George aged 20.

DISABLED AND INCONTINENT CATS. Disability usually occurs after a road accident and damage to the spine, though occasionally spastic cats occur from birth particularly in the rex breeds. Cats that are paralysed in their back legs can sometimes use a cart, though probably only a fairly placid and outgoing cat will do well with this. (Look at Helpful Stuff for manufacturers). Ask your vet about physiotherapy too. Keep an eye out for proper pain control. Cats who have difficulty swallowing or who are very arthritic may benefit from having their food bowl higher, level with their neck.

URINARY INCONTINENCE IN CATS

Always start with a vet. Cat that start peeing in the house may have kidney disease, hyperthyroidism, lower urinary tract disease, sphincter muscle incompetance, etc. Rule disease out first. Sometimes this incontinence is the overflowing of a bladder that is full. Then it is possible to learn how to express the urine which will stop the incontinence Get your vet to demonstrate.
"Hold the cat on its litter tray, facing away from you, place the palms of your hands either side of its bladder, which you can feel like a soft distended balloon. Press your palms gently but firmly towards each other in a forward direction". Or you can do it from the other way round. "We have him facing us and squeeze from the back as demonstrated."

The important thing is to make sure you know how to do it before you leave the vet's surgery and that you go back as often as is necessary to get this technique! Do not despair. Bladder control may return. "The male vets in the practice were very pessimistic but the female vet said it would be all right. I was prepared to express Tiger's bladder for as long as it took and to fight to keep him alive. Within about two and a half weeks of his accident, he was able to urinate on his own."

Even if bladder control does not come back, you may be able to cope. "The nerve damage after the accident left her incontinent and with difficulty in passing bowel movements. After four years this was becoming increasingly hard for her and the vet removed her large intestine. Since then her incontinence has lessened very slightly usually only occurring when she is sleeping but she still has very little bowel control. Obviously it is not always easy looking after her as she cannot be left alone for long but it has become part of life."

Sometimes, particularly if the tail has been amputated, cats have difficulty using the litter tray. Experiment with a low tray. These are also helpful for cats with a broken pelvis. Put a smaller tray inside a bigger one so any mistargeted urine falls in the gap between, if missing the target is a problem. Petliners, absorbent paper mats, in strategic places will help. A low litter tray, made from a human tray or a baking tray, placed on top of newspaper will help cats who are arthritic or disabled. They can walk on to this, rather than make the effort to climb into a conventional litter box.

Defecation can also be difficult. Sometimes the muscles can't nip off the faeces so there are little knobs of faeces which fall off away from the litter tray.

CONSTIPATION can be a problem too. Hairballs are a common cause of constipation in older cats. Help your cat groom itself.  I use a Zoomgroom, a hair brush and a metal comb on my cat to remove dead hair. If your cat begins to develop mats, remember to get her checked for arthritis (she may not be able to reach round to groom her back) and for tooth problems (grooming may hurt her teeth or mouth). Very occasionally a cat becomes constipated because its companion cat is preventing access to the litter tray. Cats that don't drink enough get constipated too. Encourage drinking by having at least two, preferably three drinking bowls in different shapes and materials, in three different locations. 

If a hitherto healthy cat becomes constipated, always start with a veterinary consultation. Constipation may be a  symptom of anal sac infections, anal abscesses, inflammed bladder, foreign body in the colon, fractured pelvis etc. Start with the vet. You will need to discuss remedies with him/her.  Discuss Johnson's hairball remedy or Katalax. Some vets recommend human remedies added to the food but only use these if recommended. Using human remedies on cats can cause them serious harm. There are also special diets with extra fibre which might work. Keeping your cat in at night (a disabled cat shouldn't have to go out in the cold) will help you keep an eye on what is happening in the litter tray.

 See Helpful Stuff on index for useful incontinence products.