Litter Box Problems Could Be Due to Physical Ailment

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By Sophia Yin, DVM

In a previous blog article, I talked about cats pooping out of place (What to do when your cat poops outside the box), I listed behavioral reasons and some husbandry changes you could try.

If, however, you have problems imagining that your kitty's suddenly become super-clean or really just likes his new comfy toilet spot on the carpet better, you may be right. There are some medical reasons for a cat's poor potty behavior, too.

Here's one example. “I've found that many cats who start pooping (but not urinating) outside the box have impacted anal sacs,” said veterinarian Dr. Melanie Thompson. “They return happily to their boxes after treatment,” she said.

Unlike dogs with anal glands that fail to empty — they sit straight-legged and scooch their itchy bottoms along the carpet — in cats the signs are often subtle or vague. Occasionally you may see misplaced poops, straining to poop, or even bits of blood in the stool. But nothing in a cat's behavior blares, “Anal glands full! Need emptying out.”

Consequently, it is a good idea to have a veterinarian examine your cat if it has this problem. Theoretically, you could inspect and empty the glands yourself; many dog owners do. Realistically though, with cats, unless you have a full suit of armor and a dull sense of smell, it's worth having your vet do the dirty deed. The secretions stink, and if the glands are painful, your Petunia can suddenly turn as vicious as a wild panther. If Petunia's unwilling to have her impacted or, in some cases, infected glands emptied, the veterinarian will perform the procedure under anesthesia.

Intestinal Disease

In either case, the vet can also check for other intestinal diseases such as parasites that might lead to intestinal discomfort and, consequently, displaced dung.

Unfortunately, sometimes the medical cause is more ominous than parasites or an impacted anal gland.

Says one cat owner, Mary Anne Perkowski: “Our 13-year-old cat also began 'pooping' occasionally outside the box. We did all the things you suggested and had him checked a number of times by the vet. After eight months he also began to lose weight. An ultrasound showed the presence of several tumors, one on his bowel.

“At this point his cancer has spread to other organs and he only has about five weeks to live. We now have watched and have seen him try to go in his box and then minutes later, go on the rug. It appears that when he gets the urge and can go, he now does so, even if he doesn't happen to be near enough to a box to use it. Not bad behavior, just doing the best that he can.”

This experience isn't as uncommon as one might think. Says another owner, Renea Johnson: “We experienced a similar problem, and our vet did a biopsy just in case. He took six samples, but all showed clear. After our beloved Ebony lost half her weight, we knew something was definitely wrong, and indeed she passed during the night.

“Our vet wanted to know what it was and did an autopsy; she had intestinal cancer. Obviously, even taking samples is hit-and-miss, but we tried.”

Evaluating the Problem

Does this mean everyone with a cat who poops outside the box should rush to the vet to rule out cancer? No. Start with either husbandry changes or a visit to your vet. But if you've implemented all of the behavior suggestions diligently and the problem persists, or your cat shows other symptoms such as vomiting, decreased energy or weight loss, investigate further.

This usually includes basic blood work, radiographs and ultrasound. Ultrasound can often show tumors of the intestinal tract, but only if the cancer cells are congregated into visible masses, which may not occur until later in the disease.

Another option is endoscopy, a fiber optic instrument for viewing the lining of the intestinal tract. While looking, the vet can also take biopsy samples of suspicious or even normal-looking areas for microscopic evaluation. Findings may reveal diseases, such as allergies, as well as tumors.

One limitation of endoscopy, though, is that the biopsy samples only the inner intestinal lining, and a tumor could be in a deeper layer. A more thorough sampling method is through exploratory surgery because the vet can physically inspect all of the tissues and collect full-thickness samples of the intestines as well as samples of other related organs.

Making an Informed Decision

Additionally, the vet can remove discrete intestinal masses, which is the treatment of choice with the most common intestinal tumor in cats. Doing so early on increases the animal's life span an average of six to 15 months, and some cats live more than four years.

Unfortunately, even with the most thorough evaluations, nothing's a guarantee. If you're lucky, you find the problem fast and make your choices from there. But perhaps most important, you find that your cat's pooping problem is not her fault.

To find out more about urine spraying in cats, read Urine-Spraying Cats: How To Deal With Kitty 'Graffiti'


Adapted from an article originally appearing in the San Francisco Chronicle in 2003.

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27 responses to “Litter Box Problems Could Be Due to Physical Ailment

  1. My cat is using the litter box, but has developed the problem of leaving a tiny “poop” all over the house, once or twice a day and he is dragging his rear end on the carpet. It is smaller than a gum ball. We have taken him to the vet and he cleaned out the anal gland and ran blood test and checked him rectally. The problem is now worse. He would have taken x-rays, but said he didn’t think he would find anything so I declined. Now I wonder if this was something I should have had done. This problems seems to have started in the last year. Max is about 6 1/2 years old and he weighs a little over 20 lbs. He has also licked off most of his stomach fur as has the female cat we inherited. They don’t get along because of her. I wondered if it was grief since his brother had to be put down and then we took in the female cat. Please we need all the help we can get. Thank you. Beth Bahnsen

  2. Hi Iam having a problem with one of my cats pooping outside her litter box she will pee in her litter box but will poop outside the box why is this

    1. my cat is doing the same thing..out of a sudden..she poops next to the little box..she did it couple of times..but pees in the box…what shall i do????

  3. I have two male cats. They are brothers. I’ve had them for 10 years.
    They have always used their litter box without accidents. The box is kept clean and scooped daily. One of the cats has started to poop in different places in the house…like every other day. I don’t know which one is doing it. I haven’t tried isolating one of them to determine this. But just today I noticed that one of my boys has apparently licked off his hair around the anus. There is a bald circle around it! So there must be a problem. Any suggestions what it could be?? There’s not been any weight loss and he still likes to play and be loved. Both of my boys are loving and stay close to me. Help of any kind would be soooo appreciated.

  4. I have a male cat that is fixed that has been pooping on our couch, rugs and outside his litter box off and on for the past 3 years. He has never done this before. Now it seems like he does it almost every week. I don’t know if he is acting out or if he has a problem. I need some help trying to figure out why he is doing this so that I can get him to stop.
    please help me.

  5. my cat goes in box several times a day but she does not do anything out side box either she will be 18 yrs old in june.she has lost weight and eats much less .is it just age ? i am very concerned i noticed her urine out put also decreased considerably

    1. Sorry to hear that your cat is having trouble. We do recommend you take your pet to the vet for medical concerns.

    2. My mother had a cat that was 21 when he passed, he started loosing weight when he turned about 12. We took him to the vet for his yearly shots and the vet said that it is common for older cats to lose weight, but the urine output I would take your cat to the vet because it could mean a urinary track infection. I don’t want to scare you but my brother waited with his cat when he started doing that and well.

  6. My 14 year old diabetic cat has started to.pee outside her bix. Went go vet no infection and diabetic numbers are still good. Gave her antibiotics anyways just to be sure. She is still peeing outside box and now started to poop there too. Not sure what to do next. I have scrubbed carpet and put down old piece with pee pads. She is still going now on the pads. I don’t know what else to do.

    1. She may be having diabetic nerve pain in her feet (humans get it too). If she’s happy enough using the restroom on pads, replace litter with pads or news paper in her box and redirect her there.

  7. My best friend has a cat that has fleas that uses to use the box but not cover it up.. Now she goes all over the place and there was blood in it. So it must be vet time?

    1. If you or your kid was pooping blood, it’d be doctor time,so yes – it’s time for the vet for the cat. There are lots of natural and pharmaceutical flea preventatives out there. Fleas can literally drain the health and vitality out of your animal, since they feed on blood. I’ve seen small animals succumb to flea driven anemia.

      Covering is a whole separate issue. Kittens separated from mom too early will never learn how to bury and some dominant cats feel no need to bury. This is mine. I am boss. You can smell it. One of my four is a terrible burier, but the others will bury it for him.

  8. My cat is approximately 8 years old. Recently diagnosed with diabetes and gets Lantus insulin daily plus diabetic diet (Purina). Since I brought him home 3 years ago (from the humane society) – he has been a joy and has always used his litter box. I indeed have had a struggle with the insulin ‘thing’, but have worked diligently to do what is required of me, for the health of my cat. My cat has seen several vets prior to the diagnosis and of course after. Teeth were removed as they were being reabsorbed into the bone. The vet assured me that this would help control his diabetes (infection – I guess) Now my cat has loose poops on the carpet – every day – and sometimes twice a day. The vet has had him on antibiotics, probiotics, prebiotics (not cheap these things!), all to no avail. The litter boxes are in abundance. I did try a different cat litter which he did not like before all this started, but since have made a special litter box up with his favorite litter, however he still will not use it. I do have my daughters two cats living with me now, and did worry that perhaps there was some bullying going on over the cat boxes. My cat likes to sleep downstairs, so I have made a special box with his litter in in. He will still go to an area far away from pee pads, litter box etc. and do it on the carpet. I am so frustrated with this, as I can imagine you other folks are, having to deal with this issue. I have to admit, I did think it was a behavioural thing, as the diabetic diet was totally different from what he used to have. And he did love his food -now not so much. He will eat it. But the other cats finish up what he has left.
    He also gets vit B shots – from me (Vets RX) to help his pancreas -or at least give it some support. Vets have talked about inflammatory bowel stuff – but no one has acted on it. Blood work and urinalysis were all done. No one mentioned about the anal gland possibility – and I have wondered about that. I did take a stool specimen in to the vet when I went, but someone threw it out!
    So, I guess I am commenting – and I know I am not much help to all of your problems, – to let you know that you are not alone. And it is a big problem! So even with pee pads and separate litter boxes, my cat poops outside and offside them all.
    When and if you find the answer – LET ME KNOW!!

    1. I just wanted to say thank you Debbie for sharing. My older female is about 15-16 yo, we think. She came to our doorstep on Easter wknd one year, shivering and hungry, completely declawed, staring at me through the glass. We finally opened our home to her (reluctantly, as my cat did not approve of a new member and already me cleaning up her messes was enough for me daily) after several attempts at finding her owner…signs put up, and I called the shelters. The new addition was guessed by the vet to be about 4 or 5 years old, has brought us much love & snuggles, but she has had her issues. Now it’s just the pooping outside of the litterbox that’s driving me crazy. If I shampoo my carpets much more they may fall apart lol. But with children on the floor I have to. We now have 2 indoor cats and 3 meticulously cleaned litterboxes, one for each floor. She gets in the box and will usually poop 2x a day, decent sized normal consistency poops, and has always done her urinating in the box. But she is down to 3 lbs, drinks water all day, and tries to eat, but most of it falls out of her mouth due to her teeth being bad, which in itself has caused a major snot issue. Like my walls are covered from her sneezes. So a couple of months ago she started pooping explosively in random spots, but I thought it was bc my bf bought the cheap food causing digestive stress. Went back to her normal food and it seemed to help a ton. Well now after a month back on the good stuff she is pooping on the floor again, right next to her box. She still has been trying to use the box for poop at least once a day and every pee, but she’ll climb in and try to go then gets out, takes a few steps and squats and poops right where she is, and it’s only a tsp, and soft like melting ice cream. We don’t have the ability financially to take her in and have numerous tests run, and have her treated. Best of health to you and your fur baby!

  9. Hi, my cat is 5 months old and we got her from a shelter. We’ve never had a problem with her going to the bathroom outside of the litter box l,except occasionally when traveling. Two days ago she was running around the house as normal and we noticed something hanging out of her rear. We picked her up and low and behold one small poop fell out. This morning I woke up to find another small one randomly placed on the floor. I initially disregarded it as a weird mishap, but now I am starting to worry. Do you happen to know anything about this?

    Thanks in advance for your help.

  10. My cat started urinating outside his box about 6 Mos ago. He just started peeing on different places in the house and then we started using pee pads which has curbed it a little bit. His personality is also suddenly changed and he is very cranky towards our other animals. We took him to the vet and they ran some blood and urine tests. He had a slight bacterial infection and we gave him antibiotics. It made absolutely no difference. He has also started losing hair but is also greasy. He has lost almost two pounds. We brought him back again and was told it must be behvioral and again only offered a repeat urine test. The other day he left some small watery poop spots around the house (one right while I was standing next to him). I’m frustrated. He is only 8 yrs old. Should I go to another vet? It sounds like there are many other tests that could maybe rule out other issues.

  11. My cat is almost three years old. She has been using the same litter for about 4 months now and never had an issue with it before. She’s acting normal and spunky still but keeps pooping outside of her litter. She pee’s in there just fine but only poops outside the litter. Now I put a new plug in scent smell object where her litter is to help with any type of smell but have been told that shouldn’t be an issue due to her only pooping outside her box.

    This has been occurring for about 4 days now. Again, she’s eating, drinking and acting fine.

  12. My cat is about 7 years old he is scared and quiet for most of the time but as he takes his poop on the carpet he makes a meow scream noise and he pukes and sometimes there is blood in his poop I want to take him to the vet but the vet in town will say something that’s not right then later find him passed away he has lost weight b4 any suggestions will be greatly appreciated

    1. Thank you for contacting us at CattleDog Publishing. Unfortunately, we cannot diagnose medical or behavior problems online. For medical issues, we do recommend seeing your veterinarian as soon as possible.

  13. Hi, My cat is 14 yrs. old. Recently he’s lost a lot of weight and has started to poop and pee outside the liter box. His poop is very bad smelling.

    Don’t know what to do….

    1. Thank you for contacting us at CattleDog Publishing. Unfortunately, we cannot diagnose medical or behavior problems online. For medical issues, we do recommend seeing your veterinarian as soon as possible.

  14. So i have a problem with my cat. She always used the litterbox, it is covered yes but we have always had the litterbox. For a year now actually. And when I came home there was pee and throwup on our carpet and I don’t know why the sudden cause

  15. my 16 yr. female cat has been pooping on the flr. for more than yr. she eats well, drinks well, urines in her box, has good energy. i take her to the vet every yr. for a geriatric work-up, i.e., blood, urine, etc. Up to now, all test results are fine. if she had some condition that was causing her to poop outside the box wouldn’t it show up in the test results. Appreciate any comments. thks.

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