders, it is important to do some research on what type of dog will mesh best with your lifestyle.

1. Puppy or adult? Adopting a puppy allows you to choose a dog with a temperament best suited to you and puts you in control of his early education. However, puppies require a lot of time, training and patience. If you do not have a lot of time for housetraining, socialization and obedience work, adopting an adult dog might be a better choice.

2. Breed: This is a very important consideration that requires careful thought and study. Many types of dogs have been specifically bred for certain habits and temperament. You and your future dog will be happiest if  you share common interests. For example, if you are a confirmed couch potato, a high energy border collie is not a great choice. Consider also the anticipated adult size of the canine candidates. If you live in a studio apartment, a St. Bernard puppy may not be a good fit for long!

Meet and interact with each of the puppies in a litter
to determine each pup's temperament.

3. Temperament: A dog's temperament is his personality. When selecting a puppy from a litter, observe how he interacts with his littermates. A confident puppy--who stands over or chases the others--is more likely to be strong-willed and dominant as an adult. The puppy hiding in the corner is more likely to have anxiety later on. A puppy who plays easily with his littermates, but happily follows you around when removed from the litter is a well-adjusted puppy.

If you are considering a shelter or rescue dog, find out as much as you can about his history and socialization. How does he interact with volunteers and other dogs in the shelter? How does he behave during feedings, on walks, in the kennel, when groomed?

The important thing to remember about temperament is that it is an innate part of the dog's personality. Training will NOT change his personality, but his personality will affect the type of training he will need.

4. Age at Adoption: Sadly, some very serious behavior issues stem from removing a puppy too early from his mother and littermates. Just because a puppy is weaned and eating dry dog food does NOT mean he is mature enough to leave his mother. Essential neurological and social development occurs during and after the time of weaning. Pups that leave the litter before they are 8 weeks old are at much higher risk of being fearful and anxious. Trainer Maryna Ozuna describes Five Week Puppy Syndrome for International Association for Canine Professionals Safe Hands Journal (Winter 2009-10):

• excessive mouthiness
• lack of bite inhibition
• hard biting at extraordinarily young ages
• lack of tolerance to sensory stimulation: touch, noise, visual confusion
• lack of tolerance about most anything in general
• lack of ability to generalize
• slowness of learning
• difficulty sequencing concepts and learning
• lack of bounce back
• easily confused
• highly vocal when upset or confused
• high startle response (startles easily and extremely at low stimuli)

The "piling" of puppies seen here is crucial to the normal
neurological and social development of the dog. Taking a
puppy from the litter before 8 weeks old can hinder
proper development leading to anxiety, aggression and
training disabilities.

In recent months I have met two puppies who fit this bill perfectly. One is a Brittany Spaniel who joined his human family at the very tender age of 5 weeks old! His owners complain that he is strangely and annoyingly vocal. He strongly resents affectionate touching, especially around his face. The other pup is a Visla who, though only a few months old, bites his humans extremely hard and viciously. He too is very vocal.

If these symptoms describe your early-adopted dog, don't despair. A good trainer or behaviorist can help you recondition your dog through appropriate handling, careful exposure to stimuli and tolerance training. Sometimes early separation from the mother dog is unavoidable due to her serious illness or death. However, if you are interviewing breeders and they routinely send pups home before 8 weeks of age, look elsewhere or insist the pup stay with the litter and mother longer.

5. A Word About Runts: My veterinary clients frequently report to me that they intentionally sought out the runt of the litter. While a Fern-like* desire to nurture the smallest, weakest animal is admirable, it can lead to heartache. Many times the runt of the litter is tiny because there is something physically wrong with it. Congenital liver, kidney and heart conditions, for example, can cause stunted growth and decreased vigor. While certainly every dog deserves a loving home, be prepared if choosing the runt for the increased possibility of  intensive, costly veterinary care and/or a shortened life span.

It is very difficult to overcome our emotional and psychological tendencies to choose a puppy based on it's visual appeal or antics. A little ball of fluff with mournful puppy dog eyes is hard to resist. For this reason, it is nearly impossible for some of us to visit a shelter or litter without bringing home an unplanned companion. However, it is essential for the health, happiness and well-being of your future relationship with your pet to choose wisely.

* In the classic novel Charlotte's Web by E.B. White, the heroine Fern saves runt piglet Wilbur from certain death and he grows up to be "Some Pig."

Back to School and Learn to Earn

It's that time of year again. The nights are getting cooler and coming earlier. Crickets are singing their late summer song. The Packer pre-season has begun. Back-to-school advertisements paper the kitchen countertop. Summer vacation is officially winding down and school is right around the corner again.

Obedience training my now six-month-old puppy has been on ongoing project, of course, but with another academic year looming, it seems appropriate to discuss his curriculum.

I am often asked by frustrated or anxious clients how to correct certain behaviors in their dogs. The basis of all canine training, I believe, is deference training. Also known variably as the "learn to earn" or "no free lunch" program, deference training is essentially doggie etiquette training. But like most animal training techniques, training ourselves is often the first step! Before launching any training method, thorough research into the philosophy and techniques is necessary.

Dogs sitting patiently and attending to their trainer
for a command

Timing, consistency, and attentiveness are at the heart of successful pet training programs. Deference training, done correctly, teaches even a young puppy that good things come to those who sit and wait patiently. Nothing the puppy needs or desires comes without a price. The price is not exorbitant for him, however. It is something all dogs learn early on--sitting.* The dog's meals, playtime, potty breaks, even walking through a doorway should be given only when the dog is sitting calmly and attending to you.

My puppy Guppy is expected to top 80 lbs when full-grown. It was bad enough having him barge the door when he weighed 30 lbs, but as he grew it was becoming incredibly obnoxious if not downright painful. With just a day of training, Guppy learned that the only way he was going to enter the house was if he sat nicely and watched me. Now Guppy sits at the door without any prompting on my part. Guppy also must sit nicely before he receives his meals or before he gets petted.

Deference training even helped us work through some minor food aggression problems with our late Springer Spaniel GrrrD. She was so protective over her food bowl (even empty) she made us nervous for our little kids. We overcame this irritability by having her sit nicely under our supervision while our child poured her dog food into the dish. Our child was the one who gave the "GrrrD, OK" release command to eat as well. Soon she came to realize that, though small and newer to the family, our child controlled a very dear resource--her kibble--and was to be respected (at least in this matter).

A dog learns respect for his owner and acts in accordance with her wishes because doing so benefits the dog. It's much like a star employee doing a great job not from altruism but because he knows doing so guarantees his paycheck. Pinning a dog to the ground like some kind of mutant "alpha dog" does not create an obedient dog. It creates confusion (dogs are smart enough to know you are not a dog) and potentially fear aggression.

I like many of the pet behavior resources listed on Dr. Sophia Yin's website, and here is a link to her discussion on Learn to Earn. Some dogs graduate from basic deference training to advanced programs to learn how to become search-and-rescue dogs, guide dogs, etc. But even if your dog just learns to mind his manners in certain situations (e.g., not jumping on visitors, not lunging at other dogs on walks, not barking incessantly at the cat) it is worth the little bit of effort deference training takes.

Teaching a dog to sit

* Teaching a dog to sit can be as simple as saying the word "sit" (once, not a thousand meaningless times) while holding a delectable treat over his head and then moving it backwards over his neck. Most dogs will be so "into" the treat they will naturally sit down in order to keep it in view. Eventually the dog will associate the word "sit" and your hand motion with the action of sitting, doing so on command even without a real treat. 

Weathering the Storm: Managing Noise Phobias

The recent thunderstorms have brought more than just a lot of rain to my Wisconsin community. My veterinary office has been flooded with calls from anxious owners wondering what can be done for their thunderstorm phobic dog.

Fear of thunderstorms and other loud booming noises like gunfire and fireworks is fairly common among dogs. Unfortunately, like most anxiety issues, this type of fear can worsen with time and age. The phobia is stressful for both the pet and the owner. Sometimes it is downright dangerous for the dog if he becomes destructive or escapes (thinking of Winn-Dixie here)! 

There are many reasons why some dogs react so negatively to storms and loud noises.  A dog's superior sense of hearing means these noxious sounds are louder and noticeable from even a great distance.  Your family may change routine when a storm is approaching. Anxiety or irritability among the human family members can feed your pet’s fear.  Noise phobia symptoms have varying degrees of severity and can be managed with a variety of tips and techniques.

DO

• keep your pet indoors during a thunderstorm and fireworks.  Many fearful dogs have been lost when they ran from their yards in terror during storms and fireworks.
• keep your pet in an interior, windowless room to reduce his exposure to the noise and light triggers behind his phobia.
• turn up the stereo or television to drown out some of the outside noises.
• provide toys, games, treats and positive interactions during a thunderstorm or fireworks to help distract your pet and to create as positive of an experience as possible.
• try to have someone with your dog so he does not feel abandoned. 
• consider an over-the-counter natural pet anti-anxiety supplement. Many of my patients have experienced lower stress levels during storms, fireworks, travel and in general thanks to natural supplements (ask your veterinarian for suggestions).
• consider using a Thundershirt as another alternative to medications. I love this "technological advance" for anxious animals, although the technique is old as the hills. Like swaddling for colicky babies or Temple Grandin's homemade squeeze chute for self-calming, the Thundershirt appears to provide security and comfort during stressful situations. 
• ask your veterinarian for additional training advice or specific behavior modification techniques (such as protocols to desensitize the dog to the sounds of a thunderstorm).  
• consult your veterinarian to determine if your pet would benefit from behavior modifying or anti-anxiety medications.

DON'T

• punish your dog when he is scared. Punishment only confirms to him that there is something to be afraid of and make negative behaviors worse.
• fuss, pet or try to reassure your dog when he is scared. By speaking in a high-pitched, soothing voice and lavishing extra attention on your dog you are unwittingly rewarding and reinforcing the fearful behavior. 
• be tense during storms.  Be upbeat and act normally so your dog picks up on your body language and emotions and becomes more confident during storms.

Your dog may never enjoy a good thunderstorm or thrill at a fireworks display, but with consistent, gentle behavior management I hope that you will be able to once again.

Your Pet Pooped on the Floor: Why Your Vet Can't Assume It's Behavioral

Here's the scenario. A family adopts two "teenaged" spayed female cats from the shelter. These two teeny boppers are welcomed into the household by the older neutered male cat and the family's dog. The introduction appears seamless. The new kitties cuddle with the labrador and cavort with the cat. But someone has pooped on the couch! And the rug! The owners know it's one of the cats but which one? Is it Mister, latently unhappy about sharing his digs? Is it one of the new kitties, unsure of her surroundings or just reveling in her new freedom to go where she pleases? The poops are pretty normal looking, so it seems like a behavioral issue.


As the family's veterinarian, my first response is "we gotta get a stool sample and run some tests." The only way to diagnose a behavioral toileting problem is to rule out medical causes first.  


"But how will we know whose poop is whose?"

Sometimes that matters and sometimes it doesn't. I like to run the fecal tests on the aberrant stool...one that's softer or yuckier than most or the one that's been deposited where it doesn't belong. The owner of the stool-- when we're talking cats--usually doesn't matter if the problem is infectious or parasitic. Because cats generally share litter boxes we assume that if one of them has worms (for example) they all have worms and all need to be treated accordingly.

Before long I was in possession a fresh sample from one of the new kitties. When evaluating a stool sample for abnormalities, the first test is simple observation. Yes, it's gross, but what does it look like? How does it smell? Sometimes we'll probe the sample with a be-gloved hand checking for foreign material or worms, but 3 out of 5 senses is as far as it goes! This sample happened to be soft but formed with a portion being slightly runny. 

In my veterinary practice a complete fecal test includes a smear, a float and a Giardia "snap" test. These in-house tests identify the most common causes of inappropriate defecation and outright diarrhea.

The fecal float is the test most well known. This checks for parasites such as worms and Coccidia. Coccidia are a species-specific protozoa that commonly affect young or immune-suppressed pets. As for worms, most animals with light worm loads do NOT have worms visible in their stool, so please don't get a false sense of security that your pet is worm-free just because you see no worms! The fecal float helps us identify intestinal worm infestations by showing those worms' eggs. If the worms inside the pet are not reproductively mature or simply not shedding eggs on a particular day, this test may be falsely negative for worms.

The fecal smear helps identify a bacterial overgrowth of the intestines. Every normal gut has a mixture of beneficial bacteria that help digest the food and provide essential nutrients. A wide variety of internal or external factors can destroy this delicate balance and cause abdominal discomfort and/or diarrhea. Luckily most abnormal findings on the fecal smear are not contagious to other pets and people.

Meet Giardia

The final part of the complete fecal test a Giardia "snap" test. This is a highly accurate test to identify active Giardia infections. Giardia is a contagious and zoonotic (i.e., affects people) protozoal parasite that is  common in the environment. The parasite unfortunately also rears its ugly head in shelters and breeding facilities from time to time.

Lo and behold, while the first two tests showed no significant abnormalities, the kitty's Giardia test was an obvious positive. Wow! Even though the kitty's stools have appeared pretty normal, she has an infectious and contagious medical condition. This is the most likely explanation for poop on the couch and rug, NOT a behavioral quirk. 


The good news is this kitty has a treatable medical condition rather than a behavioral problem. The bad news is all the dogs and cats in the house need treatment because of their close quarters. Shed in the feces, Giardia cysts (i.e., eggs) can remain viable in the yard, litter box, bedding and pets' fur and cause re-infection, so a thorough environmental scouring is necessary. The pets were bathed, their bedding and litter boxes washed, and the yard picked up. Each pet is currently undergoing treatment for Giardia to be on the safe side. The owners have been warned to practice good hygiene when handling the animals and to contact their physician for further advice regarding the zoonotic nature of this parasite.


It is said time and again in veterinary school, "You miss more by not looking than by not knowing." Even though the stool appeared normal and there were plenty of possible explanations for the couch poop, we discovered an important medical problem with our thorough test. Thank goodness we checked! And I'm sure the owners will feel the same way after they've completed a hellish week of medicating three feisty felines!