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 SOME REASONS WHY CATS PEE OUT SIDE THE LITTER BOX

If your cat is peeing inappropriately, the first step is to visit your veterinarian. The vet will do a physical exam of your cat and check a urine sample. Based on the results, your vet will recommend treatment. There a number of common urinary medical issues in cats:

• Bladder stones: Some cats develop actual stones in the bladder that may cause irritation and even blockage.1 Crystals may accompany bladder stones or be a precursor to stone formation. If your vet suspects bladder stones, X-rays will be needed to determine the size and quantity of the stones. Smaller bladder stones might be dissolved with a special diet, but larger stones may need to be removed surgically (cystotomy). It's common for a cat with bladder stones to also have a UTI. If so, antibiotic treatment is necessary. 
• Idiopathic cystitis: The term cystitis means inflammation of the bladder. Idiopathic means the cause is unknown. Cats with cystitis often have hematuria (blood in the urine).2 Testing a urine sample is essential because the blood may only be detected microscopically. If your vet determines that your cat's urine contains blood, but there are no crystals, bacteria or stones present, the likely diagnosis will be idiopathic cystitis. Idiopathic cystitis is usually treated with a combination of diet change and environmental enrichment. Pain and antianxiety medications may also be used.
• Metabolic disease: Symptoms of chronic kidney disease may include increased urination.3 Other metabolic diseases that may increase the amount of urination your cat produces are liver disease, diabetes, and thyroid issues. If your cat has been drinking more, or you have been finding yourself needing to clean the litter box more often, your veterinarian may want to run some blood work to check for these issues.
• Urinary tract infection or UTI: Urinary tract infections are rare in young cats, but can be a common cause of urinary issues in older cats, either by itself or in conjunction with other medical conditions affecting the urinary system.2 Bacteria in the urine may cause an inflammatory response in the urinary tract. Antibiotics are used to treat a urinary tract infection. Your vet will likely recommend follow-up testing after the antibiotics are finished to make sure the infection is gone.

When one or more urinary issues are chronic, the condition is typically called feline lower urinary tract disease, or FLUTD. If your cat is diagnosed with FLUTD, your vet may recommend a special urinary diet and/or supplements to support the urinary tract.4 

Urinary problems can lead to a serious, urinary obstruction, especially in male cats. If your cat is experiencing urinary issues, don't delay the trip to the vet. If your cat is posturing to urinate and little or no urine is coming out, your cat might have a blockage or partial obstruction. In this case, get your cat to a vet immediately as this condition can quickly become life-threatening.

In some cases, inappropriate urination occurs when a cat has a nonurinary health problem. Your cat may be peeing outside the box because of pain or discomfort elsewhere in the body. It's a good idea to have your vet order comprehensive lab work to look for a health issue if none is found during the initial exam or urinalysis. Lab work can reveal serious health problems like diabetes or kidney disease, allowing your vet to begin treatment immediately.