urinating and defecating at the same time

Question
Nugget my 14 year old female cat has been ill for the last few years with what the vet thinks is IBS. She isn't on any treatment at the moment. She's had various tests and he says her thyroid and other blood tests are normal and she's just a bit anaemic. We took her to the vet originally a few years ago because she was defecating outside of the litter box and her faeces resemble mudpies or diarrhoea, along with stomach rumbling and weight loss (in two years she's gone from 10lbs to 6lbs and doesn't seem able to gain weight again). This has continued for the last few years but she still uses her litter tray to urinate in. However over the last three months we've noticed that when she defecates on the floor she is also urinating at the same time. This doesn't happen every single time she defecates but it is becoming more frequent. She is still using the litter box to urinate in and seems to be unaware that she is urinating when she is defecating. Have you heard of this happening before if so what could be the cause?

Answer
Melanie,

I do not answer vet questions, only training and behavior. But for your poor kitty I asked a friend who has worked with a vet for 17 years and is very knowledgeable (she has a cat and dog medical site at www.Dogandcathealth.info). She was kind enough to give me an answer to forward to you on your kitty's medical issues:

"There is likely to be more then one thing going on. First I would look at what causes weightloss in older cats. If her bloodwork was normal a few years ago it may not be now. IBD is a sort of catchall but can include some pretty serious gastrointestinal conditions and if the stool is that soft then diet or medication really is likely to benefit the cat. Fecal and urinary incontinence is worrisome however. But lets look at some differentials for symptoms first. She doesn't say that the feces still looks like mudpies or diarrhea and that would be important to know. She doesn't say what tests were don't to get the diagnosis or how that cat was treated or for how long. IBD is consider a lifelong problem but cats usually vomit as well. She doesn't mention vomiting.

Weightloss in older cats is usually caused by cardiomyopathy (usually eating less), diabetes (appetite variable), hyperthyroidism (eating a lot and losing weight anyway), kidney failure (appetite variable), cancer (usually eating less), feline leukemia, feline immunodeficiency virus, feline infectious peritonitis, other systemic illness.

"There are a number of possible causes of incontinence and it can take a fair amount of testing to sort through the possible problems. Hormonal incontinence is less common in cats than it is dogs. This is also true of physical problems like ectopic ureters which lead to incontinence, but these conditions are possible. Neurologic deficits can lead to incontinence. Some cats will develop incontinence due to the presence of infection or inflammation in the urinary tract, so control of crystal formation can be helpful if it is causing inflammation and controlling inflammation from other sources is important, too. It is also a good idea to be certain that there is not a reason for increased urine production which can make a problem with incontinence worse. Examples of diseases which cause increased urination are diabetes and kidney failure.

Fecal incontinence in cats is very often related to spinal cord problems, lack of nerve response or neurological problems. If the two or seen together thats really worrisome. The two together are seen in tail trauma more often then anything else. What is commonly called tail jerk. The cat can't feel its tail because there is damage to the nerves at the base of it. cats run from things and their tails are last..they get caught in doors, by dogs..damaged by other cats and animals. Rocked on by rocking chairs. The tail can be broken, limp or just jerked and subluxated and cause nerve injury at the base and that causes urinary and fecal incontinence..it's one of the causes. Disc disease and arthritis can do it as well.

As I said, she may have several things going on concurrently or they could be related. She needs to be checked again because her health has changed and her weightloss has not stopped.

These are the things that might look like irritable bowel syndrome but not be that I can think of offhand: liver disease, chronic pancreatitis,
intestinal lymphoma (a cancer but this does usually respond to cortisone injections, at least for a while), hyperthyroidism, intestinal parasites
(sometimes it takes several fecal samples to find these) and food allergies. Once in a while a problem with megacolon in cats will look like
painful diarrhea because the big lumps of stool that can't be passed are painful but liquid stool finds its way around these and so the cat seems to
have diarrhea.

A bit anemic is a bit worrisome as well. A common cause of platelet deficiency in cats is bone marrow suppression from feline leukemia virus (usually) or feline
immunodeficiency virus (less likely). Hemobartonellosis causes anemia as well and is really hard to test for. She didn't say if the cat was inside/outside or just inside and that makes a huge amount of difference in what can be wrong.

Serious disease can exhibit mild to severe anemia so anemia in a cat with chronic weightloss is a worrisome thing. Far to many nasty things can cause it.

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2599

The cat needs bloodwork again unless those tests she is talking about are very current and have included infectious diseases if the cat goes outside. Thats the anemia part  and that certainly needs more attention. Its a matter of how she want to progress. Fecal incontinence is not treatable for the most part unless the problem causing it is a temporary trauma and the nerves recover.  She has to make some decisions about how far she wants to go medically to diagnose and treat her cat who has a pretty complicated medical condition. There is likely more that can be done to make the cat comfortable if there is still diarrhea and IBD symptoms and there may be other medications that will help. We don't have enough facts about the cat to know now though and could use some more information if she wants any suggestions about options other then this. But for now..theres just too much that's unknown."

I hope this is helpful for you.

Tabbi