The darn cat has just done it again. It seems that within the past few weeks she has made it her mission to flood every part of your house with urine. Something needs to be done about this situation, because cat urine all over is not working as a home decorating idea.

I see this scenario very frequently, and I am here to say that you probably don’t have to just live with it. Lots of people think the cat is trying to punish them somehow, but in fact there are reasons why cats urinate inappropriately, and most of them can be fixed.

The reasons for which cats refuse to use their litterbox can be separated into two major categories: physical problems, and behavioral reasons. In this column I will address the physical reasons, and in the next I will talk about the behavioral ones.

As far as I know nobody has ever gotten a cat with a urinary tract infection to stop peeing everywhere by yelling at it or punishing it. Physical problems are a very common and often not very obvious reason for inappropriate urination, and the logical thing to do is to screen to see if rather than a louder voice you may just need some antibiotics to resolve the problem.

The physical triggers for inappropriate urination fall into two broad categories themselves: Things that cause irritation in the bladder and things that cause drinking too much and urinating too much.

A cat with an irritated bladder is often urinating little spots all over with great frequency, urgency, and excessive straining. It is not unusual to see blood in the urine as well. For some reason cats with painful bladders may associate the litterbox with that pain and will start avoiding it, or they may just be hit with such strong and sudden urges to urinate that they just have to go where they are. This sort of problem can be caused by urinary tract infections, stones in the bladder, or an unusual inflammatory problem that some cats develop that is similar to a syndrome described in some people called interstitial cystitis. In this syndrome the patient has all the signs of irritation and inflammation of a urinary tract infection without an actual infection or any other triggering problem that can be discovered. This happens most often in male cats for some reason.

Diagnostics usually involve a urinalysis, possibly a urine culture, and x-rays or an ultrasound to look for stones in the bladder. Male cats with inflammation in their bladders for any reason are high risk for developing a urinary obstruction when all that floating sludge gets packed into the tiny exit tube from the bladder, the urethra, and blocks it off. If this happens the cat will be in frantic pain and will become quickly debilitated until the obstruction is relieved by his veterinarian. Appropriate treatment may include antibiotics for an infection, surgery to remove bladder (not kidney) stones, or diet changes. Most cats will go back to normal litterbox habits when their pain is relieved.

In the drinking too much and peeing too much category we have common problems like diabetes mellitus, hyperthyriodism (high thyroid hormone levels), kidney disease and liver disease. There are a handful of other less common reasons like high calcium levels that can also be culprits. A complete blood screen can usually illuminate whether any of those problems are at play and then give us a course of treatment directed at the source of the problem. Cats with these sorts of problems are usually urinating large volumes fairly frequently, sometimes overwhelming their litterbox in a day. They are often very demanding about getting water, following you around and clawing at your leg until you turn a faucet on for them or fill a glass for them. Some will climb right over your face to get at your glass of ice water while you are minding your own business reading the newspaper. Often there are other physical cues like weight loss or loss of energy too.

Almost all of these conditions have good treatment options, although shouting at the cat is still not included amongst them. Consider inappropriate urination as a cat’s way of saying "Hey I have a problem that needs to be addressed!" After all if they behave like good citizens and strain and suffer silently in the litterbox where it doesn’t cause us a problem it would probably take much longer to realize that a cat needs help.