Many years ago a very astute professor asked a group of inexperienced veterinary students which of the
hundreds of illnesses affecting the feline population was the number one fatal disease of cats. Numerous
hands shot up announcing all sorts of diseases and all were incorrect. Finally a lone student way in the
back of the lecture hall called out “peeing out of the box.” Bingo, my professor responded.
Inappropriate urination or stooling out of the litter box is the number one fatal disease of cats. Most
individuals will euthanize a cat that will not use the litterbox.
So why do our feline companions do this? I believe that 95% of all inappropriate urination and stooling
out of the box problems are behavioral not medical. The trick is to figure out the problem. So where do we
begin? First, some information.
A bladder inflammation or infection may be present in a small minority of cats. Most cats have
inflammatory problems and bacteria are not involved. Cats having an inflammatory problem will urinate
multiple times, very small amounts all over your house because they simply can’t get to the box when the
urge to urinate comes over them. They hurt! There are many theories currently being passed around
and most are centered on stress. Stress, researchers believe produces a substance in the bladder lining
that causes irritation and bleeding. Treatment in these cases centers on relieving stress by
environmental changes and medication for pain relief.
There are a group of cats that have a poor bladder mucous lining. Mucous protects bladder linings from
the scalding effects of urine. The treatment is aimed at improving this lining and relieving the subsequent
pain.
Bladder infections occur most frequently when a cat has a stone in the bladder, has kidney dysfunction or
suffers from diabetes. All of these problems predispose your pet to infections that cause irritation and the
uncontrollable urge to urinate anywhere. These problems are corrected with antibiotics and pain relief.
Crystal formation in the urine gets a lot of attention. Formation of offending crystals may cause irritation,
but the problem is the ability of the crystals and accompanying mucous to actually obstruct the urethra
(the tube from the bladder to the outside) and not allow the cat to pass urine at all. This is a whole
different problem to be discussed elsewhere. Crystal formation is handled with a prescription diet change.
Determining which if ANY of these problems your pet suffers from requires a visit to the clinic (usually all-
day unfortunately) to collect a urine sample and an examination. If your cat has a normal exam but has
blood in the urine as determined by a complete urinanalysis, then a urine culture is performed with a
radiograph to determine the presence of a stone. All cats are discharged with antibiotics until the culture
results are in. If there are bacteria, the antibiotics are continued for a set amount of time. If there are no
bacteria, then the problem is treated as a bladder inflammation with the appropriate pain relief and diet to
control crystal formation. If there is a stone, that again is a problem discussed in a one-on-one discussion
with the veterinarian. You can also visit our link “Bladder Stones” to see the options available.
Now we come to the cat that has no blood in the urine sample ( the VAST majority). Usually this means
that your pet is very stressed (i.e. a behavioral problem) about something around the house and he or
she needs to mark everything in sight with urine to make him happy again. What do I do?????
Now I’ve done all this you say. My cat has no inflammation; no infection, no crystals, he or she is fixedetc. I’ve done everything suggested for litter box happiness and nothing is working. In these cases we
can try medication to relieve stress. These medications either work spectacularly or they don’t work at
all. All you can do is try them and see if they work. Unfortunately we have seen cases that no matter what
is tried, nothing works. These cats need a complete change in lifestyle or a new home. Some indoor cats
will need to be allowed to go outside or they will continue to use areas outside their boxes. Sorry, I know
this is a politically incorrect thing to say, but it’s the sad truth. Some cats need the great outdoors. If
letting them outside (if this is possible) solves the problem, then protect them as best you can with
vaccines, flea stuff etc and let them go. They are dead if they continue to urinate or stool outside the box.
So follow these guidelines, cross your fingers and see what happens. The good news is that most cats
will come around with these suggestions.
hundreds of illnesses affecting the feline population was the number one fatal disease of cats. Numerous
hands shot up announcing all sorts of diseases and all were incorrect. Finally a lone student way in the
back of the lecture hall called out “peeing out of the box.” Bingo, my professor responded.
Inappropriate urination or stooling out of the litter box is the number one fatal disease of cats. Most
individuals will euthanize a cat that will not use the litterbox.
So why do our feline companions do this? I believe that 95% of all inappropriate urination and stooling
out of the box problems are behavioral not medical. The trick is to figure out the problem. So where do we
begin? First, some information.
A bladder inflammation or infection may be present in a small minority of cats. Most cats have
inflammatory problems and bacteria are not involved. Cats having an inflammatory problem will urinate
multiple times, very small amounts all over your house because they simply can’t get to the box when the
urge to urinate comes over them. They hurt! There are many theories currently being passed around
and most are centered on stress. Stress, researchers believe produces a substance in the bladder lining
that causes irritation and bleeding. Treatment in these cases centers on relieving stress by
environmental changes and medication for pain relief.
There are a group of cats that have a poor bladder mucous lining. Mucous protects bladder linings from
the scalding effects of urine. The treatment is aimed at improving this lining and relieving the subsequent
pain.
Bladder infections occur most frequently when a cat has a stone in the bladder, has kidney dysfunction or
suffers from diabetes. All of these problems predispose your pet to infections that cause irritation and the
uncontrollable urge to urinate anywhere. These problems are corrected with antibiotics and pain relief.
Crystal formation in the urine gets a lot of attention. Formation of offending crystals may cause irritation,
but the problem is the ability of the crystals and accompanying mucous to actually obstruct the urethra
(the tube from the bladder to the outside) and not allow the cat to pass urine at all. This is a whole
different problem to be discussed elsewhere. Crystal formation is handled with a prescription diet change.
Determining which if ANY of these problems your pet suffers from requires a visit to the clinic (usually all-
day unfortunately) to collect a urine sample and an examination. If your cat has a normal exam but has
blood in the urine as determined by a complete urinanalysis, then a urine culture is performed with a
radiograph to determine the presence of a stone. All cats are discharged with antibiotics until the culture
results are in. If there are bacteria, the antibiotics are continued for a set amount of time. If there are no
bacteria, then the problem is treated as a bladder inflammation with the appropriate pain relief and diet to
control crystal formation. If there is a stone, that again is a problem discussed in a one-on-one discussion
with the veterinarian. You can also visit our link “Bladder Stones” to see the options available.
Now we come to the cat that has no blood in the urine sample ( the VAST majority). Usually this means
that your pet is very stressed (i.e. a behavioral problem) about something around the house and he or
she needs to mark everything in sight with urine to make him happy again. What do I do?????
 | First rule of thumb in the feline world; a litter box for each cat plus one. That means if you | |
| have 2 cats you have three litter boxes, 3 cats you have four litter boxes and so forth. |
| Litter boxes are widely spaced. Do not have four litter boxes all in a row no matter how | |
| tempting. Felines that are having issues with one another do not want to use a box when their arch- enemy is using the box next to them. Your cat is urinating in the dining-room? Put one there until company arrives. |
| Do not place boxes next to machinery that cycle on and off like the water-softener or furnace. |
| Use unscented scoopable litter. Having said this, you may want to try multiple different types of | |
| litter to determine if you cat has a real litter fetish. |
| Make the litter boxes private; do not allow dogs or kids to disturb the sacred box. |
| Clean the boxes daily. Some cats are so clean that even the smallest amount of urine or stool | |
| is offensive to them and they won’t use the box. |
| Try uncovered vs covered boxes. |
| Do not leave gym bags (very smelly) or dry-cleaning bags around on the ground. Do not allow | |
| cats access to dirty laundry. Cats of any persuasion find these objects irresistible. Some cats love plush bathroom rugs. Get rid of them or put them up! |
| Make sure that stressful events are coupled with the ability of the cat to get away; new babies, | |
| company, construction etc. Try a separate room, a new high cat-tree etc. |
| Spay or neuter! Intact cats will mark everything. |
Now I’ve done all this you say. My cat has no inflammation; no infection, no crystals, he or she is fixed
can try medication to relieve stress. These medications either work spectacularly or they don’t work at
all. All you can do is try them and see if they work. Unfortunately we have seen cases that no matter what
is tried, nothing works. These cats need a complete change in lifestyle or a new home. Some indoor cats
will need to be allowed to go outside or they will continue to use areas outside their boxes. Sorry, I know
this is a politically incorrect thing to say, but it’s the sad truth. Some cats need the great outdoors. If
letting them outside (if this is possible) solves the problem, then protect them as best you can with
vaccines, flea stuff etc and let them go. They are dead if they continue to urinate or stool outside the box.
So follow these guidelines, cross your fingers and see what happens. The good news is that most cats
will come around with these suggestions.
 | |  | |  | |  | |  | |  | |  | |  |
| Inappropriate Urination; Better Known as “Oh my God, the cat peed on the Carpet” |