CRF/CKD cat peeing outside box - any way to curb this?

[joanne511]

We discovered recently that one of our two 8 year old cats, Chloe, very likely has chronic kidney disease (renal failure). Part of what prompted the vet visit a couple of weeks ago was finding cat pee in our living room, which we'd never experienced before. My research tells me that inappropriate elimination is common in cats with kidney issues, but very few places address what can be done about it.

I've now caught her peeing in our entry way several times in the last two days. I've cleaned the spots with Nature's Miracle and even ran her to the litter box myself tonight when I saw her scouting spots in the entry way. (She peed in the box.) I don't think it's a sudden overwhelming urge to urinate, because I've seen her several times now deliberately poking around before peeing. She would've had time to get to the boxes. Her energy level is pretty good, so I don't think it's that she's too weak to walk there. I can only think that she's just letting me know she feels lousy! (Which I know she does!) 

I'm planning to get Cat Attract litter and see if that will encourage her to go back to the box. I can't really put a litter box in the entry. Our house is tiny and front door area in particular is so small! We already have 3 boxes set up in the central part of our one-story house.

I've been giving 200 ml sub-q fluids every other day. She's also on antibiotics, as we're trying to rule out kidney infection before officially settling on CKD/CRF as the diagnosis. She is so young and I hope will lead a long, relatively healthy life with us despite her illness - but we also don't want to be dealing with cat pee every day. This diagnosis is enough of an emotional roller coaster without puddles of urine everywhere. It pains me to see my little buddy so out of sorts.

HELP please with any advice you have! Thank you!

 

[Ms. Freya]

It's sounds like Chloe is lucky to have you to help her through this illness.

One thing you could try is getting another litter box. Since she's not feeling well, she might be associating that discomfort with her litterbox, so is trying to avoid it. If that's the case, another one with no bad associations might help. You don' mentioned it, but have you changed litters recently? Some cats are really picky about their litter and will avoid one they don't like.

I know we have several members on here who've worked with CRF kitties as well as inappropriate elimination issues. I'm sure one of them will be along soon with more ideas. Best of luck to you and Chloe.

 

[joanne511]

Thanks for the reply! I haven't changed litters recently. I used Cat Attract for a time last year and neither cat seemed to have issues with it, nor did the seem to mind when I went back to the stuff I had been using prior (and since). But new boxes might be a good first start. My husband just spied her patrolling the entry again and took her back to the boxes, which she used. It's so odd. She's otherwise wandering around the house, jumping up to sit with me on the couch, etc. It also looks like she used the boxes overnight. I can't find any obvious urine spots and because we know she's been a bit constipated, I see she deposited some of that during the night. (I've taken to scooping twice a day to make sure the boxes don't get overloaded.) Next step: new boxes and fresh litter...

Other suggestions welcome - thank you!

 

[gumbiecat]

My girl cat Yoda doesn't pee outside the box but she doesn't squat - she stands and pees all up the sides of the box. I managed to find a covered box with really high sides and I haven't had any problems. Now, just in case she pees at the front of the box and gets pee outside the entrance - which she hasn't done - I went to PetCo and bought a pack of their doggie Pottie Pads - the ones without the attractant in. I put them at the front entrance of the boxes to protect the floors/carpets, using the front of the box to hold them in place. Why not get some of those and put them where Chloe pees outside most? My beautiful Teepee who passed away a year ago had CRF so I know exactly what you are dealing with. However, throughout his illness and right up to the end, he still managed to make it to the box. Ms. Freya made a good point too. Maybe another litter box might help. Do let us know how you get on.

 

[joanne511]

Thank you! Chloe does that too, actually - stands and pees on the sides of the boxes! I will look for the pottie pads and see if that helps. Again, thank you!

 

[gumbiecat]

You're welcome - that's why we're here!

 

[joanne511]

Got another box (#4) and put Cat Attract Senior litter into it. Neither cat seems interested, but it looks like Chloe used one of the old boxes. We just gave her fluid tonight, so the test will be tomorrow...to see if she uses the boxes or not as she absorbs and passes fluids. Crossing my fingers!

 

[orientalslave]

I presume the vet has actually diagnosed CKD with blood tests?  If not that's a priority.  If he has, hopefully with early intervention and good care she can still have a long and happy life.  And if your cats are related, I'd have the other one blood-tested as well, as some kinds of kidney disease are inherited.

If that's the case this is the most useful website I know for CKD cats and their slaves:

http://www.felinecrf.org/

http://www.felinecrf.org/subcutaneous_fluids.htm

(actually it's useful for ALL cat owners!)

BTW 200ml of fluids every day sounds far rather a lot to me, especially if she is on a wet diet.  Wet diets provide enough moisture for the average cat, if your cat weighs an average 3.5kg then 200ml is about 5% of her weight.  That would be like a 65kg person drinking over 3 litres of water a day.  Not sure if he is wanting to flush her out, but I would be concerned at continuing at that level if she was mine.  If I drunk that much I'd spend most of the day rushing to the toilet...

And whilst it can cause this, all the other reasons for cats not using the litter tray are possible as well - she doesn't like the tray, where it is, the litter, she wants it cleaner, she is upset at something, she has had a bad experience in it and so on.

A solution of biological (enzyme) washing powder or liquid will work as well as Nature's Miracle for cleaning the soiled areas, and will be far cheaper.  Through cleaning is essential - if you don't get it all out your other cat might start marking the same spots.  It's also possible your other cat has done a bit of marking and this one is picking up on it.

If you continue to have problems a behavioural approach (e.g. consulting a behaviourist) might be very useful.

 

[joanne511]

Thanks for responding! Yes, the vet is very involved. Chloe's levels are really bad; we weren't sure she was going to pull through and improve after she crashed. In fact, the vet said if Chloe could read her own file, she'd probably roll over and give up. Fortunately the two cats aren't related, so we're only focusing on Chloe's situation right now. 

Initially we were doing 200 ml every day to flush her out; she was also quite dehydrated. Now we're doing 150-200 ml every other day. She does not like getting poked, so we're trying to balance her needs for fluids with her tolerance for fluid administration. She is also not eating very much. We're giving appetite stimulants every 3rd day to keep her eating. I was force feeding her for a while; now she's up to eating about 1/2 can of wet food a day on her own. We're still working on increasing that. She went from over 9 lbs (~4.2 kg) to 7.7 lbs (3.5 kg). Between the lack of eating, bad lab levels, and dehydration concerns, the sub-q fluids are playing a big role in keeping her afloat (pardon the pun).

Knock on wood, she didn't pee outside the box yesterday. We'll see about today when we get home from work. I'm going to clean out the 3 existing boxes; both are still avoiding the new box with the new Senior litter so I'll dump that out and put regular clumping in it. I talked to the vet yesterday and she recommended making the entry unappealing (putting down tin foil or other unappreciated tactile materials) and making the litter box area more appealing with pheromones, so I am going to put the Feliway plug-ins back in that room when the refills arrive.

Thanks for the suggestion on using a solution in place of Nature's Miracle. I'll have to look online and see if there's a good ratio to mix it up. 

 

[whiskerz]

ok, I was just lurking around the boards.  I was reading this thread and seems like there is a lot of good advise.

I've had several cats over the years and sometimes a cat (in my case usually a kitten under 1 yr.) would pee around a few spots and then seem to find a favorite spot, like your entry way, and return to pee again and again.

I was exasperated trying to figure out ways to make the (1st cat I had) stop it, then a friend of mine reminded me of a basic rule; Cats don't 'poo' where they eat.

I got a little bowl of kibble and set it in the problem area and like magic it surely worked not just the once but on 4 different cats that I can remember.

I know your cat has medical problems and maybe my bit of advise isn't the answer in your case, but it might work and it certainly wouldn't hurt to give it a try. If it works, happy days!

I always loved the confused looks I'd get when the little bowl of food would be discovered LOL  If they emptied it, and they surely would, I'd refill and leave that little bowl of food there for a good few weeks, till I felt confident they weren't going to return to bad habits again.

Anyway, I wish you good luck with your kitty. and hope she gets better quickly.

 

[joanne511]

My next step was to put food there, but I haven't had to go there quite yet. I put in two Feliway diffusers - one in the main room and one in the room with the litter boxes. So far we've only had one or two inappropriate elimination episodes since I first posted and tried these new ideas. Hopefully this is a positive trend! Thanks for the suggestions and checking in on us!