By Lorie Huston, DVM
Stress affects our cats in much the same way it affects us. What's most disconcerting, however, is that when your cat is stressed or anxious, it can impact his or her health. Even a small change in routine can cause painful health issues like cystitis (inflammation within the bladder) in some cats. And although cats have evolved to hide signs of pain effectively, there are some symptoms that will be noticeable if you are being extra vigilant.
If your cat suddenly starts urinating outside of the litter box, there is cause for concern. There are many reasons that a cat may decide not to use the litter box, though medical issues should always be ruled out first. Cats suffering from cystitis or other lower urinary tract disease will often avoid the litter box.
Other possibilities include territorial "marking" (though it's a more common behavior in male cats) and displeasure with the litter box itself (location, cleanliness, etc.).
Frequent trips to the litter box may be another sign that something is bothering your cat. Often, cats with bladder issues such as cystitis have frequent urges to urinate. They may have very little urine in the bladder but still have the feeling that they need to urinate. In these cases, you may see your cat going to litter box quite frequently but passing only small quantities of urine.
Bloody urine is always cause for concern and should prompt an immediate visit to your cat’s veterinarian. Blood in the urine is never a normal situation for your cat. Even when in heat, female cats do not bleed. It may be difficult to detect blood in the litter box. However, you can pay attention if your cat urinates in a sink, bath tub, or other surface.
Some cats will lick excessively at areas that are painful. In the case of cystitis, this will mean licking at the belly. Some cats may also lick excessively at the penile or vaginal areas as well. Though excessive grooming may be indicative of other health issues as well, it is something that needs to be addressed by your cat’s veterinarian.
If your cat is straining, seems uncomfortable, or cries when trying to urinate, you'll want to consult a veterinarian immediately. This is true of both male and female cats. However, especially in the case of male cats, this situation can quickly become a life-threatening emergency. If your male cat is trying unsuccessfully to urinate, he requires immediate veterinary attention to save his life.
Eliminating stress and anxiety for your cat may not always be possible, but there are things you can do that can help. Enriching your cat’s environment is one of the most beneficial. Provide plenty of toys to keep your cat busy and entertained. Provide perches (preferably at eye level or above) where your cat can survey his environment such as near a window. Provide scratching surfaces, ideally both vertical and horizontal surfaces. Provide a private, safe location where your cat can retreat when he feels overwhelmed, and don’t forget to comfortable bedding too.
As for your cat's litter box, clean it regularly and place it in an easily accessible area away from distractions. In multi-cat households, provide enough resources for each cat. Ideally, there should be at least one litter box per cat plus one extra, as well as sufficient toys, perches, and scratching posts for all your furry friends. The type of litter box is important as well. An older, arthritic cat may like a litter box with a low opening, while another cat may prefer a covered litter box. Go with what your cat is telling you. All this may seem like a lot of work, but creating this kind of stress-free environment can help keep your cat happy and healthy.