Inappropriate Urination in Cats

I frequently hear owners calling their cats “spiteful” when they urinate outside their designated area: the litter box. While it makes sense to us to anthropomorphize our pets, this is not an accurate representation of their behavior. Cats may urinate outside of their litter box (we call it “inappropriate urination”) for various behavioral and medical reasons. They have strong preferences for their toileting area. If you notice your cat urinating somewhere he or she shouldn’t, first, ask yourself a few questions about your cat’s environment.

-How many litter boxes do you have? Current guidelines recommend one for each cat in the household, plus one extra.  (This is no easy task in New York City apartments!)

-Is the litter box clean? Cats prefer a clean litter box. Scooping 1-2 times per day and emptying all of the litter once a week should be adequate in most cases.

-Have you changed the litter brand or formula recently? Some cats have a strong preference for one texture or smell over another.

-Have you rearranged the furniture surrounding the litter box? You may have suddenly made a private area public.

-Has anything happened recently in this area that may have scared your cat? Cats will avoid areas in the house where something may have fallen or made a loud noise, as well as places where there is too much foot traffic.

-Does your cat have a history of painful urination or defecation? They may avoid their litter box due to past negative association, even if their signs have resolved.

-Has your cat’s mobility decreased? Older cats may not physically be able to get into the litter box, so they may urinate very close by. These cats would benefit from a shorter box or low-sided pan.

If all of the above issues have been evaluated and corrected, there may be an underlying medical problem. Urinary tract infections, (typically bladder infections, or “bacterial cystitis”) are very rare in cats under the age of 8 years. UTIs are more common in older animals with less effective immune systems, or with comorbidities that cause immunosuppression (diabetes, chronic kidney disease, cancer, chronic steroid therapy). UTIs can also occur if there is an abnormal environment within the bladder that fosters bacterial growth, such as urinary stones or a cancerous growth.

In general, UTIs cause increased frequency of urination, so you may see your cat running back and forth to the box, but only voiding small amounts at at time. The urine may be blood-tinged. Some cats will vocalize or seem agitated. A UTI is diagnosed with a urinalysis (where we might find blood cells, inflammatory cells and bacteria in the urine), and a urine culture (where we actually identify what bacteria are in the urine, and what antibiotics will be effective).

The MOST common condition associated with abnormal urinations in young or middle aged cats is something called feline idiopathic cystitis (FIC). Idiopathic, meaning there is no known medical cause (at least at this time); and cystitis meaning bladder inflammation. These cats have the same clinical signs as cats with a UTI, but there is no bacteria involved, and thus, no need for antibiotics. This condition is not fully understood and the cause(s) are still somewhat debated. Environmental changes or stress (the cause of which may not be immediately apparent to owners) is often implicated in FIC. Affected cats show the same signs as cats with a UTI (increased urgency, passing small amounts of urine, pain while urinating, blood in the urine).

FIC can be treated with environmental enrichment (we like the following online resource: https://indoorpet.osu.edu/veterinarians/environmental-enrichment-resources-and-references) and increasing water intake either by switching to canned food or making water more available (more water bowls) or appealing (drinking fountains). In male cats who are showing any of the urinary signs mentioned, careful monitoring is advised; if a male cat is straining and not producing urine, it is an emergency and he should be evaluated by a veterinarian immediately. Male cats have narrow urethras and are much more likely to develop a urinary obstruction, which can be life threatening; it generally requires anesthesia and hospitalization to successfully treat.

Inappropriate urination can be a frustrating problem for cat owners, but with a little troubleshooting and trial and error, many cases can be resolved.

If you have questions about inappropriate urination in cats, please ask your veterinarian for specific recommendations.

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