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These pages are intended primarily to serve as supplemental information for our clients to help them understand why we recommend what we do and to explain what can be expected after a specific diagnosis. There is a lot of good information available to the general public concerning cat diseases and we don't feel that we need to repeat that here. Part of our goal here is to clarify and expand on specific information that we have given our clients. It is specific and is intended for our clients. 

North County Cat Hospital

Inappropriate Urination

Home /  About Cats / Behavior / Inappropriate Urination

Causes of Inappropriate Urination

The reasons for cats to urinate outside the litter box can be divided into four categories.


This includes any disease that:
• Increases the urge to urinate (e.g., cystitis).
• Increases urine output (e.g., kidney disease or diabetes).
• Causes behavioral changes (e.g., hyperthyroidism or senility).
• Creates a condition that makes it more difficult for the cat to get to the litter box (e.g., arthritis).

Environmental Stress.

When cats are stressed, they may start urinating in inappropriate places. Although this may seem like a conscious decision on their part – especially when they urinate on a bed or clothing – it isn’t. It is simply a response to stress (sometimes the location of the house soiling can suggest the source of the stress). Any stressful condition can cause a cat to urinate out of their box. These include:
• A new animal or person in the household.
• A person or animal no longer in the household.
• A new home.
• Crowded conditions.
• A person in the house who is under stress.
• Animals or loud noises outside.
• Wanting to go outside and not being permitted.
• Etc., etc., etc.

Litter Box Aversion / Substrate Preference.

Cats can be averse to a litter box due to:
Past Experience – cats may refuse to use their box if they had a negative experience in the box in the past. For example:
• Past painful urination.
• A sudden noise while in the box.
Current Conditions – cats may refuse to use their box if there is something about the box that they don’t like. For example:
• The box is dirty (some cats won’t use a box with any urine or stool in it).
• The box is covered.
• The box is uncovered 
• The box is in an inconvenient location.
• The box is in too “public” an area.
• The litter is scented (or the box is near something scented).
• They don’t like the type of litter (they usually prefer sand or clumping litter).
• The area around the box is unfavorable (e.g., infested with fleas).

Marking Behavior.

This is usually manifested as “spraying” – urinating on vertical surfaces. Often cats spray onto warm surfaces (eg., stoves). This helps to spread the odor of the urine. Spraying is most common in intact males but can occur in females and neutered cats. It can be triggered by some of the same stressful events that are listed above.

Cat Photo by Max Baskakov on

Cats use litter boxes because they want to, not because they are supposed to. They don't know that it is "bad" to urinate out of the box and when they do so, they are not being passive aggressive. They are not misbehaving on purpose.

Treatment of Inappropriate Urination

The best way to treat house soiling is to treat the cause. Diagnosis and treatment may include:

Find and treat medical contributors.

  • Obtain a complete history.

  • Physical exam.

  • Laboratory testing.

  • Treating disease.​

The first step is to figure out why the cat is urinating out of the litter box.

Manipulating litter boxes.

For example:

  • The general rule is one box per cat plus one box. In a household with three cats, if one cat isn’t using the box, we recommend a total of at least four boxes. Cleaning the boxes at least daily. Initially we recommend cleaning the box as soon as it is used – once the problem is under control, this regime can be lessened.

  • Using at least one uncovered box.

  • Experimenting with different types of litter, including at least one unscented and including Cat Attract.

  • Experimenting with different locations.

Litter box.jpg

Ask your cat how they like their litter box.

Put down multiple boxes at once and offer them different options - type of litter, depth of litter, type of litter box, location, etc., and see which box they use the most. That's the box they want.

Decreasing stress.

For example:

  • Giving more attention to the cat.

  • Increase “living space” – shelves, boxes, “kitty condos”.

  • Covering windows (e.g., to prevent the cat from seeing another animal outside).

  • Using Feliway® - an artificial feline pheromone spray.


Decreasing the urge to mark.

For example:

  • Neutering intact males.

  • Using Feliway®

  • Eliminate odors.

Other things.

For example:

  • Placing a litter box in the area being “soiled”. (Eventually, this can be gradually moved.)

  • Placing food in the area being “soiled”. (Eventually, this can be gradually moved.)

  • Drugs – including catnip and prescription drugs (Elavil, Valium, buspirone, progesterone, etc.).

Feliway can help reduce stress.

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