QUARTERLY BEAT
JULY 2026
FORGET THE BOX AND FOCUS ON THE FELINES – FELINE INAPPROPRIATE ELIMINATION Dr. Amy L. Pike, DACVB WEBINAR HIGHLIGHTS
What do you do when a cat starts thinking outside the box, literally? In this VETgirl webinar on May 29, 2025, Forget the Box and Focus on the Felines – Feline Inappropriate Elimination , Dr. Amy Pike, DACVB, walks us through a systematic approach to feline inappropriate urination, from identifying the culprit and ruling out medical causes to distinguishing marking from elimination behaviors, and finally, building a multimodal treatment plan. In case you missed the webinar, watch it again HERE or read the cliff notes below!
Recommended Diagnostic Workup • Complete blood count (CBC) and serum biochemistry • Urinalysis +/- culture • Total T4 and free T4 (by equilibrium dialysis) • Comprehensive physical exam • Orthopedic and neurologic evaluation • Imaging (radiographs +/- abdominal ultrasound as indicated) Common Medical Differentials • Conditions affecting frequency, urgency, or volume (e.g., cystitis, renal disease, endocrinopathies) ◦ Also includes feline idiopathic cystitis (FIC) • Disorders affecting mobility or access (e.g., osteoarthritis, obesity) Treatment for medical disorders is imperative. Even after resolution, negative conditioned emotional responses may persist and require behavioral intervention. Behavioral therapy must then be implemented for full resolution.
Inappropriate urination is among the most common behavioral complaints in small animal practice and is a leading cause of relinquishment. These cases are frequently multi-factorial, requiring a systematic approach that integrates medical assessment and treatment, environmental modification, and behavioral assessment and treatment.
STEP 1: IDENTIFYING THE CULPRIT
Accurate identification of the offending cat is critical in multi-cat households. Misidentification can result in inappropriate treatment and worsening inter-cat dynamics. Objective tools such as motion- activated video monitoring can improve diagnostic accuracy since isolation/confinement can be stressful and not always help to determine the offender.
STEP 2: RULE OUT MEDICAL CAUSES
With any behavior change, a thorough medical evaluation is mandatory. Medical conditions must always be ruled out before attributing the issue to behavior.
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