Life with cats is full of mysteries.

Now, you can decode one of those oddities that have you scratching your head like your cat scratched the litter box.

Use this quiz to determine your cat’s litter box health  

Choose one answer from the questions below that best matches your cat.

If your cat happens to have a litter box oddity, 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 (and snooping)…

1) Does your cat urinate or defecate elsewhere besides his litter box?

A. Only when the litter box is blocked by a door, fellow household pet or intimidating person

B. My cat goes outside of the litter box without reason, but only infrequently

C. My cat chooses non-litter box 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 litter box 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) Do 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 litter box?

A. No

B. Seldom

C. Yes

D. Yes, but maybe it’s because my cat’s litter box 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 litter box.

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 litter box 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 litter box.

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 litter box 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 litter box 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 litter box 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 litter box 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 litter box.

If your cat has trouble getting in or out of the litter box, perhaps the height of the litter box 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 litter box more frequently to provide a fresh place for further voiding. Having one or two additional litterboxes can help.

Cat flatulence (farting) occurs when litter box 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 litter box 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 litter box options available in your home.

Cats that can’t fit into the litter box 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.

Patrick Mahaney VMD, CVA founded California Pet Acupuncture & Wellness (CPAW), Inc.

(CPAW), Inc. offers conventional Western and Traditional Chinese Veterinary Medicine (TCVM) on a house call basis.

See him or write him , or access Patrick Mahaney's blog here.