Dear Doctor – Our experts offer strategies to address urinating outside the litter box

Frustrated by cats litter box avoidance


[From Tufts November 2011 Issue]

My indoor neutered male 3-year-old domestic short-haired cat was diagnosed with cystitis last October after I found him urinating outside his litter box. He was placed on Clavamox for 10 days and the crystals and blood in urine disappeared. He was fine until recently when he started to urinate again outside the litter box.

There are no other cats in the house. I live alone and have changed nothing in the household routine. My veterinarian is also at a loss for his behavior. Because there were a few crystals showing in his urine recently, she deemed it unnecessary to prescribe antibiotics again. I did ask her to issue the Clavamox again for 10 days. She also prescribed seven doses of prednisolone (5 milligrams.). Her technician suggested replacing the towel under the litter box with a puppy pad, which might work better because it is softer.

I have used the same brand of litter — Feline Pine — since adopting him when he was 8 months old. Whenever he defecates, I scoop it out as soon as possible. I also replace the litter and plastic liner once a week. I first place plastic down on the cement floor, then a towel and then the litter box. To clean the soiled areas, I have used Urine Gone and Woolite Stain Remover.

He is alert, likes to play and is up to date on all his vaccinations. Please help.
Claire Muskus

Dear Claire: What you are reporting is a litter box problem, as opposed to one involving marking or medical issues. It is thought that cats with cystitis sometimes associate pain or discomfort with litter box use and that erroneous connection can lead to litter box avoidance and house soiling. That said, your litter box facilities are far from ideal for any cat, so the cystitis he had may have simply been the straw that broke the camel’s back.

Here’s what you should do and why:

  1. Switch to a fine sand-texture scoopable litter. Cats prefer sand-textured litter because they have desert ancestors and using sand is “in their blood.”

  2. Eliminate the plastic liner. Most cats dislike them.

  3. Scoop the litter box once daily. Do not hover and scoop the box immediately after each elimination incident.

  4. Use Zero Odor™ to clean up after future “accidents.” It is available online and at Bed, Bath and Beyond stores. I regard it as the best at eliminating pet odor.

  5. Get rid of the towel and plastic under the box. The towel might be a preferable substrate to the Feline Pine you have been using. Also, having plastic underlay beneath the litter box is a turn-off to some cats.

  6. Do not put down a “puppy pad.” Those contain pheromones and may encourage his urination outside the box.

  7. Make sure you add a second litter box. There should be one litter box per cat plus one.

  8. Make sure both litter boxes are on different levels of the house and convenient for your cat to access.

If you do all of the above, I am sure the problem will disappear rapidly.
Nicholas Dodman, BVMS
Animal Behavior Clinic Director
Cummings School of Veterinary Medicine
at Tufts University


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