My elderly cat has stopped using the litterbox. Help!

Dear Most Esteemed and Knowledgeable Kitties:

I need serious help. My 15-year-old Siamese, Mandy, has decided to refuse to use her litterbox. I have had to resort to putting her in the bathroom and only letting her out when supervised. She is pulling her hair out in chunks and is bleeding. She is also hissing and screeching at my son, who will not even use his bathroom anymore.

I am at my wits’ end. I do not like shutting her up all day and I do not want to get rid of her. I would have to have her put to sleep because she does not like people. What do I do to keep my baby? I need HELP. I do love my cat.

~Toothie

Siouxsie: Elderly cats do go through physiological and mental changes, much like elderly people. Their vision and hearing decreases, they get a little “creaky” in the joints, and they can develop certain diseases such as hyperthyroidism, kidney failure or diabetes. Some cats even become somewhat senile, forgetting things that were once familiar to them.

Thomas: Understandably, when those physical and mental changes happen, an elderly cat can become anxious and fearful, resulting in behavior changes such as those you’re describing.

Dahlia: The way to tell whether Mandy’s aggression is based on fear or dominance is to observe her body language. If she’s being aggressive in a fearful way, her ears will be flattened against her head, she may stand sideways to make herself look bigger, and her pupils will be fully dilated. If her aggression is about dominance, her ears will be more forward, her pupils will be contracted, and she’ll stare at whoever is in “her” space. To learn more about the body language of aggression, visit this column from our archives.

Siouxsie: Hair pulling and other self-destructive behavior, refusal to use the litterbox, and hissing and screeching in a formerly friendly (or at least tolerant) cat, often indicate anxiety, illness or pain.

Thomas: So, Toothie, the first thing you should do is take Mandy to the vet for a checkup. Your vet will be able to tell from an exam and a blood test whether she is suffering from some sort of illness.

Dahlia: The blood test will screen for thyroid, kidney and liver problems, as well as for diabetes. When your vet physically examines Mandy, he or she will be able to tell whether she’s got painful joints or a growth somewhere in her abdomen.

Siouxsie: If Mandy gets a clean bill of health, you’ll know that her problems are most likely mental or anxiety-based. There are treatments available for anxiety problems, and your vet can help you to find one that works for her.

Thomas: If Mandy’s behavior changes are due to a physical problem such as an illness, treatment of that illness should help Mandy to get back to her normal litterbox behavior.

Dahlia: And if your kitty has arthritis or some other painful condition, you may have to make some changes to adapt your environment to help her cope better. If her current litterbox has high sides, for example, you could consider getting a shallower box that’s easier for her to climb into.

Siouxsie: Also, if your litterbox is a covered one, try removing the cover and see if that helps. The cover makes it very dark inside the box, and if Mandy is losing some of her vision, it might be quite scary for her to go in there because she won’t be able to see and she won’t know if there’s something out there waiting to attack her.

Thomas: To clean up the leftover residue of urine and feces, use an enzymatic cleaner such as Anti-Icky-Poo or Nature’s Miracle. Normal carpet cleaners may clean the stain and disguise the odor as far as the human nose can tell, but a cat’s nose is a lot more sensitive. Enzymatic cleaners will neutralize all odors associated with body wastes, and Mandy won’t have a “reminder” of where she should do her business.

Dahlia: We’ve written a number of other columns about how to deal with inappropriate elimination, which you can find here in the Paws and Effect archives.

Siouxsie: If you do need to keep Mandy restrained in one room while you’re out of the house, make sure it’s a comfortable space that provides entertainment and places to rest, so she doesn’t feel like she’s being put in “kitty prison.” Make sure she has a bed, a perch to look out the window, some toys–and of course, her litterbox and water. If you free-feed her, you can leave a small bowl of kibble, too. Just make sure to put the food and water as far away from the litterbox as possible. We cats won’t eliminate where we eat. Consider leaving a radio playing, tuned to a mellow music station or talk radio, so she feels less lonely.

Thomas: Provide Mandy with plenty of reassurance and love when you’re home. She needs to know that you’re there for her and that you love her and care about her well-being and comfort.

Dahlia: The bottom line here, Toothie, is that elderly cats have special needs. As your cat companions age, you humans need to be aware of the changes going on in their bodies and minds and make accommodations for those changes. Any behavior changes should be quickly brought to the attention of a veterinarian. That way, if these changes are due to a health problem, appropriate treatment can begin quickly.

Siouxsie: Just think about the way you would want to be treated when you get old and you become less able to function the way you used to. It’s hard for humans and cats to become more dependent, less agile and more anxious. Take more time to care for her and give her emotional and physical support. That way, Mandy can enjoy a good quality of life until it’s time for her to leave her body.