House cats are normally fastidious in their urination habits, so there may be cause for concern if your cat begins demonstrating unusual behavior, such as urinating on a rug or in a sink, straining to urinate, urinating frequently, or excessively grooming themselves in the perineal region.
Consider Medical Explanations
It is very important to rule out a medical urinary problem first. This is especially true with cats, neutered or not, since crystal formation and urethral inflammation can become a life-threatening condition in a matter of hours.
Possible medical problems that relate to changes in urinary behaviors include:
It is important to be familiar with the possible signs of a urinary tract infection.
Unusual urination behavior isn't always the result of medical/physical issues. Cats may urinate in unlikely places when stressed, such as after a move to a home, after the introduction of a new family member (human or animal), in response to construction or remodeling in the house, and so on. Environmental causes usually resolve themselves in time, as the cat becomes accustomed to new circumstances.
Your veterinarian is best qualified to examine your cat, discuss the cat's behavior in the house, and do the appropriate tests, including an analysis of urine. The urinalysis will check the concentration of the urine to make sure the kidneys are functioning properly and look for red blood cells, inflammatory white blood cells, and crystals. Your veterinarian may also recommend additional blood work or radiographs.
If your veterinarian feels that an infection or blockage is present, prompt medical treatment is necessary. In the event of a blockage or partial urinary blockage, minutes and hours count, because urinary blockage can be fatal.
If the causes are environmental, your vet may also have suggestions for helping your cat resolve its emotional behavior problems.
Address the Litter
Cats that have had a urinary medical problem may continue to avoid the litter box even after the medical problem is resolved. This may be because the cat associates pain or discomfort with the litter box. Or, they may deem the box "too dirty" to use if they have used it frequently. This behavior can often be corrected by doing a deep cleaning or getting a new litter box and then reacquainting your cat with it.
Modifying the litter box avoidance behavior requires patience, but a good start is to isolate your cat in a small space (a bathroom works well) with a new, clean litter box. It is important to remove rugs and other materials that may be more tempting than the litter box. Be careful with your choice of litter material, as well—sticking with a non-perfumed litter that is familiar to your cat is a good idea.
Consult with your veterinarian anytime you see your cat urinating outside of the litter box, urinating more or less frequently, or straining to urinate. Time is of the essence—calling sooner is much better than later. By paying attention to litter box habits and acting quickly if there is a problem, you just may save your cat's life.