When cats urinate outside the litter box some or all of the time, it is called inappropriate urination or house soiling. These urine spots are large, may be caused by physical or behavioral health issues, and occur on a horizontal surface like bedding, rugs, or the bathtub. Some cats spray urine in a territorial marking behavior, which usually occurs in small amounts on vertical surfaces like walls or furniture. Both types are common reasons for veterinary visits, and the top reason cats are relinquished to shelters. 

When your cat is peeing all over the house, it is understandably frustrating, but Aloha Veterinary Hospital can help you get to the bottom of the problem and work through possible solutions. Here is an overview of reasons why cats urinate outside the litter box and how to approach this problematic behavior.

#1: Your cat has a medical problem

Medical problems are high on the list of reasons cats go outside the litter box, and should always be ruled out before assuming the problem is behavioral. Common medical problems that can cause inappropriate urination include:

  • Urinary disease — Bladder inflammation (i.e., cystitis), bladder infections, bladder stones, and urinary crystals are common in cats, and can result in cats experiencing urgency and pain while urinating. 
  • Diseases that increase urine volume — Diabetes, kidney disease, and hyperthyroidism are common diseases that increase urine output and make it more difficult for cats to use the litter box reliably.
  • Arthritis — Arthritis affects most cats by age 10 and can reduce their mobility such that getting into and out of the litter box becomes more difficult.
  • Stress or anxiety — Separation anxiety or household stress are treatable medical behavior problems that may require medications, household modifications, and working with a specialized trainer or veterinary behaviorist to resolve.
  • Cognitive dysfunction — Older cats can become senile and “forget” where the litter box is or that they are supposed to use it for urination. Some of these cats also may have vision or hearing deficits that make finding the litter box more difficult.

Cats who are urinating outside the litter box should see their veterinarian for a urinalysis, blood work, and possible X-rays or ultrasound to examine the entire urinary tract and look for any underlying disease that could be causing the problem. 

#2: Your cat has a litter box or location aversion

Cats who have had a bad experience while they are in the litter box can develop an aversion to using the box or using the box in that location. This can occur after a painful medical problem like a urinary tract infection or declaw surgery, or if the cat is harassed by other pets while visiting the box. You may need to move the litter box, offer another one in a different location, or try a different box type. Most cats prefer litter boxes larger than those commercially available, so you can try using a storage container or baby pool instead. Try offering covered and uncovered boxes to see which your cat prefers.

#3: Your cat prefers a different litter

Some cats develop a preference for specific litter types or other substrates around the house, including carpet, clothing, or tile. Your cat’s preferences may change over time, or if they urinate outside the box for another reason and decide they like the new spot better. To resolve this problem, you need to figure out which litter your cat prefers by trying new products until you land on the right one. You may have to get creative and try non-commercial products like carpet squares, dirt, sand, paper, pee pads, or cloth. 

#4: You don’t have enough litter boxes for all your cats

The rule of thumb for litter boxes in multi-cat homes is at least one box per cat, plus one extra. Place at least one box on each house level, and ensure they are in easily accessible areas not far from the “main drag.” Don’t place litter boxes in dark or noisy rooms, and avoid corners as cats prefer to have an easy escape route should danger approach. Having enough boxes reduces competition between cats, but if one cat is blocking another’s access, you may need to discuss behavioral or drug therapies with your veterinarian or a cat-savvy trainer.

#5: You aren’t cleaning the litter boxes often enough

Cats are fastidiously clean, and they will avoid boxes that are already soiled. Plan to scoop the box at least once per day, and change the litter and scrub down the box or replace it entirely every one to two weeks.

#6: Your cat is displaying territorial marking

Marking behavior can be difficult to distinguish from regular urination, so ensure you take notes on when and where it happens so you can provide your veterinarian with as much detail as possible.  Marking is common in unaltered cats, but around 10% of neutered males and 5% of spayed females spray urine territorially or as a response to stressors. Pretty much anything can stress a cat, including small household changes or larger ones such as construction. Marking requires a deep dive into your home dynamics to come up with solutions, but your veterinarian can help.

The first step in working through a feline urination problem is a trip to the veterinarian. If you aren’t sure which of your cats is the culprit or you think more than one could be involved, set up a camera in the frequently soiled area. This also can help your veterinarian tell the difference between marking and regular urination if the cause is unclear. Whether inappropriate urination or another problem, our Aloha Veterinary Hospital team is your resource for help with all of your pet’s concerning issues.