Cats are known for their meticulous grooming habits, so it can be quite alarming and frustrating when your feline friend suddenly starts peeing outside the litter box. But don’t worry, you’re not alone! Inappropriate urination is actually one of the most common behavioral problems in cats.
Ignoring this issue can lead to bigger problems like damaged furniture, lingering odors, and even strained relationships with your feline — and human — companions. More importantly, it could be a sign of an underlying medical condition that needs attention. So, let’s dive in and explore the possible reasons behind this unwelcome behavior and what you can do about it.
Why is My Cat Peeing Outside the Litter Box?
There are two main causes of inappropriate urination: medical and behavioral.
Sometimes, our feline friends have underlying medical conditions that make it difficult or painful for them to use the litter box. Feline Lower Urinary Tract Disease (FLUTD) is an umbrella term that refers to a collection of various conditions that can affect a cat’s bladder and urethra (the lower urinary tract). Here are a few common medical culprits:
- Bladder Infections (UTI): While less common in young cats, especially males, UTIs can cause inflammation and discomfort, leading to accidents outside the box. Older cats, particularly females, are more prone to this infections. Your vet can diagnose a UTI through urinalysis and urine culture. Since UTIs are uncommon in young cats, antibiotics should only be used when the urine culture is positive for bacteria.
- Bladder Stones and Urinary Blockage: In some cases, minerals in your cat’s urine can form bladder stones, which can lead to a life-threatening blockage, especially in male cats. Signs of a blockage include straining to urinate without producing much urine, frequent trips to the litter box, meowing in pain, and abdominal discomfort. If you suspect your cat has a urinary blockage, seek immediate veterinary attention!
- Bladder Cancer: Though less common than in dogs, bladder cancer can occur in cats and cause changes in urination habits. Symptoms can range from straining to urinate to blood in the urine to urinary blockage.
- Arthritis and Joint Pain: Just like us, cats can experience arthritis and joint pain as they age. This can make it difficult for them to get in and out of the litter box or to maintain the proper posture for urination.
- Diabetes: Diabetes can causes excessive thirst, peeing and loss of control of urination. Diagnosis involves blood and urine tests.
- Kidney Disease: Especially in older cats, chronic kidney disease (CKD) can also cause increased urination and possible accidents. Diagnosis involves blood and urine tests.
When medical issues are ruled out, behavioral reasons often take center stage. Here are some common ones:
- Feline Idiopathic Cystitis (FIC): Is the most common cause of FLUTD. FIC is essentially stress-induced bladder inflammation. It’s not caused by bacteria or cancer, but rather by stress in the cat’s environment. Since the consequence of stress is inflammation in the bladder, FIC essentially straddles the line between the medical and behavioral categories: stress incites a medical condition. Understanding what stresses a cat is not always an easy task. However, here are some common ones that you can consider when evaluating your cat’s environment:
- Litter Box Aversion: Your cat might dislike the litter box (location, type of litter, cleanliness, covered versus open box), or they may feel stressed by other cats using the same box.
- Inter-cat Aggression: If you have multiple cats, bullying or territorial disputes can create anxiety and lead to inappropriate urination.
- Environmental Stressors: Changes in the household, such as new pets, new furniture, loud noises, or even a rearranged room, can trigger stress in cats. Even seemingly minor changes in their routine or environment can upset some cats.
- Urine Marking: Cats use urine to communicate and mark their territory. Spraying, which involves small amounts of urine on walls and vertical surfaces, is different from inappropriate urination, which involves larger amounts of urine on horizontal surfaces. If your cat is spraying, it could be a sign of territorial anxiety or a response to stress.
Getting to the Bottom of the Issue
If your cat starts peeing outside the litter box, the first step is a visit to your veterinarian. Be prepared to provide your vet with a detailed history of your cat’s behavior, including their diet, litter box habits, any recent changes in the household, and any other symptoms you’ve observed.
Your veterinarian will conduct a thorough examination and run tests to determine the cause, which may include:
- Blood Tests and Urinalysis: Basic blood work, a urine culture, and possibly a thyroid test to assess overall health and rule out underlying medical conditions.
- X-rays: X-rays of the abdomen and pelvis can help identify bladder stones, arthritis, or spinal problems.
- Ultrasound: An abdominal ultrasound can provide a more detailed look at the bladder and kidneys to check for inflammation, tumors, bladder stones, and other abnormalities.
Treatment Options: Getting Your Cat Back on Track
Once the cause of the inappropriate urination is identified, your veterinarian will recommend a treatment plan tailored to your cat’s specific needs.
Medical Treatments
- Anti-anxiety Medications: If stress or anxiety is a contributing factor, your vet may prescribe anti-anxiety medications to help your cat relax and feel more comfortable.
- Antibiotics: If a bacterial infection is present based on a positive urine culture, antibiotics will be necessary. It is important to remember that not all urinary issues in cats require antibiotics, in fact, very few urinary issues in cats will respond to antibiotics!
- Pain Relief: Pain medications can help alleviate discomfort caused by inflammation, bladder stones, arthritis, or other painful conditions.
- Other Medications: In some cases, medications to relax the urethra to ease urination may be recommended.
- Surgery: If bladder stones are present, surgical removal of the stones may be necessary. Additionally, for male cats who experience repeated urethral obstruction, a salvage procedure called a perineal urethrostomy (PU) surgery could be considered as a last resort.
Environmental Management
Litter Box Optimization: Did you know that the location and number of litter boxes you have, the type and amount of litter and the condition of the litter box matters?
- Number: The golden rule is one litter box per cat plus one extra. So, if you have two cats, you should have three litter boxes. In a multilevel home, try placing litter boxes on separate floors of your home.
- Location: Place litter boxes in quiet, low-traffic areas where your cat feels safe and secure.
- Type: Experiment with different types of litter boxes (open, covered, size) and types of litter to find what your cat prefers.
- Cleanliness: Keep the litter boxes meticulously clean by scooping them daily and changing the litter regularly.
Feeding and Water Stations: Resource guarding of food and water can cause stress and conflict in multi-cat households. When cats are repeatedly swatted or hissed at while attempting to access these essential resources, they experience chronic stress. For example, a dominant cat might block access to the water bowl, preventing other cats from drinking, leading to fear and anxiety.
Stress Reduction
Provide vertical space: Cats feel more secure when they have access to vertical spaces, such as cat climbing trees or shelves. This allows them to observe their surroundings from a safe distance.
Create hiding spots: Offer cozy hiding spots where your cat can retreat and relax when feeling stressed.
Feline pheromone therapy: Consider using synthetic feline facial pheromones, like Feliway. These pheromones mimic the natural ones cats use to mark their territory as safe and secure. They come in diffusers or sprays and can help create a calming atmosphere, reducing stress-related urination.
Environmental enrichment: Provide plenty of toys, scratching posts, and climbing structures to keep your cat entertained and mentally stimulated. Interactive play sessions (e.g. laser pointer) can also help reduce stress.
Dietary Changes
Increase water intake: Encourage your cat to drink more water by providing fresh water sources, adding water to their food, feeding canned cat food, or using a pet fountain. This helps dilute their urine and may reduce bladder irritation.
Consider a change in diet: Some cats may benefit from a change in diet, especially switching to canned or wet food, which has a higher moisture content. Higher moisture content dilutes out the minerals in the bladder and encourages frequent urination.
Don’t Give Up!
Dealing with inappropriate urination can be challenging, but it’s important to be patient and persistent. With proper diagnosis, treatment, and environmental management, you can help your cat regain their litter box habits and enjoy a happy and healthy life.
If your cat is experiencing inappropriate urination, please contact us. We can help to understand the cause, and help to restore your cat’s urinary health.
Author:
James Woods DVM, MS, DACVIM (SAIM)
Ph: (912) 721-6410
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