Cat DOES NOT have an infection,pees outside the box 2x per day!!

I need some expert advice here. I have a 7 year old male who has been peeing outside the box for about a year now. He's been to the vet many times (which is always fun, because he turns into the devil & they have to gas him to examine him). Everytime they take his urine, they come back with a minute amount of bacteria, but not enough to qualify for an infection. He occassionally has a little old blood crusted on his privates. The vet thinks he has some type of chronic bladder inflammation disease. We tried giving him Buprenex for awhile, and it seemed to work, but I just can't see keeping him on a strong narcotic like that for more than short periods of time. THEN, she told me to try Amitriptyline plus Dasuquin once a day, every day. He's been on it for about a month, and I see no change. She says she doesn't have any other ideas, and I should probably see a specialist. I'm currently unemployed, and cannot afford this.

I've tried everything. I have conducted several behavioral "experiments", to no avail. I have 5 cats & 4 boxes, and I clean the boxes 3-4 times daily. I have tried leaving food out all the time, in case he was protesting a lack of food. They get new water & lots of it everyday. He ONLY pees right in front of the boxes, never anywhere else in the house. His pee is never discolored, and theres ALOT of it. He drinks TONS of water.

Has anyone else experienced this? Are there any vets or specialists out there who might be able to lend some advice?

Hello and welcome to TCS. I am sorry you are having this frustrating problem. I have some questions.

Has a special diet been tried? A long term round of antibiotics? Has a urine culture been done?

How many litter boxes do you have? Have you tried adding more? Do you keep the boxes clean? Do you use unscented litter?

Have you ever used feliway plug in diffusers?

Do you have other cats?

Otto-
Thank you for the welcome!

To answer your questions, yes we tried Iams Urinary, and wet food instead of dry. Neither made a change.

He has been on Clavamox for 10 days, about 4 different times. Didn't make a change, even when he was on it.

Urine & blood cultures have been done. No significant results.

I have 5 cats, 4 boxes. Used to be 3 boxes, and I added one. I use the same scented litter since I got him 7 years ago.

I tried the Feliway, too, but it didn't help either.

Uggghh!!! As you can see, I feel like I'm out of options!!!

did you get new boxes ? if not try that and maybe some cat attract added to the litter....

What blood work was run? just a CBC? or the full panel?

Technically you should have 6 boxes with five cats

Sharky-

Full blood panel was run. I know the standard is 1 box per cat plus 1 extra, but this guy has never had a problem with it before. I have the feeling there's something medically wrong. I will try the cat attract...that's a good suggestion!

For five cats you should have at least six litter boxes, but I would go with 7.

I would put a different, non fragrance litter in those boxes.

All cats are neutered and spayed?

What is your household like as far as activity and noise?

How long did you try the feliway? It takes time to work. You have to have enough of them (each diffuser covers 400 sq feet) and keep them going for a few months.

10 days is not long enough of an antibiotic for a UTI, and clavamox may not be the right antibiotic, why was no other antibiotic ever tried?

By special food I mean prescription food, like Hills Prescription c/d multicare or the Royal Canin SO.

I recommend another opinion from a different vet. If you have been seeing the same vet all this time, I would be, in addition to the adding of litter boxes and unscented litter, and installing feliway, getting a second opinion from a different vet.

Oh, and the pee spots have to be removed, to prevent him coming back to them. You have to use an enzymatic cleaner to completely break down the bacteria. Even if you can't smell it, he still can, if you don't.

Originally Posted by awesomealison

Sharky-

Full blood panel was run. I know the standard is 1 box per cat plus 1 extra, but this guy has never had a problem with it before. I have the feeling there's something medically wrong. I will try the cat attract...that's a good suggestion!

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Then by all means go with your gut and get him seen by someone else! my previous post I already mentioned what I thought about only 10 days on the clavamox, and not trying anything else.

That's why I specifically asked if a urine culture was done.

It takes a week at least to get culture results back, they grow the bacteria in the urine and try different antibiotics on it to see what it is most responsive to.

Originally Posted by otto

By special food I mean prescription food, like Hills Prescription c/d multicare or the Royal Canin SO.

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Look it up, Iams Urinary is a prescription diet - it comes in S and O (moderate and low ph). I had a former vet that carried Iams - though I usually see Hills or Purina in most clinics.

I agree, at this point you either need to treat this more aggressively or switch to another vet. And keep him on a prescription urinary food. Blood is definitely not something you want to be seeing. Has anything been done to rule out stones?

Originally Posted by strange_wings

Look it up, Iams Urinary is a prescription diet - it comes in S and O (moderate and low ph). I had a former vet that carried Iams - though I usually see Hills or Purina in most clinics.

I agree, at this point you either need to treat this more aggressively or switch to another vet. And keep him on a prescription urinary food. Blood is definitely not something you want to be seeing. Has anything been done to rule out stones?

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thanks for the info, didn't know Iams had a prescription food.

I agree, if x rays haven't been done, they should be.

Originally Posted by otto

thanks for the info, didn't know Iams had a prescription food.

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They have a few - though their urinary formulas don't have any pork (all the others do for some reason), contain fish meal, and the usual by-products. It's possible that Iams wasn't the proper food to deal with what now sounds like a chronic urinary problem.


awesomealison - Since this has been going on for a year now you also face the problem of getting all the urine scent out of anything he's peed on. I suggest you browse through the behavioral section as there are numerous threads with cleaning tips. It's possible that after all this time he thinks the litter boxes are making him hurt when he pees so definitely look into the cat attract litter or additive and maybe even try retraining as you get the health issue under control.

Iams/ Eukanuba both have Rx lines unfortunately most vets do not carry in house... one hospital in town does

I guess they didn't do a urine culture, because they called me the same day. I will ask for that next time I bring him.

As far as the pee smell, the carpet has been steam cleaned with a pet cleaner that removes urine odor & discourages them to go again in the same spot. After I cleaned it, I put down some plastic & then the underpads they use for the elderly, and towels on top. Each time he pees, I throw the underpad out and wash the towels with a scent removing detergent that hunters use. He goes in the same spot all the time, so it's pretty easy to catch.

My household is pretty quiet. It's just me, my boyfriend and the cats. No kids or anything, no loud parties.

All cats are spayed/neutered.

The food was prescription Iams Urinary-low ph. We can probably try another one. I will ask the vet what other options there are.

I think I'll go ahead and add a box, just in case.

The vet tried another antibiotic, but I can't remember the name. I only know that it was a one time injection that was supposed to last 10 days. They have not done x-rays. I will suggest that as well!

I had a cat that would poo just outside the litter box and adding more litter boxes, instantly resolved the problem.

I would be concerned, especially about the blood and maybe he did have something that the antibiotics took care of.

Is he actually getting in the box, when he goes? If so, you may need to try a litter box with very high sides.

He could just be a very particular kitty that wants to have his own box.

Originally Posted by awesomealison

As far as the pee smell, the carpet has been steam cleaned with a pet cleaner that removes urine odor & discourages them to go again in the same spot. After I cleaned it, I put down some plastic & then the underpads they use for the elderly, and towels on top. Each time he pees, I throw the underpad out and wash the towels with a scent removing detergent that hunters use. He goes in the same spot all the time, so it's pretty easy to catch.

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Sounds like you've pretty much covered it. Carpet is a really tough one, though. I think everyone has issues with that once a place gets soiled more than once.

Why not put a box in or right next to his favorite spot to pee?

I have a kitty currently on Hills, I can't say I love the ingredient list but his urine was perfect at his last check up so it's apparently helping (antibiotics helped the rest, but obviously not the crystals he had). Find something that he'll eat, has no issues with, and keep him on it. Maybe your vet will give a discount if you buy in large amounts and regularly.

To AwesomeAlison:

1. You indicated that previous urinalysis tests have shown 'some bacteria' but 'not enough to qualify as a UTI.' I'd seriously question the intelligence of a Vet who is aware that this kind of problem has been going on for a whole year but didn't have the common sense to obtain a sterile urine sample and send off for a urine culture. That's gross negligence, IMO. NO bacteria should be present; urine is considered a sterile body fluid. I'd be going to current clinic; requesting a copy of all of kitty's vet records (this is totally your right to request this; just tell them that because problem has been going on x 1 yr, you want to look back at all records, for your own knowledge. Most of us request copies of our cats' lab/urine test results and keep them on file. Then I'd advise you to find a reputable Vet in the area (would be ideal if you could find a vet clinic that is a cat-only clinic) and take kitty there, with all past records for him/her to review. I'd request a new urinalysis be done......a sterile sample obtain by cystocentesis (they just insert a very very fine needle through abdomen into kitty's bladder and obtain urine that way)...then run a full proper urinalysis AND a urine culture/sensitivity.

2. A culture/sensitive (aka C&S) is the only way to truly identify the TYPE of bacteria present (there are many, many different types).....and then they test this bacteria with various different antibiotics to see which ones are 'resistant' to that type. It takes 72 hrs for the bacteria, if present, to grow on the agar plate. If there's a ton of bacteria, it can show as quickly as 24 hrs but usually they wait 48-72 hrs. If kitty's issue IS a UTI, Clavamox may not have been the correct antibiotic for the particular type of bacteria. and you say a 2nd type of antibiotic was used; a one-shot antibiotic that worked for 10 days. I suspect you're referring to Convenia (which actually works for 14 days).....and that one is really not recommended for UTIs; it's intended for the use of certain types of bacteria present in soft tissue, not common bacteria that cause UTIs.

3. Does kitty pee ANYWHERE else in the home? Or just this spot in front of the litterbox? How big is this cat? Is it at all possible that, like some cats, he's long in stature and he sort of miscalculates where he's standing in the box and his butt area ends up hanging over the edge of the box when he pees? If so, I'd recommend you try a much larger/longer litterbox I myself prefer to use those clear Rubbermaid storage containers; can get them cheaply at places like Walmart. they generally come with a lid, I just throw the lid away. They're a good 5 inches deep and much wider and longer than even an XL litterbox.

4. How long have you had the litterboxes you have? They should be completely tossed out after a year because despite how meticulous we keep them, urine inevitably can make it's way to the bottom of the box and plastic holds bacteria and odor (might not be odor humans can smell but cats can). Because I use the above Rubbermaid containers, they're very affordable to replace each year. I've gotten them on sale for like $12.

5. You might also try replacing the box that he pees beside with a hooded box...........these ones are "higher up the sides" so harder for a cat to have their butt hanging over the edge when doing their business but personally I'd try to Rubbermaid container first.

6. Kitty should be having xrays of bladder, to check for bladder stones that can cause discomfort AND blood in the urine (due to the inflammation of the lining of the bladder) and an ultrasound of the bladder - to check for any abnormalities with the bladder (kidneys, etc). Eg) if there's inflammation there, the U/S could show some thickening.

7. If the product that was used to clean the area when the carpet was steam-cleaned was some product that the steam-cleaning company endorses as 'able to completely remove pet urine', I'd try something else, like Nature's Miracle or Simple Solution; can get these at pet supply stores. I had my carpets steam cleaned a few months ago, prompted mostly by my finding my new adoptee having peed on a pile of clean laundry and a bath mat and I was terrified she'd peed in other places. The company told me they had some type of 'sanitizer' they could spray on the carpet to completely rid any cat urine. When i asked for more info on it, did it contain enzymes...they couldn't tell me much so I somehow doubt what they spray is as good as Nature's Miracle. In fact, all the guy did was walk around and spray it on the carpet surface. To clean cat urine properly, you have to totally saturate the area (including underpad) with the proper product. So based on this, I'm very "leary" of carpet cleaning companies who claim they have products to properly clean pet urine.

GOOD BOY GOES POTTY IN THE BOX!!!! Well, it's been 3 days without any accidents, so I think it's safe to say that this problem is solved! Thanks to all of your input & suggestions!!

I went and got a 5th litter box, some good enzyme cleaner & 3 bags of Cat Attract litter. I emptied all of the old Tidy Cats, bleached the boxes & hoods, and then sprayed them with the enzyme cleaner and let them soak for 15 minutes before rinsing, to make sure I got any residual urine smell out. I re-washed all of the towels & sheets that I usually put under the boxes, with vinegar (Dr. Elsey's booklet on how to remove urine). Re-filled all boxes with Cat Attract. Tiny (that's this kitty's name) went right in and peed & has been doing it ever since!! Maybe it wasn't medical after all. I still think he has chronic inflammation, which is maybe why he was so sensitive about the boxes to begin with, but now I think we have it under control.

Thank you so much for your help! My life is much easier not having to clean up after this guy twice a day

As far as peeing outside the box, I had a cat that would do that when she was upset or I came in smelling of another cat...seemed to be a territorial thing.
I built many different types of cat boxes and finally made one with a low entry that tipped out a bit like the top of a funnel and that did the trick.
I also switched to cedar shavings which in the beginning was a bit messy as she would then play in the box (Cedar Shavings everywhere) but she settled down and no more problems.

Originally Posted by awesomealison

GOOD BOY GOES POTTY IN THE BOX!!!! Well, it's been 3 days without any accidents, so I think it's safe to say that this problem is solved! Thanks to all of your input & suggestions!!

I went and got a 5th litter box, some good enzyme cleaner & 3 bags of Cat Attract litter. I emptied all of the old Tidy Cats, bleached the boxes & hoods, and then sprayed them with the enzyme cleaner and let them soak for 15 minutes before rinsing, to make sure I got any residual urine smell out. I re-washed all of the towels & sheets that I usually put under the boxes, with vinegar (Dr. Elsey's booklet on how to remove urine). Re-filled all boxes with Cat Attract. Tiny (that's this kitty's name) went right in and peed & has been doing it ever since!! Maybe it wasn't medical after all. I still think he has chronic inflammation, which is maybe why he was so sensitive about the boxes to begin with, but now I think we have it under control.

Thank you so much for your help! My life is much easier not having to clean up after this guy twice a day

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Thanks for the happpy update! I can't remember if I mentioned this before, but if you think Tiny has chronic irritation Cosequin for cats can help with that.

It's a supplement originally used to treat arthritis in cats, but it is also very helpful in Urinary tract and bladder issues, it can help a lot with inflammation. It comes in capsules with flavored sprinkles, you can sprinkle it right on his food, or if he is finicky, just put the capsule down his throat every day.

Of course never start a med or supplement without checking with your vet but cosequin for cats is very safe and may go a long way toward relieving Tiny's discomfort.

How is Tiny doing?

My cat, Speckles, gets bladder inflammation. She's had it twice, with episodes about a year apart. Each episode lasted 2-3 weeks. When she's sick, she's in a lot of pain and needs a pain Rx. She also acts like she's in heat (she's spayed), but I'm told that's atypical. I now have a large cage to house her when she's sick; otherwise, she pees on my bed.

The vet says bladder inflammation is a chronic condition that, once gone, will return. Speckles has been checked for stones, infection, and crystals--all negative. She can have blood in her urine when she's sick, but not always. I give her Cosaquin daily, sprinkled on her food. Her vet says there is "some evidence" that may help. She also gets an anti-inflammatory for arthritis that the vet said may also discourage the bladder inflammation.

When she's not sick, Speckles uses her litter box. It's in the cage, along with her food and water. She comes and goes from the cage as she chooses, but often sleeps in it by choice. She's very social and craves my attention, so when I'm home, she's always nearby.

I would be concerned about Struvite Crystals. My Boo had those and had blood in his urine and on the outside of his privates sometimes from them, but then they got really bad and he completely stopped using the pan and peed EVERYWHERE. We thought he was mad at us for some reason but come to find out he was pretty close to death before we realized he was blocked up and couldn't pee by that time.

Hope you find out what it is