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  • Writer's pictureOxford Cat Clinic

Thinking Outside the Box – Undesirable Toileting

From a human perspective, a cat depositing faeces and/or urine outside the litter box is completely unacceptable and undesirable. From a cat’s point of view, our feline friend is sending out warning signals, saying “HELP, something is wrong!”.

It is important to get an early understanding as to why our cat companion is showing this behaviour. At the Oxford Cat Clinic we can help you to help your kitty feel happy again.

Four important differential diagnoses are:

  1. Feline Idiopathic cystitis (FIC); pain associated with urination which can lead to a negative association with the litter box;

  2. Medical reasons other than FIC e.g. chronic pain that may make the litter box tricky to negotiate, or a disease that causes excessive urination such as diabetes or hyperthyroidism, or a loss of learning associated with age, also known as cognitive dysfunction.

  3. Marking – most commonly urine spraying, but marking can also include urine pooling or faecel marking

  4. Behavioural reasons for the depositing of urine and/or faeces in inappropriate places – related to primary environmental and social factors.

The first two causes we can rule out by an in depth clinical exam and further tests including urine analysis, blood tests and if necessary diagnostic imaging. Do not worry about “how to get a urine sample?” as at the Oxford Cat Clinic we can obtain a sample by cystocentesis.

Marking and elimination are not always as easy to distinguish from one another. Both are normal behaviours for cats - but marking and inappropriate elimination usually indicate some form of stress/unhappiness. Thorough history taking, making a time scale and a house plan, helps us identify the stressors in your feline’s life and address them appropriately. Risk factors are plenty; ranging from litter box features, location, litter material and hygiene to multi-cat household, interspecific social interaction (cat/dog/human), reduced access to desirable elimination location or visual intrusion from other cats through windows, patio doors,…We help you explore all these possibilities.

Treatment of elimination-related house-soiling problems will involve dealing with potential disease, optimising the litter facilities and addressing your feline’s emotional motivations for undesirable behaviours with reference to the Five Pillars of Healthy Feline Environment.

Optimising litter facilities includes providing sufficient number of litter boxes (number of cats +1), distributed in appropriate locations and making sure to position the litter box in a separate, visually protected, easy accessible and safe site, positioning the box away from food and water. Boxes should be an adequate size (ideally 1.5x the length of the cat from nose to base of tail). Providing a choice of hooded and open trays and using a sand-like clumping non-scented litter with adequate depth to rake over the deposit may help. Cleaning at least twice daily and emptying entire contents once a week is recommended, avoiding polythene litter liners or any scented additives.

The Five Pillars of Healthy Feline Environment are:

  1. Providing a safe place;

  2. Providing multiple and separated key environmental resources: food, water, toileting areas, scratching areas, play areas and resting or sleeping areas;

  3. Providing opportunity for play and predatory behaviour;

  4. Providing positive, consistent and predictable human-cat social interaction;

  5. Providing an environment that respects the importance of the cat’s sense of smell.

For once, human, think outside the box!


  1. Heath S. Common Feline Problem Behaviours - Unacceptable indoor elimination. J Feline Med Surg, 2019, 21: 199-208.

  2. International Cat Care:

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