Inappropriate Elimination Disorders in Cats

By Ellen Lindell, VMD, DACVB; Malcolm Weir, DVM, MSc, MPH; Ernest Ward, DVM; Updated by Amy Panning, DVM

What is inappropriate elimination?

Inappropriate elimination generally refers to urination and/or defecation in places other than the litter box. The behavior is sometimes referred to as ‘house soiling’.

What causes inappropriate elimination?

Inappropriate elimination may be due to a medical condition, a behavioral disorder, or both. Behavioral stress can even trigger medical conditions in cats. If your cat is eliminating outside her litter box, the first step is to have her examined by your veterinarian. If everything checks out fine, a behavioral workup by a veterinary behaviorist is recommended. An accurate assessment from the start will improve the outcome.

What are some of the medical causes for inappropriate elimination?

Cats who experience discomfort during elimination often seek an alternate location that allows them to stretch or move their bodies more easily than they can in a confined box. Cats may also associate their pain with being in the litter box and develop an aversion to it. For example, infection or inflammation in the urinary tract causes discomfort during urination. Similarly, inflammation in the gastrointestinal (GI) tract, as with inflammatory bowel disease, may cause discomfort during defecation. Cats with orthopedic or neurologic pain may experience discomfort when entering a traditional litter box or when posturing to eliminate.

Many medical conditions that cause cats to urinate or defecate more frequently, such as kidney disease, diabetes, and digestive disorders, cause cats to produce more urine or stool. Their boxes may fill up more quickly, driving them to seek cleaner locations to eliminate.

A physical examination and lab work, including a urinalysis and fecal examination, will allow your veterinarian to reduce the medical causes underlying your cat’s house soiling. Sometimes the behavior can persist even after medical conditions have resolved. A behavioral treatment plan will be needed, as described later in this handout.

"Cats who experience discomfort during elimination often seek an alternate location..."

What are some behavioral causes for inappropriate elimination?

Behavioral causes for inappropriate elimination can be divided into two categories: toileting behaviors and communication-related behaviors. Remember that your cat could be house-soiling for one or both reasons. Communication-related house soiling is known as marking. Cats can mark with urine or stool, though marking with urine is more common. Marking behavior is often triggered by anxiety or frustration. Causes of anxiety or frustration are often related to aspects of the physical or social environment and can be complicated. For instance, marking may occur when there is an uncomfortable relationship with another cat or person. (See the handout “Cat Behavior Problems – Marking and Spraying Behavior” for more information.)

Toileting behaviors refer to inappropriate elimination related to a cat’s need to void. There are two main types of toileting-based house soiling: location preference and litter box aversion.

Location preference refers to elimination that occurs in specific locations. When a box is placed near the cat’s preferred location, it is often used immediately. Cats living in busy households often choose quiet rooms, so they are not disturbed. Cats living in big homes often select areas closest to where they spend the most time.

"Marking behavior is often triggered by anxiety or frustration."

Litter box aversion is a term used to describe elimination that is never or rarely in a litter box, though the deposits are often very close to the box. Litter box aversion may be complete or partial—some cats use one box for urine and another for stools. An aversion may relate to the type of substrate or litter, or to the box itself, for instance, if the box is too high, too small, or simply not clean enough. As described earlier, cats experiencing pain related to elimination may develop an aversion to using their litter box. Similarly, litter box aversion can occur if a cat experiences fear while in the box—for instance, if there is a loud noise as the cat is voiding.

Can inappropriate elimination be treated?

Yes. Once the causes for the behavior have been identified, inappropriate elimination will usually resolve. Treatment is very specific to the underlying cause. It is always important to treat all underlying medical conditions. Treatment for marking requires addressing the triggers (See the handout “Cat Behavior Problems – Marking and Spraying Behavior” for more information.)

If your cat has a location preference, meaning that she eliminates in specific areas, the first step is to place a litter box in those areas. She may use the box right away. If so, you may leave the new box there permanently or gradually move it to a more convenient location. It is important to find a location readily accessible for your cat and to consider what your cat likely finds attractive about the area she selected. If your house is large, place a litter box on each floor your cat uses.

There may be some areas where a litter box would not work at all. It can be helpful to change the purpose of those areas so they are no longer ‘bathrooms’. Try placing a small dish of food or a special toy in one or more of the soiled areas, and then put a new litter box in the closest convenient location available.

If your cat has a litter box aversion, meaning the box is rarely used, it is important to determine what your cat finds aversive about it. First, ensure you clean the box at least once daily. Scoopable litter substrates should be dumped out entirely and replaced with fresh litter every month. Wash the box with mild soap—do not use bleach, ammonia, or strong chemicals.

The next step is to offer your cat a litter box cafeteria. Provide your cat with several choices to learn what she likes. The boxes should be placed very close to each other, ideally all in a row. If you do not have room for several boxes in one location, you can do paired tests, changing one aspect of one box at a time every 10–14 days until you learn what is preferable to your cat. For example, test the type of litter by placing an equal amount of each substrate in each box. Since most cats seem to like clay clumping litter, at least one box should contain clumping clay. Next, test the litter depth. Using the type of litter your cat prefers, arrange one box with litter three inches deep and the other with barely an inch of litter.

You should test the size and type of litter box. Try a covered and open box side by side. Next, test a traditional box with an extra-large box. Cats usually prefer boxes that are 1 ½ times their body length. If your cat has difficulty getting in, include a low-sided box, such as an under-bed storage container, as one of your test boxes.

Keep a journal to track the results of every test. Each test should last one to two weeks to identify a clear preference. Then, once you know your cat’s litter box preferences, provide the favored box setup in at least two locations and keep them very clean.

How can I protect my furniture and carpet from being damaged by urine?

Until treatment has been completed, it can be helpful to prevent your cat from accessing or spending time in high-risk areas. You may close your cat out of an area entirely or use protective covers. If your cat is soiling on a bed, use a waterproof mattress cover under the bedding, and in addition, place a furniture cover designed for pets (these are washable and have waterproof backing) on top of the bed.

If your cat is soiling on the carpet, you can use a plastic or rubber carpet runner with the pointy nubs sticking up instead of down. Most cats do not like walking on this surface. You can use the same material on a couch and remove it when you want to relax or can supervise your cat.

Some areas can be effectively blocked by placing citrus rind or cat-safe potpourri in a small dish nearby. Most cats do not linger near these odors.

It is important that you do not simply block your cat from a location without providing an outlet for the behavior. Provide enough litter boxes of choice for your cat. Over time, as your cat begins to consistently favor using a litter box, some of these extra boxes can be removed.

"Until treatment has been completed, it can be helpful to prevent your cat from accessing or spending time in high-risk areas."

If you cannot keep your house safe, then until treatment is complete, when you are not available to supervise, you may confine your cat to a comfortable room where you can provide a litter box cafeteria. Ensure your cat has plenty of food, water, toys, and comfortable resting places. Provide quality social time, including interactive play.

Use an enzymatic cleaner, such as Urine Away® or Nature’s Miracle®, to remove residual odors that could encourage your cat to return to previously soiled areas.

How can I treat my cat’s stress-related medical condition?

Cats are susceptible to chronic stress-induced illnesses, particularly illnesses related to the bladder and GI tract. Providing social and environmental enrichment can reduce stress and help your cat stay physically healthier. Most cats living indoors benefit from kitty hunts, interactive play, interesting places to explore, a wide variety of toys, a choice of resting spots with prime views, and social interactions with their people. (See the handout “Cat Behavior and Training – Enrichment for Indoor Cats” for more information.)

Cats experiencing stress may respond to synthetic pheromones (i.e., Feliway®). If your cat is diagnosed with an anxiety disorder, your veterinarian may prescribe a medication and/or a nutraceutical. (See the handouts “Behavior Counseling – Medication” and “Behavior Counseling – Complementary Treatments” for more information.)

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