My cat is urinating outside the litter box: Now what?

“House soiling” is one of the main reasons cats are turned outdoors, given away, or euthanized. If you cat is urinating outside the litterbox it is very important to get him/her an exam by your veterinarian ASAP!  A good percentage of the time there is a medical reason as to why your cat is urinating all around your house. It is sometimes the only indication your cat will give you that he or she is in pain, and dealing with lower urinary tract disease.

Here are some other signs:

  • Straining to urinate (this looks the same as straining to defecate)
  • Going to the litterbox numerous times and only a small amount of urine is produced
  • Blood in the urine
  • Crying out while urinating
  • Licking at urethral opening

Once you bring your feline to the veterinarian, a good physical exam will be performed as well as a urinalysis. Depending on the results of those two procedures, bloodwork, abdominal X-rays, abdominal ultrasound and/or a urine culture may be needed.
There are many different reasons your cat may have stopped using his/her litterbox, but here are the 3 most common:

Feline Idiopathic Cystitis

This is very common and is diagnosed in 55-60% of cats that are housesoiling. It is an inflammation of the bladder to which no known cause can be found. So that means there is no underlying infection or crystals that cause the bladder to become inflamed. This can be a complicated and frustrating syndrome in cats because there are numerous factors that can contribute to this inflammation. The treatment can be different for every cat depending on the circumstances, but can include anti-inflammatories, a medication to help relax the bladder and urethra (anti-spasmodic), as well as other medications along with adjustments to help with stress.

Bladder Stones

Yes, cats get bladder stones. They can get large ones that are seen easily on X-ray or smaller ones that might need an ultrasound for diagnosis. Bladder stones are made up of either struvite or calcium oxalate crystals. These crystals can sometimes be detected on the urinalysis and they will be the first clue in diagnosing a bladder stone. Stones that are made up of struvite crystals can be dissolved with a prescription diet that acidifies the urine. Stones that are made up of calcium oxalate are not dissolvable and need to be removed via surgery.

Bacterial Infection

A true urinary tract infection is not common in young healthy cats. It is more likely to be diagnosed in older cats, cats that are on certain medications, or in cats that have predisposing conditions, such as diabetes mellitus. A simple infection can be diagnosed with a urinalysis and is easily treated with antibiotics. More complicated (or reoccurring) infections will need a culture and sensitivity to find out which antibiotic works against the bacteria that is causing the bladder infection. Also further diagnostics, such as ultrasound and X-rays, may be needed to help understand why your cat has a complicated or reoccurring bladder infection.

So if housesoiling is a common complaint what can be done to help prevent it? 

There are some preventative measures that we recommend to decrease the chances of urinary tract disease in your felines. We are now recommending canned food for all cats. The benefits for their urinary tract health (and overall health!) far outweigh the negative aspects for their teeth. We also highly recommend a veterinary formula for your cats, as they are formulated to prevent the formation of crystals and stones. We believe increasing your cat’s water consumption will greatly aid in prevention. Many cats have a preference for running water and a water fountain is an easy & great investment for them! Another important point is to keep clean litterboxes daily, and to have one more litterbox than your number of cats, ie. if you have 2 cats then you need to have 3 litter boxes. Each one needs to be in DIFFERENT place around your house.

If you have any other questions about house soiling or issues surrounding your cat’s litter box issues, please feel free to call us at Acadia Veterinary Hospital 384-3848!