Advances in Understanding and Treatment of Feline Inappropriate Elimination

The Impact of Environmental Enrichment on the Cortisol Level of Shelter Cats

Enriching cats' living environment in shelters is crucial in reducing their stress. Easier access to resources allows cats to display natural behavior. This study aimed to assess whether cats staying in an enriched environment would be less stressed than cats staying in a standard environment. The first group consisted of cats living in an environment with fewer resources (standard environment)-103 cats. The second group consisted of cats living in an enriched environment-76 cats. The research material consisted of hair collected to determine the cortisol level. The results indicate that cats from a more enriched environment have almost half the level of cortisol in hair than cats from an environment with fewer resources (0.059 ng/mg vs. 0.101 ng/mg; p = 0.000001).

Behavior and Cognition of the Senior Cat and Its Interaction with Physical Disease

In cats, age-related pathologic condition and neurologic degeneration can produce changes in activity, vocalization, appearance, appetite, litter box use, sleep-wake cycle, personality, and cognitive ability. These changes can influence the relationship between owner and pet. Although cognitive dysfunction syndrome (CDS) can cause altered behavior later in life, other medical or behavioral causes may mimic these clinical signs or complicate diagnosis. Management and treatment of CDS can be accomplished through pharmacologic intervention, diet and nutritional supplementation, and environmental enrichment aimed at slowing the progression of the disease.

Inflammation and Behavior Changes in Dogs and Cats

Sickness is a normal response to infections or stress triggered by proinflammatory cytokines that drive local and systemic inflammatory responses. Proinflammatory cytokines act on the brain causing the so called "sickness behavior,"which is thought to improve recovery but can become maladaptive in the long term. Chronic inflammation characterizes many diseases and there is some evidence that dogs and cats experience age-associated increases in inflammation, a condition named "inflammaging." A complex and multifactorial relationship exists between these inflammatory mechanisms, pain, and psychological illness that may complicate veterinary diagnosis and affect the outcome.

Factors associated with house-soiling in Italian cats

OBJECTIVES

The aim of the present study was to identify factors associated with house-soiling in Italian cats.

METHODS

A cross-sectional online survey collected information on respondents' and cats' details and litter management, and whether the cat showed house-soiling. Univariable and multivariable regression models were performed using house-soiling (present/absent) and the type of house-soiling (ie, urinary, faecal, concurrent urinary and faecal) as dummy variables.

RESULTS

Data from 3106 cats were obtained. The number of dogs and other cats in the household, the cat's age, the number, type and location of the litter boxes, the type of litter, and the frequency of litter scooping and full replacement were retained in the final multivariable regression model for house-soiling (model P <0.001, Akaike information criterion [AIC] = 2454.30). Urinary tract diseases, the type and number of litter boxes and the number of dogs in the household were associated with urinary house-soiling (model P <0.001, AIC = 534.08), and gastroenteric/musculoskeletal diseases, number of litter boxes and litter box location were associated with faecal house-soiling (model P <0.001, AIC = 448.52). Healthy cats, the number of dogs in the household, the type of litter and litter full replacement frequency were retained in the final multivariable regression model for the concurrent expression of urinary and faecal house-soiling (model P <0.001, AIC = 411.47).

CONCLUSIONS AND RELEVANCE

Meeting cats' preferences for litter and litter box type, location, behavioural needs and strict litter hygienic conditions is recommended. Cat owners need to be educated to prevent and manage house-soiling in their cats.

Litter Management Practices and House-Soiling in Italian Cats

There are about 10.1 million domestic cats in Italy, but information on cats' litter management and house-soiling prevalence is scant. This study described cats' and cat owners' profiles, litter management practices, and whether cats show house-soiling, also comparing between professionals (i.e., breeders) and amateurs (i.e., pet owners). A cross-sectional online survey sought respondents' housing, family, and cat details, as well as other pet details, litter details, and whether the cats showed house-soiling. Data for a total of 3106 cats were obtained. Italian cats lived mainly in apartments, along with other cats or dogs. Italians owned mostly adult European breed cats, to whom they provided covered litter boxes filled with clumping substrates, scooped daily, and completely replaced weekly. Litter cleaning was more frequent when cats were owned for financial purposes (i.e., breeders) rather than for companionship, but more space was provided for pets than for breeding cats. The recalled prevalence of elimination problems (16.7%) was lower compared to other studies, with cats mainly eliminating urine (54.6%) on objects in squatting posture (35.2%). Overall, this research increased our understanding of cat litter management in Italy. These findings could fill a gap in the knowledge regarding litter management and house-soiling incidences in Italy. Further studies to investigate possible risk factors for house-soiling are needed.

BEHAVIOURAL RESPONSES TO SEPARATION FROM HUMAN COMPANION IN THE DOMESTIC CAT: A SURVEY-BASED STUDY

The domestic cat is known to react to social separation, though the conceptual relationship between separation-related behaviours outside of a clinical context has not been described in detail. We did an online survey on participants who had cats in their households (Nparticipants=114; Ncats=133) and asked them to evaluate the frequency of 12 behavioural elements associated with social separation from human companions on a 5- point Likert Scale. We performed two dimensionality reduction techniques (component and factor analyses) to assess whether the specified behaviours related to social separation belonged to the same axis. We found four distinct components instead of one: (a) reactivity towards companion departure cues, (b) protest behaviour towards inaccessibility, (c) unusual elimination behaviour, and (d) negative responses following social separation. Our findings suggest a manifestation of different motivational states rather than a single, separation-related construct. Future studies would benefit from a careful evaluation of the separation-related behaviours in a multi-measure context to improve the accuracy of ethological classifications.

Fearfulness associates with problematic behaviors and poor socialization in cats

Problematic behavior is a remarkable welfare issue in cats (Felis catus), as it is one of the most common reasons for relinquishment. The probability of developing problematic behaviors is likely influenced by several variables, but these remain little studied. In this study, we examined the associations of fearfulness, aggression toward humans, and excessive grooming with nearly thirty variables in a survey dataset of over 3,200 cats. To identify the most important variables influencing these behaviors, we used generalized linear models. All behaviors were associated with each other suggesting comorbidity between problematic behaviors. Breed and several environmental variables were also associated with behaviors. Poor socialization with humans and a history of being a rescue cat were associated with higher fearfulness, indicating that the proper socialization of kittens is beneficial for avoiding fear-related problematic behaviors. Overall, our study highlights the complexity of three problematic behaviors in cats.

Prevalence, Risk Factors, Pathophysiology, Potential Biomarkers and Management of Feline Idiopathic Cystitis: An Update Review

Feline idiopathic cystitis is a widespread disease in small animal clinics, which mainly presents with urinary signs like dysuria, stranguria, hematuria, pollakiuria, and periuria. The etiopathogenesis of the disease may involve interactions between the environmental stressors, neuroendocrine system and bladder of affected cats. Diagnostic biomarkers have not been tested in clinical studies though they are theoretically feasible, and since the clinical signs of the disease assemble those of other feline lower urinary diseases, its diagnosis is a procedure of exclusion. The primary treatment of the disease is long-term multimodal environmental modification (or enrichment) while anti-anxiety drugs and nutritional supplements are recommended for chronic recurrent cases. Still, many medicines need to be evaluated for their efficacy and safety. This review aims to provide readers with a comprehensive understanding of feline idiopathic cystitis by summarizing and updating studies concerning the prevalence, risk factors, etiological hypotheses, diagnostic procedures, possible treatments, and prognosis of the disease.

The Behavioural Impact on Cats during a Transition from a Clay-Based Litter to a Plant-Based Litter

Current guidelines recommend transitioning cats from one litter product to another over 6 days to minimize stress. The study objective was therefore to test these guidelines using 16 adult domestic cats (2 cohorts of 8) by observing behavioural changes associated with elimination throughout the litter transition. Cats were transitioned from a clay-based litter (CLAY) to a plant-based litter product (PLANT) over 6 days (period 1) via an incremental replacement of CLAY with PLANT. All cats then remained on PLANT for 8 days (period 2). This same transition process was executed for both cohorts, and litter box behaviours were observed via remote recording. Urination, defecation, cover, and dig behaviours were not different between periods 1 and 2 (p > 0.05). Sniffing frequency was greater in period 2 than period 1 (p < 0.05); however, during the litter transition (period 1), cats sniffed the litter boxes being transitioned from CLAY to PLANT more often and for longer than they did for the boxes consisting of only PLANT (p < 0.05). These data suggest that 6 days may be an adequate amount of time to transition a cat to a new litter, although successful transition may also be specific to the types of litters investigated.

Influencing Elimination Location in the Domestic Cat: A Semiochemical Approach

Simple Summary

In the domestic cat, elimination at an inappropriate location is considered by cat owners and non-cat owners as an undesirable behaviour. The aim of the study was to assess the effects of a composition derived from cat anal glands on the elimination behaviour of domestic cats in a cattery setting. The study was conducted in four catteries housing 33 cats, using 37 litter trays. The data collection lasted two weeks, each litter tray receiving one treatment on the first week and the other treatment on the second week. The parameters studied included daily elimination (urine plus stools) weight, urine weight, stool weight, elimination type and urine/stool quantity scoring. Four out of the six parameters studied showed a treatment effect, consistently in favour of cats defecating significantly less in the litter trays sprayed with the treatment versus litter trays sprayed with the control. These results demonstrate that a composition originating from cat anal glands influences cats’ defecation location.

Abstract

In the domestic cat, elimination at an inappropriate location is considered by cat owners and non-cat owners as an undesirable behaviour. The aim of the study was to assess the effect of a semiochemical formulation, reconstituted volatile fraction of cat anal gland secretions on the elimination behaviour of domestic cats. The study was conducted in four catteries, which housed 33 cats, using 37 litter trays and followed a randomised crossover design using the litter tray as the experimental unit. The parameters studied included daily elimination (urine plus stools) weight, urine weight, stool weight, elimination type and urine/stool quantity scoring. The parameters were analysed using GLMM with SAS 9.4 software. Four out of the six parameters studied showed a treatment effect, consistently in favour of cats defecating significantly less in the litter trays sprayed with the treatment versus litter trays sprayed with the control (elimination weight p = 0.0199; elimination type p = 0.0251; stool weight p = 0.0005 and stool quantity p = 0.003). These results demonstrate that an intraspecific semiochemical message originating from cat anal glands influences cats’ defecation location.

Behavior as an Illness Indicator

When an owner notices a behavior change in their cat that concerns them enough to present the cat to the vet, there are 3 possibilities: the behavior change reflects a change in behavioral health (a change in psychological state), a change in medical health (a change in physical state), or a combination (comorbid medical and behavioral pathologies). Because many behavioral pathologies are diagnoses of exclusion, it is important that the veterinarian rule out all of the likely medical differentials for the changed behavior. This article is a behavior-by-behavior guide to the more common differentials for the most common problem behaviors.

A Case-Controlled Comparison of Behavioural Arousal Levels in Urine Spraying and Latrining Cats

Simple Summary

Urination outside the litterbox (also known as periuria) is a very frequent problem seen by veterinary behaviourists and is a common reason for the relinquishment of cats. Veterinary behaviour textbooks describe two forms of periuria (spraying and latrining), including characteristics of both, and speculations, such as spraying is more closely associated with stress. With the aim of evaluating the arousal underpinning emotional stress in cats showing periuria, we studied recorded behaviours as well as faecal cortisol metabolite (FCM) levels of 11 “sprayer” and 12 “latriner” cats along with their controls (i.e., cats that did not show periuria) from the same multi-cat homes of three to nine cats. The results indicated that households in which a cat exhibits urine spraying are generally more aroused than households with latrining cats, but “sprayers” are not more aroused than their housemates. In practical terms, such results suggest that behaviour management to control periuria in these households should be focused on all cats not just the “sprayers”.

Abstract

It is often suggested that both latrining and spraying in the home are associated with increased stress in cats. However, the scientific evidence for this is weak. We therefore examined faecal cortisol metabolite (FCM) levels in subjects using a case-control design. Eleven spraying and 12 problematic latrining cats (assessed as healthy after detailed medical examinations on an initial population of 18 spraying and 23 latrining cats) were assessed along with behaviourally normal and similarly healthy control subjects from the same multi-cat (n = 3–9) households. Individual faecal samples were collected by owners from both “case” and “control” cats after observing them defecate in all but one pair in each group. A total of five samples per cat (typically taken on a weekly basis) were collected and submitted to extraction procedures prior to FCM analysis via an 11-oxoaetiocholanolone enzyme immunoassay (EIA). Participant cats, both “cases” (nine “sprayers” and eight “latriners”) and controls, were also individually video recorded (together with the owner) for 5 min in a dedicated room. FCM levels were significantly higher in individuals (“sprayers” and their controls) from spraying households than from the latrining households (“latriners” and their controls), but there was no significant difference between cats from the same household. Within a video observation test, cats from spraying houses spent proportionally more time moving (as opposed to stationary), but again there was no difference between cats from the same house. These results indicate that households in which a cat exhibits urine spraying, are generally more aroused, but “sprayers” are not more aroused than their housemates. Accordingly, we suggest appropriate management needs to be applied to the whole household to help alleviate the potential stress of all the cats in the home, and not just the one expressing this through urinary spraying behaviour.

Owners' Attitudes, Knowledge, and Care Practices: Exploring the Implications for Domestic Cat Behavior and Welfare in the Home

Simple Summary

Available research on the link between domestic cats’ environment and welfare has primarily been conducted on cats living in animal shelters or research facilities; a better understanding of the welfare of cats living in homes is needed. We used an anonymous online survey to investigate the attitudes of current U.S.-based cat owners towards cats as pets; owner knowledge about normal cat behavior and environmental needs; current trends in cat care; behavior problems reported for these cats; and the human-animal bond. We found that owners with a more accurate understanding of cat behavior, and stronger reported bond with their cats, reported fewer behavior problems. Conversely, owners’ agreement with certain misconceptions about cats, and high perceived costs of care, were correlated with the use of punishment (e.g., yelling, hitting, or spraying with water) in response to misbehavior. Our results suggest that many cats living in private homes may be receiving only minimal environmental enrichment, particularly in the case of interactive (e.g., playing with a friendly human, or exploring changing environments) vs. static (e.g., cat toys such as stuffed mice) enrichment. Collectively, these results support the premise that better education of cat owners could benefit the welfare of cats living in private homes.

Abstract

Available research on the link between domestic cats’ environment and welfare has primarily been conducted in animal shelters or research facilities; a better understanding of the welfare of cats living in homes is needed. This study measured the attitudes of current U.S.-based cat owners towards cats as pets; owner knowledge about normal cat behavior and environmental needs; current trends in cat care; cats’ behavior in the home; and the human-animal bond. The primary hypothesis was that owners with a more accurate understanding of cat behavior and a stronger reported bond with their cats would report fewer behavior problems. Data from an online, anonymous, cross-sectional survey of 547 cat owners supported the primary hypothesis: owner knowledge, along with two measures of the human-animal bond (owner-pet interactions, and perceptions of affordability of cat ownership), were significant predictors of the number of reported behavior problems. In addition to fewer reported behavior problems, greater owner knowledge about cats was correlated with less use of positive-punishment-based responses to misbehavior, and increased tolerance of potential behavior problems when present. Owners’ agreement with certain misconceptions about cats and perception of high costs of care were correlated with the use of positive punishment in response to misbehavior. Based on the survey results, many cats living in private homes may be receiving only minimal environmental enrichment. Collectively, these results suggest the need for better education of cat owners. Topics could include: understanding normal cat behavior and correcting misconceptions; enrichment needs (particularly of indoor-only cats) and the risk of behavior problems when cats’ needs are not met; welfare risks associated with declawing; and the importance of sufficient resources to minimize social and territorial conflict.

The Behavioural Effects of Innovative Litter Developed to Attract Cats

Urination and/or defecation outside a designated location has been reported as the most common behavioural reason for surrendering a cat and comprises approximately 30% of cat intakes to shelters. The objective of this study was to determine whether cats would increase in-box elimination when provided a plant-based litter product with attractant (ATTRACT) compared to the same plant-based litter product without attractant (PLANT). Sixteen cats were split into two equal cohorts based on availability from the shelter and group-housed in an enriched room with eight identical litter boxes arranged in a circular pattern equidistant from each other. Following a two-week room acclimation and transition period from clay litter to PLANT litter, boxes were designated either PLANT or ATTRACT litter, balancing for cats' prior box location preferences. For 14 days following litter allocation, cat behaviours such as sniffing, digging, covering, urinating, and defecating were video recorded for 12 h daily. The cats urinated more often in the ATTRACT litter, suggesting that they preferred the ATTRACT litter for urination more than the PLANT litter (p < 0.05). The most significant differences observed were between genders, with males spending significantly more time sniffing and performing urination behaviours (p < 0.05). These results suggest that litter with an attractant may be more effective in eliciting usage for urination, as compared to a litter without the additive.

A closer look at the health of cats showing urinary house-soiling (periuria): a case-control study

OBJECTIVES

The aim of this study was to perform a case-control medical evaluation of cats from multi-cat households presenting with inappropriate latrining and spraying behavior.

METHODS

Owners of 18 'spraying' and 23 'latrining' cats with normal control subjects available from the same households were recruited for a case-control study. Otherwise overtly healthy dyads (each dyad consisting of a case cat and a control cat) were brought together to the veterinary hospital of the University of São Paulo for a medical work-up (ie, physical examination, complete blood count, biochemical profile, urinalysis and urine culture, abdominal ultrasound of the urinary system and in females, where possible, cystoscopy).

RESULTS

Medical problems were identified with similar frequency in the 'sprayers' (38.9%), 'latriners' (39.1%) and controls of the latrining group (26.1%), but not the controls of the spraying group (5.5%). The difference between 'cases' and 'controls' from spraying households was significant. Common potential health-related changes include renal insufficiency, cystitis and bladder lithiasis. Renal calculi, higher creatinine levels (within normal reference interval) and 'glomerulations' (detected during cystoscopy) were also found in the remaining sprayers and latriners that were considered clinically healthy. Post-cystoscopy, a new form of periuria occurred in two cats (one sprayer and one latriner).

CONCLUSIONS AND RELEVANCE

These results indicate that spraying or latrining behavior in the home, as well as living with a cat that is not using the litter box as a latrine, are all associated with a higher level of urinary tract abnormalities; living with a cat that is spraying, however, does not have this association. The findings also suggest that both forms of periuria might be associated with interstitial cystitis. We therefore conclude that all cats with periuria need to be carefully evaluated medically and that treatment of latrine-related problems should consider all cats in the house, whereas spraying may be more focused on the individual displaying the problem.

Common feline problem behaviours: Unacceptable indoor elimination

PRACTICAL RELEVANCE

One of the reasons why cats enjoy such a high level of popularity as domestic pets is the fact that they are clean. When there is a breakdown in this fastidious behaviour and elimination occurs outside of the litter box or tray, the strain on the cat-owner bond and on human relationships within the household can be considerable.

EVIDENCE BASE

Indoor elimination behaviour is one of the most common reasons for cat owners to seek professional advice and there is a wide range of articles, book chapters and research papers that reference it. In many cases the topic of urination and defecation in unacceptable indoor locations is considered in combination with the deposition of urine or faeces as a marker, but this review focuses purely on problematic elimination. An accompanying article in this special issue discusses urine spraying.

CLINICAL CHALLENGES

Indoor elimination problems necessitate a clinical approach combining knowledge from the fields of physical and emotional health and an understanding of normal feline behaviour. They also require comprehensive history-taking skills as well as effective communication skills and a degree of empathy for owners who are often finding their pet's behaviour very distressing.

GLOBAL IMPORTANCE

Early diagnosis of physical health disorders that are associated with indoor elimination is extremely important in terms of safeguarding feline welfare. As we become more aware of the interplay between physical and emotional health, the significance of identifying suboptimal social and physical environments in terms of optimising the welfare of domestic cats is also being recognised. The potential for indoor elimination problems to cause considerable human distress highlights the importance of the concepts of One Health and One Welfare.

Common Risk Factors for Urinary House Soiling (Periuria) in Cats and Its Differentiation: The Sensitivity and Specificity of Common Diagnostic Signs

Urinary house soiling (periuria) in the home is a common but serious behaviour problem in cats. Although many specific risk factors and triggers have been postulated, their importance is largely unknown. This study assessed: (1) the significance of purported risk factors for periuria as well as specifically marking and latrine behaviour in the home; (2) the specificity and sensitivity of signs commonly used to differentiate latrine and marking behaviour. Owner responses to an internet survey (n = 245) were classified into three groups: control, marking and latrine behaviour, along with 41 potential risk factors and 15 predictors used to diagnose marking and latrine problems. Univariate statistical analyses and non-parametric tests of association were used to determine simple associations. In addition the sensitivity and specificity of four cardinal signs (posture to urinate, attempt to cover soiled area, surface chosen and volume of urine deposited) were calculated. Significant potential risk factors were: age (marking cats were older than the other two groups); multi-cat household (increased risk of marking and latrine behaviours); free outside access and cat flaps in the house (higher frequency of marking); outside access in general (lower prevalence of latrine behaviour); defecation outside the litter box (higher frequency of latrine behaviour); a heavy dependence by the cat on its owner (lower frequency of latrine behaviour) and a relaxed personality (lower risk of marking behaviour). Litterbox attributes and disease related factors were not significant. Individual cardinal signs were generally not good predictors of diagnosis. This study challenges the poor quality of evidence that has underpinned some of the hypotheses concerning the causes of periuria in cats. The results, in particular, highlight the general importance of the social environment, with the presence of other cats in the household, the cat-owner bond and personality related factors, alongside factors like the use of a cat flap which might also alter the social environment, all implicated as significant risk factors. While the physical environment may be important in specific cases, it seems this is less important as a general risk factor. The findings quantify the risk of misdiagnosis if a single sign is considered sufficient for diagnosis.

Maternal-Neonatal Pheromone/Interomone Added to Cat Litter Improves Litter Box Use and Reduces Aggression in Pair-Housed Cats

Introducing a new cat into a household with one or more resident cats can be a significant source of stress for the cats involved. These studies sought to determine if rabbit maternal-neonatal pheromone (2-methyl-2-butenal [2M2B]) in litter impacted cat social behaviors and litter box use. Study 1 determined that cats preferred to eliminate in litter containing 2M2B; other semiochemicals tested did not change litter box use. Cats prone to aggression were identified in an intermediate pilot study, and eight pairs of these cats were selected for Study 2. In Study 2, cat pairs were provided litter containing either vehicle or 2M2B for 24 hours. Cats experiencing control litter displayed more aggression during the first 6 hours (p < .01) and spent more time using the litter box 12 hours and 18 hours after pairing compared with cats experiencing litter with 2M2B (p = .02). These results suggest 2M2B-infused cat litter may act as an interomone in cats housed domestically to prevent initial occurrences of aggression and may improve cat welfare in multicat households.

Stress in owned cats: behavioural changes and welfare implications

Domestic cats are exposed to a variety of stressful stimuli, which may have a negative effect on the cats' welfare and trigger a number of behavioural changes. Some of the stressors most commonly encountered by cats include changes in environment, inter-cat conflict, a poor human-cat relationship and the cat's inability to perform highly motivated behaviour patterns. Stress is very likely to reduce feed intake, and stress-related anorexia may contribute to the development of potentially serious medical conditions. Stress also increases the risk of cats showing urine marking and some forms of aggression, including redirected aggression. A number of compulsive disorders such as over-grooming may also develop as a consequence of stressful environments. Some of the main strategies to prevent or reduce stress-related behavioural problems in cats are environmental enrichment, appropriate management techniques to introduce unfamiliar cats to each other and the use of the synthetic analogue of the feline facial pheromone. As the stress response in cats depends, to a large extent, on the temperament of the animal, breeding and husbandry strategies that contribute to the cat developing a well-balanced temperament are also very useful.

Canine and feline enrichment in the home and kennel: a guide for practitioners

As general veterinary practitioners, we have a duty of care that applies not only to the physical health needs of our patients but also to their mental well-being. Advising clients about how to enrich their home and kennel environments is an important part of fulfilling that duty of care and will also enrich the relationship between the veterinary practitioner and client. This article discusses how to optimize welfare for dogs and cats in the home and kenneled environments through appropriate environmental enrichment and understanding of species-typical behavioral requirements.

Litter box preference in domestic cats: covered versus uncovered

Feline inappropriate elimination (periuria and/or perichezia) remains a very common behavioral complaint of cat owners. Treatment recommendations often include improving the attractiveness of the litter boxes available to the cat. One frequent recommendation is to avoid covered litter boxes, although this has not previously been tested experimentally. The goal of this study was to assess whether, all else being equal, cats preferentially used uncovered litter boxes over covered litter boxes. Twenty-eight cats were enrolled in the study and offered the choice of a covered or uncovered box. Waste was scooped daily from each box, and the weight of waste in the different box styles was compared and evaluated using paired t-tests and χ(2) analyses. Overall, there was no significant difference between use of the two box styles. Eight individual cats did exhibit a preference (four for covered, four for uncovered), but individual preference results are not evenly distributed, with more cats than expected showing no preference between litter box types. We postulate that, if boxes are kept sufficiently clean (ie, once daily minimum cleaning), most cats will not show a preference for either box type. The observation that a minority of cats in the study exhibited a preference supports the recommendation of providing individual cats with a 'cafeteria' of litter box styles, including a covered box, to determine whether such a preference exists. These findings add to existing literature on the topic of feline inappropriate elimination and provide additional information for clinicians recommending treatment options for cats exhibiting this behavior.