Inappropriate elimination is an umbrella term that refers to cats who urinate or defecate outside of the litter box. It is always important to rule-out medical causes of inappropriate elimination first and foremost; diseases that can cause changes in urination or defecation include urinary, gastrointestinal, endocrine, metabolic, neurologic, or pain conditions (among others). If present, these conditions must be treated and elimination behavior re-evaluated. Once medical conditions have been ruled-out, behavioral causes of inappropriate elimination should be further investigated. A veterinary behaviorist can be instrumental in helping to address these types of issues.
Stress and Environmental Changes
Urinating or defecating outside of the litter box may be a reaction to stress or anxiety, changes to the cat’s environment, litter box aversion, or marking behavior. While significant changes to the household – like a move or adding a new pet or family member – can trigger stress behavior, so can more subtle changes to their environment. Cats are perceptive; a change in the amount of attention they receive from their owner (most often noted when owners leave town or their work schedule changes) or even rearrangement of the furniture can cause a cat to become stressed. Cats may begin urinating and defecating outside of the litter box as a manifestation of stress, insecurity, or attention seeking behavior. Reassurance from the owner with appropriate and positive attention, as well as anxiety-mitigating supplements or medications can be helpful. Prescription anxiety medications, certain probiotics (Purina Calming Care), and Feliway Optimum diffusers are a few tactics that may be advised.
Marking and Spraying
Cats may urinate or spray outside the litter box to “mark” belongings, items, or areas/territory. Initial marking behavior may occur when cats feel insecure and want to “claim” items or areas; however, marking subsequently may become a pattern once they’ve established their scent and toiletry habits in a specific area. It’s important to identify new insecurities your pet may be experiencing (ie a new pet that may be perceived as a threat), remove or address those insecurities with the aforementioned methods (attention/reassurance, medications, supplements), and clean the marked areas with an enzymatic cleaner that rids the items or area of their scent.
Importantly, because stress, anxiety, and insecurity are underlying causes of marking or spraying, punishing cats for doing so is inappropriate and often worsens the behavior.
Litter Box Aversion
Litter box aversion is another potential cause of urinating or defecating outside of the litter box. Cats may have preferences regarding size of the litter box, privacy of the litter box, type/texture/scent of litter, cleanliness of the litter, and number of litter boxes. Litter boxes should scooped daily and litter discarded twice monthly so that the litter box can be thoroughly cleaned. Disposable litter boxes are also available and can be utilized as an alternative. Some cats prefer unscented, clumping litter. It’s helpful to have at least 1 more litter box than number of cats in the household, and to put those litter boxes in various areas of the house. Some cats prefer large, covered litter boxes for privacy. For cats that are older and/or arthritic, the litter box should be in an area of the house that is easily accessible and low enough for ease of entering/exiting. There are litter attractants that can be added to litter to encourage cats to use them including “Cat Attract.”
Importantly, in some cases stress can trigger a medical condition; notably, cats can suffer from “stress cystitis” whereby emotional or physiologic stress manifests as inflammation of the bladder and urethra. In those cases, a combination of medical interventions and environmental modifications are often necessary to improve the clinical signs. Increased water intake can be helpful for cats that produce very concentrated urine – this may be achieved with the introduction of canned food (increased water content) as well as water fountains or stainless steel bowls. Further, a prescription diet may be advised to re-balance the urine and manage stress.
For additional information about cat behavior, The Ohio State has established a wealth of information through their Indoor Pet Initiative: https://indoorpet.osu.edu/cats
If your pet is straining but unable to urinate or becomes acutely lethargic, very painful, or distressed, seek emergent evaluation.
We advise follow-up with your primary care veterinarian or a veterinary behaviorist to guide future treatment.