Could Dementia Be Making Your Cat Urinate Outside the Box?

Distinguishing dementia from other conditions that could interfere with proper toileting.


Your cat, older than 12 now and perhaps even older than 15, has started to urinate outside the litterbox and perhaps defecate on the floor sometimes as well. Why all of a sudden is she engaging in this undesirable behavior when she has known where to void her entire life?

It could be because of pain — musculoskeletal aches and pains, such as a worsening of arthritis that makes it more difficult for her to climb in and out of the box or walk over from wherever she is lying down when the urge strikes. Or it could be because of a new disease. Diabetes makes a cat drink more and also urinate more. Other diseases that can affect the ability to control urination include kidney disease, a bladder tumor, or cystitis — inflammation of the bladder wall that is often associated with increased urination.

That’s why it’s important for you to take your pet in for a check-up if her long held habit of going to the “bathroom” where she should has largely fallen by the wayside. Too many people, sad to say, relinquish their old cats or euthanize them because they don’t want to put up with inappropriate elimination and also don’t want to work through what the cause and solution might be. Or they assume the cat is trying to spite them or have her way. Nothing could be further from the truth. Cats don’t operate out of spite.

But what if the vet conducts a series of screenings on your pet and nothing physical can be found to account for her new behavior? If it’s not spite, what is it?

Behavioral reasons for missing the litterbox

One non-physical reason a cat may start “missing the mark”is that she is feeling stressed.

If she senses tension among the people in the household, or if someone has moved in or out, or even if furniture has been moved, she may be thrown off her game and not make it to the litterbox on time. This could be true for a cat of any age, not just an older pet. If you and your vet work backwards to determine that stress might be the issue, it falls to you and whoever lives with you to do whatever you can to make your cat emotionally comfortable.

Another reason a geriatric cat might start missing her “toilet” after years of using it correctly is dementia. Known as feline cognitive dysfunction, it affects more than 55 percent of cats ages 11 to 15 and more than 80 percent of cats 16 to 20, according to one estimate.

The condition could make a cat disoriented, losing her sense of direction even in her own home. Or it could make her uncouple the urge to eliminate with an automatic move toward the litterbox. Sometimes what has been learned simply gets unlearned as a cat’s brain becomes less cooperative. Unfortunately, you can’t reverse feline cognitive dysfunction. But you can take some simple steps that might help your pet think to use the litterbox again.

Solutions at hand

Try any of the following, or a combination of them.

  1. Put out a third, and maybe even a fourth, litterbox in different parts of the house. Any cat who lives without other cats should have at least two litterboxes as a rule of thumb. But in the case of feline dementia, having several increases the chances that she will be closer to one when she needs it, increasing the odds that she will make use of it.
  2. Don’t change the locations of the original litterboxes; put the new ones in spots that are easy to come across. The instinct, understandably, is to put them out of sight. But for a befuddled cat, out of sight may very well tend to mean out of mind.
  3. Make sure the litterboxes have low sides and are therefore easy to climb into. Anything that might be perceived by your disoriented cat as an impediment may keep her from following through as you want her to.
  4. Keep the litter scooped, and change it once a week after washing the box. Your cat may not be her old self, but her penchant for fastidiousness may still be as intact as ever.


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