One of the most common behavioral and health problems cats have is eliminating outside the box. In some cats, this is a sign of a urinary tract problem, such as urinary tract infection, increased urine production (diseases like diabetes, and many others, cause this), urinary pain from crystals/stones, and other primary urinary problems. For defecating outside the box, it may be a sign of bowel discomfort due to constipation or diarrhea. For cats with urine marking, the problem may be a sign of anxiety or stress in the cat, and respond to medication for anxiety. For cats with inappropriate elimination which is neither marking nor medical, improving the nature of the litter box and retraining their habits is key. For some of these cats, anxiety is also a component.  In older cats, especially over the age of 12, arthritis may make travelling to or entering the box uncomfortable, motivating the cat to go in other places.

The first step in evaluating this disorder is to take a detailed history about what the cat is doing, where, and how often, and including any changes in the household (such as changes in family members or pets living at home, changes in where the cat lives, home construction projects, etc.).

Next, a full physical exam and urinalysis is performed to help determine whether there is a medical cause for the signs.  If there is a medical cause, it is critical to treat it.  This may require medication for a short time or for life if the cat has a chronic disease.  In most cases, the cats do best on a canned food which helps them have good nutrition, more water intake, and a healthy weight. Your vet may prescribe a specific canned food if your cat has a urinary tract problem.

If your cat has no urinary infections, crystals or other abnormalities, the most common cause (behavior sometimes in conjunction with anxiety/stress) is likely the culprit. For these cats, behavioral modification using confinement so that they only have one place to eliminate (the litter box) is highly effective in getting the cat to resume consistent litter box use. This may also require making changes to reduce the availability of other places your cat is currently using (picking up throw rugs, putting laundry in closed bins, etc) to help change the cat’s habits.   For some cats, especially those in which we can identify that anxiety is definitely the cause, we may also use a medication to reduce their anxiety, since treating the underlying cause is the best way to solve the problem. However, even if your cat is on antianxiety medication, it will work best in conjunction with the behavior modification plan.

We do not know why some cats become stressed by what may seem like small changes in their household, especially since other people and cats in the house may not show similar signs of stress. However, we do know that cats which show this pattern of inappropriate elimination as a response to anxiety may do so repeatedly.

Further, once a cat starts using an inappropriate place to urinate or defecate, it may become habit, or attract other cats to use that place inappropriately also. Therefore, if any of your cats start to have inappropriate elimination, contact your vet promptly so we can start treatment and minimize the risk of ongoing property damage or bad habits developing.

Help Your Cat Like To Use The Box

Cats can be finicky about their litter boxes. Here are some things you can do to help ensure your litter boxes are attractive and not off-putting to your cats. We want to make the boxes some place the cat wants to go, rather than a place the cat avoids.

1. Plenty of boxes. Have one more box than you have cats: if you have 3 cats, have 4 boxes. Cats often want to go all at the same time, first thing in the morning. If all the boxes are occupied, someone may end up going outside the box.
2. Clean boxes. Make sure all boxes are cleaned every day. No one wants to use a dirty box.
3. Consistent litter substrate. Some cats don’t like change. If you’re not sure what litter your cat likes, you can line up a row of boxes with different types of litter and see which one the cat uses. If your cats have been consistently using a specific litter type, don’t change it. Change in litter type (particle size, substance, smell, etc) can make the box unattractive and make a cat stop using the box.
4. Boxes nearby. If you have multiple levels, have a box on every floor/story of your house. If your house is large, make sure there are boxes at each end of the house so that cats don’t have to travel really far to use one.
5. Easy to access. Make sure at least some boxes are easy to access. If a box is behind a closed bathroom or bedroom door, the cat can’t get to it. Upstairs, downstairs, over/under baby gates, and otherwise hard to access boxes may deter a cat which is tired, sore, or needs to go urgently. If you have an older cat or a cat recovering from injury, low-sided boxes that are easy to step into, or ramps leading into higher-sided boxes, can make it easier to use the box even with sore legs.  Boxes should be 1.5 times the length of the cat. You can use plastic storage bins or other items that are adequate in size and shape if commercial boxes are too small.
6. No scary things nearby. If the box is next to the laundry machines, and they are noisily running, it may scare off a cat. High traffic areas, places near dogs, or ones requiring the cat to go past an aggressive cat housemate may all keep the cat from feeling comfortable going to, and sitting in, the box. Try to place the boxes where they are peaceful to enter and use.
7. Privacy. Try using covered, top-entry, or other box styles (without removing the old style boxes) to see if your cat is more comfortable using a box that gives the cat more privacy.
8. Humor preferences. If you aren’t sure what your cat likes, offer a litter box buffet – a row of different boxes (covered, open, automatic; clumping, clay, other litter types, etc) so you can find out what your cat prefers to use. Sometimes finding the right combination does the trick.

Litter Box Boot Camp: Behavioral Modification for Inappropriate Elimination

All cats who start using non-litter-box places to eliminate need to be encouraged to use the box as the one, and only, suitable place to go. The best way to do this is to give the cat a very simple, routine life where the only attractive place to eliminate is the litter box.

Create a “studio apartment” for your cat. Start with a large dog crate.  These are typically made of thick wire and have a removable plastic tray in the bottom.  Place in the crate a litter box with litter, a food and water bowl, and an empty plastic cat carrier (the cat’s bed). This gives the cat a place to eat, drink, sleep and eliminate. It’s no-frills but it provides all the cat’s needs.

The cat should stay in this “studio apartment” until he/she has used the litter box consistently with no mistakes for 2 weeks.

Each level or phase will last two or more weeks, until the cat has been successful using the box for 2 weeks. If the cat fails, then go back to level one.

Level One:  Confined to “studio apartment” unless on a leash or in your arms.

Level Two: Confined to “studio apartment” unless within eyesight in same room with you and only out while you are awake/paying attention.

Level Three: Confined to “studio apartment” unless within the same room, or one room away (but still within eyesight) and only out while you are awake/paying attention.

Level Four: Confined to “studio apartment” unless you are at home and only out while you are awake/paying attention.

Level Five: Confined to “studio apartment” while you are at work or asleep. Loose in house when you are home, even if you are not paying direct attention, and while you run short errands (less than a few hours).

Level Six/regular life: Loose in house at all times even when you are not home for more than a few hours/overnight.

This Boot Camp may seem like it’s a lot to do. However, it really takes less effort than you think, especially when you realize you won’t have to spend a significant time every day cleaning the messes your cat was leaving in your house.  Also, Level One is a great time to thoroughly clean places where your cat previously eliminated, and brainstorm ways to keep them from being used again once you reach the next level.

Eliminate attractive places to go: Pick up bathmats and throw rugs. Place clean and dirty laundry in closed closets, baskets with lids, or other inaccessible areas. Use of scatmats and other deterrents can also help keep cats off of places they used to go.

Husbandry and Management for Inappropriate Elimination

In addition to the already discussed changes in the litter boxes themselves, there are household or environmental management changes that can help reduce the cat’s anxiety and significantly improve behavior.

Visit the Indoor Cat Initiative for helpful tips on making your indoor cat’s life as enriched as possible.

http://indoorpet.osu.edu/cats/

Some helpful things you can do include:

– Place Feliway diffusers in all rooms (see package for details). If unable to put them in all spaces, put them in places where the cat eliminates to help reduce the cat’s stress in these areas.

– Offer high perches such as cat trees, empty shelves, etc. for your cat to enjoy

– Ensure each of your cats have one-on-one play and quality time with you; even 10 minutes twice a day can really help relax your cat and help your cat feel less stress.

– Give your cat a room of his/her own – an entire room, a closet, bathroom, or large crate – where  your pet can retreat when desiring alone time.

– Have night lights where cats sleep in multi-cat households so no one gets startled by other cats moving around in the dark.

– Try to keep to a similar daily routine in which events, such as meals, happen at consistent times.

– Try to avoid having heavily scented items near the cat’s favorite hangouts, litter box, and food.  Heavy scents in these areas may deter the cat from using them or make the cat uncomfortable when she/he does use them.