We have a 17 year old diabetic cat. Recently he started urinating everywhere (like he didn't realize he was going), so we took him in to the vet. She ran a UTI test and fructosamine test. UTI came back negative, fructosamine indicated he needed an increase in his dose of PZI insulin. We increased his dose from 3 mg to 4 twice per day, and the problem disappeared for about a week, when he starting urinating inappropriately again. However, the difference this time was that he didn't pee on the floor until I called him or pulled back the couch to find him, which leads me to believe the problem is mental rather than physical. Yesterday he was sitting underneath the couch. I pulled the couch out from the wall and watched for a moment. As I stood watching, his tail lifted and he peed right on the floor. I picked him up and put him in the litter box, then cleaned the floor. Shortly thereafter my husband and I were sitting on the couch and he was sitting under the coffee table in front of us. I called to him to come and sit with us, and instead of coming to sit with us, he lifted his tail, peed on the floor, then began meowing and slinking away. It's definitely not uncontrolled urination - he knows he's going and he knows he's not going where he's supposed to. He's eating and drinking normally, he's active, he's not sleeping or awake more than usual. In every other respect his behavior is the same as it has been for 17 years. We've made no changes in the house, no new pets, same litter box, clean litter, no change in food. While the initial urination was diabetes related, it now seems he's having some sort of "mental anguish" about using the box. Any suggestions would be greatly appreciated! :confused:

I recently left my veterinary job of eleven years to be a stay at home mom but I think I can give you some hope. You have done the first test-UTI but did the vet spin the urine down and look for crystals? And, more importantly, was a complete CBC and chemistry done to check his kidneys? If the urine is pale and there is a lot of it, could be end stage renal failure. Lastly, talk to your vet about behavior modifying drugs. We had about a 75% success rate in older cats. These drugs are available in pill or can be compounded in a liquid appealing for cats. Like any behavior modification drug, it takes a little time to get into the system and start working. If improvement seen, you leave him on the drug for 3-6 months before tapering off, if at all. Hope this helps!

Thank you for your quick reply. Unfortunately we had a bad experience at our vet related to this very issue. When I took him in the first time, and after she had run the UTI and fructosamine, as she was walking away she said that for his age he looked really good, his heart was healthy and his kidneys felt good. I said that I was relieved to hear about his kidneys, as we had another cat with renal failure a few years ago, and as soon as he started peeing we were worried about a similar situation. To that she replied, "Well, I don't really know how his kidneys are doing. I forgot to ask you about doing a blood syrum test, which is the only way we'd know how his kidneys are." At that point my bill for the day was already very high, and I was stunned that she "forgot" to discuss it with me (a new doctor that had obviously never read his chart). When the results of his fructosamine came in (2 days later than promised), she called us and essentially accused us of neglecting his diabetes, which is absolutely not true as we had been giving him his prescribed doses daily. To my knowledge she did not check for crystals, although we have had other cats with crystals and he does not exhibit any of those symptoms. To make a long story short, we are now in the process of trying to find a new vet. His urine is almost clear but there doesn't seem to be more than normal. I was initially worried about renal failure, but because his problem urination seemed to stop for awhile after increasing his insulin dose, I thought it was being regulated and the resurgence of peeing seemed more mental than physical (since it's not uncontrolled and he only does it when called). What is your opinion about the "naughty potty" stopping for a week and then starting again? Could this still be renal failure?

It really sounds more behavioral than anything but any good vet has to do the "rule out" method with the full panel of bloodwork. I am surprised that just on knowing his age that the vet did not do the complete workup-one stick, an in-house bloodwork machine gives all the results in 12 minutes! Call around and ask the clinics if they do their own bloodwork in house and make your appointment based on that. Be certain before they draw the blood that it will be a complete CBC/Diagnostic profile including liver and kidney function. If the results are in normal range, that will mean it almost has to be behavioral!