Vet Solutions for Cat with Kidney Disease Peeing on Floor

Loss of structural and/or functional capacity in a cat’s kidneys results in chronic kidney disease (CKD). It is a chronic, progressive illness. C All cats of all ages can have CKD, although older cats are more prone to it. Researchers estimate that 8-31% of senior cats are affected by CKD. (2) In most situations, the cause of CKD is unknown.

Why Do Cats With Kidney Disease Pee So Much?

Cats with CKD almost always have increased urination (polyuria) as a symptom. The type of chronic kidney disease we see in cats causes more urine production. The kidneys can’t filter and retain water from the blood normally. Changes in kidney structure and function allow too much water to escape in the form of urine.

How Can I Stop My Cat with CKD from Peeing on the Floor?

There are three basic steps to stop your cat with kidney disease from peeing on the floor. First, identify and treat bladder infections. Next, address painful conditions like arthritis and spinal pain. Finally, make sure the litter box is easy and pleasant for your cat to use. 

Let’s go over what you can do to get your cat to urinate just in the litter box — not on the carpet or some other inconvenient place

1. Look for Urinary Tract Infection and Stones

A cat’s body has multiple ways to protect against bladder infections. Urine that is very concentrated is inhospitable to bacteria that might invade a cat’s urinary bladder.

Cats with CKD can’t produce concentrated urine so their pee is quite watery. Watery urine makes a better environment for cystitis/lower urinary tract infections. 

So when a cat with kidney disease is peeing on the floor, the first thing to check for a medical condition. The most common tests include urinalysis and urine culture to check for infection. Your vet may also recommend an abdominal x-ray or ultrasound study to check for bladder stones and tumors. 

Both an infection and a bladder stone irritate the lining of a cat’s bladder. This leads to stimulation of the nerves that send the message to the brain that the bladder is full. A painful, hypersensitive bladder makes cats pee in strange places.

tabby cat sitting in small blue litter box (cat with kidney disease peeing on floor)
Are you kidding me with this tiny litterbox???

2. Find and Treat Pain

In addition to lower urinary tract issues, many cats with CKD also suffer from chronic pain. (1) This pain usually comes from arthritis or chronic spinal changes.

Weight Management

Weight management is a good place to start when your cat has chronic pain of this type. The majority of house cats carry excess weight. Talk to your vet about what your cat should weigh and what kind of cat food you should feed to achieve weight loss.

Fatty Acid Supplementation

Omega-3 fatty acids are clinically proven to improve the symptoms of arthritis pain in animals. You can add a fish oil supplement to your cat’s meals like Nordic Naturals Omega-3 Pet.

Or you can choose a food that contains a high level of omega-3. Hill’s makes a cat food called k/d + mobility that is meant to help cats with chronic renal failure/CKD as well as mobility.

Pain Medication

Prescription medications are often very effective at controlling a cat’s pain. Your vet may recommend injectable glycosaminoglycans like Adequan or the oral form as found in Cosequin. Stronger meds used to treat cat pain include gabapentin, buprenorphine, and the cat-specific NSAID, robenacoxib (brand name, Onsior).

Acupuncture and Cold Laser 

Finally, some cat owners feel that alternative therapies are helpful in controlling their pet’s pain. Cold laser therapy and acupuncture are available in most areas–ask your vet for more info.

Bengal cat sitting on a brown paper bag

You might like my other article: How to Prevent Bladder Inflammation in Cats

3. Optimize the Litter Box

Cats with chronic kidney failure produce a lot of urine. These same cats often suffer from arthritis pain, bladder pain, and spinal pain. All of these things can add up to an unpleasant experience in the litter box when they visit to urinate.

The litter may be smelly or feel bad to their feet. They may not feel secure if the box is in a noisy place or if there are other cats competing for it. It might be that your cat has significant pain only when they get into the “peeing position” and come to associate pain with the litter box.

You can help your kitty by doing a “litter box trial.” That means getting a few different kinds of litter trays and a few different kinds of litter to see what your cat prefers. 

Litter Box Designs

You can buy or modify a litter box to have a very low entry area. Some cats even like corner-style litter trays made for ferrets.

Try boxes with very high sides as well as covered boxes. Try an oversized litter tray, too. You never know what your cat will like best.

Types of Litter

When it comes to litter, many cats prefer plain old unscented, clumping or non-clumping gravel kind. But you can also try one made from paper (Yesterday’s News or Carefresh), corn cobs (World’s Best Cat Litter) or wheat (Swheat Scoop). And Dr. Elsey’s Cat Attract litter works miracles for some cats.

You can tell which kind of litter your cat likes best by putting them in litter trays next to each other. Whichever one gets used the most is probably their favorite.

Location and Number of Litter Boxes

Follow the rule of thumb to always keep one more litter box than the number of cats living in your home. If you have 3 cats, you need at least 4 litter boxes.

First, in the case of a cat peeing on the floor far from the litter box, try placing a new litter box where they are peeing. 

Try placing the litter boxes in different locations, including near where your cat sleeps so it’s easy to get to when they wake up and need to go pee. Don’t forget to put at least one litter box on every level in your house so your cat doesn’t have to deal with stairs to get to a potty place.

Litter Box Sanitation

Like most humans, cats don’t like using a dirty, smelly toileting area! I guarantee if it smells a little bad to you, it smells downright awful to your cat. 

You can try using litter tray liners that you throw away with the dirty litter to improve cleanliness. But some cats don’t like litter tray liners, so you’ll have to experiment. 

Be sure to scoop out all wet spots and poop from every box daily. Empty every litter box monthly and wash it with soap and water before refilling it with litter.

In addition to keeping super clean litter boxes, I recommend using an enzymatic cleaner like Nature’s Miracle to clean urine from the floor. This will remove or reduce the urine scent and decrease the likelihood of the cat returning to the same spot to pee on the floor again.

Advice from Veterinary Behaviorist Dr. Sally Foote

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When a cat suffering from CKD urinates on the floor, there are several things you can do to help. Treat any urinary tract infections that are discovered immediately. Next, take care of any arthritis or spine-related pain. Last but not least, make using the litter box a relaxing, comfortable experience for your feline friend.

Remember that your cat is trying to cope with a disease. She’s not peeing on the floor to spite you! It’s your job to make sure she is as healthy as possible and make adaptations to the environment to accommodate her changing condition.

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  1. Marino, C. L., Lascelles, B. D. X., Vaden, S. L., Gruen, M. E., & Marks, S. L. (2014). Prevalence and classification of chronic kidney disease in cats randomly selected from four age groups and in cats recruited for degenerative joint disease studies. Journal of feline medicine and surgery, 16(6), 465-472.
  2. Chew, D. (2019, October 31–November 3). Artificial Intelligence Takes the Surprise Out of Chronic Kidney Disease [Presentation]. American Association of Feline Practitioners Conference, San Francisco, CA.