Sunday, July 24, 2011

More Notes from July 2011 St. Louis AVMA Conference-UTI

These are papers from the July 2011 St. Louis AVMA conference.  I’ve edited them to delete some of the vet only jargon and for space considerations.  If you see (…) that means that information has been deleted due to these considerations.  The ones listed here include HCM, and other heart related papers, treatments, papers on x-rays and echos, thrombosis, kidney disease, idiopathic cystitis, pain management, anesthesia and cardiac disease, supplements and other hazards for pets, and some other basic information I hope is helpful.

Interrelation of Behavior and Lower Urinary Tract (and other) Disease in Cats

C. A. Tony Buffington, DVM, PhD, DACVN

Professor of Veterinary Clinical Sciences

The Ohio State University Veterinary Medical Center


The American Veterinary Medical Association advises cat owners in populated areas of the

United States to house their cats indoors. With this authority comes the responsibility to

provide conditions that sustain good health and welfare for these cats.  Cats appear quite

capable  of living indoors, occasionally even in rather high  population densities, especially

when resources are abundant.  Cats are captive in these environments however, akin to zoo

animals.  And as with zoo animals, cats’ health and welfare may be affected by their

surroundings.  Cats retain their natural investigatory  and communication behaviors, such as

scratching, chewing, and elimination when  we  bring  them  indoors, and sometimes display

undesirable behaviors when deprived of appropriate outlets for their expression.

We recently reported on the effects of unusual environmental events on sickness behaviors

(SB) …in the vivarium of The Ohio State University  Veterinary Teaching Hospital.  SB

referable to the gastrointestinal and  urinary tracts, skin, and behavior were recorded by a

single observer (JS) for 77 weeks.  Four instances of UEE; changes in caretakers, vivarium

routine, and investigator interactions were identified  during 11 of the 77 weeks.  No instances

of UEE were identified during the remaining 66 weeks, so these were considered  control

periods. We found  that the relative  risk of SB was significantly higher in cats with  FIC than in

healthy cats during control periods, although prevalence was quite low, and the distribution of

SB was similar between groups.  Three SB, upper gastrointestinal tract expulsions (food, hair,

vomit), and decreased litter box use and food  intake, accounted for 88 and 78% of total SB in

healthy and affected cats, respectively during control periods. All groups showed a significant

increase in SB associated with UEE…These results demonstrate that the environment of cats

may adversely affect  their health and welfare.  

Effective enhancement and treatment of the environment requires an accurate assessment

and diagnosis; which depends on a pertinent history and physical evaluation. We take a

similar approach to effective environmental enrichment.  For enrichment, a pertinent history

means identification of features of the cat and environment that may precipitate the observed

problem.  Physical evaluation means determination of the presence and quality of physical and

behavioral resources available to the cat…These questionnaires are designed to evaluate the environment

 and to investigate problem behaviors when noted…one can methodically investigate each environmental system – physical resource, nutritional, social, and behavioral - to identify any features that may benefit from improvement.

Aspects of the environment can be organized into 5 basic “systems…

The Physical Resource System (“Space”)

Creating a physical environment that ensures a reasonable level of safety, certainty, and

predictability provides the foundation of enrichment.  A living space that keeps the cat free

from fear and distress, and that provides a predictable daily routine over which the cat

perceives it has some control, is the starting point.  Indoor cats need  unrestricted access to

resting areas where loud noises, dogs, other cats, outdoor animals approaching  the windows,

and pursuit by small children, are minimized.  Cats also need  perching options throughout the

household  that offer safety and a decent vantage point above people and other animals.

Because of their heritage as both a predator and a prey species, climbing for observation and

safety are natural domestic cat behaviors. Owners of multi-cat households need to provide

enough space to permit each cat to keep a social distance of at least 1meter (horizontally as

well as vertically) when they share a room.  Some cats within the same household rest

together and groom/rub each other, whereas most cats use common resting, perching, and

hiding locations at different times of the day.  Hence, it is important to provide multiple safe and

comfortable options for them to avoid  competition for these  resources.

One means of providing cats with secure “micro-environments” is to create “safe havens” -

refuges from household stressors for each cat in a separate room or space in a quiet area of

the home. An example of this approach is called “Free Access Crate Training (F.A.C.T.).

Fresh food and water, clean litter boxes, appropriate scratching substrates, rotating toy

choices and comfortable resting and perching sites can be provided in this area.  Electronic  cat

doors can be installed to allow access only to the individual cat wearing the door-activating

collar.  In the authors’ experience this option has been helpful when there is conflict between

household cats, or dogs in the household from which a cat may need complete escape.

The Nutritional System (“Food and Water”)

Although food  resources may adequately satisfy cat’s nutrient needs, they may not promote

expression of normal hunting (exploratory) behaviors. Meeting nutrient needs in ways that

best mimics cats’ natural preferences provides additional enrichment.  Kittens can display

strong food preferences based  on foods they encountered with their mother, although these

can change with by experience in adulthood. Cats also sometimes show decreased

preference for foods that have formed a large part of their diet in the past, the so-called

“monotony effect”, and display preferences for novel diets.  Despite these observations, some

owners perceive their cats to be “finicky eaters.  Our recent evidence that food refusal occurs

commonly in cats exposed to environmental threat suggests that such  factors may affect

owners’ perceptions.  Cats also may be more interested in novel foods offered in a separate

container next to the usual food.

Because cats evolved as solitary hunters of small prey, separate feeding containers out of

sight of other cats’ containers facilitates “solitary” feeding that cats may perceive as “safe”.

Locating bowls in quiet areas, away from appliances or machinery that starts unexpectedly and

protected from interruption by other animals, prevents the cat from being disturbed while

eating.  Cats with free access to food usually prefer to eat several small meals per day as

opposed to 1-2 large meals, and most will hunt for prey when given the option.  Although free

access to food permits frequent feeding sessions, it does not require the cat to express its

natural predatory instincts. This situation deprives the cat of mental and physical activity,

which may contribute to development of obesity and other health problems.

One can accommodate cats’ natural eating habits, and increase their daily activity, by offering

food in puzzle toys, such as balls or other devices designed specifically for cats to release dry

food or treats when physically manipulated.  Other options include hollow  toys that can be

stuffed with wet food, which require cats to work to remove the contents. For cats that can

benefit from increased moisture content in their diets, consider offering wet food daily and (or)

multiple fresh water options.

The Elimination System (“Litter boxes”)

Appropriate litter box options are another important aspect of cats’ environment.  Elimination

occurs by pre-elimination digging, elimination posturing, and post-elimination digging and

covering.  Large, open boxes, such as plastic storage containers, located away from food and

water bowls, provide distinct spaces for these normal behaviors.  Self-cleaning litter boxes

offer increased  cleanliness, although cats who find  their sound and movement  aversive may

avoid them. Covered litter boxes may trap odors and prevent the cat from having a safe

vantage point  for the approach of other animals during elimination, making them a less

desirable option for many cats.  As with feeding containers, litter boxes should be located in a

safe, quiet area, away from  machinery.  In multi-cat households, provide a box for each cat,

plus one additional box, each out of sight of each other. Most cats display a preference for

unscented and finely particulate litter material, making clumping litter a desirable option.  Avoid

plastic liners if possible, which many cats with intact claws find aversive.  Scoop boxes daily,

and empty the contents fully and wash the box with mild, unscented soap and water weekly.

The Social System (“Social Contact”)

The social system of pet cats includes all animals that share their home space. These may be

perceived as threats (dogs, humans), competitors for resources (other cats), or prey (small birds,

fish and “pocket pets”).  Let the cat determine the timing and duration of contact with non-prey

species to enhance the cat’s perception of control.  Some cats may prefer to be petted and

groomed, whereas others may prefer play interactions with owners.  Cats housed in groups do not

appear to develop distinct dominance hierarchies or conflict resolution strategies to the extent that

some other species do, often attempting to circumvent agonistic encounters by avoiding others or

decreasing  their activity.  Unrelated cats housed  together in groups appear to spend  less time

interacting  with conspecifics  than related ones do.  Cats without close affiliative relationships

prefer to have their own food, water, litter box, and  resting area resources out of sight of other

cats’ resources to avoid competition for resources, and to permit cats to avoid unwanted

interactions.  Published guidelines for introducing new cats into a home are available for clients

wishing to add additional cats to their household.  Inter-cat conflict commonly is present when

multiple cats are housed indoors together and/or when health problems are present. Conflict

among  cats can develop because of threats to their perception of their overall status or rank in the

home, from other animals in the home, or from outside cats. Signs of conflict between cats can be open or silent. Signs of open conflict are easy to recognize; the cats may stalk each other, hiss, and turn sideways with legs straight and hair standing on end up to make themselves look larger.  If neither cat backs down, the displays

may increase to swatting, wrestling, and biting.  Silent conflict result in the threatened cat

spending increasingly large amounts of time away from the family, staying in areas of the

house that others do not use, or attempting  to interact with family members only when the

bullying  cat is elsewhere.  Cats become socially mature between 2 and 5 years of age and

start to take some control of social groups and  their activities, which can lead to open conflict.

The cats involved in the conflict may never be “best friends”, but they usually can live together

without showing signs of conflict or conflict-related disease. Severe cases can be referred  to a

behaviorist for assistance.

The Behavioral System (Body Care and Activity)

Natural cat behavior includes scratching, chewing, and playing, which can be undesirable to

cat owners when they occur on valued household items. One can avoid  owner frustration by

introducing appealing alternative items such as sisal covered  posts or real bark-covered  logs

that allow the cat to hook its claws in the material.  Cats tend to scratch on prominent vertical

objects in areas where they spend much of their time, and scratch more often when stretching

after periods of rest or sleep.  Placing scratching objects in frequently visited areas of the home

and in proximity to preferred resting places will promote use.

Undesirable chewing can be avoided by offering “cat-safe” plants and grasses such as live

planted greens and fresh catnip.  An owner can rub the designated “cat plants” with tuna juice

or wet cat food to encourage investigation and chewing.  Household  plants should be clearly

separated  from the cat’s core area (household location or room(s) where cats spend the

majority of their social, resting, and feeding time), and/or marked with bitter-tasting sprays to

make them less appealing. Remove toxic plants from the household, or keep them in a “catsecure”

room.  Other chewing options include moistened  rawhide chews, dried fish, and beef

or poultry jerky.

Appropriate outlets for play comprise an essential aspect of any enrichment program.  Play

behaviors mimic the natural predatory sequence of stalking, chasing, pouncing, and biting.

Cats also enjoy play with items they can pick up, toss in the air, and pounce upon. Discourage

clients from permitting play and biting behaviors with hands and feet, which can teach the cat

that it is rewarding to stalk, pounce on and bite the owner, leading to play-related  aggression

problems.  Appropriate play outlets include wand  toys, battery-operated, self-propelling  toys

that mimic prey, balls inside a box or bathtub, and catnip-filled toys. Rotate toys every few

days to maintain novelty and interest. Window perches for wildlife observation and  cat oriented

DVD programs also can provide useful forms of play enrichment and entertainment.

Making Changes

Whenever a change in a resource, space, food, litter, etc., is contemplated, offer the new

resource adjacent to the familiar resource to permit the cat to display its preference for the new

resource. If preferred, it will be used; it not, it will be avoided. Resources imposed on a cat

that it does not prefer to the familiar only serves to create an additional stressor in the cat’s

environment. Cats have a variety of unique behaviors and needs; thorough investigation into both the

physical and social environment is crucial to permit an accurate diagnosis of the quality of the

environment and an effective treatment plan to correct any deficiencies. Further information

about environmental enrichment for indoor housed cats is available at:

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