Undesirable Elimination Disorders in Cats

What is undesirable elimination?

Undesirable elimination generally refers to urination or defecation in places other than the litter box. The behavior is sometimes referred to as “inappropriate elimination” or “house soiling.”

What causes undesirable elimination?

Undesirable elimination may be due to a physical condition, a behavioral disorder, or both. Stress can also trigger changes in your cat’s physical health. 

If your cat is eliminating outside their litter box, the first step is to have them examined by your veterinarian. If no physical cause is found, arrange a behavioral assessment with a veterinary behaviorist. An accurate assessment from the start will improve the outcome.

What physical illnesses can cause undesirable elimination?

Cats that experience discomfort during elimination often seek an alternative location that allows them to stretch or move their bodies more easily than they can in a confined box. Cats may associate pain with being in the litter box and develop an aversion to the box itself.

For example, infection or inflammation in the urinary tract can cause 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 positioning their body to eliminate.

Many medical conditions, such as kidney disease, diabetes, and digestive disorders, can cause cats to produce more urine or stool, urinate or defecate more frequently, or both. As a result, the litter boxes may become soiled more quickly, leading cats that are particular about cleanliness to seek cleaner locations to eliminate.

A physical examination and lab work, including a urinalysis (urine test) and fecal examination, can help your veterinarian to identify and treat illnesses contributing to your cat’s house soiling. In most cases, cats also need a behavioral treatment plan because house soiling can persist even after physical conditions have resolved.

What behavioral factors can cause undesirable elimination?

Behavioral causes of undesirable elimination can be divided into two categories: toileting behaviors and communication-related behaviors. Remember that your cat could be soiling for one or both reasons.

Marking behavior

Communication-related house soiling is known as marking. Cats can mark with urine or stool, although marking with urine is more common. Marking behavior is often triggered by anxiety or frustration. These emotions may arise from aspects of the cat’s physical or social environment, and their causes can be complicated. For instance, marking may occur when there is an uncomfortable relationship with another cat or person.

Toileting outside the litter box

Toileting-related house soiling occurs when a cat urinates or defecates outside the litter box to empty their bladder or bowels. There are two main types of toileting-related house soiling: location preference and litter box aversion.

• Location preference refers to a cat’s preference for eliminating in a particular location. When a box is placed near the cat’s preferred location, it is often used immediately. Cats living in busy households often develop a preference for eliminating in a quiet room so they are not disturbed. Cats living in large homes may prefer an elimination location that is close and convenient to  their main living space.
• Litter box aversion means that a cat avoids using the litter box. The deposits are often very close to the box. Litter box aversion may be complete or partial. A cat might use a box for urine but not stool, or vice versa.

An aversion may relate to the type or depth of litter, or it may be related to the box itself. For example, the box may be too high, too small, or simply not clean enough for the cat’s comfort. 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 urinating.

Can undesirable elimination be treated?

Yes. Undesirable elimination can often be successfully treated once its causes have been identified. Your cat’s treatment plan will specifically address all the physical and behavioral causes.

Location preference: If your cat has developed a location preference, try placing a litter box in that location. They 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. Choose a location your cat can easily reach and to consider what they find attractive about their preferred area. If your house is large, you may need to place a litter box on each floor.

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 used as toilets. 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.

Litter box aversion: If your cat has a litter box aversion, start by determining what they dislike about the box or litter. Scoop the box at least once daily. Empty all clumping litter and replace it with fresh litter every month. Wash the box with mild soap—do not use bleach, ammonia, or strong chemicals. A litter box preference test can help you identify the litter and box setup your cat prefers.

What is a litter box preference test?

A litter box preference test involves offering your cat several choices to learn what they like. During the test, 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 compare two boxes at a time, changing only one feature between them. Each test should last one to two weeks to identify a clear preference.

Compare litter types. Use identical boxes and put the same depth of a different litter in each one. Since most cats seem to like clumping clay litter, at least one box should contain it.

Compare litter depths. Next, test the litter depth. Using the type of litter your cat prefers, fill one box with litter three inches deep and the other with barely an inch of litter.

Compare box styles and sizes. It is also important to determine your cat’s preference for the type and size of litter box. Place a covered and an open box side by side and see which your cat prefers. Similarly, compare a traditional box with an extra-large box. Cats usually prefer boxes that are 1.5 times their body length, measured from the nose to the base of the tail. If your cat has difficulty getting into the box, offer a test box with a low entry, such as an under-bed storage container.

Record the results. Keep a journal to track the results of every test. Once you know your cat’s litter box preferences, provide the favored box setup in at least two locations and keep the boxes very clean.

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

During treatment, it can be helpful to prevent your cat from accessing or spending time in areas they are likely to soil. It is important that your cat can still freely access their favorite resting spots and play areas and continue social interactions with people and pets whose company they enjoy.

• To protect your home, you may block access to an area your cat rarely uses. Another option is to use protective covers on furniture or flooring that your cat has soiled. 
• If your cat is soiling on a small area of the carpet, you can cover the spot with a plastic or rubber carpet runner placed 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 when you can supervise your cat.
• If your cat is soiling on a bed, use a waterproof mattress cover under the bedding. You can also place a washable furniture cover with waterproof backing on top of the bed.
• Be sure to provide enough litter boxes with your cat’s preferred setup. Over time, as your cat begins to consistently use a litter box, you can remove some of these extra boxes.
• You may be able to block some areas by placing cat-safe potpourri in a small dish nearby. Most cats do not linger near these odors.
• Use an enzymatic cleaner or another pet urine odor remover, such as Urine Away® or Nature’s Miracle®, to remove residual odors that could encourage your cat to return to previously soiled areas.

What should I do if I see my cat about to eliminate outside the litter box?

Supervise your cat when possible. If you notice them heading toward an area they have used for elimination, or positioning their body to eliminate, try gently distracting them. A novel sound can often be used as a distraction, and you may then be able to lure your cat to a room with a litter box. You may be able to lure a cat directly to the litter box itself and then step back—but be careful not to frighten your cat or the box may become even less appealing.

Do not scold or otherwise try to frighten your cat. Cats are very sensitive to any form of punishment, even verbal reprimands. Punishment can cause fear and can permanently damage your cat’s trust in you.

Should I confine my cat during treatment?

If you cannot protect your home from soiling while you are unavailable to supervise, you may temporarily confine your cat to a comfortable room where you can provide a choice of litter boxes. Ensure your cat has food, water, toys, and comfortable resting places. Provide quality social time, including interactive play. Confinement can create distress and can change relationships between household pets, so it should be kept to a minimum.

How can I reduce my cat’s stress?

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 opportunities to hunt for food or toys, interactive play, interesting places to explore, a wide variety of toys, a choice of resting spots with good views, and social interactions with their people. 

Cats experiencing stress may respond to synthetic pheromones such as Feliway®. If your cat is diagnosed with an anxiety disorder, your veterinarian may prescribe medication, a nutraceutical (a supplement used to support health), or both.