Urinating Outside the Litter Box

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By Dr. Christi Hanzel

Over the past couple of years I have had several frustrated clients bring their cats into the clinic because they began using the couch or some other piece of furniture as a litter box. I explain the importance of determining if their cat has an underlying medical condition or if this is a behavioral condition. There are several different diseases that can cause a cat to go to the bathroom outside of the litter box. A few of the more common causes include urinary tract infections, cystitis (inflammation of the bladder) as a result of crystals or stones in the bladder, and kidney disease. With all of these conditions it may cause your cat to have small frequent accidents inside or out of the litter box, blood in the urine (hematuria), or painful for them to urinate. The most important aspect in determining the underlying cause of this ailment is to get a very detailed history of the cat. There have been several instances while talking to an owner that they report that cat starting urinating outside the litter box after they got another pet, or something as simple as moving the litter box to a new location. Next, performing a thorough physical exam, collecting lab work with a urine sample, and sometimes even x-rays help in determining if there inappropriate urination is a medical or behavioral condition. If one of these conditions is diagnosed then proper medical management and a possible change in diet will be done.
If the previous medical conditions have been ruled out then it is most likely your cat’s misuse of the litter box is a behavioral issue. Cats have very unique personalities and sometimes the simplest things (like moving a piece of your furry pet’s favorite furniture) can cause them to be upset and urinate somewhere outside the litter box. Identifying if any changes within the house or a stressful situation that your cat may be experiencing are needed to help try to correct the problem.
Here are a few tips that can help to make sure your cat uses his or her litter box.
1. Always make sure that the litter box is cleaned out; ideally the litter box should be scooped out daily and washed with soap and water weekly.
2. Make sure you have plenty of litter boxes; a good general rule to follow is 1 litter box per cat in the house plus 1 extra (if you have 2 cats then you should have 3 litter boxes). Sometimes it’s the type of litter box that they do not like or the type of litter.

Litter box 1      Hooded litterbox      Cat in litter box 

3. If there are multiple cats in the house try to place the litter boxes in different, quiet areas throughout the house. Some cats will become defensive of their litter box and not let the other cats near them.
Once these changes have been made and your cat is still having accidents medication may be needed. In some cases anti-anxiety or stress medications are given to help comfort and calm your cat. There is also an all-natural product called Composure that may help in these situations. This product contains natural ingredients like Tryptophan, Colostrum, and Vitamin B1. It can be given daily in your cat’s water to help relieve their anxieties and prevent them from inappropriate urination. We have had great success with this all-natural product, but only after ruling out a medical condition.
Cats urinating outside of the litter box can be a very frustrating problem for owners, and often times plays a big role in cats getting turned over to the shelters. Please help prevent this from happening to your cat if you’re having this issue with your cat please call us and set up an appointment today!


Cat in toilet



The Most Deadly Disease

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By Dr. Charles Curie

Having practiced Veterinary Medicine for 36 years you can bet that I have seen just about every imaginable disease and injury in just about every species of animal.

So I am often asked; “what is the most common disease that you see”? Or “what is the deadliest ailment that you encounter in daily practice”?

People expect me to say something like cancer, trauma, or infections. But sadly enough the deadliest disease is also the most common disease that I see. It is an epidemic.

Depending on what study you read it affects 35 – 60% of our pets in this country. This disease is the number one reason why animals are presented to veterinarians for euthanasia prior to what their life expectancy should have been.

There is plenty of research to prove beyond doubt that this disease will take a least two years off the life of an animal. That is a bunch when you consider that they may only live 12 – 15 years under the most ideal circumstances. Two years is a 15 – 20% reduction in life span.

That would be like us losing 10 – 15 years of our life. I don’t know about you but I am not interested in giving up that much of my life if I can do something to avoid it.

Furthermore this disease steals away so much quality of life! They not only die too soon they are miserable for years before they pass! Their life simply is very unpleasant because they are plagued with so many other terrible diseases which are brought on by the preventable initial one.

What other diseases?

Well the short list includes arthritis (often so severe that they become immobile!), joint degeneration, skin, liver, kidney, and heart/lung disease.

A significant reduction in energy resulting in less play and socializing is very obvious.

And if we are talking about cats they are at high risk for developing diabetes! This is a horrible disease for people who if they choose can control not only their insulin but every other aspect of their life including sleep, exercise, diet, and life style.

In animals we only have total control over the dose of insulin everything else is variable and because of that regulating the diabetic pet can be quite difficult.

So what is the “Deadliest Disease”?


This is really sad don’t overfeed your cat

The cause is simple. Taking in to many calories causes obesity. PERIOD!

Other causes are extremely rare!

Over feeding and too many treats is the culprit. You have total control over this. Do not let your pet become over weight and if it is; consult us about nutritional requirements and dieting.

Dieting is no fun. I hate it myself! But it is the only way to lose weight. It is much more logical not to allow them to gain the weight in the first place. But if they are already too heavy then a diet is the only way out.

So I said that obesity is simply eating too much and it is. So feed measure portions to your cats. Do not allow them to graze at the food bowl 24/7. The average cat only needs about 150-180 calories daily.

Go easy on the treats! If your cat needs 150 calories daily and you give 5 treats that have 10 calories each you just blew the diet by giving 33% more calories than required!

Remember this! Obesity is not a cosmetic problem. It is the most widespread deadly disease that I deal with!

Measure your cats food


Celebrating Cats

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This is Basil

Well its been a while but I’m back! It must take an important topic to force me to write about. Its funny how things come about but I never intended to create an entire month to celebrate cats but one idea snowballed and grew and grew and then grew some more.

I just wanted to help promote “Adopt a Cat” month but decided not to stop there, why not “Celebrate Cats” and try to educate people on the importance of bringing your cat into their vet for a yearly exam. This of course is based on the Bayer Study which studies the decline of cat visits.

So that’s what we will be doing, promoting and hopefully educating clients on different health concerns we see in cats. I sincerely hope everyone enjoys this monthly topic as much as I’ve enjoyed putting it together. Stay tuned…..

Meet Our “Diva” Geneva

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Diva Geneva

They call me Diva Geneva; really don’t understand where that came from but whatever. I tag along with my Dad when he decides to come to work on occasions, which is becoming less frequently. I like coming because I don’t know how they get along without me!
This week I have to get my teeth cleaned because everyone is telling me that my breath stinks, how dare they I don’t put anything that doesn’t belong in my mouth. No tasty treats like horse nuggets, or leftovers from the litter box. No way is that my life style!
Anyway I’m getting my teeth cleaned tomorrow. Everyone’s quite the buzz around here about February being National Dental Health Awareness Month. I didn’t realize that so many bad issues could come about because of a little tartar and gingivitis. I overheard my Dad saying that just by cleaning my teeth I could live 2 years longer. I certainly don’t want to be swallowing bacteria from nasty teeth and have it enter the bloodstream to affect my heart, liver or kidneys. I say sign me up and let’s do this on a regular basis possibly every year.
Chloe getting her teeh Clean<
I’m so happy that my Dad watches out for me and makes sure I get the care I deserve!
On a side note my Dad is offering to make getting a teeth cleaning easy for you too! He wants everyone to live longer and healthier so he is offering to clean your teeth for only $199 for the rest of the month and March to. Don’t waste another minute and call us to schedule your appointment.

Dad pampering me

February Is National Pet Dental Health Month

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By Dr. Charles Curie
February is national Pet Dental Health month. This event was launched by the Veterinary profession to bring awareness to the importance of dental health for our pets.
The Country Doctor (Jefferson) and Geneva Veterinary Clinics have expanded their dental health emphasis to the entire year. We educate our clients every day about these issues.
Dental health is just that important and we want every pet to have a chance to have a healthy mouth and a good life.
As our relationship with animals changed our expectations regarding quantity and quality of life issues changed as well.
My career as a veterinarian began in 1971 as I began my education at Ohio State University. At that time there was little if any emphasis on oral health in dogs and cats. We were only focused on the big problems like a serious tooth root abscess or a broken jaw.
I began my private practice here in Ashtabula County in 1978 and still neither my profession nor pet owners were giving much thought to dental health issues in pets.
But change was afoot. Pets were rapidly moving from the back yard to the bedroom and attaining status as family members.
We all wanted them to live longer healthier lives. Veterinary medicine responded to the will of its consumers and a flood of new vaccines, preventative medicines and procedures were ushered in.
Preventative dentistry was one element of this new era and it has made a major impact on quality and quantity of life for our pets. Keeping pets’ teeth clean and mouths healthy has added two years to their life span. Quality of life has improved immensely.
There are volumes of research to support these facts, but more importantly and perhaps more credible is the many millions of owners who can say wow what a difference that has made for my pet.
In the 36 years I have been practicing veterinary medicine I am pleased to say WOW as well. Pets are living almost 50 percent longer than when I began. And quality of life is so much better than back in the “Not” so good ole days!
It should be no surprise that clean teeth can make such a difference! Our dentists have been telling us this stuff for the last 75 years.
Dirty teeth cause gingivitis which leads to periodontal disease and tooth loss, which allows bacteria to enter the blood, which leads to heart, liver and kidney diseases and poor quality of life and shortened life span. Period!
Not all dogs and cats need their teeth cleaned but it is estimated that at least 60 percent of them over the age of four do. This correlates with what I see in daily practice.
I have people say well Doc I remember this old farm dog that live to be 18yrs and never had his teeth cleaned. Yea, yea, yea we all know of the exceptions. But I also know that “Ole Roy” may well have had a much better quality of life if he had a healthy mouth.
Furthermore I or any other Vet for that matter can pretty much guarantee that most small breed (under 40lbs) dogs and most cats will definitely need to have regular dental cleanings done.
Dental health is mostly a matter of genetics. They either have a predisposition for good or bad oral health. Regardless of the ads and TV commercials it has little to do with diet and treats. Sorry about that, but it is true.
So if you want your pet family member to live as long as possible and have the best quality of life you must take care of their teeth.
To find out more about celebrating “Pet Dental Health Month” and our promotions visit our websites or

Lyme disease and ticks Third article in the series

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I want to apologize about publishing the delay of this third article on ticks. No excuses just got behind and never got to it. Here it is the last article on ticks and then we will move on to other subjects to discuss!

By Dr. Charles Curie

Preventing tick infestation

The best way to prevent Lyme and other tick transmitted diseases is by preventing tick infestation. In this article we will investigate tick prevention products, and other recommendations to reduce exposure to the blood sucking disease-spreading parasite.

The first step in prevention is acknowledging that the problem exists. In the previous two articles in this series I provided plenty of information that confirms the rapidly growing tick and Lyme disease problem in Ashtabula and Lake Counties.

A recent e-mail update from the Companion Animal Parasite Counsel (CAPC) confirms this all once again. They indicate that so far this year there has been 30 new cases of Lyme in dogs in Ashtabula County. This data is based upon information from the two largest diagnostic labs in the country.

Ashtabula County Lyme cases represent 13% of all the Lyme cases in Ohio. The next highest county only represents 1.7% of the state’s cases. So that simply put means we are by far and away the Lyme hot spot.

The researchers go on to state that this statistic represents less than 30% of the true Lyme activity in the county. As I’ve said ticks and Lyme disease are a big deal here.

Don’t think that just because you are not seeing the ticks and haven’t experienced the disease that it will not affect you! Ticks and Lyme are here and definitely here to stay. The problem is only going to become worse.

Tick Talk

Oh that lucky dog!!

Yep when it comes to ticks and Lyme disease the dogs are the lucky ones. We have a great Lyme vaccine which we have been using on all our canine patients at the Country Doctor and Geneva Veterinary Clinics for the last year.

Having completed the first year of this we have now vaccinated most of our K9 patients. What a relief knowing that so many are now protected! This will remain a part of our vaccination protocol forever now.

There are also several really good tick prevention products available for dogs. These monthly topical applications safely and effectively prevent both fleas and ticks. These pests will die within several hours after arriving on the dog.


This is very important because they will never have a chance to reproduce, and the time spent feeding before they die will be very short. There is plenty of evidence that the risk of disease transmission increases dramatically the longer the ticks stay attached and feed. So a quick death greatly reduces the risk of the spread of disease.

Another extremely important factor here is that a good tick product on your pets will almost eliminate the worry about them bringing ticks into your home and bed. Ticks in people’s beds tends to really freak them out.


The one thing we hear every day from our clients is that the flea and tick products they purchase over the counter do not work. Yea we know. People have been telling me this for the last 36 years. It is just a fact.

I understand why pet owners try these less expensive options. But at the end of the day they become more expensive because you still need to buy a good prescription flea and tick product and possibly spend money on vet bills for the diseases caused by fleas and ticks.

It is easier and cheaper to do it once and be done with the problem.

Cats and other animals do not have it so good. No vaccine and very limited selection of tick prevention products! Check with us or your regular veterinarian to see what will work best for your cat. The other species are pretty much out of luck when it comes to flea and tick preventives and Lyme vaccine.

What about people. Well we are one of the other not so lucky species. No vaccine and no good preventive products. It is recommended that we layer clothing so the ticks have to crawl up to our head to find bare skin to feed on. They will be easier to find on your neck and head. So pants inside socks, shirt inside pants etc.

It is also recommended to spray your clothing down with a mosquito repellant which contains a high concentration of DEET. There is also clothing sprays which contain permethrin.

Other measures include daily tick checks. Closely scrutinize your own and your children’s body for ticks. If you find one remove it carefully with a pair of tweezers. Grasp it near the head and apply steady pressure away from your skin. This will cause the tick to release its grip in your skin. Take the tick to the county health department. They can send it to Ohio State to be identified for a small fee.

Develop tick-safe zones around your home by keeping the yard mowed; remove leaf litter, mulch the yard edge and applying anti-tick insecticide chemicals to the yard. The best time to apply these chemicals is late May early June and again in the fall for deer ticks.

These are good recommendations. However for many of us who work outdoors in tick infested areas or who have built our homes in the woods we must realize that there simply isn’t a practical solution to the problem.

For these people daily tick checks are extremely important as is tick prevention for our pets so they don’t bring the ticks into our homes.

Being a veterinarian I cannot really comment on Lyme disease in people or offer medical advice. However I do tell everyone to be proactive with their own health issues. If you think you have been exposed to tick bites and Lyme disease, or if you have unexplainable aches and pains, flu-like symptoms that do not improve you must be insistent about Lyme testing. If you are not getting anywhere find a Lyme literate physician.

For me the biggest lesson learned at the Ashtabula Kent State Lyme Symposium was that most people are misdiagnosed for a very long time and they become progressively debilitated as time goes on.

My staff will be glad to answer all questions regarding ticks and Lyme disease in pets. Just give us a call at the Geneva Vet Clinic 440-361-4363 or the Country Doctor Vet Clinic 440-576-9440.

Check out these great websites for a wealth of information: