Objective in-home monitoring for cats: Early disease signals and nutrition follow through

Cats are initially very good at managing or adapting to their illnesses,1 which makes it difficult for owners, and even veterinary teams, to spot clinically meaningful changes in urination, defecation, or other litter box behaviors between visits. Smart litter box monitors can help fill that gap by collecting objective, in-home data on elimination behaviors. When these trends are reviewed in context, they can help the veterinary team and cat owner identify changes earlier² and make more informed decisions about next steps.

Smart litter box monitors capture repeated measures of weight, elimination frequency, visit duration, estimated urine output, defecation patterns, and covering behavior, with data capture occurring 24/7, including times when owners are unable to observe their cat. This gives the veterinary team a more complete picture than owner recall alone, and these reports can support triage, diagnostic prioritization, nutrition planning, and follow-up.

Early detection of chronic kidney disease

Chronic kidney disease (CKD) is common in older cats, and early signs can be gradual and easy to miss.³ In a recent study conducted by scientists from Nestlé Purina PetCare Global Research and Development and from The Ohio State University, one of this article’s authors and colleagues evaluated whether passive, in-home data could identify elimination patterns associated with CKD. The study compared cats with CKD with age- and sex-matched cats with no known conditions.²

The study included 136 cats across training and validation sets, and device-derived behavioral features were integrated into a machine-learning framework for predictive modeling.²

The study identified several meaningful differences in cats with CKD:

• More frequent urination, longer urination duration, and increased estimated urinary output²
  • Clinical implication: Changes should prompt consideration of renal, endocrine, or metabolic differentials.
• Reduced post-elimination covering behavior²
  • Clinical implication: Behavior may reflect altered comfort, energy, mobility, or elimination behavior.
• Differences in defecation measures, including longer active defecation time²
  • Clinical implication: These patterns may help guide questions about hydration, stool quality, appetite, diet, and concurrent disease.

Abnormal trends should prompt veterinary review and, when indicated, physical examination; serum biochemistry; urinalysis, including urine specific gravity; blood pressure measurement; and CKD staging.³

These findings also fit with growing interest in the gut-kidney axis — the idea that the gut microbiome, waste products, inflammation, gut barrier health, and kidney function are closely connected. Over time, this area of research may help support earlier CKD detection.^4,5

At the 2026 American College of Veterinary Internal Medicine Forum, scientists from Nestlé Purina PetCare Global Research and Development and collaborators from Texas A&M University, The Ohio State University, University of Pennsylvania, and Kansas State University reported differences in fecal metabolites in cats with CKD. These included lipid-related changes, higher short-chain fatty acids, and N1-methyl- 2-pyridone-5-carboxamide as a potential fecal marker.⁵

From a nutrition perspective these findings support strategies that may help promote a healthier gut microbiome and reduce the buildup of waste products linked to kidney disease.^4,5

After CKD diagnosis, therapeutic renal nutrition can help manage phosphorus and electrolyte balance, renal workload, energy intake, protein adequacy, and quality of life.3 Earlier recognition may allow intervention while appetite and body condition remain more stable.

Detection of metabolic and urinary disorders

Trends related to litter box usage may also help veterinary teams spot signs of metabolic, endocrine, or urinary tract problems earlier.¹

Increased urine output or more frequent urination, especially with weight change, may point to conditions such as diabetes, reduced kidney concentrating ability, hyperthyroidism, or other systemic diseases.1 Follow-up questions should cover thirst, appetite, weight changes, urine clump size, medications, diet, and behavior.

Urinary tract disease may show up as more frequent litter box visits, longer or unproductive attempts to urinate, changes in urine color, or elimination outside the box.⁶ Nutrition may also support management by helping to dilute urine and reduce the risk of recurrence in susceptible cats.⁷

Integrating monitoring data with nutritional intervention

Monitoring data is most useful when they lead to clear action.

Nutrition affects metabolism, immune function, the gut microbiome, body composition, and kidney health.4,5,8 Early detection is most valuable when it is paired with individualized nutrition recommendations.

Clinical teams can support early detection and proactive nutritional intervention by helping to:

• Explain renal-supportive nutrition recommendations
• Track weight, body condition, appetite, diet acceptance, and follow-up needs
• Coach clients on hydration, litter box access, stress reduction, and when to call

Advancing proactive veterinary care

At the Purina Institute Global Summit 2026, this proactive veterinary care approach was described as anticipatory care supported by real-time data, preventive medicine, and nutrition science.^9-11

Device-generated trends become clinically useful when they are reviewed consistently, documented clearly, communicated accurately, and confirmed diagnostically when indicated.

Conclusion

Smart litter box monitoring can help reveal changes in elimination behavior and body weight before clinical signs are obvious. These data should be interpreted alongside history, examination findings, laboratory testing, blood pressure assessment, and other diagnostics.

When paired with clear workflows, client communication, timely escalation, and nutrition follow-through, monitoring trends can support earlier intervention and more individualized long-term care.

References

1. Quimby J, Gowland S, Carney HC, et al. 2021 AAHA/AAFP Feline Life Stage Guidelines. J Feline Med Surg. 2021;23:211-233. doi:10.1177/1098612X21993657
2. Langenfeld-McCoy N, Snow L, Gordon H, et al. Enhancing Detection of Feline Chronic Kidney Disease Through Smart Litter Box Monitoring. Animals. 2026;16(9):1319. doi:10.3390/ani16091319
3. Sparkes AH, Caney S, Chalhoub S, et al. ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease. J Feline Med Surg. 2016;18(3):219-239. doi:10.1177/1098612X16631234
4. Purina Institute. Purina Institute Digest, Volume 12: Systemic effects of the gut microbiome. Published March 2026. Accessed October 23, 2026. https://www.purinainstitute.com/sites/default/ files/2026-03/Purina_Institute_Digest_Vol12_ENG.pdf
5. Schmidt T, Quimby JM, Whitehouse WH, et al. Changes in fecal gut metabolites in cats with chronic kidney disease. Abstract presented at: 2026 American College of Veterinary Internal Medicine Forum; June 11-13, 2026; Seattle, WA.
6. Buffington CA, Chew DJ, Kendall MS, et al. Clinical evaluation of cats with nonobstructive urinary tract diseases. J Am Vet Med Assoc. 1997;210(1):46-50.
7. Forrester SD, Roudebush P. Evidence-based management of feline lower urinary tract disease. Vet Clin North Am Small Anim Pract. 2007;37(3):533-558. doi:10.1016/j.cvsm.2007.01.009
8. Wernimont SM, Radosevich J, Jackson MI, et al. The Effects of Nutrition on the Gastrointestinal Microbiome of Cats and Dogs: Impact on Health and Disease. Front Microbiol. 2020;11:1266. doi:10.3389/fmicb.2020.01266
9. Wilkie S. New and emerging technologies in preventive healthcare – The connected pet. Presentation presented at: Purina Institute Global Summit; May 27-28, 2026; virtual. Accessed October 23, 2026. https://globalsummit2026.purinainstitute.com
10. McKenzie B. New and emerging biomarkers in preventive healthcare – The monitored pet. Presentation presented at: Purina Institute Global Summit; May 27-28, 2026; virtual. Accessed October 23, 2026. https://globalsummit2026.purinainstitute.com
11. Vester Boler B. Nutrition as the cornerstone of proactive and preventive pet health – The thriving pet. Presentation presented at: Purina Institute Global Summit; May 27-28, 2026; virtual. Accessed October 23, 2026. https://globalsummit2026.purinainstitute.com