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Rosie_MRCVS, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1065
Experience:  BVetMed MRCVS, Qualified veterinarian of ten years in small animal practice in England
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My cat uses the litter box to urinate but has stopped using

Customer Question

My cat uses the litter box to urinate but has stopped using it to poop. This morning there was a drop of bright red blood next to the stool. What tests should I have my vet perform to determine if there is a medical issue creation this problem?
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Rosie_MRCVS replied 2 years ago.
Hi I'm Rosie one of the vets and I'd like to try and help you and Smoky. I'm sorry that he is unwell at the moment. The litter box issues may be related to his problems with faeces - sometimes when it hurts cats to defaecate they associate the pain with the litter box, and think that by going to the toilet somewhere else it won't hurt them (if this makes sense).
If the blood was fresh this indicates that he either has a problem with his large intestine or his rectum - any problems with his small intestine or stomach and the blood is digested so is black when you see it. As for tests, there are quite a few tests that you can do depending on how far you want to investigate the problem. The first one, and least invasive, that I would recommend in this situation, is a faecal sample to the lab. Even if he is an indoor cat sometimes they can still pick up infections by eating things that you can bring into the house. I would want to check this for parasites and for bacterial infections. I usually start with this because it is the least invasive - so would be the nicest for Smoky. To get the best results you would need to collect a sample from three consecutive days, and check at least 5g of faeces. It takes between a week and ten days to get the results.
Other tests include blood tests, to check for underlying causes of faecal problems. To be honest, I might be inclined to skip this one if I saw Smoky at the clinic as these problems tend to cause liquid, long-term diarrhoea, rather than a bit of fresh blood. If you did go down this route you would mainly want to check that his liver is happy. After this, it depends on how far you want to go with things. Cats are quite prone to inflammatory bowel disease (IBD), but the tests from hereon tend to get more invasive and cost more as well. He could potentially have an ultrasound scan of his abdomen to check that his guts are physically ok. He could have an endoscopy up his rectum to check for polyps and other sources of blood. You could even go as far as an anaesthetic and biopsies of his intestines - this is by far the best way to diagnose IBD but it would involve an anaesthetic. There is also a 10% chance of the internal sutures breaking down which is potentially life-threatening.
Other ways to tell if he has IBD is to perform a diet trial, as most of them do respond to an allergy free diet. This is basically feeding him something that he cannot be allergic to, and water, and nothing else. I usually use a prescription diet called rcw (royal canin) hypoallergenic. You would need to do this for a minimum of four weeks to see the results. Some patients also benefit from vitamin B12 injections, although this is mainly for those with long-term diarrhoea.
It might be worthwhile getting another litter box to break the cycle. I would definitely see your vet if he has blood in his faeces - he will probably need some antibiotics (not because I think there's a bacterial cause, but because the blood indicates a breakdown in his defences) and some anti-inflammatories to make him feel better. Once it doesn't hurt him to defaecate I would try him on a different box, with different litter in a different area. He should go the toilet in this, realise it doesn't hurt, and then continue using it. I would also speak with your vet about any of the above tests that you feel is warranted, and I would probably bring a faecal sample with you to the appointment. A regular appointment will do - I don't see the need to go rushing to an ER vet at this point.
I hope I've helped - if you have any questions from this then just hit 'reply' and I will get them and get back to you. Otherwise, if you have found this useful, please leave a positive rating so that I may be compensated for my time. Thank you, ***** ***** luck, Rosie.
Expert:  Rosie_MRCVS replied 2 years ago.
Hi Margaret Barclay,

I'm just following up on our conversation about your pet. How is everything going?