First, rule out any Medical issues
Medical Record Analysis

Litter box avoidance can have a number of causes, but first, you have to rule out any medical causes, keeping in mind that even once the medical condition that led a cat outside of their box is solved, the cat may have developed a habit of urinating outside the box, and this habit needs to be addressed separately with Litter box retraining. 

Medical issues that can lead cats out of their boxes

  • Urinary tract infection

  • FLUTD (Feline Lower Urinary Tract Disorder, an umbrella term for many conditions that affect the bladder or urethra)

  • Blockages/Bladder stones

  • Feline Idiopathic Cystitis (abbrev. FIC, and a type of FLUTD)

  • Endocrine disorders like Hyperthyroidism

  • Medical conditions affecting nerves, muscles or joints, like arthritis or Cerebellar Hypoplasia

  • Kidney disease or failure

  • Neoplasia or tumor

  • Anatomical abnormalities

  • Any illness that stresses them out

Remember, some issues may come and go, so even though your cat's lab work looks good one time, this doesn't mean there isn't a serious health issue that is leading her out of the box. Be your cat's advocate: do some research, ask questions, and keep in contact with your vet when your cat's health or behavior changes.  

Clean bill of health?  Next stop: Litter Box Basics