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Lower Urinary Tract Disease: THE Most Common Kitty Disorder and Its Potentially Life-Threatening Tell-Tale Signs

Pet cat peeing

If your kitty is relieving himself outside his litter box, there’s a reason.

Find out what’s behind the behavior by using your investigative skills.

According to, cats typically eliminate outside their boxes for one of three reasons:

  1. The cat may be suffering from a medical issue that is causing him to pee outside of the litter box.
  2. The cat may be marking his territory. This is more commonly known as urine spraying or urine marking.
  3. The cat may be avoiding the litter box and choosing a more desirable area or substrate to use when he pees.

In order to fix the problem, you must first discover what’s causing it.

Dr. Becker's Comments:

One of the reasons most cats are so easy to potty train to a litter box is because their natural instinct is to eliminate in a substrate (earthy material) that allows them to bury their urine and feces.

Your kitty’s ancestors were African wildcats -- the desert was their cat box. Modern-day felines probably gravitate to litter because it’s the closest substrate to sand they can find inside a house.

It’s also the nature of cats to bury their feces in their urine, and in the wild, wet desert sand fit the bill. This is likely why most domesticated kitties prefer clumping litter to other varieties.

Since it’s entirely natural for Fluffy to seek out her litter box to eliminate in, you should assume something is up when she chooses another location to do her business.

And I caution you not to jump to the conclusion your favorite feline has suddenly developed anger issues or an attitude problem. There’s a reason for your pet’s behavior and she’s counting on you to help her sort it out.

Rule Out a Health Problem First

Urinating outside the litter box is one of the primary symptoms of the most common kitty disorder, Feline Lower Urinary Tract Disease (FLUTD). Other signs your cat might have this problem include:

  • Frequent or prolonged attempts to urinate
  • Straining to urinate
  • Crying out while urinating
  • Blood in the urine
  • Excessive licking of the genital area

Also known as feline urologic syndrome (FUS), FLUTD is actually a group of conditions, any of which can affect your cat’s bladder or urethra, including cystitis (inflammation of the bladder), urinary tract infections, urinary stones, urethral plugs, cancer and other disorders.

Any kitty can develop a lower urinary tract disorder, but it’s most commonly seen in cats that:

  • Are middle-aged
  • Use an indoor litter box exclusively
  • Are fed a dry food diet
  • Don’t get enough exercise and are overweight
  • Are stressed by their environment

If you suspect your cat might have a lower urinary tract infection, it’s important to make an appointment with your veterinarian. The only way to find out if the litter box problem is really a medical problem is to have your vet test a urine sample.

This is a critical first step to addressing inappropriate urination.

If your pet isn’t passing urine, a situation more commonly seen in males than females but can happen to either sex, this is a life-threatening medical emergency and you should seek immediate care. Once a kitty’s urethra is completely blocked, the kidneys can no longer do their job. This can lead to uremia, a ruptured bladder, as well as organ failure and death within just a day or two.

Preventing Lower Urinary Tract Disease

I strongly encourage all my cat owner clients -- especially those whose kitties have experienced urinary tract disorders – to avoid feeding dry food (kibble).

Dry pet foods contain neither the high quality protein nor the moisture content your cat needs for optimal health. If your kitty lived in the wild, her natural diet (prey) would be about 70 percent water. Dry food is from five to 12 percent water.

Cats have a low thirst drive. Nature intended them to get most of the water their bodies need from food sources. Your kitty simply can’t make up the water deficit from a kibble diet at her water bowl.

Your cat should be eating species-appropriate canned or raw food. For cats, this means grain-free food (no corn, wheat or rice that can greatly alter urine pH). Learn how to transition your kitty to a healthy, balanced diet here. The quality of the canned food is also very important.

Tragically, lots of kitties with FLUTD-related disorders wind up at the local shelter rather than at the vet’s office because their owners mistake a manageable medical condition for a stubborn behavioral problem.

Remember – your cat is wired to be stoic no matter how he’s feeling. As a result, it can be hard to tell when he’s sick. Very often the only clue you’ll have of a problem with your kitty’s health is a change in his behavior, so your first move should be to make an appointment with an integrative or holistic veterinarian.

Urine Spraying

Some cats spray an area outside the litter box to ‘mark’ it. If your cat’s doing this, he’s not technically relieving himself – he’s sending a message, usually to other kitties in the vicinity.

Spraying is accomplished by backing up to a vertical surface like a wall and urinating while standing.

Most people associate this activity with tomcats, and while it’s true neutered males are much less likely to mark their territory than their intact counterparts, about ten percent of neutered males and five percent of spayed females will spray at some point.

It’s assumed by behaviorists kitties spray to keep other cats away from their domain. So if you’re suddenly discovering yellow stains on walls, baseboards, window coverings or furniture, you need to figure out what your cat’s reacting to.

It could be another cat in the household, especially if the other kitty is a recent addition to the family. It could also be the sight, sound or smell of cats outside your home that your kitty has become aware of.

Tips for dealing with spraying behavior:

  • Minimize exposure to other cats. (This is obviously much easier to accomplish if the problem is a neighbor cat and not another feline in your household.) Close the blinds if your cat is seeing other cats in his yard. Relocate his window perch or the piece of furniture he sits on to watch the offending cats outside.
  • Thoroughly clean the areas your cat has sprayed with an enzymatic solution that discourages re-soiling.
  • Put something your cat won’t want to walk on, such as two-sided tape, aluminum foil or a plastic carpet runner turned spiky side up along the sprayed areas to discourage kitty from getting close enough to spray.
  • Provide your cat with something stimulating to watch like kitty videos or a bird feeder placed outside, but well away from the areas of your yard neighborhood cats frequent.
  • Consider investing in a pheromone product like Feliway® to help curb spraying behavior.
  • Minimize changes to your cat’s routine and environment. Stress can trigger spraying behavior.
  • Talk to your holistic or integrative vet about other safe alternatives for de-stressing your kitty, including calming flower essences, herbs, amino acids, homeopathic remedies and nutraceuticals.

Litter Box Issues

A third possible reason your cat may relieve herself outside her box is that she isn’t comfortable using it.

She may dislike its location, the type of litter, or the size of the box. If you’ve made a change to any of those three things recently, it could be what’s behind your kitty’s sudden change in elimination behavior.

Some general guidelines:

  • The placement of the litter box should be in a relatively quiet, low traffic area of the house where there’s little chance of interruption while she’s using the box.
  • Research indicates kitties prefer large litter boxes to small ones, and many cat parents have been able to resolve outside-the-box soiling by simply investing in a larger litter box.
  • If you have a multi-cat household, you should have a minimum of one box per cat.
  • Research suggests the majority of cats favor unscented, clumping litter. If that’s not the type you use, I recommend giving it a try to see if your kitty prefers it.
  • Cleanliness of the box is also very important, as kitties are fastidious creatures and are offended by dirty litter. I recommend twice a day scooping of all feces and urine clumps, and weekly disposal of all used litter.
  • It’s important to wash the box thoroughly after dumping the used litter to remove as much odor as possible. Use plain hot water. If you use soap, choose a natural, fragrance free variety. Avoid any cleaning product that is scented or contains potential toxins.

Keep in mind these are simply guidelines, and even if studies indicate the majority of cats prefer this or that, your feline companion may have her own unique preferences when it comes to her bathroom design.

Please Don’t Make a Bad Situation Worse!

If your cat suddenly starts relieving himself where he shouldn’t instead of where he should, try to remember there’s a reason for the behavior. The reason may not make sense to you, but it does to your cat, and now is a good time to remember he is, after all, a different species! Your pet needs your help to find the cause of his behavior and fix the problem.

Under no circumstances should you ever punish a cat for improper elimination.

The first order of business is to get him to the vet to either rule out a health problem or uncover one and get him the help he needs to feel better. Punishing a sick cat won’t resolve the issue and is certainly not something a concerned, loving pet parent should ever do.

Next on the list is to make sure his bathroom suits him by focusing on the location and size of his litter box and the type of litter in the box.

Imagine if you were forced to relieve yourself in a dirty, cramped or unnatural spot, with activity swirling around you. Then imagine being punished for finding a more suitable location for yourself. Work with your cat, not against him, to help him be comfortable with his potty area.

If your cat is marking his territory rather than relieving himself outside his box, you’ll need to figure out what’s provoking the behavior and take steps to extinguish it. If you’re not able to handle the situation on your own, consult your holistic or integrative vet or a board certified animal behaviorist.

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