Elmo is a big, sweet, 14-year-old cat. His owners brought him to my clinic for several issues, but one of his problems was eliminating outside of his litter box. Elmo used to use his box, but over the past months, his behavior had changed, and this was causing his owners to become very frustrated with him.

Elmo shared his box with another cat, and the owners assured me that the box was scooped several times a day. The box was located in the garage and had a cover.

One of Elmo’s other problems was having trouble walking. I wasn’t surprised by this since, unfortunately, Elmo weighed almost 21 pounds.

I examined Elmo, ran some lab work and took x-rays. I wanted to be sure that Elmo didn’t have any urinary tract disease or diabetes. I needed to know about his internal health and ability to handle medications so I could treat him properly and, hopefully, improve his comfort and behavior. X-rays of Elmo’s elbows showed arthritic changes, and x-rays of his spine and hips showed arthritis and degeneration in his lumbosacral region –where the spinal cord ends and many important nerves that control the back legs, urination, defecation and the tail are found.

Lab work did not reveal any bladder infection, kidney disease or other significant problems found in senior cats. The diagnostic results indicated that Elmo had arthritis, possible nerve root compression (in which the material between vertebrae push on a disc, causing pain), and behavioral house soiling. I believed that Elmo was in pain and he had decided that it was too hard to get to and use his litter box, so he was urinating and defecating where he was more comfortable – everywhere else in the house.

I discussed these findings with Elmo’s owners. We started him on some oral anti-inflammatory medication. I wanted to decrease his joint and spinal pain and see if we could get him moving more comfortably. I also believed that Elmo could not physically fit into his current litter box. The combination of his size and arthritis were making a traditional covered litter box impractical for him to use. Cats need to easily posture when they eliminate, and will do so where they are most able. In Elmo’s case, this was all over the house.

Fortunately Elmo didn’t have to go through a pet door to get to his litter box in the garage, and his owners were keeping it clean. To make his box easier to use, it needed to be significantly bigger. Studies show that cats need a box that is about 1.5 times the length of their bodies in order to comfortably “assume the positions” needed to eliminate. Elmo’s owners got a plastic sweater box to use as a litter box and this and the pain-relieving medications have so far taken care of his inappropriate elimination issues.

Since Elmo was showing improvement with two of his health problems, I recommended that we next work on his size. Elmo’s ideal weight is about 13 ½ pounds, so he is more than 7 pounds overweight. Although Elmo was on a “light” diet, his portions were not being controlled. It is impossible to get a cat to lose weight without strict portion control. Free feeding of dry food, even the least caloric types, will never lead to proper weight management. He was also eating some canned food, but I thought this was good since it was increasing his fluid intake. I made a portion-measurement plan for both cats in the home to share, and I hope to see some weight loss success at Elmo’s next visit.

Elmo will need to continue anti-inflammatory medications to control his arthritis pain, and we may need to make some adjustments in the future. I was very happy that being more comfortable and having an appropriately sized, clean and accessible litter box had solved Elmo’s bad behavior problem.

Studies have shown that more than 80 percent of cats over the age of 14 years have some arthritis. Overweight cats of any age are more likely to develop arthritis. If you have a senior or overweight cat that stops properly using his litter box, have him checked for arthritis and be sure to provide a box that he can comfortably use. Most litter box problems can be fixed with early intervention and proper assessment of the cat’s health and behavior.

Written by Dr. Wexler-Mitchell of The Cat Care Clinic in Orange, CA
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