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Cher, Feline Specialist
Category: Cat
Satisfied Customers: 21067
Experience:  Feline Healthcare & Behavior Specialist 40+ years Experience
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My 2 year old Persian female cat has recently been urinating

Customer Question

Hello. My 2 year old Persian female cat has recently been urinating outside of the litter box. She has had 3 urinalyses (all showed moderate bacteria) but the culture came back negative. She has had two blood tests. The most recent shows a RBC of 5.37, HGB 9.5, Mcv 58, mch 17.7, neutrophil 1558. All other values within normal range. Thoughts? Next steps?
Submitted: 5 months ago.
Category: Cat
Expert:  Cher replied 5 months ago.

Hello, and welcome.

I'm sorry your kitty is experiencing this problem.

Please allow me a short time to compose and send your detailed answer.

Thank you,


Expert:  Cher replied 5 months ago.

Hi again, and thanks for your patience.

If the urinalyses showed moderate bacteria, was your girl put on antibiotics for a UTI? This might help with her discomfort upon urination and then she'll move back to eliminating in the litterbox all the time.

When cats eliminate inappropriately, it can also be caused by stress or anxiety and a condition called idiopathic (cause unknown) interstitial cystitis, which causes discomfort. Diet might also be related to this condition, so make sure you are feeding a high quality canned food that contains no artificial ingredients and real meat (no by-products) is the first ingredient. Canned is better than dry, because it contains more moisture. Encourage her to drink more by getting a cat drinking fountains. Cat love to drink from a moving water source.


Get some Feliway plug in diffusers; these emit calming pheromones to help diminish stress.


You can also try Rescue Remedy for Pets or Composure treats (one at a time, not simultaneously). These are over the counter oral anti-stress treatments.

Get some 'Cat Attract' litter or litter additive to add to her current litter (which should be unscented) and make sure her litterbox(es)--you should have at least 2) are open, not covered. Cat Attract contains herbal attractants that encourage use of the litterbox.

It's also important to clean the soiled areas with an enzyme-based cleaner for organic/pet stains and odors, like Nature's Miracle, Zero Odor, Odor Mute or many more you will find at your pet supply stores. If she continues to smell where she went before, she'll be attracted to it and think it is an acceptable toileting area. After you clean these areas and they're all dry, you can lightly spray some Feliway spray on them, to make her think she 'marked' there, already. Let the spray dry completely (about 30 min.) before allowing her access to these areas.

There are also various prescription medications that can help with inappropriate urination; they are typically in the anti-anxiety/anti-depressant class. Clomicalm is well recommended, so discuss this with your vet:



If your cat is uncomfortable, also discuss some pain medication for her, to help her feel better.

I hope all will be well with your beautiful Persian girl!

Please be so kind as to rate my answer with positive feedback, as that is the only way I receive recognition from the site for my assistance. Thank you very much!

Providing a positive rating will not end our conversation, should you need me for any follow-up. Simply click 'Reply' for clarification or additional information, if needed.

Warmest regards,


Customer: replied 5 months ago.
Duchess was on a 14 day course of Zeniquin and at one point went 8 consecutive days with no accidents. Some inappropriate urination resumed post treatment. I am now using cat attract and just plugged in a feliway diffuser today. My main question now pertains to the blood results I referenced. Are these results of concern? Anemia?
Expert:  Cher replied 5 months ago.

Hi again, and thanks for your additional and helpful information.

I'm glad she was treated with Zeniquin, you're now using Cat Attract and just started using a Feliway diffuser, today!

As for her blood values, an RBC of 5.37 is within normal levels, although toward the lower value number, so unless her gums, tongue, paw pads (if pink) are appearing very pale, almost white, she should not be anemic, however, her HGB at 9.5 is also within normal limits, but at the lowest end of the scale (for normal), so it might point to anemia. An MCV of 58, is only 3 points above normal range, and MCH is within normal limits. Normal range for neutrophils is 3,000 to 12,000/µ l, so your kitty is running quite low. Neutrophils are a type of white blood cells of the immune system. An elevation or decrease in absolute or total neutrophil counts can indicate a variety of processes including stress, inflammation, infection, or other disease processes. A decrease in neutrophils could indicate a viral infection, while at an elevated number, it helps to fight bacterial infections. I would explore this further with your vet or ask to be referred to a specialist. Specialists are usually found in ER animal hospitals, but you usually need a referral from your regular vet. I'd request further testing for viral infection at this time. You can start her on a multivitamin to increase her red blood cells, and discuss this with your vet, first.

Please be so kind as to rate my answer with positive feedback, as that is the only way I receive recognition from the site for my assistance. Thank you very much!

Warmest wishes,