If you’ve ever cuddled up with your favorite blanket, only to catch a whiff of cat urine and find a wet spot, you know the frustration when your cat pees outside the litter box. And, you’re definitely not alone. In fact, inappropriate elimination is one of the most common reasons cats are surrendered to animal shelters. The All Pets Medical Center team wants to preserve your loving bond with your feline friend by helping you find the underlying cause of your cat’s inappropriate elimination. When we perform a physical exam and diagnostic testing on a cat who is peeing outside their litter box, we most commonly encounter one—or more—of the following seven causes.

#1: Feline idiopathic cystitis

Feline idiopathic cystitis (FIC) is a frustrating condition for pet owners and veterinarians alike. Termed idiopathic because the condition has no true cause, the theory is that stress is a major factor. When a cat becomes stressed because of environmental changes, intercat aggression, or any unsettling situation, their bladder walls can become painfully inflamed, which causes them to urinate small, frequent amounts, possibly with blood visible in the urine. Your cat may then avoid the litter box, because they associate the box with the pain of urinating, and seek a different, soft location, such as a jacket, blanket, or rug. 

Young, indoor, adult male cats most commonly have FIC, which can also cause the formation of crystals and bladder stones that can block the urethra. This is a potentially life-threatening emergency for your kitty. If your cat goes in and out of the litter box and does not produce any urine, or only small amounts, contact our veterinary team immediately, as they might have a blocked urethra.

#2: Urinary tract infection

Urinary tract infections (UTIs) are similar to feline idiopathic cystitis, as affected cats urinate small, frequent amounts that may be bloody. However, a UTI has a definite cause—a bacterial infection. Occasionally, cats with UTIs will also have crystals in their urine because of an unbalanced pH. These crystals rough up the bladder wall, allowing bacteria to feed on the nutrient-rich blood cells, and creating a more serious infection. For complete resolution, the bacteria and the crystals must be treated. Unfortunately, UTIs most commonly occur in older cats who have an existing disease, such as diabetes, which can complicate treatment.

#3: Kidney disease

Kidney disease affects many senior cats. As kidney function declines, the kidneys can no longer adequately concentrate urine, or filter waste and toxins from the bloodstream. So, your cat will drink more water to help flush out toxins and, since the kidneys cannot concentrate urine, they will also urinate more frequently. Sometimes, they cannot get to the litter box in time, or the litter box fills up too quickly and becomes unusable. 

#4: Diabetes

Diabetes is another common condition in cats that causes excessive urination. Glucose builds up in the bloodstream, your cat drinks more water to try to flush out the glucose, and creates more urine. Diabetes is often confused with kidney disease without diagnostic testing.

#5: Litter box size and placement

The average house cat is growing larger, and many cannot fit in a standard-sized litter box. Ideally, your cat should have a box that is one and a half times their length, offering plenty of room to scratch and find a clean spot. Litter box placement is also important, since many cat owners like to place the boxes in out-of-the-way areas that cats do not appreciate. For example, avoid placing your cat’s litter box next to the furnace, washer, or dryer, as these loud appliances can startle your pet during a sensitive moment. Choose a quiet, secluded, private spot, and offer multiple litter box locations around your home to give your cat options.

#6: Litter box cleanliness

Nobody likes using a dirty toilet, much less your finicky feline. Aim for scooping the litter box at least twice daily, and fully change the litter and disinfect the box weekly. If you have multiple cats, provide one box per cat, plus one additional box, to handle their elimination needs and ensure cleanliness. 

#7: Stress

Cats can become easily stressed in almost any situation. And, while you may think your cat is peeing on your favorite sweater out of spite, they’re likely stressed. Take this example—you welcome home a rambunctious new puppy who will not stop pestering your cat. The next morning, you discover your sweater lying on the floor with the distinct odor of cat urine. Your cat did not pee on your sweater because they were mad you brought a puppy home—they urinated inappropriately because they’re stressed, and peeing outside the litter box clearly indicates they’re uncomfortable. So, your cat urinating outside the box after a stressful event can likely be chalked up to their nerves. 

If your kitty is missing their litter box, they could be suffering from a serious medical problem. Don’t delay—contact All Pets Medical Center for an appointment.