By Sophia Yin, DVM
In a previous blog article, I talked about cats pooping out of place (What to do when your cat poops outside the box), I listed behavioral reasons and some husbandry changes you could try.
If, however, you have problems imagining that your kitty's suddenly become super-clean or really just likes his new comfy toilet spot on the carpet better, you may be right. There are some medical reasons for a cat's poor potty behavior, too.
Here's one example. “I've found that many cats who start pooping (but not urinating) outside the box have impacted anal sacs,” said veterinarian Dr. Melanie Thompson. “They return happily to their boxes after treatment,” she said.
Unlike dogs with anal glands that fail to empty — they sit straight-legged and scooch their itchy bottoms along the carpet — in cats the signs are often subtle or vague. Occasionally you may see misplaced poops, straining to poop, or even bits of blood in the stool. But nothing in a cat's behavior blares, “Anal glands full! Need emptying out.”
Consequently, it is a good idea to have a veterinarian examine your cat if it has this problem. Theoretically, you could inspect and empty the glands yourself; many dog owners do. Realistically though, with cats, unless you have a full suit of armor and a dull sense of smell, it's worth having your vet do the dirty deed. The secretions stink, and if the glands are painful, your Petunia can suddenly turn as vicious as a wild panther. If Petunia's unwilling to have her impacted or, in some cases, infected glands emptied, the veterinarian will perform the procedure under anesthesia.
In either case, the vet can also check for other intestinal diseases such as parasites that might lead to intestinal discomfort and, consequently, displaced dung.
Unfortunately, sometimes the medical cause is more ominous than parasites or an impacted anal gland.
Says one cat owner, Mary Anne Perkowski: “Our 13-year-old cat also began 'pooping' occasionally outside the box. We did all the things you suggested and had him checked a number of times by the vet. After eight months he also began to lose weight. An ultrasound showed the presence of several tumors, one on his bowel.
“At this point his cancer has spread to other organs and he only has about five weeks to live. We now have watched and have seen him try to go in his box and then minutes later, go on the rug. It appears that when he gets the urge and can go, he now does so, even if he doesn't happen to be near enough to a box to use it. Not bad behavior, just doing the best that he can.”
This experience isn't as uncommon as one might think. Says another owner, Renea Johnson: “We experienced a similar problem, and our vet did a biopsy just in case. He took six samples, but all showed clear. After our beloved Ebony lost half her weight, we knew something was definitely wrong, and indeed she passed during the night.
“Our vet wanted to know what it was and did an autopsy; she had intestinal cancer. Obviously, even taking samples is hit-and-miss, but we tried.”
Evaluating the Problem
Does this mean everyone with a cat who poops outside the box should rush to the vet to rule out cancer? No. Start with either husbandry changes or a visit to your vet. But if you've implemented all of the behavior suggestions diligently and the problem persists, or your cat shows other symptoms such as vomiting, decreased energy or weight loss, investigate further.
This usually includes basic blood work, radiographs and ultrasound. Ultrasound can often show tumors of the intestinal tract, but only if the cancer cells are congregated into visible masses, which may not occur until later in the disease.
Another option is endoscopy, a fiber optic instrument for viewing the lining of the intestinal tract. While looking, the vet can also take biopsy samples of suspicious or even normal-looking areas for microscopic evaluation. Findings may reveal diseases, such as allergies, as well as tumors.
One limitation of endoscopy, though, is that the biopsy samples only the inner intestinal lining, and a tumor could be in a deeper layer. A more thorough sampling method is through exploratory surgery because the vet can physically inspect all of the tissues and collect full-thickness samples of the intestines as well as samples of other related organs.
Making an Informed Decision
Additionally, the vet can remove discrete intestinal masses, which is the treatment of choice with the most common intestinal tumor in cats. Doing so early on increases the animal's life span an average of six to 15 months, and some cats live more than four years.
Unfortunately, even with the most thorough evaluations, nothing's a guarantee. If you're lucky, you find the problem fast and make your choices from there. But perhaps most important, you find that your cat's pooping problem is not her fault.
To find out more about urine spraying in cats, read Urine-Spraying Cats: How To Deal With Kitty 'Graffiti'
Adapted from an article originally appearing in the San Francisco Chronicle in 2003.