new atlantic veterinary college | upei - my cat is peeing all over the...
TRANSCRIPT
![Page 2: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/2.jpg)
Murphy4.5 yr old, MN, Persian, 7#
• Presenting complaint:
– Urinating on horizontal surfaces
• Occurrence
– Daily
– Onset – always
• Observation of behavior
– Scratches surface, squats and urinates
![Page 3: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/3.jpg)
Type of elimination problem(N=340)
0
5
10
15
20
25
30
Marking
Urination
Defecation
M+UM+DU+DAll
Percent
![Page 4: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/4.jpg)
History
• Obtained at 8 months of age from breeder
– Two previous homes
• Lives with John and Kate
• Zach – previous cat
– 6 yo, MN, Persian
– New home
![Page 5: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/5.jpg)
History
• Zach was attacking Murphy
– Started 3.5 years ago
– Sent to stay with friends 1 year ago
• No effect on house soiling
![Page 6: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/6.jpg)
Environment
• 1200 sq foot home
– No access to bedroom, office, media room
• Outdoor access
– On leash
• Preferred location
– Living room
![Page 7: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/7.jpg)
Floor Plan
Kitchen
Living room
Bath
Pantry
BedroomOfficeDeck
Bath
Master
Entry
![Page 8: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/8.jpg)
Inappropriate Elimination
• Bath mats
• Suitcase
• New objects
• Door mats
• Area rug
• Comforter
• Cardboard Boxes
• Newspapers
• Gym bag
• Cat carrier
• Couch
• Beds
• Purse
![Page 9: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/9.jpg)
Environment - Litter Box
Box
Type Open
Age 3 years
Location Near stairs
Litter type Clumping clay
Additives Liner
Scooping Daily
Emptying Every 2 months
![Page 10: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/10.jpg)
Elimination Behavior
• Leaves stool uncovered
• Scratches on wall, edge of box
• Eliminates just after box is cleaned
![Page 11: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/11.jpg)
Previous Treatments
• Feliway spray and diffusers
• Closing doors
• Cat repellent
• Sticky Paws
• Nature’s Miracle
• Added second litter box
![Page 12: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/12.jpg)
Diagnostic Process
• Rule out medical conditions
• Take detailed behavior history
• Determine frequency of problem
– Progress can be assessed
![Page 13: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/13.jpg)
Differential Diagnoses
• Litter box
– Size
– Hygiene
– Covered
• Location avoidance
– Lack of access/inconvenient
• Location preference
![Page 14: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/14.jpg)
Floor Plan
Kitchen
Living room
Bath
Pantry
BedroomOfficeDeck
Bath
Master
Entry
![Page 15: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/15.jpg)
Substrate Aversion
•Avoids touching litter
•Shakes paws
•Stands on edge of box
•Fails to cover
![Page 16: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/16.jpg)
Litter Box Activity
0
50
100
150
200
250
Cover Dig Sniff Total
Elim
Tim
e (
sec) Control
Problem
![Page 17: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/17.jpg)
Digging in Substrate (p=0.001)
0
2
4
6
8
10
12
14
Control Problem
Digging
Dura
tion
Dig
gin
g /
Bo
ut (s
ec)
![Page 18: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/18.jpg)
Diagnosis - Substrate Aversion
• Long-haired cat
• Litter box hygiene
• Disturbances near litter box
– Altercations with other cat
![Page 19: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/19.jpg)
Simple Treatment Steps
3.
Quantify the Problem
2.
Medical Evaluation
1.
Identify Caregiver Goals
4.
Manage Environment
5.
Drug Therapy
6.
Follow-Up
Compliance is
achieved when
– Specific and consistent recommendation is made
– Client accepts that recommendation
– Follow-through occurs
![Page 20: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/20.jpg)
Initial Treatment Plan
•Litter box
•Litter preference trial
•Soiled areas
•+/- Medication
![Page 21: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/21.jpg)
Litter Box Size
• For large cats, even largest commercially available box may be too small
• Purchase plastic storage boxes
![Page 22: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/22.jpg)
23” x 16”
40” x 25”
35” x 16”
![Page 23: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/23.jpg)
Long Hair
• Litter and waste material may get caught in toes and perineal area of some long-haired cats
• Keep long hair between toes and in perineal area trimmed short
![Page 24: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/24.jpg)
Litter Box Hygiene
• Frequent cleaning
– Check and scoop twice daily
– Change clumping litters monthly
• Avoid scented litters, additives, and liners
![Page 25: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/25.jpg)
Substrate
![Page 26: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/26.jpg)
Which litter type do most cats prefer?
A. Pellets
B. Clumping Clay
C. Wheat
D. Clay (non-clump)
E. Crystals (silica)
![Page 27: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/27.jpg)
Which litter type do most cats prefer?
A. Pellets
B. Clumping Clay
C. Wheat
D. Clay (non-clump)
E. Crystals (silica)
Borchelt P, Vet Clinics North America 1991
Neilson JC, Pearl vs. Clumping, ACVB Proceedings, 2002
![Page 28: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/28.jpg)
Substrate Aversion
• Litter smorgasbord
– Begin with two or more readily available brands
– Offer different litter types in same location simultaneously
– Keep log of usage
• Most cats prefer fine textured, unscented, clumping litter
![Page 29: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/29.jpg)
Substrate Preference Test
• Offer substrates that resemble preferred substrate– Current litter
– Wheat: SWheat Scoop, Wheat ‘n Easy
– Corn cob: WBCL, Cobby Cat
– Paper: Pa-Purr, Yesterday’s News
– Cedar: Feline Pine
– Cloth: diapers, training pads
– Sand
![Page 30: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/30.jpg)
Substrate Preference
• Cats can develop preferences for substrate other than litter
• Likely if cat uses multiple sites, but is consistent regarding type of substrate
![Page 31: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/31.jpg)
Substrate Preference
• Isolate from substrate or prevent access to substrate
• Allow on substrate only under supervision
• Gradually allow out with decreasing amounts of supervision if inappropriate behavior does not resume
![Page 32: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/32.jpg)
Medication Options
• Buspirone Buspar®
• Paroxetine Paxil®
• Fluoxetine Prozac®
• Sertraline Zoloft®
• Gabapentin Neurontin®
![Page 33: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/33.jpg)
Maintenance Drugs
Standing Therapies
• Treatment of chronic conditions– Relief of mild to moderate anxiety
• Slow onset of action– 4-8 weeks to see maximum effects
• Daily dosing– Steady state plasma levels
• Supportive of behavior modification– May enhance learning
• Rare to see tolerance
![Page 34: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/34.jpg)
Pheromone Therapies
Pheromones
• Nonvolatile, bioactive compounds
• Activate vomeronasal organ sensory neurons
• Regulate social behaviors and neuroendocrine release
![Page 35: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/35.jpg)
Commercially-Available Pheromones
• Feliway
– Facial pheromone
• Feliway Multicat
– Appeasing pheromone
![Page 36: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/36.jpg)
Follow-Up, 4 weeks
• No episodes since consult
• Owners removing targets
• Two large litter boxes
– Murphy loves them
• Preference trial
– Clumping clay
– Covering both urine and stool
![Page 37: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/37.jpg)
Follow-Up, 10 weeks
• Owners took 3-week vacation
– Murphy had pet sitter
– 2-3 accidents
![Page 38: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/38.jpg)
Follow-Up, 5 months
• Moved one month earlier and Murphy started house soiling again
– Couch
• Treat sofa with AIP
• Rx buspirone
– 2.5 mg bid po
![Page 39: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/39.jpg)
Buspirone (Buspar®)
• Direct-acting 5-HT1A receptor agonists
• Dopamine (D2) receptor antagonist
– Anxiolytic properties similar to BZD
– Non-sedating, non-habit-forming
![Page 40: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/40.jpg)
Buspirone – Side Effects
• Friendliness (to owners)
• Agitation
• Sedation
• GI upset
• Increased assertiveness
![Page 41: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/41.jpg)
Follow-Up, 7 months
• Several accidents
– Yoga mat
– Rug
– Door mat
– Blanket on floor
• Change to paroxetine
– 2.5 mg daily po
![Page 42: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/42.jpg)
Treatment Failures
• Review behavior and environmental modification protocol
• Switching versus Augmenting
– If one drug does not work, another one might
– Even drugs with same mechanism will sometimes have very different effects in individual patients
![Page 43: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/43.jpg)
Paroxetine (Paxil)
• Selective serotonin reuptake inhibitor
![Page 44: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/44.jpg)
•Gastrointestinal
– Constipation
– Inappetance
Paroxetine - Adverse Events
![Page 45: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/45.jpg)
Follow-Up, 9 months
• Several episodes of urination
– Area rug
• Switched to fluoxetine
– 2.5 mg daily po
![Page 46: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/46.jpg)
Follow-Up, 11 months
• No accidents, complete resolution
– Introduced two new rugs
– Vacation
• Continue medication 2 months past complete resolution
– Taper dose by 50% x 30 days
![Page 47: New Atlantic Veterinary College | UPEI - My Cat is Peeing all over the …awc.upei.ca/files/2017/09/FelineHouseSoiling.pdf · 2019. 11. 6. · Murphy 4.5 yr old, MN, Persian, 7# •Presenting](https://reader035.vdocuments.mx/reader035/viewer/2022071219/60586a0dbb7bf730f3062221/html5/thumbnails/47.jpg)
Duration of Treatment
• Expected duration
• Follow-up and reevaluate
• Limit number of refills
• Plan for tapering or weaning medication
Lifelong treatment with medication should be the exception, not the rule