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I have an 18 and a half year old cat who has been urinating…

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I have an 18 and...
I have an 18 and a half year old cat who has been urinating on my bed. He has had urinary issues for a long time but the past year has been significant. He has been being treated for thyroid issues and stomatitis in his mouth getting injections of cortisone and convenia about every six weeks. He takes medication for thyroid and I have just started him on alprazolam a few days ago in an effort to try and deal with the behavior. He also takes a supplement called composure which has helped a good deal with night time howling. He also urinates outside the litter pan next to it and in the bathtub. He has not had an infection. He also sits or sleeps in the bathtub on and off. He has had blood work which shows some initial decrease in kidney function but overall is not awful for his age. I also think he is confused sometimes but it is hard to tell. What else can I do to manage the urinating on my bed?
Submitted: 2 years ago.Category: Cat Veterinary
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Answered in 13 minutes by:
1/25/2016
Cat Veterinarian: Dr. Joey, Board Certified replied 2 years ago
Dr. Joey
Dr. Joey, Board Certified
Category: Cat Veterinary
Satisfied Customers: 5,089
Experience: 15 yrs in practice, specialist canine/feline medicine
Verified

Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 16 years of experience. I look forward to working with you.

This can be a very frustrating problem! He's certainly got some medical issues that could contribute to this behavior such as the early kidney disease. It is always important to confirm there is absolutely no new medical issue prior to assuming this is behavioral, although it is certainly suspicious. So, I must ask if he has had a urinalysis and urine culture in the past 2 months and we are absolutely sure he has no bladder/kidney stones. If so, then we can work on this as a behavioral issue. As a behavioral issue there is no way to sugarcoat this...this will be tough to combat. But I have a few suggestions for you.

First, we must assess the litterbox situation. Do you have enough litterboxes? The recommendation by specialists at this point is that you have one box per cat plus one. If you have one cat, you should have two boxes. This is just the recommendation out there by veterinary behaviorists and internal medicine specialists. Some cats are extremely territorial about their box and may prevent another cat in the household from using the box. An especially fearful cat may not approach a box because something terrifying is between him and the box, such as a vacuum cleaner. Therefore, he will eliminate outside the box instead of approaching it. With two boxes, the problem is solved.

Where is the litterbox located? Cats don’t like to have their litterbox close to their food or bedding. They like to have a consistent, private place to do their business. So, don’t put the box in one of the busiest rooms in the house. Be careful with boxes in the bathroom. If a cat gets sprayed by the shower while eliminating in the box, you can be guaranteed he may refuse to use the box again. Is the box easy for the cat to get into? This may be silly, but some people keep the boxes in a closet and then forget to leave the door open!

I always like to assume you are doing a great job with cleaning the box (scooping all daily; cleansing out the litter entirely every 3 to 4 weeks and when you do this complete change-out you actually cleanse the box itself with a non-ammonia cleaner). I recommend try a different litter type. Try one that isn't as dusty and doesn't have an overt odorizer. For example you can try either "World's Best Cat Litter" or "CatAttract". I've had a few clients with success with either one of these.

I think I forgot to mention above that if you have a hood on the box, take it off. Some cats dislike the gas chamber effect they create. Other cats that are arthritic or on the larger side have a super tough time maneuvering into/out of the box to go, and ultimately give up and go near it. If you feel like it is a smaller box and one of the offending cats does have arthritis, then perhaps try a larger box that he can maneuver around in. Some people buy one of the tupperware containers that is a low rectangular box and cut an entry-way into it. This works superbly. Our goal is that we want all the cats to love their boxes. We want them to jump in there, scratch around and make a big mess which means they likes being in the box.

Some cats need to be confined to a smaller area for a while until they earn the privilege to get back into the whole house by proving they can consistently use the box. You should not feel guilty about confining all or just the offenders to 1 or 2 rooms for a few weeks until they prove that they are able to do this. During that time you can make the litterbox an excellent experience as noted above. Also we can work on reducing anxiety since this can sometimes play a role in these problems. If not already tried, buy a Feliway Diffuser or Feliway Spray. Use the diffuse/spray in the room he has been urinating. This releases the positive cat pheromone that makes cats feel awesome and are less likely to misbehave (can't hurt and might help). If you have the spray, cleanse the area he urinates thoroughly (products mentioned below) and then spray this area. Spend quality time with him daily doing what he likes whether that be petting, brushing, playing (laser pointer chasing, feather on a pole chasing, retrieving, etc) for at least 10 to 20 minutes a day. This helps him know you still care.

As some final notes, be sure not to punish him when you find the disasters. I know it is our first instinct, but this only serves to increase anxiety and can worsen the situation.

The other thing it is very important to thoroughly cleanse all areas that a cat has inappropriately eliminated. I recommend using an enzymatic cleaner such as UrineAway or UrineEase. These can help get rid of the odor. If you have carpets, steam clean. If the cat smells it, then he is more likely to go again in these areas...plus it improves the odor for your nose as well.

Cleaners that work:

URINE OFF - there is a formula for dogs and one for cats

Anti-Icky Poo!

Eco-88

Odor removers (to use after cleaning):

F.O.N.

Elimin Odor Feline

Cat-Off Odor Concentrate

The list isn't long but that's it. They work. You will read many online that use some of the natural easily available products like Nature's Best, ***** ***** this product like many is very sensitive to temperature and can be affected by other cleaners that you use. So, I can't recommend it.

Finally, if all this fails or you have already done ALL of this, then you need to speak with your veterinarian about medication to reduce his anxiety; something other than alprazolam. This isn't designed for this problem but as a one-time use drug; also this category of drugs is not great in cats. Instead, I would advocate discuss use of long-term Prozac (fluoxetine) or amitriptyline. Both can be compounded into a transdermal gel you rub on the inside of his ear once daily to work.

I am at a point I need to know what questions you have. I hope that the information I provided has been helpful.

Please let me know if for any reason you need further clarification, have more questions, or were expecting a different type of answer.

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Cat Veterinarian: Dr. Joey, Board Certified replied 2 years ago
Hi Dawn Scott,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Joey
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