Hi, I’m Dr. Lauren! Read my introduction to learn more about me and my two adventurous cats, Pancake and Tiller.
Pancake and Tiller aside for this week, one of the most common reasons I see young cats in clinics as a vet is for inappropriate urination. Called by different terms, which confuse the issue, such as Feline Lower Urinary Tract Disease (FLUTD), Feline Inappropriate Urination (FIE-U) and so on, it is a bit of a minefield, at times.
Inappropriate urination refers to cats going outside the litter box to urinate, either on horizontal surfaces such as beds and floors, or on vertical surfaces such as walls. Some owners even see things like blood or crystals in the urine. Often, these cats go undiagnosed, and pet parents and undoubtedly the cats themselves, are left frustrated.
In general, there are several common reasons why a cat urinates outside the box, including but not limited to their gender and sexual status, medical causes, and behavioral reasons. A quick look at each one can give you some better idea of what’s going on. There are some unusual reasons, as well, but we’ll leave those, for now!
Common Reasons Cats Have for Inappropriate Urination
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- Gender and sexual status: Full (unneutered) male cats, and even male cats that have been neutered late in life, are commonly brought to veterinarians for urinating around the house. .
- Medical issues, such as urinary/bladder crystals, bladder stones, and urinary tract infections can cause a cat to urinate outside the litterbox. Sometimes they can be difficult to diagnose, so even with many visits to the vet they can be missed! In particular, struvite crystals may be common. In my experience as a veterinarian, it is often found in young, overweight cats that eat mostly dry food. And diagnosing them is trickier than you might think; often ultrasound and a trained eye are key to making the diagnosis! (Google twinkle artefact for fun information about possible findings)
- Causes of the behavior: We don’t fully understand how it develops, but believe that long-standing medical issues, even if resolved, or other factors, can lead cats to urinate outside of appropriate places in the house. The longer a behavior persists, the harder it is to change.
- Grooming issues: Cats may not use the litter box if they don’t like the style of the box, or the litter, or the location, etc.
What To Do If Your Cat Pees Outside The Litterbox
As you probably already know, the first step is a visit to the vet. Even if your cat is old, or even many times old!
As a veterinarian, I certainly understand that it can be very frustrating not getting answers, and having to take your cat in for multiple visits. However, just as different people can fix cars in different ways, or cook lasagna with different recipes, veterinary medicine is sometimes as much an art as a science. ! How you were trained, what school you attended, your veterinary advisors, and the equipment you have in your practice can all influence how you approach any case.
So, if as a cat owner, you’re feeling frustrated and feel like there should be answers when there aren’t, it doesn’t hurt to ask or get a second opinion from a fresh set of eyes. As a veterinarian, I promise we won’t disagree, and I’d be happy to support your search for answers!
What to Ask Your Vet
In cases of inappropriate urination, useful things to order include an ultrasound of the bladder, and sterile urine sampling for culture and microscopic examination, if your veterinarian thinks it may be medical in origin. . (The microscopic test should be a dry and stained sample, if looking for bacteria, which is bacteria in the urine, in case the urine culture is false negative).
Crystals are easy to miss if only a sterile urine sample is taken, so multiple bladder sampling and imaging techniques can be invaluable for some cats!
Providing your cat’s history along with the results of all tests prior to the appointment can make the visit more productive, and ultimately, a resolution more likely. Also, book the appointment as a second opinion for inappropriate urination, so that the appropriate time for the exam can be scheduled. However, diagnostics may need to occur in a separate visit.
If you can, find a cat-oriented vet, who can help! This could mean a feline specialist, or a feline-only clinic, or even a vet with additional certifications in feline medicine. Especially the clinics for cats are used to working with cats, they will have a higher number of cases of similar issues, and sometimes this familiarity can help in getting under an issue! Googling “feline vets near me” is often a good starting point.
Other things to look for
Other considerations for inappropriate urination in cats and things you can look for at home:
- Whether your cat urinates on horizontal or vertical surfaces can be important. Horizontal surfaces more often mean underlying medical issues, whereas vertical surfaces may indicate marking of territory or purposeful behavior.
- Is the urine stronger or smellier? This can be significant, possibly indicating infections, dehydration, or other issues
- Is the observed urine bloody, or does it feel or look sour?
- Bringing a diagram of your house and litter boxes, or even better photos, can help detect any farming issues at play.
Also be aware of pseudo spraying or phantom spraying. This can look like true spraying, where a cat (male or female) backs up to a vertical surface, holds their tail upright, and essentially wags their tail. These cats do not actually spray or urinate, but rather express pleasure, and happiness, often associated with you, their owner, being fed, or other positive experiences.
Final Thoughts
Hopefully, this will give you some more ideas about what could be going on, and some options to pursue in getting some answers to the question of why a cat might be peeing outside the litterbox.
It can be frustrating, but also rewarding when the answers come. In my experience, most of these patient cats have a medical reason for doing this, so getting them seen by a veterinary professional is key; Finding one that is comfortable with these types of issues with cats can also be important, as it can be a very subtle workup. You’re not alone, as this is a fairly common complaint for many cat owners. But, with proper help, it is often resolved.
