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Hi there-

I truly sympathize with what you are going through because I have been there myself. For some reason, in my house, it is always the females that urinate. I truly think all female cats wish they were the only cat in the house!

 

Now, the first thing you really need to do is find a different vet who will take this seriously and have her (whoever you most suspect) urine checked. There is absolutely no way to tell if this is truly behavioral or medical until this is done. There are a lot of "mistruths" out there about what entails a behavioral issue, but none of it is true. Several of the medical problems that create urinating outside the box can look like behavioral issues and persist for years. People waste a lot of time, money, and emotions trying to correct what they think is a bad behavior, only to find out their cat has crystals or something else that really makes this problem not their fault! I am horrified that your vet didn't check the urine. That is inexcusable.

 

I am going to give you two things to read. They are a bit lengthy so you may want to print them off to make it easier. The first is the handout I created that we use in our clinic for "behavioral consults" for this exact problem. Pay close attention to the recommendations. We have a high success rate solving these problems (not necessary curing them forever but greatly diminishing the rate of occurrence).

 

The second is a handout on what cats should be eating. Three of the four medical conditions that can cause peeing out of the box have been directly linked to dry foods. If you want even more information on this beyond the handout below, visit http://www.catinfo.org/.

 

To find a good cat vet (highly recommended), try http://www.catvets.com/. If you still have questions after reading this material, please let me know. I will be on line tomorrow.

 

 

DOES YOUR CAT URINATE OUTSIDE THE CATBOX?

 

Cat's who urinate inappropriately can be very frustrating. With a little understanding of the reasons why our beloved cats begin doing this behavior, we can take positive steps toward finding a resolution.

 

Inappropriate urination can occur for two different reasons. It can indicate a medical problem or it can be a behavioral problem. Cats begin urinating outside the box as a response to something that is wrong, either with them or their environment. It is not just them "behaving badly" and cats don't urinate inappropriately out of "spite". It is unfair and ineffective to spend weeks or months blaming a cat for urinating inappropriately when it may not be his/her fault. As responsible pet owners, it is our duty to try to figure out what they are trying to tell us.

 

Cats can experience 4 different medical causes of inappropriate urination. It is a common misunderstanding that the only medical reason is a bladder infection. An infection, especially in cats with good kidney function, is rare. Cats commonly get a condition called cystitis (sterile inflammation). This is thought be caused by eating primarily dry foods. Some cats can also have microscopic crystals in their bladders that can cause irritation. These crystals are thought to be linked to a diet of primarily dry food, although the carbohydrate content (grains) in the diet can play a role by changing the pH of the urine from what it should be. Cats can have small stones in their bladder that cause chronic irritation.

 

Some of the above listed medical conditions can cause intermittent inappropriate urination. Most people think if a cat only exhibits signs occasionally, it is behavioral. This is not true. The only way to tell the difference between medical and behavioral causes is to have the urine checked by a veterinarian. Another common misconception is that only male cats spray, or spraying a vertical surface always indicates a behavioral issue. This is also not true. Female cats can spray just like males, and ANY urination outside the box should be checked with a urinalysis.

 

The most common symptoms of a medical problem are frequent attempts to urinate, more frequent visits to the cat box, producing smaller amounts of urine, taking longer to pass the urine (straining), crying during urination, licking the genital region a lot, or urinating outside the box. Every cat experiences a different level of discomfort and not all signs may be present. It is important to take any changes very seriously.

 

Male cats are especially susceptible to forming a urinary obstruction. If this happens it is a life-threatening emergency. If you are ever unsure if your cat is passing urine, and he is male, seek veterinary attention immediately.

 

True behavioral problems can often be solved by following these general rules:

 

1. You should always provide at least one box per cat.

2. These boxes should be in separate rooms in the house, not next to each other.

3. The boxes, or at least one box, should be uncovered.

4. The boxes should be the largest you can find. We prefer the plastic storage containers you can find in variety or home improvement stores.

5. We always prefer scoopable, unscented litter. The natural, scoopable litters are thought to be healthier than clay litter (i.e.: corn, wheat). Silica crystals are also acceptable and great for odor control.

6. The boxes should be scooped of all urine and feces at least daily (no exceptions).

7. The entire litter amount should be completely changed at least every 2 weeks because the clean looking litter will eventually absorb odor.

8. The boxes should be kept away from noisy appliances or ‘busy' areas of the house.

9. Use appropriate odor control/cleaning methods in soiled areas (see below).

10. If you have more than one box, try different types of litter in each.

 

We can't read our cat's minds so we are much more successful at solving the problem by offering our cats choices. Addressing all 10 points above will make your chance at success greater.

 

The reason we always recommend at least one box per cat is to reduce perceived competition among cats. Even if your cats get along, if one is using the box or they have just had a sibling "spat", there will always be an available box for the other one to choose from. This is the reason you should never keep all cat boxes right next to each other. Cats sometimes want privacy and their own space.

 

Covers were designed for human convenience. While some cats don't mind them, most prefer to have a good view of their surroundings while eliminating. Covers can make them feel cornered. They also trap odors inside which can be distasteful to your cat.

 

Even jumbo cat boxes are too small for many cats. They need room to be able to move, dig an appropriate hole, squat, eliminate, and then cover. If they feel cramped or if they are older and arthritic, they may chose an easier location.

 

Cat's toe pads are extremely sensitive, like our fingertips. Cats can be very opinionated about what texture of litter they prefer. Choosing something soft is usually best. Offering a choice of litter types will also help make sure they stay satisfied. We always recommend scoopable litters (except in the case of crystals) as these produce a cleaner cat box. The dust from clay litter can be unhealthy for the lungs. Scoopable litters such as Swheat Scoop (wheat) or World's Best (corn) are a natural alternative to clumping unscented litters if your cat likes them.

 

The location of the box is also extremely important. The laundry room is the most common location. However, it can be extremely noisy and sometimes scary due to the washer, dryer, etc. Consider adding a box in a different location.

 

Normal cat urine will glow under a black light in a darkened room. This is an easy way to locate areas of inappropriate urination. The strongest, most effective odor removal product currently on the market is called Urine Off. It is not recommended to clean the area prior to using this product. It is available at many veterinary clinics, pet stores, and online.

 

 

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High Protein/ Low Carb (grain-free) diets

Nutritionally speaking, cats are "obligate carnivores". This means they need very high levels of protein to thrive and don't have a very good ability for utilizing carbohydrates (grains, sugars). Cats also need some nutrients that can only be obtained from animal tissue, not plants. By ancestry, cats are descendants of desert cats (African wild cat, F. lybica). This is why they have very concentrated urine and don't need to drink as much as other species of similar size. In the wild, cats hunt primarily small rodents and birds as prey. All these creatures are about 70% moisture. This is how wild cats get most of their water requirements.

 

Now let's think about what we typically feed our cats over their lifetime. They usually get most of their food in the form of dry kibble. Some people feed canned food but rarely exclusively. This traditional way of feeding cats presents two major problems as discussed below.

 

First, most of the common brands of cat foods are full of carbohydrates in the form of grains (corn, rice, soy, wheat). As "obligate carnivores", cats aren't designed to use high levels of carbohydrates for nutrition. Cats specifically do not have the enzymes in their liver or saliva that are optimal to process carbohydrates. Their mouths, teeth, digestive tracts, pancreas, and liver are specifically designed for a high protein diet. So why are most pet food companies putting so many grains (carbs) into cat food? The answers could be many including convenience, larger profit margins, or the mistaken conception that cats are small dogs. When reading the ingredient label on food, a meat source is usually listed first but this doesn't mean the diet is high protein. If the next several ingredients are a form of grain (listed above), this is a high carbohydrate food. Plants do contain protein, but for an obligate carnivore like cats, this is a lower quality protein. Animal based proteins have biologic values (a measure of usability) ranging from 100% (egg) to 78% (beef). Plant based proteins range from 67% (soybean) to 45% (corn).

 

What does a carbohydrate loaded diet mean in the long run to your cat? High carbohydrates can predispose to obesity, just like in people. Diabetes is common in cats and high carb diets and obesity are known to be risk factors. Obesity also leads to arthritis. Add to this scenario the typical spoiled, well-loved cat that doesn't have to "hunt" for its food, and you have a sedentary lifestyle that also increases the risk of obesity and diabetes. It is known that a high carb diet actually changes the ph level and thus the bacterial types that grow in the mouth and digestive tracts. This change in bacterial content can lead to intestinal problems in some cats. Grains can be a source of allergies for some cats too.

 

The second problem a dry diet creates is a potentially dehydrated cat. Wild cats get most of their moisture from the prey they eat (mouse=70% water). The average dry food is only 10% water. Most feline practitioners and internal medicine specialists are now recommending an exclusively canned diet since the moisture in canned food most closely mimics their natural prey. It is thought that the lack of moisture in dry diets can contribute to urinary tract disease such as cystitis, crystals, and stones.

 

Many people have been told canned food is bad for teeth and can lead to dental disease. This is only partially true. Although canned food can leave more residue on the teeth than dry food, dry food does virtually nothing to help keep the teeth clean. It would be the equivalent of your dentist telling you it is ok to eat crunchy cookies to help clean your teeth. There are a few dental diets on the market that do a better job at scraping plaque off the teeth, but they are high carb and are only minimally effective at actual cleaning. The real reason for dental disease is lack of daily care. Obviously it is difficult to get a cat to accept daily tooth brushing, but there are some "cat friendly" options available. Your veterinarian can advise you on these products.

 

So what should your cat eat for optimal health? The more moisture your cat receives, the better. If your cat loves canned food and you don't mind feeding it exclusively, it is currently thought to be the best option as it mimics their moisture requirement. Grain-free canned food is the lowest in carbohydrates. If your cat refuses to eat canned food, the grain free dry foods are still the best option nutritionally. Many cats will accept the dry food with some water added. It is imperative to have fresh water available at all times.

 

It is important to realize there is no such thing as the perfect pet food. Changing brands every once and a while or mixing brands may help ensure your cat gets the best each company has to offer. It is also good to offer variety so we don't train our cats to become finicky eaters. There are many grain free dry and canned foods on the market. High protein levels may not be advisable for select medical conditions. Please talk to your veterinarian regarding the recommendations for your cat.

 

 

Expert:	purr doctor
Pos. Feedback:	100.0 %
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Answered:	1/15/2009

Cat Veterinarian

9 yrs in feline-only medicine/surgery/end of life care. Special interest-feline nutrition/geriatrics