Should You Euthanize An Old Cat Who Urinates Everywhere?

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  • Pet ownership is an experience filled with moments of joy, companionship, and, unfortunately, challenging decisions. Euthanasia, the act of humanely ending a pet’s life to alleviate suffering, is one such difficult choice pet parents often face. This article seeks to explore the tough question of whether or not to euthanize an old cat who has started to urinate all over the house. 

    Understanding old age in cats

    Aging in cats, just like in people, comes with inevitable changes to the mind and body. Senior cats (those over 12 years of age) require some additional care and consideration from their pet parents. While age itself is not a disease, several medical conditions are more common in older cats. 

    Causes of inappropriate urination in senior cats

    If your cat is urinating outside of the litter box, it is understandably a frustrating situation. In fact, inappropriate elimination is one of the top reasons that cats are relinquished to shelters (and often subsequently euthanized). However, before considering euthanasia, it is important to see your vet for a thorough exam and workup. Several medical or behavioral conditions can cause your older cat to start urinating around the house, and many of them are treatable.

    Lower urinary tract disease

    Feline lower urinary tract disease is a common cause of inappropriate urination and includes conditions such as urinary tract infection, stones, and cystitis (inflammation of the bladder). These conditions can cause discomfort or pain during urination, leading the cat to avoid the litter box. Other symptoms may include blood in the urine, straining to urinate, and frequent licking of the genitals. Cats with lower urinary disease, especially males, are also at risk for developing a life-threatening urinary obstruction. Treatment will vary depending on the cause but may include antibiotics, anti-inflammatories, dietary changes, or even surgery. Increasing your cat’s water intake, usually by feeding wet food or a prescription diet, can also help.

    Kidney disease

    As cats age, their kidneys can begin to function less effectively, leading to a condition known as Chronic Kidney Disease (CKD). This can result in an increase in thirst and urination and, consequently, more frequent accidents. Cats with CKD may drink excessive amounts of water, lose weight, and appear less active. While there’s no cure for CKD, there are ways to manage the disease and slow its progression. A prescription renal diet is usually recommended. Your vet may also prescribe medications to manage symptoms, such as vomiting and anorexia, and associated complications like high blood pressure or anemia. 


    Much like kidney disease, diabetes mellitus also leads to an increase in urination and drinking, as well as weight loss despite an increased appetite. Treatment usually involves daily insulin injections and dietary changes. In some cats, diabetes may be a temporary condition if treated aggressively. Regular monitoring of blood sugar levels and veterinary follow-up are essential for this condition. 


    This condition results from an overactive thyroid gland producing too much thyroid hormone. Symptoms can include increased urination, increased thirst, weight loss, hyperactivity, unkempt appearance, and increased appetite. Treatment involves daily medication or a more permanent solution like radioactive iodine therapy.


    Arthritis is an inflammation of the joints that is common in older cats. The condition can make movement painful, and the discomfort can deter cats from using their litter box, especially if it is too small or has high sides that are difficult to climb over. Cats with arthritis may show signs of stiffness, reluctance to jump or climb, reduced activity, and changes in play or grooming habits. There are treatments available to manage arthritis in cats, including pain relief medications, supplements, and lifestyle adaptations such as providing a litter box with lower sides.

    Cognitive dysfunction 

    Senior cats can experience a decline in cognitive function, similar to dementia in humans. Disorientation and confusion can lead to forgetting the location of the litter box or how to use it. While there’s no cure for cognitive dysfunction in cats, certain medications, dietary supplements, and lifestyle changes can help manage the symptoms. 

    Stress or anxiety

    Changes in the household environment, such as a new pet, a new baby, moving to a new house, or even rearranging furniture, can cause stress and anxiety in sensitive cats. This emotional upheaval can result in changes in their bathroom habits. If a cat feels unsafe using the litter box for any reason, it can also lead to urinating outside the box. 

    Changes causing stress should be minimized when possible. Anti-anxiety supplements, medications, and pheromone diffusers can also help. Providing a safe space and enough resources and enrichment for your cat are also critical in decreasing stress. 

    Issues with the litter box 

    Cats can be picky about the location, cleanliness, substrate (type of litter), and number of litter boxes. Especially if you have multiple cats in your family, it is important to follow these basic litter box guidelines

    Other tips for managing inappropriate elimination

    Consider these additional tips for managing inappropriate urination in cats:

    • Use an enzymatic cleaner to clean up accidents 
    • If your cat frequently urinates in the same place, consider putting a litter box there, blocking off the room, or changing the significance of the area to make it a food or water station, resting area, or play space. 
    • Increase the number of litter boxes and frequency of cleaning
    • Consider offering your cat a litter box buffet (including different styles of litter boxes and litter substrates)
    • Consult a veterinary behaviorist 

    Euthanasia: A difficult decision

    The decision to euthanize a pet is complex and deeply personal, and must take into account your cat’s quality of life as well as your emotional well-being. In the case of inappropriate urination, it is always best to consult your veterinarian to rule out medical causes first. You should also consider alternatives to euthanasia, such as modifications to living conditions, medication, or rehoming. Some vets may decline to euthanize an otherwise healthy cat for reasons of convenience. Euthanasia may be appropriate if: 

    • You have had a candid discussion with your vet about your concerns 
    • Your vet has performed a physical exam and diagnostic testing to rule out medical causes of inappropriate urination
    • Your cat has a poor quality of life – for example if they are unable to eat, drink, move, clean themselves, or enjoy the things they once loved. 
    • You have exhausted other options such as rehoming or transitioning to an outdoor lifestyle
    • Your mental health is at risk


    • Dr Liza Cahn, Veterinarian

      Dr. Cahn graduated in 2013 with a Doctorate of Veterinary Medicine (DVM) from from Michigan State University. She loves working with dogs and cats and educating owners on all aspects of veterinary medicine, especially animal behavior and dermatology. Dr. Cahn has an active veterinary license in Washington State.