Recent research has shown that peeing outside the litter box, no matter the cause, can be improved by keeping the litter boxes really clean.


But what if there is a medical problem? Things such as urinary tract infections or crystals in the urine can cause cats to have painful urination. These cats may also be unable to make it to the box at times. Other urinary tract diseases, like bladder stones or a bladder inflammation can also cause these problems. In older cats, things like kidney or liver disease could be causing the trouble.


Having your veterinarian check out Fluffy is a good idea, because medical problems aren’t going to go away without treatment. Sometimes, the physical exam doesn’t show much, but a urinalysis and maybe some blood tests can be very helpful.


When a cat starts urinating outside the litter box, the first thing I’ll do is a physical examination. I’m checking out everything with my eyes and hands, but I’m also looking specifically for things like dehydration, feeling the kidneys and bladder (if I can), and looking for signs of illness like weight loss. For a lot of bladder issues, I won’t find anything abnormal on my exam. Then, I look you in the eye and tell you we need to do a urinalysis.


The response is either a blank stare or confusion. How do we get pee from a cat?


Believe it or not, there are multiple ways.


I have met an unusually skilled and motivated owner who, combined with a very relaxed cat, can catch a free-flow sample while kitty is urinating. This is rare, and I’ve never seen it in the wild. But, I’ve had an owner bring me a sample that was obtained this way. I’d wear a glove before trying it.


Often, we can get a urine sample by replacing the regular cat litter with a special sand that does not absorb the urine. Then, the owner at home or the staff in the clinic will use a little tube to collect the urine sample off the top of the sand.


If we have a cat who will not use the litter box at all, or if the amount of urine passed is too small, we may try to express the bladder but this does not often work well and does have risks.


With male cats, a urinary catheter can be passed up the urethra to get a sample. For obvious reasons, this requires sedation.


There is also a procedure called cystocentesis, where urine is removed directly from the bladder using a needle. This procedure has more risks than simply waiting for kitty to urinate, but sometimes is necessary and can usually be done without sedation. It can be done ‘blind’, by feel (holding onto the bladder) or with ultrasound guidance.


If we are doing tests such as a culture, where we are trying to grow bacteria from the urine, then a catheter or cystocentesis sample is going to give the best results.


And that’s how we get urine from a cat.