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Ask the Vet - Litter Box Blues

Dr. Lopez, DVM:

Why is my cat peeing outside the box?


Cats peeing outside of the box is not only smelly, but also frustrating for everyone involved! Why would your cat do this, and when should you be concerned?


Causes for peeing outside of the box

There can be many reasons for a cat to not make it to the litter box. If occurring, it is important to rule out medical reasons first.


Medical reasons:

  • urinary tract infection

  • bladder stones

  • certain diseases that can cause thirst/frequent urination (diabetes, kidney disease)

  • bladder inflammation (also known as cystitis or feline idiopathic cystitis)

These are important to investigate, and a veterinarian may recommend a urine sample, bloodwork and possibly an x-ray or ultrasound of the bladder to see if these are the causes. If normal, then we move on to behavioral reasons.


Behavioral reasons:

  • Litter box is too dirty- ideally scoop at least once a day, and deep clean (empty the litter box entirely, wash box with soap and water) once a week.

  • Not enough litter boxes- the goal is to have one more litter box than the amount of cats you have. So if you have 2 cats, you would need three litter boxes in different areas of the house. Litter boxes next to each other don’t count!

  • Cat doesn’t like the litter or the litter box style- Has there been a recent change in the litter type or brand? (clumping vs pellet, fragrance vs no fragrance). If you only have closed litter boxes, try introducing an open one without a top.

  • Cat is being bullied- was there a recent ambush in the litterbox by another animal in the home? Is there inter-cat fighting going on?

  • Lingering urine smell- be sure to clean any urine spot with enzymatic cat urine cleaner. Cats will continue to urinate on any spot that has their urine smell, so ensure proper cleaning each time.

  • Cat is seeing other cats outside through the window- Seeing cats outside can stress your cat, or cause them to mark territory even if they are neutered. If noted, try covering the bottom portion of the window with a hazy window cling, or preventing your cat’s access to that window.


So you saw your vet, and labs were normal, now what?

Some cats are prone to developing painful bladder inflammation without infection. We often refer to this as FIC, or feline idiopathic cystitis. Stress is often thought to be a trigger. Here are a few ideas to decrease stress for your cat:

  1. Purchase a Feliway diffuser for your home. These release a calming pheromone to help calm anxious cats. Plug in where your cat hangs out the most, and replace monthly.

  2. Ensure your cat has a “safe place”. If living with dogs, is there a spot kitty can escape out of reach when they want alone time? A nice bed elevated higher than the dog, or a quiet room only they can access during the day?

  3. Environmental enrichment- Is kitty mentally stimulated throughout the day? Try adding 10 minutes of play a day, or varying the toys left out. Food puzzles are great for getting your cat to hunt or work for their food. Ohio State Veterinary Medicine has a wonderful website that goes more in depth on how to enrich your cat’s space: For Cat Owners | Indoor Pet Initiative (osu.edu)


When to go to the vet

If your cat has urinated outside of the litter box more than once recently, consider seeking a vet visit to ensure none of the medical issues above are the cause. Your vet can work with you to develop a plan to investigate medical and behavioral causes. Depending on what your vet finds, treatments may include a urinary diet, behavioral medication, pain medication or environmental enrichment.


If your cat is straining to urinate but nothing or very little is coming out, this would be an emergency, and vet care should be sought right away. Male cats are especially prone to urinary blockages, which can be life threatening. If straining is noted, seek an ER vet immediately.


In summary

As much as it seems like Fluffy is urinating on your clothes because she is mad at you, cats urinating outside of the box means they are trying to tell us something! They may have a medical issue, be too scared or uncomfortable to use their litter box or be overly stressed out. Work with your vet to make a plan that works best for you and your kitty. 🐾

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