One of the most common reasons an owner brings a cat to my practice is for urinating outside the litter box. I love cats, but finding urine on the floor or smelling it in a pile of clothes is aggravating. Many people think their cat is urinating on the floor out of spite, but cats don’t have human emotions. So if it isn’t spite, what is the problem?
Urinating outside the litter box can be due to a urinary tract infection, bladder stones, arthritis (causing pain getting to and into the box), and inflammation of the bladder caused by stress. This stress cystitis is painful for a cat, and there can be blood seen in the urine. We assume they feel the pain in the litter box and, thus, avoid the box. It may also be that they’re trying to get your attention because something is wrong.
The most probable reason a cat urinates outside the litter box is that the box isn’t clean. Cats like clean litter that doesn’t smell of poop and urine, that is easy to dig in, and that is open so they can make a fast getaway if threatened. Get a large box—your cat should easily fit in the box with lots of room to spare. Plastic sweater boxes or big oil pans will work as well as regular litter boxes. Fill the box with a scoopable litter that doesn’t have a lot of perfumes. Cats don’t like those strong smells. Cats generally like a good amount of litter so that, if they are diggers, they can make a nice, deep hole and have plenty of litter for covering. Even though your cat might kick litter out of the box, don’t cover it. Either get a deeper box or place it next to a three-sided cardboard box to prevent the litter from getting everywhere. Then scoop the box every day. Imagine if you didn’t flush your toilet and you’ll understand why cats don’t like a dirty litter box.
The number of litter boxes is also important. The general rule is to have the same number of litter boxes as cats, plus one extra. This is good advice, but sometimes not possible to accomplish. Another way to judge how many boxes you need is to look at the family groups of cats in your home. A family group is determined by which cats will groom each other. For example, I have four cats during the week. Eddie grooms the other three cats and they groom him back. This makes one family group. On the weekend, I bring the clinic cat, Charlie, home. Interestingly, while the two female cats don’t like Charlie, Eddie also grooms him, making him part of the family. For my four and a half cats, I have two large litter boxes and no urine problems unless the boxes get dirty. But if you have four cats and only two groom each other, that’s one family group, and you may need another two boxes for the other two cats and then a fourth box as a spare.
If you have the litter box under control, then you have to look for other sources of stress. A change in routine can be very hard on some cats. While dogs can get depressed when the kids go back to school, a cat might get stressed when everyone comes back home. Noise, chaos, disruption of normal sleep schedule, and visiting pets can be very stressful to a cat. Think about your last family gathering or dinner party—did your cat greet everyone or did it hide under the bed? Some cats are shy and introverted, and those cats tend to develop stress cystitis. Give the cat a quiet space to get away from the commotion of visitors. If there are small children visiting, keep the cat in a quiet bedroom and don’t let the kids try to grab and pet it. Make sure the cat’s food, water, and litter box are in a quiet, easily accessible area so it doesn’t have to pass through the kitchen, where everyone is talking and laughing.
Introducing a new roommate is also very stressful, whether it’s another cat, dog, or person. Keep in mind that when you adopt another cat, it’s a pet for you, not a companion for your cat. It’s like getting a dorm roommate—maybe you’ll hit it off right away or maybe you’ll just tolerate each other.
If you do introduce a new cat, do it gradually. Feliway, a chemical that mimics the pheromone produced by mother cats, can be very calming to cats. It comes in a diffuser, which will spread the pheromone around the house. This pheromone can help lower the stress level for all the cats in the house. When you do allow both cats to have access to the house, make sure to have multiple water and food bowls and a new litter box. Get cat trees with multiple platforms, as cats like to be up high and survey the rest of the room. If the cats don’t get along, separate them for part of the day to relieve some stress.
If your cat continues to urinate outside the box, have him seen by a veterinarian. It’s important to rule out an infection, crystals, bladder stones, arthritis, and an underlying disease that may be painful or cause the cat to drink more water. These problems will require different treatments.
If stress cystitis (also known as FLUTD—Feline Lower Urinary Tract Disease), idiopathic cystitis, or interstitial cystitis is the diagnosis, anticipate your veterinarian prescribing pain medications for up to a week to allow the inflammation in the bladder to subside. This isn’t due to a bacterial infection, so antibiotics aren’t going to help. For long-term treatment, reducing the stress in the environment is very important. Encouraging your cat to drink more water can help flush the bladder, so add water to canned food, get a cat drinking fountain, put out more water bowls, and make tuna ice cubes: one can of tuna in water, then frozen as ice cubes. Put out a couple cubes on a plate each day. Some cats do better long term if fed a prescription cat food formulated for bladder health. Some cats are so anxious and nervous every day that fluoxetine or another antianxiety medication may be needed.
Please, if your cat is urinating outside the litter box, don’t yell at it. That just makes it more stressed! Empty the litter box, scrub the inside, and fill it with fresh litter. Then give it a treat of canned food mixed with lots of water and make an appointment with your veterinarian to make sure nothing else is going on. Your cat doesn’t hate you, it just wants your attention.
Lori Scarlett, DVM, is the owner and veterinarian at Four Lakes Veterinary Clinic. For more information, visit fourlakesvet.com .