Inappropriate Urination - Arthritis Or Crf?

[kh2b1]

I took my 14 y/o male cat, Mr. Cuddles, to the vet last Monday morning because he was having urinary and other issues. He was diagnosed as having arthritis in his hind legs and the vet is 99.9% certain that is causing the urinary issues that I'm seeing. I'm supposed to try some joint supplements, but in the meantime, I still need help with the urinating issues.

What happens is that Mr. Cuddles steps into the litter box, tries to squat into position, but ends up peeing right over the side of the litter box. I end up with puddles on the floor. Right now I'm using pee pads made for humans as they're cheaper than the dog pads I could find. I don't really like this setup as litter gets everywhere and the other cats step in the wet pad when I'm asleep. Sometimes, the pads can't contain all the wetness and urine leaks onto the linoleum floor.

Changing the height of the litter box will not help, because I would need to raise it to prevent the urine stream from going outside. But then Mr. Cuddles would probably have more difficulty getting into the box. The vet is saying I need a litter box that Mr. Cuddles can walk into rather than step into, but I'm still going to end up with puddles on the floor.

Does anyone have any suggestions on what I can do? Or is this something we just have to live with?

I actually typed this last week, but was not able to post due to the site upgrade. The other night, I saw Mr. Cuddles urinating on the floor without even attempting to get into the litter box - he was perpendicular to it. The vet still says it's his arthritis. However, his lab results show he has advanced CRF and I can't help but think they're related.

I would love to get some feedback on this matter.

 

[abyeb]

Maybe try putting a ramp into the litterbox for him to walk up instead of stepping or jumping in. I think that it is most likely that his arthritis is causing this, as it seems that the biggest obstacle to him getting his urine into the litterbox is actually getting into the box in the first place. I hope you can get this figured out! I'm sure other posters will have more suggestions.

 

[kh2b1]

I don't know. When this problem first started, he was completely in the litter box, but he wasn't squatting so the urine would go onto the floor. The only way to prevent the urine from going on the floor is if he stepped further into the litter box. A ramp won't help with that.

I thought of enclosing the litter box and putting a flap there at the entrance, but I think the majority of the cats in the house would be unhappy with that.

I also thought about asking for some Buprenex to see if that makes a difference. I would think that would tell me if it's arthritis causing the problem.

 

[mrsgreenjeens]

Are you saying you only have one litter box in your household with more than one cat? If that's the case, you probably need to have more than one anyway, and surely you can one ONE low sided one for Mr. Cuddles, can't you? You could even just use a baking sheet or something like that. I'll tell you what I did with my old guy who had both arthritis and CKD when he got really bad and that was to use the black plastic trash bags to set the litter boxes on to protect my wood floors. He was (apparently) like your old guy, and would just get one foot in the box and then "go". So if I had pee pads on the trash bags around the litter box, then I could pick them up and easily replace them. Worked well for us.

ARE you giving him any Cosequin or Dasequin yet? Not sure how the prescription pain killers will affect his CRF...that could be an issue.

 

[cat nap]

What about buying those clear 'underbed storage boxes' which are very long, and have low sides.
IRIS 50 Qt. Underbed Buckle Up Storage Box in Clear-100802 - The Home Depot

Or else using the 'baking sheet idea' above, from mrsgreenjeens and placing it in a 'clear high sided storage tote', but cutting an opening along the long side of the box, almost to floor level, or about 2 inches above floor level, so that Mr. Cuddles would easily be able to get inside, and not be able to 'hang over the sides'. The higher sides should contain any spray, or flow, and he would not have to squat.
Sterilite Latching 64 Qt. Storage Box-14978006 - The Home Depot

Mr. Cuddles may want a much softer litter, too, if he prefers to urinate on the pee pads, which are soft.

Advanced CRF does cause a cat to urinate in large amounts. Poor guy.
Has your vet recommended a phosphorus binder, or sub-q fluids to be given at home?

 

[kh2b1]

I have several litter boxes, but there's one he prefers because it has a more central location.
I do have trash bags under the pee pads, but that hasn't worked the last two days. From what I can tell, during the night he urinates several times on the pee pad. When it's used up, he pees on the floor nearby. Then there's the problem of the other cats trying to cover up the pee spots and messing up the pee pads in the process. I can't have trash bags and pee pads all over the floor.

I'm not sure I'm explaining the litter box situation clearly enough. So let's say I use the idea of the baking sheet in the plastic tote. What will happen is the same as what's happening now: Mr. Cuddles will walk in, barely inside the litter box. He will stand or halfway squat to urinate, and urine will go all over the floor. When he urinates in the proper squatting position, he aims for the where the litter box meets the litter. He's that close to the entrance of the litter box. No matter what type of litter box I get, it's still going to be the same problem because he's aiming for the entrance area.

I can't do much about the litter because I do have other cats and litter changes would be unacceptable to them and me. I have enough trouble now trying to please them all.

I'm not convinced it's arthritis causing the problem. The urinating issues showed up around the time I started noticing classic CRF symptoms (increased thirst, sitting by the water bowl for long periods of time, weight loss, not eating as much, weakness). His blood tests reveal low potassium and high phosphorus, which could be causing/contributing to the urination issues.

I just got Epakitin and am waiting on the Tumil-K. He's receiving sub-q fluids at home, but it's very difficult to give them to him. I can't get enough skin to make a proper tent and the needle keeps going through to the other side. I never had a problem with inserting the needle with the other cats as long as they held still. I'm also concerned because he's between 5-6 lbs. and the vet prescribed 150 -200 ml to be given everyday! I modified that to 75 every other day because that's way too much. If he were 10 lbs. that would be different. He definitely seems to do better with 75 ml than 100 ml.

I'm having trouble getting him to eat. I've switched to canned only because he refuses dry food. He seems interested in eating, but is being picky about what's offered. He was never picky before and would gobble up anything offered. I may have to check with the vet about an appetite stimulant.

 

[cat nap]

I'm not sure I'm explaining the litter box situation clearly enough. So let's say I use the idea of the baking sheet in the plastic tote. What will happen is the same as what's happening now: Mr. Cuddles will walk in, barely inside the litter box. He will stand or halfway squat to urinate, and urine will go all over the floor. When he urinates in the proper squatting position, he aims for the where the litter box meets the litter. He's that close to the entrance of the litter box. No matter what type of litter box I get, it's still going to be the same problem because he's aiming for the entrance area.

So what you are saying is that Mr. Cuddles will always urinate at the entrance, and not further inside the box?

So these set-ups would not work?
Pine Pellets Cat Litter Box - All
Just look at the opening, not the litter inside. You could cut it anywhere on the box, and make it as low or high as you need.

This link has the tote box set-up, with cut-out, and mat in front of opening.
The Litter Box From Your Cat’s Point of View
(it's the 3rd image, down the page.)

You might also be able to get a box, and place it inside a bigger box. That way, if he is near the opening..inside the internal box, the outer box would catch the run-off. Even just trying a litter box inside a larger cardboard box, might give you the idea if it would work or not.

Have you seen Tanya's site, where she gives tips on getting CKD cats to eat:
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Persuading Your Cat to Eat

 

[mrsgreenjeens]

I would wait until you start giving him the Potassium before doing anything drastic. Low Potassium comes with it's issues, like mobility problems, low energy, so he may perk up once he's being medicated for it.

As far as food goes, all of my kidney cats went thru what he's going thru. it's a matter of finding and switching foods constantly with them. What I found worked best for my last one was feeding several (7 - 9 ) small meals throughout the day and night. She was also on an appetite stimulant, AND an acid reducer (via injection) All wet food, supplemented with extra water. For the middle of the night feedings I simply put a couple of bowls of food in the freezer an hour or so before bedtime, then took them out and set one on icepaks on my nightstand (in ziplock bags.) and one on a towel to start thawing. She'd come to me to eat and I would take the thawed one out of the bag and give it to her while still in bed, then take the other one off the icepak and place on the towel to start thawing. This would get us thru till morning. AND, I kept nutritious treats under my pillow to give the other cats for being good and waiting for her to finish eating. When she was done, they would each get two treats.

For fluids, my girl weighed 5ish pounds, and got 150 mls every 3 days so. Does he have a heart condition? That's where you really have to be careful.

That website (Tanya's) is a wonderful resource!