Litter Box Accidents – What To Do When My Cat Won’t Pee In The Box

Ron Hines DVM PhD

Destructive behavior?

Aggressive Cat?

Trazodone for anxiety? here & here

Forsaking their litter box and urinating in inappropriate places is the number one problem that cat owners face. Perhaps 10% of  neutered male cats and 5% of neutered female cats have this troublesome habit. For some cats it is purely a behavioral issue. For others it is a medical one. For a few it is both. With the exception of neuter surgery and vaccinations, non-medical and medically-related urination issues lead the list of reasons cat owner bring their cats to veterinarians. (read here) Included in the group are kitties that inadvertently pick a wrong area of your house in which to pee and poop and the cats that spray-mark their house with “puffs” of urine. All are “elimination issues”; but they represent a great number of very different problems – all with different causes and possible solutions. The non-medical causes are considerably more common in multi-cat households. In single-cat homes, underlying medical issues are the leading cause. 

Cats that puff or spray only urine are marking their territory. It is a natural trait of un-neutered male cats. In multi-cat households, it can be a sign of insecurity or rival dominance. These cats usually continue to use their litter boxes too. Cats that squat and deposit large amounts of urine or poop were either never properly house trained, no longer find their litter box satisfactory for one reason or another, have territorial issues with their housemates or have a medical issue that needs veterinary attention.

Why Does My Cat Do This When It Knows How Much It Irritates Me!

A lot of cat owners see their cats as their intellectual equals. We talk to our cats – at least I do. We celebrate their birthdays. We buy them presents. Be that as it may, your cat doesn’t know that elimination issues irritate you. Your cat is not taking revenge for some slight. It isn’t out to get revenge. It isn’t doing it to to seek attention or to annoy you. If you decide to look at the issue as a “who’s-in-charge” or revenge attempt, you are not going to solve the problem and there will be at least two unhappy individuals in your home – kitty and you.

Cat owners need to understand that it is natural for cats in the wild and cats that live with us to use their urine as a “calling card”. They do that to announce their identity and presence, to assert themselves over other cats and most importantly to stake out their territory. Cats hunger for territory to call their own. Without it, they are highly insecure. (read here) Scientists think they do the same thing when they rub against us releasing cat-specific hormonal compounds call pheromones. (read here) Glands that release these compound can be found under your cat’s chin, at the base of its ears, on its forehead, cheeks and tail, its rear end and paw pads. Pheromones are also present in its urine – imparting much of its unique smell. Those secreted from its skin have no odor noticeable to humans but very noticeable to other cats.

When we teach our cats to urinate in one small specific area, we are going against these natural, inborn instincts of cats. That is because the wild European ancestors of our cats were lonely, solitary creatures hunting alone at dusk and dawn. Each had a territory of about 1.5 – 8.5 square miles which it jealously guarded from competitors. (read here) It did this by leaving urine and feces in strategic open places and against objects where passing cats would be likely to notice and move on. Young cats, leaving their mother, and wandering adults nervously left their scent marks and deposited their scats (poop) in conspicuous locations along the trail too, to avoid antagonistic encounters with the cat that “owned” the territory.  Those wild ancestors of our cats only sought out companionship from February to March in order to mate. Then they again went on their separate ways. 

These are very powerful instincts that remain to this day in all cats – including yours. They are the same instincts that continue to motivate your cat to affectionately rub on your leg, utilize its favorite scratching post, and pee where you don’t want it to when it feels threatened, insecure or stressed out.

Is This Always The Reason Cats Pee In Places We Don’t Want Them To?


There are many other possible reasons. One key is that cats that spray urine to stake out territory rarely defecate in inappropriate places. When cats urinate and poop outside of their litter box, it can be something about the box or litter that displeases them. It can also be due to a urinary tract health issues. (although even when present, psychological issues and litter box etiquette can play a part as well (read here & here

Medical Issues:

Although I listed these medical issues first, the majority of cats that are lax about peeing in their litter boxes do not have medical issues – the majority have territorial,  anxiety or litter box hygiene placement or litter issues. Us veterinarians tend to dwell on the medical rather than emotional, situational or psychological causes for behavior because that is the way we were trained – that’s how we make our living, that’s what we do.

Feline Urological Syndrome  (aka FUS, FLUTD, etc.)

The number one medical problem that causes cats to break their litter box training is irritation of their lower urinary tract and bladder. This condition, called Feline Urological Syndrome, just FUS for short, or Feline Lower Urinary Tract Disease is a quite common disease of house cats.

In FUS, crystals form in your cat’s urine, causing inflammation, painful, frequent urination and the urge to go. Early in this disease, many cats get the urge to urinate in exotic places such as a closet or bathroom sink. FUS is easily diagnosed when your veterinarian examines a urine sample from your cat. (read here)

Other Medical Problems:

There are three other common diseases of cats that can also cause them to urinate in the wrong areas. These are all diseases that cause your pet to drink more – and consequently, to urinate more. They are hyperthyroidism,   chronic kidney disease and diabetes. All three are identifiable through blood and urine tests.

In some cats, particularly recent arrivals, diet change and trash-marauding felines, transient diarrhea forces them to soil the house. Other cats develop inflammatory conditions such as inflammatory bowel syndrome (IBD) or leukocyte intestinal wall infiltrates (triad disease) that have the same result.

Aged cats sometimes develop arthritis, neurological, and other debilitating diseases that also cause them to break their litter box training. (read here)

Less common than urinary accidents are stool accidents. The majority of cats with this problem do not have organic disease. They are just not as tidy as the average cat. But it is still wise to have your veterinarian rule out problems of the lower intestine that might be causing increased urgency to defecate. These problems include chronic constipation or diarrhea, parasites, food allergies, neurological disease, arthritis, eating sticks, grass and other non-food material. You might consider a diet change. Your pet ’s mental acuity declines as it ages – just ours does. (read here) So expect more accidents in elderly pets. In a few, that mental decline is related to liver failure.

Occasionally, cats born without a tail will also have difficulty controlling their bladder and bowel function. 

So you can see why a complete health-screening exam is important when dealing with a stubborn kitty-house training problem. There is no sense altering the cat’s environment if there is a correctable problem within the cat itself.

I estimate (with no hard data) that in 1 out of 4 problem cats living in single-cat households, your veterinarian will find a medical explanation for your pet’s litter box issue. This is particularly true when your living situation – and the cat’s – have been stable and the problem begins out-of-the-blue.

Male Cats That Have Not Been Neutered And Those In Which A Testicle Was Missed

Sex hormones play a big role in typical cat behavior. That is why un-neutered male and female cats are much more likely to urine mark their homes. The problem is worst in tomcats. But un-neutered females (queens) do it too – especially when they are cycling through their heat periods (estrus). The problem usually ceases soon after they have been surgically neutered.

Some new novice cat owners unexpectedly find out that their cat is secretly a tomcat that has not been surgically neutered. Its been my duty many times over the years to inform them. As those baby toms mature, they almost all begin to urine-mark and develop the greasy acned tail and wide jowls that give them away. If that is a possibility, have your vet check it out. Claudine may be Claude.

Occasionally male cats are born cryptorchid with their testicle(s) undescended from their abdomens. If a retained testicle is left in the cat, it will begin to spray like an ordinary tomcat. If it has the suspicious jowls and tail of a tomcat, it needs a testosterone level check. Spayed female cats that continue to go through overly-affectionate periods during which they spray urine also need a hormone analysis to detect ovarian fragments that may have been missed during their spay surgery.

In the case of a male cat that one suspects might have residual testicular tissue somewhere in its body that produces testosterone and the urge to spray, an injection of a GnRH analogue medication would be the best way to confirm that. That test can also be used to detect female cats with residual ovarian tissues. (read here)

Well, My Vet Gave My Cat A Clean Bill Of Health – What Should I Do Now?

Here is what I suggest you try to solve the problem:

If It Is Possible, Return Things To How They Where Before The Problem Began

Try to think about any things that have changed from before your cat was having this problem. Do this as soon as possible – the longer you delay, the harder bad habits are to correct. If nothing comes to mind, ask friends what things they recall.

In Multiple Cat Households, Find The Neglectful Feline

If you have more than one cat, confine them to different areas of the house so you can decide which cat has the problem. Remember however, that stress affecting the cat with the urination issue could be the result of stress generated by another of your cats that does not have the issue.

Check For Litter Box Hygienic And Odor Issues

Many cats stop using their litter boxes because they now find the box undesirable for one reason or another. Others do so because unpleasant experiences occur in the area of the box (such as commotion, noise or a second hostile cat). Cats with this issue often begin by eliminating next to the box rather than in it. Cats that are content with their litter box spend relaxed time in it sniffing and pawing about. They don’t make quick bathroom runs and a fast exit.

Have you been cleaning your cat’s litter box less frequently? Dirty litter boxes are the number one cause cat’s stop using them. Be sure you are cleaning your cat’s litter box frequently enough. Check for litter box odor and uncleanliness at least once a day – more frequently if you have multiple cats.

Cats “see” the World through their ears and nose. Their sense of smell is 20 times better than yours. No matter how much you scrub out the litter box, your cat will continue to recognize it as a signpost that needs to be marked to advertise the fact that the territory belongs to it. The smell of a fresh litter box is a powerful attractant to cats and a stimulant to eliminate there and, for most cats, this single marking/elimination area is sufficient. The smell of a poorly cleaned litter box can be enough to cause your cat to choose a new spot.

Because of their sensitivity to odors, some cats avoid the smell of chemicals and detergent we often use to clean the litter box. Some of these same strong chemical aromas are added to cat litter to conceal cat urine odor. After you wash the box, be sure to rinse it several times in running water to remove residual chemicals odors. Some cats do not like to use litter boxes that have a lid. These lids intensify odors within the box. If you use a closed litter box, you need to clean it more frequently.

If you still experience problems, try relocating the litter box to another location where it sits on a mopable, ceramic or vinyl surface. Find a location without a lot of through-traffic and disturbances – but one that is not too far from where your cat(s) hang out. If you have a problem cat, having multiple litter boxes may help. This also lets you experiment with various box shapes and sizes as well as types and depth of litter in the box. If you have multiple cats, have at least one box more than your number of cats. Some cats prefer their litter box in a well-lit area while others prefer the dark. Washer/drier rooms are convenient for most owners – but your cat may not appreciate the machine’s noise or the odor of the chemical perfumes added to laundry detergents and softeners. Some cats prefer their box in a corner nook or cranny. Once your cat becomes accustomed to eliminating in the wrong area, residual odor will attracted it to the same area again and again. If you can, make that area inaccessible or inhospitable to your cat. If you cannot do that, scrub the area well with an enzymatic cleaner and then cover that area with a large object. A thin sheet of fabric with mousetraps placed upside down under it also works well.

Some cats dislike litter boxes with high sides. Other, older cats, fat cats and small kittens, find it difficult to get into them. Try various containers until you find one your cat seems to like. They need not be designed for cats. Be sure the box is large enough for large cats. The box should have a length and width the same as the cat’s length with its tail extended.
Replace the litter box when it no longer has its shiny surface and retains odor – but don’t throw it away until you know your cat is content with the new one. Given their choice, most cats prefer an uncovered litter box. Uncovered, rather than enclosed litter boxes, require more cleanup, but they may be your best option. Covered litter boxes also trap more odor the cat may find objectionable. Some believe that the character of the room in which the litter box is located is as important as the box itself. 

If your cat has mobility issues and difficulty getting about, cut one side of the litter box lower.

In practice, I have noticed that owners of long haired and purebred Persian-type cats have more litter box problems than owners of common domestic short hair cats. Try trimming the hair between the paws of long haired cats as well as the hair around their anus. Be very careful when you do this so as not to accidentally snip the pet.

Litter Composition And Brand Issues

Cats have individual preferences in types and brands of cat litter. They often do best when you use an unscented, non-clumping mineral litter or one composed of biodegradable cellulose material. You can also experiment using towels, diapers or potting soils. Cats like deep layers of litter (3-4 inches). Don’t be skimpy when you fill the box.

Cat litter manufacturers know you hate to clean the litter box. So they make exaggerated claims as to how long their litter lasts. Do not believe them. Change the litter much more frequently than they suggest. When manufacturers add perfuming agents and chemicals to their litter, they do so based on owner preference – not cat preference.

Territorial Issues

Some cats defend their territory more fiercely than others. Territorial issues cause some cats to spray urine around their home. It can be another cat that your cat sees through the window or screened porch, furniture or objects that have the scent of another cat, or a move to a new home where a cat previous resided.

When it is a rival cat on your property, try closing your windows and blinds. Lawn sprinklers work well to chase off cats that wander onto your property and most cats avoid wet or dampened grass and soil. ScareCrow®, motion-activated lawn sprinklers and similar brands are really great for this problem – just be prepared to get squirted when you forget they are there.

The cat repellents, sold in stores, do not work. Have-a-heart traps and relocation are sometimes the only effective way to deal with stray, nuisance cats.

Generalized Stress Issues

Cats that are anxious or stressed for any reason are more likely to develop litter box problems.

Moving to a new apartment or home is a major stress for all cats. They are comforted by familiar scents sounds and settings and a sudden move to new ones can be very traumatic for them. The old familiar scents are suddenly gone and are replaced by unfamiliar scents and possibly those of prior pet residents. The same issues can occur when you buy new or used furniture, carpets, etc.

Some stressors are things you might not normally consider – like the flame retardant PBDEs in carpets and pet foods or perfumes and fragrances that you find pleasant.

Consider Environmental Enrichment

One way to neutralize stress in your cat’s life is to provide it with pleasant distractions. Try adding more scratching posts, catnip-filled toys, and sunning areas. Fishbowls, ping-pong balls ,squeaky toys, dripping water, jars of bugs and time in an outdoor cage or enclosure are all things that many cats enjoy. Sprout gardens are great entertainment for cats – just be sure to use edible seeds from the supermarket and not treated seed from a garden or lawn supply.

Presenting food and treats in challenging ways keep cats occupied and stress low. Puzzle feeders keep cats challenged and lessens boredom. 

What If I Care For Lots Of Cats?

The more cats you keep at one time, the more likely it is that some of your cats will feel the need to urine spray. It happens because of social, inter-cat issues and rivalries. Cats communicate these issues between themselves in subtle ways that are often unapparent to their owners.

Here are some things you can do to try to minimize this natural behavior:

When you bring in a new cat, keep it confined to a cage in a separate area for a week. Your other cats will know it is there.

Always have more litter boxes than cats. Keep the litter boxes in separate areas out of visual sight of one another. The same thing goes for food and water dishes – have several of them in separate areas. Provide resting and sunning platforms or kitty habitats in separate areas as well – cats need their private space.

If this fails, consider separating problem cats to their own areas of the house. Sometimes they can be reintroduced again gradually, but sometimes they need to be kept apart permanently.

Your other option is to try some of the medications and products veterinarians dispense to relieve stress and anxiety.

General Tips

Most cats do not like to do their “business” and eat in the same area. Some cat owners have found that placing food and water dishes in a problem area solves the problem.

Mouse traps, gingerly placed upside down under fabric deter most cats from entering forbidden areas. Gates, noisy motor-driven appliances like fans and radios will accomplish the same thing.

Punishment never works. You can scat the cat away or squirt it with a mist bottle when you discover it in the act, but you are very unlikely to solve any problems that way.

Are There Medications That Might Help?

Yes, but none are as effective as changing the conditions that caused your cat to develop this problem in the first place. In that respect, they are all like mascara and make-up. In almost all instances, the problem will reappear when you stop administering the medications.


The first one to try is Feliway® . This product is sold as a cat feel-good pheromone but it’s active ingredient is said to actually be valerian (However, a 2017 study did not find Feliway-type products very helpful in combating stress in cat shelter situations (read here). Valerian contains some compounds similar to catnip (read here) But it contains a lot of other compounds with sedative potential as well. (read here)

Your other choices are all true pharmaceutical medications with known actions and side effects. None of them are FDA-approved for this use in cats. All of them have helped end problem behavior in certain individual cats but not in others and all have problematic side effects. Once the medications are no longer give, the problem often returns if environmental changes have not been made.

Medications that effect behavior, can also affect your cat’s ability to learn. So it is best not to give them when you are attempting behavior and environmental changes to solve the problem. Use them only when no other options remain available. They all take considerable time to show their effects. You will need patience. If the cat improves on these medications without serious side effects, it should stay on them for 4-6 months.

Clomipramine (Clomacalm®, Anafranil®)

Clomipramine and the following drug, Fluoxetine, are human medications developed for anxiety problems. Of the medications available for litter box problems in cats, clomipramine and fluoxetine seem to cause the fewest side effects. A 2005 study compared their use in cats with urine-spraying problems. They appeared to be equally effective, when the medications were discontinued, the problems resurfaced. When they were given again, the problem went away. (read here)

Fluoxetine (Prozac®, Reconcile®)

Lilly Drug Co (aka Elanco). recently began marketing their chewable fluoxetine tablet (Reconcile®) specifically for pets (at the time of writing, cats not included on label – talk to your vet). Fluoxetine appears to be as effective as clomipramine in curbing cat anxiety. Most cats tolerate it well. A few cats on this medication will develop excessive lethargy and sleepiness; a few others restlessness and inter-cat aggression.

Amytriptyline (Elavil®)

Amytriptyline is an older human anti-depressant. It is still used in pets because it is inexpensive. It takes a long time before you can expect positive results. Side effects are dry skin and mouth. In some cats, it has caused a variety of side effects that include toxic heart, lung and neurological problems.

Buspirone (BuSpar®)

Some cats seem to respond best to buspirone. Buspirone is an anti-anxiety drug as well as a sedative. It is not as likely to drug your cat into a stupor as is diazepam.

Diazepam (Valium®)

This workhorse human tranquilizer causes a general ratcheting down of alertness and anxiety in cats similar to its effect on people. But unlike in people, in cats diazepam does not seem to loose as much of its effectiveness with long-term use. Its chief side effect is that most cats become less responsive to everything while on the medication. Diazepam/Valium is also an appetite stimulant that might make your cat gain unwanted weight. (read here)

Because the drug is suspected of occasionally causing liver failure in cats, it is safest to have liver tests run on your pet before administering diazepam and now and then while the cat is taking it.

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