My old cat is peeing outside the litter box and I'm out of answers! Please help!

My cat is almost 16 years old. He has been diagnosed with kidney disease, but it's being managed through diet. A couple months ago I noticed that he started spraying. 

Since then I have tried everything. I even had to get my carpet taken out in my apartment and put down vinyl floors, which unfortunately didn't do much to help the previous smell, although I literally pour buckets of nature's miracle on the spots where he has gone before daily. (BTW, anyone have any suggestions to get rid of the old smell in the subfloor? I just ordered Icky Poo. I live in an apt so I can't do much by way of renovations).

I tried moving the litter box, and even using a different, more natural litter, which has stuff in it, which apparently attracts them to use the litter box.

I use a plug-in cat pheromone next to the box, and spray nature's miracle calming spray near the box as well. 

I have to keep a lid on it because I tried taking it off, and he peed sideways and it went all over my furniture. 

I have spent thousands on, and because of him, over the last year.

My stress is through the roof and I'm constantly watching him in the apartment to see if he's going anywhere. 

He has on and off GI issues (diarrhea one day, constipation the next). 

The thing is though, he seems pretty normal otherwise. He does kind of sit on the couch all day without moving much anymore, but he doesn't look sick or lethargic. 

I can't take much more of this either emotionally or financially. I love my little guy, but I wonder if it's time to let him go? 

I could try cat prozac or another little box in ONE of the places he has gone before, but am I just dragging this thing out? I weighs on my mind heavily!! 

Please help!!

Wow, you really have been put through the ringer with this little guy.  No wonder you are feeling frustrated at this point!  

Is he actually spraying or just urinating standing up?  Senior cats often start to pee standing up because they have arthritis and it hurts to squat.  Coincidentally, if he has a UTI, he might start peeing outside his box. The combination of the two might lead you to think he's spraying.  Have you had him checked for a UTI?  This is where I would start.  I'd also ask the vet about possible arthritis and treatment.  

In terms of getting another litter box, that is a very good idea. The rule of thumb is one per cat and one for the house so definitely, add another box.  And try adding one that is easy to get in and out of.  To find a box that is easy to get in and out of and that is covered or has high sides, you might need to consider making your own. You can do this by cutting an entrance into a plastic storage bin, like the ones made by Sterlite.

You mentioned trying Prozac at the end of your post - have you discussed this with your vet? We have members who have dealt successfully with intractable litter box problems using Prozac so it's worth seriously considering.  

And finally - about that subflooring.  According to a former landlord of mine, the only way to deal with it once pee gets in the subflooring is to replace it.  I know that is not what you want to hear. I didn't want to hear it either, especially since I ended up paying for it.  

Please let us know how things work out!  

Thank you so much for your response. See below!

Is he actually spraying or just urinating standing up?  Senior cats often start to pee standing up because they have arthritis and it hurts to squat.  Coincidentally, if he has a UTI, he might start peeing outside his box. The combination of the two might lead you to think he's spraying.  Have you had him checked for a UTI?  This is where I would start.  I'd also ask the vet about possible arthritis and treatment.  

I think he has done both. I have seen him both spray (back into a corner and wiggle his tail) and kind of squat. I did have him checked out medically (on several occasions) and he doesn't have a UTI or anything that looks unusual (aside from his kidney disease). There is, of course, the possibility of arthritis. 

In terms of getting another litter box, that is a very good idea. The rule of thumb is one per cat and one for the house so definitely, add another box.  And try adding one that is easy to get in and out of.  To find a box that is easy to get in and out of and  that is covered or has high sides, you might need to consider making your own. You can do this by cutting an entrance into a plastic storage bin, like the ones made by Sterlite.

I went to petco today and couldn't find anything that worked but will look online for one that is hopefully a good fit that I can put on the other end of the apartment. Gah more money!!!  

You mentioned trying Prozac at the end of your post - have you discussed this with your vet? We have members who have dealt successfully with intractable litter box problems using Prozac so it's worth seriously considering.  

I tried the liquid prozac but he puked it right away and was drooling, so the vet said I could try the pill one if he started peeing again. I have already contacted them. Again, more money!

And finally - about that subflooring.  According to a former landlord of mine, the only way to deal with it once pee gets in the subflooring is to replace it.  I know that is not what you want to hear. I didn't want to hear it either, especially since I ended up paying for it.  

 

The thing is though they ripped up the carpet, the padding, AND some really ugly linoleum that was below that, only leaving cement. Obviously I can't rip up cement. Given this is an apt, this is just money going down the drain and I already had to pay for vinyl flooring myself. I'm dumped a bucket-load of anti-icky poo on the area and I'm trying to let it soak through to the cement and wait to see if it dries and works. If not, I might just be lighting a lot of candles for the rest of my time at this place. I've spent THOUSANDS on him in the last year! 

I'd take him to the vet, make sure it's not any problems arising from the earlier or a new illness. 

I am so sorry to hear this. Thank you so much for loving him the way you do and doing everything you are doing for him.

Is he spraying to mark or is he going all over and not using the litter box much or at all?

There could be a couple of things going on.

Cats typically do not use the litter box due to pain. Given his health history he may be in pain. I always suggest ruling out medical issues with a vet visit especially with pain as that tends to be the easiest solution. Please ask your vet.

It could be behavioral. It sounds like you do a good job of cleaning. Cleaning properly is very important. So it could be because of two things. He could be feeling territorially insecure. Is he spraying in certain areas or is it very random? Do any of your neighbors have cats? Are there any ferals that might be coming around by your windows, patio doors etc? Could their be rodents in the walls? He could be marking to say "this is my territory, stay out". And/or it could be due to the heightened stress in the house. Cats take on our emotions and things can escalate. So a cat does something, we get stressed, the cat gets more stressed and does more bad behavior we get more stressed etc. I know it is easier said than done but please try to be as calm and confident around him as much as possible. If it is stress and we can reduce it hopefully he will use his litter box more.

As I get more information about the situation hopefully I can narrow down the problem and we can solve this. Please share as much info regarding the questions I asked as possible. And please ask anything anytime. I am happy to help.

Thanks again for caring so much about your cat.

I did on Sunday. A complete workup. Nothing unusual.

I see what you mean about the cement.  Mmmm.   Yeah, that really is a problem.  It sounds like your approach of trying to deodorize it by dumping stuff through the floor might be the best solution.  I really have to give you credit for being so devoted to him that you spent all that money.  

Prozac for cats can also be formulated so you can just rub it on their ears.  That might be another option. 

Best of luck with this.  You've done so much and worked so hard toward a solution, I really hope the Prozac works.  I've lived in a house that smelled like cat pee before - you really have my sympathy!  

I totally agree with CalicosRspecial. Your cat may have another medical issue with regard to the marking or he could be smelling another animal.

I use Fourpaws Industrial, I don't know if it's better than Nature's Miracle but many of the people here swear by it so changing to that may not help things?.  

Correct me if I'm wrong, vomiting is not a symptom of kidney disease, he may be reacting to the food or something else may be happening. There are some extremely experienced people answering questions there and CKD comes up a lot. There is also this page.  

Sorry, posted before I saw your reply.

I took him to the vet on sunday and had a complete workup. Nothing unusual. He has typically gone near the front door and back door, but a couple times in the bathroom, although he hasn't done that in about a month. No cats are coming around to my knowledge. What I've been noticing is that he sleeps ALL day in the same spot on the couch (like today he literally has not moved an inch), and then when I get home from work (I just happen to be working from  home today) he starts to move. I feed him wet cat food, then he starts wandering around and that is when he has been going outside the litter box. He HAS used the litter box to pee and poop at times, but its not all the time.

the vomiting was from the liquid prozac, which I stopped immediately per my vet. Since it's winter the doors and windows have been closed, and I haven't seen any stray cats around (I have no idea about rodents....yikes!), so I'm not sure it could be that. 

What % of the time does he not use his litter box? Does he not use it for both?

Can you ask your vet is he or she thinks the cat may be in pain at times?

By the front and back doors suggests cats might be coming around and marking. Do you have access to a black light? I would see if the outside of those areas have marking. I can't understand the bathroom marking. Is it by the window at all? But glad it has not happened there in a month.

Is he acting normal when you come home from work? Or differently? Since the marking has been happening.

When was the last time you had a urinalysis done? What's his urine pH? Older cats, and cats with kidney disease are prone to UTIs. They are very, very common. I would go back to the vet ASAP and have a urinalysis done.

he was in sunday for a complete work up and there was nothing unusual that came back. He has been to the vet nearly every month since Spring. I just spoke to them again and might see about a different version of prozac, and I'll try getting another litter box. 

good question. It seems he can go a couple days without peeing, but then it might be once a day. Like yesterday he peed in a corner (I think he peed and didn't spray-usualy I can tell by the amount). But then last night he actually went inside the litter box. He has been on the couch all day and he doesn't move an inch. That has been something I noticed lately too. I mean he was lazy, but he did move around a little during the day. He does move around at night and first thing in the morning though. I may just be paranoid and over analyzing every situation. 

What do I do if a stay is spraying the outside? I can't prevent that from happening.  

I also put another call into my vet about the situation. 

My 16 year old man pees right outside of the box. I probably won't be a lot of help, because it's been going on for about a year- but here's what I have tried and deduced for my boy.

Full $200+ blood panel shows he's in perfect health, just old- but he does have arthritis. Tried amitrypyline (like prozac) compounded into an ear cream. Prozac made him foam at the mouth. He doesn't pill well at all. It was not cheap, and there was some improvement, but not consistent. Vet decided since he poops regularly in the box it was likely arthritis driven and now behavioral. We have been a month on gabapentin, again compounded- this time into a liquid he tolerates well. He moves better and I can tell he's more spry, but still pees right outside the dang box! I put a heavy duty tarp under the box area he prefers (I have several and several cats, but he claims one as his own). I got the tarp at Walmart- the kind you'd put on your roof after wind damage. It's waterproof. I toss down a few paper towels where he likes to pee to catch it in advance. I keep a box of disposable rubber gloves nearby too. It's easy to pick up the soiled paper towels (think puppy pee pads but cheaper) and I have a spray bottle of a water bleach solution. I give a few quick sprays, wipe the tarp down with another paper towel and set out fresh towels ready for his next visit. I wish I could solve the problem, and maybe the Gabapentin will help more over time. In the meantime, my tarp/papertowels solution has been pretty smell and mess free.

Good luck!

Be careful of bleach at cat pee. The ammonia in cat pee and bleach can make that a lethal fume. And it just attracts them more to that spot I would recommend just about anything besides bleach. I guess my question to that is, how are you now super stressed about the situation? I know I could try more and more and more, but at what cost mentally? It's been taking over my life the last few months...and this could go on for years?