Kitties can produce some odoriferous tinkles and sprinkles and drizzles and downpours that leave their owners with less than affectionate feelings toward their furry felines. The good news is that I believe people are beginning to understand cats that eliminate inappropriately might have a behavior problem. So they take action. And this might also be the bad news.

Some cat owners might ask a cat expert friend, even if that friend lives with eight cats in a house that reeks of cat pee. Due to the myriad of traditional media and Internet stories—including my own—people become instant experts themselves and take action based on what they've read, perhaps adding another litter box or changing the brand of cat litter.

At first cheek rub, this sounds good—but it's not. As you know, no advice is going to help with a cat when its accidents are a result of diabetes, hyperthyroid disease, interstitial cystitis, osteoarthritis, kidney disease, feline cognitive dysfunction syndrome, or any other medical problem. So it's vital for you to place yourself in the chain of communication so you can discuss these medical problems with pet owners.

Uncover litter box issues

The first hurdle is to explain that litter box issues may not be behavioral in the first place. For example, you might start by explaining diabetic cats might always be thirsty. And with increased water intake, sometimes diabetic cats just can't make it to the box. Or their once pristine box quickly becomes too dirty to tolerate. Of course, these cats benefit far more from insulin than a new and trendy cat litter—and cat owners will understand once you explain their pet's condition. Just remember, even if you're treating a medical condition in some cases you may also need to use behavior modification to resolve the pet's problem.

Some cat owners are simply too embarrassed to talk about their cats' accidents. So this is where a trusting relationship may not only save a client, but also a cat's life.

Many cat owners just don't think of you as a resource for behavior problems. So, the right time for a conversation about all behavior problems is the very first moment the client appears with a new kitten or cat. Don't be afraid to bring up the topic and ask questions. For example, "Tell me about the litter box. Does your cat have good aim?" Even if you include behavior questions on a questionnaire, it's a good idea to ask them verbally and watch for the client's response, which might be hesitant at first.

As the veterinarian works to identify any underlying health issues that may contribute to the problem, you can offer support and advice that will complement the cat's care—and, with persistence, possibly bring the cat back to appropriate litter habits.