Quiz: What the Litterbox Says About Your Cat's Health

It might be tough, but if you take a closer look at your cat's litterbox you might find insight into your cat's health.

By Patrick Mahaney, DVM

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Cat with Litterbox
Be a litterbox investigator, and you might learn about your cat's health.

Life with cats is full of mysteries. Now, you can decode one of those. Determine your cat's health by looking closer at the litterbox. Veterinarian Patrick Mahaney, DVM, decodes some of the more common cat litterbox mysteries with this quiz.

Choose one answer from the questions below that best matches your cat. If your cat happens to have a litterbox flaw, read through the scores at the end to see if you can find the reason behind your cat's problem. Good luck, and happy scooping!

1) Does your cat urinate or defecate elsewhere besides his litterbox?
A. Only when the litterbox is blocked by a door, fellow household pet, or intimidating person
B. My cat goes outside of the litterbox without reason, but only infrequently
C. My cat chooses non-litterbox sites at least once a week
D. Yes — and my cat's had a physical exam and diagnostic testing (urinalysis, urine culture, fecal testing, ultrasound, X-rays, etc.) to investigate the problem, but without help

2) Does your cat vocalize or strain while urinating or defecating?
A. Never
B. Once or twice only
C. It's frequent and sometimes severe
D. Free to roam indoors and out through a pet door

3) Is climbing in or out of the litterbox challenging for your cat?
A. Maybe once or twice
B. Occasionally, but it's happening more often
C. Yes
D. Yes, ever since we got different style box

4) Does your cat eat litter?
A. No
B. Maybe once or twice
C. Often
D. Yes, but my cat is healthy otherwise, according to the vet

5) Does your cat's urine have an unusual appearance (red, brown, lacking color, etc) or smell?
A. It's clear and yellow, without strong odor.
B. It's appeared cloudy and off-colored, and smelled strongly, but only once or twice
C. It's red/brown/lacks color/has a bad smell
D. Something's off, but my cat's health has been cleared by a veterinarian

6) Does your cat's feces have an unusual appearance (soft, liquid, blood, mucus, flatulence) or smell?
A. My cat's stool is moist but firm, formed, brown feces lacking blood, mucus and explosive gas
B. Rare, mild changes occur
C. My cat's stool is soft or liquid/contains blood or mucus/erupts with gas
D. Things have changed, but my vet doesn't know why

7) Is your cat frequently flatulent/Does your cat fart often?
A. Sometimes, especially now that my cat is older/has had some/exposure to toxins or infectious organisms/we've changed his diet
B. Yes, more and more so
C. Yes, constantly
D. Yes, but don't ask my vet why; my cat is 100% healthy

8) Does your cat get feces stuck to her hind end?
A. Sometimes on the perineum (area around the anus)
B. Often
C. Very frequently
D. Almost never

9) Are there occasions where you cat does not urinate or defecate for 12 hours or more?
A. Never
B. Maybe once or twice
C. Yes
D. Yes, but, like I might have said before, my cat is completely healthy otherwise

10) Does your cat's size cause difficulties in fitting into his litterbox?
A. No
B. Seldomly
C. Yes
D. Yes, but maybe it's because my cat's litterbox is the size of a deck of cards

When you're done, count the number of As, Bs, Cs an Ds.

If you answered mostly As, you've got a Healthy Cat. Most of your cat's behaviors are common and healthy. Vocalizing while eliminating would reveal a cat's location in a vulnerable position and potentially attract a predator. Urination or defecation should occur at least every 12 hours in a domesticated, healthy cat. A cat having a normal body conditions score (see Nutritional Support Services at The Ohio State University College of Veterinary Medicine's Body Condition Scoring Chart) should be able to easily fit into the litterbox.

If you answered mostly Bs, you've got a Healthy Cat, With Maintenance. Keep an eye on your cat. Bring up infrequent litter mishaps with your cat's veterinarian during the next wellness examination (at least every 12 months). Log your calendar when your cat vocalizes during elimination and pursue a consultation with your veterinarian if the behavior persists or worsens. If you note your cat eating litter on a one time basis, then closely observe for additional episodes. For stool changes, monitor for worsening. If your cat gets bowel movement stuck to her hair often, then make a sanitary clip of the area to provide a clear path for feces to exit the body. If you see no urine or feces in your cat's litterbox or elsewhere in the house on an infrequent occasion, then closely monitor these habits. A cat having a normal body conditions score (see Nutritional Support Services at The Ohio State University College of Veterinary Medicine's Body Condition Scoring Chart) should be able to easily fit into the litterbox.    

If you answered mostly Cs, you've got a cat who needs to See a Vet. You have some cat health concerns to deal with.
  • If a cat goes outside the litterbox once a week or more, a vet must examine the cat right away to determine if cat health issues exist.
  • Cat's that vocalize during elimination might have cystitis (bladder inflammation), anal sacculitis (swollen and painful anal sacs), urinary tract infection, constipation, or other issues. Vocalization can indicate that.
  • The observation of your cat's struggle to get in or out of the litterbox is a trend that could indicate pain from arthritis, lack of mobility from obesity, general weakness and muscle loss from kidney failure, or a host of other health problems.
  • If your cat eats litter, This tendency is called Pica and can lead to and indicate mild to severe internal organ abnormalities.  A thorough veterinary examination including laboratory diagnostics (blood/urine/fecal testing, X-rays, ultrasound, etc) should be performed.
  • For cat's off-color urine or strong-smelling urine, a variety of potential causes may be to blame. Crystalluria (crystals in urine), urinary tract infection (bacteria, other), metabolic illness (kidney/liver disease, hyperthyroidism, diabetes mellitus, etc), cancer, or other serious problems may be brewing.
  • Cat stool changes, like those listed, need immediate veterinary care. Inflammatory bowel disease, food sensitivity, bacterial overgrowth, parasite infestation, cancer, and other factors may be contributing. Physical examination and diagnostic testing will determine the most appropriate treatment (pre-/probiotics, antibiotics, dietary changes, etc). 
  • Cat flatulence has similar causes to those that cause feces to have an unusual appearance (see Question 6) and odor. The diagnostics and prescribed treatments are comparable.
  • If poop often clings to your cat's perineum hair, then underlying health issues causing muscle weakness, pain or abnormal stool consistently may be present.  A veterinary examination and appropriate diagnostic testing should be performed.
  • Lack of cat defecation and urination can indicate mild to severe health issues (urinary obstruction, anuric kidney failure, constipation, anal sacculitis, etc) that should be explored during an examination with your veterinarian.
  • Your cat doesn't fit in the litterbox because he's overweight. Obesity is a growing problem affecting both people and pets that has life threatening (diabetes, pancreatitis, etc) and potentially irreversible (arthritis, intervertebral disc disease, cruciate ligament rupture, etc) side effects. Your veterinarian's examination and diagnostic testing can determine the moist appropriate wellness plan to promote weight loss
If you answered mostly Ds, your cat needs Behavior Modification. Your cat is physically healthy — your cat has been examined by a veterinarian — but these problems indicate that changes must occur in the household.
  • When a cat misses the litterbox or sprays around the house, but is healthy, pursue veterinary prescribed medications, nutraceuticals (supplements), pheromone sprays and environmental enrichment to help.   
  • When cats vocalize during elimination, increase water consumption, modify diet  and try stool softeners, pain medication, nutraceuticals (like joint supplements) to see if these or other treatments improve comfort while cats use the litterbox.
  • If your cat has trouble getting in or out of the litterbox, perhaps the height of the litterbox wall or other aspect of the design is inhibiting your pet's optimal entry and exit.  Choose a style that permits your cat's easy navigation.
  • If your cat eats litter but has no health problems, change the litter to see if the behavior continues.
  • If your cat's urine color/smell is off, then dietary changes, increased water consumption, and other habit changes can lead to more normal appearing urine.
  • If your cat is defecating abnormally and more frequently, clean the litterbox more frequently to provide a fresh place for further voiding.  Having one or two additional litterboxes can help.
  • Cat flatulence (farting) occurs when litterbox choices are limited, in number or style.
  • Poop that sticks to your cat's hind end could be left elsewhere in the house, so cover furniture and obstruct your cat's access to locations that could be soiled.
  • When your cat doesn't eliminate for 12 hours or more, perhaps the cat's access to the litterbox is obstructed. When this happens, urine or feces may be held for a longer time. Make sure plenty of opportunity exists for your cat to eliminate by having multiple litterbox options available in your home.
  • Cats that can't fit into the litterbox might be obese. Obesity is a growing problem affecting both people and pets that has life threatening (diabetes, pancreatitis, etc.) and potentially irreversible (arthritis, intervertebral disc disease, cruciate ligament rupture, etc.) side effects.  Your veterinarian's examination and diagnostic testing can determine the moist appropriate wellness plan to promote weight loss
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Quiz: What the Litterbox Says About Your Cat's Health

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Reader Comments

wanda    tyler, TX

6/21/2013 8:20:05 PM

Very helpful...thank you...working on an issue with my holistic vet at this very moment and this little quiz is a great home check list! Thank you again for sponsoring it :) Simon's mom»·«

Ann    Simi Valley, CA

8/24/2012 5:31:48 PM

Question 3 - my cat has no problem getting in/out of box - NO ANSWER FITS

Question 7 - My cat is never flatulent - Again NO ANSWER FITS

Lyn    Halifax, NS

6/12/2012 2:20:34 PM

that was interesting

CatChannelEditor    Irvine, CA

6/11/2012 8:03:39 AM

Luthien -- If your cat didn't have some of these issues, that's great! Sounds like you have a healthy cat. :)

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