Got a cat peeing outside the litter box? Some cats start peeing anywhere and everywhere in your house, while others choose specific spots, like the bathtub or even your bed. Before you address this problem, it's important to understand why your cat is peeing inappropriately. Cats may urinate outside the litter box due to medical or behavioral issues.

Here are 9 reasons cats pee outside the litter box and what you can do to help.

Medical Reasons

If your cat is peeing outside the litter box, the first step is to visit your veterinarian. The vet will perform a physical examination and check a urine sample. Based on the results, your vet will recommend treatment. Many medical issues can cause inappropriate urination in cats. Some of the more common include:

Urinary Tract Infection

Urinary tract infections are uncommon in young cats but often cause urinary issues in older cats. Bacteria in the urine may cause an inflammatory response in the urinary tract. Antibiotics are used to treat a urinary tract infection. Your vet will likely recommend follow-up testing after the antibiotics are finished to make sure the infection is gone.

Bladder Stones

Some cats develop stones in the bladder that may cause irritation and even blockage. Crystals may accompany bladder stones or be a precursor to stone formation. If your vet suspects bladder stones, X-rays will be needed to determine the size and quantity of the stones. Smaller bladder stones might be dissolved with a special diet, but larger stones may require surgical removal (cystotomy). It's common for a cat with bladder stones to also have a UTI. If so, antibiotic treatment is necessary. 

Idiopathic Cystitis

The term cystitis means inflammation of the bladder. Idiopathic means the cause is unknown. Cats with cystitis often have blood in their urine (hematuria). Testing a urine sample is essential because the blood may only be detected microscopically. If your vet determines that your cat's urine contains blood (but no crystals, bacteria, or stones), the likely diagnosis will be idiopathic cystitis. This condition is usually treated with diet changes and environmental enrichment. Pain and anti-anxiety medications may also be used.

FLUTD

When one or more urinary issues are chronic, the condition is typically called feline lower urinary tract disease, or FLUTD. If your cat is diagnosed with FLUTD, your vet may recommend a special urinary diet or supplements to support the urinary tract.

Urinary problems can lead to serious urinary obstruction, especially in male cats. If your cat is posturing to urinate and little or no urine is coming out, your cat might have a blockage or partial obstruction. In this case, get your cat to a vet immediately as this condition can quickly become life-threatening.

Systemic Disease

Inappropriate urination may occur when a cat has a non-urinary health problem. Your cat may be peeing outside the box because of pain or discomfort elsewhere in the body.

Symptoms of chronic kidney disease may include increased urination. Other diseases that may increase the amount of urination your cat produces are liver disease, diabetes, and thyroid issues. If your cat has been drinking more, urinating more, or the litter box needs cleaning more often, see your veterinarian for help.

Your veterinarian may recommend comprehensive lab work to look for a health issue if none is found during the initial exam or urinalysis. Lab work can reveal serious health problems, and early discovery can allow your vet to begin treatment immediately.

Behavioral Reasons 

If no medical cause is found for your cat's inappropriate urination, your cat's inappropriate urination may have behavioral reasons. It's important to determine if environmental factors are causing the behavior.

Litter Box Preferences

Cats are particular about their toilets and may avoid a litter box if it's not to their liking. Your cat may feel the box is too close to the action in the house (or too far away from it). Nearby noises, such as a washing machine, may scare them away. Many cats dislike covered boxes because they feel cramped, but they still want some privacy. Or, a cat may dislike the scent or texture of the cat litter. With so many variables, it may take some trial and error to figure out your cat's preferences.

Dirty Litter Box

Sometimes the litter box is simply too dirty for your cat. It's important to properly scoop your cat's litter box at least once daily and top it off with clean litter. Empty and clean the box every week or two, then refill it with clean litter.

Old Urine Smells

If your cat has peed in an area before, the smell might remain even after you clean up the accident. If old urine odors remain in your home, there's a very good chance your cat is returning to the area because of the lingering smell. Use a urine detector to find the stain, then a stain and odor remover, and start scrubbing.

Stress

Your cat may be peeing outside the litter box because they're stressed out at home. They may be unhappy with another animal in the household and are marking their territory to send a message to the other animal. Or, your cat may feel it's too dangerous to access the litter box if the other animal is out and about. Other sources of stress include moving to a new home or having a new human stay in the home.

Cats are sensitive to the smallest of changes in their environments. No matter what the source of the stress is, make sure your cat has a quiet place where they can get away. The new animal or human should not have access to this place of refuge.

How to Stop a Cat From Peeing Outside the Litter Box

Once you have an idea of the reasons behind it, you can take steps to stop your cat from peeing outside the litter box.

Rule Out Medical Concerns

Before you deal with behavioral issues on your own, contact your veterinarian for advice. It's important to rule out medical causes, even if your cat has no other symptoms. In addition to treating medical issues, your vet can give you sound advice about addressing the behavioral aspects.

You can often prevent new issues from cropping up by keeping your cat healthy. Visit the vet for routine checkups and contact the vet if you have any concerns.

Improve Litter Box Conditions

Perhaps the most common reason cats urinate inappropriately is that they dislike the litter box. If your cat is peeing everywhere, and you've ruled out medical issues, then it's time to reassess your litter boxes. 

• Make sure your cat's litter boxes are as clean and desirable as possible. Choose the largest litter boxes possible and try to keep them uncovered. Your cat may feel cramped inside a covered box, especially if they're large or fluffy.
• Place litter boxes in a quiet yet accessible area of the home. Make sure they're not placed in the area where your cat eats or drinks. For the sake of your cat's privacy, consider a decorative screen to separate the cat litter box area from other areas.
• Make sure there's a box on each floor of your home, if applicable.
• For older cats, the litter box should be easy to get into. Consider getting a shallow cat box or placing a ramp at the entrance of the box. 
• Find a good cat litter that your cat likes. Ideally, choose an unscented, scoopable litter that cats love, such as Dr. Elsey's Cat Attract. 
• Many veterinarians recommend having one litter box per cat, plus one extra. This means having two litter boxes in a one-cat household as some cats use one box for urine and the other for stool. In multiple-cat homes, extra boxes can prevent competition between cats for territory.

Reduce Stress

Your home should be a happy place for your cat. Provide feline enrichment by adding toys, scratchers, and vertical space (like cat trees) to optimize your cat's environment. Remember to play with your cat with toys they enjoy. If environmental changes are not helpful, your vet may recommend calming aids, including supplements and pheromones. Some cats will benefit from prescription medication to reduce stress and anxiety, especially when they are severe. 

Seek Professional Help

If things are not going well, don't stress. Talk to your vet about finding a credentialed behaviorist who can work with you and your cat. It may take time, but patience and persistence will help.