Protocol for Cats With Elimination Disorders
From Overall: Clinical Behavioral Medicine for Small Animals

1. All affected areas must be cleaned with an odor eliminator.
2. After cleaning, cover affected areas with heavy-gauge plastic both to change the tactile sensation for the cat and to prevent further penetration in the event of elimination.
3. Encourage the client to use multiple litter boxes, generally one more than there are cats, unless there are more than five cats; large numbers of cats may render the stimulus too strong. These litter boxes should be placed in a variety of locations and be of a variety of styles (open, covered, deep, shallow, big, small).
4. Litter should be scooped daily, and most litters should be dumped totally every other day. The exceptions to this are the newer, clumpable litters; these do not have to be discarded as frequently but do need to be "topped up." Many cats differ in their preference for litter depth. Boxes should be washed weekly. Some old boxes may be so permeated with scent that they should be discarded.
5. A variety of litters should be offered to the cat in a variety of boxes. If the cat is using soft substances, consider softer litters: No. 3 blasting sand, playground sand, shredded newspaper or toweling, sawdust, or wood chips (not cedar). Many clients at the Behavior Clinic at the Veterinary Hospital of the University of Pennsylvania (VHUP) are now using recyclable, clumping litters with almost universally excellent results. Be creative and persistent. Consider trying one of the new trays where urine passes through rocks onto a pad below. Watch the cat and find out what works. Use this information to plot your strategy. Some cats prefer very little or no litter.
6. Cats are not trained to litter boxes; this is a behavior that develops in the absence of human intervention as kittens. Accordingly, a cat with an elimination problem cannot be trained to use a litter box; however, it can be encouraged to use a specific substrate by taking the cat to the litter box frequently, waiting with it, and praising it whenever it uses the box.
7. If the cat is observed squatting outside the box, punishment works if the cat is startled within the first 30 to 60 seconds of the onset of the behavior (that includes circling, facial expressions, and digging) and the startle is sufficient to make the cat abort the behavior and leave. Foghorns, water pistols, whistles, and tins of pennies all work with some cats. Foghorns are usually inappropriate in apartments, although clients derive much satisfaction from their use. Regardless, physical punishment, including rubbing the cat's nose in the soiled area, is useless after the fact and is potentially dangerous to the client and injurious to the cat during the act.
8. Some cats may need to be confined to a restricted area at first. If you do this, make sure that the cat has the same choice of litters and boxes mentioned previously and that you give much attention to the cat during its confinement. If the cat was very social beforehand, confinement must be arranged to meet the cat's social needs. If the behavior of the other cats in the household changes when one is isolated, this hints at a social problem that may need to be addressed as part of the treatment for the elimination disorder. Access to the rest of the house can be expanded once the cats are using litter appropriately in the confined area. It is important that the expanded access be closely supervised both because of the poten-tial relapses and because of potential social problems that may not have been previously recognized. A bell sewn to the cat's collar can act as a reminder that supervision is necessary. Access should be gradually expanded—do not give the cat free access to the entire house all at once after 6 weeks of confinement. If the cat has truly learned and demonstrated a preference for a litter or box style, this will be generalized to the rest of the house if the reintroductions are gradual. Remember that the number of boxes still must be maintained at the increased number and all cleanliness rules still apply.

Checklist

1. General
   • Scoop litter boxes daily
   • Dump litter at least every other day
   • Wash the litter box in hot, soapy water once a week; use no ammonia products, and make sure that the box is well rinsed and dried
   • Clean soiled areas with an odor eliminator; repeat and cover with plastic to prevent resoiling
   • Take the cat to the box often and praise for scratching and/or use of substrate (If this scares the cat, do not do it.)
   • Provide one more box than the number of cats
   • Change litter types, depths, and box styles
2. Location
   • Follow general instructions
   • Place a scent deterrent in the area (mint or deodorant-scented soap or something you know the cat dislikes)
   • Place food and/or water dishes on the spot(s)
   • Place a litter box on the spot
3. Substrate
   • Follow general instructions
   • Try different litters Types tried:
     1. ____________________
     2. ____________________
     3. ____________________
     4. ____________________
   • Try with and without litter box liners
   • Try covered versus open boxes
   • Try different depths of litter, including no litter