Wednesday, January 12, 2011

Inappropriate Elimination, Behavioral Techniques, and Prozac for Cats

In a previous post, I mentioned that we had litter box issues and aggression issues and that two of our cats were on amitriptyline, a psychotrophic.  I wanted to post an update.

To recap: I doubt your vet or cardiologist will let you put a HCM cat on any psych meds.  Hopefully your HCM cat isn't experiencing inappropriate elimination, that term used to describe a cat going out of the box on anything from your rug to your washer.  Yes, in our house we've seen it all. When one cat began last summer to not use the box all the time, it led to the others at some point to follow suit. 

Eventually, we had to give psych meds to two of our male cats-one because he was bigger and more aggressive towards the younger male and the other cats; and to the other because he was being bullied, was anxious, and not using a litter box all the time.  They were both receiving amitriptyline. The larger cat was getting 3/8 of a 10 mg. tab while the younger and smaller male was receiving a quarter tab. 

Before giving the meds to the younger male, we worked with him for weeks using various behavioral techniques:

1) It was recommended that I clean the house with orange cleanser and not with lemon or vinegar or anything with ammonia (and many lemon cleansers have ammonia) which I did and it seemed to soothe him.
2) We used Feliaway spray and plug ins-the spray acted as a deterrent on areas where he liked to go, and the plug ins created a soothing effect on both males.
3) We used catnip, first as a playtime activity but then I discovered that by scattering catnip over areas where he liked to go, it deterred him from going there. Yes, there was a slight mess, and yes, it was vacuumed up each week that I cleaned but it worked.
4) We scheduled bathroom breaks and used treats around the boxes and gave him treats for using the box. We tried to determine when he needed to go again and kept an eye on his behavior (when he wanted to go in a room he would sniff around so that was our clue.)  Granted, you can't schedule a cat bathroom break but we tried with much success.
5) We used wheat litter and added a wheat litter box to three rooms where there were boxes. We thought if he had negative associations with the clay (if he felt unsure around the boxes for whatever reason) maybe a new litter would not be associated with that fear and that actually worked.  He began to use the wheat litter without issue and eventually began to use the clay litter boxes without hesitation.
6) He had a routine and his own play time, and we alternated nights he slept upstairs with us while the other cats slept downstairs. 
7) I gave him treats around various areas of the house where he liked to eliminate and places where I didn't want him to go.  I had read that if you gave cat food in those areas, they will not go. So, I began spending time with him, tossing treats around the house. I tossed them into corners and his marked areas first. Then I put them on rugs and the stairs and on furniture. Tossing treats around the house also gave him exercise, time with us, and allowed him to associate those areas with something good and he stopped eliminating in those areas.

The results were good but didn't completely solve the issue. We still had incidents in October and the older male had drawn blood when he attacked the younger male. That's when we decided to put the older one on meds first. While that helped them both a lot, it didn't solve the younger one's problems.  So, in November, he went on amitriptyline, also.  That solved the majority of his marking/inappropriate out of the box elimination. We were down to only a handful of incidents in December. But still, towards the end of December, he would still mark and the meds seemed to make him a bit wonky-a bit dazed and confused.  We wanted to move him to Clomicalm because we had read that it had a higher improvement rate than amitriptyline even though it was the same class of drug (tricyclic.) But the vet recommended that if we were going to change meds, to change to Prozac especially if we thought he might need something long term.

So, first week of January we put him on Prozac. We had given him amitriptyline on Thursday night, and Prozac on Friday night. There was conflicting information about whether or not we should wean him off of the amitriptyline. We decided to go ahead with the Prozac and let them overlap if indeed there was any amitriptyline still in his system. We noticed that on Saturday, he was much less dazed looking in the eyes and was much more active than he had been.

But by Sunday and after, the Prozac kicked in and while he's using the box and so far, no marking issues, he seems a bit anxious, fearful and unsure of what we want when we approach him and only wants to be held or to cuddle part of the time. At other times, he's running and playing and active.  His appetite did change immediately-he stopped eating and we had to entice him with regular canned tunafish which he did eat. He has begun to eat his cat food again as well as the tuna. I can't find reliable information on the effect of Prozac on a cat outside of any health issues.  No one seems to have made observations about a cat's behavior while on Prozac, only the results (box use, stopped excessive biting or cleaning, etc.) 

The one good result is that he's not being aggressive towards Myrna, the HCM cat as he still was a bit while on amitriptyline. The vet said to give him weeks before deciding if we want to move him off of Prozac and back to a tricyclic.  The amount of Prozac he needs might need to be adjusted-less, more-too difficult to tell for now.

The younger male and his sister in the cat tree

1 comment:

  1. My cat has been on Prozac for about 3 years now due to inappropriate urinating. He was found to have anxiety and also after trying every step you mentioned above, Prozac was the final attempt. This worked great. My cat reacted well to it and was his usual loving and personable self. He only takes a 1/4 3 times a week and I put it into science diet wet food mixed with water and he gobbles it up. I always mix with water as the vet said Prozac can make cats dehydrated, so this way I know he's getting loads of water...along with his kitty water fountain he uses.

    He has just today been diagnosed with HCM and I had advised the specialist of the Prozac, which she advised would be fine to have with the Plavix and frusemide