Original Question: "Hello! My 4-year-old male cat has started to pee outside of the litter box sometimes. It has been going on for about 4 months. I took him to the vet when the behavior was first found - they did an X-ray and urinalysis and it was all normal. The vet thought it might be behavioral but also gave me some prescription food. I tried various litter box changes (changed litter, litter box, etc.) The changes got him to pee in the box again but he still occasionally pees outside of the box. When he pees outside of the box it is always on the couch or chair (on the back so it’s a more vertical surface). Also, he only uses a litter box when it is next to the couch in the living room (I’ve even switched out the living room litter box) but it seems like location is his only concern. He is on a primarily wet food diet with some kibble mixed in. He seems to drink water okay. Thank you for any insight! Also, he has another vet appointment in a week but I wanted to get another opinion." - Rachel
Whenever our pets are eliminating inappropriately, whether it be urination or defecation, it can be caused by two things, medical reasons or behavioral reasons. So the first thing we have to do is rule out medical problems. It helps that you have worked with your veterinarian to resolve some medical questions. You did not mention if blood tests were done or if early signs of arthritis may have been noted on the X-rays. Otherwise, the behavior aspect must continue to be investigated or addressed.
Cats are very in tune with their environment and so there are many stimuli that can cause them to become anxious or change their behavior. Cats can also perceive things that we can't, so a high-pitched sound that doesn't bother us, may bother them and cause them to be fearful around the litter box. Now you may go hunting for these things, but in the end, it's rare to find. It doesn't take much for a cat to start eliminating inappropriately and once they do, the reason they started doing it may be gone but they are now just continuing. The longer you let this go on, the more it's going to be ingrained and difficult to resolve.
There are some strategies you can employ to focus their attention on the litter box. You can start putting treats near the litter box but I always tell people not to let the cat know you're putting them there. This way they just happen to find them there. They may start visiting in the litter box just to see if they've shown up again and since they're there, they might as well use the litter box.
If you haven't added a second litter box to the home, it's definitely time. Keep in mind that cats can develop issues like arthritis, which can make it difficult for them to go up and down the stairs and this may be the cause of not visiting the litter box.
When a cat is really overweight and large, they may no longer fit in the litter box and it may not be comfortable to use it. I often have owners buy a large bin, cut the sides really low, put it in a garbage bag and sprinkle litter on top of it creating their own litter box with a much larger surface area and low sides to it so it's very easy to step in and out.
There are also products that you can sprinkle in the litter that is supposed to attract them to it. These can work in some cases but not in others.
If anxiety is the cause, you may be able to improve this with environmental enrichment. Get your cat playing more and engaging it with toys. This will reduce stress. If your cat is overweight, this alone can make it stressed so focusing on weight loss in cooperation with your veterinarian would help as well.
Since your cat is eliminating in a particular spot, you can restrict access to this area if possible. Always clean the area where they have eliminated very thoroughly. Even a small amount of debris or odor will make them return to that place and think it's an appropriate place to eliminate.
Lastly, a lot of cases do take medication to solve these issues. I would have to say that anxiety, in general, is usually the cause of the problem. Whenever I say this to clients, I always get the same response that their cat is not stressed. But what clients don't understand is that although you're providing a very nice home for your pet, we have to remember that these were animals that lived in the outside environment and engaged with their world by hunting and hiding. Many cats can develop stress just by being an indoor cat. You can speak to your veterinarian about anti-anxiety supplements and anti-anxiety medication to use as a trial if the aforementioned strategies do not work.
If you reach an end and are considering euthanasia....and I only say this because I have seen it before, I'm not making any assumptions but I just need to make the point. You could consider drastic measures, such as restricting your cat to a small room or small area of the house, give them anti-anxiety treatment so they are not stressed about that, and give them very little choice other than to eliminate in a litter box. I must stress that this is as a last resort before giving a cat up for adoption or making them an outdoor cat which in itself can be quite dangerous and still may not fix the problem when he is in your home.
I hope this helps,
Dr. Ryan Llera
Disclaimer: healthcareforpets.com and its team of veterinarians does not endorse any products or services mentioned. Advice presented by our veterinarians is not meant to replace a regular physical exam and consultation with your primary veterinarian. We always encourage you to seek medical advice from your regular veterinarian.
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